By Mandeep Mudhar, Head of Alphega Pharmacy
Nearly two years after Pharmacy First began, the service stands as a landmark opportunity for community pharmacy, marking a pivotal moment in its integration into primary care. It represents a shift in the recognition of pharmacists as frontline healthcare providers, relieving the burden on GPs and hospitals.
Pharmacy First brings valuable support and benefits for both patient care and community pharmacies. However, its implementation and management needs to be handled effectively, or its full impact could be undermined.
Alphega members have welcomed the introduction of Pharmacy First with optimism. Many pharmacists are already seeing the benefits for patients and relationships being built with local GPs. It is a service that allows community pharmacy to show the full extent of its capabilities and to step confidently into a more vital role in frontline care.
However, the success of Pharmacy First depends not just on the quality of the service delivered, but also on how it is supported and administered. In some cases, we are hearing from members that aspects of the current process are creating challenges that could be streamlined for better results.
One example of this is an Alphega member in Berkshire who discovered that their claim for the May 2025 Pharmacy First consultation had not been accepted. Whilst the platform indicated that the necessary steps had been taken for the submission, they later realised the claim had failed but it was too late to resubmit. This has illuminated a potential issue in the process, and highlights a need for an escalation route when pharmacies do face issues with claim submissions.
This underscores the necessity for administrative systems to be robust, transparent, and supportive, especially during the early stages of the service. A failure to recognise when pharmacies are acting in good faith, or accommodating misunderstandings, impact real patients, workloads, and the viability of pharmacy businesses which are already under financial pressure.
Jonathan Burridge, Business Mentor at Alphega Pharmacy, has been working closely with members across the country. He noted that while many Alphega members are performing well and seeing strong engagement with their local GP practices, there are still several pharmacies that continue to struggle with receiving referrals.
Even after having several meetings with GP practice managers, some involving Health Board representatives, there are pharmacies where referral levels remain very low or non-existent, despite clearly communicating how the Pharmacy First service can relieve pressure on GP surgeries. This is not just a missed clinical opportunity, but also a missed financial opportunity.
Pharmacies stand to earn up to £1,000 per month for delivering more than 30 Pharmacy First consultations, in addition to £17 per consultation completed. With income from dispensing continuing to decline, services like Pharmacy First are essential to the long-term future of pharmacy.
Pharmacies are being supported by digital tools that streamline the consultation process, helping to reduce workload and improve service delivery. For example, the Alphega Member Hub enables patients to scan a QR code in the pharmacy to complete a short pre-consultation questionnaire. This determines whether they’re eligible for a Pharmacy First service, allowing the pharmacist to quickly review the information and proceed with the appropriate clinical decision.
However, even with digital tools in place, some pharmacies are still not making the referrals needed to unlock the full potential of the service. Whether due to administrative delays, lack of GP engagement, or uncertainty around the process, the result is the same: lost income and underutilised services.
The future of Pharmacy First depends not only on pharmacists’ ongoing commitment, but also on the strength of the systems designed to support delivery. Administrative processes should be transparent and designed to reward good practice. Likewise, support from general practice and the NHS must continue to grow, so that patients can access Pharmacy First quickly and efficiently.
Pharmacy First represents a significant opportunity to enhance the role of community pharmacy within integrated primary care. To fully realise that potential, it must strike the right balance between accountability and flexibility. Success will depend on continued collaboration across the healthcare system, with all partners working together to support pharmacies in delivering the highest standards of patient care.
