Compliance · GPhC

Why pharmacies fail GPhC inspections: what 2,197 inspection outcomes reveal

Most pharmacies pass. Of 2,197 routine GPhC inspections conducted between January 2022 and December 2024, some 87.5 per cent met all twenty-six standards, which is a reassuring headline concealing an uncomfortable distribution beneath it. A study published on 14 July 2026, co-authored by researchers at the University of Strathclyde and two employees of the regulator itself, found a consistent gradient across ownership structures, with the odds of failing an inspection rising steadily as the number of premises owned fell. Independent single-owner pharmacies recorded failure rates several times those of the national chains. The same analysis identified the seven standards which account for most failures, and drew three themes from inspectors' own written comments. This guide sets out what the data shows, which standards to attend to, why the vaccination finding is more subtle than it appears, and what a small independent should take from it.

Last reviewed 4 August 2026 by Arham Jamaal, Superintendent Pharmacist. Analysis of Goswami et al., Pharmacy 2026;14(4):107, published 14 July 2026, open access.

What percentage of pharmacies pass GPhC inspection?

A study published on 14 July 2026 in the journal Pharmacy analysed published GPhC inspection data covering January 2022 to December 2024. The authors are based at the University of Strathclyde and at the GPhC itself, with two of the four employed by the regulator, which is declared within the paper and which gives the analysis unusual proximity to the data whilst warranting note by any reader.

Of 2,296 routine inspections reported, 99 were excluded as hospital, prison, veterinary, temporary or dispensing-hub premises, leaving 2,197 pharmacies. Of those, 1,918 were traditional bricks-and-mortar community pharmacies whilst 279 were other models, predominantly internet and distance-selling pharmacies together with clinics. The great majority were in England, with 241 in Scotland and 80 in Wales.

In total 1,922 pharmacies, being 87.5 per cent, met all twenty-six standards. The remaining 275, or 12.5 per cent, failed at least one.

One methodological point improves the reading of that figure. The analysis deliberately excluded re-inspections, which follow a recent failure, and intelligence-led inspections, which are triggered by information received. The 87.5 per cent therefore describes routine inspection performance rather than the sector's overall record, and the true picture including targeted activity would be less flattering. The period was chosen because it follows the pandemic's disruption and precedes the changes made to the inspection model in January 2025.

Which GPhC standards do pharmacies fail most?

Compliance exceeded 85 per cent across all five principles, and performance was not evenly distributed within them. Seven individual standards accounted for disproportionate failure irrespective of pharmacy type.

StandardWhat it requires
1.1The risks associated with providing pharmacy services are identified and managed
1.2The safety and quality of pharmacy services are reviewed and monitored
1.6All necessary records for the safe provision of pharmacy services are kept and maintained
2.2Staff have the appropriate skills, qualifications and competence for their role
3.1Premises are safe, clean, properly maintained and suitable for the services provided
4.2Pharmacy services are managed and delivered safely and effectively
4.3Medicines and devices are obtained from a reputable source, stored securely and supplied safely

Two of those reached statistical significance when vaccinating and non-vaccinating pharmacies were compared, being standard 1.1 concerning risk management and standard 3.1 concerning suitability of premises. By principle, the weakest areas were governance, where 8.6 per cent of pharmacies failed at least one standard, and services, at 7.7 per cent. Equipment and facilities produced almost no failures at all, with 99.4 per cent compliance.

For a pharmacy preparing for inspection, that distribution is the practical finding. Attention directed at equipment is attention largely wasted, whilst risk management, monitoring, records, staff competence and premises account for very nearly everything which goes wrong.

Do independent pharmacies fail inspections more often?

THE OWNERSHIP GRADIENT

This is the study's most uncomfortable finding and the one most relevant to this site's readership. The authors categorised pharmacies into six ownership bands, running from independent single-owner premises through to national chains exceeding one thousand sites, and observed a consistent gradient across them, with progressively higher odds of inspection failure as ownership size decreased. Independent single-owner pharmacies recorded incidence rates of roughly four to ten per cent across the problem standards. National chains of more than a thousand premises fell below 1.5 per cent across all standards, with an estimated odds ratio around 0.5. The confidence intervals shifted further from parity as the ownership category grew smaller, and the pattern held most strongly across the same seven standards identified above. The authors attribute the difference to organisational infrastructure rather than to professionalism, noting that larger organisations benefit from centralised governance systems, dedicated compliance teams and standardised operating procedures deployed across sites, whilst smaller independents face greater operational constraints including limited staffing and fewer support structures. The finding is therefore not that independent pharmacists are worse pharmacists. It is that governance is easier to industrialise than to improvise, and a sole owner is improvising against the same twenty-six standards as a chain with a compliance department.

Independent single-owner pharmacies and independent chains of two to five premises together accounted for nearly half the inspections analysed, at 503 and 550 pharmacies respectively, so this is not a marginal segment of the sector encountering the difficulty.

