NHS Pharmacy First
NHS Pharmacy First: pathways, fees, and the remote-delivery rules
Pharmacy First is an advanced service under the Community Pharmacy Contractual Framework, launched 31 January 2024. On this page: the seven clinical pathways and age ranges, what each consultation pays under the 2026/27 CPCF (agreed 29 May 2026), and what the specification allows for remote video delivery.
The seven clinical pathways
The seven Pharmacy First pathways and their age ranges.
| Clinical pathway | Age range | Remote delivery |
|---|---|---|
| Sinusitis | 12 years and over | Yes, live video |
| Sore throat | 5 years and over | Yes, live video |
| Infected insect bites | 1 year and over | Yes, live video |
| Impetigo | 1 year and over | Yes, live video |
| Shingles | 18 years and over | Yes, live video |
| Uncomplicated urinary tract infections | Women 16 to 64 years | Yes, live video |
| Acute otitis media (earache) | 1 to 17 years | In person (needs an otoscope) |
Payments
Pharmacy First and NHS service fees (2026/27).
Under the 2026/27 Community Pharmacy Contractual Framework, each NHS service pays a per-consultation fee. These fees were held at their 2025/26 levels for 2026/27. More consultation capacity means more of these fees.
Pharmacy First consultation
£17
clinical pathway or minor illness, unchanged for 2026/27
New Medicine Service
£28
£14 initial plus £14 follow-up
Pharmacy Contraception
£25
initiation or continuation, plus £20 oral emergency contraception
Blood pressure check
£10
clinic check, or £50.85 for ABPM
Plus a fixed monthly payment for Pharmacy First. On top of the £17 per consultation, sites earn a monthly payment by consultation volume: £500 for 20 to 29 consultations a month, and £1,000 for 30 or more consultations a month. Unchanged for 2026/27.
As illustration: ten extra £17 consultations a week is roughly £8,800 a year, before the monthly payment. Run your own numbers.
Keep figures current. These 2026/27 fees are from the gov.uk CPCF 2026/27 settlement (29 May 2026), last reviewed July 2026. Always check the latest CPCF before relying on them. Shown for context, not financial advice.
The question everyone asks
Can Pharmacy First be delivered remotely?
Yes, within the rules. The NHS England Pharmacy First service specification permits the clinical-pathway consultation by good-quality live video for six of the seven conditions (earache needs an otoscope, so it stays in person). The Pharmacy Contraception Service and the Discharge Medicines Service are also explicitly deliverable by live video, and the GPhC’s February 2025 guidance treats remote versus face-to-face as a risk-based professional judgement rather than a ban.
One point is still being confirmed: exactly where the remote pharmacist must be located. The specifications require a pharmacist at a pharmacy premises; whether a shared hub can serve several sites is something we are confirming directly with Community Pharmacy England and NHS England before we build the business case on it.
This is exactly what Remote Pharmacist is built for: the in-room terminal, the pharmacist at registered premises, and the notes, consent and audit that make the consultation claimable. See how a consultation works.
Coming in 2026
Independent prescribing is being added to Pharmacy First.
As part of the 2026/27 contract agreed on 29 May 2026, the government announced a national NHS independent-prescribing offer, planned from autumn 2026 (likely October), extending Pharmacy First and the Pharmacy Contraception Service. Up to five new prescribing-only pathways are proposed, subject to a clinical reference group; the specific conditions are not yet finalised. Separately, from September 2026 newly qualified pharmacists register as independent prescribers.
Announced and planned, not yet live. This is announced and planned, not yet operational. We will update this as the service goes live. Source: gov.uk / DHSC & NHS England (29 May 2026). More capacity to deliver prescribing-led pathways is exactly where added consultation capacity helps.
Practical
Where a remote pharmacist fits in your Pharmacy First numbers.
A remote pharmacist adds capacity without a second on-site salary. See how a consultation works, or the services you can deliver.
Never turn a patient away
Keep the consultation room open on short-staffed days so eligible patients are seen.
Add capacity, not headcount
A remote pharmacist absorbs consultation demand without a second on-site salary.
Standardise across sites
Consistent pathways, notes and audit help each site deliver more consultations reliably.
Pharmacy First FAQ
Common Pharmacy First questions.
What are the seven conditions covered by Pharmacy First?
Sinusitis, sore throat, infected insect bites, impetigo, shingles, uncomplicated urinary tract infections (women 16 to 64) and acute otitis media (earache).
How much does each consultation pay?
Under the 2026/27 CPCF, a Pharmacy First clinical-pathway consultation pays £17 (unchanged from 2025/26), a New Medicine Service pays £28 in total, and Pharmacy Contraception £25. There is also a fixed monthly payment: £500 for 20 to 29 consultations in a month and £1,000 for 30 or more.
Can Pharmacy First be delivered over video?
Yes for the six video-suitable pathways, by good-quality video (not telephone), provided the pharmacist delivering the consultation is at a registered pharmacy premises. Acute otitis media needs an otoscope and must be delivered in person.
Do you replace our Responsible Pharmacist?
No. Your Responsible Pharmacist remains required and present on the premises for dispensing and supply. Remote Pharmacist adds a consultation clinician; it does not remove your RP or provide remote supervision of dispensing, which is not permitted.
How do referrals into Pharmacy First work?
Patients can walk in or self-refer for the seven clinical pathways; urgent supply of medicines and minor illness consultations come by electronic referral (for example from NHS 111 or general practice).
Is independent prescribing part of Pharmacy First?
A national NHS independent-prescribing offer is planned from autumn 2026 to extend Pharmacy First and the Pharmacy Contraception Service, with up to five new prescribing-only pathways still to be confirmed. It is announced and planned, not yet operational.
See how many consultations you could add
Use the calculator to size the upside, or book a demo to see the model against your own sites.