Background
The NHS Pharmacy First Service (PFS) is a new Advanced Service provided by pharmacy contractors in England, with effect from January 31 2024. Only pharmacists may conduct consultations.1,2
The PFS replaces the Community Pharmacist Consultation Service (CPCS) by combining the existing NHS referrals for minor illness and the urgent repeat medicine supply services (supplied under the CPCS) and introduces a new element, the clinical pathways service.3
The major change is the introduction of clinical pathways with pharmacists able to offer advice and supply NHS treatments under patient group directions (PGDs). At the launch of this service, there are 24 PGDs for 14 separate medicines covering seven different conditions:3,4
- uncomplicated urinary tract infections (UTIs) in women (16-64 years);
- shingles (18 years and over);
- impetigo (1 year and over);
- infected insect bites (1 year and over);
- sinusitis (12 years and over);
- sore throat (5 years and over);
- acute otitis media (1-17 years old).
Multiple PGDs for a condition reflect factors such as age, the possibility of pregnancy, and drug unsuitability.
Each PGD has an initial triage phase to determine whether the patient is suitable for consideration under the clinical pathway service, needs to be referred or could be treated under the minor illness route. If the ‘gateway’ point is passed, the consultation with the pharmacist can continue, attracting a consultation fee.1,4