When pharmacists step into full scope practice, the shift is immediate. Newly acquired clinical skills and reasoning result in every interaction being viewed through a different lens.
Across different community pharmacy settings, structured consultations are uncovering risks, providing timely treatment, and changing the trajectory of patient health. While access to primary healthcare in rural areas adds weight to this work, the truth is that full scope services are not just a rural solution.
They are relevant, viable, and essential in every community pharmacy, regardless of postcode.
Inside the consult room: the clinical return
Every full scope service is delivered as a structured health consultation. Each one begins with a full history, followed by clinical assessment, documentation, and a clear plan for follow-up.
This approach changes the nature of care. Rather than focusing narrowly on a single symptom, we look beyond the immediate concern to understand the patient as a whole. Taking the time to gather a complete history often reveals patterns, risks, or contributing factors that would otherwise be missed.
The impact has been significant. We have identified hidden risks and conditions that required referral, further investigation, or immediate action. These findings were the result of taking a full history and considering the patient beyond a single symptom.
One consultation revealed red flag symptoms of a gastric bleed in a patient who initially presented with vomiting. Another saw irregular heartbeats detected during a smoking cessation consult, prompting referral and a subsequent diagnosis of arrhythmia. The consultation space also allows conversations to deepen. Patients often share concerns they may not have raised elsewhere. A discussion that starts with one symptom naturally extends into prevention, lifestyle, or future planning. These interactions strengthen rapport, build trust, and create lasting loyalty.
Patients leave not only with a treatment plan but also with clarity and confidence about their health. This clinical return on investment results in patient care that is structured, holistic, and transformative.
Is delivery of scope financially viable?
Alongside the clinical return, there is a clear financial return. Early projections and extrapolations prepared by Felicity Crimston from Pitcher Partners show consultation rooms consistently outperform traditional retail space.
Average gross profit per hour from structured consultations demonstrates clear sustainability, and the broader impact is seen in repeat visits, family referrals, and the willingness of patients to invest in meaningful care.
For patients, the value is clear. They experience timely, structured consultations that feel professional, safe, and worthwhile. That confidence only exists because services are delivered under strong clinical governance and regular auditing, ensuring consistency and quality every time.
For practitioners, viability comes from how workflows are redesigned. By transitioning triage and patient intake to interns, and shifting routine administrative tasks to pharmacy assistants, pharmacists can focus their time on high-value clinical activities.
For the practice, this alignment ensures the consult room becomes the most productive and purposeful space in the pharmacy. Financial return is therefore not separate from patient return; it grows out of delivering meaningful, structured care that patients trust and choose to return for.
Shifting patient expectations
Perhaps the most striking change has been in patient behaviour. Personalised care builds trust rapidly. A woman who attends for contraception may leave with a clearer understanding of her cycle health. A UTI consultation can open into education about hydration, prevention, or sexual wellbeing.
These touchpoints strengthen health literacy and reframe what patients expect from their pharmacist. Pharmacy is shifting from a place of supply to a relational health hub where patients know they can receive professional, evidence-based care.
At the same time, managing expectations around traditional pharmacy services is important. As pharmacists transition more of their time into clinical care, wait times for dispensing may occasionally increase.
Communicating this shift helps patients understand the value of structured consultations and why their pharmacist’s time is being directed where it has the greatest impact.
There are also opportunities to move routine health discussions off the floor and into the consult room. By creating space for deeper, uninterrupted conversations, pharmacists can provide greater levels of care, enhance safety, and ensure patients leave feeling supported and informed.
Challenges still to navigate
The pathway has not been without challenges. The absence of PBS prescribing, increases costs and disadvantages patients who choose care through their pharmacist, limiting the full potential of the model. Until this is addressed, affordability will remain a limiting factor for some patients.
At the practice level, every pharmacy must develop workflows that fit its own environment. The transition from supply-focused roles to clinical consultations cannot be achieved with a single template.
Each team needs to find the right balance by reallocating administrative tasks, embedding booking processes, and creating space for the pharmacist to focus on high-value clinical care.
What is evident is that services can be delivered successfully across a variety of community pharmacy settings and locations. This includes single pharmacist models, where there may be only a limited number of pharmacists in the region, through to larger practices with multiple pharmacists and broader clinical teams.
These challenges are real, but they are not insurmountable. With strong clinical governance, regular auditing, and structured feedback, services continue to strengthen. The foundations are in place for pharmacy to deliver consistent, safe, and sustainable clinical care, and the potential for growth remains significant.
The future of pharmacy
The broader lesson from early adopters is that full scope is not tied to geography. It is not a rural fix, and it is not a metro convenience. It is a whole-of-industry step forward.
Pharmacy is moving from a transactional model to a relational, patient-centred health destination. Financial viability will increasingly be linked to purpose, and patients are already demonstrating through their trust and their choices that they value this evolution.
The next horizon is specialisation. Full scope creates space for pharmacists to develop services that reflect their expertise and interests, whether that is in chronic disease, preventive health, or women’s health.
Women’s health is an area of immense need and opportunity. Structured consultations provide space to support women through contraception, hormonal health, perimenopause, and beyond in a way that is accessible, evidence-based, and deeply supportive
This shift reinforces the very foundation of pharmacy: improving health, inspiring wellbeing, and connecting with communities in meaningful ways. Full scope is no longer a dream on the horizon. It is here, it is viable, and it is reshaping what pharmacy means to the people we serve.
