Pharmacy First: supporting access to NHS care


  • Community pharmacy contractors
  • GP contractors


  • Integrated care boards:
    • chief executives
    • medical directors
    • directors of primary care
    • chief pharmacists
  • Primary care networks:
    • clinical directors

As the NHS launches Pharmacy First today, we wanted to thank you for making a vital contribution to healthcare for patients and local communities. The launch of Pharmacy First in over 10,000 community pharmacies is a huge opportunity for community pharmacy to step further into its clinical future, working more closely with general practices as part of the integrated NHS primary care team.

Community pharmacy is taking on a wider patient-facing role in the NHS and the Delivery Plan for Recovering Access to Primary Care set out how this could be developed through the expansion of clinical services delivered through pharmacies to patients and communities.

We are delighted that the vast majority of pharmacy contractors have chosen to offer the Pharmacy First service and, building on our letter to the NHS system of 25 January 2024, we would like to add our voices in support of those endorsing the clinical and professional skills of community pharmacists and their teams, who have been assessing and treating minor illnesses for many years. In addition, we want to highlight key aspects of the NHS governance and assurance that are in place to support community pharmacy to continue to maintain its high standards of patient safety.

Before beginning to deliver the service, pharmacy contractors must ensure that pharmacists who are providing the service, including locums, are competent to do so, and are familiar with the 7 clinical pathways, clinical protocol, and patient group directions. These provide robust pathways for pharmacists to follow, and ensure services and medicines are provided in a safe and consistent manner, which the public and NHS can trust. They have been designed by experts and incorporate the principles of antimicrobial stewardship. Reporting of community pharmacy consultation outcomes will enable surveillance of antimicrobial supply and the National Institute for Health Care Research is leading an evaluation of this service that will include any implications for antimicrobial resistance.

More generally, NHS England has also provided online and face-to-face clinical examination skills training, including in the use of otoscopes. The training is designed to be accessed as part of a self-assessment framework process that supports pharmacists in considering their previous learning and experience in responding to minor illnesses in the pharmacy. This framework highlights the key competencies required to provide high-quality, person-centred care to people accessing the service and builds on the fundamental professional requirements of the General Pharmaceutical Council’s Standards for Pharmacy Professionals. It helps pharmacists evidence their competence or identify further learning, with some suggested resources that they can complete to support their development.

Fundamentally, we believe Pharmacy First is a shared responsibility of primary care teams, with support needed for community pharmacy colleagues from general practice and primary care networks, and from integrated care boards. A key element of our success in realising the full benefits for patients and the NHS will be those effective and sustainable relationships between general practice and community pharmacy teams at a local level.

We all want to deliver excellence, and this service will help to support everyone, including those who need the NHS’s help most, to access the right care at the right time. Thank you to community pharmacy and general practice teams for your vital role in providing NHS care at the heart of local communities and for your great contribution to patient care.

Yours sincerely,

David Webb
Chief Pharmaceutical Officer
NHS England

National Medical Director for Primary Care
NHS England

Classification: Official
Publication reference: PRN01123