NHS England (NHSE) is not expecting Pharmacy First to influence whether a patient is more likely to be given antibiotics, its primary care director has told a parliamentary inquiry.

And she said that NHSE was not expecting the scheme to contribute to antimicrobial resistance (AMR).

Speaking to the Health and Social Care Select Committee (HSCC)’s pharmacy inquiry this week, Dr Amanda Doyle said that ‘the evidence doesn’t back... up’ claims that pharmacists supplying antibiotics would exacerbate problems with AMR.

And while she said that the scheme’s impact on antibiotic use would be assessed, NHSE expected ‘to gain reassurance’ from this evaluation.

‘I would expect that there will be no change in whether a patient gets the antibiotic regardless of whether they went to a GP practice or pharmacy,’ Dr Doyle told the inquiry.

She said that the patient group directions (PGDs) used by a pharmacist to decide whether or not to supply antibiotics under the Pharmacy First clinical pathways were ‘quite tight clinical protocols’ developed by an expert technical group with reference to NICE guidance.

And she suggested that the decision-making process contained within the PGDs was the same as what would be in use within GP practices.

While it did not therefore expect Pharmacy First to increase antibiotic use, Dr Doyle said that NHSE still had a ‘duty to properly evaluate that’.

‘It’s really important that we don’t inadvertently contribute [to AMR] but we’re not expecting to, we’re expecting to gain reassurance,’ Dr Doyle told the parliamentary committee.

She added that a formal evaluation of Pharmacy First would lay the groundwork for an increase in pharmacist prescribing, following pilots currently running across the country.

With all new pharmacists graduating as independent prescribers from 2026, ‘starting this process of Pharmacy First with a really formal evaluation will absolutely help us to move on as soon as that happens,’ Dr Doyle said.

NHSE, the Department of Health and Social Care (DHSC) and Community Pharmacy England (CPE) have committed to 'closely monitoring' antimicrobial supply following the launch of Pharmacy First, with an evaluation of the service’s impact on antimicrobial resistance to be commissioned by the National Institute for Health and Care Research (NIHR).