A Blog from Dr Philip Xiu, Local GP & DPP – Independent Prescribing
At CPWY, we’re running a series of updates to support anyone who is thinking about starting their own IP journey. Whether you’re already preparing your application, still weighing up your options, or simply curious about what the training involves, we want to help you feel informed, supported, and confident. See the document here which details the steps to take if this is something you are interested in.
Our ‘Your Path to Independent Prescribing Webinar’ took place on Tuesday 30th June. The session was recorded and can be watched here. 🎥
Have a read of our next brilliant blog by Dr Philip Xiu below, where he talks as the DPP to the IP trainee, instilling some of the information that a trainee may wish to have.
So You’re Thinking About Independent Prescribing? An Honest Letter from Your Future Designated Prescribing Practitioner (DPP)
There’s a particular look I’ve come to recognise on the face of a community pharmacist sitting across from me at our first DPP meeting. It’s somewhere between excitement and quiet panic. They’ve been counselling patients for years, picking up prescribing errors a GP missed, running flu clinics, soothing anxious parents at the Pharmacy First desk, and now they’re about to step over a line they’ve stood next to their entire career.
From the DPP side I can tell you it is one of the biggest predictors of whether a trainee thrives or struggles. I’ve sat with that look more times than I can count, both as a GP and as a DPP supervising pharmacists in a busy GP practice.
This is the conversation I wish I could have with every trainee.
The Landscape You’re Walking Into
First, some perspective. As of September 2025, there were 19,615 pharmacist IPs on the GPhC register in England, about 34% of all pharmacists (The Pharmaceutical Journal). From 2026, virtually every newly registered pharmacist will qualify as an IP from day one, which means the profession around you is shifting faster than most people acknowledge.
That has two implications for you. The first is opportunity: NHS England’s vision, the 2024 manifesto commitment to a community pharmacy prescribing service, and the expansion of Pharmacy First all point firmly toward your skill set becoming central rather than supplementary. The second is pressure: you’re training alongside an unprecedented surge of foundation trainees competing for the same DPPs, the same placement slots, and the same patient exposure. That’s the honest backdrop. It should sharpen your preparation, not dampen your ambition.
The pharmacists who do well in this environment are rarely just the “brightest” in an academic sense. They are the ones who start with a realistic scope, secure a DPP relationship that is genuinely supervisory rather than symbolic, and build access to the right patients, records, decision-making opportunities and protected time early on. The ones who struggle tend to underestimate how much the course depends on clinical environment, diagnostic reasoning, documentation quality and deliberate supervision, rather than enthusiasm alone (The Pharmaceutical Journal).
As a GP-based DPP who has supervised multiple pharmacist prescribers, my honest framing is this: do not think of the IP programme as a badge to collect. Think of it as supervised entry into a higher-risk, higher-accountability clinical role that demands evidence of safe patient assessment, sound prescribing decisions and clear professional boundaries.
Front-Load Your Hours and Shadow More Than One Prescriber
If there is one piece of advice in this article I want you to underline, it is this: front-load your supervised hours, and use the early portion of them to shadow at least three different prescribers.
The instinct of most trainees is the opposite. People tend to delay observed consultations until they “feel ready,” and they tend to stick with a single supervisor because it feels safer and more relationship driven. Both instincts hurt you.
Front-loading matters because waiting until late in the programme to let your DPP see you in real consultations is one of the most avoidable mistakes I see. Early observation during your university course gives you time to correct habits such as leading questions, narrow differentials, weak structuring, poor safety-netting or overconfident closure. Catch those in month two and they’re coachable. Catch them in month five and you’re rebuilding under exam pressure.
Shadowing multiple prescribers matters because every prescriber does it differently, and you need to see that range before you start forming your own style. GPs, advanced nurse practitioners, pharmacist IP and paramedic prescribers will structure a consultation, take a history, frame uncertainty, negotiate with the patient and document the encounter in noticeably different ways. Even amongst a group of GPs, no one will take the history the same. None of them are wrong. Each one will show you something the others won’t. Each person that you shadow will have something to teach you, one might give you a masterclass in efficient history-taking, another in shared decision-making, another in safety-netting language, another in resisting patient pressure to prescribe. Three prescribers to shadow is my minimum recommendation; four or five is better if you can engineer it.
