Community pharmacy advanced service specification: NHS Pharmacy First Service

Document first published:
Page updated:
Topic:
Publication type:

This service specification and these patient group directions and protocols are for the NHS Pharmacy First Service.

The NHS Pharmacy First Service incorporates the previous Community Pharmacist Consultation Service and builds on it to enable community pharmacy to complete episodes of care for 7 common conditions following specific clinical pathways.

This will enable the management of common infections by community pharmacies through offering self-care, safety-netting advice, and supplying certain over the counter and prescription only medicines via clinical protocol and patient group directions.

These files may not be suitable for users of assistive technology. Please contact ENGLAND.CommunityPharmacy@nhs.net to request an alternative format.

Contents

  1. September 2025 update
  2. Community pharmacy primary care network engagement role
  3. Launch of NHS Pharmacy First advanced service
  4. Community pharmacy advanced service specification: NHS Pharmacy First Service
  5. NHS Pharmacy First – clinical pathways
  6. Urinary tract infection patient group direction
  7. Shingles patient group directions
  8. Impetigo patient group directions and protocols
  9. Infected insect bites patient group directions
  10. Acute sore throat patient group directions
  11. Acute sinusitis patient group directions
  12. Acute otitis media patient group directions
  13. Pharmacy First PGD master authorisation sheet
  14. GP Connect: Update Record

September 2025 update

Following a clinical stocktake, minor changes have been made to the NHS Pharmacy First Service clinical pathways, patient group directions (PGDs) and protocol. In anticipation of these changes coming into effect from Wednesday 1 October 2025, the updated service documents have been published. The current clinical pathways, PGDs and protocol will remain in place until 11.59pm on Tuesday 30 September 2025, and are available on the NHS Business Services Authority website.

Community pharmacy primary care network engagement role

Link

Community pharmacy primary care network engagement role

Community pharmacy primary care network engagement role

NHS England is not responsible for content on external websites.

Summary

Accessible content. Published 28 May 2024.

Launch of NHS Pharmacy First advanced service

Link

Pharmacy First: supporting access to NHS care

Pharmacy First: supporting access to NHS care

NHS England is not responsible for content on external websites.

Summary

Letter to community pharmacy and general practice professionals regarding the launch of Pharmacy First.

Accessible version.

Published 31 January 2024.

Link

Launch of NHS Pharmacy First advanced service

Launch of NHS Pharmacy First advanced service

NHS England is not responsible for content on external websites.

Summary

Letter confirming that the new NHS Pharmacy First advanced service will launch on Wednesday 31 January 2024.

Community pharmacy advanced service specification: NHS Pharmacy First Service

Document

Community Pharmacy advanced service specification: NHS Pharmacy First Service

Community Pharmacy advanced service specification: NHS Pharmacy First Service

  • PDF
  • 699 KB
  • 25 pages

Summary

Published 27 November 2023.

NHS Pharmacy First – clinical pathways

Document

NHS Pharmacy First – clinical pathways

NHS Pharmacy First – clinical pathways

  • PDF
  • 437 KB
  • 7 pages

Summary

Published 27 November 2023 and updated 23 September 2025.

Urinary tract infection patient group direction

Document

1a: Supply of nitrofurantoin capsules/tablets for the treatment of urinary tract infection under the NHS England commissioned Pharmacy First Service

1a: Supply of nitrofurantoin capsules/tablets for the treatment of urinary tract infection under the NHS England commissioned Pharmacy First Service

  • PDF
  • 437 KB
  • 14 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Shingles patient group directions

Document

2a: Supply of aciclovir tablets/dispersible tablets for the treatment of shingles herpes zoster) infection under the NHS England commissioned Pharmacy First Service

2a: Supply of aciclovir tablets/dispersible tablets for the treatment of shingles herpes zoster) infection under the NHS England commissioned Pharmacy First Service

  • PDF
  • 447 KB
  • 15 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

2b: Supply of valaciclovir tablets for the treatment of shingles (herpes zoster) infection under the NHS England commissioned Pharmacy First Service

2b: Supply of valaciclovir tablets for the treatment of shingles (herpes zoster) infection under the NHS England commissioned Pharmacy First Service

  • PDF
  • 465 KB
  • 16 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Impetigo patient group directions and protocols

Document

3a: Supply of topical hydrogen peroxide 1% cream (e.g. Crystacide® 1% cream) for the treatment of localised non-bullous impetigo under the NHS England commissioned Pharmacy First Service

3a: Supply of topical hydrogen peroxide 1% cream (e.g. Crystacide® 1% cream) for the treatment of localised non-bullous impetigo under the NHS England commissioned Pharmacy First Service

  • PDF
  • 402 KB
  • 13 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

3b: Supply of fusidic acid 20mg/g (2%) cream for the treatment of localised non-bullous impetigo under the NHS England commissioned Pharmacy First Service

3b: Supply of fusidic acid 20mg/g (2%) cream for the treatment of localised non-bullous impetigo under the NHS England commissioned Pharmacy First Service

  • PDF
  • 335 KB
  • 13 pages

Summary

Published 19 December 2023.

