A qualitative exploration of stakeholder perspectives of independent prescribing by newly qualified pharmacists: a theoretical domains interview study.

Abstract

Objectives: To explore the perspectives of stakeholders on the General Pharmaceutical Council's revised Standards for the Initial Education and Training of Pharmacists that enable pharmacists to prescribe at the point of registration, from 2026.

Methods: This qualitative study used the Theoretical Domains Framework (TDF) to develop schedules for structured interviews that were conducted with various stakeholders and recorded via Microsoft Teams. Recordings were transcribed verbatim, checked for accuracy, and then analysed using the Framework approach, facilitated by NVIVO® software.

Key findings: In total, 43 participants (patients, community, hospital and primary care pharmacists, GPs, and nurses) were interviewed. Eleven out of the fourteen TDF domains were identified, the most frequently cited being 'beliefs about consequences', e.g. reducing pressure on the healthcare service, and concerns that non-prescribing pharmacists will be disadvantaged by the change. The domain 'environmental context and resources' was also cited where increasing placement opportunities to develop the required clinical skills were key enablers to implementation, while a lack of confidence, and lack of space, equipment and commercial pressures were considered barriers.

Conclusions: Overall, stakeholders in the study were supportive of pharmacists registering as independent prescribers upon qualification, however, there were concerns raised regarding their readiness, as well as preparedness of employers for this change. These concerns must be addressed to reassure stakeholders and to ensure that universities and employers adequately prepare pharmacists to prescribe at the point of registration and provide them with support and the necessary infrastructure to do so safely.