A “major expansion” in the number of pharmacist IPs joining the register from September could be “undermined by gaps in supervision, training and workforce planning” which could, in turn, put plans to shift more care into the community at risk, a Nuffield Trust report has warned.
Published today, it highlighted that newly qualified prescribers will require “strong supervision and continued professional development” as they will often be “relatively inexperienced in their chosen clinical area”.
But research carried out by the Trust – between September 2025 and January 2026 – found that access to supervision in community pharmacy is “already limited” with “shortages of suitable supervisors and inconsistent arrangements for providing oversight” reported.
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“Without stronger planning and support”, there is a risk that newly qualified IPs “may not be able to use their skills in practice” which could “potentially lead to a loss of confidence” or even “movement into private sector roles”, the report warned.
It highlighted that access to funding for training “is piecemeal and fragmented and does not support the full costs of training” – such as clinical supervision and continuing professional development.
“Lack of access to DPPs”
It also noted that there is a “risk of deskilling for IPs who do not use their prescribing rights in practice”, adding that “additional assurances are needed for IPs to ensure those who do not prescribe often are up to date on their knowledge, competencies and skills”.
“Some local leads expressed the desire for the national commissioning of independent prescribing in community pharmacies,” it also found.
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The report emphasised that these issues are “particularly significant” for community pharmacy, where pharmacists are “currently least likely to be actively prescribing despite having the highest proportion of prescribers within their profession”.
And it said that challenges for IPs in the community include “a lack of access to designated prescribing practitioners (DPPs)”, a failure to address independent prescribing in “national policies and plans” and concerns that information on prescriptions from pharmacies and other settings “does not get recorded in the patient’s medical record, or is not easily accessible”.
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The Trust’s research also highlighted that “there is a need for better monitoring across the board on the prescribing patterns of IPs” to enable a deeper understanding of the “balance of risks and benefits from widening prescribing roles in different settings”.
It found that independent prescribing “could be of great benefit in support of an ageing population and the increasing prevalence of people with long-term conditions” but noted that “the role of IPs in medicines reviews and de-prescribing could be strengthened”.
And it said that it will be “essential” that further iterations of the NHS Long-Term Workforce Plan “address the future of independent prescribing”, including details on the roles IPs can be expected to undertake in neighbourhood health teams.
“Worrying barriers”
Other recommendations from the report include:
- Considering the “balance of incentives” for independent prescribing in community pharmacies to ensure that prescribing qualifications are used in the community while also recognising resource needs for supervision and support
- “Commissioning an evaluation of the effectiveness and cost-effectiveness” of independent prescribing across different settings
- Designing an “independent prescribing monitoring system”, including the monitoring of antibiotic prescribing rates and “ensuring that the risk of over-prescribing is considered within monitoring”
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Commenting on the report, Nuffield Trust deputy director of research Sarah Scobie said that “we have an ageing population which is now living with more health issues, and the government hopes its ambitions to shift more care closer to home will tackle some of the problems this poses”.
She stressed, however, that the NHS “will need to harness the full potential of its fast-growing prescribing workforce to realise this change” as the Trust’s report “identified some worrying barriers”.
“To get the most out of independent prescribing, the forthcoming NHS workforce plan must set out clearly the role prescribers will play within neighbourhood teams, and plans must be based on local population needs,” Scobie said.
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“Better monitoring of independent prescribing practice in all settings will also be crucial,” she added, noting that without this, “the opportunities presented by the incoming wave of new pharmacist prescribers will sadly be missed”.
National Pharmacy Association (NPA) chief executive Henry Gregg said that the body shares the Trust’s concerns about the “insufficient planning by the NHS and government to utilise the skills of thousands of IPs”.
“As this report notes, in all professions new prescribers need proper support networks and adequate clinical supervision,” he said.
And Gregg reiterated that prescribing “absolutely cannot come at the expense of fully funding pharmacies for their dispensing work but without improved planning”.
