The missing layer

Overflow capacity in Australian community pharmacy

Posted 19 May 2026 · By a Qiri staff contributor · 5 min read

Every other part of Australian healthcare has built overflow capacity. Hospitals have surge wards and locum medical workforce agencies. General practice has after-hours services and home doctor networks. Emergency departments have urgent care centres siphoning the simpler end of the queue.

Community pharmacy has none of this. When the bench is overloaded, the only release valves are the same two it had thirty years ago. Pay more for a locum, or push the queue out into the afternoon.

That gap is becoming uneconomic to leave open.

What's changed

Three pressures are arriving at the same time, and none of them are temporary.

The workforce gap is structural. The Pharmaceutical Society of Australia's National Pharmacy Workforce Analysis, run with the University of Queensland, frames community pharmacy as short by approximately 1,657 FTE pharmacists, against a wider profession shortfall of around 2,725 FTE.¹ Regional and remote Australia carries the worst of it. About one in ten pharmacists report they plan to leave the profession soon.²

Locum economics have plateaued. Raven's Recruitment Pharmacy Salary and Market Report, summarised in AJP in mid 2025, notes that the gap between top and bottom locum hourly rates is tightening and that owners have hit the ceiling of what they will pay.³ At an average locum rate around $72 an hour,⁴ a single regional pharmacy covering even a moderate locum book sits in the order of tens of thousands of dollars per year in overhead, before factoring in agency fees, travel, accommodation, or the owner's time managing the roster. Owners cannot raise the bid further. The market has met the limit.

Regulatory change is adding script volume without adding pharmacists. From 1 July 2024, vape retail supply outside pharmacy became unlawful, and from 1 October 2024 lower-strength nicotine vaping products moved to Schedule 3, pharmacist-only supply.⁵ Pharmacy is now the single legal supply channel for therapeutic vapes in Australia, and the PSA's own guidance flags that pharmacists should expect increased demand for nicotine dependence management as a consequence.⁶ On a separate axis, the Therapeutic Goods Administration authorised approximately 979,000 medicinal cannabis prescription applications through its Special Access pathways in 2024 alone, with the market on track to clear AUD$1 billion in sales by the end of 2025.⁷ Authorised prescriber numbers have grown from fewer than 100 in 2019 to more than 1,700 in 2025.⁸ The operational fact for the dispensary is more scripts hitting the same bench.

The pattern the bench already knows

Anyone who works community pharmacy in Australia knows the shape of the week. Monday morning carries the weekend's accumulated scripts and the early-week prescriber backlog. The day after a public holiday is worse. Post-Christmas is its own category. Regional and rural sites without a second pharmacist on the floor cannot stretch to absorb these peaks. Metro sites with a second pharmacist can stretch, but the second pharmacist was already booked into vaccinations, MedsChecks, or a UTI consultation under expanded scope.

The pharmacist on shift has three options. Stretch and accept the safety cost. Push the queue back and accept the customer-experience cost. Or pay above the market for a same-day locum if one is even available, and accept the financial cost. There is no fourth option in the current toolkit.

Where locums fit, and where they don't

The locum model has a clear place. It works for planned leave, rostered coverage, and known absences booked in advance. It does not work as well for the kind of peak the bench actually faces day to day, which is a few hours of overload triggered by something the pharmacy could not predict to the day. The locum supply chain is not built to spin up for a half-day surge, and even when it can, the cost-per-script of doing so is punitive. Rates plateauing at the top end is the symptom that this single-channel model is at the end of what it can deliver on its own. Overflow capacity does not replace locums. It reduces reliance on them for unpredictable peaks, and lowers the loaded cost of the days they still need to be booked.

The category that needs to exist

Overflow capacity, as a category, is what the rest of healthcare has built and pharmacy has not. The defining features are:

• Remote, so geography is decoupled from supply.
• On-demand, so the unit of work is the script or the queue, not the shift.
• Compliant with AHPRA's requirements for pharmacist verification, so it is supply, not surveillance.
• Priced as variable cost, so it scales with the peak instead of sitting idle in the trough.

None of those features are exotic. Adjacent industries have built them. The reason pharmacy has not is that the dispensing software stack was built in the 1990s for a model of work that did not anticipate any of the three pressures above, and the regulatory environment for remote pharmacist verification has only recently caught up with what is now technically possible.

How Qiri thinks about it

Qiri is building the layer that makes overflow capacity practical. The clinical reasoning engine triages and prepares the routine end of the queue so a remote AHPRA-registered pharmacist can verify at volume. The pharmacy keeps the patient relationship and keeps the regulatory chain of custody. The pharmacy also gets capacity that was not available to it before. We think this is the first time the unit economics work in favour of overflow capacity rather than against it.

That is a thesis. We are testing it now with pharmacists who carry the bench reality. If you run, own, or work a community pharmacy in Australia and have a view on whether this is the right frame, we want to hear from you. The Journal is open to letters and counter-arguments. Burnout and the alert override rate, which we have written about previously,⁹¹⁰ are the surface symptoms. The deeper diagnosis is that the system has no overflow layer at all. Building it is the work.

If you want to talk to us about co-designing what overflow capacity looks like for your store, reach us here.