Some sort of 'mechanism' is needed to enable joined-up care for patients whose long-term conditions are being managed by community pharmacist prescribers in the future, chief pharmaceutical officer (CPhO) for England David Webb has suggested.

Speaking via live video link to the Sigma Conference 2025 in Baku, Azerbaijan, the three CPhOs for England, Scotland and Northern Ireland were asked whether they thought requiring patients to register with a pharmacist, as they do with a GP, would help 'ensure that there is a job role' for community pharmacist independent prescribers.

Data shows that 21,804 pharmacists now have an independent prescribing (IP) annotation, representing 33% of all registered pharmacists.

And from 2026, new pharmacists will join the register as prescribers.

Mr Webb responded that he was 'not sure' that registration was the answer, but suggested that where independent prescribing was used to support a patient with a long-term condition such as diabetes, having a 'collaborative arrangement' between everyone involved in the patient's care, as well as 'a mechanism to support people through that', was needed.

He said pharmacists and pharmacy technicians were 'ready to make a profound contribution' to achieving the government's vision for healthcare 'in terms of prevention, long-term conditions management, patient safety, elective recovery and many more areas'.

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While he had not seen the government's incoming 10-Year Health Plan expected in June, Mr Webb said that from his perspective, 'pharmacy and medicines optimisation are critical elements' within the shift from hospital to community, from treatment to prevention, and from analogue to digital.

'Pharmacy expertise is absolutely essential in all NHS teams across all sectors, in my view, and pharmacists and pharmacy technicians are highly skilled, relatable professions that are trusted by the public,' Mr Webb said.

'The three shifts, in my view... could have been written for pharmacy,' he commented.

However, in order to achieve the government's shift, he suggested 'we need to enhance the capacity and support and flexibility available to integrated multi-professional neighbourhood teams'.

'And our professional practice will need to orientate around helping people use medicines more effectively, and that's grounded in data and organised where people need those services, whether digitally or in person,' he added.

'I believe community pharmacy teams can make a real impact by continuing to focus on medicines optimisation to increase value, efficacy and safety, helping prevent hospital ambitions, addressing health inequalities and supporting the prevention of ill health. Pharmacists and pharmacy technicians have a key role to play in helping frail, vulnerable and complex patients in primary care and preventing avoidable admissions.'

Alison Strath, CPhO for Scotland, highlighted that the 'infrastructure that allows us to work really effectively' also needed to be considered.

'I'm not sure, necessarily [about] registration... I think it is more about that collaborative approach and how we work together,' she told Sigma 25 delegates earlier today.

'Integration happens because individuals make it work,' she added later in the session.

She suggested that community pharmacy was 'really well placed to do that', because it has 'people at the centre' of what it does.

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'I think as long as we keep that to the core of what we're doing, we'll see pharmacy flourish,' she said.

And she suggested that changes to the profession, including supervision legislation, could help pharmacists 'be more effective at how you integrate and work with others'.

Meanwhile, Cathy Harrison, CPhO for Northern Ireland, said that patient registration for pharmacies had 'never really materialised' when it had been proposed in the past.

'I'm not sure... if that is the model we need to go to,' she said.

Instead she suggested that commissioning might be a helpful focus when considering services that included pharmacist prescribers.

'In community pharmacy, I think we're going to move very quickly in the next two years, away from just solely looking at acute single episodes of care in Pharmacy First, into longer term condition management. To do that, community pharmacy needs to have a recognised, identified and formalised role within integrated clinical pathways, so that also needs to be wrapped up in different commissioning roles,' she said.

'I think there's a real opportunity here to work with primary care more collectively.'

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Ms Harrison added: 'I do think we need more collaborative work between community pharmacy and general practice... I think that will be an interesting journey... it is really the beginning of a period of immense change.'

And she stressed that appropriate funding would be a 'key enabler' for this, as well as the growing evidence base around the importance of the 'left shift'.

Last week, NHS England representatives shared that more than 17,000 community pharmacist prescribing consultations had taken place so far as part of the pathfinders project.