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Numark chair Harry McQuillan has said Community Pharmacy England (CPE) and Labour must talk about “creating the foundations” for independent prescribing (IP) to support patients with more complex conditions beyond Pharmacy First and contraception “sooner rather than later”.

McQuillan (pictured) told Independent Community Pharmacist that although he did not regard talks on 2026-27 funding, which resulted in a £340 million increase in the sector’s global sum and integration of IP into Pharmacy First and the pharmacy contraception service, as “a missed opportunity”, it raised the question of whether CPE and the Government were “being ambitious enough”.

Its chief executive Janet Morrison insisted Labour did not have the money to expand pharmacist prescribing to complex conditions.

McQuillan, who described the introduction of IP to Pharmacy First and contraception as “a first step on a quest” for broader pharmacist prescribing across a range of disease areas, said community pharmacy's “value cannot ultimately be limited to treating minor ailments and common clinical conditions”.

Ambition requires investment

“As we approach a future where all newly qualified pharmacists will register as prescribers, it is fair to ask whether the sector should already be planning for something much wider,” he said.

McQuillan used mental health, cardiovascular disease and respiratory conditions as areas where pharmacist IPs could make a significant impact but conceded that “ambition requires investment”.

“Every day, pharmacy teams support patients living with long-term conditions, manage increasingly complex medicines regimes and provide advice to people who often struggle to access other parts of the NHS,” he said.

“The question, therefore, becomes should this settlement have gone further in creating the foundations for pharmacists to support patients with more complex conditions?”

McQuillan said the expanded hypertension case-finding service was “an excellent example” of how pharmacists could use their prescribing skills to bring about better health outcomes if they are funded to do so. 

“Across the country, patients can face lengthy waits to access support or medication reviews, while GPs continue to manage growing demand,” he said.

“Community pharmacists already have regular interactions with patients receiving antihypertensives and other cardiovascular medicines. They are often the healthcare professional patients see most frequently.

“Prescribing, in this area, is already well supported by clinical guidelines and formulary availability making its adoption and deployment a little easier.

“The same principle applies across a number of long-term conditions and I believe there is clearly an opportunity to explore where appropriately trained pharmacist prescribers could safely play a greater role in supporting patients, particularly in areas such as medicines optimisation, treatment continuation, routine reviews and ongoing management under agreed clinical frameworks.”

However, McQuillan cautioned that expanded IP should not be rushed into because of the “management of clinical risk, additional clinical responsibility, governance requirements, workforce implications and infrastructure demands” involved.

“Prescribing brings a change in mindset,” he said. “The reality is that becoming a prescriber and operating as a prescriber are two very different things.

“Having more pharmacist prescribers in the workforce is undoubtedly positive, but unless pharmacies have the capacity, infrastructure, technology and funding required to deploy those skills effectively, there is a risk that much of that clinical potential remains untapped.”

McQuillan added: “The inclusion of prescribing within Pharmacy First and the contraception service establishes an important precedent. It creates the contractual mechanisms, operational experience and clinical confidence needed to demonstrate what pharmacist prescribing can achieve. What matters now is what comes next.

“The Government's commitment to a wider reform programme provides an opportunity to think much more strategically about the future role of prescribing within community pharmacy.

“Rather than asking what pharmacists can prescribe today, we should be asking what healthcare challenges pharmacists are best placed to help solve over the next decade.”