Why do vaccinating pharmacies pass more often?

The study's headline comparison concerned vaccination services, and the difference is substantial. Of pharmacies offering vaccinations, 90.9 per cent met all standards, against 80.4 per cent of those which did not. The gap was widest on governance, at 94.4 per cent against 85.2 per cent, on premises, at 98.5 per cent against 92.8 per cent, and on services, at 94.5 per cent against 87.6 per cent.

Multivariable logistic regression found that vaccinating pharmacies remained less likely to fail even after adjusting for ownership type, with an adjusted odds ratio of 0.49 and a confidence interval of 0.40 to 0.64, and a sensitivity analysis treating ownership size as a quantitative variable produced a comparable result. The association is therefore not merely an artefact of larger chains being more likely to vaccinate.

The interpretation nonetheless requires care, and the authors supply it themselves by stating that the relationship should not be read as causal. Administering vaccines does not improve a pharmacy's risk assessments. The likelier explanation, which the paper advances, is that delivering vaccination services requires trained staff, suitable consultation facilities and clear clinical governance systems, such that a pharmacy capable of satisfying those requirements is already a pharmacy capable of satisfying an inspector.

The paper then identifies a consequence which deserves more attention than it has received. Pharmacies already struggling with workforce development, premises suitability or governance capacity are less likely to take on vaccination services, and therefore do not access the additional remuneration which commissioned services provide and which could be reinvested in the very infrastructure they lack. That is a self-reinforcing disadvantage, and it argues for commissioning approaches which build governance maturity rather than paying purely upon volume.

What do inspectors write about governance?

The authors examined 99 inspector comments attached to the standards showing the largest differences, and coded three themes. The first concerned governance.

Recurring observations included ineffective management of dispensing errors and near misses, inadequate risk assessment, and a general absence of accountability, alongside gaps between written procedures and actual practice, unresolved actions carried over from previous inspections, and systemic failures capable of compromising patient safety. One inspector's comment described a pharmacy whose written procedures did not reflect current practice, whose management of near misses and incidents was incomplete, and whose team members were unclear how to provide services safely in certain circumstances.

Two of those merit particular attention because they are entirely within an owner's control and cost nothing but attention. Unresolved actions from a previous inspection convert a survivable finding into evidence of a pharmacy which does not respond to regulatory feedback. And procedures which do not reflect current practice is the failure our SOP guide exists to prevent, arising not because procedures were never written but because practice moved and the documents did not.

What do inspectors write about staffing?

The second theme concerned staffing levels and competency, and the comments divide into two distinct failures which are frequently conflated.

The first is insufficient staff, with inspectors describing arrangements inadequate for the workload and routine tasks going uncompleted or completed late. The second is insufficiently trained staff, with comments describing team members undertaking tasks without the right training, and individuals unclear about their own role and its limitations. Notably, one such comment came from a pharmacy within a medium-sized chain, which indicates that scale mitigates the gradient without eliminating the problem.

The contrast drawn in the paper is instructive. Among the pharmacies meeting standards, inspectors recorded structured ongoing training, protected time to learn during working hours, and team members holding appropriate skills and competence for the tasks they performed. The distinguishing feature is not whether training exists but whether it is structured, protected and evidenced.

What premises problems do inspectors find?

The third theme concerned the physical environment, and the specific findings are unglamorous and entirely remediable.

Inspectors recorded unsuitable medicines storage, absent systems for stock rotation and expiry checking, compromised security and uncontrolled access to medicines, and medicines capable of causing harm or being misused not being suitably managed. Pharmaceutical refrigerators were frequently found not working properly or containing inappropriate items including foodstuffs. Cleanliness issues appeared. One comment described a dispensary as disorganised and cluttered, with limited clear space to dispense and check safely, items on the floor presenting tripping hazards, and an untidy consultation room.

Against that, pharmacies meeting standards were characterised by good housekeeping, clean and well laid-out premises, and adoption of technology or newer working methods making service provision safer or more effective. The gap between the two descriptions is a morning's work in many cases, which is precisely why this theme repays attention before an inspector arrives rather than afterwards.

Why do online and distance-selling pharmacies struggle?

The paper identifies difficulties specific to internet and distance-selling models, and they will be familiar to readers of this site's other coverage.

On governance, inspectors noted the transactional nature of medication requests, misleading website content, and a particular absence of adequate risk assessment, with one comment describing a distance-selling pharmacy which did not appropriately review its prescribing service to establish whether its processes kept people safe. That is the same architectural failure our consultation flow guide addresses, appearing in an inspector's own words.

On premises, the findings were physical rather than digital. Inspectors described insufficient storage for the volume of stock held, floors congested with overflow, and premises lacking the space to support the dispensing volume being undertaken. Growth had outrun the building, which is a recognisable failure mode for any online pharmacy scaling faster than its lease.

