Chemists in England to prescribe medications to patients

The Pharmacy First scheme will allow most chemists in England to issue some medications to patients without appointments or referrals. NHS England says it will free up about 10 million GP appointments a year. Pharmacy groups welcome the move but there is concern about funding and recent chemist closures. Under the new service, pharmacists can carry out confidential consultations and advise whether any treatment, including antibiotics, is needed for the list of seven minor ailments. Patients needing more specialist or follow-up care will be referred onwards.

What can pharmacists supply medicines for now?

• sore throat
• earache
• sinusitis
• impetigo
• shingles
• infected insect bites
• uncomplicated urinary tract infections in women

Patients can access the new service by walking straight into a chemist or being referred by NHS 111, urgent treatment centres, emergency departments or their GP. Those who are not registered with a GP can still access the service. Pharmacists can treat patients if they diagnose one of the seven ailments, rather than sending them back to their GP. 

Pharmacies already offer advice on medicines - when to take them, information on side effects and how to dispose of them - and have always been somewhere patients can go for advice on symptoms.

You can also get emergency contraception and blood pressure checks at most pharmacies in England. Some offer advice on how to stop smoking, how to lose weight as well as screening and treatment for chlamydia, a common sexually-transmitted infections. 

What happens at a consultation?

The pharmacist will ask about symptoms and possibly about any previous medical issues. They may ask for consent to check the patient's health record if they can access it.

For some conditions, the pharmacist may perform an examination - for example of a patient's ear.

This allows them to recommend the best course of action for each patient, which could include a treatment bought over the counter such as a cream or ointment, a restricted set of prescription-only medicines or advice that the issue will go away on its own.

The consultation will be noted and shared with GPs to add to the patient's record.

Will more antibiotics be given out?

There is a strict protocol in place for providing medicines for each of the seven conditions, says Tase Oputu, who chairs the Royal Pharmaceutical Society (RPS) in England, That includes giving information, advice and symptom relief before supplying antibiotics, if needed. Antibiotics are used to treat or prevent bacterial infections, but do not work against viruses such as colds and flu.  Overuse of them in the past has meant they are becoming less effective against serious infections - known as antimicrobial resistance. NHS England said the new service would be "continually" scrutinised in case there was any effect on that issue. In Scotland, Wales and Northern Ireland, where the service is already running, the RPS said there was no evidence of an increase in levels of antibiotics supplied.

'More choice'

More than 90% of community chemists had registered to deliver the new service, NHS England said. They have been paid £2,000 each and will receive £15 per consultation plus £1,000 a month if they see a set minimum number of patients. Similar services are already offered in Scotland, Wales and Northern Ireland. NHS England's chief executive Amanda Pritchard called it "great news for patients". "GPs are already treating millions more people every month than before the pandemic - but with an ageing population and growing demand, we know the NHS needs to give people more choice and make accessing care as easy as possible," she said.

The RPS called it a "leap forward" in patient care.