NHS Pharmacy First

The new Pharmacy First Service will enable community Pharmacists to complete episodes of care for patients without the need for the patient to visit their general practice. This alongside expansions to the pharmacy blood pressure checking and contraception services, will save up to 10 million general practice team appointments a year and help patients access quicker and more convenient care, including the supply of appropriate medicines for minor illness.

The Pharmacy First Service builds on the previous Community Pharmacist Consultation Service (CPCS) by enabling community pharmacies to manage patients for seven common conditions, following specific clinical pathways. The overal service consists of three core elements:

Pharmacy First (clinical pathways) - new element
Pharmacy First (urgent repeat medicine supply) - previously commissioned as the CPCS
Pharmacy First (NHS referrals for minor illness) - previously commissioned as the CPCS

The seven conditions are:

Clinical Pathway	Age Range	Symptoms	When to see a GP	Treatment (If confirmed)
Acute Otitis Media	1 – 17 years	Earache Discharge From Ears	Children under 1 or over 17 Pregnant individuals under 16yo Severely unwell or severe pain	Antibiotics
Impetigo	1 year and over	Adults & children over 1yo Pregnant women over 16yo	Children under 1 Severe symptoms (large fluid filled blisters over 2cm) Associated symptoms (diarrhoea, fever & swollen glands) Pregnant individuals under 16 Immunocompromised More than 2 episodes in the last year	Creams Antibiotics
Infected Insect Bites	1 year and over	Must have been over 3 days. Redness of skin Pain or tenderness on area Swelling of skin Surrounding skin hot to touch	Children under 1yo Bite or scratch caused by human/animal/ whilst travelling outside of UK. Pregnant individuals under 16yo Severely unwell or severe pain	Antibiotics
Shingles	18 years and over	Rash on one side of the body Fluid filled blisters which dry and form crusts. Can be painful	Immunosuppressed Severely unwell or severe pain Pregnant individuals	Antivirals
Sinusitis	12 years and over	Nasal blockage/discharge/facial pain Cough day or night (children) Loss of sense of smell	Had symptoms for over 12 weeks. Severely unwell or severe pain Pregnant individuals under 16	Nasal sprays Antibiotics
Sore Throat	5 years and over	Fever (over 38 degrees) Coating or puss Severely inflamed tonsils	Cannot swallow, speak, drools & distressed. Severely unwell or severe pain Pregnant individuals under 16	Antibiotics
Uncomplicated Urinary Tract Infections	Women 16 – 64 years	Burning pain when passing urine. Needing to pass urine at night. Cloudy urine	Pregnant Severely unwell or severe pain Shaking chills or high temp More than 2 in the last 6 months Blood in urine/vaginal discharge	Antibiotics

Patients will access the new clinical pathway element by walking into the pharmacy directly or where appropriate, by contacting them by video consultation. In addition, patients will access the service via referrals from:

NHS 111 (online, telephone or NHS app)
integrated urgent care clinical assessment services
urgent treatment centres
emergency departments
999
general practice ( GPs cannot make a referral for urgent repeat medicine supply)

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