Consultation-room technology and connectivity for remote consultations

Start with the room you already have

Remote delivery does not need a new build. It runs in the private consultation room your pharmacy already uses for Pharmacy First, with the IT that room already has. The on-site Responsible Pharmacist (the pharmacist legally in charge of the premises) stays on the premises throughout and is never replaced. On-site staff greet the patient and start the call, so the patient is never left alone in front of a screen.

What changes is who is on the other end of the video. A GPhC-registered pharmacist consults remotely from registered pharmacy premises, adding consultation capacity without funding a second pharmacist on your floor. The flow of a consultation stays recognisable to your team, because the room and the way a patient is received barely change.

The terminal in the consultation room

The terminal is the secure video device that sits in the consultation room. It is more than a video call. It captures the patient's consent, structures the clinical notes against the relevant pathway, and writes an append-only, hash-chained audit trail. Access is role-based with multi-factor authentication (MFA), and any recording is consent-gated and off by default.

This is a deliberate contrast with a generic meeting app. A purpose-built clinical terminal is designed for the record-keeping, access control and clinical-safety expectations of an NHS service, which a consumer video-calling tool is not. We set that difference out in more detail in live video versus generic video calling.

Recording notes in the NHS-assured Pharmacy First system

A Pharmacy First consultation has to be recorded contemporaneously in the NHS-assured Pharmacy First IT system, the assured clinical system your pharmacy already uses to log consultations and submit claims. The consultation room therefore needs the IT to reach that system while the consultation is happening, not afterwards from memory.

The terminal supports the consultation; the NHS claim still flows through your own assured system, not through us. That keeps your existing claiming route and your NHS Business Services Authority (NHSBSA) submissions unchanged, and it keeps the clinical record where your pharmacy is already accountable for it.

A connection good enough to examine

For six of the seven clinical pathways, good-quality video is the delivery method, and the standard is practical: the picture has to be clear enough to examine. That means resolving a rash for infected insect bites or impetigo, or seeing a urine sample clearly enough for an uncomplicated urinary tract infection consultation. A blurry, stuttering call does not meet that bar.

In practice this is about upload bandwidth and stability, not headline download speed. Two-way video leans on the connection's upload capacity, which is usually the weaker direction on a standard broadband line. A wired link to the terminal is steadier than Wi-Fi in a room surrounded by shelving and other devices, and a second route such as a 4G or 5G failover gives you something to fall back on. There is no single official minimum speed to quote, so test the room under real, busy conditions rather than out of hours when the network is quiet. Our note on what a consultation room needs keeps to this practical framing.

Where the remote pharmacist has to be

The pharmacist delivering a remote consultation must be physically at a registered pharmacy premises while providing it. A remote consultation is not a pharmacist working from home. That shapes connectivity planning at both ends: the patient's room and the pharmacist's location each need an assured, stable setup.

Whether one off-site pharmacist may cover several separate registered pharmacies from a single location is not yet confirmed, and we do not present it as settled. The rules on remote delivery are the reference point here, and we will follow the position that Community Pharmacy England and NHS England set.

When a call drops: plan the recovery path

Networks fail. The design decision that matters is what happens when a consultation is interrupted. You need a defined recovery path: the patient and pharmacist re-establish the video connection, or the consultation is rescheduled, with the on-site team supporting the patient in the room throughout so no one is left waiting alone.

One thing the recovery path cannot be for a clinical pathway is a switch to audio only. Telephone or audio-only delivery is not permitted for the seven clinical pathways, so if the video cannot be restored to an examinable quality the consultation is completed another way or another time. Minor-illness and urgent-medicine-supply referral consultations are different, and those referral conversations may be conducted by phone or by video.

The earache pathway still needs an otoscope

Acute otitis media (middle-ear infection, the earache pathway, ages 1 to 17) requires examining the eardrum with an otoscope, so it stays an in-person consultation. It is the one clinical pathway of the seven that cannot be delivered remotely. Keep an otoscope and a suitably trained on-site pharmacist available for it.

The other six pathways, sinusitis, sore throat, infected insect bites, impetigo, shingles and uncomplicated urinary tract infection in women, can be delivered by good-quality video. We work through what can and cannot move to video in can Pharmacy First be delivered remotely.