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The DHSC and NHS England need to present a more realistic proposal, says Tas Bhatti

The Independent Pharmacy Contractors Network is not supportive of the current independent prescribing proposals, and our current advice to independent pharmacy contractors is that they should not opt into the service under the current model.

We believe the current proposal places significant additional clinical, professional, governance, operational and financial responsibilities on independent pharmacy contractors without providing a sufficiently realistic level of funding to support the service properly.

We believe independent prescribing has the potential to be an important development for community pharmacy.

However, the opportunity must not be confused with the viability of the current implementation model. We should not be asking independent contractors to take on substantial additional clinical responsibility and business risk simply because the NHS has decided that the service should be introduced.

The current prescribing software arrangements are another illustration of this wider problem. With only one EPS solution currently available for community pharmacy prescribers, contractors are potentially being placed in a position where they need to enter into a commercial relationship with a single technology provider in order to participate in an NHS service.

That is not a position IPCN believes contractors should be placed in.

In particular, we would not want contractors entering into lengthy or expensive contracts with a technology provider simply because there is currently limited choice, only to find that alternative NHS approved systems subsequently become available.

However, it is important to stress that IPCN's concern is not specifically about CLEO or about prescribing technology itself. CLEO is essentially a symptom of a much wider issue with the current model. The fundamental question is whether the NHS has created a service that is properly funded and commercially sustainable for independent contractors.

Our position is that it has not.

The current funding needs to be considered against the full cost of delivering independent prescribing, including the pharmacist's clinical time, additional workload, clinical governance, supervision, training, staffing, IT infrastructure, administration, professional responsibility and the wider operational risks associated with becoming a prescribing service.

We therefore do not believe that the existence of the current infrastructure payment should be regarded as resolving those concerns, nor should NHS funding effectively become a mechanism through which a disproportionate amount of the available funding is transferred to technology suppliers.

Our advice to contractors is consequently not to opt into the service under the current model and not to enter into significant long term contractual commitments purely to enable participation.

We believe the Department of Health and Social Care and NHS England need to come back with a substantially more realistic proposal which properly recognises the cost and responsibility of delivering Independent Prescribing.

That proposal should also provide genuine contractor choice around technology, appropriate interoperability and data portability, and sensible arrangements allowing contractors to change systems as the market develops without being exposed to punitive exit costs or disruption to patient care.

IPCN will continue to make these concerns known to DHSC, NHS England and other relevant stakeholders. We remain supportive of pharmacists making greater use of their independent prescribing skills, but we do not support the current model of implementation.

Independent prescribing needs to be properly funded, commercially viable and sustainable for independent pharmacy before contractors are expected to participate.

Tas Bhatti is a pharmacy owner and director at IPCN