Pharmacy First Service
Details of a new national Pharmacy First service have been announced as part of an an agreement setting out how the £645 million investment pledged within the Delivery plan for recovering access to primary care will be used to support community pharmacy services.
Under the agreement, a new Pharmacy First service which includes providing advice and NHS-funded treatment, where appropriate, for seven common conditions will be launched on 31st January 2024 (subject to the required IT systems being in place) as an Advanced Service.
Consultations can be provided to patients presenting to the pharmacy as well as those referred by NHS 111, GPs and others. The service will also incorporate the existing Community Pharmacist Consultation Service.
In the consultations with a pharmacist, people with symptoms suggestive of the seven conditions will be provided with advice and will be supplied, where clinically necessary, with a prescription-only treatment under a Patient Group Direction (PGD). In the future, we hope that independent prescribers will be able to use their skills to complete episodes of care within the service, without the need for a PGD.
Latest news on the service
Webinar series announced (29th November 2023)
Community Pharmacy England will be hosting a series of webinars to help pharmacy owners and their teams to prepare for the new Pharmacy First service, and changes to the Pharmacy Contraception Service (PCS) and Hypertension Case-Finding Service.
There are two webinars planned on the Pharmacy First service:
Pharmacy First: Getting to know the service (Wednesday 13th December 2023, 7-8.30pm)
Pharmacy First: Getting ready for launch (Monday 15th January 2024 7-8.30pm)
What does the service involve?
The new Advanced service involves pharmacists providing advice and NHS-funded treatment, where clinically appropriate, for seven common conditions:
- sore throat
- acute otitis media
- infected insect bite
- uncomplicated urinary tract infections in women.
Consultations can be provided to patients presenting to the pharmacy as well as those referred by NHS 111, general practices and others.
The service will also incorporate the existing elements of the Community Pharmacist Consultation Service, i.e. minor illness consultations with a pharmacist and the supply of urgent medicines (and appliances), both following a referral from NHS 111, general practices and other authorised healthcare providers.
In the consultations with a pharmacist, people with symptoms suggestive of the seven conditions will be provided with advice and will be supplied, where clinically necessary, with a prescription-only treatment under a Patient Group Direction (PGD) or in one pathway, an over-the-counter medicine.
Service specification and other documentation
The service requirements are included in the service specification and the associated clinical pathways.
The drafted PGDs and protocols can be found here
All of these documents will be essential reading for pharmacy owners and pharmacists who will be providing the service.
The acute otitis media clinical pathway requires the use of an otoscope.
Getting ready to provide the service
Where ear examinations are performed within the pharmacy, the pharmacist must use an otoscope. Consequently, all pharmacies providing the service must have an otoscope.
Guidance on selecting a suitable otoscope can be found in Annex C of the service specification.
Standard Operating Procedure
Pharmacy owners must have a Standard Operating Procedure (SOP) for the service, which all staff participating in provision of the service must be familiar with and follow.
Various pharmacy support organisations provide template SOPs which their members can personalise for use in their pharmacy.
Competency and training requirements
The pharmacy owner must ensure that pharmacists providing the service are competent to do so, including the use of an otoscope and be familiar with the clinical pathways, clinical protocol and PGDs. This may involve completion of training.
The pharmacy owner must keep documentary evidence that pharmacy staff involved in the provision of the service are competent and remain up to date with regards to the specific skills and knowledge that are appropriate to their role, and to the aspects of the service they are delivering.
CPPE have also developed with NHS England a Pharmacy First self-assessment framework, which pharmacists can use to assess their knowledge in relation to the service and to identify any gaps in their knowledge, which need to be filled.
Select an IT system
As with the current Community Pharmacist Consultation Service, an NHS-assured Pharmacy First IT system, which meets the minimum digital requirements of the service (as specified within the Community Pharmacy Clinical Services Standard and including an application programming interface (API) to facilitate transfer of data into the NHSBSA MYS portal) must be used by pharmacy owners.
When choosing an IT supplier, pharmacy owners may want to refer to the NHS CPCS IT Buyers Guide.
These IT systems allow pharmacy staff to make a clinical record for the service and the data in the record will then be used by the IT system to populate a claim for payment within the NHSBSA’s MYS platform.
The NHS-approved clinical IT system will also send messages containing a summary of the consultation to the patient’s general practice.
The following four IT suppliers are currently working with NHS England to develop their systems to include functionality to support the service, but over time, we expect other suppliers will add the service to their systems:
|System and supplier|
|HxConsult (Positive Solutions)|
|Pharmacy Manager (Cegedim)|
|PharmOutcomes (Pinnacle Health)|
|Sonar health (Sonar informatics)|
Sign up to provide the service
Pharmacy owners must notify NHS England that they intend to provide the service by completion of an electronic registration through the NHS Business Services Authority’s (NHSBSA) Manage Your Service (MYS) portal.
Registrations will open on 1st December 2023.
Withdrawal from the service
If the pharmacy owner wishes to stop providing the service, they must notify NHS England that they are no longer going to provide the service via the MYS platform, giving at least 30 days’ notice prior to the cessation of the service. The pharmacy owner may be asked for their reason for withdrawal from the service.
Funding and claiming payment
Initial fixed payment
Funding, caps and activity thresholds for the service have been the subject of much negotiation and we are pleased to have secured an initial fixed payment of £2,000 per pharmacy to be made available ahead of the launch.
The initial fixed payment will be reclaimed if pharmacy owners do not provide five clinical pathways consultations by the end of March 2024.
Pharmacy owners can sign up to provide the service from its commencement date and claim the initial fixed payment by making a declaration on the NHSBSA’s Manage Your Service (MYS) portal by 23:59 on 31st January 2024.
Declarations can be made from 1st December 2023.
Pharmacy owners who make the declaration on MYS before 23:59 on 31st December 2023 will receive the £2000 payment on 1st February 2024, with those that subsequently make a declaration before 23:59 on 31st January 2024 receiving the payment on 1st March 2024.
Consultation fees and monthly fixed payment
Pharmacies will be paid £15 per completed consultation.
From February 2024, in addition to the £15 consultation fee, a monthly fixed payment of £1,000 will be paid to pharmacy owners who meet a minimum activity threshold of clinical pathways consultations (the threshold will increase over time as set out below).
|Month||Minimum number of clinical pathways consultations|
|October 2024 onwards||30|
Pharmacy First Clinical pathways – medicines included in the PGDs and medicines protocol
- Bites and Stings
- Cellulitis and Erysipelas
- Acute Cough
- Otitis Media
- Sore Throat
- UTI Visual Summary