Frontline pharmacists call for ‘mandated staffing levels’ for Pharmacy First

A total of 73 per cent of frontline pharmacists reported being pressured to meet the threshold number of Pharmacy First consultations

Most frontline pharmacists do not believe pharmacies are adequately staffed to safely deliver Pharmacy First and other NHS-contracted services.

A recent snapshot survey conducted by the Pharmacists' Defence Association (PDA) ahead of the service’s first anniversary has revealed significant concerns among its members regarding staffing levels and operational challenges in delivering the Pharmacy First.

A striking 94 per cent of respondents reported no increase in staffing levels following the introduction of Pharmacy First.

This comes despite NHS data indicating that over three million consultations have been carried out in the first nine months of the service.

Three-quarters (75 per cent) of surveyed pharmacists stated that did not feel the pharmacies they work in are adequately staffed to deliver Pharmacy First and other NHS contractual services safely.

Many emphasised the necessity of having a second pharmacist on-site to manage the workload effectively.

Furthermore, 95 per cent of respondents supported that minimum staffing levels should be mandated to ensure the safe and effective delivery of Pharmacy First and other services.

The survey, conducted between 16 January and 26 January 2025, received 924 responses.

Protected learning time or paid training

Only 22 per cent of pharmacists felt that their workplace, including pharmacy support staff, was well-prepared for the launch of Pharmacy First on 31 January 2024.

Over two-thirds of respondents reported that their employer had not provided protected learning time during contracted hours or financial compensation for training related to Pharmacy First.

When asked about future service expansions, 97 per cent of respondents agreed that protected learning time or paid training should be mandated to support pharmacists and staff in delivering additional pathways and conditions.

Locum pharmacists highlighted difficulties in undertaking extensive training without compensation for their time or loss of earnings, while part-time pharmacists found the time pressures around training stressful.

Pressure to meet targets

A major concern identified in the survey was the pressure placed on pharmacists to complete Pharmacy First consultations.

A total of 73 per cent of respondents reported being pressured to meet the threshold number of consultations required for NHS payments. Nearly 60 per cent of them said that the pressure to meet targets came from area managers.

“The pressure is there every month to reach a figure which feels wrong, it should be pharmacist lead,” one participant commented.

Future expansion and necessary improvements

While support for Pharmacy First remains high, with 69 per cent of respondents favouring its continuation, opinions on expanding the service were more divided.

• 12 per cent supported expansion without conditions.
• 56 per cent agreed with expansion but with certain conditions in place
• 32 per cent opposed further expansion of the service.

Key conditions cited by respondents for any future Pharmacy First expansion included:

• Electronic GP referrals for patients with red flag symptoms or those not meeting pathway criteria.
• Protected learning time for pharmacists to support new clinical pathways.
• Increased staffing with more trained and competent support staff in community pharmacies
• A phased rollout of new clinical pathways.
• A second pharmacist in pharmacies offering the Pharmacy First service.
• Better access to Pharmacy First training for locum pharmacists.
• Improvements to IT systems to record and submit Pharmacy First consultations.

Some pharmacists pointed out that documentation takes a lot of time, noting that they are required to go through multiple pages to register patients and complete consultation records. They suggested integrating documentation into one page to for easy time management.

Those who disagreed with the expansion of Pharmacy First stated that they were still getting used to examining patients for the covered seven conditions.

If more conditions are to be included, a second pharmacist should be present just to do the service, they suggested.

Pharmacist representation in future discussion

Respondents overwhelmingly agreed (98 per cent) that representatives of the pharmacist workforce should be part of discussions with the NHS and employer organisations around any further expansion of contractual services.