To achieve the necessary objective of an increasingly integrated and cost effective healthcare service organised, as far as possible, on prevention rather than cure will require out of the ordinary policy changes. The purpose of Medicine Use Reviews (MURs) is to assist patients to use their medicines more effectively, improve their safety and reduce medicine wastage occasioning reduced costs to the provider. A one-year trial of MURs in Guernsey commenced on 1st November 2007, two and half years after their introduction in the United Kingdom. (The States of Guernsey subsequently approved their permanent adoption). The processes leading to the implementation of the MUR service in Guernsey were evaluated employing the Context, Mechanism and Outcome (CMO) model of Pawson and Tilley (2004). Using a mixed methods approach both quantitative and qualitative methodologies were applied to collect and analyse the data. The provision of healthcare services is strictly controlled by laws and regulations, in many instances, specific to the island and its defined community. Thus, two significant strengths of this study were the availability of accurate data which enabled the creation of precise statistics and the ease of access to stakeholders. However, there were limiting factors, primarily those of confidentiality and the small number of GPs (4) and community pharmacists (3) who agreed to be interviewed. At an early stage in the project the researcher became conscious of the emergence of three significant and inter-related concepts, namely those of time, training and tools. All tasks require time to be accomplished, every task requires training and no task can be completed without the correct tools (facilities). Also conspicuous was the frequency the significance of mutual trust was specified by interviewees. The indications are that the concept of the MUR is sound and that, in collaboration with other healthcare professionals, pharmacists have a public health role to play, especially in promoting health education and offering advice. However, one of the major issues currently facing pharmacists is the lack of trust placed in their capabilities by other healthcare professionals and patients. Nonetheless, given the necessary time, tools (facilities) and an enhanced training coupled with access to patient medical records, community pharmacists can carry out a useful and vital role in public health promotion.