The long-term success of Pharmacy First in Scotland, and an impressive, though challenging, first year in England, shows that Pharmacy First can evolve further, says Harry McQuillan of Numark

Last year was a landmark year for community pharmacy in many ways, not least with the launch of Pharmacy First in England. Having seen the transformative impact of the service in Scotland, I welcomed this milestone as a real opportunity to enhance patient care south of the border.

In Scotland, we showcased the service just two weeks before the Covid-19 pandemic lockdown hit and then launched it during that time on 1 July 2020.

It was a baptism of fire to say the least, and thankfully we persevered, because today, Pharmacy First is an undeniable success. In fact, early figures show that patient access in Scotland increased by 20% up to the end of December 2024 compared to the previous year. I think this is a remarkable figure considering there has been no Government lead marketing campaign.

This leads me to conclude that it is the quality of service and access to advice, referral and treatment that is encouraging patients to attend their community pharmacy.

Challenges in England

In England, it’s fair to say that the rollout has been challenging. The instruction to go live felt rushed, coming straight after the busy December period, and an ineffective advertising campaign didn’t help. As a result, the experience has been varied: some pharmacies have seen strong uptake, while others have struggled to encourage patients to use the service.

What Pharmacy First does is put formal emphasis on the consultation element of community pharmacy. Of course, consultations have always been part of what we do, but this service embeds that role within the NHS framework. To do it well, pharmacists need time for training, preparation, and ensuring patients are directed to the right place for care.

The care of common clinical conditions belongs in the community, it’s where we deliver real value for patients and the wider NHS. For Pharmacy First to reach its full potential, it needs the right funding and support. Pharmacists must be resourced and supported by financial backing to deliver this vital service effectively.

Funding is a critical issue

And that’s the real sticking point; funding. The lack of a stable, predictable funding framework remains a critical issue for pharmacies in England. This is a priority, and I am cautiously optimistic that the current negotiations will recognise the vital role pharmacies play in their communities and will secure the financial stability our sector needs to thrive.

That said funding alone won’t make Pharmacy First a success. We also need a collaborative approach from the wider healthcare system, particularly from GPs. In Scotland, we saw the impact that true partnership working can have.

When GPs and pharmacists work together, patients benefit. Pharmacy First is designed to ease pressure on GP surgeries, not compete with them. We need to ensure that GPs are supporting the service, signposting patients appropriately, and not working against the very system designed to relieve strain on primary care. This is about making the best use of the highly skilled healthcare professionals we have in our communities.

Evolution ahead as an expanded prescribing service?

We’ve seen in Scotland that as Pharmacy First evolves, its cost-effectiveness improves. That’s where we need to get to in England. Looking ahead five years, I fully expect Pharmacy First to evolve into an expanded prescribing service, especially as more independent prescribers join the community pharmacy workforce.

Pharmacy First, linked to prescribing from a community pharmacy setting, has the power to be truly transformative for community-based care. The will is there, both from pharmacists who want it to succeed and from patients who want to use it. Numark will continue to stand by its members, providing the support they need to make this service work and ensure community pharmacy remains at the heart of accessible, high-quality healthcare.