Pharmacy First

The Pharmacy First service builds on the NHS Community Pharmacist Consultation Service which has run since October 2019. The consultation service enables patients to be referred into community pharmacy for a minor illness or an urgent repeat medicine supply.

The new Pharmacy First service, launched 31 January 2024, adds to the existing consultation service and enables community pharmacies to complete episodes of care for 7 common conditions following defined clinical pathways.

The benefits of Pharmacy First

In May 2023, NHS England and the Department of Health and Social Care announced a Delivery plan for recovering access to primary care. Part of the plan includes enabling patients to get certain prescription medications directly from a pharmacy, without a GP appointment.

This new service is expected to free up GP appointments for patients who need them most and will give people quicker and more convenient access to safe and high quality healthcare. It includes the supply of appropriate medicines for 7 common conditions including earache, sore throat, and urinary tract infections, aiming to address health issues before they get worse.

Currently, NHS patients in England must visit their GP to access prescription only medication, meaning repeated GP visits and delays in treatment.

Community pharmacies offer a more convenient way to access healthcare that includes support with healthy eating, exercise, stopping smoking, monitoring your blood pressure, contraception, flu and covid vaccinations.

The public perceptions of community pharmacy survey found that over 90% of patients who sought guidance from a community pharmacy within the past year reported receiving good advice.

The government and NHS England are committed to ensuring patients receive the right treatment at the right time. The NHS Long Term Plan highlights the need to make greater use of community pharmacists’ skills and opportunities to engage patients. This is why we have launched a new Pharmacy First service.

Accessing Pharmacy First services

The following table shows the 7 conditions pharmacists can manage across various age ranges.

Clinical pathway Age range
Acute otitis media* 1 to 17 years
Impetigo 1 year and over
Infected insect bites 1 year and over
Shingles 18 years and over
Sinusitis 12 years and over
Sore throat 5 years and over
Uncomplicated urinary tract infections Women 16-64 years

* Distance selling pharmacies will not complete consultations for acute otitis media.

Patients will be able to access the 7 clinical pathways element via referrals from referring organisations including general practice, urgent and emergency care settings, and NHS 111 (online and via telephone). In addition, for the 7 common conditions clinical pathway consultations only, patients can access the service by attending or contacting the pharmacy directly without the need for referral.

Providing high quality health and care services

For the 7 common conditions, pharmacists will follow a robust clinical pathway which includes self care and safety-netting advice and, only if appropriate, supplying a restricted set of prescription only medicines without the need to visit a GP.

These clinical pathways have been developed with input from various experts including practising GPs, pharmacists, and antimicrobial resistance specialists as well as representatives from national organisations such as the National Institute for Health and Care Excellence (NICE) and UK Health Security Agency. This ensures that the steps we take together match the care patients would receive in general practice and follow the latest national guidelines.

Pharmacies have private consultation rooms that can be used for consultations with patients, and pharmacists can see patients for clinical services without always needing an appointment.

Every pharmacist trains for 5 years in the use of medicines and managing minor illnesses, so they are well equipped to provide health and wellbeing advice to help people stay well. They are also experienced in spotting warning signs, otherwise known as red flag symptoms, which may warrant a referral to another healthcare provider.

After a consultation with the pharmacist, the pharmacy will send a notification to the patient’s GP on the same day or on the following working day. 

Further information