[9]Figure 1 illustrates the increasing numbers of prescriptions dispensed

in England and Wales between 1995 and 2010 (compiled from[10,12–15]). In the financial year 2009–2010, just under 880 selleck screening library million prescriptions were dispensed in community pharmacies in England and Wales alone.[10] This trend is also evident in Scotland; 63.08 million prescriptions were dispensed by community pharmacies in 2001, increasing to 88.97 million in 2009–2010.[11,12] Technological progression, particularly in the last 20 years, has influenced the way pharmacists dispense; although prescription numbers have increased, original pack dispensing now dominates, with few items remaining to be ‘assembled and compounded’ in the pharmacy. For most community pharmacies, a key source of income is the contract to provide NHS pharmaceutical services, and this is reliant upon government funding. In 2005, a new CPCF was introduced in England and Wales.[16] This three-tiered model, involving essential, advanced and enhanced services, greatly

increased the scope of services that pharmacies can offer to the public and helped to realise some of the recommendations of the Nuffield Report[3] and Pharmacy in a New Age.[4–6] An example of a national advanced service is the Medicines Use Review (MUR). More than one million were conducted by community pharmacists in England and Wales in 2007–2008 compared with 152 854 in 2005. This represented a considerable increase in the work required of pharmacists over a short period of time.[13] With many pharmacies reliant on the Selleck MG 132 provision of NHS services for approximately 90% of their income, these services are important considerations relating to workload.[17] However, in the UK, pharmacies are private businesses and the pharmacist will not only be responsible for supervising the

sale of over-the-counter (OTC) medicines, but will often have additional legal, management, administrative or ownership responsibilities. STK38 These factors have the potential to impact hugely on a pharmacist’s personal workload. The reclassification of various prescription-only medicines (POM) to pharmacy medicines (P) has provided pharmacists with a greater range of medicines to treat minor ailments. This commenced in 1983 with ibuprofen being granted P status for specified strengths and indications. Although slow to start, progression of this scheme has increased in pace with over 30 POM medicines being granted P status since the early 2000s.[18] However, the sale of these new ‘over the counter’ medicines, often for limited quantities or with restrictions on indications for legal sale, frequently requires more pharmacist time and attention to specific details. For example, the sale of Alli (an anti-obesity medicine) involves calculating a patient’s body-mass index and providing detailed dietary advice. Complex consultations such as these are an additional source of workload for pharmacists specifically.