Independent prescribing to be added to Pharmacy First

The new community pharmacy contract will introduce independent prescribing (IP) as an extension of the Pharmacy First programme.

The Department of Health and Social Care (DHSC) announced today that under the 2026/27 Community Pharmacy Contractual Framework (CPCF) pharmacists who hold an IP qualification will be able to assess patients and prescribe medicines directly.

The department said the changes, which will be rolled out from Autumn 2026, will reduce the number of referrals back to GPs and patients needing to go to A&E.

NHS England’s national director for primary care and community, Dr Amanda Doyle, added: ‘Community pharmacies already play a vital role in delivering NHS care closer to home, and this agreement will make it easier for patients to get advice, treatment, and medicines through their local pharmacy.

‘Expanding independent prescribing will help make better use of the clinical expertise within our community pharmacy teams, helping patients get the right care in the right place while helping reducing pressure on other NHS services.’

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However, while pharmacy leaders supported the plans, they raised concerns that the 10.3% funding uplift in the contract was not enough to enable the ‘full and effective introduction of IP’.

Community Pharmacy England (CPE) said it had raised concerns during contract negotiations that with the proposed funding the addition of IP to the contract risked being set up to fail.

CPE said: ‘We are not persuaded that sufficient investment is being made to enable the full and effective introduction of IP, given the workload, enhanced clinical responsibility, clinical governance and infrastructure requirements that it will entail.

‘Throughout the negotiations, we raised our concerns that with the proposed funding, the addition of IP to the CPCF risked being set up to fail.

‘It will be down to pharmacy owners to decide on an individual basis whether they want to provide the service or prioritise the use of IP skills elsewhere in their business.’

CPE said that under the new contract community pharmacist prescribers will be allowed to prescribe within the existing Pharmacy First clinical pathways as well as provide up to five new Pharmacy First prescribing-only pathways.

These will need to be approved by a clinical reference group before their rollout, but they will count towards the monthly minimum activity requirement.

CPE said that pharmacist IPs will also be able to prescribe an alternative medication where necessary – if the original prescription drug is out of stock for instance.

It added that supporting documentation and changes to the terms of service are expected to follow the contract announcement, which will set out the clinical governance requirements related to new prescribing activities.

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CPE also said the current capping mechanism for Pharmacy First consultations will be retained, and a similar approach will be used for IP consultations.

This means there will be two caps within each band: one applicable to pharmacies signed up to provide prescribing services, and one for those who are not.

CPE also agreed a two-month late claim window for Pharmacy First and the New Medicine Service (NMS) – the two advanced services that still have a one-month claim window – giving contractors a total of three months to make a claim.

The Royal College of Pharmacy (RCPharm) described the introduction of IP as a ‘positive step’ toward delivering more care closer to home – one of the key ambitions of the government’s 10-Year Health Plan.

However, its director for England Amandeep Doll said the shift also brought greater clinical responsibility and time pressures.

‘Its success will depend on sufficient investment in workforce training and capacity, protected time for professional development and system leadership, and strong clinical governance to ensure high standards of care,’ she added.

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‘Without this, there is a risk that the ambition for prescribing in community pharmacy will not be fully realised.’

Olivier Picard, chair of the National Pharmacy Association (NPA), said he was also concerned that the current funding levels will mean that many pharmacies will struggle to take this development forward.

He added: ‘Community pharmacies are ready to play a much bigger clinical role within the NHS, but ambitions for expanded patient services must be matched by sustained funding.’