INTRODUCTION

The transformation of Hong Kong’s healthcare system towards a more community-based, preventive, and integrated model under the Primary Healthcare Blueprint, issued by the Health Bureau of Hong Kong SAR Government in 2022, has opened new avenues for the development of community pharmacy services. In support of this strategic direction, the Hong Kong Jockey Club Charities Trust has initiated and funded Jockey Club PHARM+ Community Medication Service Network Project.

 

Under the project, the Department of Pharmacology and Pharmacy, The University of Hong Kong (HKU) is committed to build the capacity of community pharmacies, evaluate service effectiveness and enhance professional standards to ensure service quality, efficiency and consistence. Taking a leading role in fostering the establishment of primary healthcare pharmacy model, HKU creates a network among providers of community pharmacy services to foster knowledge exchange, collaborative learning and stakeholder engagement. HKU regularly convenes roundtable meetings with stakeholders from different sectors. These forums foster knowledge exchange and alignment of practice models, as well as strengthening interprofessional collaboration to meet the goals of a strengthened primary healthcare system.

 

Roundtable Meeting on Scope of Community Pharmacy Services in Evolving Primary Healthcare Model (the Roundtable) was successfully held on 19 February 2025 in campus of The University of Hong Kong. This article presents the summary and key insights made in the Roundtable regarding scope of community pharmacy services.

 

OBJECTIVES OF THE ROUNDTABLE MEETING

Bringing together frontline practicing community pharmacists, other healthcare professionals and community partners to discuss and collectively explore the future direction and scope of pharmacy practice in community settings.

 

This meeting aims to:

• Articulate the service scope in community pharmacy in the context of the evolving primary healthcare model
• Harmonise the service scope across various community pharmacy settings
• Drive the development of framework and guidelines for service scope and standards in community pharmacy services
• Foster dialogue, knowledge-sharing and consensus-building to drive best practices and innovation in community pharmacy services

 

Photo 1: Introducing the background of the Roundtable

 

ROUNDTABLE HIGHLIGHTS

The Roundtable brought together 39 participants from community pharmacies, district health centres (DHC), DHC express, and community partners.

Three featured presentations offered practical insights into development of community pharmacy services:

• Ms Gladys Cheung, pharmacist from HKU, shared about the Communication Toolkit: Constructing a Trustworthy Community Pharmacy Model with Well-defined Service Scope
• Mr Terry Lee, senior pharmacist from PHARM+ Hong Kong Sheng Kung Hui
Community Pharmacy, shared about Extent of Pharmacy Practice in Medication Management Services – Service Gaps, Cases Sharing and Insight.
• Mr. Stephen So, Health and Research Manager from Mannings, delivered a sharing about Innovation in Community Pharmacy: Potential Development of Immunization Service.

During the Roundtable, participants contributed valuable insights and opinions on shaping the scope of community pharmacy services through group discussions.

Photos 2, 3 and 4: Speakers shared practical insights in development of community pharmacy services

 

Executive Summary: Communication Toolkit: Constructing a Trustworthy Community Pharmacy Model with Well-defined Service Scope

• A strategic approach has been adopted to raise public awareness of primary healthcare pharmacy services.
• HKU has built a variety of communication toolkits such as standardized terminology and service models via collaborative approach so that the pharmacy profession could establish a common language and shared vision to facilitate effective communication and collaboration. This initiative aligns the understanding of key primary healthcare concepts among different stakeholders.
• A variety of public education initiatives have been organized by HKU to improve health literacy and public awareness of primary healthcare pharmacy services. These initiatives center on raising public awareness of primary healthcare pharmacy services and the role of community pharmacists as accessible, frontline health resources. By using a unified public messaging approach, the aim is to improve health literacy, empower self-care practices, and underscore pharmacists’ contributions to preventive healthcare in Hong Kong.
• User case sharing could build trust and relatability with the audience. HKU has initiated a call-to-action to collect engaging user experience for educational purposes and stakeholder engagement.

 

Executive Summary: Extent of Pharmacy Practice in Medication Management Services – Service Gaps, Cases Sharing and Insight

• PHARM+ Hong Kong Sheng Kung Hui
 Community Pharmacy delivers medication management services (MMS) in community pharmacy, outreach for singleton and doubleton families, and residential care homes.
• Service gaps are discovered throughout the implementation of MMS, namely healthcare system gap, tripartite communication opportunities and challenges (pharmacist-doctor-patient), patient engagement and awareness, and operational gap.
• Integrating pharmacists into the primary healthcare team is essential for better holistic care of patients for optimization of medication use.

