Remote pharmacist vs a second on-site pharmacist: what actually changes

What each option is actually for

The two are often discussed as if they are interchangeable, but they address different constraints. A second on-site pharmacist, whether employed or a locum, puts another qualified person physically in your building. That person can take responsibility, cover the Responsible Pharmacist role during absences, and share the dispensing and consultation load.

Adding remote consultation capacity does something narrower. It gives you extra clinical consultation time from a GPhC-registered pharmacist working from registered pharmacy premises, without a second person on your own shop floor. If your real bottleneck is finding time for Pharmacy First and private consultations around dispensing, that is the gap it is designed to fill. Our how it works page walks through the mechanics.

What a second pharmacist or locum day actually costs

There is no official or regulated locum rate, so any figure is illustrative and moves with the market. As a rough guide, England averaged around £30.55 an hour in July 2025, which works out at roughly £245 to £275 for a typical 8 to 9 hour day. Rates had fallen about 12% over the preceding year, and they vary widely by region and by the date and notice of the booking.

An employed second pharmacist is a fixed salary plus on-costs rather than a daily rate, but the underlying point is the same. With either arrangement you are committing to the cost of the day before you know how many billable consultations will actually happen. Always check current rates for your own area rather than relying on a single national average.

Why the Responsible Pharmacist is required either way

Neither option removes the requirement for a Responsible Pharmacist on the premises. That role is a fixed feature of running a community pharmacy, not something a remote arrangement can absorb.

A remote pharmacist is added capacity and is never a substitute for the on-site Responsible Pharmacist. They do not provide remote supervision of dispensing, which is not permitted. So the choice is not really "remote pharmacist instead of the Responsible Pharmacist"; it is whether to add a second on-site person or add consultation capacity alongside the pharmacist you already have.

How remote capacity is added rather than swapped in

In the remote model the patient is never left alone with a screen. On-site staff greet them, take them into your existing consultation room and start the call. The consultation is then delivered by a GPhC-registered pharmacist who is themselves at registered pharmacy premises.

That is the key difference from hiring. You are not replacing your on-site pharmacist or thinning out your team; you are adding consultation time on top of what you already run. You can read more about the delivery model on the Pharmacy First remote delivery page.

Matching cost to activity

The commercial contrast is between a fixed cost and activity-linked income. A locum day is paid in full regardless of consultation volume. Pharmacy First income, by contrast, is £17 per completed consultation (unchanged for 2026/27), plus a fixed monthly payment of £500 once you reach 20 to 29 consultations in the month and £1,000 at 30 or more.

Other services layer on top of this, such as the New Medicine Service at £28 and the Pharmacy Contraception Service at £25 per consultation. None of this is guaranteed income; what you earn depends entirely on the volume you actually deliver. To sketch your own figures, use the pricing calculator, and see our guide to Pharmacy First payments for 2026/27 for the full fee picture.

What remote can and cannot cover

Remote capacity is not a like-for-like replacement for a second body on the dispensary floor, and it is important to be clear about its limits. Six of the seven Pharmacy First clinical pathways can be delivered by good-quality video; acute otitis media (earache) needs an otoscope and stays in-person. Telephone or audio alone is not permitted for the clinical pathways.

A remote pharmacist also cannot supervise dispensing. So if what you actually need is someone to run the dispensary or hold the Responsible Pharmacist role while your regular pharmacist is away, that is a job for an on-site locum or employee, not a remote consultation service. Our guide on whether Pharmacy First can be delivered remotely sets out the boundaries in detail.

Choosing between them, or using both

The honest answer is that they are not really competitors. If your constraint is dispensary cover or Responsible Pharmacist absence, you need a person in the building, and a locum or employed pharmacist is the right tool. If your constraint is consultation capacity that your single on-site pharmacist cannot fit around dispensing, remote capacity targets that specific gap without the fixed cost of a second daily rate.

Some sites use both, keeping locum cover for genuine absences and adding remote capacity to grow consultation activity. Whichever way you lean, the sensible next step is to model your own numbers rather than work from averages. Everything here is illustrative, and nothing about volumes or income is guaranteed.