Scotland has highest proportion of independent prescribers in the UK

Scotland has the highest proportion of pharmacists with an independent prescribing (IP) qualification in the UK, a new analysis has found.

A Nuffield Trust analysis of General Pharmaceutical Council (GPhC) data found that in March 2025 almost half (48%) of pharmacists registered in Scotland were IPs, compared to 44% in Wales, 33% in Northern Ireland, and 32% in England.

This variance may be caused by the ability to access funded independent training places and differences in commissioning and prescribing in community pharmacy services in the devolved nations, the report said.

It also noted that pharmacy placement providers in England receive less funding than those in Scotland and Wales – an estimated £20 per day per student in England compared to £120 in Wales and £150 in Scotland.

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And data gathered from one university in Scotland suggested that all applicants were offered a place on the independent prescribing course. Data from two universities in England showed that the number of applicants relative to the number of places available on IP courses had increased since 2023.

The report highlighted that Scotland has national plans to expand the IP workforce, with NHS Education for Scotland increasing funding for pharmacist IP training and new places being funded to meet growing demand across the community, hospital and primary care sectors.

As in England, all newly registered pharmacists in Scotland will be pharmacist IPs from 2026 – part of wider plans to expand the role of pharmacists in clinical care. And the Royal Pharmaceutical Society (RPS) in Scotland has set out an ambition for all patient-facing pharmacists to be IPs by 2030.

In September 2020, the NHS Pharmacy First Plus service was introduced in Scotland, allowing community pharmacist IPs to prescribe treatment for a wider range of common clinical conditions than under the original Pharmacy First scheme.

There is an expectation that all community pharmacies in Scotland will provide a Pharmacy First Plus service by the early 2030s, the Nuffield Trust report said.

Currently, there is no equivalent enhanced service in England, the Nuffield Trust said. An independent prescribing pathfinder programme was set up in 2023 to establish a framework for the future commissioning of NHS community pharmacy clinical services incorporating independent prescribing.

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This pilot programme formally ended on 31 December 2025, with most ICBs continuing to fund their pathfinder sites until closedown on 31 March 2026. The Westminster government is now consulting on a national prescribing service.

In a letter sent to integrated care boards (ICBs) on 30 October 2025, NHS England said that a national prescribing service, offered by community pharmacies, would be informed by the pathfinder programme.

And an independent evaluation of the programme, conducted by researchers from the University of Manchester and ICF International, said that any national service must be implemented ‘incrementally’ with sufficient funding.

Several pharmacy leaders have called for independent prescribing to be embedded in the next pharmacy contract, which the government and Community Pharmacy England (CPE) are still negotiating.

Chair of the National Pharmacy Association (NPA) Olivier Picard, speaking at the 2025 Sigma UK Conference, said: ‘The reason it’s not happening in England is because of other healthcare professionals. They don’t respect us, they don’t trust us, and they don’t think we are able to do the job.’

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The Nuffield Trust report also said that Scotland also had the highest proportion of Nursing and Midwifery Council (NMC) registrants with an IP qualification (10%) followed by England (9%), Wales (6%), and Northern Ireland (5%).