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Fewer than half of the local prescribing services trialled under NHS England’s ‘Independent prescribing in community pharmacy pathfinder programme’ have been continued into the 2026/2027 financial year, an investigation by The Pharmaceutical Journal has revealed.
We asked 36 integrated care boards (ICBs) in England which pathfinder sites and services they planned to continue from 1 April 2026. Of the 20 ICBs that responded, 13 said they had commissioned prescribing services for 2026/2027, with several imposing limitations on consultation numbers or funded hours (see Figure 1).
Figure 1: Where are pathfinder sites being continued?
Just under one-third of respondents (n=7) said they had not yet commissioned any community pharmacy prescribing services for 2026/2027. It is estimated that the 16 ICBs that did not respond represent around 120 pathfinder services.
In April 2026, ICB mergers took place, reducing the number of ICBs in England from 48 to 36. As part of this process, 12 ICBs were abolished, 6 new ICBs were established and the boundary of one existing ICB was widened. Nearly all the ICBs that responded said they would keep their service offering under review.
Continuing on the path
The ‘Independent prescribing in community pharmacy pathfinder programme’ launched in spring 2024 to test models of community pharmacy prescribing, with a view to creating a national community pharmacist prescribing service in England.
In October 2024, a letter sent by NHS England to ICBs announced plans to consult with Community Pharmacy England (CPE) from April 2026 to determine what will form part of the national service, based on its learnings from the pathfinder sites.
In the meantime, the programme has been hailed as a success. Over the two years during which the pathfinders have been running, nearly 200 community pharmacies tried out different ways of using pharmacist prescribing to meet patient needs in a community setting. The pathfinders focused on a range of clinical models, identifying barriers and the support required.
The programme demonstrated clear benefits to patients and the wider health system: as of April 2026, community pharmacist prescribers had offered almost 63,000 patient consultations, 53% of which resulted in prescribing activity that would otherwise have been done by a GP or at a hospital. Interim findings also show that 20% of prescribing activity took place in the most deprived decile of England.
The pathfinder programme formally concluded on 31 December 2025, but NHS England said in a letter to ICBs, seen by The Pharmaceutical Journal, that it would support services wishing to continue until the end of March 2026 with a one-off £1,500 payment per site and funded access to the CLEO Solo IT system used to issue prescriptions.
Following this, on 15 April 2026, NHS England wrote to ICBs again to announce another funding extension “to ensure continuity with prescribing in community pharmacy”.
The letter said that NHS England would fund existing pathfinder sites with £500 per pharmacy per month from April to October 2026. However, The Pharmaceutical Journal understands that this funding extension does not cover the cost of CLEO Solo.
Local ICBs were told to decide which prescribing sites to continue, prioritising “active pharmacy sites with patient consultation activity”, where possible.
In Essex, some prescribing sites have been extended for six months “to retain trained prescribers ahead of national commissioning in September 2026”, a spokesperson for Essex ICB told The Pharmaceutical Journal.
Meanwhile, Ewan Maule, director of medicines at North East and North Cumbria ICB, told The Pharmaceutical Journal that his priority was to retain prescribers in community pharmacy to be able to commission prescribing services in the future.
[NHS Derby and Derbyshire ICB is] actively working to embed community pharmacy prescribing into local commissioning plans
Shazia Patel, community pharmacy clinical lead at NHS Derby and Derbyshire Integrated Care Board
Shazia Patel, community pharmacy clinical lead at NHS Derby and Derbyshire ICB — which is continuing to offer prescribing services at all four of its pathfinder sites, albeit with caps on consultation numbers — said it had “been a success locally, improving access to primary care for patients while offering a professional development opportunity for community pharmacists”.
She added that the ICB is “actively working to embed community pharmacy prescribing into local commissioning plans”.
“This will make sure it supports our wider priorities, addresses local population health needs and contributes to tackling health inequalities,” Patel said.
“We are currently working with our primary care training hub to support designated prescribing practitioner (DPP) provision for community pharmacists undertaking the independent prescribing course, recognising that this support is crucial to growing the future prescribing workforce.”
Financial concerns
In seven ICBs, however, commissioners had not yet committed to taking forward any further prescribing services following the pathfinder programme.
When compared with the list of pathfinder sites obtained by The Pharmaceutical Journal in November 2025, around 140 local prescribing services were confirmed to be discontinued as of April 2026, with a further 44 services still under review. Around 80 local pharmacy prescribing services were confirmed to be continuing in some form (see Figure 2).
