Bulletin 10: Pharmacy First – Think Beyond the Pathways

Community Pharmacy & the Delivery Plan for Recovering Access to Primary Care – Bulletin 10

Bulletin 10:

Pharmacy First - Think Beyond the Pathways

A huge thank you to all our pharmacy teams for continuing to deliver the Pharmacy First Service with such commitment and care. We know just how much effort goes into providing this service day in, day out, so it’s fantastic to share that the latest BSA claims data for December 2025 shows a record-breaking achievement, 27,199 consultations delivered, the highest ever since the service launched 2 years ago. This milestone is a direct reflection of your hard work and dedication to ensuring patients can access timely, convenient care when they need it most.

It’s Not Just About Clinical Pathways

Pharmacy First builds on the foundations of the former Community Pharmacist Consultation Service (CPCS), which enabled GP practices and other settings to refer directly for minor illness consultations. Expanding on this work, the Clinical Pathway element was introduced to enable community pharmacists to complete episodes of care for 7 common conditions but the minor illness element of the service remains and minor illness referrals do not have to relate to a Clinical Pathway condition.

Some common myths we hear from pharmacy teams include:

Myth - patients with only certain minor illnesses can be electronically referred for the minor illness strand of Pharmacy First. INCORRECT - if an electronic referral is received for any minor illness these patients can be seen under the Minor illness strand of the service.

Myth - patients who are electronically referred but do not meet the gateway criteria for the clinical pathway strand of the service should be rejected. INCORRECT - if a patient is electronically referred for a clinical pathway condition but does not meet the eligibility criteria, they can instead be seen under the minor illness strand of the service. For example, if a patient is electronically referred for earache but is an adult, they would not be eligible for the acute otitis media clinical pathway, but the pharmacist could provide the minor illness strand of the service for this patient.

This CPE article tackles some of the common misconceptions around Pharmacy First referrals and is well worth a read to help increase understanding of the service.

Remember!

What Constitutes a Digital Referral?

Any electronic request from a practice or NHS 111. This does not need to be in any specific format but should include patient details and a brief description of the condition the patient is being referred for (see the example below). The referral can be sent directly to your services IT platform or to the pharmacy shared NHSmail address (using a template such as AccuRx, Arden’s or just a simple NHSmail message).

Completing Referrals

For any digital referrals not received directly to your IT platform (e.g. via NHS mail), at service entry select “email referral”. This will allow you to record a minor illness or clinical pathway consultation. If you have a digital referral, any minor illness can be provided under Pharmacy First and you are eligible to claim the £17 consultation fee.

Remember - if you receive a digital referral for a clinical pathway that doesn't meet the gateway criteria, you can treat this as a minor illness consultation.

Tip – for referrals received via NHSmail, consider setting up a dedicated email folder to securely store all referrals. This will make it easier to retrieve evidence if your pharmacy is selected for Post Payment Verification.

Are You Using the Latest Versions of Clinical Pathways and PGDs?

The clinical pathways and PGDs were updated in September 2025 (current versions here). Key changes to the clinical pathways included updates to Gateway points, with some criteria adjusted and additional Gateway points introduced, making it more likely that a consultation fee can be claimed for a wider range of patients.

For example, within the sinusitis pathway, the requirement for patients to have symptoms for 10 days before passing the Gateway point was removed. Now, patients presenting with sinusitis symptoms can pass the Gateway regardless of symptom duration.

Quick Dose: Knowledge Capsules for Pharmacy First

The full Pharmacy First podcast series is now available on the CPWY website here. The series features seven short, focused episodes, each covering one of the Clinical Pathway conditions. In each episode, local GP Dr Phil Xiu shares practical insights, expert guidance, and useful tips to support community pharmacists in delivering confident, effective consultations.

Support Available

A reminder that our three Advanced Service Facilitators are available to support both GP practices and community pharmacies with implementing Pharmacy First, as well as other national services.

This case study highlights key learning and reflections from Todmorden Group Practice, showcasing their experience of working with a CPWY Advanced Service Facilitator to successfully embed Pharmacy First into everyday practice. The team can support with hands on and face to face support for all colleagues involved in these services.

Please get in touch with Phil Wiles at phil@cpwy.org if you require support.

Kind regards,

CPWY

Community Pharmacy West Yorkshire

www.cpwy.org

info@cpwy.org

0113 272 7560

Click here to join our CPWY Connect WhatsApp group where members can discuss Pharmacy First and other pharmacy topics which may be useful for you.

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