The lowest monthly total of minor illness referrals yet have been recorded for August, according to latest Pharmacy First data for England.

Some 87,405 claims for minor illness consultations in August were submitted to, processed and published by the NHS Business Services Authority (NHSBSA) by 25 November.

This was nearly 50,000 fewer than those recorded for February 2024, the first full month of Pharmacy First in England.

The number of referrals to the minor ailments pathway, which replaces the Community Pharmacist Consultation service (CPCS), has been falling since the service began.

And the data suggests a steeper decline between July and August.

Dr Leyla Hannbeck, chief executive of the Independent Pharmacies Association (IPA), said that the trend was due to a lack of referrals from GP surgeries.

She highlighted that the monthly totals of urgent medicines supply – which are usually referred to pharmacies by NHS 111 - had increased month-to-month, while minor illness referrals – referred by both GPs and NHS 111 – were down.

'The Pharmacy First model should be a pull model that patients can self-refer into and not a push model from the GPs,' she said.

And she suggested that a lack of referrals from GPs was preventing 'vital funding coming to pharmacy'.

The sector's negotiator has also previously called for all parts of Pharmacy First to be open to walk-ins.

And a survey conducted by Community Pharmacy England (CPE) earlier this year found that 48.54% of community pharmacy respondents told CPE they had seen a reduction in Pharmacy First electronic referrals from GPs since some practices began collective action in August.

Earlier this year, GP practices voted overwhelmingly in favour of participating in a choice of actions proposed by the British Medical Association (BMA), including limiting daily contacts per clinician to 25, limiting referrals, and switching off the  GP Connect Update Record functionality.

A survey by The Pharmacist conducted in September and October found that two-thirds of community pharmacist respondents had been negatively impacted by GP collective action.

Respondents noted a lack of formal referrals from GP practices to pharmacies for services including Pharmacy First.

And one pharmacist said that following the start of GP action, the pharmacy had received 'more walk-in requests for unfunded services', with one major practice having stopped referrals altogether, instead sending patients to the pharmacy via texts and word of mouth.

CPE has previously estimated that informal referrals to community pharmacies deprive pharmacies of more than £115 million each year.

This is the amount that would have been paid if existing referral routes had been used appropriately by GPs and NHS 111, rather than patients being signposted informally to their local community pharmacy.

The total number of Pharmacy First consultations delivered in England in August shrank overall compared to the previous month, from 418,970 in July to 402,059 in August, the data suggests.

Alastair Buxton, director of NHS services at CPE, noted the seasonal variation in the clinical pathways, with more infected insect bites consultations and fewer for sore throats in the summer months.

And he said there was 'still significant scope for more referrals from general practices and NHS 111'.

'The service can only help alleviate the pressure on general practices if they refer appropriate patients to pharmacies and we continue to encourage all practices to engage with the service,' he said.

And he said the NHS needed to provide more support to general practices to ensure Pharmacy First referrals are made.

The August data also highlighted the impact of the threshold rise, from 10 to 15 clinical pathway consultations per pharmacy required for the £1,000 monthly payment.

The lowest number of pharmacies yet failed to meet the threshold in August. Some 5,905 met this threshold in August, compared to an estimated 4,284 participating pharmacies that did not.

The Department of Health and Social Care (DHSC), NHS England (NHSE) and the British Medical Association (BMA) have been approached for comment.