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The Pharmacists’ Defence Association is pushing for a new commissioning framework for community pharmacy clinical services, arguing that the way such services are commissioned and assured has not kept pace with the needs of patients and the NHS.

PDA director of pharmacy Jay Badenhorst says this is not a rejection of existing contractual arrangements, but a recognition of their limits.

“Community pharmacy contractual frameworks have played an important role in supporting pharmacy’s traditional function as a medicines supply and distribution network, alongside a defined set of professional and public‑health services,” he says.

“They provided stability, consistency and a mechanism for remunerating a network delivering high‑volume, transactional activity at scale. However, whether you like it or not, the role of community pharmacy is changing.”

Pharmacists are increasingly delivering complex, risk‑bearing clinical services, including independent prescribing, long‑term condition management and urgent care pathways, Mr Badenhorst argues in the latest PDA blog.

“These are not simply extensions of supply; they are clinical interventions, delivered to defined populations, with direct implications for patient safety, outcomes and system flow. A framework designed primarily for medicines distribution is therefore being asked to do something it was never built for.”

CPCF mechanisms may remain appropriate for funding distribution and baseline quality improvement, but they are structurally unsuited and not sufficient as assurance vehicles for prescribing‑based and diagnostic‑adjacent care, Mr Badenhorst says.

As NHS‑commissioned clinical services expand in community pharmacy, the locus of assurance must move, he continues. Professional and clinical assurance should be designed, owned and audited at NHS local system level. This, he says, reflects established NHS practice elsewhere.

GPs, dentists and optometrists delivering NHS care operate within performance frameworks, embedded in commissioning governance. These systems provide clear entry and maintenance standards, with ongoing appraisal and scope assurance. They offer proportionate remediation and suspension powers and maintain public confidence through transparent governance.

“Pharmacists delivering NHS‑commissioned prescribing services currently do not benefit from equivalent structures, despite holding comparable clinical risk and responsibility,” he argues.

Independent prescribing, expanded clinical pathways and neighbourhood care models demand a different commissioning mindset, Mr Badenhorst concludes. “The PDA’s advocacy for a new commissioning framework is therefore not radical, it is necessary.”