Educational supervision is needed to support community pharmacists as independent prescribers 

Pharmacists face a whole host of difficulties when trying to gain and apply their independent prescribing (IP) qualification in community pharmacy. 

The ‘Independent prescribing in community pharmacy pathfinder programme’ is aimed at making this easier, in part. It is currently underway to test out different models that will inform how best to commission and implement IP as part of clinical services in community pharmacy. 

Pharmacies in all 42 integrated care boards are involved in the pathfinder programme, which the Centre for Pharmacy Workforce Studies (CPWS) at the University of Manchester is in the process of evaluating, to determine what works (and what does not), how and why. 

Provided the pathfinder programme identifies a route to implementing national clinical services in community pharmacy that require (or at least include) IP, the identified ‘lack of opportunity’ to apply IP skills owing to a lack of available services will be addressed. 

However, there are several other obstacles to overcome. One of these is to ensure that pharmacists can not only qualify as independent prescribers but are supported during the transition to become competent and confident prescribers, making autonomous prescribing decisions for which they hold professional responsibility. This will be particularly relevant for pharmacists qualifying as IPs at the point of registration from 2026, but also relevant to those gaining an IP annotation having practised in community pharmacy for some time.

The two largest healthcare professions — doctors and nurses or midwives — have an established structure of clinical and education supervision, which supports their learning and practice at crucial transition points, particularly the early years post-qualification, known as ‘foundation years’ for medics^​1​. 

In NHS hospitals — and more recently in general practice — newly qualified pharmacists have benefited from both formal learning, such as postgraduate diplomas or the primary care pharmacy education pathway (PCPEP), and informal learning through some form of supervision, while also being exposed to the wider multidisciplinary team. 

However, this tradition or culture of learning and support does not exist in the same way in community pharmacy^​2​. Nevertheless, it is equally — if not more — important that community pharmacists are supported in this way, because they typically work in professional isolation with limited opportunity for peer support and limited time to focus on learning and reflection^​3,4​. As a result, education supervision may be of particular relevance or benefit in community pharmacy because regular clinical or work-based supervision will be challenging for many working in the sector. 

While clinical supervisors ensure clinical competence within the workplace, education supervisors encourage learners to reflect on challenging issues and offer support in managing stress.

Education supervision

The concept of education supervision is gaining increasing recognition, and evidence — including from pharmacy — is emerging that it is both valued by pharmacists (learners) and may offer a workable solution to some of the current inherent barriers to learning and support in community pharmacy.

This ‘model’ of supervision was first tested by Magola et al., who developed a coach-led intervention for newly-qualified pharmacists, with remote one-to-one discussions with a coach and several online coach-led peer group sessions^​5​.

This approach informed the newly qualified pharmacist programme (NQPhP), funded by NHS England, which the CPWS evaluated in 2023^​6​. The NQPhP is not mandatory, offers choice and differs between sectors (general practice, hospital and community pharmacy).

For newly qualified community pharmacists (other than those who work for Boots), the Centre for Pharmacy Postgraduate Education (CPPE) offers a 12-month structured NQPhP, blending online learning, workshops and assessment, supported through the allocation of an education supervisor. 

Unfortunately, there was little understanding or incentive for community pharmacists to enrol in this programme. This does not mean that those who did enrol did not find it very valuable — we found many positive experiences, particularly with education supervision. But the vast majority of community pharmacists did not enrol, giving reasons of being too busy and/or not really seeing the point, having just completed five years of intense learning at university and during preregistration foundation training^​6​.

This differs from newly qualified pharmacists in hospitals, many of whom enrolled on the newly qualified pharmacist pathway. Interestingly, however, many did not know they had enrolled, since they just followed the well-established path in hospital pharmacy to undertake a postgraduate diploma, commonly a condition for progressing to the next NHS pay band.

While one can argue that newly qualified hospital pharmacists did not embrace this pathway as the first step towards advanced and consultant practice, they at least saw a purpose in engaging. Indeed, it is probably OK if the driver for this is career and salary progression, as long as the awareness of foundation, advanced and consultant level practice emerges.

Pharmacists in primary care have also been funded and supported by the Pharmacy Integration Fund (PhIF) via an 18-month pathway, which involves a range of modules, clinical supervision, an education supervisor and protected learning time^​7​. Education supervisors on this programme are employed by CPPE, are independent of workplace or employer, and act remotely to support pharmacists’ learning.

Evaluations of education supervision as part of the PhIF^​8​ and PCPEP^​9​ have revealed that the role of these education supervisors is predominantly formative (educational) and restorative (ensuring the learners’ wellbeing). These education supervisors oversee pharmacists’ developmental trajectory, and — under the formative function — education supervisors offer the ‘space’ to focus on learning, reflection and the opportunity to discuss challenging issues away from the workplace. 

In its restorative function, education supervision can reduce stress by providing opportunities to recognise limitations and discuss coping strategies, particularly when put under pressure; for example, to work outside their areas of competence or confidence.

Education supervision should also play a role in supporting both newly qualified pharmacists — particularly those qualifying as IPs from 2026 — as well as existing pharmacists who qualify as IPs and work in community pharmacy. Education supervision is particularly important at important transition points and we have described a model of education supervision initially developed for PCPEP and subsequently used for community pharmacists in the NQPhP, alongside a way of training and quality assuring education supervision^​7​.

Our evaluation of the NQPhP showed that those community pharmacists who enrolled found education supervision beneficial to their learning progress and practice. The NQPhP helped them to become more confident and competent practitioners, gaining clinical, management and leadership skills. However, unlike their counterparts in hospital and general practice, they were usually not given any protected learning time.

Although clinical supervision in the workplace is important, dedicated education supervisors can create space for learning, overcoming time pressures — particularly in practice, where supervision is commonly not prioritised over patient care. Newly qualified pharmacists or pharmacist prescribers should not be expected to be fully formed practitioners and should be supported to thrive and develop as confident clinical professionals, even more so when they qualify as independent prescribers from the summer of 2026. Education supervision should be central to this.

It will be particularly important to create support and supervision mechanisms for community pharmacists new to prescribing, so that they have protected opportunity for reflection and to hone their clinical skills and confidence. This will hopefully set many more community pharmacists up for a safe and smoother journey towards advanced practice in community pharmacy, contributing as valued members of the primary care workforce to provide the best patient care and outcomes.