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A recent analysis conducted by the Company Chemists' Association (CCA) has revealed stark disparities in patient engagement with the Pharmacy First service across the country, likening the pattern to a 'patchwork quilt'. It indicated that patients in the highest-performing Integrated Care System (ICS) received seven times more Pharmacy First consultations than those in the lowest-performing regions. As of April 21, more than 3,000 CCA member pharmacies had delivered 126,484 Pharmacy First consultations since the programme's launch. However, the analysis found significant regional variations, with nearly 13,000 consultations completed in the North East and North Cumbria ICS, while only 948 were completed in Gloucestershire ICS. The CCA calculated that if every ICS had as many consultations as the highest-performing ICS, there would have been an additional 600,000 Pharmacy First consultations nationwide.

With the Pharmacy First services scheduled for launch end of this month, legislators explored the potential of community pharmacies to offer specific diagnostic and treatment services in the second public evidence session of pharmacy inquiry this week (January 16). The new service, which will enable pharmacists to offer advice and prescribe treatment for seven minor ailments, is expected to alleviate the pressure on the NHS, reduce GP workload, and cut waiting lists. But MPs and healthcare leaders also acknowledged that there's hesitancy and the mindset of 'GP first, not Pharmacy First' among members of the public. "We must accept that many patients are used to seeing their GP as their first port of call for many health conditions. Pharmacy First is welcome, but there are going to be some restrictions on how quickly some patients will want to take up some of those services, rather than seeing their GP," said William Pett, Head of Policy, Public Affairs and Research, Healthwatch England.

In a recent report released by the Company Chemists' Association (CCA), data from the NHS Pharmacy First service indicates a substantial uptake and positive impact on patient care just two months after its launch. The CCA's findings shed light on the service's efficacy in meeting patient needs and its potential to alleviate pressure on General Practices (GPs) within the NHS. According to the report, over 90,000 Pharmacy First consultations were conducted solely by CCA members within the initial two-month period. Impressively, 88 per cent of these consultations, totaling 81,627, were deemed eligible for NHS-funded care indicating a significant demand for the service among patients. In the first month, the data revealed that more than 90 per cent of eligible patients received necessary care directly through Pharmacy First, bypassing the need for further referral.

To maximise the benefits of the Pharmacy First service for patients, the NHS, and community pharmacies, Community Pharmacy England (CPE) has advised the community pharmacists to to establish a robust relationship between community pharmacies and local general practices. The news comes after several reports highlighted issues regarding GP referrals for the seven minor ailment conditions under the Pharmacy First services. According to the reports, many pharmacists claimed that "many GPs in England are not sending patients to them to be treated - and that some are refusing to participate at all in the "groundbreaking" Pharmacy First scheme". In response to foster better relationship with the GPs, CPE has said that strong local collaborations will enable general practice teams to confidently refer patients to the Pharmacy First and other community pharmacy services where appropriate. Moreover, the organisation emphasised implementation of long-term changes in practice will take time. The current focus on integrating GP referrals to Pharmacy First will likely require sustained effort over several months or longer.

In response to concerns raised by Community Pharmacy England (CPE), ministers have decided to lower the October threshold for the Pharmacy First service to 20. This decision addresses a major worry for pharmacy owners who have struggled to meet the required number of clinical pathways for monthly Pharmacy First payments, especially as the October increase to 30 pathways approached. CPE has been actively engaged in discussions with the Department of Health and Social Care and NHS England over the past few weeks to address this issue. Commenting on the decision, Janet Morrison, CEO of Community Pharmacy England, said: "It is great that ministers have responded to our concerns about another increase to the Pharmacy First payment threshold: this decision will save many community pharmacies from missing out on a vital payment this month." Morrison added that CPE will continue to monitor service data and, if needed, make further representations to ministers about future months. She also emphasised the need to find a long-term solution, which involves "NHS England marketing Pharmacy First effectively and ensuring that GPs are actively referring people to the service."

In response to concerns raised by pharmacy owners, the government has decided to adjust the August threshold for the Pharmacy First service from 20 to 15 clinical pathways. The ability of pharmacy owners to achieve the thresholds for the monthly Pharmacy First payments has been a topic of great concern. Community Pharmacy England (CPE) has been actively discussing this issue over the last few weeks with the Department of Health and Social Care and NHS England. Ministers have now decided to adjust the August threshold for the Pharmacy First service to 15, CPE announced today (July 31). Commenting on this decision, Janet Morrison, CEO of Community Pharmacy England said: "We are pleased that Ministers have listened to our concerns and acted quickly to make an adjustment so soon after coming into office."

