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NHS England is to publish guidance for integrated care boards (ICBs) and pharmacy owners to support the introduction of pharmacist independent prescribing, Community Pharmacy England (CPE) has said.
Speaking at a press briefing on 2 June 2026, Alastair Buxton, CPE director of NHS services, said that during talks on the new community pharmacy contract, the negotiator proposed a standardised set of prescribing services from which ICBs could commission. However, the government turned the proposal down.
ICBs are responsible for commissioning local pharmacy services and developing plans for integrated neighbourhood health services, which can include community pharmacist prescribing.
Without a standardised national framework, ICBs will be free to commission prescribing services, but the scope of, and funding for, those services will vary by ICB.
Buxton said: “We proposed a national enhanced service to help structure that commissioning.”
During negotiations, he said “that’s not what ministers wanted to do” but added: “That’s still something that DHSC [Department of Health and Social Care] and NHS England could agree with us to make it easier for ICBs to commission a service.”
Instead, Buxton said NHS England would issue guidance to support ICBs and pharmacy owners to support the introduction of prescribing within existing national services.
“I think they will both provide a really important foundation over and above the national commissioning in Pharmacy First and [the pharmacy contraception service], which can then be used by ICBs at that local level to commission some of those more clinically challenging areas,” Buxton said.
“So I think we lay some foundations here with NHS England and DHSC to support more local commissioning, and we will continue to support our colleagues in the LPCs to make those of opportunities at a local level.”
In a briefing published alongside the 2026/2027 pharmacy contract, CPE said that from autumn 2026 pharmacist prescribers can prescribe within the existing Pharmacy First clinical pathways and the pharmacy contraception service, and provide up to five new Pharmacy First prescribing-only pathways.
When asked about the discrepancy between some pharmacies offering prescribing services and others not, Buxton said: “It is inevitably going to be a variable. You could call it a two-tier system for a while.”
“We were stuck with this dilemma — on the professional development side, we of course want to see IP develop, follow in the path that our colleagues in Scotland and Wales have set very successfully, for example, but on the other side, we’ve got that big funding black hole … and really wanted any new money to be spent going into filling the black hole rather than anything else,” Buxton added.
CPE chief executive Janet Morrison added at the briefing: “We all know the potential … we’ve seen it demonstrated through the IP pathfinders.”
However, she said the government “didn’t have enough money” to commission this as a national enhanced service.
Mahendra Patel, England Pharmacy Advisory Council chair at the Royal College of Pharmacy, said: “Pharmacist prescribing has significant potential to improve access to care and help patients receive treatment closer to home, so commissioners must make full use of the growing number of pharmacist prescribers working in community pharmacy.
“Without a nationally commissioned prescribing service, there’s a risk that patients’ access to pharmacist prescribing will depend on where they live. While local commissioning can support services that meet the needs of local populations, variation in provision should not result in a postcode lottery that limits access to care or widens health inequalities.”
