The public health role of the community pharmacy workforce—a scoping review

Abstract Introduction Legislative and regulatory frameworks governing the practice of community pharmacy public health services (CPPHS)—and the way in which the community pharmacy workforce (CPW) interacts with them—tend to focus on the role of the community pharmacist. This focus influences associated policies, guidance, evaluations and research. Team-based CPPHS activities, however, could optimise skill mix to provide timely and appropriate advice, support and interventions. An initial policy review for England, as part of this PhD research programme, suggested a systemic failure to fully recognise and articulate the potential of involving the wider CPW in CPPHS, and a lack of inclusive policy frameworks and educational strategies for non-pharmacist staff, despite their growing involvement in CPPHS delivery. Aim To examine the CPPHS literature to establish which members of the CPW are participants therein, the nuances of their roles, and reflections on education and training (E&T) required for CPPHS delivery. Methods JBI methodology1 guided a scoping review (ScR) including the use of the PRISMA-ScR checklist. The Sample (S), Phenomena of Interest (P of I), Design (D), Evaluation (E) and Research (R) type SPIDER2 search framework defined the inclusion criteria. Scopus, CINAHL Ultimate and MEDLINE databases were searched with specific keywords to identify articles published in English or French from 1st January 2008 to 14th February 2025 and conducted in the UK, USA, Australia, New Zealand or France. Searches were combined in the sequence of S + (P of I1 + P of I2) + (D or E) + R. The PhD researcher undertook the selection of included studies in three phases (title, abstract and full text). Data were charted into a Microsoft Excel spreadsheet using pre-defined parameters in line with the search strategy. Mixed method data analysis approaches (content and thematic analysis) were used, with study characteristics being analysed quantitatively and extracted data relevant to the ScR objectives being analysed qualitatively. Results Thirty-four studies were included from a yield of 579 articles, the majority of which came from England (n = 13). All studies referenced pharmacists, but they were only participants in thirty. Sixteen studies included at least one cohort of non-pharmacist participants, such as healthy living champions (HLCs) (n = 7), pharmacy technicians (n = 4) and/or pharmacy assistants (n = 4). Characterisation of non-pharmacist roles was predominantly missing, with studies focusing on overall service delivery as opposed to individual capabilities. In respect of E&T, an important finding in respect of non-pharmacist roles was that other healthcare professionals do not view CP support staff as having the same level of knowledge as their counterparts in GP practices, e.g. healthcare assistants. Conclusion A strength of this ScR is that it has exposed the gap in the literature relating to the PH role of the non-pharmacist CPW, which is consistent with the perpetual cycle of missed opportunities to create whole workforce, evidence-based policy in this field. Addressing this research gap will align well with government-stated need for a new team-based approach to CPPHS delivery. The ScR was limited by predominantly absent definitions for non-pharmacist workforce groups, making it difficult to compare roles across different countries.