Pharmacy First has demonstrated the enormous value of community pharmacy in providing accessible front-line care. However, pharmacists continue to face several challenges in delivering the service. "Pharmacy First is a success, but it needs proper support to reach its full potential," said Numark chairman Harry McQuillan. In the first year alone, community pharmacies in England delivered an incredible 2 million consultations, highlighting the vital role pharmacists and their teams play in supporting the NHS. "This significant number shows the high demand for accessible healthcare and the trust patients place in their local pharmacy teams. It's clear that when empowered, community pharmacy delivers," McQuillan told Pharmacy Business. Key challenges in providing the service While Numark members have embraced Pharmacy First, McQuillan pointed out several challenges that persist: "Workforce capacity continues to be a concern, with patient demand sometimes outpacing available resources. "The administrative burden, particularly around IT interoperability, data capture, and reimbursement processes, adds complexity." "Additionally, some geographical areas are still struggling with public awareness, meaning more work is needed to ensure patients understand when and how they can access Pharmacy First."

As an Alphega pharmacy mentor, Sue Dobson has worked with pharmacists across the country, helping them adapt to the growing responsibilities and challenges they face in their profession. One of the most exciting developments in recent years has been the Pharmacy First initiative, which positions community pharmacists as key players in patient care, especially through GP referrals. However, Sue has seen firsthand that the success of this initiative depends largely on the strength of the relationships we build with GPs and how we integrate these referrals into our day-to-day operations. Some pharmacists have thrived by establishing strong, collaborative relationships, while others have struggled to break down initial barriers of trust. In this conversation, she speaks with Anil Chauhan, a Preston pharmacist who, along with his partner Yasar Hussain, has made GP referrals a seamless part of their practice. Their success story is a great example of how perseverance, trust-building, and a proactive approach can truly make a difference in the Pharmacy First model. Sue Dobson: Anil, you and Yasar have done a great job with the Pharmacy First initiative and GP referrals. Can you start by sharing how you first got involved with GP referrals and what made it successful in your practice?

Ensuring comprehensive healthcare services for the community necessitates collaboration between pharmacies and GP surgeries. However, several pharmacists have voiced concerns about a lack of cooperation from their local GPs in implementing the Pharmacy First (PF) service. In a survey conducted by the National Pharmacy Association (NPA) covering 470 pharmacies across England, three-quarters of pharmacists (77 per cent) indicated that local GP practices are not appropriately referring patients to the new service. The survey highlighted instances of patients either not being referred or being referred but found ineligible for support through Pharmacy First. Additionally, one in five NPA members (19 per cent) felt that their local GP practices were not engaging with the initiative at all. Commenting on the issue, NPA chair Nick Kaye said: "Feedback from across our network suggests that the rollout of Pharmacy First varies considerably from area to area.

The Company Chemists Association (CCA) has published a report highlighting the key findings of a roundtable it hosted earlier this month. The CCA convened the virtual roundtable to examine the best practice undertaken by a cross-section of LPCs to promote the delivery of the Pharmacy First service. Key recommendations for how LPCs can help support pharmacy contractors to deliver the Pharmacy First service include: Direct engagement with NHS regions who can supply funding to drive Pharmacy First engagement and promotional activity. Engagement with a variety of staff within GP surgeries, ranging from reception staff to GP partners, to drive referrals, as well as build understanding and awareness of the benefits to General Practice. Harnessing data to inform GP surgeries how they are performing locally Using data to ensure pharmacies close any open referrals promptly. Using multiple channels to promote the service, including the sharing of best practice, myth busting, use of data and creating tools which can be readily used by pharmacies and GPs. Encouraging pharmacy staff to highlight the Pharmacy First service to customers - with specific emphasis on the provision of NHS-funded care, timely access and convenience the service provides. The CCA said the report is intended to support all LPCs and pharmacy contractors as they work together to care for patients requiring urgent NHS care in their community.

