Independent Prescribing Independent Pathfinder Programme

From September 2026, all newly qualified pharmacists will be independent prescribers on the day of their registration.

This programme allows qualified healthcare pharmacy practitioners to take on greater responsibility for prescribing medications and managing patients' treatment plans within the NHS, thereby enhancing patient access to medicines and healthcare services.

There is recognition that harnessing the skills and workforce capabilities of pharmacist independent prescribers and enhanced pharmacy technician roles would enable pharmacist independent prescribers to support patients with access to treatment in a community pharmacy setting.

Aims

• To support the Fuller Stocktake report’s vision for transforming access to services, improving experience for patients with long term conditions and preventing ill health through integration with neighbourhood teams.

• To ensure we maximise the opportunities for service delivery available from 2026 when all newly qualified pharmacists will become independent prescribers at qualification and create the opportunity to train undergraduate and foundation programme trainee pharmacists as independent prescribers within the community pharmacy sector.

• To build on the investment set out in the delivery plan for recovering access to primary care, which proposes to expand the role of community pharmacy by supporting common conditions through delivery of a Pharmacy First service and expand the NHS Community Pharmacy Blood Pressure Check Service and the NHS Pharmacy Contraception Advanced Service

Service Description Summary

The pharmacy independent prescriber (PIP) would be expected to initiate treatment for non-complex hypertensive patients and support previously diagnosed non-complex patients needing dose adjustment that have been referred by a relevant GP practice. PIPs may also opportunistically identify and measure the blood pressure of consenting adults who come into the pharmacy of those who have not previously been identified as having hypertension or a related condition or who has not had their blood pressure measured by a health professional within the previous six months if clinically appropriate. Pharmacy contractor sites to be registered to provide the NHS community pharmacy blood pressure check service and must be familiar with the NICE Hypertension in adults: diagnosis and management guideline.

Resources

Pharmacist independent prescribers must provide service provision in line with local and national hypertension guidance including: 

·        Hypertension | Health topics A to Z | CKS | NICE

·        NHS community pharmacy blood pressure check service (england.nhs.uk)

·        BP @home – Monitoring Hypertension in Adults - download (hweclinicalguidance.nhs.uk)

·        HWE hypertension treatment guidelines available at download (hweclinicalguidance.nhs.uk)

Service Description Summary

PIPs would provide annual asthma reviews from community pharmacy reviewing patients for step up/step down treatment. There are asthmatic patients which GP practices cannot review because they fail to book annual reviews but will come to the pharmacy to collect inhaler medication; therefore, community pharmacies may identify patients via this route. Alternatively, PIPs may review patients that have been referred by an aligned GP practice that would be able to make referrals from the outset.

Resources

Pharmacist independent prescribers must provide service provision in line with local and national asthma guidance including: 

·        Guidelines for management of confirmed chronic Asthma in adults (hweclinicalguidance.nhs.uk)

·        Guidelines for management of confirmed chronic Asthma in CYP (hweclinicalguidance.nhs.uk)

·        Step down guidance for controlled asthma in adults(18 years and over) download (hweclinicalguidance.nhs.uk)

·        Overview | Asthma: diagnosis, monitoring and chronic asthma management | Guidance | NICE

Service Description Summary

The pharmacist independent prescriber (PIP) may prescribe for any minor illness condition including those outlined in the existing NHS Pharmacy First service. PIPs may prescribe Prescription Only Medicines (POMs) for those conditions and/or patient cohorts not included within the PGDs in the Pharmacy First Service if in line with Hertfordshire and West Essex clinical guidance and prescribing formulary here, enabling scope of practice within agreed prescribing guidance. Written communication which may include email must be provided to the relevant GP practice. The community pharmacy pathfinder sites to be registered for Pharmacy First and expected to support those patients referred from local GP practices that may require this service.

Resources

Pharmacy independent prescribers to prescribe in line with local and national guidance:

o   UTI (Lower) Women

o   Conjunctivitis - infective | Health topics A to Z | CKS | NICE

o   Impetigo | Health topics A to Z | CKS | NICE

o   Insect bites and stings | Health topics A to Z | CKS | NICE

o   Scenario: Infected eczema | Management | Eczema - atopic | CKS | NICE

o   Otitis media - acute | Health topics A to Z | CKS | NICE

o   Diarrhoea - adult's assessment | Health topics A to Z | CKS | NICE

o   Constipation | Health topics A to Z | CKS | NICE

o   Overview | Headaches in over 12s: diagnosis and management | Guidance | NICE

o   Fungal skin infection - foot | Health topics A to Z | CKS | NICE

o   Common cold | Health topics A to Z | CKS | NICE

o   Allergic rhinitis | Health topics A to Z | CKS | NICE

o   Local formulary and guidance: Prescribing, Policies and Pathways (hweclinicalguidance.nhs.uk)