Pharmacy First Toolkit

Purpose of the toolkit

The Pharmacy First Toolkit is a resource designed to support the implementation of the Pharmacy First service within our Bedfordshire Luton and Milton Keynes integrated care system (BLMK ICS). While it primarily caters to general practice and community pharmacy teams, it also provides insights for professionals working across various sectors, including Urgent and Emergency Care (UEC).

Contents of the Toolkit:

Within this toolkit you will find a variety of resources that can be used to support the implementation of the Pharmacy First Service and includes the following:

• Support Implementation: The toolkit equips healthcare professionals with essential resources, reference materials, and referral aides to facilitate the successful implementation of the Pharmacy First service. Whether you are a pharmacist, a GP, or part of the wider healthcare team, this toolkit offers practical guidance.
• Background Information: Understand the context and rationale behind the Pharmacy First service. Learn about the seven new clinical pathways that allow pharmacy teams to assess and treat common conditions that would traditionally require treatment in general practice.
• Urgent Repeat Medicines Supply: Explore the section on urgent repeat medicines supply. UEC and 111 settings can refer patients to community pharmacies for timely access to essential medications. General practices do not handle referrals for this element of Pharmacy First.
• NHS Referrals for Minor Illness: Learn how patients can be referred from general practice, UEC, or 111 settings to a community pharmacy where a community pharmacist assesses the patient, provides advice, recommends treatments, or makes appropriate referrals.
• Collaboration and Resolution: The toolkit supports the growth of the Pharmacy First service and provides solutions for any challenges encountered. It is a dynamic resource that is evolving as Pharmacy First is being implemented nationally and will be updated regularly with the latest information and guidance.

Please note that the contents of this toolkit are not intended for patient/public use but serve as a guide for healthcare professionals. If you need further information or support, refer to the contacts listed within the toolkit.

NHS Pharmacy First Service Overview

The NHS Pharmacy First Service builds upon the existing Community Pharmacist Consultation Service (CPCS), which has been operational since October 2019 effectively ended on the official launch of the Pharmacy First Service. The service was first announced as an essential part of the Primary Care Access and Recovery Plan in May 2023, and included a commitment to community pharmacies and one of the key elements of this commitment was strengthening the role of pharmacies in primary Care.

The NHS Pharmacy First Service which is a new community pharmacy advanced service launched on the 31^st of January 2024 empowering pharmacists to assess and treat seven common conditions previously requiring GP visits in addition to the minor ailment referral, and urgent repeat medicines supply previously known as Community pharmacy consultation service (CPCS). This service aims to free up GP time, provide faster patient care closer to home, and reduce the pressure on the NHS by effectively managing minor illnesses in community pharmacies.

Enhanced Access:

The primary objective is to provide patients with quicker and more convenient access to healthcare services directly from their local pharmacy. By offering advice and NHS-funded treatment for common health conditions, these minor health issues are addressed promptly and prevented from worsening. The full Pharmacy First service is made of three elements below:

1. Pharmacy First- Clinical Pathways:

The Pharmacy First service includes seven new clinical pathways that enable pharmacists to manage specific health conditions. These pathways cover common issues such as sore throat, earache, sinusitis, and urinary tract infections. Please see the seven clinical pathways below in a separate section.

2. Pharmacy First- Urgent Repeat Medicine Supply:

Community pharmacies will continue to provide urgent repeat medicine supply to patients, through Urgent Care Centres and NHS 111 settings and other emergency care settings where patients are referred to community pharmacies for a supply of urgent repeat medicine. Note that general practices cannot refer into this element of pharmacy First.

3. Pharmacy First- NHS Referrals for Minor ailments:

Patients can be referred from various settings (general practice, urgent and emergency care, NHS 111) to community pharmacies for minor ailments consultations. Pharmacists will assess the patient, offer self-care advice, recommend appropriate treatments following robust clinical pathways, or refer to another setting or service if needed.

The New clinical pathways

The seven common conditions on the clinical pathways’ element of pharmacy First service are:

Information on the clinical pathways, including who can access, the inclusion/exclusion criteria have all been clearly set out in patient group directions (PGDs) to support the decision making for community pharmacists.

Patients can only self-refer into pharmacy service through the seven clinical pathways and general practices can also refer patients to pharmacies for conditions on the clinical pathways in addition to the minor ailment referral process of the pharmacy first service.

Referral Process and Patient Journey through Pharmacy First Service

A detailed patient journey and referral process has been written and included in the NHS Pharmacy First Service specification.

General practices should refer patients to pharmacies using either an integrated GP electronic referral system or NHS mail. Community Pharmacies will send the outcome of the consultation via the referral routes according to locally agreed communication feedback processes.

Resource List for General Practice

Below you will find resources that can be used to support the implementation of Pharmacy First in general practice:

Resource list for Community Pharmacies

Below you will find a suite of resources that can be used to support the implementation of Pharmacy First in a community pharmacy.