Primary care systems across Europe are under pressure and pharmacists could be part of the solution. In the UK, a shortage of general practitioners (GPs) prompted efforts to expand multidisciplinary teams, including the integration of pharmacists into general practice. A decade later, the results are mixed: pharmacists brought clear benefits, but lack of integration hampered impact.
Albania is now exploring how pharmacists could support primary care. But the question is not whether to integrate pharmacists, it’s how to do it right. Drawing on lessons from the UK, this is an opportunity for Albania to design a more effective and inclusive approach from the outset.
The UK experience: why pharmacists were needed
The decision to bring pharmacists into general practice in the UK was largely driven by workforce pressures. An ageing population, a growing burden of chronic disease, and an overstretched GP workforce demanded new approaches. According to The King’s Fund, the NHS workforce was at a make-or-break point. In 2015, the government launched a pilot scheme that funded 89 applications from GP federations. Over 490 pharmacists (equivalent to more than 450 full-time posts, measured as whole-time equivalents, WTE) were recruited to work across 658 practices.
Early signs were promising. Pharmacists helped manage long-term conditions, provided medication reviews for patients on polypharmacy, and improved access to health checks. Their presence was seen as enhancing safety, quality, and efficiency, whilst allowing GPs to focus on patients with more complex needs.
More recently, under the GP Contract Framework reform, funding for additional roles, including pharmacists in general practice, was guaranteed through the Primary Care Network (PCN) DES. This model supports up to 20,000 extra staff, with 70% of salary costs for pharmacists covered. The goal was to establish the non-medical workforce’s place within primary care teams and scale up.
What worked and what didn’t
The benefits of pharmacists in primary care were clear in some areas. Patients responded positively to consultations with practice-based pharmacists, expressing confidence in their recommendations and appreciation of having more time during consultations. Where integration worked well, pharmacists had access to appropriate training and supervision, and strong collaboration within multi-disciplinary teams.
But the rollout has not been without flaws. Early on, the role of pharmacists was not clearly defined, especially for newly qualified pharmacists.
Supervision has also been inconsistent and often lacking. In practices without well-established team structures, integration of pharmacists has been patchy. There have also been disparities in pharmacist roles amongst different GP practices.
Albania: The missed potential
Albania’s primary healthcare system remains centered around general practitioners, with each citizen assigned a family physician. However, pharmacists continue to function outside the integrated clinical framework, primarily focusing on medicine dispensing without involvement in collaborative care processes. They are not granted access to shared health records, do not participate in referral systems, and are excluded from national immunization programs.
Furthermore, pharmacists are not included in structured interventions for chronic disease management or pediatric care, areas where gaps are increasingly evident. This is particularly critical in a context marked by a high prevalence of non-communicable diseases and deficiencies in child health services. Out-of-pocket health spending, which accounts for about 25% of national expenditure, further highlights the importance of pharmacies as informal yet crucial access points for many families.
In contrast, countries such as the United Kingdom have integrated pharmacists into primary care teams, where they contribute to medication optimization and public health interventions. Initiatives like the Pharmacy Integration Fund have placed pharmacists within general practices, leading to improvements in patient safety, treatment adherence, and overall satisfaction.
Similar reforms in Albania, beginning with pilot initiatives in chronic care and immunization, could strengthen the healthcare system. Realizing this potential, however, requires a deliberate policy shift that formally embeds pharmacists into primary care service delivery.
Looking ahead
For Albania, the question is no longer whether pharmacists belong in primary care but rather how to empower them to contribute meaningfully. Structured roles in chronic disease management, public health, and care coordination could help close service gaps and improve outcomes.
For the UK, the next challenge is consolidation: clearer role definitions, stronger supervision, and investment in long-term integration models.
One lesson is clear: pharmacists can play a vital role in general practice but only when systems are built to support their success. As Albania considers its next steps, it must seize this chance to build a more collaborative, inclusive future in primary care. Success extends beyond deploying more pharmacists, but in preparing them to be trusted, integrated contributors to patient care.
Authors: Ali Hindi is a Lecturer in Pharmacy Practice at The University of Manchester. His research focuses on the integration of pharmacists in primary care and the evolving roles of pharmacy professionals within multidisciplinary teams.
Eriona Petro is a PhD researcher at the WHO Collaborating Centre for Pharmaceutical Policy and Regulation (Utrecht University) and currently serves as Chief of Primary Healthcare Services in Durrës, Albania. Her research focuses on access to pediatric medicines and pharmaceutical policy reform in low- and middle-income countries.
Competing interests: None
Handling Editor: Neha Faruqui