Since its launch in February 2024, the Pharmacy First service has fundamentally changed how common health conditions are managed in England. For the first time, community pharmacists can clinically assess patients, provide advice, and — where clinically appropriate — supply prescription-only medicines for seven specified conditions, without the patient needing to see a GP first.

Two years into the programme, understanding what Pharmacy First covers and how to access it remains valuable for patients, pharmacists, and pharmacy staff alike.

The seven Pharmacy First conditions

NHS England's Pharmacy First service covers the following conditions in adults and, where specified, children:

1. Sinusitis

Pharmacists can assess and manage acute sinusitis, providing advice on symptom relief and, where appropriate, supplying a delayed antibiotic prescription. Most sinusitis is viral and resolves without antibiotics, but the pharmacist can make a clinical judgement on when antibiotics are warranted.

2. Sore throat

Patients presenting with sore throat can receive a clinical assessment, including use of scoring criteria to determine the likelihood of bacterial infection. Pharmacists can supply antibiotics where clinically indicated, helping to reduce unnecessary GP appointments for a condition that affects millions of people each winter.

3. Earache

Ear pain — one of the most common reasons for GP attendance — can now be assessed and managed at the pharmacy. The pharmacist can examine the ear, provide pain management advice, and supply appropriate treatment. This links directly to community pharmacies' existing role in ear care and OTC product advice.

4. Infected insect bites

Insect bites that show signs of infection (redness, swelling, warmth, discharge) can be assessed by the pharmacist, who can supply topical or oral antibiotics where appropriate. Demand for this service peaks during summer months.

5. Impetigo

This contagious bacterial skin infection, most common in young children, can be diagnosed and treated at the pharmacy. Pharmacists can supply topical antibiotics, reducing the need for a GP visit and enabling faster treatment initiation.

6. Shingles

Pharmacists can identify suspected shingles and supply antiviral medication within the treatment window. Early treatment is important for reducing severity and complications, making the accessibility of community pharmacy particularly valuable for this condition.

7. Uncomplicated urinary tract infections (women aged 16-64)

Women experiencing symptoms of an uncomplicated UTI can receive assessment and, where appropriate, a short course of antibiotics from their pharmacist. This is one of the highest-volume Pharmacy First conditions, given the prevalence of UTIs and the previous difficulty of obtaining timely GP appointments.

How Pharmacy First works in practice

For patients:

1. Walk into any participating community pharmacy — no appointment is needed
2. Tell the pharmacy team you would like a Pharmacy First consultation
3. The pharmacist will take you to a private consultation room
4. Following clinical assessment, the pharmacist will either provide treatment, recommend self-care, or refer you to a GP or urgent care if needed
5. The service is free of charge (standard NHS prescription charges apply if a medicine is supplied, unless exempt)

For pharmacies:

Each Pharmacy First consultation attracts an NHS fee of £15 to the pharmacy, regardless of outcome. For a pharmacy conducting 400 Pharmacy First consultations per year, this represents approximately £6,000 in additional annual NHS revenue — on top of any medicines supplied.

The service requires pharmacists to complete specific training modules and maintain clinical competence in assessment of the seven conditions.

Finding a Pharmacy First pharmacy

The vast majority of England's 13,147 registered community pharmacies participate in Pharmacy First, though the level of active engagement varies. To find a participating pharmacy near you, use PharmSee's pharmacy search, which lists pharmacies across England with their services and locations.

Impact on the pharmacy workforce

Pharmacy First has had a measurable effect on how community pharmacy teams operate. The service requires dedicated pharmacist time for clinical consultations — time that cannot simultaneously be spent on dispensing. This has increased demand for dispensers and pharmacy technicians to manage the dispensing workload while pharmacists conduct Pharmacy First consultations.

PharmSee's vacancy tracker currently shows 1,693 active pharmacy job listings across England, with a substantial proportion of chain vacancies focused on dispensing roles. Among Boots's tracked listings, for example, approximately 66% are for dispensers — a staffing pattern consistent with pharmacists being increasingly deployed in clinical rather than purely dispensing roles.

For pharmacists considering their career options, Pharmacy First has strengthened the clinical dimension of community pharmacy work. For the latest salary data and job listings, visit PharmSee's salary guides and job search.

Caveats

Pharmacy First does not replace GP care for complex or recurring conditions. Pharmacists will refer patients onward where the condition falls outside Pharmacy First criteria, where symptoms suggest a more serious underlying cause, or where the patient has relevant comorbidities. The seven-condition scope may be expanded in future, but as of April 2026, the list above represents the current service specification.