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Giving every new pharmacist independent prescriber status is one of the boldest reforms the profession has ever seen. But the qualification alone will not transform practice. It’s the support, culture and confidence built around it, says Trevor Gore…

In just a year from now, every newly qualified pharmacist in the UK will join the register, not just as a medicines expert but also as an independent prescriber (IP).

That means prescribing authority from day one, right at the start of their career. This is a seismic shift. Right now, around a third of England’s pharmacists already hold the qualification.

You’ll find them spread across GP practices, hospital trusts and community pharmacies. And let’s be honest, GPs often have the smoother ride, with access to budgets, IT systems and prescribing codes already built into their roles.

So, what happens when a whole new wave of prescribers enters the workforce? Will they be welcomed into well prepared systems or will they find themselves in limbo, ‘prescribers on paper’ but not in practice?

And the bigger question still: if you don’t become a prescriber, do you risk being left behind as little more than a glorified dispenser? Pharmacy is standing at a critical junction.

One road leads to a confident, prescriber-led future, where pharmacists are central to patient care. The other risks leaving parts of the profession behind, stuck in supply-driven roles while the rest of the health system moves on.

The writing is on the wall. Prescribing is the future. The real challenge now is making sure every pharmacist feels capable, supported and motivated enough to embrace it.

To understand what’s stopping pharmacists from stepping into prescribing roles, it helps to break it down using the COM-B behavioural model (Capability, Opportunity and Motivation – Behaviour)

Capability: Psychological and physical. Psychological capability is about knowledge, skills, and confidence. Many pharmacists, particularly older cohorts, never had prescribing exposure built into their undergraduate training.

That leaves a gap in clinical decision-making experience and a sense of self-doubt. It’s not about intelligence, it’s about confidence. Physical capability refers to the practical side, about having the right tools, processes, and practice opportunities. If pharmacists don’t get hands-on chances to apply prescribing in safe, supported settings, they won’t build the muscle memory they need.

Nudges to help: Share case studies of colleagues who’ve made the transition to inspire confidence. Build refresher training at career milestones like role changes, revalidation or CPD cycles, so pharmacists can re-engage without feeling left behind.  

Opportunity: Social and environmental. Physical opportunity is about infrastructure, time, money and supervisors. Right now, many pharmacists struggle to access protected learning time.

Designated Prescribing Practitioners (DPPs) are in short supply, and in community pharmacy especially, the role of the IP isn’t always clearly mapped out. Social opportunity is about culture. If colleagues, employers or professional networks aren’t supportive, it’s much harder to make progress.

Nudges to help: Employers can make enrolment on IP pathways the default option when funding CPD, removing friction. Offer incentives and recognition, whether through prescribing premiums, awards or visible celebration of prescriber roles.

Motivation: Reflective and automatic. Reflective motivation is shaped by conscious beliefs – ‘will prescribing really benefit me in my role? Will it make me more employable?’

Automatic motivation is the emotional side, the fear of litigation, anxiety about risk or simply not seeing oneself as a prescriber. These emotions are powerful blockers.

Nudges to help: Use social proof and promote the message that ‘most pharmacists are now prescribers’. Nobody wants to be left behind. Frame prescribing as career insurance – greater autonomy, more employability and professional status. This taps into loss aversion bias. The fear of missing out on opportunities is often more powerful than the promise of gain.

Not every pharmacist will become an IP immediately, but opting out altogether carries risks. For individuals, fewer career prospects, exclusion from advanced roles and greater job insecurity as employers increasingly prioritise pharmacist IPs. For the profession, a fractured workforce, with fresh graduates arriving as prescribers while older cohorts risk being left behind.

That could weaken pharmacy’s influence in integrated care systems. For patients and the NHS, it could mean unequal access to prescribing services, bottlenecks in primary care models and missed opportunities to ease GP pressures.

Of course, some still ask whether it’s a conflict of interest to both prescribe and dispense. But is this any different from dispensing doctors, who’ve long managed both roles? The key lies in governance and transparency. With robust systems, pharmacists can wear both hats safely, delivering prescribing services without compromising professional integrity.

Rolling out IP status to every new pharmacist is one of the boldest reforms the profession has ever seen. But it’s not the qualification alone that will transform practice. It’s the support, culture and confidence that’s built around it.

Unless we tackle apathy, paralysis and anxiety, we risk creating prescribers in name only. But if we align capability, opportunity and motivation, through smart nudges, employer backing and visible wins, we can ensure pharmacy takes its place as a confident, prescribing profession.

The choice is clear – either seize this prescriber-led future or risk being left behind as the healthcare system moves on without us. The writing’s on the wall. The future of pharmacy is prescribing. The question is, are we ready to step into it?

Trevor Gore is the founder of Maestro Consulting, a Self-Care Forum trustee and associate director at the Institute for Collaborative Working.