This story was originally published by Independent Community Pharmacist.

Pharmacists have reacted with concern to NHS England’s guidance that foundation trainees should focus on one clinical area when taking their independent prescribing training from 2025-26.

In its guidance, published last week, NHSE said foundation trainee pharmacists must have “a nominated prescribing area in which to complete some of the prescribing assessment activities, specifically those that require a prescribing consultation with decision-making to be demonstrated.”

NHSE justified that approach by suggesting it would provide trainee pharmacists with "a sufficiently focused area that isn’t too wide or overwhelming.”

“To put it another way, the nominated prescribing area gives the foundation trainee pharmacist a setting in which to demonstrate the generic skills of a prescriber,” NHS said, insisting the “nominated prescribing area will not limit the future scope of practice for the foundation trainee pharmacist.”

“The pharmacist prescriber can develop and widen their scope of practice when registered, supporting this with effective CPD,” it added.

The guidance prompted pharmacists to air their concerns on social media. Consultant pharmacist Paul Forsyth posted on X: “I'm one of the most sub-specialist pharmacists that you'll find, but surely FTY pharmacists need a grounding in generalist medicine, not specialisms.”

Agreeing with that assessment, Community Pharmacy Scotland’s director of operations Matt Barclay posted: “It’s a hangover requirement of the IP course that could do with adapting to the brave, new world. Fortunately, our standard operating procedure in Scotland have at least adapted a ‘common clinical conditions’ generalist ‘specialism’.”

GP pharmacist Laura Buckley posted: “Are we saying that pharmacists can't be generalists now? Choosing a ‘specialty’ for IP feels redundant in general practice when the vast majority of us cover broadly.”

Hospital pharmacist Chris Green posted: “The whole thing’s nonsense. Never asked for it, no need for it, the educational process is poorly thought out, the funding model for those delivering clinical placements is a joke, we’ve learned nothing from medical day one prescribers other than it’s ‘exciting’ times!”

The Royal College of Nursing’s General Practice Nursing Forum also had its say, insisting that “specialising too early will surely lead to narrowing, not widening practice” even though it is “essential” for independent prescribers to have “a broad range of clinical knowledge and expertise.”

NHSE said it does not have “a list of nominated prescribing areas that must be used” or “chosen from for a foundation trainee pharmacist in the foundation training year” but provided an outline of what the nominated prescribing area needs to be.