NHS risks missing out on independent prescriber benefits
Growing the ranks of non-medical prescribers is a key part of the UK's plans to push the NHS towards a more community-based approach, but is at risk of being undermined by gaps in supervision, training, and workforce planning.
That's the finding of an independent report published today by the Nuffield Trust, funded by the Association of the British Pharmaceutical Industry (ABPI), which has uncovered weaknesses in support for independent prescribers, such as nurses, pharmacists, and paramedics.
NHS reforms have led to a surge in independent prescriber roles, with more than 98,000 – almost a quarter of the entire prescribing workforce – qualified at the start of April. Numbers are set to rise further, as all new pharmacists will qualify as independent prescribers from September by default, adding thousands to the tally each year.
The government is banking on them to support its community care drive, part of a three-pronged reform package along with digitalisation and an emphasis on prevention, rather than treatment, in the current 10-Year Plan for the NHS, and better support people living with multiple long-term conditions.
There are also benefits for the healthcare professionals, according to a 2025 study, which found increased job satisfaction among independent prescribers enrolled into the Pathfinder pilot project, which gauged the effectiveness of non-medical prescribing for minor ailments and chronic conditions like cardiovascular and respiratory diseases and menopause.
The Nuffield report warns that 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, but access to supervision – particularly in community pharmacy – is "already limited."
That is compounded by limited funding for training places and opportunities for continued professional development, as well as a lack of protected time for prescribers to maintain and develop their skills, according to the authors.
"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," said Nuffield Trust deputy director of research, Sarah Scobie.
"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."
Better workforce planning, stronger supervision arrangements, and improved monitoring of prescribing practice and activity will be needed if independent prescribers are to fulfil their intended role in expanding community-based NHS care, they conclude.
Commenting on the findings, the ABPI's medical director, Dr Amit Aggarwal, said: "Putting the recommendations of this report into action will be crucial if the government wants to deliver a true neighbourhood health service."
He added: "Nurses, pharmacists, and allied health professionals play a vital role in both prescribing medicines and taking patients off medicines when they no longer need them. The training needs of the independent prescribing workforce have been overlooked in recent years, and it is essential that training, supervision, and access to protected time for learning catch up."
