With the recent introduction of the Common Conditions Service pharmacists are now positioned more than ever as accessible, frontline healthcare professionals. Patients can walk into any pharmacy in the extensive national network of community pharmacies, receive expert advice, and access a range of treatments for common conditions without needing a GP appointment. It’s efficient, patient-centred, convenient, and a hugely positive step for the profession.
The approach is structured, protocol driven, and formally recognises what pharmacists have long been doing, assessing patients, making decisions, and providing timely, accessible care for a defined set of conditions. It brings clarity, consistency, and visibility to the clinical role of the pharmacist.
For me, it’s introduction stimulated a broader question. If we were to take this structured approach and apply it beyond the current list, what else might we begin to see more clearly? In my ideal world, there might be a tenth common condition. Not one defined by pathology or a pathogen, but by something much more subtle, and undoubtedly more universal. Many patients presenting to community pharmacy are not acutely unwell, but they are struggling, not thriving, often feeling flat, tired, or off balance.
The vision for the Common Conditions Service is that patients will present with one of a number of clearly defined complaints, from conjunctivitis, to impetigo, to urinary tract infections. The process is familiar; a presenting complaint, a structured assessment, a decision, followed by an intervention. However, alongside the majority of presenting conditions there is often something less visible.
The person seeking treatment for a minor ailment who quietly mentions that they are ‘out of sorts’, ‘wrecked’, or ‘just not themselves’. The patient who, in the course of the conversation, mentions sustained stress, broken sleep, or overwhelm. These are not separate from the presenting complaint, but are part of it.
Wellbeing, the ability to feel good and function effectively, sits quietly in the background, influencing the development and persistence of many of the conditions we treat. And yet, unlike the nine recognised conditions, it is rarely named.
The strength of the Common Conditions Service lies in its structure. It provides us with a shared language and a clear pathway to assess, identify, and intervene. In an ideal world we would borrow this structure, not to formalise wellbeing as a clinical condition, but to bring it into sharper focus in our everyday practice.
Imagine a hypothetical ‘Wellbeing Protocol’ that would mirror the logic of the existing structure.
Presentation:
Assessment:
Intervention:
As with all pharmacy interventions, experience shows us that clear, proportionate interventions are key. The same applies with wellbeing. In this imagined protocol, the treatment for sub-optimal wellbeing would not be complex. It would not involve lifestyle overhauls, long lists, or unrealistic expectations. It would consist of one small, human, effective suggestion, tailored to the individual:
These interventions may appear modest, but their impact when repeated over time is cumulative. The evidence is clear, wellbeing is shaped not by dramatic large changes, but by small, consistent behaviours repeated over time.
“ Wellbeing, the ability to feel good and function effectively, sits quietly in the background, influencing the development and persistence of many of the conditions we treat. ”
A framework such as the REVAMP model, derived from Martin Seligmans science backed, research-based PERMA, offers a useful lens through which to interpret responses. It identifies six pillars of wellbeing namely: Relationships, Engagement, Vitality, Accomplishment, Meaning, and Positive Emotions. Not as a checklist but as a way of understanding patterns.
For example, a patient overly career focused may be experiencing a gap in Relationships. A lack of enjoyment or lightness in life point towards diminished Positive Emotions. A patient overwhelmed by constant demands, fatigue and poor sleep has reduced Vitality. These pillars are not abstract but are clinically relevant contributors to how patients present, recover, and respond to treatment.
Borrowing again from the Common Conditions Service we might imagine a simple internal checklist guiding these interactions for our Wellbeing Protocol.
During the consultation consider;
This need not be an additional task merely a refinement of what is already happening. It is the opportunity within the service. The Common Conditions Service has expanded the clinical scope of pharmacists, but it has also expanded the opportunity for influence. Each structured consultation creates a moment not only to treat a condition, but to understand the context in which it has arisen. This allows us to offer something small that extends beyond the immediate symptom. Over time these moments accumulate, shape behaviour, support prevention, and influence outcomes.
Wellbeing is unlikely to appear as an official tenth condition within the Common Conditions Service anytime soon. But perhaps it doesn’t need to, because the framework and skills are already there, and the opportunities present themselves every day across the pharmacy counter.
The Common Conditions Service has given pharmacist a clear, structured way to deliver clinical care. In an ideal world we might extend that same clarity to something less visible, but equally important. Because while medicines treat conditions, it is often the small, human, consistent actions that shape how people feel and function over time. And sometimes within the structure of a consultation there is just enough space to nudge that process forward.
Séamus Ruane
Community Pharmacist and Positive Psychology Practitioner
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