THE PHARMACY GUY · PRESCRIBING & GOVERNANCE
Pharmacist prescribing is live. Who’s your named clinical supervisor?
NHS prescribing within the Community Pharmacy Contractual Framework (CPCF) started on 29 October 2026. Most of the talk has been about the fees and the IT. The requirement I think business owners will find hardest, and are most likely to overlook, is a named clinical supervisor for every prescriber.
My answer in brief
- What’s live: approved pharmacist prescribers can prescribe within Pharmacy First, the Pharmacy Contraception Service and five new prescribing-only pathways.
- What it pays: £500 to set up, then £525 a month, plus the usual consultation fees.
- What you need: ICB approval for the pharmacy and each prescriber, a prescriber available 24 hours a week for 45 weeks a year, and the IT and governance behind it.
- What people will overlook: regular access to a named clinical supervisor or prescribing mentor, with time to review prescribing.
Watch my explanation
Captions available. Read the transcript · Follow me on TikTok, @pharmacyguy5 ↗
What went live on 29 October 2026?
Amended Secretary of State Directions gave the legal basis for prescribing within the CPCF from 29 October 2026. Approved pharmacist prescribers can now:
- prescribe within the existing Pharmacy First clinical pathways, instead of supplying under patient group directions (PGDs)
- prescribe within the Pharmacy Contraception Service
- prescribe through five new prescribing-only pathways: acute otitis externa (adults), seasonal allergic rhinitis (children aged 4 to 11), mild to moderate acne, low-frequency episodic migraine (adults aged 18 to 64), and mild skin and soft tissue infections including scabies
“Live” on paper isn’t the same as live in practice, though. On launch day, Community Pharmacy England said that in reality there were no authorised prescribers or pharmacies ready to start, while ICBs processed a small number of early-adopter applications. Everyone is starting from the same line. Community Pharmacy England.
What does it pay?
| Payment | Amount | What it’s for |
|---|---|---|
| Setup | £500, one-off | Paid once the ICB has approved you and confirmed a go-live date |
| Infrastructure | £525 a month | Ongoing costs such as prescribing software, clinical supervision and other governance |
| Consultations | Usual fees | Pharmacy First or Pharmacy Contraception Service consultation fees |
Notice that clinical supervision is named as one of the costs the £525 is meant to cover. It’s part of the model, not an optional extra.
There are strings attached. You need to evidence prescribing activity (at least one completed NHS prescribing consultation) within three months of onboarding, or future monthly payments are withheld. If there’s still no activity at six months, NHS England can reclaim the setup payment and the monthly payments already made. Community Pharmacy England.
What does a pharmacy need before it can start?
The prerequisites are that you’re meeting your terms of service, already provide Pharmacy First and/or the Pharmacy Contraception Service, and have access to a pharmacist prescriber with the right annotation on the GPhC register. Then the preparation begins:
- Two approvals. The pharmacy premises must be approved by the ICB, and so must each pharmacist prescriber who will prescribe there. Add a new prescriber later, and they need approval before they start NHS prescribing consultations.
- Availability. A prescriber available for at least 24 hours a week during opening hours, for at least 45 weeks of each financial year, with evidence kept at the pharmacy for three years.
- At the premises. Consultations can be face to face or remote, but they must be provided at or from the pharmacy. The prescriber has to be at the pharmacy, even if the patient is at home.
- IT. A clinical record system, an EPS-approved prescribing system, access to the patient’s record, and a secure way to send the outcome to the GP practice.
- Governance. A prescribing SOP, a risk assessment for adding prescribing, updated business continuity plans, indemnity, a development plan for each prescriber, and regular audit of prescribing quality and safety.
I’ve written in more detail about the governance behind community pharmacy prescribing, and about how a locum’s competence and the pharmacy’s governance fit together.
The requirement I think will catch people out
Among the requirements Community Pharmacy England says may need more significant effort before you sign up is this one: making sure pharmacist prescribers have regular access to a named clinical supervisor or prescribing mentor, and time allocated regularly to review their prescribing practice (a prescribing appraisal). Community Pharmacy England.
The hours and the fees are easy to plan around. The supervisor is harder. Ask yourself:
- Who, by name, supervises each of your prescribers?
- Do they have the experience to supervise in the areas being prescribed, from acne to migraine to contraception?
- When does the prescribing review actually happen, and where is it recorded?
- If you’re a lone prescriber, or a locum covering several pharmacies, who do you take a difficult case to?
A good clinical supervisor does three things for a prescriber: supervises their decisions, audits their prescribing, and trains them where there are gaps.Faheem Ahmed
Without that, you have a prescriber working in isolation. That’s a patient safety risk, and a weak point in your governance.
What does good supervision look like?
Community Pharmacy England points owners to NHS England’s supervision guidance for primary care network multidisciplinary teams as a guide to implementing clinical supervision for pharmacist prescribers. It was written for PCN teams, so treat it as a model to borrow from rather than the CPCF contractual requirement itself. The useful parts:
- It separates day-to-day support (someone to ask in the moment) from regular clinical supervision with a named, more experienced clinician.
- It recommends monthly clinical supervision for clinical pharmacists, with each session lasting at least an hour.
