A pathfinder pilot scheme running between 2023 and 2025 looked at how best to commission and implement community pharmacy services, including IP, in England. The Independent Prescribing in Community Pharmacy Pathfinder Programme noted:⁷

·      integrated care boards (ICBs) can provide ‘handholding’ support and foster stronger relationships with general practice and other stakeholders;

·      formal clinical supervision, typically by a GP, with one-on-one sessions, helps build pharmacist confidence and knowledge (especially in new clinical areas), as well as build GP trust;

·      informal support networks, eg with peers, allow shared learning and builds collaborative support;

·      securing appropriate indemnity should become easier as insurers become more familiar with IP delivery;

·      mandatory standard operating procedures (SOPs) are required to managing the potential conflict of interest between prescribing and dispensing roles;

·      skill mix across community pharmacy teams needs to develop to allow the IP pharmacist to focus on IP activities, eg by having a two-pharmacist model or increasing auxiliary staff numbers.

A limiting factor was access to the patient record. Pathfinder sites had been using the nationally designated prescribing system CLEO a standalone platform intended to enable IP pharmacists to practise as independent practitioners. Lack of access to the patient’s full medical history, may impact prescribe safely, collaborative aspects or audit trail clarity.⁷