Setting Up and Checklists

What does the new Pharmacy First service involve?

The ‘new’ service incorporates all elements of the Community Pharmacy Consultation Service (CPCS) service, now known as Pharmacy First – Minor Illness.

Pharmacy First referrals must also be triggered by an electronic referral from NHS 111, general practices or other authorised healthcare providers. (NB: the service is not available free to patients presenting in the pharmacy without a referral).

Pharmacy First also continues to include Urgent Medicine Supplies (and appliances) where requested by NHS111.

The crucial new feature in Pharmacy First is the option that pharmacists now have to supply certain prescription only medicines (POMs) where appropriate for seven specific conditions, as listed below. It is notable that early symptoms associated with these conditions have previously been referrable under CPCS (as indicated within the brackets) but the difference is pharmacists can now treat them more effectively with the POM options, as facilitated by Patient Group Directions or PGDs.

• sinusitis                     (blocked/painful sinus was in CPCS)
• sore throat               (was also referred to as ‘sore throat’ in CPCS)
• acute otitis media (ear ache was listed in CPCS)
• infected insect bite(insect bites & stings)
• impetigo                    (skin rash/lesions)
• shingles                     (skin blisters)
• uncomplicated UTI (cystitis)

The Pharmacy First service requirements are included in the Service specification and the associated Clinical Pathways.

Download the service specification and clinical pathways

There are 23 patient group directions (PGD) and one protocol supporting the service authorising the supply of these medicines at NHS expense

Download the PGDs and protocol

Distance Selling Pharmacies (DSPs) are able to provide six of the seven Pharmacy First clinical pathways remotely via video consultations. But DSPs may not provide clinical pathways consultations on their premises (due to links with the support for self-care Essential Service and restrictions regarding the provision of Essential Services on the pharmacy premises).

The acute otitis media clinical pathway requires the use of an otoscope, so this pathway will not be provided by DSPs.

There are many resources available via the Community Pharmacy England (CPE) website

Pharmacy First specification (Guidance on selecting a suitable otoscope can be found in Annex C)