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Competing Interests: Competing interests: We have read and understood BMJ policy on declaration of interests and have the following interests to declare: SHB is clinical lead for cancer for Leeds Office of West Yorkshire Integrated Care Board. In this role he has supported a scheme to facilitate community pharmacists to advise patients with common respiratory symptoms to have a chest x ray. During 2017-21 he was an executive committee member of the Fabian Society, a political think tank affiliated to the UK Labour party. In this role he co-edited a series of essays on health inequalities, the publication costs of which were paid for by the Association of the British Pharmaceutical Industry and Lloyd’s pharmacies. WTH sits on a primary care advisory group for NHS England and has advised on the current pilot of pharmacy cancer detection. He is a co-applicant on an NIHR funded study aiming to optimise colorectal cancer detection through pharmacies. All authors are writing in a personal capacity, and opinions expressed here should not be considered to represent the views of any organisation to which the authors have an affiliation. Provenance and peer review: Not commissioned; externally peer reviewed.