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Where are all the designated prescribing practitioners?

There simply aren't enough designated prescribing practitioners (DPPs) to meet the ambitious plans for more independent prescribers (IPs), warns Danny Bartlett. But could better funding streams provide a solution?

With an ever-increasing demand for DPPs for trainee independent prescribers (IPs), it’s hard to see how all sectors will cope with the supervision burden edging closer in 2026.

The new General Pharmaceutical Council (GPhC) standards for the initial training and education of pharmacists proposes to incorporate independent prescribing – meaning all foundation pharmacists and undergraduates will not only require a foundation year tutor, but also a DPP.

Read more: What does the NHS workforce plan really mean for pharmacy staffing issues?

A DPP is an experienced healthcare professional, who must also be a qualified IP. Their role is to supervise and mentor pharmacists completing their training on an IP course. This will include foundation pharmacists from 2026, as it will be incorporated into their initial education.

Currently, there is already a supply demand for DPPs. Through my own experience, I have found that both general practice and community pharmacy don’t appear to have the robust workforce plans required to increase the numbers of DPPs in these sectors.

Having been an IP for three-and-a-half years myself, multiple people have approached me asking me to become their DPP – even though some of them have worked in a different sector to me.

The role of a DPP shouldn’t be taken up unless proper time can be given to the trainee prescriber, in addition to functioning in their role as a clinician so patient access to services is not reduced. This would strike a tricky balance, and therefore will require adequate planning.

An IP trainee requires 90 hours of supervised practice to demonstrate competency and proficiency in prescribing within their chosen scope of practice – 45 hours of this must be spent with their DPP.

Read more: Maintaining authentic patient contact in the shift to remote consultations

This is a huge time commitment for the DPP, but also for the trainee, who must ensure that the other 45 hours are supervised by appropriate prescribing clinicians within their chosen scope, or relating to their development as a prescriber.

Many of the prescribing pharmacists in community pharmacy that I speak to barely make use of their additional qualification due to the increasing strain and demand on the sector.

Without a rise in key funding streams to allow some free time for these qualified IP community pharmacists, it is hard to envisage them being able to supervise any trainee IPs anytime soon – let alone when the integrated training comes into play.

 

The solution

 

I believe the solution to this increasing problem has two key domains to it: upskilling every existing IP to become a great DPP, and funding them so they have more time to supervise trainees. Recent GPhC figures from this year show that there are over 15,000 qualified IPs, while there are over 62,000 pharmacists on the register. It’s therefore clear that we need to get IPs up to a DPP standard – and those who are yet to complete their training need to be given clear pathways to becoming a DPP.

The Royal Pharmaceutical Society (RPS) published guidance on a clear competency framework for becoming a DPP, and all pharmacists that are actively prescribing should be encouraged to follow this framework to ensure good supervision for incumbent trainees.

Read more: What will the push for access in the new GP contract mean for pharmacists?

In relation to funding, it should be widely accepted and noted by companies that the role of a DPP isn’t simply a title on paper. It is a vital role that requires adequate time and planning to allow the trainee to get the most out of the DPP’s experience and knowledge. 

This means, in practice, any potential DPP in any sector should be backfilled, and the system in which they work in should receive adequate funding in order to maintain routine running of their services. A small, incentivised payment or bursary to support the DPP to take on students could encourage more IPs to take on the role in practice.

Read more: Blister packs: Proof that good things do come in small packages?

For someone who is actively working as a DPP, as well as teaching at the University of Brighton on the prescribing course for pharmacists, my hope is that all prescribing colleagues that can take the mantle of this supervision, do take it on.

It is also clear that goodwill alone won’t solve this incoming prescribing supervision problem; we need clear plans and funding models to ensure we are ready to go when the initial education changes come into force in 2026.

Danny Bartlett is a lead pharmacist at Horsham Central PCN, senior lecturer at the University of Brighton and English pharmacy board member at the Royal Pharmaceutical Society

 

 

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