In Views

Follow this topic

Bookmark

Record learning outcomes

We’re being asked to prepare for a clinical future that hasn’t yet been commissioned, writes Malcolm Harrison

Independent prescribing has the potential to be transformative for the profession, for patients, for the community pharmacy sector and for wider primary care.

With demand increasing across the NHS, the sector has argued for decades that community pharmacists are an underused clinical asset.

They are highly trained, accessible and well placed to deliver care closer to peoples’ homes, which is exactly what the government wants to achieve through its 10-year plan.

Are we really ready?

Independent prescribing in England is finally moving from ambition to reality.

From Autumn 2026, NHS-funded independent prescribing will begin to roll out in community pharmacy in England. But that shift brings a difficult question with it: are we really ready?

Independent prescribing would allow pharmacists to use more of their clinical skills, reduce unnecessary onward referrals and give patients faster access to treatment.

On paper, it is a no-brainer, but in practice, it is more complicated than that.

This is not a question of whether pharmacists are capable. Community pharmacy has shown time and again that it can adapt, expand and deliver when the right framework, funding and support are in place.

We saw that during the COVID-19 vaccination programme, in the rollout of Pharmacy First, and in the growing range of clinical services now being provided.

The sector has demonstrated flexibility, capability and a clear willingness to do more.

Having said that, we need to understand that prescribing is not simply another service to slot into an already overstretched working day.

It brings a different level of responsibility, accountability and clinical risk, and it demands a different level of operational readiness in return.

To do it safely and consistently at scale, pharmacy businesses need more than just qualified professionals.

Ensuring independent prescribing’s success requires substantial changes

Prescribing must be built into the entire pharmacy operating model, and not just on the back of a single individual’s qualifications.

A service that works only because one capable pharmacist is holding it together is not a scalable model. To provide independent prescribing, pharmacies need workforce capacity, redesigned workflows, clear governance, reliable record keeping, appropriate consultation space, digital tools that support safe decision-making, and teams set up to work differently. Services need to be delivered consistently and not only when a particular pharmacist is available.

That is where some tension lies. At present, the sector is understandably cautious about making major investments in systems, premises, staffing and service redesign without clarity on long-term commissioning plans.

Whereas commissioners may be reluctant to move at pace unless they are confident the sector is operationally ready.

The result appears to be an age-old chicken-and-egg situation. Businesses are being asked to prepare for a clinical future that is not yet fully commissioned, while the system waits for visible readiness before commissioning and subsequent funding.

Laying the groundwork now

However, this does not mean the sector should stand still. There is important preparatory work that can and should happen, and pharmacy businesses should already be thinking about what a clinical future means in practice. Pharmacies need to be asking themselves some hard questions now.

Are current staffing models compatible with more clinical care? Can dispensing workflows be redesigned to embrace the supervision changes and free up pharmacists’ time for prescribing? Are governance arrangements strong enough to support safe, auditable practice across multiple sites? Do teams have the right mix of skills, including making the best use of technicians and support staff? And are decisions about premises, equipment and digital infrastructure being made with a prescribing future in mind?

The current financial climate is a worry for many in the sector, however there are good reasons to be optimistic about independent prescribing.

Recent national announcements have confirmed both new investment in community pharmacy and the intention to roll out NHS-funded independent prescribing from autumn 2026.

All newly qualified pharmacists in England will enter the register as independent prescribers from September 2026 and the NHS in England continues to expand training routes for existing registrants.

But policy intent on its own will not make prescribing work. Success will depend on whether national ambition is matched by local readiness, sustainable commissioning and realistic implementation.

Community pharmacy has proved before that it can quickly adopt innovation and scale up change when the circumstances are right. But if independent prescribing is to work at scale, it cannot rely on individual pharmacists prescribing whenever the opportunity arises.

It must be supported through business models, service design and system-level commissioning that make safe, consistent prescribing possible in everyday practice, across all pharmacies.

The real question is not whether prescribing is the future, but whether the NHS, the profession and the community pharmacy sector are prepared to build for it.

Malcolm Harrison is chief executive of the Company Chemists’ Association