📦 Where Are Your Prescriptions Really Being Processed?

Reflecting on the Rise of Distance Selling Pharmacies in the Community Pharmacy Sector

It has been over five years since I made the transition from community pharmacy to hospital pharmacy, specifically EPMA and clinical informatics. During that time, I have seen, and been part of, some significant changes in how medicines are managed across the NHS. But recently, I found myself looking back...

As part of my current postgraduate studies in Digital Health Leadership, I completed a module on health innovation. For the assessment, I chose to analyse a model I had direct experience with, one that continues to reshape the community pharmacy sector: the rise of Distance Selling Pharmacies (DSPs).

While digital transformation in pharmacy is often discussed in broad strokes, DSPs offer a unique example of how innovation has disrupted one of the most traditional parts of the profession. These services operate entirely remotely, delivering prescriptions across England without the need for a physical pharmacy premises and in doing so, have introduced a new model for how EPS (Electronic Prescription Service) items are dispensed.

This blog is part reflection, part analysis. It draws on my time working for Well Digital Pharmacy in 2018 and Co-op Health in 2019. Well Digital was a really exciting time in my career and it gave me my first insight into digital pharmacy services. Revisiting that experience through the lens of academic study has only reinforced what I suspected back then: DSPs are not just a passing trend, they are part of a much broader shift in how community pharmacy operates.

💻 A Personal Digital Origin Story

Back in 2018, I joined Well Digital Pharmacy, one of the early major DSPs in the UK. At the time, this was a new frontier: pharmacy without a counter, without patient footfall, and without the constraints of locality. It was also my first time working in a dedicated digital health team. It was exciting. I was there from the very start, literally an idea on a whiteboard. Within 6 months we had created a full end-to-end operation with a front end user app and back end operating system. The tools we were building, app-based ordering, digital repeat prescription management, national delivery, were genuinely disruptive for their time. The team I worked in was extraordinarily talented and it felt like a real privilege to be a part of.

In 2019, I moved on to Co-op Health, where we continued to push boundaries in how repeat prescriptions could be made more convenient, scalable, and patient-centred. These two roles gave me an early view of how pharmacy services were beginning to digitise, not just operationally, but culturally.

Fast forward to today, and although I’ve since moved into hospital pharmacy EPMA, revisiting the DSP model during my postgraduate studies reignited my interest. It reminded me that digital transformation in pharmacy isn’t theoretical, it is already here, changing the way we deliver core services like repeat prescribing.

📊 What the Market Data Shows: Steady, Silent Growth

When I started at Well in 2018, Distance Selling Pharmacies processed just 2.6% of all NHS prescriptions in England. It felt small, but we could sense the trajectory.

That sense was well-founded. According to NHS Business Services Authority (NHSBSA) data, the market share of DSPs has grown steadily, year-on-year:

Fiscal Year	Total Items Dispensed (m)	Items by DSPs (m)	Market Share (%)
2016/17	1,005	13.2	1.3%
2018/19	1,025	27.0	2.6%
2020/21	1,050	45.0	4.3%
2023/24	1,110	66.6	6.0%

In other words, DSPs now dispense over 66 million items annually, and that figure is only moving in one direction. For a sector that didn’t exist two decades ago, that’s remarkable.

🔍 What’s Driving the Growth?

So, why are more prescriptions flowing through DSPs?

Here are the key enablers:

🖥️ 1. EPS Release 2 (2014)

The game-changer. This allowed patients to nominate a pharmacy, enabling digital prescriptions to be sent directly to any chosen provider, regardless of location. This removed the need for paper scripts and unlocked the door for DSPs to operate nationally.

🦠 2. COVID-19 Pandemic (2020)

The pandemic accelerated digital adoption across every industry and pharmacy was no exception. Lockdowns, shielding requirements, and reduced mobility led to a surge in demand for home-delivered medicines. Even after restrictions lifted, many patients stuck with the digital providers they’d discovered.

📱 3. Tech-First Design

DSPs are built on digital infrastructure, mobile apps, automated reminders, smart workflows. This means they’re naturally better placed to offer streamlined, user-friendly experiences than some traditional providers.

🎯 4. National Digital Marketing

While your local pharmacy relies on footfall, DSPs invest in SEO, online advertising, and app-store rankings. They scale fast and they know how to get in front of digital-savvy patients.

📦 5. Regulatory Flexibility

It’s hard to open a new high street pharmacy due to the Pharmaceutical Needs Assessment (PNA). But DSPs are exempt, allowing for rapid entry into the market by digitally mature operators.

📦 What Makes the DSP Model So Disruptive?

As I explored in my recent innovation report, DSPs meet several previously unmet patient needs:

• Convenience for working adults and carers

• Access for rural or housebound patients

• Adherence support via automated repeat ordering

• Privacy for patients with sensitive medication needs

• Digital-first UX for the modern consumer

Unlike traditional high street pharmacies, DSPs aren’t bound by geographic location or limited opening hours. The combination of EPS, automation, and mobile access has turned pharmacy into a 24/7 digital service and patients have responded.

🔍 So Why Are They Still Only at 6%?

It is a fair question, one I tackled in my critical appraisal.

While DSPs have made undeniable gains, several limitations remain:

• Digital exclusion (especially among the elderly or vulnerable)

• Lack of in-person clinical interaction

• Delivery delays and logistical errors

• Weaker links to local GP and care networks

• Governance challenges for regulators like the GPhC

In essence, DSPs have disrupted, but not displaced. They have carved out a strong niche, primarily in stable, repeat prescriptions, without replicating the full scope or community integration of traditional pharmacy services.

🧭 Looking Ahead: What Does This Mean for the Future?

As pharmacy leaders, digital teams, and commissioners, we have to ask: Where is the dispensing journey heading next?

DSPs now sit comfortably within the NHS digital health ecosystem. They’ve proven scalable, cost-efficient, and patient-friendly. But as their market share grows, we need to ensure they’re not just convenient, but also safe, equitable, and clinically integrated.

That means:

• Ensuring digital models support clinical dialogue, not replace it

• Improving interoperability with primary care

• Strengthening regulatory oversight

• Recognising the blended future of pharmacy: part physical, part digital

🤔 Final Thought

Revisiting the DSP model through the lens of innovation and market disruption reminded me how quickly pharmacy is evolving and how important it is to stay connected to the trends shaping that evolution.

From my early days processing prescriptions in Manchester warehouses to leading digital transformation in hospital systems today, the theme is clear: pharmacy is becoming digital, whether we’re ready or not.

As clinicians, informaticians, and digital leaders, we need to pay attention to where the prescriptions are actually going, because increasingly, they’re not going to the chemist on the corner. They’re going through APIs, fulfilment centres, and mobile apps.

That is not just a disruption... it is the future.