The unveiling of the Pharmacist Enhanced Practice Pathway (PEPP) pilot at the Clinical Pharmacy Congress in London on 8 May 2026 marked a definitive attempt by NHS England to formalise the transition of newly registered pharmacists from competent to confident prescribers.
As the profession stands on the precipice of summer 2026 — when every new pharmacist registrant in the UK will enter the workforce as an independent prescriber — the pathway, announced by David Webb, chief pharmaceutical officer for England, carries both the promise of increased professional responsibility for pharmacists and the weight of unresolved issues in the prescribing pathway.
Strong first steps
On paper, the PEPP pilot is a robust and long overdue early path beyond proficiency. It seeks to rectify a fragmented post-registration landscape where support for newly qualified pharmacists was often determined by their sector of choice or location.
Structured as an 18-month intervention designed to move pharmacists from foundational competence to high-level proficiency, PEPP has nine core elements, including a unified e-portfolio, modular credentialing and defined supervision standards, which align with the Royal College of Pharmacy’s revised enhanced curriculum.
The NHS must now prioritise the surrounding support structure for this pathway to sustain new pharmacists in practice
This is a necessary recognition that newly registered pharmacists will need support after completing their MPharm to feel fully confident in understanding the complexities of prescribing. Yet, the NHS must now prioritise the surrounding support structure for this pathway to sustain new pharmacists in practice.
Protecting learning time
PEPP’s potentially fatal flaw lies in its lack of protected learning time support. David Gibson, pharmacy dean for the North East and Yorkshire, confirmed at CPC that the pathway will not provide funding to backfill pharmacists for the time they spend on development. Instead, he called for a “whole-systems approach”, placing the burden of support onto employers.
This stance has long been met with justifiable scepticism, even outside of the context of the new pathway, and sits in stark contrast with the offering in Wales and Scotland for newly qualified pharmacists. In Wales, the Post-registration Foundation Pharmacist (PRFP) ‘Model of support’ — set to begin in September 2026 — will offer each pharmacist 15 hours of protected development time per month, supported by their employer. Educational supervisors will be funded by Health Education and Improvement Wales for 60 hours per month to ensure consistent and high-quality supervision. In Scotland, the 15 hours of protected learning time is offered to community pharmacists specifically.
The PEPP risks becoming an elite offering available only to those in well-resourced settings
Meanwhile, in England, community pharmacy continues to face extreme financial stress, with many contractors reporting six-figure annual losses. In February 2024, survey results published by the then Royal Pharmaceutical Society highlighted the stakes: 93% of community pharmacists reported insufficient learning time, compared to a cross-sector average of 61%. Without a contractual entitlement to fully funded protected learning time, the PEPP risks becoming an elite offering available only to those in well-resourced settings, further driving a talent drain to sectors where protected learning time is formalised in job plans.
A pathway without a destination
This talent drain will be compounded by the lack of national prescribing service in community pharmacies in England. While the NHS will train approximately 2,800 new pharmacist prescribers every year from 2026, there is still no nationally commissioned prescribing service in England for them to use to practice their skills. The ‘Independent prescribing pathfinder programme’ was intended to inform this framework, but its conclusion on 31 March 2026 has left many sites with uncertain futures as some ICBs stopped commissioning the service owing to a lack of national funding.
Without a clear national clinical home, leading pharmacists have warned in The Pharmaceutical Journal this month that “delays between qualification and practice lead to skill decay, reduced confidence and attrition of clinical competence”.
“The absence of a national community pharmacy prescribing service in England currently prevents many pharmacists from consolidating their skills, creating both professional frustration and a potential patient-safety risk through de-skilling,” they said, highlighting that both Scotland and Wales have “had community pharmacy prescribing services for several years”.
As skills atrophy, professional frustration may drive ambitious new pharmacists in England out of the community setting if they find themselves relegated to traditional dispensing roles despite their advanced qualifications.
Digital parity
Even with protected learning time and a prescribing service, for a community pharmacist to be a true partner in a neighbourhood health team, they require digital parity with their GP and secondary care counterparts.
Frustrations with current IT systems are rampant
Frustrations with current IT systems are rampant. The recent promise in the King’s Speech on 13 May 2026 of a single patient record is a welcome step, but its initial focus on maternity and frailty care means many pharmacists will continue to prescribe with greater risks until this is rolled out more widely.
And, as Amandeep Doll, director for England at the Royal College of Pharmacy, said: “With pharmacists providing ever more clinical services, managing long-term conditions, optimising medicines and preventing harm, it’s essential they are included in access to the record from the outset.”
Safe prescribing also requires access to pathology records and point-of-care testing, both of which are diagnostic tools that remain largely out of reach for community pharmacists.
Reinforcing silos
Perhaps the most disappointing aspect of the pilot’s design is the apparent exclusion of ARRS-funded pharmacists. While NHS England said at CPC that these pharmacists have access to the Primary Care Pharmacy Education Pathway (PCPEP), this siloing of the workforce at such an early career stage prevents the cross-sector mobility that PEPP is supposed to foster.
The neighbourhood health vision relies on pharmacists moving fluidly between community and general practice roles. By tying educational support to the care setting, the NHS is reinforcing the very silos it intends to disrupt. If we are to have an equitable pathway, it must be open to all newly registered pharmacists.
By prioritising 300 newly qualified community pharmacists working in independent pharmacies or as locums, the pilot rightly acknowledges that these cohorts face the highest barriers to development, often working in professional isolation without the clinical supervision found in hospital settings or large multiples. However, without additional IT support, prescribing service availability and protected learning time, the concern for independent pharmacists — and newly registered pharmacists, more broadly — is purely lip service to the wider issue.
As the University of Manchester begins its evaluation of the PEPP pilot, the profession needs to remain vocal. We must ensure that the 2026 registrants do not become a lost generation of prescribers who are qualified to lead but lack the space, tools and contractual framework to do so. PJ
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