NHS sets ambitious timeline for pharmacy-led primary care expansion with prescribing services by 2026/27

NHS England has unveiled an ambitious new blueprint to enhance the role of community pharmacies by embedding 'pharmacy-first' approaches and introducing prescribing-based services starting in the 2026/27 financial year. This medium-term planning framework, covering 2026/27 to 2028/29, is hailed as the most ambitious NHS plan in a generation and aims to redefine community pharmacy's function from primarily dispensing medicines to becoming a frontline provider of accessible, timely primary care.

A key directive within the framework mandates Integrated Care Boards (ICBs) to introduce prescribing-based services within community pharmacies during 2026/27 and actively embed pharmacy-first models. This includes ensuring local commissioning discussions make the best use of pharmacy capacity to ease pressures across primary care. The plan also emphasises enhancing collaboration between general practice and community pharmacy to support broader access to pharmacy services, whilst maximising initiatives like the Discharge Medicines Service to reduce medication-related harm and hospital readmissions, and improving access to emergency contraception via pharmacies.

This framework builds on political momentum seen during the Labour Party’s recent election campaign, which pledged to create a Community Pharmacist Prescribing Service to extend independent prescribing rights among pharmacists. Confirming these intentions, MP and pharmacist Sadik Al-Hassam, chair of the All-Party Parliamentary Group on Pharmacy, has suggested a community pharmacist prescribing service could be operational within two to three years. However, questions remain about the specific nature and scope of these prescribing services and their operational impact across both ICBs and community pharmacists.

The NHS Community Pharmacy Independent Prescribing Pathfinder Programme complements this strategy and aims to mainstream independent prescribing within community pharmacies. Starting September 2026, all newly qualified pharmacists will be independent prescribers, expanding their ability to prescribe medications directly. The programme focuses on developing clinical pathways, governance frameworks, and clinical systems such as the NHS Electronic Prescription Service to empower community pharmacists to prescribe safely and effectively. Funding and support for commissioning these services will be provided to ICBs, ensuring readiness to integrate prescribing into routine primary care.

Despite the potential benefits, pharmacy leaders have expressed concerns about readiness and resourcing. Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA), highlighted the critical need for clarity on the availability of designated prescribing practitioners (DPPs) to support rolling out prescribing services. He advocated for a national prescribing service framework to ensure consistent, equitable patient access across the country. Without timely commissioning ahead of the autumn 2026 deadline when independent prescribing becomes standard for new pharmacists, there is a risk of underutilising these new skills, potentially resulting in their erosion.

Community Pharmacy England (CPE) chief executive Janet Morrison also raised caution, warning pharmacy leaders to prepare for “hard choices” as the upcoming community pharmacy contractual framework negotiations may be challenging amid constrained funding. Olivier Picard, chair of the National Pharmacy Association (NPA), similarly noted that many community pharmacies are currently “squeezed dry” and lack the capacity to provide additional services without substantial government investment.

Nevertheless, pharmacy leaders affirm the transformative potential of the pharmacy-first model showcased by the Pharmacy First service, which has already demonstrated improved access, reduced waiting times, and alleviated pressures across the NHS. The new NHS plan’s explicit endorsement of pharmacy-first approaches signals that community pharmacies are integral to future primary care and the government’s Neighbourhood Health Service strategy. This vision also aligns with the broader 10-year health plan’s aspiration to increase community pharmacies’ role in managing long-term conditions and complex medication regimens, shifting the sector towards integrated, patient-centred care.

In summary, while the NHS England Medium Term Planning Framework offers a bold roadmap to expand community pharmacy’s clinical role through prescribing and pharmacy-first models, achieving these goals will require clarity, funding, and collaboration to overcome logistical and workforce challenges. The next few years will be critical in transitioning community pharmacies from medicine dispensers to pivotal local health hubs capable of easing pressure on general practice and improving patient outcomes.

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Source: Noah Wire Services