“Health system resilience is the ability of health systems not only to prepare for shocks, but also to minimise the negative consequences of such disruptions, recover as quickly as possible, and adapt by learning lessons from the experience to become better performing and more prepared.”
Organisation for Economic Co-operation & Development (OECD)

In many countries community pharmacists are the most accessible and most frequented health professional, and are conveniently located close to where people live or work. Globally, community pharmacists are the third largest healthcare professional group in the world after physicians and nurses and between 2000 and 2019, the number of pharmacists per capita increased in all OECD countries for which time series are available by almost 40% on average.

Evidence from the COVID-19 pandemic response (see Appendix 1) has clearly demonstrated the importance and effectiveness of community pharmacy as an integral part of public health infrastructure. Community pharmacies and their staff have shown that they contribute to more productive and resilient health systems and integrated, streamlined, primary care teams. Preparatory measures for future shocks must include enabling community pharmacists to take a greater role as part of more agile and flexible health systems. To ensure a better performing, more prepared health system, these greater roles should not be activated only at times of system stress or shock - community pharmacists should be authorised and funded to perform at their full scope of practice at all times.

Through the pandemic, community pharmacies all around the world demonstrated their agility and previously untapped potential. They quickly and effectively took on roles traditionally delivered elsewhere in the health system, when other medical services were either closed or stretched to their limits. In doing so, negative health outcomes were minimised for millions of patients who would have otherwise had disruptions to treatment. Pharmacies were also recognised as both an essential service provider and a first point of contact in the healthcare system. Further, pharmacies became a core component of COVID-19 vaccination rollouts, becoming the leading provider of vaccinations in several countries, including the USA.

Unfortunately, some of these roles have been removed or reduced as the pandemic impact has lessened, with regulators choosing to revert to the traditional, less efficient and less flexible delineation of health system functions and roles.

The pharmacy examples during the pandemic should instead become the new normal, and the starting point for further advancement toward enabling full scope of practice. National health system leaders should review experience from around the world to see how health services can be improved through broader use of community pharmacies in areas including (but not limited to) public health and prevention, management of long-term conditions, point-of-care testing, and triage and treatment for common illnesses. Some examples are presented in Appendix 2.

Trusted by patients, highly accessible, highly skilled, locally-focused and agile, community pharmacies are vital to more resilient, adaptable and high performance healthcare systems.