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No formal impact assessment was conducted for the introduction of community pharmacy prescribing in the ‘Community pharmacy contractual framework’ (CPCF) for 2026/2027, despite concerns that inadequate funding could lead to a “postcode lottery of patient access”, The Pharmaceutical Journal has learned.
In response to a Freedom of Information (FoI) request, sent to The Pharmaceutical Journal on 3 August 2026, the Department of Health and Social Care (DHSC) revealed that no impact assessment has been conducted for any CPCF since 2023.
“The most recent impact assessment covered the 2022/2023 and 2023/2024 financial years and related to the introduction of a new service under the CPCF,” the DHSC added.
The pharmacy contraception service was introduced in 2023, while Pharmacy First — a funded scheme for community pharmacy treatment of seven minor ailments — was introduced in 2024.
Under the CPCF for 2024/2025 and 2025/2026, services were expanded, which included the addition of antidepressants to the new medicine service, as well as emergency hormonal contraception being added to the pharmacy contraception service.
The changes outlined in the CPCF for 2026/2027 will enable qualified and competent pharmacists to use their prescribing skills within Pharmacy First — which will have additional pathways added to it — and the pharmacy contraception service.
However, in its FOI response, the DHSC said: “The changes introduced following the consultation on the 2026/2027 CPCF, and across other years since 2023/2024, did not reach the threshold for an impact assessment notwithstanding that they did build on and expand existing services within the CPCF.
“This included extending the existing Pharmacy First and pharmacy contraception service to incorporate independent prescribing, rather than introducing a new standalone service.”
When the CPCF for 2026/2027 was announced in May 2026, pharmacy bodies raised concerns that funding for the settlement would be too little for overstretched pharmacies and that the payments for prescribing would not be enough for contractors to take it up.
Amandeep Doll, director for England at the Royal College of Pharmacy (RCPharm), warned at the time: “New prescribing services must be adequately supported to avoid a postcode lottery for patient access.”
Commenting on the FoI response, a spokesperson for Community Pharmacy England (CPE) said: “During negotiations, CPE clearly set out its analysis that the 2026/2027 settlement would not close the gap between NHS funding and pharmacies’ costs, highlighting our concerns that financial pressures and pharmacy closures will persist.
“And while we have always supported the introduction of independent prescribing within the CPCF as a welcome step for pharmacy services, we were adamant that it will need further significant investment if it is to succeed at scale.”
A spokesperson for the Pharmacists’ Defence Association described the lack of a formal impact assessment for prescribing as “concerning”, “as such assessments are essential to ensuring transparency and informed decision-making”.
“Prescribing is not simply an extension of existing activity; it brings additional clinical responsibility, professional accountability and workload, with potential consequences for patient access, workforce capacity, pharmacist wellbeing and equality of opportunity across the profession,” they said.
“If service uptake depends on local workforce capacity, employer support, training opportunities and commissioning arrangements, patients in different parts of the country may experience different levels of access to pharmacist prescribing. That risk should be monitored transparently and addressed through national workforce planning, investment and meaningful engagement with pharmacists and their representatives.”
Mahendra Patel, chair of the RCPharm English Pharmacy Advisory Council, commented: “Independent prescribing in community pharmacy is a significant opportunity to improve timely and equitable access to care while making better use of pharmacists’ clinical expertise. Patients should benefit from these services wherever they live.
“As pharmacist prescribing is rolled out, it must be backed by sustained investment, alongside access to patient records, robust professional assurance and continued workforce development to ensure safe and high-quality delivery of care.”
