When a patient rings their GP surgery with a sore throat, an earache or a suspected urinary tract infection, the receptionist no longer has to book them into the next available GP slot. In many cases, the NHS now pays the surgery to send them to a community pharmacy instead.

The pathway is sometimes still called the Community Pharmacy Consultation Service, or CPCS, and from January 2024 it has been folded into the broader Pharmacy First scheme in England. It is the mechanism that connects general practice's ringing phones to the empty consultation room round the corner.

This article explains how the referral scheme works, which conditions are in scope, and why the NHS built it in the first place.

What the scheme is

The minor illness referral pathway is a commissioned NHS service that lets GP receptionists, NHS 111, and a growing number of urgent care and A&E units formally refer a patient to a community pharmacist for a consultation. It is not a suggestion — it is a booked appointment, with a named pharmacy, passed through the electronic referral system.

The pharmacist who receives the referral has a legal duty to consult with the patient within an agreed window — typically the same day — and has structured clinical pathways to follow. If the pharmacist can resolve the issue, they do. If they cannot, they escalate back to the GP or to urgent care, with notes attached.

Which conditions are in scope

The Pharmacy First clinical pathways cover seven specific common conditions in England, each with its own clinical protocol:

Each pathway is underpinned by NICE guidance and has specific exclusion criteria. A pregnant patient with a UTI, for example, is referred to the GP rather than treated in the pharmacy. Detailed guides for each pathway are available on PharmSee, including the UTI pathway, the sore throat pathway, the shingles pathway, and the impetigo pathway.

Alongside the clinical pathways, pharmacies also take referrals for a much wider range of minor illnesses under what was formerly the CPCS minor illness route. These include coughs, colds, mouth ulcers, rashes, headaches, diarrhoea, and similar self-limiting conditions that pharmacists have long been able to advise on over the counter, but which can now be formally booked by a GP practice rather than managed informally.

How a referral works

Patients rarely see the mechanics, but the flow is roughly as follows:

1. The patient phones the surgery or NHS 111 and describes the symptom.
2. The receptionist, care navigator or 111 adviser assesses whether the issue fits the scheme.
3. If it does, they offer the patient a pharmacy consultation, usually at a pharmacy of the patient's choice from a list of local providers.
4. The referral is transmitted electronically. The pharmacist sees it arrive and contacts the patient to confirm a time, or takes them as a walk-in.
5. The pharmacist carries out the clinical consultation in a private consultation room, which every contracted pharmacy must provide.
6. Outcome — treatment, advice, or escalation — is recorded and a note is sent back to the GP record.

According to Community Pharmacy England, the consultation is free to the patient. Any NHS prescription charge that applies to medicines supplied follows the normal rules.

Why the scheme exists

The policy logic is straightforward. General practice in England has been running at capacity for years. Conditions that pharmacists are qualified to handle have historically taken up GP appointment slots because the NHS had no commissioned pay-for-service route to redirect them. The minor illness referral scheme and Pharmacy First are that route.

PharmSee's job-market data shows the workforce effect on community pharmacies. As of April 2026, 1,693 active pharmacy vacancies are tracked across 11 public sources, with 534 of those listed by one large chain and 490 on NHS Jobs (source: PharmSee aggregated listings). The advanced-service pharmacy contract, which is what pays for the referral pathway, creates demand for pharmacists and pharmacy technicians who can deliver clinical consultations alongside the dispensing workload.

For a sense of the workforce that actually delivers the service, see our analysis of relief pharmacist demand and of pharmacy staffing models compared.

The patient's experience

From the patient's side, the practical difference is this. Instead of a three-day wait for a GP telephone triage, you get a same-day pharmacy consultation with someone who can issue a prescription if clinically appropriate. You do not need to re-book, do not need to travel further than the local high street, and do not pay anything for the consultation itself.

If the pharmacist judges that the case is outside the pathway — you need imaging, blood tests, or a face-to-face examination beyond the scope of pharmacy — they escalate immediately, and the GP practice reserves its appointment for that next step.

What the scheme is not

It is not a way of pushing patients away from the NHS. A Pharmacy First consultation is an NHS consultation, delivered by an NHS-contracted professional, recorded in the NHS record.

It is not a limitless list of conditions. The seven clinical pathways are defined, and anything outside them is either advice-only or a referral back to the GP.

Finding a participating pharmacy

Almost every NHS-contracted community pharmacy in England is signed up to the service. To check which pharmacies near you have active contracts and are taking referrals, browse the PharmSee pharmacy directory. Detailed walkthroughs of what happens inside the consultation room are available in our Pharmacy First consultation guide.

Sources

• NHSBSA — Pharmacy First service commissioning details
• Community Pharmacy England — Pharmacy First advanced service specification
• NICE antimicrobial prescribing guidelines (NG91, NG109, NG111, NG117, NG120)
• PharmSee live vacancy database — April 2026 snapshot

PharmSee provides UK pharmacy market analysis based on public NHS data and live job-market tracking across 11 sources.