 

Executive Summary: Innovation in Community Pharmacy: Potential Development of Immunization Service

• Supported by medical doctor, pharmacist-led influenza vaccination service has been piloted.
• The major objectives of pharmacist-led vaccination service are to promote public health, enhance vaccination rate, and offer convenient alternatives to individuals who wish to receive influenza vaccines
• Important considerations for implementing vaccination service are doctor engagement, development of standard protocols (e.g. health assessment form, emergency protocol), insurance coverage, vaccine supplies, clinical waste handling, cold chain management and manpower arrangement.  
• Several challenges were identified in the pilot vaccination service:
  • Legal framework for pharmacy-based vaccination service:
    Currently there is no robust framework supporting vaccination service in community pharmacy.  The most applicable and available reference framework is Vaccination Subsidy Scheme Doctors’ Guide published by the Centre for Health Protection, Department of Health, which highlights that vaccination should be administered by qualified healthcare professionals or by trained personnel under the doctor’s personal supervision, and the doctor should be present at the venue during the vaccination activity; or else, he/she should be personally and physically reachable in case of emergency at non-clinic settings.
  • Quality assurance:
    ​As in other healthcare systems, vaccines with favorable safety profile can be delivered by other qualified healthcare professionals including pharmacists in community pharmacy. Quality assurance and regulatory framework can be established to empower qualified pharmacists to contribute to the vaccination services while safeguarding patient wellness and safety. [1]
  • Constraints from prescription-only classification of vaccine:
    Vaccines are prescription-only medicines which community pharmacy cannot supply without prescription. The future regulatory framework should take this issue into account. Reference can be taken from the United Kingdom Patient Groups Directions which enable qualified community pharmacists to supply and administer the prescription-only vaccines to healthy individual without prescription under defined inclusion criteria. Electronic record will automatically share with doctors on National Health Service IT system after vaccination.  [2]
  • Physical setting of pharmacy and its equipment:
    The setup of vaccination venue requires space and privacy for consultation, vaccination and resting. In the meantime, various equipment is highly desirable including Electronic Health Record Sharing System and purpose-built pharmaceutical-grade refrigerators which are costly and require extra space.
• Despite the challenges, users of the pilot service were highly satisfactory with service quality and professionalism of pharmacist, which marked as a foundation for further development of immunization service in community pharmacy.

 

KEY INSIGHTS FROM THE DISCUSSION

Photo 5: Representatives from community pharmacies, DHC, DHC express, and community partners discussed various topics during the Roundtable.

1. Expanded Role of Community Pharmacists in Primary Healthcare

Participants reached consensus that community pharmacists should play a pivotal role in chronic disease prevention and management:

• Chronic disease management: Community pharmacists have a significant role in chronic disease management including optimization of medication therapy, side effect management of medication therapy, regular monitoring of health conditions and health promotion.
• New medication service: Regarding MMS, emphasis can be placed on patients who are recently discharged from hospitals and are put on new medications. A robust referral mechanism should be established between hospitals and community pharmacies.
• Health screening and assessment: Health screening and assessment should be developed in a structured manner in community pharmacy which has great accessibility to the public. Particularly, follow-up on blood pressure monitoring and assessment of continuous blood glucose monitoring were highlighted in the discussion. Community pharmacists could conduct a comprehensive review on these self-care monitoring and provide tailor-made recommendations on disease management.
• Smoking cessation service: Community pharmacy plays an important role in smoking cessation service. Community pharmacy serves as a good access point for this service where both professional consultation and medications such as nicotine replacement therapy (NRT) are available in this setting.  However, the service models and workflow compared with the currently available services in other settings remain a challenge to community pharmacy. For example, service fee in other settings is fully subsidized while that in community pharmacy is not and the service user might need to pay for the service fee or the NRT.
• Health resource hub: Community pharmacy acts as a health resource hub where community pharmacists offer a wide range of comprehensive medication and health information. Pharmacist consultation conducted in this context in a detailed manner should be strengthened and service fee should be considered in the future for cost recovery.
• Health empowerment on over-the-counter products and supplements: Community pharmacists play a proactive role in health empowerment for the public on wise use of over-the-counter products or health supplements. While redefining the scope of community pharmacy services, health empowerment is always one of the integral elements of community pharmacy.

