Waiting weeks for a GP appointment when you feel unwell is not just frustrating. It can mean your condition gets worse before it gets better. That is exactly why NHS Pharmacy First was introduced.
Launched by NHS England in February 2024, the Pharmacy First scheme means that for seven of the most common health conditions, your local pharmacy is now your first port of call. No waiting room. No lengthy referral. Just straightforward, professional care from a qualified pharmacist, often on the same day.
At Pharmacy M, our NHS-accredited pharmacists are fully trained to assess, advise, and where clinically appropriate, prescribe treatments for these seven conditions under the Pharmacy First programme. Whether you walk in off the street or pop in on your lunch break, we are here to help.
In this guide, we will explain exactly what NHS Pharmacy First covers, which seven conditions are included, who is eligible, and how Pharmacy M makes the whole process as easy as possible.
What Is NHS Pharmacy First?
NHS Pharmacy First is a free NHS service that allows trained community pharmacists to assess and treat patients for seven common conditions, without them needing to see a GP first.
Before Pharmacy First, if you had a UTI, a skin infection, or suspected shingles, your only NHS option was to book a GP appointment or visit an urgent care centre. Now, your pharmacist can consult with you, carry out a clinical assessment, and where clinically appropriate, issue a prescription for treatment on the spot.
This is a significant step forward. Pharmacists are highly qualified healthcare professionals, not just dispensers. Under Pharmacy First, they work at the top of their clinical skillset: listening, assessing, and making evidence-based treatment decisions.
For patients, this means faster care, fewer pressures on GPs, and better access to the NHS, especially for people who struggle to get time off work, have childcare responsibilities, or simply cannot wait days for an appointment.
How Does Pharmacy First Work at Pharmacy M?
Using Pharmacy First at Pharmacy M is simple and straightforward. Here is what to expect when you visit us.
Step 1 – Walk in. No appointment is necessary for most Pharmacy First consultations. Simply come into the pharmacy and let our team know you would like a Pharmacy First assessment.
Step 2 – Private consultation. One of our pharmacists will take you into our private consultation room. This is a confidential, one-to-one conversation, not a rushed exchange over the counter. We will ask about your symptoms, how long you have had them, and any relevant medical history.
Step 3 – Clinical assessment. Our pharmacists are trained to use clinical pathways specific to each of the seven Pharmacy First conditions. For sore throats, for example, they use the FeverPAIN scoring tool. For UTIs, they check your symptoms against NICE-approved clinical criteria.
Step 4 – Treatment or referral. If your condition falls within the Pharmacy First criteria, our pharmacist will either provide over-the-counter treatment or, where appropriate, issue an NHS prescription for a prescription-only medicine at no cost to you. If your symptoms suggest something more serious, we will refer you to your GP, NHS 111, or A&E.
The whole process typically takes 15 to 20 minutes. Most patients leave with a clear plan the same day.
The 7 Conditions Treated Under NHS Pharmacy First
The NHS has identified seven clinical pathways where community pharmacists are best placed to provide fast, effective care. Here is everything you need to know about each one.
1. Earache (Otitis Media) in Children
Who it affects: Children aged 1 to 17 years.
Earache is one of the most common reasons parents call their GP, but under Pharmacy First, our pharmacists can now assess and treat acute otitis media (middle ear infections) directly.
Symptoms to look out for:
- Ear pain, often worse at night
- Tugging or pulling at the ear, especially in younger children
- Difficulty hearing or muffled sounds
- Fever or general irritability
- Fluid or discharge from the ear
Our pharmacist will examine your child’s symptoms and, where appropriate, offer either pain management advice and over-the-counter treatment, or for more severe cases, a prescription for antibiotics. We will also advise you clearly on when to seek further medical attention.
Bringing a sick, unhappy child to a GP waiting room is not easy. At Pharmacy M, you can walk in, get seen, and go home with a plan.
2. Impetigo
Who it affects: Adults and children aged 1 year and over.
Impetigo is a highly contagious bacterial skin infection that most commonly affects the face, hands, and neck. It spreads quickly, particularly among children in school and nursery settings, so getting treatment promptly really matters.
Symptoms to look out for:
- Red sores or blisters, often around the nose and mouth
- Sores that burst and form a golden, honey-coloured crust
- Itching and discomfort in the affected area
- Spreading patches of redness on the skin
Under NHS Pharmacy First, our pharmacists can prescribe topical antibiotics for localised impetigo or refer you for oral antibiotics if the infection is more widespread. We will also provide clear guidance on hygiene practices to stop the infection spreading to others.