- Supervision can be a package: one-to-ones with a named supervisor, supplemented by group supervision, action learning sets and peer support. Those can add to the named supervisor, but not replace them.
- It recommends protected time, a written supervision agreement, recording sessions (which doubles as CPD and revalidation evidence), and training for supervisors.
| Named clinical supervisor | Group or peer supervision | |
|---|---|---|
| Who | A named, more experienced clinician or prescribing mentor | Colleagues and an experienced facilitator, inside or outside the pharmacy |
| What it covers | Reviewing prescribing, discussing cases, auditing, a development plan | Case discussion, different perspectives, reducing isolation |
| Stand-alone? | It’s the core requirement | No: it supplements the named supervisor |
If you’re struggling to find supervision or an MDT
Plenty of community pharmacists don’t work alongside a GP, a dermatologist or a psychiatrist. If that’s you, this is where owners need to get creative, and it’s why we built Clinickly.
Clinickly’s multidisciplinary team lets you submit anonymised cases you see in practice and get a documented response from a relevant panel member, join monthly MDT sessions, and build reflective CPD. It’s for teaching and training only, not clinical decision-making: the treating clinician always decides and remains responsible. It doesn’t replace your named clinical supervisor. It’s the kind of group and peer support that sits around one, and it’s particularly useful if you’re building services in areas like ADHD, dermatology or interpreting blood results.
Join the Clinickly MDT ↗ Talk to me about your prescribing service
Commercial disclosure: I’m involved in Clinickly and offer training and support through MEDLRN.
The bottom line
Pharmacist prescribing in community pharmacy is a genuine milestone. But this isn’t simply “get your IP and start prescribing”. The fees, the hours and the IT are the visible parts. The named clinical supervisor is the part that keeps your prescribers safe and your governance defensible, and it’s the part I’d start on first.
Don’t underestimate the need for clinical supervision.
Frequently asked questions
When did prescribing within the CPCF start?
Prescribing within the Community Pharmacy Contractual Framework started on 29 October 2026. On launch day, Community Pharmacy England said no pharmacies or prescribers had yet been authorised to start, as ICBs were still processing a small number of early applications.
How much do pharmacies get paid for NHS prescribing?
A one-off £500 setup payment, then a £525 monthly infrastructure payment to help cover costs such as prescribing software, clinical supervision and governance, plus the usual Pharmacy First or Pharmacy Contraception Service consultation fees.
How many hours a week must a pharmacist prescriber be available?
At least 24 hours a week during the pharmacy’s opening hours, for at least 45 weeks in each financial year. Evidence must be kept at the pharmacy for three years.
Does a pharmacist prescriber need a named clinical supervisor?
Community Pharmacy England lists regular access to a named clinical supervisor or prescribing mentor, with time set aside to review prescribing practice, among the preparations to make before signing up. NHS England’s PCN supervision guidance can be used as a guide to how to do it.
Can a pharmacist prescriber prescribe from home?
Not under these NHS services. Consultations can be remote, but they must be provided at or from the pharmacy premises, so the prescriber must be at the pharmacy.
Does Clinickly give clinical advice on my patients?
No. Clinickly is anonymised, case-based teaching and CPD. Panel responses are advisory only and never directions for a live patient; the treating clinician decides and remains responsible.
Related reading
The governance behind community pharmacy prescribing · Independent prescribing in community pharmacy: is it worth it? · Pharmacists in 2030
Video transcript
Read the transcript of my video
So, on 29 October, as part of the Community Pharmacy Contractual Framework, pharmacists are now essentially going to be able to prescribe, and all the documentation is now ready for pharmacists and business owners to have a look at.
What we do know is the fees are around £500 as a one-off fee, then £525 a month, and there are certain things that have to be in place which you’re probably already aware of: IT, governance, risk assessments, training and so on.
Two things to note. One, the pharmacist prescriber has to be approved, and the site has to be approved. Keep that in mind.
But what I want to focus on is this idea of having a named clinical supervisor for the prescriber. This is what I think is going to be a lot more challenging to have in place, and maybe overlooked if you’re a business owner or you’re looking to prescribe. Yes, you have to have a pharmacist available for 24 hours a week over a 45-week period. That’s fine. But it’s whether you actually have this named clinician in place to help supervise, really audit, and deliver training for the prescriber. That’s what I’d recommend you definitely focus on as a business owner.
If any of you are struggling to have access to a multidisciplinary team, or struggling to find a named supervisor to implement the service, Clinickly have developed a fantastic tool that lets you submit cases you might see in practice and get feedback for teaching and training purposes only, not clinical decision-making, but also be part of that multidisciplinary team. So you could also implement new services, like an ADHD prescribing service, a dermatology prescribing service, or interpreting blood tests, and considering CQC.
As always, folks, if you’re interested in being part of this multidisciplinary team and having access to it, get in touch. But do not underestimate the need for a clinical supervisor. Thank you for watching. Subscribe, like and share. Let’s make a difference.
Edited transcript of my “Pharmacist prescribing is live” video. In the video I said 25 hours; the requirement is 24, corrected here. The article above expands on it with sourced detail.
Faheem Ahmed
The Pharmacy Guy. Clinical education, mentoring and professional development.