The NHS Pharmacy First Service (PFS) is a new advanced service launched on January 31, 2024, replacing the Community Pharmacist Consultation Service (CPCS). It’s designed to enhance access to healthcare for common conditions and streamline the process of obtaining necessary medications. The key aspects of the PFS include:
Clinical Pathways: The service includes seven new clinical pathways, allowing pharmacists to offer advice and prescribe NHS medicines for conditions like sinusitis, sore throat, earache, infected insect bites, impetigo, shingles, and uncomplicated urinary tract infections in women.
Elements of the Service: The PFS comprises three main elements – clinical pathways, urgent repeat medicine supply, and NHS referrals for minor illnesses. This comprehensive approach aims to provide efficient and targeted healthcare through community pharmacies.
Eligibility: Any community pharmacy meeting the service provision requirements can register to provide the Pharmacy First service. It’s not compulsory, and pharmacies can opt out
Operational Aspects: Pharmacies must comply with the service specification and understand the payment requirements detailed in the drug tariff. They also need to prepare for the service by ensuring staff competence and upgrading IT systems to support the clinical pathways and data management for payments and monitoring.
Patient Access: For clinical pathway consultations, patients can directly attend or contact the pharmacy without needing a referral.
Monitoring and Stewardship: The service is designed with antimicrobial stewardship in mind, ensuring that pharmacists supply antimicrobials only when clinically appropriate, thereby addressing concerns around antimicrobial resistance.
The NHS England states that the rollout of the Pharmacy First service marks a significant step in expanding services within the NHS’s primary care access recovery plan. It aims to build and sustain local relationships between general practice and community pharmacy teams, enhancing the overall healthcare delivery.
However, the NHS Pharmacy First Service (PFS) has raised several concerns among pharmacists, primarily regarding workforce strain and antimicrobial resistance (AMR). A survey conducted by the Pharmacists’ Defence Association (PDA) revealed significant apprehension among pharmacists:
Workforce Concerns: About 90% of the surveyed pharmacists are concerned about the impact of the Pharmacy First service on an already strained workforce. They fear that the rapid implementation of the service could lead to increased patient abuse and violence due to heightened expectations.
Service Delivery Concerns: Only a small proportion of pharmacists feel confident in delivering the Pharmacy First service alongside their existing workload. Many are worried about being pushed to practice new services before feeling adequately prepared.
Antimicrobial Resistance (AMR): NHS England has indicated that the Pharmacy First service could be suspended if concerns about AMR emerge. The service will be closely monitored, with particular attention to the appropriate use of antimicrobials to avoid increasing AMR risks.