Getting treatment early is the key to stopping impetigo in its tracks, and with Pharmacy First, you do not need to wait for a GP slot to do it.
3. Infected Insect Bites
Who it affects: Adults and children aged 1 year and over.
Most insect bites are harmless and settle within a few days. But sometimes, scratching or bacteria entering the skin can lead to a secondary infection, and that is when you need professional help.
Signs that a bite may be infected:
- Increasing redness, swelling, or warmth around the bite
- Pus or fluid oozing from the site
- A spreading red streak from the bite (this can indicate cellulitis and needs urgent care)
- Fever, chills, or feeling generally unwell
- Pain that is getting worse, not better
Our pharmacists will assess the bite site and the severity of infection. For mild to moderate infections, they can prescribe antibiotic cream or oral antibiotics via the Pharmacy First pathway. If there are signs of a more serious reaction, such as spreading cellulitis or signs of an allergic response, we will refer you immediately for further care.
If you are worried about a bite that does not seem to be healing, do not leave it. Pop into Pharmacy M for a quick assessment.
4. Shingles
Who it affects: Adults aged 18 and over. Treatment is most effective in adults aged 50 and over, or those who are immunocompromised.
Shingles is caused by the reactivation of the chickenpox virus (varicella-zoster) that lies dormant in the nervous system. It can be extremely painful and, if not treated promptly, can lead to long-term nerve pain called postherpetic neuralgia.
The critical thing to know: antiviral treatment for shingles is most effective when started within 72 hours of the rash appearing. Speed of access matters enormously here, which is why Pharmacy First is a genuine game-changer for this condition.
Symptoms to look out for:
- A tingling, burning, or itching sensation on one side of the body
- A red, blistering rash that follows a band or stripe, often on the torso, face, or neck
- Sensitivity to touch in the affected area
- Headache, fever, or light sensitivity
Our pharmacists can assess your symptoms and, if shingles is suspected and caught early enough, prescribe antiviral medication under the Pharmacy First pathway. This is the same treatment previously only available via a GP. We will also provide clear pain management advice and let you know when further support may be needed.
5. Sinusitis
Who it affects: Adults and children aged 12 and over.
Sinusitis is inflammation of the sinuses and one of the most common conditions that sends patients to their GP. It usually follows a cold or upper respiratory infection and can leave people feeling miserable for days or even weeks.
Symptoms to look out for:
- Blocked or runny nose
- Pain, pressure, or tenderness around the cheeks, eyes, or forehead
- A reduced sense of smell
- Thick, discoloured nasal discharge
- Headache or toothache
- Pressure that worsens when bending forward
For most cases, our pharmacists will provide evidence-based self-care advice, including saline rinses, steam inhalation, and the appropriate use of decongestants. For acute sinusitis where antibiotics are clinically indicated, Pharmacy First enables our pharmacist to prescribe directly, saving you a GP visit and getting you feeling better faster.
If you have had symptoms for more than 10 days, or they are getting worse rather than better, do not suffer in silence. Come and see us.
6. Sore Throat (Tonsillitis/Pharyngitis)
Who it affects: Adults and children aged 5 and over.
A sore throat is one of the most common reasons people visit their GP, yet the vast majority are caused by viruses and do not benefit from antibiotics at all. Under Pharmacy First, our pharmacists use clinically validated scoring tools to identify the smaller number of cases where antibiotics genuinely make a difference.
Symptoms to look out for:
- Pain or scratchiness in the throat, especially when swallowing
- Swollen, red tonsils, sometimes with white spots
- Swollen, tender lymph nodes in the neck
- Hoarse voice
- Fever above 38 degrees Celsius
Our pharmacists use the FeverPAIN scoring tool to assess whether your sore throat is more likely to be bacterial or viral. This is the same clinical approach used in GP surgeries. Where your score suggests a bacterial infection, our pharmacist can prescribe a course of antibiotics under Pharmacy First. For viral sore throats, we will recommend the most effective evidence-based self-care and advise on when to seek further help.
7. Urinary Tract Infections (UTIs) in Women
Who it affects: Women aged 16 to 64 (uncomplicated UTI).
Urinary tract infections are incredibly common. Around half of all women will experience at least one in their lifetime, and they can be deeply uncomfortable. The burning sensation, urgency, and pelvic pressure of a UTI can make it difficult to concentrate on anything else.
Historically, getting treatment meant booking a GP appointment, often waiting days, and sometimes providing a urine sample that needed lab testing before any prescription was issued. Pharmacy First changes this completely.
