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England only

Pharmacy First support

Helping community pharmacies in England with Pharmacy First implementation, service requirements, bundling obligations and preparing for Independent Prescribing from autumn 2026.

In summary: Pharmacy First is an NHS England advanced service launched on 31 January 2024, enabling pharmacists to provide NHS-funded advice and treatment for seven common conditions via clinical pathways and PGDs. It applies to England only — Wales has a separate Clinical Community Pharmacy Service (CCPS). The service is evolving rapidly: Independent Prescribing will extend Pharmacy First from autumn 2026. TI Pharmacy Consultancy supports English community pharmacies with Pharmacy First compliance, bundling requirements and preparation for forthcoming changes.
England only. Pharmacy First is an NHS England service and applies to England only. If your pharmacy is in Wales, see our Wales services page — the Clinical Community Pharmacy Service (CCPS) in Wales operates under a different contractual framework.

What is Pharmacy First?

The NHS Pharmacy First Service launched on 31 January 2024, replacing the Community Pharmacist Consultation Service (CPCS). It is an advanced service under the English Community Pharmacy Contractual Framework (CPCF) and involves pharmacists providing NHS-funded advice and treatment for seven common conditions — sinusitis, sore throat, acute otitis media, infected insect bites, impetigo, shingles and uncomplicated urinary tract infections in women aged 16–64.

Consultations are provided to patients presenting at the pharmacy and those referred electronically by GP practices. Where clinically appropriate, pharmacists can supply medicines under patient group directions (PGDs). The service fee is £17 per consultation.

What TI Pharmacy Consultancy does

  • Advising on Pharmacy First service requirements, eligibility and registration
  • Reviewing compliance with the current clinical pathways, PGDs and protocol — updated October 2025
  • Advising on the bundling requirements — Hypertension Case-Finding Service and Pharmacy Contraception Service registration
  • Monitoring cap thresholds and advising on the implications of monthly consultation cap limits
  • Preparing pharmacies for the Independent Prescribing extension from autumn 2026
  • Advising on the governance arrangements required for advanced service delivery
  • Keeping pharmacies updated as the Pharmacy First service evolves

Independent Prescribing — coming autumn 2026

As part of the 2026/27 CPCF negotiations, Independent Prescribing will be introduced into the CPCF as an extension of Pharmacy First and the Pharmacy Contraception Service from autumn 2026. Pharmacist independent prescribers will be able to complete episodes of care within the service without the need for a PGD.

This is a significant development for community pharmacy. Pharmacies will need to ensure that pharmacist independent prescribers are appropriately prepared and that governance frameworks are in place. TI Pharmacy Consultancy is advising pharmacies on preparation for this change now.

Recent Pharmacy First changes

Following a clinical stocktake, NHS England published updated Pharmacy First clinical pathways, PGDs and protocols from 1 October 2025. The updated documents replaced the previous versions. TI Pharmacy Consultancy monitors changes to the service specification and advises pharmacies promptly when updates take effect.

Need help with Pharmacy First?

Contact TI Pharmacy Consultancy for a free initial discussion about your Pharmacy First compliance position, bundling requirements or preparation for the Independent Prescribing extension.

Free initial discussion

Frequently asked questions

The NHS Pharmacy First Service launched on 31 January 2024. It is an advanced service under the English Community Pharmacy Contractual Framework (CPCF) that enables pharmacists to provide NHS-funded advice and treatment for seven common conditions using clinical pathways, patient group directions (PGDs) and a clinical protocol. It replaced the previous Community Pharmacist Consultation Service (CPCS). Pharmacy First is an NHS England service — it applies to England only. Wales has a separate Clinical Community Pharmacy Service (CCPS) under its own contractual framework.

Pharmacy First covers seven common conditions: uncomplicated urinary tract infections in women aged 16–64, shingles, sinusitis, sore throat, acute otitis media, infected insect bites and impetigo. Age restrictions apply to some pathways. Pharmacists provide consultations and can supply medicines under PGDs where clinically appropriate. From autumn 2026, pharmacist independent prescribers will be able to complete episodes of care within the service without the need for a PGD.

To receive the monthly Pharmacy First payment when the monthly consultation target is met, pharmacies must be registered to provide the Hypertension Case-Finding Service and the Pharmacy Contraception Service. From October 2025, pharmacies must also deliver at least one ambulatory blood pressure reading per month. These bundling requirements were retained under the 2025–26 CPCF settlement. TI Pharmacy Consultancy advises on the current bundling requirements and what is needed to maintain eligibility.

As part of the 2026/27 CPCF negotiations, it has been agreed that Independent Prescribing will be introduced into the CPCF as an extension of Pharmacy First and the Pharmacy Contraception Service from autumn 2026. This will enable pharmacist independent prescribers to complete episodes of care within the service without the need for a PGD. Pharmacies will need to ensure that their pharmacist independent prescribers are appropriately prepared and that governance arrangements are in place. TI Pharmacy Consultancy advises on preparation for the Independent Prescribing extension.

Following a clinical stocktake, NHS England published updated clinical pathways, PGDs and protocols from 1 October 2025. The updated documents replaced the previous versions. TI Pharmacy Consultancy monitors Pharmacy First regulatory updates and advises pharmacies on the implications of changes to the service specification, clinical pathways and PGDs.