Abstract Objectives To assess the strong motivators and barriers to the implementation of prescription monitoring and review services by community pharmacists either in pharmacies or in general practitioner (GP) surgeries. Method and setting A systematic review was used to develop questionnaire statements for a two-part postal Delphi survey to a purposive sample of 120 community pharmacists working in Britain. Responses were analysed, a repeat questionnaire was mailed (including feedback of individual and group response), and respondents re-ranked the statements. The main outcome measure was attainment of consensus as to whether the statements represented motivators or barriers. This was defined as 75 per cent of respondents giving a score of ≥5 (a strong motivator/barrier) or ≤3 (not a motivator/barrier) on a seven-point scale. Key results Eighty-four pharmacists (70 per cent) responded to both questionnaires. Consensus was attained that 23 of 24 statements were strong motivators and 14 of 23 statements were strong barriers. There were high levels of agreement that providing a prescription monitoring and review service would improve perceptions of pharmacists, help develop relationships with patients and give pharmacists professional fulfilment. The key barriers to the implementation of these services were their time-consuming nature, locum difficulties, the prohibitive cost and unwillingness of pharmacy owners or GPs to fund services. Conclusions The study suggests that these community pharmacists were motivated to participate in prescription monitoring and review schemes by a complex set of personal, professional and altruistic reasons. However, if such services are to be generally successful, adequate remuneration structures, internal rivalries and the structure and culture of the profession itself also need to be considered.