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A new report from the Nuffield Trust warns that community pharmacists with an independent prescribing annotation are at risk of “deskilling” due to a lack of opportunities to use their qualification – potentially driving them into hospital work or the private sector. 

And with the current cohort of foundation year pharmacists to be the first to qualify as IPs at the point of registration, the report raises numerous concerns about the structures in place to support and supervise these professionals in their practice. 

Published today (April 9), the Nuffield Trust report considers how the UK’s workforce of over 98,000 non-medical prescribers – of which nurses form the largest cohort – are currently being deployed and whether policymakers are sufficiently focused on the needs of this growing workforce. 

The report, which is based on research carried out between September 2025 and January 2026, identifies numerous “gaps in support” that could “undermine” the IP workforce, including “patchy opportunities” for CPD, a lack of access to supervision for inexperienced prescribers and poor visibility of the work carried out by IPs.  

It makes several recommendations, including carving out a dedicated plan for non-doctor prescribers in future iterations of the NHS workforce plan and ensuring that prescribers carry out role-specific CPD as part of their yearly revalidation.  

“Limited supervision can have substantial impacts, including demotivating staff from working in the community and risking a more vulnerable workforce,” say the authors.

They add: "The extent to which IPs are using their prescribing abilities in practice is difficult to determine. 

“Where professionals are not actively prescribing, there is a significant risk that they will lose their prescribing skills and confidence or seek prescribing roles outside NHS-funded services.”

This ‘deskilling’ also gives rise to “emerging risks around safety assurances,” said the Nuffield Trust, adding that professional regulators are “best placed to address these risks through the revalidation process”.

“These issues are particularly significant for community pharmacy, where pharmacists are currently least likely to be actively prescribing despite having the highest proportion of prescribers within their profession,” say the authors.  

Sarah Scobie, deputy director of research at the Nuffield Trust, 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.” 

Commenting on the report, Company Chemists’ Association chief executive Malcolm Harrison said: “At the core of the issues is the absence of a nationally NHS commissioned independent prescribing service in England.

“Without this, the full benefits of pharmacist prescribing cannot be fully realised.”

National Pharmacy Association chief Henry Gregg commented: "We share the Nuffield Trust's concerns about the insufficient planning by the NHS and government to utilise the skills of thousands of independent prescribers who are currently working in pharmacies or will be qualifying in the coming months. 

"Prescribing absolutely cannot come at the expense of fully funding pharmacies for their dispensing work but without improved planning, there is a growing risk that newly qualified pharmacist prescribers will leave community pharmacy for hospitals or GP practices.

"As this report notes, in all professions new prescribers need proper support networks and adequate clinical supervision.

"Prescribers in community pharmacy have enormous potential to enable care closer to home supporting implementation of the 10 Year Health Plan and the shift from hospital to community and drive fresh opportunities for pharmacies.

"It is right that we use the skills of pharmacists fully in dispensing, managing repeat prescriptions and optimising medicines use."