Prescribing pathfinder update: Showing the path ahead

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NHS England’s Independent Prescribing Pathfinder Programme is picking up momentum across England. At least half a dozen community pharmacies have been up and running with the CLEO SOLO EPS (electronic prescription service) since December last year, and there are more to come. 

The first site to go live with the CLEO system was Well Pharmacy in Keighley, Yorkshire, in December last year. This was particularly fitting as this was also the first pharmacy in England to process an electronic prescription issued by a GP – in February 2005. 

The Keighley pharmacy was followed in January this year by Well Pharmacy in Lees, Greater Manchester, under the guidance of pharmacy manager and clinical pharmacist independent prescriber Amul Mistry and his team.

Commenting on the launch of the IP pathfinder programme at Well, group superintendent Ifti Khan says: “Our colleagues were excited to have the opportunity to support this transformational initiative and the wider NHS, enabling pharmacy to truly be the first point of contact for patients with minor ailments. We are looking forward to watching the benefit this service will have to local patients and how we can continue to support the Government’s agenda of Pharmacy First and early detection and prevention.”

Patient satisfaction high

Jainil Patel, deputy superintendent and head of professional services at the Hollowood Chemists group in Manchester, sent off his first NHS prescriptions as an independent prescriber as part of the pathfinder project in February.

Specialising in common ailments, respiratory, hypertension and lipid management, Patel says patients “love the service so far” – and he is also a fan. 

“The benefits for us include being at the cutting edge of pharmacy practice and utilising our clinical skills to improve prescribing habits, which not only helps immeasurably patients who cannot access healthcare but also has a positive impact on our relationship with GP practices,” he says. “It also paves the way for the next generation of pharmacists and the next chapter of pharmacy.”

Nonetheless, Patel says there are still some clear challenges, which he will be feeding back to NHS England. These include, he explains: “Lack of IT infrastructure and a pharmacy-GP instant communication platform/portal; no access to lab tests; a lack of integration of different IT platforms, such as a booking system and clinical records; and funding issues.”

Black Country progress

In the West Midlands, five pharmacies have been selected to participate in the pathfinder programme. This utilises the expertise of more than 16 pharmacist IPs, who will support patients from diagnosis to prescribing for common conditions including earache, eye infections, muscular pain and skin problems, as well as the contraceptive pill. 

Four of the five sites are now live, starting with Bloxwich Pharmacy in Walsall in December 2024, followed by Masters Pharmacy in Sandwell in January, and Dixons Green Pharmacy in Dudley and Ettingshall Pharmacy in Wolverhampton in February. The remaining site – Swinford Pharmacy in Dudley – is set to go live in the next few weeks.

Hemant Patel, chief pharmacy officer, director of medicines and clinical policy at the NHS Black Country ICB, says: “There has a been a great deal of hard work and collaboration that has gone into bringing these sites live, including GP practices, local NHS clinical directors, those responsible for information governance, digital platforms and finance, NHS England, independent pharmacists, pharmacy owners and the ICB itself.” 

He added that despite the delay in launching the pilot, Black Country ICB ensured that all IP pharmacists were kept up to date on what progress was being made, “including fortnightly update meetings to discuss why there were delays and what actions were being taken to resolve the issues”.

Patel says feedback from patients so far has confirmed how convenient and professional the service is, while reaction from GP practices has been positive on how the pharmacies are supporting them with access and capacity challenges. 

In addition, he says: “Pharmacy colleagues are excited to be part of this transformational initiative and supporting the wider NHS, enabling pharmacy to be the first point of contact for patients with common conditions.”

However, he acknowledges: “We also recognise there is still a great deal of work to do, including new conditions to add, further feedback to collate, and educating both GP practices and patients on what the service involves and how it aligns to the Primary Care Access Recovery Plan and the ICB’s five-year primary care transformation strategy of having equitable access to high quality health and care for all, building resilient communities with improved health outcomes.”

Patel says that the ICB is in the process of gathering feedback to share with NHS England.

Results imminent

A wide-ranging review of the pathfinders is set to come from the University of Manchester, which has been commissioned to report on what the programme has delivered. This includes looking at its impact on health inequalities, as well as making recommendations for the service in the future. The report is expected any time now.

In the meantime, Community Pharmacy England’s service development subcommittee has said it will “continue to work with NHS England and other stakeholders through the IP Pathfinder Operational Delivery Group to support the pathfinder sites”. 

If all goes well, patients and pharmacists should expect to see even more access to diagnoses and prescribing through the doors of community pharmacies in England in the near future.