This exercise focuses on how patient care can be delivered in primary care and what role pharmacy will play in 2030. This may seem a long way away, but the years fly by fairly quickly.

Trend analysis

In order to make any meaningful prediction of what might happen to pharmacy in the future, it is important to have an understanding of what is happening now within the pharmacy sector, both in the UK and globally. The best way to do this is to monitor and analyse the trends in the current environment.

A good analytical tool for pharmacy is the PESTLE (Political, Economical, Sociological, Technological, Legal and Environmental) analysis. Using this helps to explain the role that each of these forces currently plays in pharmacy.

Political factors

What are the key drivers of relevance? Healthcare is a very regulated sector and one that sucks up an immense amount of financial resources in just about every country in the world. What happens in the United States may influence the European legislators, while EU directives affect each of the member countries.

Since 85 per cent of our income here in the UK relies on one paymaster, whatever the government does in the NHS impacts on pharmacy. The ruling that pharmacy needs to be in ownership and control of pharmacists in the EU stopped pharmacy consolidation in many EU countries, including Germany, France and Italy. In the UK, forty per cent of the sector is still in the hands of independents, but what will be the case by 2030?

The growing small, medium and larger multiples will lead to a far diminished number of single owner/manager pharmacies in the independent sector. If the government ever wishes to reduce the number of pharmacies, it may inevitably target the smaller independent pharmacies trading just above the minimum level to qualify for basic practice allowance. Where will this threshold be in 15 years time and how many pharmacies will still be viable at the lower level?

The entry regulations for controlling the number of pharmacies are determined by politicians, but each political party has a totally different policy regarding the NHS. The Conservative party is more focused on austerity, which leads to ‘more for less’ and backdoor privatisation of parts of the NHS.

The Labour party, on the other hand, is a ‘tax and spend’ party, so your scenario needs to look at the political landscape. Britain’s relationship with the EU, for example, has an impact on healthcare, in terms of regulatory issues, as well as economic ones.

Economic factors

Pharmacy is a great example of a public-private partnership. The Government may commission dispensing and other services, but pharmacy has to fund it in the interim. This includes the NHS, goodwill, fixtures and fittings, stocks and NHS debtors.

Macro economic factors – such as the housing bubble that led to the collapse of Bear Stearns in the US, taking down countries such as Iceland and Greece and bringing the whole of the UK’s banking to its knees – affect pharmacy as much as any other business. Financial capital is not easy to access any more and it is very difficult to fund an acquisition. Independents find it difficult to acquire their first shop and this leads to consolidation by the small, medium and large chain owners.

The economic state of the country determines interest rates, access to capital, taxation and government spending, as well as the strength of the pound against other currencies. All of these factors have a direct impact on pharmacy.

Social factors

How is our society changing? The baby boomers are now turning 70 and are living longer. The pressure on healthcare spend is immense and is squeezing our margins and forcing us to find innovative ways of delivering healthcare.

But it also creates opportunities, as the ageing population will need more prescriptions and greater intervention by pharmacists. The new generation are very tech-savvy and are beginning to turn to technology, using smart phones and apps to help look after their healthcare needs.

Pressure to treat chronically ill patients at home has led to a prolific growth in domiciliary and palliative care, which often bypasses pharmacy.

Technological factors

What are the current technology imperatives, changes and innovations? Locating a pharmacy close to a doctor’s surgery has been the most important criteria for success to date. But there are big drives to make all prescriptions paperless.

Now a prescription can travel vast distances within milliseconds and can be delivered within hours. Online pharmacies are targeting doctors’ surgeries that are EPS Release 2 enabled. This is just the beginning.

What might happen by 2025? Goods may even be delivered by drones. How many prescriptions will be dispensed by online pharmacies in the future?

Other technological advances include mobile apps that help patients self-diagnose and order pharmacy and prescription medications over the internet, as well as remote diagnostics that help monitor patients at home. Will pharmacy have a role to play here, or will new players such as Virgin Healthcare dominate? Will a company such as Amazon want to be the largest online pharmacy?

Robotics are driving down costs in the hub-and-spoke model, so will there be a place for the bricks and mortar pharmacy in 2025? How many will be viable and survive? 3D printing is another eye opener.

If it is already possible to print guns, why not print medicines directly in people’s homes? Could doctors computer-print medicines instantly in patients’ homes? What then would be the role of the pharmacist of the future?

Legal factors

How does legislation affect us? The EU has already made a ruling on the role that pharmacists play in the ownership of pharmacies in many European countries. Government legislation regarding supervision and the ability to diagnose and issue prescriptions is beginning to take place.

How far can future legislation stretch the role of pharmacy? The legal issues bring regulatory burdens, some of which can cause stress to pharmacies and inflict large bureaucratic burdens on businesses with excessive red tape.

Environmental factors

What are the environmental considerations, locally and globally? The pressure to reduce our carbon footprint is rising. How will collections and deliveries be made in the future?

The environmental pressure on inhalers and the manner of drug delivery, including packaging and waste, is constantly changing. As a whole, pharmacy is pretty environmentally friendly, however, so this aspect has the least impact on our sector.