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Health leaders and patient representatives who took part in a summer roundtable discussion on independent prescribing (IP) called for the establishment of national standards to ensure its safe, effective and consistent delivery in community pharmacy.

The discussion in London in July, which involved the Royal College of General Practitioners, Doctors' Association UK and the Patients Association as well as representatives from pharmacy, examined research commissioned by the National Pharmacy Association (NPA) which pulled together the views of pharmacists, other primary care professionals and patients about IP.

The research had uncovered deep concerns, with only 30 per cent of 187 community pharmacists who took part saying current infrastructure was “adequate for scale” and 76 per cent of prescribing pharmacists insisting better funding was needed to expand IP.  Funding and IT were described as “the two critical bottlenecks”.

In a report summarising the roundtable’s findings, published today, the NPA said the experts “broadly” recognised the research was “an accurate reflection of current experience across all attendee groups, including the devolved nations”. However, some experts thought the sample size of professionals who took part, in particular 15 GPs, “was too small to be a definitive evidence base”.

“There was a clear request for further, more active recruitment of GPs, patients and other professional groups before the findings are used more widely,” the NPA said.

Patient perspective is 'more explicit and more continuously present'

Nonetheless, the discussion centred on a draft national framework of IP standards, developed by Thiscovery and the NPA, laying out the conditions needed for the expansion of IP and ensuring the “patient perspective” is “more explicit and more continuously present” in the standards.

“There was strong support for a nationally set minimum standard or baseline independent prescribing offer, paired with local flexibility in delivery, to avoid inconsistent patient access to IP across the country (a postcode lottery),” the report said. “And a clearly identified gap around who provides practical implementation support to make this happen locally.”

The report said “the biggest single takeaway” from the discussion was “the gap” between pharmacists feeling they are ready to roll out IP and “perceived readiness among other professions and the public”. Some experts felt this was “fundamentally a trust and visibility problem rather than a genuine competence gap”.

When it came to Pharmacy First, which was integrated into IP as part of the 2026-27 funding settlement and will have five new prescribing clinical pathways added it to from this autumn, the experts felt patient awareness of IP “had been a ‘flash in the pan’ and called for “a consistent public message”.

The experts also agreed that integrated IT and shared access to patient records was “central to safe scaling” of IP but they “flagged that what patients understand and expect around record-sharing needs testing directly with them rather than assumed”.

The report warned “ongoing GP industrial action adds further complexity to record access in the short term”.

The research did not address de-prescribing

The report added: “The discussion also raised a further question for the framework to address directly: what level and type of record access community pharmacist prescribers themselves would need to support safe prescribing and continuity of care.

“For example, read-only versus read-write access, and access to which parts of the record. An existing shared-care-record model (read-only, cross-sector, tested over two years in a regional pilot) was cited as evidence this is deliverable at scale.”

The report noted the research did not address de-prescribing, prescribing data collection or audit-trail practices or the risk of de-skilling for prescribers who use their qualification infrequently.

Responses to an anonymous poll submitted after the framework presentation called for IP to be “explicitly” embedded “in existing local planning conversations, including urgent and emergency care, single points of access and neighbourhood health planning, rather than treating it as a standalone workstream”.

The NPA said the “framework and roadmap” for expanding IP over the next three years will be published on September 24. Insisting IP is “one of the greatest opportunities community pharmacy has had in many years”, NPA vice-chair Sukhi Basra, who chaired the roundtable, warned “significant obstacles to roll-out remain”.

But she added: “As more pharmacists qualify as prescribers, we have a great chance to bring more care out of hospital and into the community, to improve access for patients and make better use of capacity across the health system.”