Figure 2: How many prescribing services have been continued?
A spokesperson for Leicester, Leicestershire and Rutland ICB said it was “currently facing a challenging financial position, therefore all services that we commission and fund must be aligned to population health needs, not service availability”.
In April 2025, NHS England announced that ICBs would need to cut their operating costs by 50% as part of the government’s NHS reforms, which pharmacists have said would “set NHS ambitions back”.
Informed by the learnings from the pathfinder, we plan to work with NHS England on relaunching an interim model that is more feasible for wider adoption
A spokesperson for Leicester, Leicestershire and Rutland Integrated Care Board
Leicester, Leicestershire and Rutland ICB said it had not currently commissioned any community pharmacy prescribing services, but going forwards, its spokesperson said it wanted to commission neighbourhood level community pharmacy prescribing services.
“Informed by the learnings from the pathfinder, we plan to work with NHS England on relaunching an interim model that is more feasible for wider adoption and has better alignment with patient needs while any future national services are being negotiated and developed,” they explained.
Service closures
Around one-third of sites that offered minor ailments (n=25/97), contraception (n=8/19) and lipid management services (n=7/13) under the pathfinder programme have been able to continue offering them in some form (see Figure 3).
Figure 3: For which conditions are community pharmacists still prescribing?
However, The Pharmaceutical Journal has been able to confirm service continuation for just 3% of hypertension services (n=1/28) and 8% (n=4/46) of combined hypertension and lipids services.
Respiratory services have also been particularly affected by the end of national funding to support community pharmacist prescribing. One respiratory service has been funded for a further 6 months, 4 are still under consideration and 21 have been discontinued.
Just 7 sites were confirmed to be continuing prescription management services, out of the 55 that were originally trialled, with a further 7 deprescribing services discontinued.
Pharmacies in Hampshire and the Isle of Wight trialled a contraception prescribing service, which supported more than 200 patients per month during the pathfinder programme.
Our priority is to provide patients with convenient, high-quality care through services that are both sustainable and deliver the greatest impact
James Roach, director of primary care and local care at NHS Hampshire and Isle of Wight Integrated Care Board
James Roach, director of primary care and local care at NHS Hampshire and Isle of Wight ICB, said the decision had been made not to recommission the service to avoid duplication with the existing pharmacy contraception service.
“We already have a well-established and widely utilised advanced service for pharmacy contraception, through which around 3,000 patients are seen each month,” he said.
“Given the strength, scale and accessibility of the existing service, we took the decision not to continue the pilot to avoid duplication and ensure we are making the best use of available resources and scaling even further.”
Rather, he said the contraception pathfinders had “proved the concept” of pharmacy prescribing, and “now we are moving into our wider commissioning strategy for community pharmacy.
“Our priority is to provide patients with convenient, high-quality care through services that are both sustainable and deliver the greatest impact,” he said.
“We will revisit opportunities to expand the use of independent prescribing within community pharmacy once the community pharmacy assurance framework for 2026/2027 and further commissioning guidance are published, ensuring any future developments are aligned with national direction and local patient need,” Roach added.
Upcoming strategy and guidance
Speaking at the Clinical Pharmacy Congress in London on 8 May 2026, David Webb, chief pharmaceutical officer for England said commissioning guidance for prescribing in clinical services and professional assurance framework guidance for pharmacists and pharmacy technicians are both in development.
Although an evaluation of the pathfinders found participating pharmacist prescribers reported increased job satisfaction, it said NHS England and the Department of Health and Social Care should “develop a national strategy for robust infrastructure, essential training and ongoing clinical supervision and support”, while ICBs should fund protected time for community prescribers.
Webb also said that NHS England would be introducing a pharmacist enhanced practice pathway, with particular support for newly registered community pharmacist prescribers from 2026 who do not have access to clinical supervision via their workplace.
A spokesperson for NHS England told The Pharmaceutical Journal: “The NHS is transforming primary care services for patients as part of the ten-year health plan. We are working closely with integrated care boards to support the ongoing development of pharmacy-based prescribing, including funding the continuation of many pathfinder pilot sites into 2026/2027.”
But, until a national service is commissioned, prescribing services available to patients and pharmacists look to remain variable around the country.
