Pharmacy First Is Getting Bigger – And That's Good News for Patients

Five more common health conditions are being added to Pharmacy First prescribing – and this could be one of the most important changes we've seen in community pharmacy for years.

For generations, the routine when you became unwell was fairly predictable.

You called your GP surgery.

You waited for an appointment.

You saw a doctor.

You received a prescription.

Then you took that prescription to your pharmacy.

But what if, for many everyday health conditions, some of those steps simply aren't necessary?

That's exactly the direction the NHS is heading.

Following the success of Pharmacy First, NHS England has announced that five additional clinical pathways will be introduced from autumn 2026, allowing appropriately qualified pharmacist independent prescribers at participating pharmacies to assess and treat even more common conditions.

And we think that's a significant step forward.

What are the five new conditions?

The new Pharmacy First prescribing pathways cover:

Migraine – low-frequency episodic migraine in adults aged 18–64.

Mild to moderate acne – providing another route to treatment for young people and adults.

Seasonal allergic rhinitis (Hayfever) – for children aged 4–11.

Acute otitis externa – an infection/inflammation of the outer ear canal, for adults aged 18 and over.

Mild skin and soft tissue infections and scabies – allowing suitable patients to be assessed and treated through community pharmacy.

These will sit alongside the existing Pharmacy First clinical pathways and represent another major expansion of what community pharmacists can do for patients.

Why is this so important?

Because sometimes the biggest improvement you can make to healthcare isn't building another hospital or asking people to wait for another appointment.

It's making better use of the healthcare professionals who are already there.

Community pharmacists are highly trained healthcare professionals.

Yet traditionally, there have been situations where a pharmacist could recognise what was likely to be wrong, understand the appropriate treatment and advise the patient – but the system still required that patient to go elsewhere before treatment could be provided.

Independent prescribing changes that.

Where clinically appropriate and within the new pathways, a pharmacist independent prescriber will be able to assess the patient and prescribe the necessary treatment directly.

That means fewer unnecessary steps.

And potentially much quicker care.

Think about the traditional patient journey

Imagine you develop a painful ear problem.

Traditionally, you might phone your GP surgery first thing in the morning.

You wait in the telephone queue.

You try to secure an appointment.

Perhaps you need time away from work.

You attend the appointment.

The GP assesses you.

You receive a prescription.

You then travel to your pharmacy.

Finally, you collect your medicine.

Now imagine being able to walk into a participating community pharmacy, speak to an appropriately qualified pharmacist, be assessed and – if the condition falls within the pathway and treatment is clinically appropriate – receive the care you need.

That's not about replacing GPs.

It's about making better use of everyone's time.

Taking pressure off GP surgeries

This is perhaps one of the biggest benefits.

GP surgeries are under enormous pressure, and a significant proportion of their workload involves conditions that may be safely managed elsewhere.

If community pharmacies can appropriately manage more of these consultations, GP appointments can be available for patients who genuinely need a GP's expertise.

The potential scale is huge.

NHS England estimates that once the five new pathways are fully rolled out, between two and three million consultations every year could take place in community pharmacies instead.

That's potentially millions of occasions where somebody could receive care closer to home while freeing capacity elsewhere in the NHS.

And Pharmacy First is already demonstrating what is possible.

Since the service launched in 2024, NHS England says Pharmacy First has delivered 14 million consultations, including around two million for acute sore throats and more than 1.7 million for urinary tract infections.

Community pharmacy isn't waiting to become part of the solution.

It already is.

It's also about taking pressure off A&E

There's another part of this conversation that is sometimes overlooked.

When people cannot access healthcare easily, some eventually turn to urgent treatment centres or A&E.

That's understandable when you're worried and don't know where else to go.

But emergency departments need to be able to concentrate on emergencies.

Giving patients another accessible route to professional assessment for everyday conditions can help ensure people receive care in the right place.

For a migraine, acne or an uncomplicated ear problem, that place may increasingly be your local pharmacy.

For something more serious, pharmacists are also trained to recognise warning signs and refer patients onwards when appropriate.

That's an important point.

Pharmacy First doesn't mean “everything can be treated at the pharmacy.”

It means pharmacists can assess patients and determine the appropriate next step.

Sometimes that's treatment.

Sometimes it's advice.

And sometimes the correct decision is that you need further medical assessment.

Healthcare on your high street

Accessibility is one of community pharmacy's greatest strengths.

According to NHS England, around four in five people in England live within a 20-minute walk of a community pharmacy.

Think about what that means.

For many people, their local pharmacy is one of the most accessible healthcare settings available to them.

You don't necessarily need to travel to a hospital.

You don't always need to spend the morning repeatedly calling for an appointment.

You may have a qualified healthcare professional just minutes from your front door.

That accessibility becomes increasingly valuable as the range of services pharmacies can provide grows.

The role of the pharmacist is changing

There is still a perception that pharmacists simply dispense prescriptions.

That hasn't reflected reality for quite some time.

Modern community pharmacies increasingly provide clinical healthcare services alongside their traditional medicines expertise.

Pharmacists already assess patients through Pharmacy First, provide contraception services, carry out blood pressure checks and vaccinations, offer medicines advice and support people with a wide range of health concerns.

Now independent prescribing represents another major step.

From September 2026, newly qualified pharmacists joining the professional register will also qualify as independent prescribers.

We're therefore moving towards a future where prescribing becomes an increasingly normal part of community pharmacy practice.

And that could fundamentally change how we access primary healthcare.

This isn't about replacing your GP

We think this is important to emphasise.

GPs provide an enormous range of complex care that cannot and should not simply be transferred elsewhere.

Pharmacy First isn't about replacing doctors.

It's about allowing different healthcare professionals to use their skills appropriately.

If pharmacists can safely manage more common conditions, GPs have more capacity to manage complex conditions, chronic disease, diagnostic uncertainty and patients requiring medical investigation.

Pharmacists get to use more of their clinical training.

GPs can focus more of their time where their expertise is most needed.

Patients get faster access to care.

And the NHS uses its workforce more effectively.

Everyone benefits.

From seven conditions to a much bigger idea

When Pharmacy First launched nationally in 2024, the focus was on seven common conditions.

The addition of five new prescribing pathways is important in itself.

But we think the bigger story is what it represents.

It's another step towards community pharmacy becoming a genuine first port of call for healthcare.

Not simply somewhere you visit after seeing another healthcare professional.

Somewhere you can start your healthcare journey.

Because sometimes the answer to improving access to healthcare isn't asking patients to wait longer.

It's giving them more doors to walk through.

And your local pharmacy is increasingly becoming one of those doors.

Ask your pharmacy first

The next time you develop a minor illness or common health condition, don't automatically assume your only option is to try to get a GP appointment.

Speak to your local pharmacy team.

If we can help you, we will.

If another healthcare professional is more appropriate, we'll tell you that too.

As Pharmacy First continues to expand, community pharmacies have an increasingly important role to play in making healthcare quicker, easier and more accessible.

And for patients, GPs and the wider NHS, that's a very positive step forward.

Aston Pharmacy – small enough to care, big enough to help.