This is also allowed and actively encouraged by the standards. Your DPP is not required to be physically present for all 90 hours, supervision can be shared across other appropriately qualified prescribers, provided your DPP retains overall accountability for your development.
What Good DPP–Trainee Relationships Actually Look Like in Community Pharmacy
A good DPP–trainee relationship is structured, honest and psychologically safe, but it is also professionally demanding. The Pharmaceutical Journal’s practical guidance for DPPs emphasises mutual trust, an early shared contract and regular needs-based meetings, and from my side of the desk I can tell you those are the trainees who finish strong.
The relationship works when the trainee feels able to say “I don’t know,” “I was unsure,” or “I think I anchored too early on one diagnosis.” Prescribing training is unsafe when uncertainty is hidden, and the trainees who scare me are the ones who confabulate around a gap rather than naming it. The DPP, in turn, has to offer more than reassurance, we have to observe, challenge, calibrate and document whether competence is actually being reached.
In community pharmacy specifically, the relationship works best when four things are agreed early:
- Where the learning will happen (your pharmacy, a GP practice, a PCN clinic, a community service).
- Which patient groups will be prioritised, tied to your declared scope of practice.
- How feedback will be given: written, verbal, immediate, end-of-clinic, on the portfolio.
Agree on this before or during your first meeting. It will save you months of mutual irritation.
Because I work as a GP-based DPP, I can say this plainly: one of the biggest advantages for a community pharmacist learner is exposure to a GP setting where you see the full arc of clinical care, presentation, records, examination, investigations, prescribing, follow-up, and the consequences of decisions.
That exposure often corrects one of community pharmacy’s hidden risks, which is fragmented visibility of the patient journey. Without access to records and robust communication routes, a community pharmacist may be clinically capable but still system constrained. Good DPP supervision has to account for those constraints rather than pretending they don’t exist.
The Community Pharmacy Problem (and How to Solve It)
Let me speak frankly about something the official guidance dances around. The standards were not written with community pharmacy as the default learning environment, and it shows. You will face structural challenges.
Limited prescribing exposure on-site – Your community pharmacy probably doesn’t have a consultation room set up for diagnostic examinations, doesn’t have a defined patient list, and doesn’t generate the kind of longitudinal caseload that builds prescribing confidence. The honest answer is that most community pharmacist trainees will need to complete some of their hours outside their own pharmacy, typically in a GP practice, a PCN clinic, or via a community-based service such as sexual health, smoking cessation, or a respiratory hub.
Finding a DPP: the real bottleneck, and the resource most trainees don’t know about – This is where most community pharmacist trainees lose weeks of momentum. The PDA, BPSA and several LPCs have been raising concerns for over a year about pharmacists scrambling for supervisors, with some trainees losing their DPP mid-programme and having to restart the search from scratch (The Pharmacist). Don’t wait for a DPP to fall into your lap, and don’t assume your HEI will solve it for you.
Start with your local network. Approach your PCN clinical pharmacist lead, your GP practice’s prescribing pharmacist, and your ICB non-medical prescribing lead for advice and warm introductions. The strongest matches almost always come through someone who already knows both parties.
A word of caution about commercial DPP-matching services. Several have appeared in the last couple of years, charging significant fees, and I would urge you to think hard before signing up. What I have seen, and heard repeatedly from colleagues, is that the matching is often a black box. You pay, you’re assigned a DPP, and you don’t get meaningful input into who that person is, what their clinical area is, or whether their working style fits yours. When that pairing breaks down (and it does), the trainee is the one left scrambling, often several months in, with a portfolio half-built around the wrong scope, and the very real prospect of paying a second fee to be rematched. I have personally supervised trainees picking up the pieces of exactly this scenario.
There is a better option that most trainees simply haven’t heard of. DPPSupport.co.uk is an NHS England-funded and endorsed directory of DPPs across the UK, and it is completely free to use for both trainees searching for a supervisor and for prescribers willing to act as one. The directory is searchable by distance from your location, scope of practice, and DPP type, so you can shortlist supervisors who actually match your intended area of prescribing rather than accepting whoever a commercial service hands you. It is, in my view, the single most underused resource in the IP pathway, and the first place I now point any community pharmacist who asks me how to find a DPP.
