NHS Pharmacy First
NHS Pharmacy First: the complete guide for contractors
Pharmacy First is an advanced service under the Community Pharmacy Contractual Framework, launched 31 January 2024. It has three elements: clinical pathways for seven common conditions (supply under Patient Group Directions), urgent supply of medicines, and minor illness referrals.
The seven clinical pathways
Exact conditions and age ranges.
Sinusitis
12 years and over
Video-suitableSore throat
5 years and over
Video-suitableInfected insect bites
1 year and over
Video-suitableImpetigo
1 year and over
Video-suitableShingles
18 years and over
Video-suitableUncomplicated urinary tract infections
Women 16 to 64 years
Video-suitableAcute otitis media (earache)
1 to 17 years
In-person onlyNeeds an otoscope, so it cannot be delivered by remote consultation alone.
Payments & thresholds
Why reaching the monthly threshold matters.
Per consultation
£17
Clinical-pathway consultation fee (from April 2025).
Monthly fixed
£1,000
At 30+ clinical-pathway consultations a month, or £500 at 20 to 29.
Also required
+2
From June 2025, offering Pharmacy Contraception and Hypertension Case-Finding is a condition of the monthly payment.
Keep figures current. Funding rates change, so always check the effective date. Figures here reflect published NHSBSA and Community Pharmacy England guidance and are shown for context, not as financial advice.
The question everyone asks
Can Pharmacy First be delivered remotely?
NHS England’s guidance for community pharmacy teams permits delivering consultations via a good-quality live video link, with IT equipment available in the consultation room. So a remote-pharmacist video terminal is compatible with existing NHS guidance.
The important condition: the pharmacist delivering an NHS Pharmacy First consultation must themselves be at a pharmacy premises. So Remote Pharmacist works as added clinical capacity from a registered pharmacy hub, not delivery from an unregistered location, alongside private services and advice.
Our operating model. Our pharmacists consult from a registered pharmacy hub, and acute otitis media is always handled in person because it needs an otoscope. We describe the NHS service factually and never imply NHS or GPhC endorsement.
Practical
How to reach and hold the threshold.
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
Straight answers.
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 many consultations do I need to reach £1,000?
30 or more clinical-pathway consultations in a calendar month earns the £1,000 fixed monthly payment; 20 to 29 earns the £500 tier. Each clinical-pathway consultation also attracts a fee (£17 from April 2025).
Can Pharmacy First be delivered over video?
Yes for the video-suitable pathways, provided the pharmacist delivering the consultation is at a pharmacy premises. Acute otitis media needs an otoscope and must be delivered in person.
How do referrals into Pharmacy First work?
Patients can walk in or self-refer for the clinical pathways; urgent supply of medicines and minor illness consultations come by electronic referral (for example from NHS 111 or general practice).
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.