Why most pharmacies will struggle with full scope, and what the top performers are doing differently

This is where the gap becomes visible

Across APP 2026, the conversation around full scope pharmacy was largely optimistic. Access is improving, services are expanding, and patient demand is clear.

In our previous analysis, Full scope is not a clinical shift, it is a business model transformation, we explored how pharmacies are building commercial value beyond the consult. What became clear in this session is that execution is where that model is won or lost.

Sitting in the Strengthening Community Pharmacy’s role in primary care panel at APP 2026, facilitated by Steve Kastrinakis, Managing Director of Independent Pharmacies Australia, and joined by a leading panel of industry experts including Chelsea Felkai, Aged Care and Disability Pharmacist, a different reality emerged.

The challenge is not whether pharmacists can deliver these services, but whether their businesses are set up to support them.

Capability is not the constraint

One of the more consistent assumptions across the conference is that full scope is primarily a clinical shift. Felkai challenged that directly, pointing instead to how pharmacies are structured and how work is actually done day to day.

“Resource allocation is fundamental to getting things done.”

It is a simple line, but it reflects a deeper issue.

Pharmacists already have the capability to deliver more care, yet many lack the time, space and operational support to do it consistently.

What the Veri Health team observed, reinforced through Felkai’s comments, is that many pharmacies are approaching full scope as an addition. They are adding consults, adding services and adding expectations, but not removing or redesigning anything in return.

Dispensing still needs to happen, retail still needs to be managed, and teams are still operating within the same constraints. The result is not transformation, but added pressure across the business.

As services increase, so does complexity. Workflows become fragmented, staff are pulled between competing priorities, and consults and scripts begin to compete for attention.

Without structural change, these models become difficult to sustain. Felkai’s point around resource allocation becomes critical here, not just in terms of how many staff are available, but how they are deployed, what they are responsible for, and how the day is structured around care.

What leading pharmacies are doing differently

What separates the pharmacies seeing results is not simply that they have adopted full scope, but how they have built around it.

Across discussions at APP, a consistent pattern emerged. High-performing operators are not layering services on top of existing workflows, but redesigning those workflows entirely.

They are structuring teams differently, protecting time for consultations, and using support roles to reduce pressure on pharmacists. In these businesses, care is not competing with dispensing, but being prioritised alongside it.

The risk of getting this wrong

There is a tendency to see full scope as an inevitable shift, but execution will ultimately determine whether it succeeds.

Without operational redesign, services risk becoming inconsistent, staff become overextended, and patient experience begins to suffer. What starts as an opportunity can quickly become a strain on the business.

Takeaway

What became clear to the Veri Health team sitting in that session is that full scope is not simply expanding what pharmacists can do clinically, but changing how pharmacies operate.

The difference between those who succeed and those who struggle will not come down to capability, but to how their businesses are designed.

For those willing to redesign how care is delivered, the opportunity is significant. For those who are not, the gap will only widen.

Part of the APP 2026 series

This article is part of Veri Health’s on-the-ground coverage of APP 2026, where our team analysed how primary care, business models and service delivery are shifting in real time.

Across the series, three themes emerged.

In our first article, we explored where primary care in Australia is heading, and how pharmacy is becoming a frontline access point for care. What APP 2026 taught us about where primary care in Australia is heading

In our second, we examined the commercial model behind full scope, and how pharmacies are building value beyond the consult. Full scope is not a clinical shift, it is a business model transformation

This article focuses on execution, and why many pharmacies will struggle to operationalise full scope in practice.