EMIS Pinnacle, the leading Pharmacy First IT supplier, has begun implementing the GP Connect Update Record feature to all community pharmacies in England that use PharmOutcomes. Starting June 28, this new feature was made available for use with the Hypertension case-finding service and the Pharmacy contraception service, as announced by the Community Pharmacy England (CPE). The GP Connect Update Record will enable community pharmacies to securely share "structured" information with GP practices regarding consultations conducted under the Pharmacy First programme, which includes minor illness and clinical pathways, along with Hypertension Case Finding and Pharmacy Contraception services Live testing is underway with EMIS Pinnacle for Pharmacy First minor illness and clinical pathways. There are plans to expand the system in the future to include updates for urgent supply of medicines under the Pharmacy First service. EMIS Pinnacle is the third CPCF IT system supplier to offer this functionality, following Cegedim's Pharmacy Services system and Positive Solutions' HXConsult system.

Scotland's first minister, John Swinney, has announced the expansion of the NHS Pharmacy First Service as part of the government's strategy to shift more care into communities. However, Numark chairman Harry McQuillan has stressed the need for additional funding to support this expansion effectively. Speaking at the National Robotarium in Edinburgh on 27 January 2025, Swinney outlined the government's plans for enhancing public services and renewing the NHS, promising a significant boost in NHS Scotland's capacity to reduce waiting times. Recognising the importance of identifying new approaches, Swinney underscored the critical role of community pharmacies in easing pressure on GP services. He said: "I want to see the NHS Scotland Pharmacy First Service expand so that community pharmacies can treat a greater number of clinical conditions and prevent the need for a GP visit in the first place." McQuillan welcomed the announcement, stating that this advancement will "empower pharmacists to provide even greater value, leveraging their clinical expertise to deliver comprehensive care directly to patients." However, he noted that the sector should be provided with extra funding to support this expansion.

The nationwide implementation of the Pharmacy First service is viewed as a significant development that benefits pharmacies, primary care, and the broader National Health Service (NHS). Pharmacy teams are striving to ensure its success despite challenges within the industry landscape. However, not all pharmacists are able to reap the benefits from it. Recently, two members of Numark shared their experiences of how the scheme is impacting their pharmacies. Graham Phillips, who owns Letchworth Pharmacy in Hertfordshire, revealed that patients are responding favourably to the service. "It's all good, people are just delighted to have easier access to care," he said. In its first month, Letchworth Pharmacy provided around 100 consultations, and Phillips envisions that as the service matures, they will be able to conduct an average of 200 interventions per week. "That will make it financially viable for us and mean that we're acting at scale from an NHS perspective. That's 200 GP appointments we've freed up in a week - that's a huge capability and capacity bump for the NHS," he added. Graham credits part of his success with Pharmacy First to the strong relationship he has established with local GPs in his area.

Pharmacists, who are working on the frontline of healthcare, can play an important role in raising awareness about mental health and helping those experiencing poor mental health. With this belief, the Pharmacists' Defence Association (PDA) is encouraging its representatives at Boots to participate in Mental Health First Aid (MHFA) training offered by the company. Nicola Rees, PDA Rep and Boots pharmacist from Solihull, who has recently undertaken training as a Mental Health First Aider, said that trained pharmacists can help in reducing the stigma associated with mental health and identifying the early warning signs that someone may be experiencing poor mental health. Mental Health First Aid training enables pharmacists to "support individuals and signpost to sources of advice and support." Rees expressed that becoming a mental health first aider has empowered her and greatly increased her confidence in being able to support someone dealing with a mental health issue, such as having thoughts of suicide or self-harm.

Pharmacy owners can make their claims for February Pharmacy First consultations until 5pm on Friday 15 March 2024, the NHS Business Services Authority (NHSBSA) announced on Monday. The deadline for Pharmacy First submission was extended following a technical issue in the NHSBSA Manage Your Service (MYS) portal, which led to the claims appearing incorrectly in the portal. The NHSBSA has been working with suppliers and NHS England to investigate and address the problem. While the problem has been resolved, the NHSBSA has advised pharmacy owners to check their submissions carefully before submitting. If any issues persist, they are advised to contact their Pharmacy First IT system supplier helpdesk to escalate the matter and not to confirm their claims in MYS until the issue has been resolved. Pharmacy owners are informed that the extended deadline is for February only and it includes any consultations completed on 31 January 2024.

