Prescribing within the CPCF

As part of negotiations on the Community Pharmacy Contractual Framework (CPCF) arrangements for 2026/27, it was agreed that prescribing (independent prescribing) will be introduced into the CPCF as an extension of Pharmacy First and the Pharmacy Contraception Service (PCS) from the autumn of 2026.

Community pharmacist prescribers will be enabled to:

• Prescribe within the existing Pharmacy First clinical pathways and the PCS.
• Provide up to five new Pharmacy First prescribing-only pathways – options to be considered include bacterial conjunctivitis, allergic conjunctivitis, oral thrush, skin infections and respiratory tract infections. In advance of their rollout, the new pathways will need to be approved by a clinical reference group. These consultations will count towards the monthly clinical pathways minimum activity requirement.
• Prescribe an alternative item where there is a need to meet the needs of an individual patient, e.g. where there is a supply chain issue relating to the original prescription, and there are arrangements in place with the original prescriber to allow such an approach.

The proposals build on the approach taken in many of the pharmacies involved in NHS England’s Independent Prescribing Pathfinder Programme, which sought to create a framework for future commissioning of NHS community pharmacy clinical services incorporating prescribing.

Supporting documentation and changes to the Terms of Service will cover a range of clinical governance requirements related to prescribing activities.

Funding

Funding will include a one-off setup payment of £500 payable when a pharmacy owner has signed up to provide the relevant services and has a confirmed go-live date with an NHS-assured Electronic Prescribing Service (EPS) IT system.

Additionally, there will be a monthly infrastructure payment of £525.

Pharmacy owners will also receive the usual Pharmacy First or PCS consultation fees.

CPE’s view on the addition of prescribing to the CPCF

In principle, we are supportive of the addition of prescribing to the CPCF, as it represents a strategically important service development for all in the sector.

However, while the funding for the sector is under such strain, we did not believe it was the right time for such a service to be introduced into the CPCF, with funding coming from the contract sum.

Instead, during negotiations we proposed to DHSC and NHS England that they agree with us a National Enhanced Service for prescribing that could then be commissioned locally by ICBs, with their local budgets funding the service.

For the Government, adding prescribing to the CPCF was a must, as it was a manifesto commitment.

However, despite our acceptance of the final CPCF offer, we are not persuaded that sufficient investment is being made to enable the full and effective introduction of prescribing, given the workload, enhanced clinical responsibility, clinical governance and infrastructure requirements that it will entail.

The details of the clinical governance requirements will be published in due course, but while they are necessary to ensure a safe prescribing service, they also require appropriate resourcing. That will not just be monetary, as in many cases, pharmacy owners will likely also need external support with implementing and sustaining the clinical governance requirements.

Throughout the negotiations, we raised our concerns that with the proposed funding, the addition of prescribing to the CPCF risked being set up to fail.

DHSC did increase the monthly payment level for pharmacies providing a prescribing service as a result of our arguments during the negotiations, but we do not believe it is set at a sufficiently high level when the IT and governance costs are considered.

Similarly, we believe a higher consultation fee should be paid for prescribing services compared to those provided using a PGD, due to the enhanced clinical responsibility of practising as a prescriber.

Ultimately, the CPE Committee had to decide on the overall final 2026/27 CPCF offer made by Ministers, which included the addition of prescribing to the CPCF. The wider benefits to the sector of a 10.3% funding increase and other elements of the final offer meant the offer was accepted, despite some elements not being to our liking, such as the funding for prescribing.

It will be down to pharmacy owners, cognisant of the above information, to decide on an individual basis whether it makes commercial sense for their business or whether they will instead prioritise the use of IP skills elsewhere in their business.

It will be imperative that next year, and in future years, sufficient funding is secured to fully support prescribing within the CPCF and we will be lobbying intensively for this.

Frequently asked questions

 Q. How is the EPS IT necessary for the introduction of IP into the CPCF to be funded?
DHSC and NHS England expect the cost of the EPS system to be covered by the one-off setup payment of £500 and the monthly infrastructure payment of £525.

Q. Will consultations within the new Pharmacy First prescribing-only pathways count towards the monthly clinical pathways minimum activity requirement (for the £500/£1000 payment)?
Yes.

 Q. When will IP be implemented into services?
Subject to the necessary preparatory work being completed by NHS England and DHSC, IP will start in the autumn (likely in October).

Q. How does IP apply to Distance Selling Premises (DSP) pharmacies?
Where a DSP pharmacy provides the current Pharmacy First and PCS via remote consultations, an IP could prescribe within the scope of those services. Similarly, the provisions for issuing replacement prescriptions, e.g. where there are supply chain issues, would also apply to DSP pharmacies with an IP.

During the development of the five additional prescriber-only Pharmacy First clinical pathways, consideration will be given to whether those conditions are suitable for management via remote consultations.

Further information

We will continue work with DHSC and NHS England which commenced during the 2026/27 negotiations to agree the fine detail of the service and regulatory requirements related to the addition of prescribing to the CPCF.

Further information will be published ahead of the go-live date in the autumn.

For more information on this topic please email services.team@cpe.org.uk