The treatment of minor illnesses and the urgent supply of medicines under the Pharmacy First service should be made accessible to walk-in patients, Community Pharmacy England (CPE) has told The Pharmacist.

The negotiator's ask, which it is using in its influencing and public affairs work, comes as The Pharmacist's recent roundtable with community pharmacy and GP leads found clear calls for walk-in access across all three streams of the service.

Currently, pharmacies in England may provide advice and treatment where appropriate for seven common conditions, following patient group direction (PGD) based clinical pathways, to any patient who walks into their pharmacy or is referred to the service.

Pharmacies also receive a Pharmacy First consultation fee of £15 if a patient is formally referred to community pharmacy from a GP or NHS 111 for any minor ailment or an urgent repeat medicine supply.

But if a patient walks into the pharmacy seeking minor ailment care or urgent repeat medicine supply, the pharmacy will not be paid for the advice and care they give in these instances.

In August, The Pharmacist brought together stakeholders from community pharmacy and general practice, for a roundtable discussion reflecting on the first six months of Pharmacy First in England.

Several attendees suggested that the minor ailments part of the service should be made a walk-in service, as well as possibly the urgent medicines supply part.

Head of Community Pharmacy Clinical Services at The Black Country Integrated Care System Sukhy Somal suggested that pharmacists should be funded for the diagnoses, advice and treatment they have been giving to patients for free for many years.

While GP partner Dr Selvaseelan Selvarajah commented that direct patient access to Pharmacy First ‘would really help’ both community pharmacy and general practice.

Meanwhile Harry McQuillan, Numark chair and former chief executive of Community Pharmacy Scotland, highlighted that allowing patients to access community pharmacies as a first port of call was 'in the title’ of Pharmacy First. And he said the move would be ‘strategically’ right for the network.

Commenting on the issue, Alastair Buxton, CPE director of NHS services, said that the negotiator had 'always believed the minor illness and urgent supply of medicines elements of the Pharmacy First service, and previously when they were the constituent parts of the CPCS [Community Pharmacist Consultation Service], should be accessible by patients walking into pharmacies, rather than patients needing a referral from NHS 111, a general practice or other healthcare organisations'.

NHS England has previously said that it was not considering removing the need for a GP referral for minor illnesses and urgent repeat medicine supplies.

But Mr Buxton told The Pharmacist that the ask had recently been added to CPE's published service development priorities which it was currently using in its influencing and public affairs work.

A walk-in approach 'would improve access to primary care services for patients and reduce burdens on other parts of the NHS', he said.

'It would also address the challenges most pharmacies are currently experiencing where general practices informally refer patients to pharmacies, rather than making electronic referrals,' Mr Buxton added.

This issue was also highlighted during The Pharmacist's roundtable discussion, with Jonathan Cooper, owner of independent pharmacy group Cooper’s Chemist in the North East of England, saying that local practice staff were not making formal referrals but rather signposting patients to the pharmacy.

He said that too few referrals from general practice, coupled with patients not knowing about the service and pharmacy teams being busy with high prescription volumes, meant that some pharmacies in his group were not conducting enough clinical pathway consultations to meet the monthly payment threshold.

In addition to a £15 fee per Pharmacy First consultation, contractors receive a monthly fixed payment of £1,000 if they conduct a minimum number of clinical pathways consultations each month.

The minimum threshold has risen each month, from one in February to 20 in September, and will reach 30 from October onwards.

The increase originally set out for August was reduced as a one-off adjustment over concerns that pharmacies would be unable to meet it.

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

And CPE has expressed concerns that pharmacies may walk away from delivering Pharmacy First if they cannot reach the thresholds for the £1,000 monthly payment.

Meanwhile, NHS England has confirmed to The Pharmacist that it 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.