NHS England announced at the Pharmacy Show this morning that Ministers have decided to amend the Pharmacy First thresholds for the remainder of the year. This decision follows concerns raised by Community Pharmacy England (CPE) regarding difficulties faced by pharmacy owners in meeting the required number of clinical pathway consultations for monthly Pharmacy First payments In response to CPE's representations to the Department of Health and Social Care (DHSC) and NHS England, the threshold was earlier reduced from 20 to 15 in August, and from 30 to 20 in October. At the Pharmacy Show on Monday, Ali Sparke from NHS England announced the revised thresholds, setting them at 20 for November and December 2024. Starting in January and February 2025, the number of clinical pathway consultations needed for the monthly Pharmacy First payment will rise to 25, with a further increase to 30 in March.

Since its launch on January 31st, the Pharmacy First service by the Company Chemists Association (CCA) has achieved a significant milestone, completing over 200,000 consultations to date. This milestone underscores the service's vital role in providing same-day NHS care through community pharmacies across England. Recent analysis by the CCA has revealed a pressing need to bolster GP referrals, with disparities observed between different Integrated Care System (ICS) areas, resulting in what's described as a 'postcode lottery' for patients. CCA Chief Executive, Malcolm Harrison, emphasised the importance of sustained funding for Pharmacy First beyond 2025, ensuring its availability for patients, community pharmacies, and the wider NHS.

The Royal Pharmaceutical Society (RPS) and National Pharmacy Association (NPA) have both urged the new health secretary Steve Barclay to back the 'pharmacy first' approach in England as mentioned by his predecessor on numerous occasions. "Sajid Javid recognised the vital role of community pharmacy and the potential of a 'Pharmacy First' to support patient access to care. I would urge the new Health Secretary to see this through to completion," said chair of RPS in England Thorrun Govind. Thorrun hopes the new health secretary will engage with pharmacy leaders about how we can make the most of our health and care workforce to support the NHS recovery, including reducing health inequalities, managing the growing cost of long-term conditions, and utilising the enhanced skills of Pharmacist Independent Prescribers. Commenting on the new appointment, she said: "This is a crucial time for the future of health and care - with continued pressures on teams, changes to NHS structures and organisations, and the need for long-term investment in the workforce. "With a 'refresh' of the NHS Long-Term Plan and the Government's workforce plan expected later this year, these must support a more ambitious approach to advancing the clinical role of pharmacists across the NHS to better meet changing patient demand, backed by investment in pharmacy education and training.

Acknowledging the ongoing challenges in delivering the required IT systems for the scheduled launch of the Pharmacy First service on January 31, NHS England reported progress in fulfilling 'many' commitments outlined in its plan to enhance primary care access during a board meeting on Thursday. However, it noted that the digital infrastructure supporting Pharmacy First, included in the £645 million fresh funding for community pharmacy, will require additional time for implementation. "Delivery remains challenging due to changes needed in digital infrastructure, and we are working with suppliers to support January implementation," NHSE said. "A public campaign is planned for 2024." The Pharmacy First service allows pharmacists to supply prescription-only medicines for seven common health conditions (sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women), eliminating the need for a GP visit. Meanwhile, NHSE is leveraging the widespread accessibility of pharmacies by expanding blood pressure monitoring and introducing direct prescribing of clinically safe oral contraceptives-an initiative that has been well-received.

Recently, the English Health Secretary has talked about introducing a 'Pharmacy First' model similar to that which exists in Scotland. This would be a win-win outcome providing people with better access to essential healthcare support, advice and treatment whilst relieving strain on other parts of the NHS, not least GPs and A&E. It is a no-brainer and yet despite a few media headlines there are still no firm proposals on the table to make this a reality. It surely cannot be right that you can receive a broad range of patient care services in Scotland which are not available in England. It works well in Scotland, Wales is keen to develop more pharmacy-based services and Northern Ireland, leaving aside the current funding dispute, has had a minor ailments service for many years. If the English Health Secretary is sincere in his interest in adopting an English version of the Scottish model, then there are critical aspects he needs to consider. Firstly, start with the patient journey through the healthcare ecosystem from illness prevention through to long-term condition management. What is the role of community pharmacy and how do we guide people to seek support from the most appropriate healthcare professional? What is the vision for community pharmacy delivering patient care in the next decade? The lesson from Scotland is that the government needs to sit down with the sector and map that out together. There are no quick fix overnight solutions. This needs to be a long-term commitment backed by adequate funding. Supervision regulations need to change and there needs to be a thought through workforce strategy which avoids community pharmacy shortages as that does nothing to deliver improved patient outcomes.