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Pharmacy’s ‘Great Prescribing Future’ is an uneasy fit with a contract that predates smartphones, writes Outsider

It’s only six months until the end of the summer holidays, holidays planned often months if not years in advance. That means it’s also six months from the arrival of the next wave of MPharm graduates – graduates who, if all goes to plan, will emerge from their Foundation Training Year in 2027 as fully fledged independent prescribers (IPs). 

Like many holidays, the planning for this has been years in the making, at least in theory. In reality, the road between ‘graduate’ and ‘IP’ is beginning to resemble Dad claiming he’s taking that never-ending shortcut on the way to the caravan park.

The problem isn’t the graduates. They’ve been meticulously shaped by the new Initial Education and Training standards that bake prescribing exposure into the curriculum with the confidence of a chef adding garlic: boldly, repeatedly, and without apology. They’re trained for clinical practice, ready for diagnosing, ready for personalised care. They are, in essence, the pharmacy profession’s answer to plug-and-play prescribers.

But plug-and-play only works if someone remembered to install the power socket. And that’s where we begin to look askance at this new model. Because while the 2026 graduates will march out confidently, they still need Designated Prescribing Practitioners (DPPs) – actual humans, not theoretical constructs – to supervise their practice, sign off their development, and turn their hard won theory into realworld prescribing competence.

Except there’s a small wrinkle. There aren’t enough DPPs. Not by a long shot. The system, which already struggles to produce enough clinical supervisors for existing programmes, is now meant to conjure an entire new supervisory workforce out of thin air. The plan appears to assume that DPPs grow on trees. They do not.

This shortage creates an awkward set of possibilities. Firstly, students may not receive a foundation training place at all if providers are told, solemnly and apologetically, that without a DPP they can’t offer a clinical year. Secondly, providers may accept trainees anyway, in the optimistic hope that a DPP will materialise at some point between August and Christmas, like a benevolent prescribing fairy. 

And if no such miracle occurs? Then a trainee might reach the end of the year having successfully completed absolutely everything – except the part where they get to practise prescribing. Meaning no IP annotation. Meaning they emerge into the job market not as the promised next generation clinicians, but as graduates with a missing piece of paperwork because the system ran out of supervisors.

And then there’s the final and most galling option: that these bright, clinically trained graduates simply look elsewhere. General practice, industry, Canada, New Zealand, anywhere with an actual plan. The profession has spent years trying to persuade students that community pharmacy is a vibrant, modern, clinically progressive career option. Discovering that their Foundation Training Year may turn into a game of “Find the Supervising Adult” is unlikely to help.

Meanwhile, community pharmacies themselves are still scrambling through the wreckage of the last decade. Funding pressures continue to squeeze the sector like a Victorian corset: dispensing at a loss one minute, battling staffing costs the next, all while trying to keep up appearances for patients understandably concerned about cost-of-living crises. 

Into this environment strolls the expectation that pharmacies will smoothly host prescribing placements, supervise future clinicians, and embrace service expansion – all while still operating on a contract architecture that predates smartphones.

Where then are Community Pharmacy England (CPE)? One must imagine CPE as a sort of national level stage manager: dressed in black, clipboard in hand, assuring everyone that the next act is going wonderfully, while behind the curtain performers are improvising with no props, half the lights have blown, and the set is held together with pharmacy tape. CPE will insist it is planning for the future, and perhaps it is, but its planning has the feel of someone dusting the mantelpiece while the chimney collapses quietly behind them.

The sector needs a contract that acknowledges prescribing – correction: anything but dispensing as core, not optional. What it has instead is a negotiator still trying to prop up the old dispensing-based framework with periodic injections of funding – funding that, while significant, remains too late and too small for the job. A negotiator that demands an increase in funding that contractors can only dream of but will nonetheless pay for.

What the profession requires is honest clarity: if the 2026 cohort is to become the 2027 prescriber workforce, the system must deliver DPPs, prescribing-enabled placements, and sufficient clinical service pathways. Without these, the promise of a prescribingready profession becomes little more than an annual marketing slogan – ambitious, inspiring, and largely fictional.

Six months isn’t long, but it must be long enough for the sector to either confront these gaps head-on. The graduates will arrive on schedule. Whether the system that receives them is equally prepared remains an open question – and a slightly worrying one at that. 

Outsider is a community pharmacy commentator