Evaluation of Independent Prescribing in Community Pharmacy Pathfinder Programme

Independent prescribing (IP) for pharmacists was first introduced in 2006, subject to completion of a General Pharmaceutical Council (GPhC) accredited IP course. These postgraduate university courses aim to equip pharmacists with diagnostic and consultation skills. In 2020, GPhC approved new standards for the initial education and training of pharmacists, which made prescribing skills an integral part of pharmacists’ initial education. In 2020, GPhC approved new standards for the initial education and training of pharmacists, making prescribing skills an integral part of pharmacists’ foundational education. From 2026, all MPharm-qualified pharmacists will be granted IP rights upon registration

Despite the growing number of IP pharmacists, there are limited opportunities to utilise these skills within community pharmacy settings. Moreover, many who qualified as prescribers and work in community pharmacies are no longer active prescribers. The lack of opportunities to use prescribing skills can quickly lead to these skills being lost, alongside a loss/reduction in confidence to prescribe.

NHS England launched the Independent Prescribing in Community Pharmacy Pathfinder Programme with the strategic aim of establishing a framework for the future commissioning of NHS community pharmacy clinical services incorporating IP for patients in primary care. Each of 42 Integrated Care Boards (ICBs) identified ‘Pathfinder’ sites to test out a range of IP services, with 210 Pathfinder sites chosen by NHS England to deliver a range of prescribing models and pathways.

The Centre for Pharmacy Workforce Studies (University of Manchester), in collaboration with ICF, has been commissioned by NHS England to conduct an independent evaluation of the impact and learning from the Community Pharmacy Independent Prescribing Pathfinder Programme. We used realist evaluation to understand what makes IP in community pharmacy work (or not), for whom, under what circumstances, and why. Realist evaluation uses a context (C)–mechanism (M)–outcomes (O) framework to understand the implementation of complex interventions in practice. It focuses on the underlying mechanisms that lead to outcomes, considering the context in which the intervention is implemented. This method allows us to explore the complexity of the Pathfinder programme and its varying clinical models across different sites and provide actionable recommendations.