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NHS England (NHSE) has said the decision to pay pharmacies the same £17 fee for prescribing consultations as with PGD-based supplies under Pharmacy First was a “very deliberate” one.

Anne Joshua, deputy director of pharmacy commissioning at NHSE, made the comments in a talk at the Pharmacy Show in Birmingham yesterday (October 12).

Asked by P3pharmacy whether the fee should be higher in light of factors like the increased liability risk associated with independent prescribing activity, Ms Joshua replied: “The agreement we've had with Community Pharmacy England and when we consulted alongside Department of Health is [that] the actual fee per episode of care is the same whether it involves a prescriber or a non-prescriber.

“We've taken a very deliberate view on this, and one of the things we didn't want to do was to incentivise the prescriber.”

“Making the payments not dependent on the prescription being issued… was a very key principle. 

“So it's the same, there is no change in that whether it's a PGD or whether it's actually a prescribed prescription.”

She pointed to the £500 set-up fees for pharmacies participating in the IP Pharmacy First expansion and the £525 monthly payments – which some contractors have warned could be eaten up by IT fees and other costs, such as staffing.

On the IT arrangements for prescribing, Ms Joshua predicted that it will take between 18 months and two years to achieve integration with pharmacies’ existing digital systems they use to record other NHS services. 

In the meantime, pharmacies will be required to use a standalone module to record and claim for IP consultations.

At present, Cleo’s EPS2 module is the only approved solution – but the trade show heard yesterday that in early 2027 rival IT suppliers will be advised of the technical requirements to build their own modules, with Ms Joshua saying NHSE assurance teams will then work with these suppliers to get them assured “as quick as the fastest can be”.

The talk also heard from NHSE pharmacy integration lead Wasim Baqir, who said a Prescribing Development Programme (PDP) will seek to explore prescribing opportunities for pharmacies beyond the Pharmacy First clinical pathways. 

Mr Baqir said: “We're really keen to really work with you, ICBs and community pharmacy yourself to to see what more support we can give.

“We've got lots of ideas and over the coming months we're going to start engaging with the with the sector more.

“We know that the national service is going to be good. It puts a baseline governance process in place for all prescribing pharmacies.

“But we also know from the Pathfinder [programme] that community pharmacies can do a lot more.”

He referred to Pathfinder pharmacies that helped “manage long-term conditions like cardiovascular disease, patients with blood pressure and lipid management, respiratory disease… there's a lot of, a lot of really complex stuff that we were doing really well”.

“We want to really understand over the next year and a half what it looks like for, local commissioning and especially local commissioning across, neighbourhoods.

“We're going to be working with our ICB colleagues on a neighbourhood test beds program where we focus on cardiovascular, kidney, and metabolic disease.

“We’ll look at the role of pharmacy, community pharmacy in that pathway, and we look at what interventions community pharmacy are doing.”

Advising audience members to “watch this space,” Mr Baqir said any potential commissioned services that result from the PDP’s work will be commissioned at the local level by integrated care boards (ICBs) and not at the national level.