Pharmacy First service

The new Pharmacy First service, which was 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.

The new national Pharmacy First service aims to support communities in staying well and local healthcare systems to meet the needs of their populations. The service will launch on 31st January 2024. The service involves providing consultations to give advice and NHS-funded treatment (via Patient Group Directions), where appropriate, for seven common conditions (clinical pathways consultations). The consultations can be provided to patients who self-refer to the pharmacy (e.g. walk-ins) as well as those referred by NHS 111, GPs and others.
The service will also incorporate the current Community Pharmacist Consultation Service (CPCS), meaning there will be three elements to the Pharmacy First service:

  • Pharmacy First (clinical pathways consultations) – new element (includes walk-ins)
  • Pharmacy First (urgent repeat medicine supply) – previously commissioned as the CPCS
  • Pharmacy First (NHS referrals for minor illness) – previously commissioned as the CPCS

Infections to be managed via Clinical Pathways:

Clinical Pathway 

Uncomplicated UTI
Infected Insect Bites
Sore Throat
Acute Otitis Media

Age range

Women 16-64 years
18 years and over
1 year and over
1 year and over
12 years and over
5 years and over
1 to 17 years

Patients may be referred to Pharmacy First by one of the following organisations/routes:

  • NHS 111 telephony or 111 online
  • Integrated urgent care clinical assessment service (IUC CAS)
  • 999 services
  • General practice (low acuity minor illness conditions and the seven clinical pathways only)
  • Other urgent and emergency care provider (e.g. UTC, ED, UCC)

Additionally, for the clinical pathway consultations only, patients can access the service by attending or contacting the pharmacy directly without the need for a referral.

An initial fixed payment of £2,000 was available to claim from December up to the the launch of the Pharmacy First service. 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). Full details are available in Briefing 030/23: Funding for Pharmacy First, and other funding-related changes in the Recovery Plan deal.


There are many scenarios within the Pharmacy First service. The below resource lists the different scenarios, whether you need to make an entry in your Pharmacy First IT system for that scenario and whether you can claim payment:

The Pharmacy First service – When can you claim

Please click here to visit CPE for more information on the following:

  • Introduction and background
  • Service specification and other documentation
  • Getting ready to provide the service
  • Providing the service
  • Promoting the service to the public (new checklist available, May 24)
  • Funding and claiming payment
  • Frequently Asked Questions
  • Resources

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 (except for DSPs) and be familiar with the clinical pathways, clinical protocol and PGDs. This may involve completion of training.

CPPE Pharmacy First page (including the Pharmacy First self-assessment framework)

Other training options we have been made aware of:

Cliniskills training (NHS England funded) for Pharmacy First, including otoscope training webinar on 18th Jan 2024

Agilio iLearn Pharmacy First training

Local ENT/Otoscope training for pharmacists (including trainee pharmacists):

Humber LPC held local face to face training on the 31st Jan 2024 & the 14th of March 2024. Thank you to all who attended, we hope you found it useful and went away more confident in how to provide the service. Attendees have been sent a certificate of attendance.

No further local training is planned, however please see training resources above.

PharmOutcomes training guides:

A series of Pharmacy First guides have been provided by PharmOutcomes along with an instructional video guide for more information on how the service operates.

  • PharmOutcomes User Guide – Pharmacy First service guide
  • PharmOutcomes User Guide – Provider Pays – Costs, sign up and joining affinity groups
  • PharmOutcomes User Guide – PharmOutcomes Direct Registration Guide
  • PharmOutcomes User Guide – How to join an affinity group
  • NHS Pharmacy First – Minor Illness and Clinical Pathways video

View on PharmOutcomes website.

Streamline Clinical Referrals with PharmOutcomes webinar on-demand:

The webinar from PharmOutcomes held on the 28th Feb 2024 is now available on-demand and can be accessed via the link below.

The webinar aimed to cover:

• How the Pharmacy First service works vs CPCS – what’s new!
• The GP referral process – how they’re supporting GP teams to identify patients suitable for pharmacy referral.
• How PharmOutcomes is supporting pharmacies with referral management.
• How to manage urgent medicines supply.
• How to view the patient GP record in PharmOutcomes and an overview of the writeback process into the GP record.

Pharmacy First: Streamline clinical research with PharmOutcomes (

Streamlining Pharmacy First referrals from general practice to community pharmacies:

From the 18th of June 2024, clinical IT system suppliers commenced the roll out of a new feature enabling Pharmacy First referrals from general practices, using EMIS Web Local Services or PharmRefer, to flow into the workflows in pharmacy clinical systems. Referrals will be received into the same workflow as Pharmacy First referrals from NHS 111 telephony and 111 online (NHS 111).

Click the link to find out more: BaRS_information pack_NHSE Regions_final

Virtual Outcomes Pharmacy First training:

  • Introduction and Service Overview
  • Fungal Infections
  • Acne
  • Impetigo
  • Infected Insect Bites
  • Otitis Media
  • Shingles
  • Sinusitis
  • Sore Throat
  • UTI
  • GP Training – Click on the course and share the weblink with your surgery

Visit Virtual Outcomes


Annex D Key Contact Details:

Annex D’s for Pharmacy First have been prepared by the ICB and were emailed to all pharmacies on Friday the 26th of January 2024. There is one for Hull and ERoY, one for NL, and one for NEL. These are similar to the old Annex Cs required under CPCS. If you are unable to find the email or need copy of these contact details then please or

ICB Newsletters:

Pharmacy First newsletters are sent by the ICB to all pharmacies NHS shared mailboxes. The March edition of the newsletter contains important information on PF waste disposal, actions to take should you need to temporarily withdraw from the service, and more…

HNY ICB Mar 24 Pharmacy First Newsletter (CP)

HNY ICB Apr 24 Pharmacy First Newsletter (CP)

HNY ICB Apr 24 Pharmacy First Newsletter (GP)

Pharmacy First Key Promotional Resources:

You may also find the following document useful which contains links to some key promotional Pharmacy First resources that have been collated and are easy to download.