 

2. Considerations for Scope of Community Pharmacy Services

As flagged up in the Roundtable, most participants concurred that there were few significant dimensions for future discussion:

• Sustainability is a crucial consideration when developing various innovative community pharmacy model
• Pharmacists working in primary healthcare settings always encounter health enquiries of different levels of details ranging from simple drug information such as side effects to complex disease management. The resources needed to address these health inquiries may vary significantly. Hence, pharmacist consultation fee should be explored in the future to signify the pharmacist's contribution and value to the service.
• Tele-services are at the forefront of shaping the future landscape of healthcare development. The pharmacy profession should put more emphasis on integrating technology into pharmacy service development.
• A shared communication platform among healthcare providers and pharmacists working at different workplaces is necessary to ensure continuity of care.

Pharmacists can play a crucial role in medication management of residential care homes.

3. Current Challenges of MMS
As discussed in the Roundtable, majority of the participants agreed with the challenges identified in scaling MMS:

• There is insufficient system integration among pharmacists, doctors, other healthcare providers and community organization. Systematic referral and a co-created communication platform should be made readily available to all healthcare providers so that each party could access the patient health records and communicate at one stop.
• The communication mechanism between community pharmacists and prescribers should be strengthened. Currently, it is challenging for pharmacists to directly reflect the medication therapy problems identified during MMS to the prescribers.
• Health information is scattered in different clinical settings which hinders MMS efficiency as pharmacists are required to identify the potential medication therapy problems arising from various contexts.
• Regarding the medication adherence issues identified during MMS, currently there is no consistent follow-up nor prescriber reporting system to support the intervention.

 

A consensus was reached on the importance of system-level reforms, including interoperable health records and shared care protocols to enable multidisciplinary collaboration.

 

4. Potential for Immunization Services

As brainstormed in the Roundtable, many participants were eager to explore the potential of developing pharmacist-led vaccination service in supporting public health initiative.

Participants acknowledged that community pharmacies offer convenient and trusted access points for vaccination. However, a policy-driven framework is crucial to guide service development, ensure professional standards, and establish public confidence.

While many existing local community pharmacies do not have the necessary settings, transformation and preparations are immensely resource demanding. Participants proposed that reimbursement of pharmacy refit with installation of new equipment should be considered to transform the community pharmacies to meet the future needs and ensure primary healthcare sustainable.

 

SUMMARY OF ROUNDTABLE OUTCOMES

By characterizing the scope of community pharmacy services and associated process of care, the primary healthcare pharmacy model can be shaped more clearly. The Roundtable aligned the profession in ensuring community pharmacies being integrated into broader health initiatives and ignited new ideas regarding the capabilities of community pharmacies.

 

ACTION PLAN AND NEXT STEPS

The Roundtable concluded with a shared commitment to advancing community pharmacy services in alignment with government priorities on primary healthcare reform. A consolidated set of opinions and recommendations will be reflected to the Task Group on Guideline Formulation, with the aim to:

• Standardize service delivery and define scope of practice
• Support policy advocacy for funding and service recognition
• Promote interprofessional collaboration through integrated digital platforms
• Encourage continuous service innovation tailored to community needs

 

CONCLUSION

The evolution of community pharmacy services in Hong Kong is both timely and necessary. As Hong Kong strengthens its primary healthcare system, community pharmacists must be empowered to deliver high-quality, patient-centred care. Through collective action and stakeholder collaboration, HKU will continue to take the lead to build a future-ready pharmacy model that supports preventive care, chronic disease management, and improved population health outcomes.

 

Source of Funding

The Roundtable, under the Jockey Club PHARM+ Community Medication Service Network, was initiated and funded by the Hong Kong Jockey Club Charities Trust.

References

1. Chan PP, Li, JCW, Wong, JKT. Review of Pharmacy-Based Vaccination in Hong Kong. Hong Kong Pharmaceutical Journal. 2023. 30(2): 54
2. Inactivated influenza vaccine: national protocol, UK Health Security Agency [Internet] Available from: https://www.gov.uk/government/publications/national-protocol-for-inactivated-influenza-vaccine)