It’s been a year of amazing achievements and significant progress, but Pharmacy First has really only just got started, says Shilpa Shah of Community Pharmacy North East London (CP NEL)

A year on, and how are we doing with Pharmacy First? The answer is that it’s a mixed picture.

Some surgeries have embraced this service and are sending through lots of referrals; others have yet to send one. Some ICBs were proactive and supported with various IT systems to make referrals simple.

I am lucky that CP NEL works closely with NEL NHS ICB, and we have secured EMIS integration that feeds into community pharmacy IT systems easily. It will be interesting to see how the government ambition from analogue to digital will ensure interoperability between HCP’s IT systems – and, though I’m not holding my breath, one day maybe pharmacists will be trusted to write on the records; not just read them.

Of course, the real heroes are the community pharmacy teams who worked hard to ensure that they were signed up and ready for the service to start on 31 January 2024, even though they had December to contend with, traditionally the busiest month of the year.

Yet again, we have shown that we can work at pace and deliver. The hours that the pharmacists and their teams put into setting up the service, training (attending half day sessions on how to look in children’s ears at the weekend, often on their only day off), reading the PGDs etc was astounding – yet also expected of them.

What’s next?

The real question is where do we go from here? We need this service opened up to many more conditions.

From my own recent conversations with the secretary of state for health and social care, Wes Streeting, I know that the government is keen to move care from hospital into the community. To do this we need to share the workload in primary care. The more conditions we have as part of the Pharmacy First service means we can see more patients who would otherwise try to see the GP, freeing up appointments for those that really need them.

We need the service to be walk in – if we really want to save GP time and increase patient access then walk in is the way forward.

We also need a national scheme added on to Pharmacy First that allows for eligible patients to receive free OTC medication for certain minor conditions. Although most minor conditions are self-limiting, many patients, especially in deprived areas, cannot afford to take time off work either for themselves or to look after ill children. If we truly want to decrease the health inequality gaps and increase accessibility to healthcare, then this is a must.

We need better advertising for patients, so they know that if they have one of the seven clinical conditions, they need to go to the pharmacy first. This will also only work if the GP also then refers all patients presenting with one of the seven clinical conditions to the community pharmacy, so that messaging is consistent. The advertising needs to be all year round, not just for short periods in winter.

Community pharmacy and general practice need to work together to make this service a success. There are many misconceptions about how much community pharmacy gets paid and where the funding is coming from, but for our patients we must put all that aside.

Workforce across the NHS is an issue, and one that we can’t solve immediately; access to healthcare services for patients is an issue. This scheme is a small step towards helping both those issues. For that reason, I urge all GP practices to get behind Pharmacy First, and for all pharmacies to deliver the service to a high standard.

I am hopeful that this service will continue to grow. I am confident that we will see an extension of conditions added to the service, as well as seeing more referrals from general practice.

Shilpa Shah is writing in her own capacity. She is CEO at Community Pharmacy North East London, a RPS fellow, an advisory member of the Inclusive Pharmacy Practice board and an Independent Expert Member, UK Pharmacy Professional Leadership Advisory Board