Nurses make up majority of independent prescribers

Registered nurses account for the largest professional group of independent prescribers and more than half of nurses in general practice are actively prescribing, a new report has found.

Nuffield Trust’s new research report, Independent prescribing in the UK, reveals that nurses make up 69% of independent prescribers – 68,180 prescribers. This translates to around 8% of all nurses.

The analysis found that nurse prescribers are seen by employers to bring the ‘most benefit’, as they have a ‘wider scope of practice, being able to prescribe controlled drugs’.

The research suggests that allied healthcare professionals are therefore ‘losing out’ on funding for prescribing training positions in favour of nurses.

Data included in the research from the Nursing and Midwifery Council (NMC) shows that the number of nurses and midwives with an independent prescribing qualification has increased over time, from 47,595 in March 2020 (6.7% of registrants) to 69,061 in March 2025 (8.2% of registrants).

Scotland had the highest proportion of NMC registrants with an independent prescribing qualification (10%) in March 2025, followed by England (9%), Wales (6%) and Northern Ireland (5%).

Related Article: Nursing in Practice takes general practice nurse pay concerns to Parliament

Almost all NMC registrants with an independent prescribing qualification were nurses (98.7% in March 2025) but some midwives also held the qualification (0.9%).

While nurses are the largest group of independent prescribers in terms of volume, there is limited data about the extent to which they use their skills on a regular basis.

For nurses working in hospitals, community services or mental health services, Nuffield Trust was unable to find data to assess this.

However, primary care data on prescribing by role, combined with primary care headcount data, indicates a high level of prescribing in the primary care nurse workforce, with just over half of nurses working in primary care (53%) being independent prescribers as of March 2025.

The purpose of Nuffield Trust’s report was to ‘explore the current and future direction of the independent prescribing workforce in the UK health care system’.

It found that nurses have been able to be independent prescribers for the longest and can prescribe an increased number of controlled drugs compared to allied health professionals.

With the government’s move to strengthen neighbourhood health services, the report authors stressed that ‘wide use’ of independent prescribing skills will be required.

However, it flagged that its research suggests ‘the greatest challenges to independent prescribing are in community settings’.

Nuffield Trust deputy director of research Sarah Scobie said: ‘We have an ageing population which is now living with more health issues, and the government hopes its ambitions to shift more care closer to home will tackle some of the problems this poses.

Related Article: NHSE sets out instructions for trusts on Band 5 nurse role review

‘The NHS will need to harness the full potential of its fast-growing prescribing workforce to realise this change, but we have identified some worrying barriers.

‘To get the most out of independent prescribing, the forthcoming NHS workforce plan must set out clearly the role prescribers will play within neighbourhood teams, and plans must be based on local population needs.

‘Better monitoring of independent prescribing practice in all settings will also be crucial. Without this, the opportunities presented by the incoming wave of new pharmacist prescribers will sadly be missed.’

The Nuffield Trust also explored the entry requirements for independent prescribing courses, finding that it varies from each professional healthcare group.

There is no minimum number of years before pharmacists can take a course but for nurses, following the new NMC education standards introduced in 2019, the entry requirement has been reduced from three to one year post-registration experience.

However, the report suggests there is ‘no evidence that this will lead to an increase in the number of independent prescribers’.

Related Article: NMC unveils ‘anti-racism’ principles for nursing practice and education

Stakeholders involved in the research said ‘it is unlikely that many nurses will be entering a training course one year post registration because the diagnostic skills requirement is unlikely to be met in this timeframe’, the report said.

It added: ‘There is now a greater need for clarity on what measures will be taken to assess the competence and ability of nurses who wish to undertake a prescribing course.’

A Nursing in Practice report published last year, The Power of Practice Nurses report, found that 49% of nurses in general practice prescribe medicines, 70% conduct regular reviews across a range of different clinical areas and nearly half are changing medications or dosages when needed.