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Exclusive: With the Pharmacy First independent prescribing pathways set to launch in October, concerns have been raised around what Community Pharmacy England (CPE) has called the “significant shortcomings” of the IT arrangements currently in place. 

Only one prescribing IT solution – Cleo Systems’ EPS Community – has been approved for use ahead of the “interim” IP service arrangements that commence next month, with NHS England saying it is “working to establish a broader range of suppliers”. P3pharmacy understands this costs £2,500 a year before VAT.

It currently operates separately from existing software used for Pharmacy First. CPE has said this means pharmacies must log into a separate system to generate prescriptions and manually submit payment claims for every consultation.

Cleo EPS Community was used by the roughly 200 pharmacies that participated in the Community Pharmacy Prescribing Pathfinder project, which fully concluded at the end of March.

To help cover the cost of prescribing IT, the 2025-26 Community Pharmacy Contractual Framework (CPCF) contains provisions for participating pharmacies to receive a £500 one-off set-up payment and monthly £525 infrastructure payments.

P3pharmacy understands that rival IT companies have built much of the EPS2 prescribing functionality that is required but are waiting for NHS England to set out the formal technical requirements for joining the NHS buying catalogue. 

An email from an NHS Digital project manager to community pharmacy IT (CPIT) suppliers sent on September 9 and seen by P3pharmacy states: “In the next period, NHSE will be considering the policy and ministerial requirements, and will determine the optimum specification and inclusions needed to meet the longer-term strategic capability for the final product.

“Therefore, we will not be issuing any specifications or requirements for suppliers to develop anything in relation to this interim solution.

“This interim approach will remain in place until such time as we notify the market that a future item is ready for presentation and consideration, through the pharmacy consultation roadmap.”

Contractors ‘nervous about being cornered’

Surrey contractor Sunil Chandarana recently told P3pharmacy he would not be signing up to provide the IP service from October, commenting: “I've spoken to a lot of pharmacists who believe the same.

“They're not going to be doing the service because there's an IT costs element associated that’s in the hundreds of pounds, while the reimbursement makes a negligible difference.”

Brij Valla, managing director of membership group Avicenna, told P3pharmacy: “Our members are not nervous about prescribing. They are nervous about being cornered. A contractor who wants to be live in October has one approved EPS2 solution to choose from, at a price that swallows close to half the infrastructure payment before they have paid for anything else.

“They still have a consultation platform to fund. They still have a MYS platform to fund. They have not yet paid a prescribing pharmacist a penny. That is not a market. Buying groups exist because we know exactly what happens to price and terms when there is no competition in the room.”

Mr Valla called on the NHS to explain “what ‘interim’ actually means,” adding: “How many new solutions will be approved, and when? Where does that leave a contractor who signs a two or three-year agreement and then watches the catalogue open in the new year?”

He said that until those questions are answered, Avicenna is advising members to “negotiate a rolling arrangement, keep the notice period short, and sign nothing that assumes today's market is the one you will be trading in next summer”.

CPE: Arrangements ‘far from ideal’

Alastair Buxton, director of NHS services at Community Pharmacy England, said the interim IT arrangements are “far from ideal” with only one prescribing system approved by the NHS.

Mr Buxton also cited “the need to use separate clinical record modules or systems from those pharmacies are currently used to using to record their Pharmacy First and PCS consultations, the consequent lack of GP Connect Update Record functionality and the lack of an MYS API, meaning a manual payment claim for each consultation will have to be made”.

He said CPE has provided “frank feedback” to NHSE and the Department of Health and Social Care around the “significant shortcomings” of the interim IT arrangements, commenting: “Pharmacy owners considering providing CPCF prescribing services need to reflect on those arrangements as part of their overall consideration as to whether the operational and governance requirements to provide the service and the funding on offer make commercial sense for their business.”

Cleo: We can offer flexible contracts

A spokesperson for Cleo Systems told P3pharmacy: “Cleo Systems is excited to be able to enable the community pharmacy digital prescribing process as they support patients through new independent prescribing pathways. 

“We remain committed to providing community pharmacy with flexibility and choice and look forward to sharing news regarding this soon. This with the full intent of ensuring independent prescribers have both the solutions and contractual arrangements that meet their needs.”

The company said that as the technology provider selected by NHSE for the pathfinder programme it “worked closely with NHS England, Integrated Care Boards, and participating pharmacies to deliver and test an electronic prescribing solution capable of supporting independent prescribing into the future”.

It added: “Following the successful rollout of our prescribing technology within the Pathfinder programme, we are delighted that we can make Cleo Community EPS available to Pharmacy First pharmacists who choose to use the solution.

“We recognise that pharmacy businesses have different requirements and we therefore do not take a one-size-fits-all approach.

“Our commercial terms are designed to balance flexibility with the investment required to support implementation, onboarding, and service delivery of our CLEO Community EPS solution. Contract lengths therefore will vary depending on the specific package and requirements agreed.

“Commercial arrangements are agreed directly with community pharmacy and are treated as confidential between the parties.”

NHSE has been approached for comment.