Key Summary
- Newly-qualified prescribers need strong supervision and continued professional development to prescribe safely and confidently.
- But access to supervision – particularly in community pharmacy – is limited due to a lack of suitable supervisors.
- There is limited funding for training places, and opportunities for continued professional development are patchy.
The Nuffield Trust has warned that the induction of pharmacist independent prescribers to the NHS could be undermined by gaps in supervision, training and workforce planning.
In its new report, the trust pointed out these shortcomings could put the government's ambitious plan to shift care into the community settings at risk.
From 2026, pharmacists graduating from the Master of Pharmacy (MPharm) programme will qualify as independent prescribers at the point of registration for the first time. The first cohort is expected to join the professional register in September 2026.
But the report warns that these newly-qualified prescribers will often be relatively inexperienced in their chosen clinical area and will require strong supervision and continued professional development to prescribe safely and confidently.
Limited avenues
Researchers found that access to supervision – particularly in community pharmacy – is already limited.
Trainee prescribers rely on supervision from experienced clinicians known as designated prescribing practitioners, but local leaders report shortages of suitable supervisors and inconsistent arrangements for providing oversight.
The report said that wider structural challenges affect the independent prescribing workforce, including limited funding for training places, patchy opportunities for continued professional development and a lack of protected time for prescribers to maintain and develop their skills.
These issues are particularly significant for community pharmacy, where pharmacists are currently least likely to be actively prescribing despite having the highest proportion of prescribers within their profession.
The report stated that over 98,000 non-medical clinicians across the UK – including nurses, pharmacists and several allied health professions – are now qualified independent prescribers, representing almost a quarter of the prescribing workforce as of the start of April 2025.
Nurses account for 69 percent of non-medical prescribers (68,180) but the total percentage is only 8 percent.
Moreover, there is no data collection about nurse prescribing outside of primary care, leaving a significant knowledge gap about this workforce.
Pharmacists have the highest percentage (33) of qualified independent prescribers (22,770).
The number of pharmacist independent prescribers is increasing at a faster rate than the other professions and is expected to increase rapidly as all newly qualified pharmacists will become independent prescribers from this year onwards.
Robust training needed
Nuffield Trust Deputy Director of Research, Sarah Scobie said, “We have an ageing population which is now living with more health issues, and the government hopes its ambitions to shift more care closer to home will tackle some of the problems this poses.
"The NHS will need to harness the full potential of its fast-growing prescribing workforce to realise this change, but we have identified some worrying barriers.
“To get the most out of independent prescribing, the forthcoming NHS workforce plan must set out clearly the role prescribers will play within neighbourhood teams, and plans must be based on local population needs. Better monitoring of independent prescribing practice in all settings will also be crucial. Without this, the opportunities presented by the incoming wave of new pharmacist prescribers will sadly be missed.”
National Pharmacy Association chief executive Henry Gregg said, "We share the Nuffield Trust's concerns about the insufficient planning by the NHS and government to utilise the skills of thousands of independent prescribers who are currently working in pharmacies or will be qualifying in the coming months.
"Prescribing absolutely cannot come at the expense of fully funding pharmacies for their dispensing work but without improved planning, there is a growing risk that newly qualified pharmacist prescribers will leave community pharmacy for hospitals or GP practices.
"As this report notes, in all professions, new prescribers need proper support networks and adequate clinical supervision.
"Prescribers in community pharmacy have enormous potential to enable care closer to home supporting implementation of the 10 Year Health Plan and the shift from hospital to community and drive fresh opportunities for pharmacies. "It is right that we use the skills of pharmacists fully in dispensing, managing repeat prescriptions and optimising medicines use."
Company Chemists' Association chief executive Malcolm Harrison said, “The rollout of independent prescribing in community pharmacy will play a significant part in moving care from hospitals and into the community. This will improve access for patients and relieve pressure on other parts of the NHS.
"The Nuffield Trust report rightly highlights several challenges the CCA have been raising for some time. At the core of the issues is the absence of a nationally NHS commissioned independent prescribing service in England. Without this, the full benefits of pharmacist prescribing cannot be fully realised.
"An independent prescribing service would enable community pharmacy employers to develop their own network of prescribing practitioners, meaning they would be better placed to provide prescribing supervision to their own trainees, reducing their reliance on other parts of the system and create a more sustainable training model.
"An NHS-commissioned independent prescribing service would also enable community pharmacy employers to develop their own network of prescribing practitioners, meaning they would be better placed to provide prescribing supervision to their own trainees, reducing their reliance on other parts of the system and create a more sustainable training model.
"A recent parliamentary question secured by the CCA confirmed that over 400 pharmacy graduates undertaking their foundation training this year still did not have an assigned Designated Prescribing Practitioner.
"Community pharmacists who are already independent prescribers would be able to use those skills to their full extent. This is essential if community pharmacy is to retain experienced prescribing pharmacists.”
