The Company Chemists’ Association (CCA) has called for further expansion of Pharmacy First in England, saying community pharmacies could help meet growing demand for urgent care by treating a wider range of conditions.
The call comes after independent prescribing was formally introduced into the Community Pharmacy Contractual Framework (CPCF) on 29 October, adding five new prescribing-only pathways to Pharmacy First.
In its report, Expanding urgent care through community pharmacy: next steps for Pharmacy First in England, the CCA welcomes recent expansion of the service, but says further steps are needed to make greater use of community pharmacists’ clinical capabilities and improve access to treatment.
Malcolm Harrison, CCA's chief executive, said the community pharmacy sector has proven its role in supporting patients with urgent care needs.
"The Pharmacy First service in England has shown the potential of community pharmacy in increasing access to urgent care, delivering millions of consultations since its launch. The integration of independent prescribing into the service provides a landmark opportunity to expand and transform access to care. We must not waste this opportunity," he said.
Community pharmacies in England support urgent care provision through the seven Pharmacy First pathways, five new Pharmacy First pathways for pharmacist prescribers and urgent medicines supply.
Untapped opportunity
Despite the recent changes to Pharmacy First in England, the report says the offering remains limited by the number of commissioned pathways and eligibility criteria, including age and symptom restrictions.
Future expansion of Pharmacy First should focus on conditions where community pharmacy can deliver the greatest patient and NHS benefit, the CCA said.
The report identifies areas where community pharmacies could play a greater role for further expansion, including adult respiratory tract infections, acute dermatological conditions, acute lower back pain and dental pain. Acute gout, oral thrush and minor wound infections have also been considered.
The report highlights rising pressure on NHS services as urgent and emergency care demand continues to rise, with more than 27 million A&E attendances recorded in England in 2024/2025. This represented a 4% increase on the previous year and was up to 30% higher than a decade earlier. NHS 111 demand has also increased, with 1.6 million calls recorded in a single month in 2025 – half a million more than during the same period in 2021.
In 2024-2025, more than 3.8 million consultations were delivered across the Minor Illness Referral Service and seven clinical pathways. Pharmacy First delivered almost five million consultations during its first year.
Funding and workforce needed to support expansion
The report says further expansion must be supported by sustainable funding, sufficient prescribing capacity and clinical supervision. Its four recommendations are to:
- Expand Pharmacy First through independent prescribing
- Fund Designated Prescribing Practitioner (DPP) provision and widen access to funded prescribing training
- Improve digital integration through the Single Patient Record (SPR) and interoperable systems, and
- Establish national service specifications and governance standards.
The report also identifies the need for sufficient consultation-room capacity, appropriate clinical tools and diagnostics, clear referral and escalation routes, and consistent patient safety arrangements.
Scotland and Wales demonstrate potential
The report compares Pharmacy First in England with community Pharmacy services in Scotland and Wales.
Wales recorded more than twice as many consultations per head as England in 2024/2025. Scotland also recorded markedly higher use, although its different service model makes direct comparisons less straightforward.
In England, NHS–funded minor illness consultations require a referral from another NHS service, which is not the case in Scotland and Wales. The report cautions that differences in policy frameworks, prescription charges and restrictions on NHS–funded pharmacy medicines mean England is unlikely to replicate devolved nations’ consultation volumes simply by adopting their models.
Commenting on the recommendations, Malcolm Harrison, Chief Executive of the CCA, said: “Demand for urgent care continues to grow, but there is a huge opportunity sitting within community pharmacies to help meet it”.
“Expanding Pharmacy First provides the opportunity to do that. Combined with independent prescribing, it would enable more patients to access convenient care closer to home while releasing capacity elsewhere in the NHS”.
Harrison added, “With the right funding, workforce and infrastructure in place, community pharmacy can play a much bigger role in meeting urgent care needs.”
The work was part of a collaborative project including the National Pharmacy Association (NPA) and Pfizer.
Henry Gregg, Chief Executive of the National Pharmacy Association (NPA), commented that there was untapped potential in the Pharmacy First programme, and there was scope for the NHS to "turbo charge" the scheme:
“We agree that there is a huge amount of untapped potential in the Pharmacy First programme and the government should widen the number of conditions a patient can be seen for at their pharmacy”.
“In Scotland, a patient can be treated for around 30 different ailments at their pharmacy, with over a third of the population accessing Pharmacy First, last year.”
He added: “with pressure and costs mounting on the wider health system, the NHS should turbo charge Pharmacy First in order to provide first class care, close to people’s homes”.
