The government should set out its plans for independent prescribing (IP) in community pharmacy, including by investing in a more ambitious Pharmacy First service, the Company Chemists’ Association (CCA) has urged.

The CCA said that the incoming national Pharmacy First service should make use of pharmacist independent prescribers (PIPs) ‘immediately’, and that the government must set out a clear role for the future of PIPs in clinical services so that businesses can be incentivised to train the workforce.

The CCA also warned against a soft launch of Pharmacy First, saying that all services should be commissioned nationally from day one of the scheme, as ‘there is no need to pilot something with so much evidence’.

The ‘bolder’ vision set out by the CCA, which includes calls for community pharmacy to be able to supply non-prescription medicines and prescribe additional prescription-only medicines, would transfer 30 million urgent appointments from GPs to community pharmacy every year, the association said.

This goes well beyond the six million appointments that the association expects could be transferred from general practice to community pharmacy under the government’s current plans, which CCA chief executive Malcolm Harrison described as ‘welcome’, but ‘only a drop in the ocean’.

The current plans for a nationally funded Pharmacy First service will allow pharmacists to supply prescription-only medicines to treat seven common health conditions under a Patient Group Direction (PGD) without the need for patients to visit a GP.

The service is due to be launched in England before the end of 2023, subject to consultation.

Mr Harrison said: ‘Under current plans, pharmacies are expected to free up six million GP appointments annually – but our analysis shows pharmacies could do five times this number.

‘Action to address the historic underfunding of pharmacies and a roadmap to utilise the clinical skills of pharmacists are essential to achieving this.’

He added: ‘The Covid-19 vaccination programme showed what pharmacies can do when the government places its faith and investment in pharmacies.

‘An investment in community pharmacy, is an investment in greater capacity for the NHS, enhanced resilience in primary care and better patient outcomes.’

According to the CCA, only 5% of employed and relief community pharmacists in England are currently IP qualified, and the organisation said it was likely that an even smaller number actually use their IP qualifications regularly as there are no NHS commissioned opportunities to do so.

The CCA said that despite low initial numbers, IP trained pharmacists should be able to prescribe within the Pharmacy First framework immediately.

And they added that the sector needs 95% of community pharmacists to be trained as IPs by 2030, saying that the use of IPs is ‘essential to unlocking the long-term potential of the sector’ and attracting and retaining the workforce.

Speaking at the Clinical Pharmacy Congress last month, chief pharmaceutical officer (CPhO) for England David Webb said that the plans for Pharmacy First to launch by the end of this year ‘supports the trajectory towards independent prescribing in NHS community pharmacy services’.

Towards that end, he said that NHS England (NHSE) was working on several pathfinder pilot projects which would be established in every ICB this year.

The pathfinder pilots will explore the range of services that could be offered by qualified prescribers in community pharmacy and to identify how those would fit into wider patient pathways in local integrated systems

And Mr Webb repeated his call for all employers – NHS, general practice and community pharmacy – to train enough pharmacists to meet the needs of the sector.

But the CCA said in today’s report that the government must set out its plans to make use of prescribing skills in community pharmacy, including the likely future earning potential for prescribers and businesses, as well as the required time frames, so that businesses can understand and be incentivised to support the workforce to transform.

The CCA also said that the sector needs:

  • immediate and continued funding investment;
  • a new approach to clinical governance;
  • reform to legal and regulatory frameworks;
  • electronic clinical communications;
  • and the national promotion of a Pharmacy First approach to patients.

A Department of Health and Social Care (DHSC) spokesperson said that the department was working closely with NHS England and Community Pharmacy England (formerly known as PSNC) to launch Pharmacy First by the end of 2023, adding that it ‘will share an update on timings shortly’.

And it said that it was ‘taking a range of actions to modernise and enable better use of resources and automation, allowing pharmacists to provide more care for patients’, as well as investing in IT infrastructure to enable read/write access to patient records for community pharmacies across England.

‘Community pharmacies play a vital role in the NHS and we are providing them with an additional £645 million investment that could free up as many as 10 million GP appointments a year. This is on top of the agreed annual £2.6 billion of funding set out in the pharmacy framework’, the spokesperson added.

The department also confirmed that NHS England is committed to undertaking an economic analysis that will inform future consultations on the payment the NHS makes for pharmaceutical services.

And it confirmed that it was currently in consultation with sector on the service specification and funding for the seven common conditions service outlined in the Pharmacy First plan, and was working on having all seven of these patient pathways, as well as the underpinning IT systems, ready for the launch of the service.

The department also said that from 2026 all newly graduated pharmacists will have a prescribing qualification and that it was upskilling the existing workforce to be prescribers.