Community Pharmacy Independent Prescribing: Is It Worth It?

There’s a lot of talk about community pharmacy independent prescribing right now, and a lot of it is hype. So let me answer the three questions I actually get asked: is NHS community pharmacy really going to use independent prescribing? What are the risks and benefits? And what does it mean for your wage? Here’s the honest version — no spin.

1. Is community pharmacy actually going to use independent prescribing?

Short answer: yes — but the first thing you have to do is separate the four nations. This is a devolved health service, and the picture in England is nothing like the picture in Wales or Scotland.

In Wales and Scotland, prescribing already exists in community pharmacy, and it’s being used — to the extent that the individuals who can prescribe effectively have their own prescription pad, or something very close to it. They’re not waiting for a policy announcement; they’re already doing it. If you want a preview of where England is heading, look there.

In England, it’s different — we don’t have that yet. There’s been a lot of noise about the roughly £340 million of funding, about pharmacists “prescribing from August”, and so on. The honest answer to “is it happening?” is yes and no. Yes, prescribing is coming. But there is no national independent prescribing framework in England yet. What’s actually been agreed is a limited set of around five clinical conditions — think along the lines of conjunctivitis, some respiratory presentations, and certain skin or hay-fever-type conditions — that will be nationally agreed for pharmacists to prescribe against.

That is not open, independent prescribing across a broad range. You don’t get to say, “right, I’ve got my pad, I’ll prescribe whatever I think.” It doesn’t work like that. Over time I’d expect it to broaden — England will probably move towards where Wales and Scotland already are — but as it stands right now, it’s those five conditions, starting around August or September.

England vs Wales & Scotland: the reality

2. What are the risks and the benefits?

This is the interesting one. My read is that those five conditions won’t be dropped on you with no support — there’ll almost certainly be some sort of framework wrapped around them, probably PGD-style, to guide what you do. And that’s a good thing for risk: doing this inside a national governance structure is less risky than prescribing totally on your own, because there’s scaffolding around your decisions.

But — and this is the part people skate over — the liability still stands with you. A framework reduces your risk; it does not remove it. Whenever you’re prescribing, there is risk, full stop. So the benefit (structure, support, a defined scope) comes with a permanent condition attached: you have to be trained properly. Without the right training you will genuinely struggle.

And here’s the distinction I want to hammer home, because it’s where people get into trouble: prescribing is not the same as diagnosing. The clever bit isn’t signing the prescription — it’s correctly working out what’s in front of you. You need to be able to diagnose, not just prescribe. If your diagnostic skills aren’t up to it, a prescribing qualification just gives you a faster way to be wrong. Get that training right and the risk is manageable; skip it and you’re exposed.

If you’re not yet a prescriber, that’s the first practical step — and finding the right supervisor is half the battle. I’ve written separately on how to find a DPP. And if you’re thinking about building a private service on top of the NHS work, the governance side matters enormously — that’s all in how to set up an online prescribing service.

3. What does it mean for your wage? The honest bit

This is what everyone actually wants to know, so let me be straight. The consultation fee for these services is roughly the bog-standard £17-plus per item or consultation. Now — how much of that does the employed pharmacist see? That’s a conversation you have to have with the owner. It doesn’t automatically land in your pay packet.

Before you march in demanding a cut, understand how a pharmacy actually makes money. It used to come largely through the margin on dispensing medicines. That balance has shifted — funding has moved out of the medicine margin and into services. So when you look at it and think, “this pharmacy’s getting £17 a time and doing 100 consultations, I want a piece of that,” — yes, perhaps. But a lot of money has been moved around to fund these services in the first place, so the real profit margin isn’t as fat as the headline £17 × 100 makes it look.

Which is why, honestly, I can’t see hourly wages jumping off the back of this right now. A pharmacist’s basic might be around £20 to £24 an hour as a base, topped up through services. I don’t see the model where you get £35–£40 an hour on top of your service income being sustainable, because pharmacies will genuinely struggle to fund it. That’s not me being pessimistic — it’s just the maths of where the money sits.

So my advice: understand the owner’s position, then negotiate from an informed place. If you want to know what’s realistically on the other side of the table, it’s worth understanding how much a pharmacy owner actually makes before you sit down. And I do believe there’ll be levels to prescribing — if you’re genuinely good at it, you can negotiate and do well. This isn’t “everyone gets the same rate.” The strong prescribers will earn it.

So — is it worth it?

Yes, on balance — with conditions. It’s going to happen. It benefits patients. The profession is clearly changing direction, and you can see that not just in prescribing but in the relaxation around supervision too. Standing against the tide isn’t a career strategy.

But the individual pharmacist has to be trained properly, because the risk to you increases. That’s the trade. And if you want to see where England is heading, don’t just read the press releases — look at Wales and Scotland, where they’re already prescribing a lot more. That’s your roadmap.

Get the training right, understand the money, and negotiate from knowledge rather than hope — and community pharmacy independent prescribing is absolutely worth getting on board with.

If you need help developing your prescribing skills for these conditions, or you’re looking for a DPP to get qualified, get in touch. I run structured training through medlrn.co.uk, and I mentor pharmacists directly. Happy to help.

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