A rapid expansion in the number of pharmacist independent prescribers entering the NHS could be undermined by insufficient supervision, training and workforce planning, according to a new report from the Nuffield Trust.
The analysis warns that, without stronger support structures, ambitions to shift more care into community settings and better support people with multiple long‑term conditions could be put at risk.
The report found that more than 98,000 non‑medical clinicians across the UK — including nurses, pharmacists and allied health professionals — are now qualified independent prescribers.
As of April 2025, these clinicians account for almost a quarter of the UK’s prescribing workforce, reflecting a major shift in how care is delivered across the NHS.
Independent prescribing is seen as central to modernising services, improving access to treatment and reducing pressure on doctors. However, the Trust said the workforce is entering a period of rapid and complex change that risks exposing weaknesses in existing systems.
From 2026, pharmacists graduating from the Master of Pharmacy (MPharm) degree will qualify as independent prescribers at the point of registration for the first time.
The first cohort is expected to join the professional register in September 2026, and the report’s authors estimate this change will add several thousand new pharmacist prescribers every year. This is based on the fact that over 4,000 students have enrolled annually on the MPharm programme over the past four years.
However, the report cautions that many of these newly qualified prescribers will be relatively inexperienced in their chosen clinical areas, requiring robust supervision and ongoing professional development in order to prescribe safely and confidently.
Access to supervision was identified as a key concern — particularly in community pharmacy, where researchers found it is already limited and inconsistent.
Trainee independent prescribers rely on supervision from experienced clinicians known as designated prescribing practitioners (DPPs). Local leaders told the Nuffield Trust there are shortages of suitable supervisors, alongside variation in how supervision arrangements are organised and funded.
These challenges risk slowing the development of prescribers at a time when demand for community‑based care is growing.
The report also highlights broader structural issues affecting the independent prescribing workforce, including limited funding for training places, patchy access to continued professional development, and a lack of protected time to maintain and develop skills.
These issues are particularly acute in community pharmacy, where pharmacists currently have the highest proportion of prescribers within their profession, yet are least likely to be actively prescribing.
Without stronger workforce planning and support, the report warns there is a risk that newly qualified prescribers may be unable to use their skills in practice.
This could lead to loss of confidence among newly trained prescribers, reduced retention within the NHS, and movement into private sector roles, undermining public investment in training.
The authors argue that better planning, stronger supervision arrangements and improved monitoring of prescribing activity are essential if independent prescribers are to fulfil their intended role.
The Nuffield Trust is calling on the forthcoming NHS workforce plan to clearly set out:
- How independent prescribers will be integrated into neighbourhood health teams
- How the NHS will model and prepare for the influx of pharmacist prescribers from 2026 onwards
They also argue that improved oversight could strengthen the contribution of independent prescribers not only in community settings, but also within hospital and mental health services.
The report also highlights several important workforce statistics:
- By 2025, non‑medical clinicians made up 24% of the independent prescribing workforce
- Pharmacists have the highest proportion of their profession qualified to prescribe: 22,770 prescribers, representing 33% of all pharmacists
- Nurses account for the largest number overall: 68,180 prescribers, or 69% of non‑medical prescribers, though data gaps exist outside primary care
- By November 2025, 4% of physiotherapists, 7% of paramedics, 7% of chiropodists/podiatrists and 5% of therapeutic radiographers were independent prescribers
Deputy Director of Research at Nuffield Trust, Sarah Scobie, said:
“We have an ageing population which is now living with more health issues, and the government hopes its ambitions to shift more care closer to home will tackle some of the problems this poses. The NHS will need to harness the full potential of its fast-growing prescribing workforce to realise this change, but we have identified some worrying barriers.
“To get the most out of independent prescribing, the forthcoming NHS workforce plan must set out clearly the role prescribers will play within neighbourhood teams, and plans must be based on local population needs. Better monitoring of independent prescribing practice in all settings will also be crucial. Without this, the opportunities presented by the incoming wave of new pharmacist prescribers will sadly be missed.”
The number of pharmacist independent prescribers is increasing faster than in any other profession and is expected to rise significantly once a universal prescribing qualification is introduced.
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