Document

3c: Supply of flucloxacillin capsules/oral solution/oral suspension for the treatment of widespread non-bullous impetigo under the NHS England commissioned Pharmacy First Service

3c: Supply of flucloxacillin capsules/oral solution/oral suspension for the treatment of widespread non-bullous impetigo under the NHS England commissioned Pharmacy First Service

  • PDF
  • 458 KB
  • 15 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

3d: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of widespread non-bullous impetigo under the NHS England commissioned Pharmacy First Service

3d: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of widespread non-bullous impetigo under the NHS England commissioned Pharmacy First Service

  • PDF
  • 490 KB
  • 17 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

3e: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of widespread non-bullous impetigo in pregnant individuals (aged 16 years and over) under the NHS England commissioned Pharmacy First Service

3e: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of widespread non-bullous impetigo in pregnant individuals (aged 16 years and over) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 480 KB
  • 16 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Infected insect bites patient group directions

Document

4a: Supply of flucloxacillin capsules/oral solution/oral suspension for the treatment of infected insect bite(s) and sting(s) under the NHS England commissioned Pharmacy First Service

4a: Supply of flucloxacillin capsules/oral solution/oral suspension for the treatment of infected insect bite(s) and sting(s) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 471 KB
  • 16 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

4b: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of infected insect bite(s) and sting(s) under the NHS England commissioned Pharmacy First Service

4b: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of infected insect bite(s) and sting(s) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 501 KB
  • 17 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

4c: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of infected insect bite(s) and sting(s) in pregnant individuals (aged 16 years and over) under the NHS England commissioned Pharmacy First Service

4c: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of infected insect bite(s) and sting(s) in pregnant individuals (aged 16 years and over) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 513 KB
  • 17 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Acute sore throat patient group directions

Document

5a: Supply of phenoxymethylpenicillin (penicillin V) tablets/oral solution/oral suspension for the treatment of acute sore throat due to suspected streptococcal infection under the NHS England commissioned Pharmacy First Service

5a: Supply of phenoxymethylpenicillin (penicillin V) tablets/oral solution/oral suspension for the treatment of acute sore throat due to suspected streptococcal infection under the NHS England commissioned Pharmacy First Service

  • PDF
  • 477 KB
  • 16 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

5b: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of acute sore throat due to suspected streptococcal infection under the NHS England commissioned Pharmacy First Service

5b: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of acute sore throat due to suspected streptococcal infection under the NHS England commissioned Pharmacy First Service

  • PDF
  • 511 KB
  • 18 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

5c: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of acute sore throat due to suspected streptococcal infection in pregnant individuals (aged 16 years and over) under the NHS England commissioned Pharmacy First Service

5c: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of acute sore throat due to suspected streptococcal infection in pregnant individuals (aged 16 years and over) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 500 KB
  • 17 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Acute sinusitis patient group directions

Document

6a: Supply of fluticasone furoate 27.5 micrograms/dose nasal spray (e.g. Avamys® nasal spray suspension) for the treatment of acute sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

6a: Supply of fluticasone furoate 27.5 micrograms/dose nasal spray (e.g. Avamys® nasal spray suspension) for the treatment of acute sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 449 KB
  • 13 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

6b: Supply of mometasone furoate monohydrate 50 micrograms/dose nasal spray for the treatment of acute sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

6b: Supply of mometasone furoate monohydrate 50 micrograms/dose nasal spray for the treatment of acute sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 418 KB
  • 14 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

6c: Supply of phenoxymethylpenicillin (penicillin V) tablets/oral solution/oral suspension for the treatment of acute bacterial sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

6c: Supply of phenoxymethylpenicillin (penicillin V) tablets/oral solution/oral suspension for the treatment of acute bacterial sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 482 KB
  • 15 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

6d: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of acute bacterial sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

6d: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of acute bacterial sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 498 KB
  • 17 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

6e: Supply of doxycycline capsules/dispersible tablets for the treatment of acute bacterial sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

6e: Supply of doxycycline capsules/dispersible tablets for the treatment of acute bacterial sinusitis (rhinosinusitis) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 441 KB
  • 15 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

6f: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of acute bacterial sinusitis (rhinosinusitis) in pregnant individuals (aged 16 years and over) under the NHS England commissioned Pharmacy First Service

6f: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of acute bacterial sinusitis (rhinosinusitis) in pregnant individuals (aged 16 years and over) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 486 KB
  • 16 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Acute otitis media patient group directions

Document

7a: Supply of Otigo® (phenazone 40mg/lidocaine hydrochloride 10mg/g) ear drops, solution for the symptomatic relief of pain due to acute otitis media (AOM) under the NHS England commissioned Pharmacy First Service

7a: Supply of Otigo® (phenazone 40mg/lidocaine hydrochloride 10mg/g) ear drops, solution for the symptomatic relief of pain due to acute otitis media (AOM) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 427 KB
  • 13 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

7b: Supply of amoxicillin capsules/oral suspension/oral solution for the treatment of acute otitis media (AOM) under the NHS England commissioned Pharmacy First Service

7b: Supply of amoxicillin capsules/oral suspension/oral solution for the treatment of acute otitis media (AOM) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 447 KB
  • 14 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

7c: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of acute otitis media (AOM) under the NHS England commissioned Pharmacy First Service

7c: Supply of clarithromycin tablets/oral suspension/oral solution for the treatment of acute otitis media (AOM) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 482 KB
  • 17 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Document

7d: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of acute otitis media (AOM) in pregnant individuals (aged 16 or 17 years) under the NHS England commissioned Pharmacy First Service

7d: Supply of erythromycin tablets/oral suspension/oral solution for the treatment of acute otitis media (AOM) in pregnant individuals (aged 16 or 17 years) under the NHS England commissioned Pharmacy First Service

  • PDF
  • 481 KB
  • 16 pages

Summary

Published 19 December 2023 and updated 23 September 2025.

Pharmacy First PGD master authorisation sheet

Document

Pharmacy First Service – master patient group direction and protocol authorisation sheet

Pharmacy First Service – master patient group direction and protocol authorisation sheet

  • Microsoft Word
  • 127 KB
  • 3 pages

Summary

Published 25 January 2024 and updated 23 September 2025.

GP Connect: Update Record

Link

GP Connect: Update Record

GP Connect: Update Record

NHS England is not responsible for content on external websites.

Summary

GP Connect: Update Record is being introduced to support the delivery of Pharmacy First and other pharmacy services.