Community pharmacy independent prescribing programme delayed further

Integrated Care Boards (ICBs) are still finalising plans to launch the first nationally funded service to allow community pharmacists to use their independent prescribing qualifications.

The Independent Prescribing (IP) Pathfinder programme was originally planned to launch in January 2023, but has faced ongoing delays amid concerns about its funding and implementation.

A spokesperson for NHS England (NHSE) told The Pharmaceutical Journal in October 2023 that ICBs were expected to finalise plans for the pathfinder sites in their area by November 2023.

However, on 4 December 2023, a spokesperson for NHSE said that ICBs were still “continuing to progress standing up” the programme.

Local pharmacy leaders around England have confirmed that details are still being worked out before pathfinder sites in their area can begin prescribing.

Helen Musson, chief officer at Community Pharmacy Hertfordshire, said the local pharmaceutical committee (LPC) was collaborating with NHS Hertfordshire and West Essex ICB “to work through the practical and professional issues, which need to be addressed before the IP pathfinder can be implemented locally”.

Four community pharmacy pathfinder sites in NHS Hertfordshire and West Essex ICB are planning to offer minor illness, respiratory and hypertension services.

Musson said concerns had been raised by members about aspects of the programme, “particularly the low level of funding, which we do not think adequately reflects the costs and wider economic consequences of participation in the programme for pharmacy owners”.

“The pathfinder sites are being commissioned as a local enhanced service, which means the ICB, as commissioner, has a duty to consult the LPC on the contractual terms, but we do not consider a proper consultation has been undertaken, where the funding levels are fixed by NHS England,” she said.

Stephen Noble, chief officer at Community Pharmacy Dudley, told The Pharmaceutical Journal that the pathfinder programme across the NHS Black Country ICB was “now due to be launched mid to end of January” 2024. Four pathfinder sites are planned across the ICB area, offering minor ailments, oral contraception and hypertension services.

Noble added that plans were going well but had been delayed because of a need to test the IT system, which will link the independent prescribers with GP surgeries. 

Raj Matharu, chief executive officer at Community Pharmacy South East London, said that NHS South East London ICB had asked primary care networks to take over the administration of the pathfinder programme and had sent out a call for expressions of interest.

Five pathfinder sites are planned for the area, offering hypertension, respiratory diseases and antidepressant deprescribing services.

NHS South East London ICB declined to comment on the management of pathfinder sites.

The roll out of the IP Pathfinder programme comes ahead of plans for all newly qualified pharmacists to become independent prescribers at the point of registration from 2026.

The programme is intended to explore how community pharmacists can deliver independent prescribing across all regions in England before NHSE’s “overarching aim” of establishing a commissioning framework for the service by March 2024.

Speaking at The Pharmacy Show in Birmingham on 16 October 2023, Anne Joshua, head of pharmacy integration at NHS England said: “We’ve always had the ambition that we want to run the [IP Pathfinder] programme for at least a year, if not more, and that’s what we are still hoping to do.”