Pharmacy First refresh

From 1 October, NHS England’s updated elements of clinical pathways, Patient Group Directions (PGDs) and gateway criteria for Pharmacy First took effect, necessitating pharmacies refreshing their Standard Operating Procedures (SOPs) and training.

Make sure you have:

• Identified the latest clinical pathways/PGDs from NHSE when your Integrated Care Board (ICB)/Local Pharmaceutical Committee prompts go live; re-train teams and re-sign PGD user lists
• Realigned triage questions and gateway criteria in your workflow tool (or paper proforma) so counter staff funnel to the right pathway first time.

The changes to the clinical pathways include movement of some of the gateway points within the pathways and the addition of further gateway points.

Contraception services ramp up

England confirmed a national service for free oral emergency contraception (EHC) via community pharmacies, folded into the NHS Pharmacy Contraception Service (PCS). Pharmacies need to keep safeguarding, Fraser competence and STI signposting front and centre. The service went live nationally in late October.

There is standardised national funding, with a set-up fee of £900 per pharmacy premises paid in instalments until 10 consultations are completed, and a consultation fee of £20 irrespective of the outcome of the consultation. Pharmacy technicians are enabled within the service model alongside pharmacists.

New Medicines Service (NMS)

With depression now included in the NMS pathway, passive adoption is not an option. Pharmacy teams must actively establish how local GP practices manage follow-up for new depression diagnoses and align their NMS consultations accordingly.

If pharmacies wait for referrals rather than integrating themselves into existing care pathways, patients will miss out – consultations will either be delivered too early, before treatment has stabilised, or too late, when engagement has already waned.

Wales: 2025 snapshot

The All Wales Common Ailment Service (CAS) Formulary was updated in June (e.g. allergic rhinitis, sore throat monographs). Make sure your local PGDs and patient leaflets align with the refreshed formulary.

Make sure the CAS is used to standardise self care and safety-netting and maintain a stock check against formulary-listed items to avoid missed supplies. 

Scotland: 2025 snapshot

There has been a range of updates for Pharmacy First Scotland and Pharmacy First Plus:

• The approved list updates landed in March and April 2025 – notably respiratory section changes and removal of Simple linctus sugar free from “cough”. Review your OTC sections and remove obsolete items from “approved list” assumptions

• There are ongoing expansion signals from the Scottish Government to cover more clinical conditions; the trajectory is towards more independent prescriber-led care and fewer PGDs as prescriber numbers rise

• Financially, PCA(P)(2025)18 details the annualised pool for Community Pharmacy Independent Prescribing (Pharmacy First Plus) – pharmacies should plan staffing and training pipelines accordingly.