NHS England (NSHE) is currently reviewing its projected trajectory of how many Pharmacy First, blood pressure and contraception service consultations will be delivered by community pharmacies in 2024/25.

And an NSHE spokesperson has revealed that more than half a million Pharmacy First consultations were delivered in the first three months of the service.

In an update within the primary care recovery plan, published in April this year, NHSE said that by March 2025, it wanted 'to grow the monthly patient volumes' across all three services 'by at least' 71,000 blood pressure check consultations; 25,800 oral contraception consultations; and 320,000 Pharmacy First clinical pathways consultations.

And it said it would 'review the ambition of this trajectory in September, when public uptake of the service in the first nine months is understood'.

This week, NHSE confirmed to The Pharmacist that it was currently reviewing these trajectories.

An NHSE spokesperson told The Pharmacist that the take-up of the service had been 'highly successful', with 'more than nine in 10 pharmacies in England already signed up to deliver convenient access to health help and treatments for patients'.

'Eight in 10 people live within a 20-minute walk of a pharmacy, and Pharmacy First marks a significant expansion in the service offer from pharmacies with 592,000 consultations delivered in the first four months,' they added.

At the Avicenna conference earlier this month, Community Pharmacy England's director of NHS services Alastair Buxton revealed that the negotiator was concerned pharmacies might pull out of the Pharmacy First service if they could not meet the thresholds required for the £1,000 monthly payment.

This month, pharmacies must conduct 20 clinical pathway consultations to receive the £1,000 payment. This is up from 15 in August, 10 in May - July, 5 in March - April and 1 in February.

The threshold is set to increase to 30 in October.

The August threshold was originally supposed to be 20, but was reduced amid concerns that pharmacies were unable to meet it.

And the latest available data shows that increasing numbers of pharmacies are failing to meet the rising thresholds each month.

Speaking on a panel at the Avicenna conference, Mr Buxton suggested that the highest threshold of 30 had been set to ensure the pharmacy-based service cost the NHS less than a GP appointment.

'If you divide the overall fees for the service by the number of clinical pathway consultations provided, and do a comparison with what the notional cost of a GP appointment, or an appointment cost within an urgent treatment centre is, it needs to look reasonable, was their [NHSE and DHSC's] viewpoint,' Mr Buxton said.

And on the highest threshold of 30 consultations each month, he added: 'If you divide the 30 by the £1,000, plus the fees, you would get £15 fees [per consultation] - it gets you to something round about the notional cost of a GP appointment.'

He said the negotiator had 'said all along that we think those are too high', but that government had wanted to 'see how the service goes'.

Mr Buxton added that consultation numbers so far 'seems to suggest that the growth that we're seeing in the numbers of consultations isn't great enough'.

And he said the negotiator would continue to push for the monthly thresholds to be reduced, as well as for minor illness consultations to count against the monthly threshold.

'It's all meant to be about moving workload from general practice, those minor illness people are people who would otherwise have gone to general practice,' he said.

'At the moment, we seem to be pushing against a bit of a closed door, but we're not giving up on that.'

Also on the panel, Brij Valla, sales and purchasing director at Avicenna, said the group's pharmacies in Wales - where a 'very equivalent' service was in place with even more clinical pathways - these premises 'never go over 25' clinical pathway consultations each month.

Mr Buxton responded that CPE would present data-based arguments to NHSE, and urged pharmacies to share information with the negotiator, for example through CPE's pressures surveys, to demonstrate that pharmacies 'are continuing to do lots of consultations that have not been funded properly'.

And he said that the median number of clinical pathway consultations delivered by community pharmacies in England was 'increasing month on month'.

'We are seeing growth, even though I know a lot of people say that it's not the way it feels,' he said.

'Whether it will get to the point to get to 30, I'm not sure we will, but we're going to keep on pushing this issue as the data comes along,' Mr Buxton said.