UK
Clinical Pharmacy
Association
UK
Clinical Pharmacy
Association
In the UK, there are approximately 11 million people 65 and older, accounting for 19% of the population. The number is projected to increase to 24% in 2043. The number of people aged 85 and older, however, is projected to double from 1.7 million in 2022 to 3.3 million in 2047.
The plan emphasises Neighbourhood Health Services, which aims to reduce hospital admissions and improve patient outcomes by housing diagnostics, mental health support, and rehabilitation services under one roof. The new model replaces the individual GP practice focus with a comprehensive “neighbourhood team” of professionals, including GPs, nurses, social care workers, and pharmacists.
Concurrently, the plan champions the integration of technology into the system.The vision is to make the NHS the most AI-enabled care system in the world, utilisingartificial intelligence (AI) for drug discovery, early disease detection, and predictive health assessments, and implementing tools like ambient voice technology and digital outpatient appointments to enhance efficiency.
The success of this entire transformation hinges on the effective deployment of the specialist geriatric pharmacy workforce. As the population ages, demand for their expertise in specialised care will increase significantly. The move towards a community and neighbourhood model provides numerous opportunities for frailty pharmacists to play a pivotal role across various settings, including care homes, emergency departments, and urgent care. They are essential for managing complex discharge issues and polypharmacy to ensure safe and prompt patient care.
Geriatric pharmacists can contribute significantly to urgent and emergency care by solving complex discharge issues and managing polypharmacy. Their medication expertise enables appropriate escalation to frailty or safe, prompt discharge to virtual wards and communities, helping to reduce adverse drug events, which are common among elderly patients with multiple comorbidities. In terms of prevention, they are crucial for frailty, polypharmacy, fracture, and falls prevention. They can use frailty scores and polypharmacy frameworks to identify high-risk patients for early intervention. They can potentially use genomic databases for medication reviews and automate scores to optimise bone health and manage falls risk-increasing drugs (FRIDs).
The expertise of geriatric pharmacists can also be used to input into the system and development. They can help highlight high-risk patients, set Key Performance Indicators(KPIs) for systems, and track performance. By using IT records and AI, pharmacists can inform frameworks for Integrated Care Boards (ICB) to identify frail and vulnerable patients with polypharmacy issues. Using big data for research and reviewing the impact of pharmacy input in medication optimisation and deprescribing further enhances patient outcomes.
Provide rapid identification of medication-related problems in frail patients in ED.
Example: One audit showed that ED frailty pharmacist’s input led to interventions in 92% of the patients, reducing polypharmacy burden and optimising medicinesbefore discharge.
Providing specialist medication reviews, deprescribing and solving complex concordance issues in older adults.
Example: Specialist frailty pharmacists reduced the number of new medicines initiated and increased permanent deprescribingduring the hospital stay. This intervention also led to an increase in the likelihood of medication changes being adhered to in primary care (67% vs 54%).
Providing hospital-level care for frail patients in their own homes, specialist medication reviews, deprescribing, identifying concordance problems and liaising between care settings.
Example: Pharmacists’ intervention in frailty virtual wards showed a direct correlation between medication reviews and medication changes, with 74% of reviews resulting in changes, of which 69% were in relation to deprescribing.
Working closely with MDTs in primary care to provide structured medication review, reduce problematic polypharmacy, and optimise bone heath.
Example: Care home pharmacists reduced reported emergency hospital admissions by 21%, reduced ambulance callouts by up to 30%, and drug cost savings (e.g., £249 per patient per year). Interventions are proven to improve medication safety, reducing falls and cognitive impairment risk.
Provide medication support, improve adherence, and identify environmental risks during home visits for housebound patients. In addition, working with primary care teams and highlighting vulnerable patients with high risks of falls, problematic polypharmacy, and concordance issues. They also provide a discharge medicine service (DMS) to avoid medication errors from transfer of care.
Example: multiple studiesshowed that DMS improves medicine safety, reduces readmission rateand saves money.
To enable the pharmacy workforce to flourish and deliver on the NHS 10-Year Plan, strategic investment must address key barriers:
Although independent prescribing is a positive step forward in increasing pharmacists’ autonomy, many aspects of geriatric care require further specialist skills and knowledge. Accredited courses and clear development pathways must be created, focusing on polypharmacy management, frailty assessment, and the use of technology and AI. Opportunities should be available for pharmacists to specialise in key geriatric areas such as dementia, Parkinson’s, palliative care, and stroke.
This moment also presents a critical opportunity for national professional bodies, such as UKCPA and the Royal College of Pharmacy, to take a leading role in shaping specialist curricula and advocating for a structured, recognisable career pathway in geriatric pharmacy. By driving the development of competency frameworks, advanced practice standards, and accredited training routes, these organisations can help ensure a strong, future‑ready workforce capable of delivering consistent, high‑quality care for older adults across the NHS.
An increase in specialist roles and sustained funding is essential to maintain specialist services across healthcare settings. such as deprescribing rates, and completion rates could be used within payment schemes to incentivise to continuously invest in the workforce and their training.
Collaboration with other healthcare professionals is crucial. While the neighbourhood model is designed for integration, its effective implementation is challenged by role ambiguity and a lack of consistent recognition within MDTs. Integration requires not just co-location but cultural change and defined governance structures that empower pharmacists to lead medication strategy and make autonomous prescribing decisions within the MDT.
A critical operational barrier is the poor interoperability of IT systems across different care settings. Pharmacists rely on comprehensive patient data to manage complex polypharmacy and transitions of care. However, the inconsistent ability to access full GP systems or acute hospital electronic patient records creates safety gaps, limits the quality of structured medication reviews, and severely impedes the seamless care transfer envisioned by the plan.
The NHS 10‑Year Plan marks a decisive shift toward neighbourhood‑based, technology‑enabled care. However, its success depends on fully harnessing the expertise of specialist geriatric pharmacists. As demand rises with an ageing population, these pharmacists provide vast potentials across acute, community, and virtual settings, driving safer prescribing, reducing hospital admissions, and improving outcomes through frailty prevention, polypharmacy management, and data‑driven decision‑making.
To realise this potential, the system must invest in advanced training, interoperable IT, and meaningful MDT integration. National bodies such as UKCPA and RCPharm should lead the development of specialist curricula, workforce proposals and advocacy, and structured career pathways, enabling a strong, future‑ready workforce capable of delivering consistent, high‑quality care for older adults.
The opinions expressed in this article are those of the author. They do not purport to reflect the opinions or views of the UKCPA or its members. We encourage readers to follow links and references to primary research papers and guidance.
The author declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
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