In the 2026/27 community pharmacy contractual framework (CPCF), announced last week, the Department of Health and Social Care (DH) and Community Pharmacy England (CPE) confirmed that independent prescribing (IP) will be introduced this autumn.
The a nationally commissioned service will be funded by the NHS as “an extension” of Pharmacy First and the pharmacy contraception service (PCS), meaning prescribing can take place within those pathways.
The new contract will also see the introduction of “up to five new prescribing-only pathways” for Pharmacy First, though what exactly these will be has not yet been announced.
And prescribers will be enabled to supply patients with “an alternative item where there is a need” - for example, if supply chain issues impact a prescription.
How will it work?
Pharmacy First funding will now be combined with the contract’s core budget, which CPE said “guarantees the funding envelope to the sector” and “removes the previous risk of underspending”.
Contractors will get a one-off payment of £500 when they sign up to deliver the service and have confirmed their “go-live date” with an electronic prescribing service (EPS) provider.
There will also be a £525 monthly infrastructure fee paid to pharmacy owners, as well as consultation fees based on the pathways delivered.
Read more: CPE announces contract funding deal for 2026/27
The five new prescribing pathways will be paid at £17 per consultation, the same fee paid out for existing Pharmacy First clinical pathways.
Contractors will receive £20 per emergency hormonal contraception consultation, and £25 per initiation or ongoing contraception consultation.
CPE said the “current capping mechanism” for Pharmacy First “will be retained”, but the approach will be extended to include a cap for IP consultations – meaning there will be one for pharmacies signed up to independent prescribing services and one for those which are not.
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The DH said the fixed payment arrangements for Pharmacy First clinical pathways will stay the same, and the new independent prescribing pathways will count towards the payment thresholds.
Contractors will continue to receive £500 for delivering 20 to 29 consultations per month, and £1,000 for delivering 30 or more.
“First step”
Pharmacy minister Stephen Kinnock said independent prescribing will play “a major part” in the “landmark 10-year health plan”.
It will help ease “pressures on GPs, cutting unnecessary red tape and helping patients get the right care closer to home”, he added.
Read more: ‘To put it bluntly...’ The industry reacts to the contract news
England chief pharmaceutical officer David Webb said it was “great news” that community pharmacists will “for the first time be able to prescribe NHS medicines across a range of health conditions as a nationally commissioned service”.
And CPE chief executive Janet Morrison said independent prescribing is “a first step towards making fuller use” of pharmacists’ “clinical expertise”.
“Overlooks reality”
Concerns over funding for the new service were raised by Independent Pharmacies Association (IPA) chief executive Leyla Hannbeck, who said it is “nowhere near enough to end the financial crisis in the pharmacy sector”.
“Allowing pharmacists with an independent prescribing qualification to assess patients and prescribe medicines directly will provide the opportunity for a welcome boost to patients,” she said.
“But patients will only feel the benefits of empowering pharmacies to do more if the doors of their local pharmacy remain open.”
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And Pharmacists’ Defence Association (PDA) policy and communications director Alison Jones said independent prescribing has “clear potential to benefit patients, but it must be delivered safely and sustainably”.
It follows a PDA report published in April finding that community pharmacy’s growing workload is “not sustainable”, and workforce capacity must be increased to support it.
Read more: Pharmacy First should be expanded with new IPs, says CCA
“This announcement once again overlooks the reality on the ground,” Jones said. “Many pharmacies simply do not have the staffing levels, capacity or premises required to take on this significant additional clinical responsibility safely.
“If the government wants this to succeed, it must match ambition with proper workforce planning, investment in staffing and clear standards for safe delivery.”
“Fundamentally misunderstands”
The Independent Pharmacy Contractors Network (IPCN) welcomed the independent prescribing announcement, but raised concerns around governance, funding, training and safety.
It said it must “not be treated as a simple extension of existing service models”, emphasising the “materially different level of clinical responsibility, governance requirement, professional risk and operational complexity”.
“A rushed rollout risks creating unsafe variation, inconsistent governance, increased professional liability, workforce strain and operational pressure on already stretched pharmacies,” the body warned.
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It said funding should be ringfenced specifically for independent prescribing and be supported by “genuine new investment”, rather than “funded by repackaging existing money”.
By funding the new service at Pharmacy First levels, it added, the contract “fundamentally misunderstands the nature of prescribing risk and must be firmly rejected by contractors”.
“IPCN is clear that independent prescribing must not become another example of community pharmacy being asked to do more, carry more risk and absorb more responsibility without the funding and infrastructure required to make it safe.”
More lobbying?
In a CPE briefing on the new contract, the negotiator said the government saw adding independent prescribing as “a must” because it was one of their manifesto commitments.
But as C+D reported last week, CPE was “not persuaded that sufficient investment is being made to enable the full and effective introduction of IP, given the workload, enhanced clinical responsibility, clinical governance and infrastructure requirements that it will entail”.
It said at the time that with the proposed funding, the of independent prescribing “risked being set up to fail”, and pharmacy owners should decide whether to offer the service or “prioritise the use of IP skills elsewhere”.
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And CPE committee member and National Pharmacy Association representative Mike Hewitson commented that during negotiations, the committee faced “impossible choices”, as it was “clear the allocation for IP will not be enough for many pharmacy owners to take on the additional clinical responsibility”.
“By accepting this deal, we hope to signal our continued commitment to IP, and we will now lobby hard for further investment so it can become a genuine success from the next financial year onwards,” he said.
“Common sense”
Meanwhile, Company Chemists’ Association (CCA) chief executive Malcolm Harrison said introducing a national funded IP service is a “generational opportunity” but warned that “unlocking the full potential of independent prescribing will require continued ambition, collaboration, and investment”.
Royal College of Pharmacy England director Amandeep Doll also said it was a “positive step” - but said “progress must not stop here” and called for appropriate support for pharmacists taking on “greater clinical responsibility and time pressures”.
Read more: Gaps in supervision and training could ‘undermine’ IPs, trust warns
And NPA chair Olivier Picard said that while introducing the IP service was a “common sense move”, it is “nowhere near ambitious enough to transform patient access to care”.
“We are also concerned that the current funding levels mean that many pharmacies will struggle to take this development forwards, risking its success,” he added.
