Abstract
Introduction
The Independent Prescribing Pathfinder Programme has been introduced by NHS England to inform the future commissioning framework for community pharmacy clinical services incorporating independent prescribing (IP). This presentation will report insights gained from the national evaluation, which explores how IP is being implemented across diverse community pharmacy settings in England.
Aim
This study aims to understand what makes IP within community pharmacy work, for whom, under what circumstances and how.
Methodology
The evaluation runs from April 2024 to September 2025. Through an expression of interest to be part of the programme, there were 210 Pathfinder sites that were intended to go live in April 2024. However, delays with the Electronic Prescribing Service meant that the first few sites went live in October 2024. As a result, data collection took place between November 2024 and June 2025. Initial key informant interviews were conducted to inform our understanding and the design of the study. Data includes: (i) analysis of expressions of interest; (ii) short telephone interviews with Community Pharmacy Clinical Leads and IP pharmacists, and (iii) case studies. The latter involves in-depth interviews with pharmacy teams and their system partners, such as stakeholders from Integrated Care Boards (ICBs) and primary care partners, and some include observations at pathfinder sites. Data are being analysed in NVivo using a realist-informed approach to identify key contexts, mechanisms, and outcomes across sites [1,2]. This evaluation was approved by the University of Manchester Proportionate University Research Ethics Committee (Ref: 2024-20036-37105).
Results
The intended outcomes of the pathfinder programme include improving patient access to care, ensuring community pharmacists are working to their full clinical potential, supporting general practice, better enabling ICB level service delivery planning and improving patient experience. Our preliminary insights identified some of the facilitating factors. First, embedding IP-enabled clinical services into existing primary care pathways, through close collaboration with general practice and establishing positive relationships, supports coordinated care and appropriate referrals. Second, empowering IP pharmacists and mitigating their professional isolation is important for delivering safe and effective care, often supported through clinical mentorship, ad-hoc clinical support, and peer networks. Third, embedding IP-enabled clinical services into community pharmacy practice and workflows, through upskilling the pharmacy team, could enable IP pharmacists to focus on delivering clinical services incorporating IP. Within these areas, ICBs have adopted varying approaches. This variation allows us to identify what contextual factors and mechanisms are needed to achieve the outcomes intended. Our findings are presented around five key domains: clinical, digital, governance and safety, people, and funding and contracts.
Discussion
This evaluation offers valuable insights into the commissioning and governance of IP in community pharmacies. Findings will inform future commissioning and policy, which will be of importance as all newly qualified pharmacists will be independent prescribers on the day of registration from 2026. Limitations of the study include the delayed rollout of Pathfinder sites, which meant that some sites had limited time to implement IP services before data collection concluded. This may have restricted our ability to capture the data longitudinally.
The Independent Prescribing Pathfinder Programme has been introduced by NHS England to inform the future commissioning framework for community pharmacy clinical services incorporating independent prescribing (IP). This presentation will report insights gained from the national evaluation, which explores how IP is being implemented across diverse community pharmacy settings in England.
Aim
This study aims to understand what makes IP within community pharmacy work, for whom, under what circumstances and how.
Methodology
The evaluation runs from April 2024 to September 2025. Through an expression of interest to be part of the programme, there were 210 Pathfinder sites that were intended to go live in April 2024. However, delays with the Electronic Prescribing Service meant that the first few sites went live in October 2024. As a result, data collection took place between November 2024 and June 2025. Initial key informant interviews were conducted to inform our understanding and the design of the study. Data includes: (i) analysis of expressions of interest; (ii) short telephone interviews with Community Pharmacy Clinical Leads and IP pharmacists, and (iii) case studies. The latter involves in-depth interviews with pharmacy teams and their system partners, such as stakeholders from Integrated Care Boards (ICBs) and primary care partners, and some include observations at pathfinder sites. Data are being analysed in NVivo using a realist-informed approach to identify key contexts, mechanisms, and outcomes across sites [1,2]. This evaluation was approved by the University of Manchester Proportionate University Research Ethics Committee (Ref: 2024-20036-37105).
Results
The intended outcomes of the pathfinder programme include improving patient access to care, ensuring community pharmacists are working to their full clinical potential, supporting general practice, better enabling ICB level service delivery planning and improving patient experience. Our preliminary insights identified some of the facilitating factors. First, embedding IP-enabled clinical services into existing primary care pathways, through close collaboration with general practice and establishing positive relationships, supports coordinated care and appropriate referrals. Second, empowering IP pharmacists and mitigating their professional isolation is important for delivering safe and effective care, often supported through clinical mentorship, ad-hoc clinical support, and peer networks. Third, embedding IP-enabled clinical services into community pharmacy practice and workflows, through upskilling the pharmacy team, could enable IP pharmacists to focus on delivering clinical services incorporating IP. Within these areas, ICBs have adopted varying approaches. This variation allows us to identify what contextual factors and mechanisms are needed to achieve the outcomes intended. Our findings are presented around five key domains: clinical, digital, governance and safety, people, and funding and contracts.
Discussion
This evaluation offers valuable insights into the commissioning and governance of IP in community pharmacies. Findings will inform future commissioning and policy, which will be of importance as all newly qualified pharmacists will be independent prescribers on the day of registration from 2026. Limitations of the study include the delayed rollout of Pathfinder sites, which meant that some sites had limited time to implement IP services before data collection concluded. This may have restricted our ability to capture the data longitudinally.
| Original language | English |
|---|---|
| Journal | International Journal of Pharmacy Practice |
| DOIs | |
| Publication status | Published - 7 Nov 2025 |