The patient mix – The strongest community-based trainees I’ve worked with chose a narrow nominated prescribing area: hypertension, contraception, minor ailments/illnesses and then deliberately structured access to that cohort. The Pharmaceutical Journal’s guidance on the 90 hours puts it bluntly: pick an area of “appropriate clinical complexity” where you have “plenty of access to patients.” Don’t pick something exotic. Pick something common, and own it. Also have an awareness that for a lot of university IP courses, some of the OSCE summative exams cover a lot of the common prescribing areas listed above. If you have a very narrow scope of practice for your DPP, it can really harm your chances of passing the course.
Negotiating time – If you’re employed by a multiple, do not assume your Area Manager will give you protected study time without a written conversation. If you’re a contractor or locum, model the cost honestly before you apply. The course fee may be funded; the hours away from the dispensary are not.
Practical Advice: How to Make the Programme Work Rather Than Survive It
A handful of specific habits separate the trainees who finish strong from the ones who limp over the line:
Treat your supervised practice like booked study time, not flexible spare time – If you don’t ringfence it, pharmacy operational pressure will consume it, especially in community settings. A standing weekly slot in your diary is worth more than ten “I’ll do it next week” intentions.
Write portfolio entries within 24 to 48 hours of meaningful cases whenever possible – Delay blunts clinical detail and reflective quality. The case you remember vividly on Tuesday is a haze by Friday and a fiction by the following Monday.
Use the RPS Competency Framework for All Prescribers actively rather than retrospectively – Print it. Tick off where you’ve already gathered evidence. The framework will help you spot where your evidence is thin, typically governance, shared decision-making, or reviewing response to treatment so you can deliberately find cases to plug the gap.
Deliberately collect cases that show limits as well as successes – Good prescribing includes knowing when not to prescribe, when to refer, when to defer, and when more information is needed. That matters particularly in antimicrobial decisions, symptom triage and the community presentations where patient expectation pushes toward prescribing before the evidence supports it.
Bring me cases, not questions – “Can you help me understand antihypertensive choice?” is a tutorial request. “I saw Mrs X today, her ACR is 4.2, she’s 72, and I’m torn between titrating amlodipine or adding ramipril for her blood pressure. Here’s my reasoning” is a prescribing discussion. The second one is what supervised practice is for, and it’s what your portfolio needs.
Don’t hide your wobbles – If you’re struggling, the worst thing you can do is go quiet. HEIs are far more forgiving of a trainee who flags difficulty in month two than one who collapses at the final OSCE. There are routes, extensions, additional support, restructured plans but we can only use them if we know.
What DPPs Privately Wish You Knew
We don’t expect perfection on day one, but we do expect seriousness about risk, uncertainty and preparation. We notice very quickly whether a trainee reads around their cases, seeks out feedback, turns up prepared, and can convert feedback into visible improvement.
We notice immediately whether you’ve read the standards. A trainee who arrives at our first meeting having actually read the GPhC standards and the RPS framework starts twenty hours ahead of one who hasn’t.
We also notice whether you want proximity to prescribing, or actual accountability for it. Those are different mindsets, and only the second one will carry you safely through.
We wish more trainees appreciated that the consultation, not the prescription pad is the real core skill. Pharmacy training tends to over-prepare you for the pharmacological decision and under-prepare you for the human encounter that frames it. History-taking, shared decision-making, safety-netting and managing patient expectations are where most trainee performance is won or lost.
Saying “I don’t know” is the marker we’re actively looking for. The 90 hours are not 90 hours of shadowing. We will not chase you for portfolio signoffs. And we always know when you’ve prepared for the consultation and when you’ve winged it.
A Final Word, From One Side of the Desk to the Other
Independent prescribing is the most professionally rewarding thing many community pharmacists will do in their careers. The patients you’ll see, the autonomy you’ll hold, the integration into primary care teams that’s now genuinely possible, none of it is rhetoric. But the programme is demanding in ways that aren’t obvious until you’re in it, and the community pharmacy route is harder than the hospital or PCN route in ways the prospectus won’t tell you.
Go in eyes open. Front-load your hours. Shadow at least three prescribers before you settle into your own style. Choose your scope narrowly. Find your DPP early and treat them like a colleague rather than a gatekeeper. Read the standards before you need to. And remember that the credential at the end isn’t the point, the safe, confident, named clinician you become is. The IP annotation is the start of practice, not the end of it.
I look forward to meeting you across the desk.
