Pharmacy First – 2026/27
Independent Prescribing to be introduced into the CPCF 2026/27
As part of the Community Pharmacy Contractual Framework (CPCF) arrangements for 2026/27, it has been agreed that independent prescribing will be introduced as an extension of Pharmacy First and the Pharmacy Contraception Service (PCS) from autumn 2026.
Under the proposals, community pharmacist independent prescribers will be able to:
- Prescribe medicines within the existing Pharmacy First clinical pathways and PCS.
- Provide up to five new Pharmacy First prescribing-only pathways. Options under consideration include bacterial conjunctivitis, allergic conjunctivitis, oral thrush, skin infections and respiratory tract infections. The pathways will require approval by a clinical reference group before they are introduced. Completed consultations will count towards the monthly Pharmacy First clinical pathways minimum activity requirement.
- Prescribe an alternative item where this is necessary to meet an individual patient’s needs—for example, when the originally prescribed product is affected by a supply issue. Appropriate arrangements must be in place with the original prescriber to support this approach.
The proposals build on learning from NHS England’s Independent Prescribing Pathfinder Programme, which tested how prescribing could be incorporated into future NHS community pharmacy clinical services.
Supporting guidance and changes to the Terms of Service will set out the relevant clinical governance requirements for prescribing activities.
Funding for independent prescribing
The funding arrangements will include:
- A one-off £500 setup payment, payable once the pharmacy owner has signed up to provide the relevant services and has a confirmed go-live date with an NHS-assured Electronic Prescribing Service (EPS) IT system.
- A monthly infrastructure payment of £525.
- The usual Pharmacy First or Pharmacy Contraception Service consultation fees for eligible consultations.
Further information about implementation, service requirements and timescales will be shared with LLR pharmacy owners as it becomes available.
Pharmacy First clinical pathways and PGD updates (June 2025)
NHS England, with input from clinical experts and community pharmacists, published updated draft clinical pathways and Patient Group Directions (PGDs) for Pharmacy First.
Pharmacy teams should review the materials in Pharmacy First Clinical Pathways v2.5 and ensure they are competent to deliver the updated service requirements.
Key changes introduced from 1 October 2025 included:
- Changes to the position of some clinical gateway points.
- The addition of eight new gateway points.
- An increase in the number of consultations potentially eligible for a consultation fee.
- Updated clinical pathways, PGDs and service requirements.
Accurate record-keeping remains essential. This includes completing the required legal documentation for medicines supplied under a PGD or through the urgent supply element of the service.
IT suppliers updated their systems overnight on 30 September 2025, and the revised pathways went live on 1 October 2025. The final documents and updated service specification were also published on 1 October 2025.
To support LLR pharmacy teams, we have created a summary table outlining the pathway changes.
[Click HERE to access and download the summary table.]
Monthly payment bands and claiming deadlines
A volume-based monthly payment model applies to Pharmacy First clinical pathway consultations:
| Clinical pathway consultations per month | Monthly payment |
|---|---|
| 20–29 consultations | £500 |
| 30 or more consultations | £1,000 |
To support Pharmacy Teams track their monthly Pharmacy First activity we have produced the PHARMACY FIRST- LLR ACHIEVING THRESHOLD GUIDANCE
Need support?
Contact the LLR Services Support Team if you have questions or need help with any of the above (email: admin@leics-lpc.co.uk) or click below to request an appointment.