Symptoms to look out for:
- Burning or stinging when urinating
- Needing to urinate more frequently than usual
- Cloudy, dark, or strong-smelling urine
- Pain or pressure in the lower abdomen or pelvis
- Feeling generally unwell or slightly feverish
Important note: If you have symptoms such as a high fever, back or side pain, nausea, or vomiting alongside urinary symptoms, this may indicate a kidney infection. Please seek urgent medical attention rather than pharmacy advice alone.
For uncomplicated UTIs in women aged 16 to 64, our pharmacists can carry out a clinical assessment and, where appropriate, prescribe a course of antibiotics directly under the NHS Pharmacy First pathway. Most women leave with treatment the same day they visit us.
What Happens If My Condition Is More Serious?
We know it can feel uncertain going to a pharmacy rather than a GP, especially if you are worried your symptoms might be more serious than they appear.
Here is what we want you to know: our pharmacists are clinically trained to recognise when something needs to be escalated. If your symptoms suggest a condition outside the Pharmacy First pathway, or if something does not look right, we will always refer you to the right place. That might be your GP, NHS 111, or in an emergency, A&E.
You will never leave Pharmacy M without a clear plan. Our job is not just to treat. It is to make sure you are safe, informed, and in the right hands.
If you are ever unsure whether your symptoms need urgent attention, please do not hesitate. Call 999 for life-threatening emergencies, call 111 for urgent but non-life-threatening concerns, or simply come and speak to one of our team.
Who Is Eligible for NHS Pharmacy First?
NHS Pharmacy First is available to patients registered with a GP in England who present with one of the seven covered conditions and meet the age and clinical criteria for their specific pathway.
Age eligibility varies by condition. Earache applies to children aged 1 to 17. Sinusitis and sore throat apply from age 12 and age 5 respectively. Shingles applies to adults aged 18 and over, with the greatest clinical benefit for those aged 50 and over. UTI treatment under Pharmacy First is available to women aged 16 to 64 with uncomplicated presentations.
The service is completely free on the NHS. There is no consultation fee, and where a prescription is clinically indicated, standard NHS prescription charges apply unless you are exempt.
If you are unsure whether you are eligible, simply come in and ask. Our team will help you understand your options within a few minutes.
Why Choose Pharmacy M for Your Pharmacy First Consultation?
At Pharmacy M, our pharmacists are NHS-accredited, experienced, and genuinely invested in your health. We are not a faceless online service. We are your local pharmacy, and we treat every patient as an individual.
When you visit us under Pharmacy First, you will receive a private, unhurried consultation in our dedicated consultation room. Our pharmacists will listen carefully, assess thoroughly, and explain your options in plain language. If treatment is appropriate, we will arrange it there and then. If you need to see someone else, we will tell you exactly where to go and why.
We also offer same-day walk-in appointments, extended opening hours, and a full range of pharmacy services including repeat prescriptions, travel health, and NHS vaccinations. Whatever you need, we are here to help.
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Frequently Asked Questions
Is Pharmacy First free?
Yes. NHS Pharmacy First is a free NHS service. There is no charge for the consultation. If a prescription is issued, standard NHS prescription charges may apply unless you are exempt (for example, if you are under 16, over 60, or hold a valid exemption certificate).
Do I need to be registered with a GP to use Pharmacy First?
You need to be registered with a GP in England to access NHS Pharmacy First. However, you do not need to contact your GP or get a referral to use the service. Simply walk into Pharmacy M and ask for a Pharmacy First assessment.
Can children use Pharmacy First?
Yes, but the eligible age varies by condition. Children aged 1 to 17 can be assessed for earache under Pharmacy First. Children aged 5 and over are eligible for sore throat assessments, and children aged 12 and over can be assessed for sinusitis. A parent or guardian should accompany children to the consultation.
What if I need a prescription?
If your pharmacist determines that prescription medication is clinically appropriate, they can issue it directly under the Pharmacy First pathway, without you needing a separate GP prescription. This is one of the most important benefits of the scheme.
How long does a Pharmacy First consultation take?
Most consultations take between 15 and 20 minutes. You will be seen in a private consultation room, and you should leave with a clear treatment plan or referral on the same visit.
What if my condition is not one of the seven?
If your condition falls outside the seven Pharmacy First pathways, our pharmacist will still be happy to advise you. For conditions that need a GP or specialist review, we will point you in the right direction. We will never turn you away without helpful guidance.
Ready to Be Seen Today?
You do not need to wait days for a GP appointment to get the care you need. At Pharmacy M, our qualified pharmacists are ready to assess and treat your condition under NHS Pharmacy First, quickly, professionally, and at no cost to you.
Walk in to see us, or contact our team to find out more about the services we offer. We are here when you need us most.
