NHS could introduce performers list for independent prescribing pharmacists

NHS England is considering setting up a performers list for pharmacist prescribers, in line with similar lists held for doctors and dentists, the deputy chief pharmaceutical officer for England has said.

Speaking at an event for members of the Association of Independent Multiple Pharmacies (AIMp) on 29 September 2022, Bruce Warner said the consideration was part of wider plans to pilot independent prescribing services in community pharmacies from January 2023, with expressions of interest expected to open from October 2022.

In September 2022, David Webb, the chief pharmaceutical officer for England, told The Pharmaceutical Journal that ‘pathfinder’ sites would begin trialling NHS-commissioned independent prescribing pharmacy services in each integrated care board.

However, Warner told AIMp members that the issues with setting up such a service at scale in community pharmacy “are considerable” and are “going to take years to work through”.

“I completely appreciate the pressures people are under at the moment,” he said. “If we wait for conditions to be right before we even start with this work, we’re going to miss the boat.

“We need to have something that is ready for when conditions are right, that we’re ready to go.”

Warner said that the issues under consideration included those related to “assurance and regulation”.

“Unlike other professions, we don’t have a performers list for pharmacy; so the medics and the dentists have a performers list, which is above the baseline competence to practice that the GPhC are interested in, but more about whether somebody is ready to provide NHS services and provide the services that we want,” he said.

“It’s a very labour-intensive process to manage and to run but we’re starting to think about, now we have pharmacists working and potentially prescribing in multiple different sectors, we’re starting to think about whether or not what we have is enough [and] how those performers lists might work,” he continued.

The current performers list for England is managed by NHS England, with clinicians required to apply to join the list, providing employment history, clinical referees and appraisal history.

In February 2022, NHS England concluded a review of the performers list for GPs, removing four duplicative training and employment checks that were required for the application process, in an effort to reduce bureaucracy.

Also speaking at the AIMp event, Anne Joshua, head of pharmacy integration at NHS England, announced plans to open the pathfinder independent prescribing programme to expressions of interest from October 2022 until November 2022.

“From October [2022] to November [2022] we’ll be running expressions of interest through our regional teams,” she said. “We’re really keen to work with the LPCs and work with organisations and actually find out where independent prescribers are. We don’t know.”

Joshua added that NHS England is looking to commission “at least one pathfinder site in every ICS”, with the “overarching aim” of establishing a commissioning framework for the service by March 2024. 

“This is the biggest transformation project I think we’ve ever done through the Pharmacy Integration Programme,” she said.

Warner added that the independent economic review of community pharmacy promised by the government as part of its latest contractual agreement with the Pharmaceutical Services Negotiating Committee will “try and build that commercial case for community pharmacy in terms of developing new clinical services”.

“We need to really understand what that business case is, what the requirements are, what’s going to make it work and what isn’t from a financial perspective,” he said, adding that the business case will then be put to the Treasury for consideration.

“It’s not about a financial review in terms of the viability of community pharmacy.”