One important qualification applies. Since these inspections were conducted the GPhC has issued updated guidance on providing services at a distance and on ensuring a safe and effective pharmacy team, and has subsequently reported improvement in internet pharmacy performance. The distance-selling picture within this dataset is therefore historical rather than current.

What does this mean for a small independent?

The gradient is a description rather than a destiny, and the study's own themes indicate where effort produces the greatest return.

Industrialise the governance a chain would centralise. The advantage larger organisations hold is documented, repeatable process rather than superior judgement. A single pharmacy can write the same risk assessments, run the same near-miss review and keep the same records, and the effort required is a fraction of what running the pharmacy already demands.

Close the loop on previous findings. Unresolved actions from a prior inspection appear repeatedly within the comments and are the most avoidable finding available.

Make training structured and evidenced. Protected time and a record of it distinguished the compliant pharmacies, and both are within a sole owner's gift.

Walk the premises as an inspector would. The refrigerator, the floor, the expiry checks, the consultation room and the security of access account for a substantial share of failures and require no capital.

Consider whether the services gap is compounding. If limited governance capacity is preventing a move into commissioned services, that decision is also withholding the funding which would improve capacity, and breaking that circle is a strategic question rather than a compliance one.

What does the study not show?

Four limitations warrant stating, three of which the authors identify themselves.

Inspection outcomes represent performance at a single point in time and do not describe ongoing practice. The relationship between vaccination provision and inspection outcome is associative rather than causal. The analysis does not distinguish between vaccination service models, whether NHS-commissioned, locally commissioned or private. And the data predates both the January 2025 changes to the inspection model and the updated inspection framework published on 13 January 2026, which replaced the 2019 version, added guidance on supervision and delegation, hub and spoke services and prescribing, and introduced new categories inspectors may record covering good practice and areas for improvement. The framework generating these outcomes is accordingly not the one operating now, and for weight management services in particular the current framework makes failure to independently verify weight, height or BMI an inspection failure, as the verification duties article sets out.

A further point of method deserves noting for readers who assess evidence carefully. The thematic analysis of inspector comments was assisted by a large language model for initial visualisation and categorisation, with the authors stating that all outputs received academic oversight and that coding followed an established thematic analysis framework with themes agreed by all authors. That is a transparent and increasingly common approach, and it is disclosed rather than concealed, which is the appropriate treatment.

Key takeaways

  • Across 2,197 routine inspections from 2022 to 2024, 87.5 per cent of pharmacies met all twenty-six standards, a figure which excludes re-inspections and intelligence-led inspections.
  • Seven standards account for disproportionate failure, covering risk management, safety monitoring, records, staff competence, premises suitability, safe service delivery and medicines handling.
  • A consistent ownership gradient was observed, with independent single-owner pharmacies recording four to ten per cent failure incidence against below 1.5 per cent for national chains, attributed to centralised governance rather than professionalism.
  • Vaccinating pharmacies passed more often, at 90.9 against 80.4 per cent, with the association surviving adjustment for ownership, though the authors state it should not be read as causal.
  • Pharmacies lacking governance capacity are less likely to take on commissioned services, and therefore forgo the funding which would improve that capacity, which is a self-reinforcing disadvantage.
  • Inspector comments produced three themes, comprising inadequate governance, insufficient or untrained staff, and unsuitable premises including congested dispensaries and malfunctioning refrigerators.
  • The data predates the January 2025 inspection model changes and the updated distance-selling guidance, since which the regulator has reported improvement in internet pharmacy performance.

FAQs

Across 2,197 routine inspections between January 2022 and December 2024, some 1,922 pharmacies, or 87.5 per cent, met all twenty-six standards. The remaining 275, being 12.5 per cent, did not meet at least one standard. Those figures exclude re-inspections and intelligence-led inspections, which would materially alter the picture since re-inspections follow a recent failure.
AJ
WRITTEN BY
Arham Jamaal
Superintendent Pharmacist · Published researcher, pharmacokinetics
This article summarises Goswami C, Carmel Y, Gittins R, Akram G, Pharmacy 2026;14(4):107, doi 10.3390/pharmacy14040107, published open access on 14 July 2026. Two of the four authors are employed by the GPhC, as declared within the paper. Figures describe routine inspections between January 2022 and December 2024 and predate the January 2025 changes to the inspection model. The current Standards for Registered Pharmacies and GPhC guidance are the authority for what any inspection assesses. General guidance rather than legal advice. Last reviewed 4 August 2026.

Governance you can industrialise.

The gradient this study found is about documented, repeatable process rather than better judgement, which is the one advantage a large chain holds that software can level. Dataforge PMR keeps the near-miss log, the service records and the audit trail that standards 1.1, 1.2 and 1.6 are assessed against, without a compliance department behind it.

See Dataforge PMR

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