Can Pharmacy First be delivered remotely? What the spec allows

The short answer

Yes, most of Pharmacy First can be delivered remotely, within clear limits set by the service specification. Of the seven clinical pathways, six can be provided by good-quality video. Only acute otitis media (earache), which needs the pharmacist to look inside the ear with an otoscope, has to be done face to face.

Two points trip people up. Telephone or audio-only delivery is not allowed for the clinical pathways, and the pharmacist running the video consultation has to be at a registered pharmacy the whole time. Get those right and video delivery is squarely within the rules. Our Pharmacy First remote delivery page walks through how this maps to a consultation room.

Which pathways can be delivered by video

The seven Pharmacy First clinical pathways and their age ranges are unchanged for 2026/27. Six are eligible for good-quality video delivery; the seventh, earache, is in person only because it requires an otoscope.

• Sinusitis (12 and over): video
• Sore throat (5 and over): video
• Infected insect bites (1 and over): video
• Impetigo (1 and over): video
• Shingles (18 and over): video
• Uncomplicated urinary tract infection, women aged 16–64: video
• Acute otitis media / earache (1–17): in person only, otoscope required

Video only, not telephone

For the clinical pathways, good-quality video is required and an audio-only phone call is not acceptable. The reason is straightforward: the pharmacist needs to see the patient to assess them against the pathway, whether that is inspecting a rash or looking at a urine sample. A voice call cannot support that examination.

The two Pharmacy First referral routes are treated differently. A minor-illness referral consultation and an urgent supply of medicine can be delivered by telephone or by video, because they do not involve the same structured clinical examination. It is worth being precise about which type of consultation you are running before you decide the channel.

The pharmacist must be at a registered pharmacy

The specification is explicit that any pharmacist providing the service must be at the pharmacy premises when delivering a remote consultation to a patient. So remote refers to the patient being at their own pharmacy's consultation room while the pharmacist consults from elsewhere, not to a pharmacist working from home. The consulting pharmacist has to be at registered pharmacy premises throughout.

On the patient's side you still need a proper consultation room with the IT to record the consultation contemporaneously in the NHS-assured Pharmacy First IT system, and NHS claims continue to flow through the pharmacy's own NHS-assured system. The on-site Responsible Pharmacist stays on the premises and is never replaced; see how it works for the on-site and off-site split.

The video has to be good enough to examine

Good-quality video is not a throwaway phrase. It means the picture has to be clear enough for the pharmacist to genuinely assess the patient: to see impetigo or shingles on the skin, or to inspect a urine sample for a suspected UTI. A grainy consumer video call would not meet that bar.

This is why the camera, lighting and connection in the consultation room matter as much as the clinical decision itself. Our guides on consultation room technology and connectivity and live clinical video versus generic video calling set out what to check.

What the GPhC distance guidance says

The GPhC's Guidance for registered pharmacies providing pharmacy services at a distance (February 2025) remains current in mid-2026, and it is worth reading as risk-based professional judgement rather than a ban on remote care. For higher-risk situations the prescriber must not rely on a questionnaire alone; they should independently verify the information, and where it cannot be verified or it is not safe to prescribe, redirect the patient to an appropriate care provider, the convert-to-face-to-face route.

One thing to be clear about: the GPhC registers pharmacists, pharmacy technicians and pharmacy premises, not software. No platform can be described as GPhC registered or approved, and you should be wary of any supplier that claims otherwise. What matters is that the pharmacy delivering the service meets the professional standards, supported by suitable technology and clinical-safety arrangements.

Can one pharmacist cover several pharmacies?

A common question is whether one off-site pharmacist could deliver Pharmacy First consultations for several separate registered pharmacies from a single location, sometimes called a multi-site hub model. This is not confirmed. No official source currently authorises or prohibits it, and the rule that the pharmacist must be at a registered pharmacy premises implies that each consultation originates from a registered pharmacy.

We treat this as an open question that should be checked with Community Pharmacy England or NHS England, and we never present it as settled. If you are planning around it, confirm the current position first rather than assuming it is permitted.