Its findings confirm what the PDA’s Wider than Medicines policy has long set out: when pharmacists are enabled to practise as medicines experts within an integrated, patient‑centred system, outcomes improve and the profession thrives; provided the right safeguards, resourcing and infrastructure are in place.
The PDA also recognises the evaluation’s actionable recommendations and its call for NHS England, DHSC, ICBs and employers to act responsibly and collaboratively to address the barriers it identifies.
Crucially, the pharmacist workforce voice (pharmacist independent prescribers and non‑prescribing pharmacists) must be hard‑wired into planning and commissioning from the outset, not consulted as an afterthought. Early, formal engagement will surface practical risks and workforce implications sooner, improve service design and secure the buy‑in needed for safe delivery at scale.
Against this backdrop, the PDA’s position focuses on three imperatives and the impact they have on pharmacists’ workloads, wellbeing and professional practice.
Supervision reform must genuinely release pharmacists for clinical care
Pathfinder sites show that IP consultations routinely run 15–30 minutes or more, requiring full history‑taking, clinical decision‑making, documentation and follow‑up for long‑term conditions. Expecting pharmacists to deliver this while simultaneously accuracy‑checking, managing workflow and handling front‑of‑house demands fragments time and raises stress. Supervision reform should therefore actually free pharmacists from routine dispensing so they can provide safe, sustainable clinical care.
The PDA has consistently advocated for more than one pharmacist per pharmacy where clinically led services are delivered, enabling prescribing and non‑prescribing pharmacists to build fulfilling careers in patient care. The PDA’s model pairs a patient‑facing pharmacist with an independent prescriber, supported by trained technicians, the wider pharmacy team and, where appropriate, automation.
The evaluation itself highlights how a two‑pharmacist approach protects clinical time and patient safety. When protected clinical time is available, IPs can practise at the top of their licence, improving confidence, job satisfaction and retention, while non‑prescribing pharmacists develop in patient‑facing roles. Notably, several participants reported that the opportunity to do meaningful clinical work kept them in the profession.
Skill mix and role clarity are prerequisites for safe delivery
Where pharmacies succeeded, they either ran a two‑pharmacist model or had a robust skill mix with accuracy‑checking technicians, trained dispensers and foundation trainees maintaining workflow while the IP pharmacist consulted. Where skill mix was thin, teams came under pressure, patients waited longer, and pharmacists were repeatedly pulled back to the bench.
Skill‑mix change must be funded and planned, not left to goodwill. The PDA supports a national blueprint for roles, competencies and training pathways that mirrors our policies and approach: patient‑facing pharmacist plus clinic pharmacist, underpinned by technician/automation capacity.
Equally important is role clarity. Consistent with the Leng Review, the PDA distinguishes boundaries of clinical practice, set at practice level for staff groups (for example, who may see undifferentiated patients and under which protocols), from an individual professional’s scope of practice, which is defined by training, competence and ongoing credentialling.
Boundaries describe what the role is commissioned to do within the pathway, and scope describes what the individual is competent to do. Both must be respected when deploying IP services, roles must not be blurred, and patients must always be clear who they are seeing and at which stage of their care.
Infrastructure and governance must be delivered to the frontline responsibly and on time
The evaluation identifies digital fragmentation and limited read/write access to GP records as major drivers of duplicated administration and extended appointments, with safety concerns for complex cases. Access to pathology and phlebotomy varied widely, creating bottlenecks and uncertainty over who orders, reviews and acts on results.
Clinical governance, digital standards, data‑sharing and diagnostic accountability must be set and owned at NHS system level (national/ICB) under a single framework, not reinterpreted or diluted according to local commissioning intentions or individual contract holders. That approach aligns with the evaluation’s call for a national governance framework to ensure consistent safety, accountability and equity. These are preconditions for delivery at scale; without them, pharmacist workload and risk escalate while patient care stalls.
Conclusion
When these responsibilities are fully implemented, pharmacists experience higher professional fulfilment, safer workloads and genuine integration within neighbourhood health teams. When they are only partially implemented, pharmacists shoulder excess administrative burden, unsafe multitasking and uncertainty, eroding the gains IP is intended to deliver.
The evaluation’s message is unequivocal: successful IP in community pharmacy depends on freeing pharmacists to be clinicians, resourcing teams properly, fixing the infrastructure and upholding system‑level governance. That is the direction of travel the PDA has consistently advocated for and it remains the right path for patients, for pharmacists and for the NHS.
Learn more
- Evaluation of Independent Prescribing in Community Pharmacy Pathfinder Programme
- Wider than Medicines
- The Leng review: an independent review into physician associate and anaesthesia associate professions
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