On 29 May 2026, the Department of Health and Social care (DHSC) announced a £340 million funding package aimed at improving access to healthcare for millions of patients across England by making fuller use of pharmacists’ clinical expertise. The proposals build on the growing clinical role of community pharmacists and mark a further step towards integrating pharmacy services into frontline patient care. The reforms expand existing independent prescribing arrangements by introducing a nationally commissioned NHS prescribing service within community pharmacy from Autumn 2026. This is intended to improve patient access to treatment and alleviate pressure on GP services. With increased clinical responsibilities for pharmacists, questions inevitably arise around accountability, risk management and potential exposure to clinical negligence claims.
The expansion follows the introduction of the Pharmacy First service in January 2024, which enabled patients to seek treatment for seven common conditions directly from community pharmacies without requiring a GP appointment. Those conditions include:
The initiative was designed to improve access to timely treatment while alleviating pressure on primary care services. Since its launch, the role of community pharmacies has continued to broaden, with many also offering services such as blood pressure monitoring, contraception consultations and access to emergency contraception.
The scheme has proved popular. According to DHSC figures, there were more than 3.3 million Pharmacy First consultations between March 2025 and February 2026, representing a 43% increase on the previous twelve months. The Government also reported that 86% of users had a positive experience when accessing support through their local pharmacy.
Independent prescribing is not a new concept within pharmacy practice. Pharmacists have been able to qualify as independent prescribers for a number of years and many already prescribe within specialist and primary care settings. The proposed reforms, however, represent the first nationally commissioned NHS service enabling community pharmacist independent prescribers to prescribe NHS medicines across a broader range of clinical pathways.
Under the Government’s plans, community pharmacists who hold an independent prescribing qualification will be able to prescribe within the existing Pharmacy First pathways and up to five additional prescribing pathways. Additionally, community pharmacist prescribers will be able to prescribe an alternative item to meet the needs of an individual patient.
Whilst details of the five additional conditions yet to be confirmed, there are several being considered, including bacterial conjunctivitis, allergic conjunctivitis, oral thrush, skin infections, respiratory tract infections.
The reforms represent a further step towards positioning community pharmacies as a key access point within the NHS, allowing patients to receive treatment more quickly and conveniently while reducing demand on GP surgeries, A&E and urgent care services.
There is little doubt that these developments will be welcomed by many patients and healthcare providers given their potential to improve access to treatment, reduce waiting times and make greater use of pharmacists’ clinical expertise. The expansion does, however, represent a substantial increase in responsibilities borne by community pharmacists.
The most common legal claims arising from pharmacy services typically include dispensing errors, failures to identify prescription anomalies and medication supply issues. Independent prescribing extends responsibilities beyond the supply of medicines and into patient assessment, diagnosis, clinical decision making and prescribing. Consequently, the scope for potential medico-legal scrutiny becomes considerably broader than that associated with traditional dispensing functions.
As prescribing services expand, pharmacist independent prescribers will also need to ensure they maintain a clearly defined scope of practice, reflecting their individual competence, training and clinical experience. Prescribing outside of that scope may increase patient safety risks and medico-legal exposure.
With greater autonomy comes greater accountability. Pharmacists undertaking patient assessments may face medico-legal challenges relating not only to medication errors but also to clinical decision making.
Potential areas of risk could include:
These risks are not unique to pharmacists, and are routinely encountered by GPs and other primary care clinicians. However, they represent a growing area of medico-legal exposure for community pharmacy services.
An important consideration will be the extent to which pharmacists have access to a patient’s medical records at the point of consultation.
Effective prescribing relies on a comprehensive understanding of the patient’s medical history, current medications, allergies and previous treatments. Where prescribing decisions are made based on a limited record or self-reported history, there is an increased risk of there being incomplete information to allow proper clinical judgement.
If access to clinical records is inadequate, concerns may arise regarding the safety and appropriateness of prescribing decisions, particularly in patients with complex medical histories or multiple pre-existing comorbidities. Ensuring that independent prescribers have access to appropriate digital systems and information sharing arrangements will therefore be important from a patient safety perspective and in mitigating medico-legal risk.
The practical realities of community pharmacy practice should not be overlooked.
Pharmacies already operate within busy and often challenging environments. Expanding prescribing responsibilities is likely to increase consultation volumes and add pressure to the service. High patient throughput, competing demands and time pressures are all recognised contributors to mistakes in healthcare settings.
Robust documentation will become increasingly important as pharmacists assume greater clinical responsibility.
Contemporaneous clinical records serve several essential functions. They support continuity of care, demonstrate the clinical reasoning behind decisions and have the potential to become crucial evidence in the event of a claim or investigation.
In clinical negligence litigation, courts frequently place significant weight on written records when assessing the standard of care provided. Conversely, inadequate documentation can create evidential difficulties and may lead to adverse inferences being drawn where critical aspects of a consultation have not been recorded.
As consultation volumes increase, appropriate systems and processes become increasingly necessary to enable accurate and efficient record keeping without compromising patient care.
Whilst the expansion of prescribing services presents significant opportunities for community pharmacy, it also reinforces the importance of robust clinical governance.
Pharmacists undertaking prescribing activities should ensure that they:
As the scope of pharmacy services continues to develop, effective governance, training and documentation will remain key in protecting both patients and practitioners.
The success of the independent prescribing expansion will ultimately depend on the effectiveness of the governance arrangements that accompany it. Appropriate training, clinical supervision, workforce support, access to patient information and robust record-keeping systems will all be critical in ensuring patient safety and minimising medico-legal risk.
While the reforms undoubtedly represent an exciting development for community pharmacy, they also mark a significant shift in professional responsibility. As pharmacists take on an increasingly central role in patient assessment and prescribing, careful attention will need to be paid to managing the legal and clinical risks associated with this expanded scope of practice.
For further information and advice, contact our healthcare experts.
Jade Clarey - Associate, Healthcare and Sport
Katie Everson - Senior Associate, Healthcare and Sport
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