Big changes are happening in pharmacy prescribing across England — and the details might surprise you. For the first time, a full list of the community pharmacy independent prescribing pathfinder sites and their clinical focus areas has been made public, thanks to data obtained by The Pharmaceutical Journal through a Freedom of Information (FOI) request to NHS England.
The findings highlight a shifting landscape in community pharmacy care. More than two-thirds (69%, or 133 sites) of these pathfinder locations are concentrating on minor ailments — the kinds of everyday health issues typically managed by general practitioners (GPs). Nearly half (43%, or 83 sites) have taken on the challenge of hypertension management, exploring how pharmacists can help tackle one of the nation’s most persistent health concerns. But here's where it gets interesting — and maybe a bit controversial.
Around one-fifth (21%, or 40 sites) of the pathfinder pharmacies are experimenting with prescription management, suggesting a move toward more active oversight of patients’ medicines. Contraceptive prescribing is the focus at 14% (27 sites), while 13% (33 sites) are engaged with or plan to study respiratory conditions. Smaller but notable numbers have ventured into other clinical areas: eight pharmacies (4%) in women’s health, seven (4%) exploring deprescribing practices, and three (2%) each studying the role of pharmacists in depression management and broader health outcomes.
Exploring how far pharmacists can go
The pathfinder initiative, launched in 2024, was designed to test pharmacist-led prescribing in specific health areas. According to Wasim Baqir, head of pharmacy integration at NHS England, the programme has already recorded an impressive 45,656 consultations as of November 2025. “We’ve had a phenomenal response,” Baqir told attendees at the Clinical Pharmacy Congress (CPC) North in Manchester.
In 41% of these consultations (18,664 cases), pharmacists issued new prescriptions — medications that would otherwise have required a GP visit. Baqir painted a vivid picture: “Imagine visiting a pharmacy, having a consultation, but then being told you need to see a GP just to get the prescription — it’s inefficient and frustrating.” The new system, he said, “is better for patients, better for doctors, and better for pharmacists.”
Medicines were modified in about 10% of consultations (4,745 cases) and discontinued in 3% (1,266 cases). By August 2025, a total of 12,597 prescription items had been issued across most British National Formulary (BNF) categories, with drugs targeting infections, ear-nose-and-throat issues, skin conditions, cardiovascular disorders, and central nervous system concerns being among the most common.
Funding concerns on the horizon
However, national funding for the pathfinder programme is scheduled to end by late 2025. NHS England has since urged Integrated Care Boards (ICBs) to continue supporting local prescribing projects where possible. As Baqir explained, “We’re thinking hard about what national and local pharmacy prescribing services could look like within neighbourhood systems.”
He noted that NHS England is simultaneously reviewing digital infrastructure, including electronic prescribing systems, and considering adjustments to payment structures and the Pharmacy First scheme to integrate prescribing more seamlessly. “Professional assurance is critical,” he emphasized. “Pharmacists taking on prescribing duties must have the right safety net and support.”
The data speaks — but the full story isn’t out yet
An independent evaluation led by the University of Manchester is underway but has not yet been published by NHS England. Ellen Schafheutle, professor of pharmacy policy and practice, offered a glimpse into the ongoing assessment during CPC North. Researchers conducted 110 interviews across 39 of England’s 42 ICBs, collecting insights from ICB leads, prescribing pharmacists, GPs, and major pharmacy chains. They also included sites that dropped out of the pilot to understand their challenges.
The evaluation includes ten in-depth case studies that looked closely at how teams function within pharmacies. One major insight? “Skill mix in community pharmacies is crucial,” Schafheutle observed. Many pilot sites adopted a two-pharmacist model to enable independent prescribers to run clinics safely and efficiently. Others expanded their pharmacy teams with diverse skill sets to free up pharmacists for clinical duties.
A cautious but promising path
At the Pharmacy Show in October 2025, Baqir revealed that nearly two-thirds (60%) of all consultations in the programme so far have involved minor ailments — reaffirming that pharmacists are increasingly on the front line of everyday healthcare. However, questions remain about how widely this model can be sustained once central funding ends.
First announced in 2022, the pathfinder initiative set out to test NHS-funded pharmacist prescribing services in every region of England. Although pilot sites were expected to begin in 2023, regulatory delays and the development of a specialized IT system meant the first site didn’t officially launch until late 2024.
The big question now is whether this groundbreaking shift will become a permanent part of England’s healthcare system — or whether it risks stalling just as it gains momentum. Are community pharmacists ready to take on this expanded clinical role, or does the system still rely too heavily on traditional GP models? What do you think — should pharmacist prescribing become the new norm in primary care? Share your views in the comments.
