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We can look for all the excuses in the world not to make this happen but the Government need to just get on with it, says Mike Hewitson…

Becoming an independent prescriber has opened up so many opportunities for me to develop my practice and skillset that I encourage anyone to do it.

If you’re in any doubt about the importance of prescribing, look to the Government’s commitment of a community pharmacist prescribing service, although it was only mentioned in its election manifesto.

The IP pathfinder programme is at least 12 months behind schedule and its objective is to show that prescribing can work in a community pharmacy setting.

I sent first ever NHS prescription written by a community pharmacist 

After many hurdles with IT, I can confirm I sent the first NHS prescription ever written by a community pharmacist in Dorset. It does work and is helping patients to connect with the right medicines much more promptly than waiting weeks for a GP appointment.

Prescribing is absolutely the future for the sector, with every new pharmacist from next August qualifying as a prescriber upon registration. This will bring a step change in the number of qualified IPs every year thereafter.

Sure, the legacy workforce needs to be trained and there are still bottlenecks with designated prescribing practitioners, but pharmacists are definitely keen.

So, how will Labour’s plan work?

Well, the couple of sentences in their manifesto are understandably light on detail but it would be logical to assume the IP pathfinders will potentially morph into the new service.

Funding for it will have to come from outside the community pharmacy contractual framework global sum, because that pot is already more than fully committed to keeping the lights on.

In Wales, the service is worth up to £3,000 per pharmacy per month which is meaningful, but given our diverging payment systems, a higher fee may be required in England because the rest of the funding package is much less generous.

What are all of these prescribers going to be doing?

The big question is ‘what are all of these prescribers going to be doing?’ Again, Wales has some really useful resources with their All Wales Common Ailments Formulary which details 27 different conditions. 

This would be a really good starting point. I hope the pathfinder programme would be able to generate a similar approach in England, so there is some consistency over the offer or else we will end up with a piecemeal postcode lottery of provision across the country.

It doesn’t mean there couldn't be more specialism or local bolt-ons, merely there would be a common starting point to help patients.

National prescribing service needs commitment to CPD, audit and peer review 

Prescribing isn’t just about writing a prescription. That’s the easy bit. It’s a completely different way of thinking and practising as a pharmacist. Any national prescribing service needs to build in a hard commitment to support CPD, audit and peer review which are all integral to a quality prescribing service.

We are going to be waiting some time for the results of the IP pathfinders and nobody really knows what will happen to the sites that are already up and running. It would be unforgivable if they were put into abeyance until the report was published.

It is entirely possible that an interim prescribing service emerges in a relatively short space of time but this needs a commitment from all sides and at a pace so far unseen in the pathfinder programme.

We can look for all of the excuses in the world not to make this happen or we could just get on with it. Current IT is laughable but functional, but we don’t need to spend two years waiting for the NHS to re-procure a new IT system.

We also don’t need to spend two years over-engineering a solution or tying professionals in knots. We need to set our pharmacists free to be clinicians with suitable guard-rails but as autonomous professionals.

Already, I’ve used the pathfinder to help patients who would otherwise have bounced into A&E, out-of-hours or eventually back to the GP, which has been professionally rewarding.

But prescribing isn’t like following a PGD how-to-do-it manual. It’s about using your professional knowledge and judgement for the benefit of the patient.

Independent prescribers aren’t going to want to take unnecessary risks and I know pharmacists well enough to know they aren’t going to be prescribing willy-nilly.

It is a hassle doing the IP Smartcard dance, swapping from device to device (honestly patients must think I’m mad), and I can’t see people writing prescriptions for trivial reasons.

Streeting wants wholesale reform and prescribing is best story we have to tell

The NHS simply doesn’t have the time to wait until 2027 or beyond to get this off the ground. We need bold leadership and we need advocates for an independent prescribing service throughout Government and the civil service.

If they want to see the power of what it can do, I urge them to find some prescribers to talk to about their experiences. I guarantee they will leave feeling a lot more energised about the opportunity than appears to be the case today.

Health secretary Wes Streeting wants wholesale reform and prescribing is the best story we have to tell.

Mike Hewitson is a pharmacy contractor and councillor at Somerset Council.