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The Department of Health in Scotland has introduced an “upper threshold” for Pharmacy First claims in order to “ensure a more equitable distribution” of the moneys available to reimburse the sector.

As of November 1, claims for advice, referral and treatment are capped at a funding weighting of 0.1 if a pharmacy has already completed 1,000 consultations that month. This applies to ‘standard’ and PGD-based consultations, as well as advice and referral claims for the Pharmacy First Plus independent prescribing-based service. 

In addition, the financial weighting for PGD-based advice and referral activity is also being downgraded from 3 to 1, chief pharmacist Alison Strath revealed in a recent letter to contractors in which she said the Scottish Government and Community Pharmacy Scotland will be tweaking the service “as the cohort of independent prescriber pharmacists increases and experience is gained in its scope and delivery”.

Contractors will still receive the £3,000 base payment for each full month they provide Pharmacy First Plus – but those who can’t provide access to an independent prescriber for 25 hours a week, 45 weeks a year are not eligible, Ms Strath reminded business owners.  

And from December, those delivering the IP service “as specified” will also receive an activity payment from a new monthly pot for IP prescribing activity, initially set at £0.5m per month with no minimum activity threshold. 

Ms Strath explained: “Where an independent prescriber has decided that it is absolutely necessary to treat a common clinical condition, they may submit an NHS Pharmacy First Plus “Supply” claim using the Universal Claim Framework (UCF) to access the newly established pot.” 

This will apply to prescriptions written on IP pads issued by NHS health boards for prescription medicines, as well as P and GSL products not on the NHS PFS approved list and ones that are on the list but are being usd outside their P or GSL licence restrictions.  

The activity fee will have a minimum value of £30 and a maximum value of £40, with retrospective payments for December to be made in February 2026. 

In addition, contractors who provided Pharmacy First Plus consultations in the month of October will receive a share of a £0.5m “balancing payment” in December. 

“Future arrangements with regards to remuneration for hours of operation will be discussed and agreed between CPS and the Scottish Government in 2026,” said Ms Strath, adding that an updated service specification for Pharmacy First Scotland and Pharmacy First Plus will be agreed in 2026 to “bring together various adjustments” made since the service launched in 2020 and to introduce “prospective changes” to the service model. 

She also reminded pharmacy teams of their responsibility to tackle antimicrobial resistance and to supply antibiotics only when “absolutely necessary”.

Related: Scotland the Brave: Leading pharmacy’s prescribing revolution 

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