Prescribing, Pennies and Pressure: A Pharmacy Owner’s Read on the Last Fortnight
As pharmacy owners ourselves, we read the sector news the same way our members do, looking for what it means on Monday morning in the dispensary. The past fortnight has brought the most significant change to the NHS contract in years, and alongside it the same grinding pressures on supply, cash flow and staff. This is our assessment of what matters, and what PharmaPlus will do about it.
Prescribing arrives, but not on firm ground
The headline development is prescribing within the NHS contract. NHS England has confirmed that independent prescribing pharmacists in England will be able to prescribe for migraine, rhinitis, ear infections in adults, acne and scabies as part of Pharmacy First. Community Pharmacy England expects the sign-up form to become available at some point in October 2026, subject to NHS England and DHSC completing the necessary work and publishing the documentation owners need to review first.
The direction is right. The foundations are not. On 18th September, CPE set out its concerns that the interim IT arrangements rely on a single NHS-approved prescribing system, require separate clinical record modules from those pharmacies currently use for Pharmacy First and contraception consultations, lack GP Connect Update Record functionality, and have no MYS API, meaning a manual payment claim for every consultation. CPE has told owners to consider whether the operational and governance requirements, and the funding on offer, make commercial sense for their business. That caution is echoed across the sector, with the Company Chemists’ Association warning that the funding identified is likely insufficient for the wider adoption needed, and the PDA arguing that expanding prescribing without adequate resources could fail to improve access and add pressure on pharmacists.
Our view is simple. Signing up is a business decision, not a statement of professional ambition. Double recording and a manual claim for each consultation are real costs in staff time. Owners should run the numbers for their own premises before committing, not sign up by default.
New rules from 1st October
Regulations laid before Parliament take effect from 1st October 2026 and introduce new conditions governing when independent prescribers can prescribe within NHS services, along with provision for pharmacies to close for up to four hours a month for learning and development, subject to conditions. The regulations also require explicit patient consent before an EPS nomination is changed, and from January 2027 pharmacists and pharmacy technicians, including locums, should hold an enhanced DBS certificate. The protected learning time is welcome. The nomination consent rule closes a loophole that has cost independents patients. The DBS requirement needs planning now, particularly for owners who rely on a pool of regular locums.
Money leaking out through the back door
Supply-side pricing remains unstable. By 18th September, DHSC had granted 119 price concessions for September, with CPE submitting further applications, and a fourth update followed on 22nd September.
Less visible, but just as damaging, is income lost to disallowed items. Between July 2025 and June 2026 there were around 32,000 disallowed prescription items, and 22% of these, roughly 7,000 items, were disallowed because the dentist or community nurse prescriber was not permitted to prescribe what was ordered. CPE is encouraging owners to review their disallowed items on the MYS portal and challenge any they believe were wrongly disallowed. Every one of those items is stock supplied and margin lost.
Shortages, and the people at the counter
The human cost of the supply chain lands on our teams. CPE’s 2026 Pressures Survey found 66% of pharmacy teams had experienced verbal abuse from patients related to medicines shortages, and 7% reported physical abuse. A BBC Morning Live report this month heard from staff who described feeling vulnerable and intimidated by abuse occurring almost daily. No business model survives a workforce that does not feel safe.
The politics
In a Westminster Hall debate on 9th September, several MPs warned that the Government’s ambitions for more care in the community cannot be delivered unless pharmacy funding is put on a sustainable footing. The health minister, Diana Johnson, agreed to meet MPs to discuss amendments that would give ICBs emergency powers over failing pharmacy providers. Owners should watch that closely. Powers designed for failing providers can reshape local markets. CPE is taking pharmacy owners’ priorities to the party conferences this season, and the more evidence it carries from real pharmacies, the better.
What PharmaPlus will do
On prescribing, we will publish a decision guide for members as soon as the NHS England documentation is released, setting out the true cost of the interim IT arrangements, the time burden of manual claims, indemnity and governance requirements, so that every member decides on evidence. We will also extend our Pharmacy First consultation checklists to cover the five new prescribing pathways.
On the new regulations, we will update the PharmaPlus SOP library ahead of 1st October to cover closures for learning and EPS nomination consent, and provide a DBS readiness checklist for staff and regular locums ahead of the January 2027 deadline.
On reimbursement, we will give members a simple monthly routine for checking disallowed items on MYS, checking prescriber entitlement before dispensing dental and nurse prescriptions, and reporting products bought above Drug Tariff price so that CPE can make the case for further concessions.
On staff safety, we will provide practical guidance on de-escalation, incident logging and supporting team members after an abusive encounter, because documented incidents carry weight with commissioners and police in a way that anecdote does not.
On representation, we will gather member evidence and feed it to CPE and to MPs. We urge every member to complete the Community Pharmacy Workforce Survey, which opened on 14th September 2026, and to invite their MP to visit. We will cover all of this in detail at the PharmaPlus member seminar coming soon.
Community pharmacy is being handed more responsibility with less certainty about whether it is properly paid for. Our job is to make sure members take on the new work with their eyes open, protect the income they already earn, and keep their teams safe while they do it.