What Is NHS Pharmacy First? The Complete Guide

What is NHS Pharmacy First?

NHS Pharmacy First is a service that was launched across England in January 2024, giving patients direct access to clinical care at their local pharmacy — no GP appointment needed. For residents in Medway and across Gillingham, pharmacy first means that for seven specific conditions, a pharmacist can now assess your symptoms, make a clinical decision, and supply prescription-only medicines where appropriate, all in a single visit.

Before Pharmacy First, patients with minor illnesses typically had two options: book a GP appointment (often days away) or purchase over-the-counter treatments themselves. The new service fills that gap. NHS England commissioned community pharmacies to take on these seven clinical pathways because pharmacists are highly trained clinicians who are ideally placed to manage minor illness quickly, safely, and at no cost to the patient.

The scheme is part of a broader NHS strategy to reduce pressure on GP surgeries and emergency departments. By directing suitable patients to pharmacies, GPs are freed up to focus on more complex cases, while patients benefit from faster access to treatment — often the same day they develop symptoms.

Which conditions does Pharmacy First cover?

The NHS Pharmacy First service covers seven clinical pathways. Each pathway has defined eligibility criteria — age ranges, symptom requirements, and in some cases gender restrictions — to ensure the service is used safely and appropriately. Here is a summary of who qualifies for each condition:

• Sinusitis— adults and children aged 12 and over presenting with facial pain or pressure, blocked or runny nose, and symptoms that have been present for at least 10 days or are worsening after initial improvement (the “double sickening” pattern).
• Sore throat — patients aged 5 and over with an acute sore throat. The pharmacist uses the FeverPAIN or Centor scoring tools to assess the likelihood of a bacterial cause and determine whether antibiotics are clinically appropriate.
• Earache (acute otitis media) — children aged 1 to 17 years with ear pain that has lasted fewer than 4 days. The pharmacist assesses temperature, pain severity, and other symptoms to guide treatment.
• Infected insect bites — patients aged 1 year and over where a bite site has become infected, showing signs such as redness, swelling, warmth, or discharge, and the infection is uncomplicated and localised.
• Impetigo — adults and children aged 1 year and over with non-bullous impetigo (the most common type) affecting a localised area. The pharmacist will confirm the diagnosis and supply topical or oral antibiotics as appropriate.
• Shingles — adults aged 18 and over presenting within 72 hours of rash onset. Early antiviral treatment is most effective, so prompt access via Pharmacy First is particularly valuable for this pathway.
• Urinary tract infection (UTI) — women aged 16 to 64 years who are not pregnant and have no complicating factors (such as diabetes, kidney disease, or catheterisation). This pathway is restricted to women because UTIs present differently and are far more common in this group; men or those outside the age range should see a GP.

If your condition falls outside these criteria, your pharmacist at Medway Pharmacy will advise on the most appropriate next step, which may include referral to your GP or, in urgent cases, to an urgent treatment centre.

How does a Pharmacy First consultation work?

The process is straightforward and designed to be as convenient as possible. Here is what to expect when you use Pharmacy First at a participating pharmacy in Gillingham or elsewhere in Medway:

1. Book or walk in. You can book a Pharmacy First appointment online through our SimplyBook system, or simply walk in. Many patients are seen the same day they develop symptoms — no waiting weeks for a GP slot.
2. Private consultation room. You will be seen in a private consultation room, separate from the main pharmacy area, so you can discuss your symptoms confidently and in complete privacy.
3. Clinical assessment. The pharmacist will take a brief medical history, ask about your symptoms, and carry out a clinical assessment appropriate to the pathway. For sore throat this includes a scoring tool; for earache it may involve looking in the ear with an otoscope. The pharmacist follows nationally approved NHS clinical protocols throughout.
4. Treatment supplied at no charge. If the pharmacist determines that treatment is clinically appropriate, they can supply prescription-only medicines — including antibiotics — directly to you under the Pharmacy First service. There is no prescription charge and no consultation fee.
5. Safety-netting advice. Before you leave, the pharmacist will explain what to expect as you recover, which symptoms would indicate your condition is worsening, and when you should seek further help. This safety-netting step is a standard part of every Pharmacy First consultation.
6. GP referral if needed. If your symptoms do not fit the Pharmacy First criteria, or if the pharmacist has clinical concerns, they will refer you to your GP or another appropriate service. The pharmacist will send a summary of the consultation to your GP electronically so your records are kept up to date.

Most consultations at Medway Pharmacy take between 10 and 20 minutes. You do not need to bring a prescription or see a doctor first.

Is Pharmacy First free?

Yes. NHS Pharmacy First is entirely free for eligible patients. There is no consultation fee for the pharmacist appointment, and any prescription medicines supplied as part of the service are provided at no charge — you do not pay the standard NHS prescription charge of £9.90 per item.

The service is commissioned and funded directly by NHS England. The pharmacy receives a payment from the NHS for each completed consultation, which is how the service is financially sustainable without any cost to the patient.

It is worth distinguishing Pharmacy First from private pharmacist consultations, which also exist. Some pharmacies, including Medway Pharmacy, offer private services for conditions or treatments not covered by the NHS. These private services carry a consultation fee and any medicines supplied are charged separately. Pharmacy First is not a private service — it is an NHS-commissioned service available to all eligible patients, exactly as a GP appointment would be. If you are unsure whether your condition qualifies for the free NHS pathway, speak to one of our pharmacists in Gillingham and they will advise you.

Pharmacy First at Medway Pharmacy, Gillingham

Medway Pharmacy at 465 Canterbury Street, Gillingham, Kent, ME7 5LJ is a fully contracted NHS Pharmacy First provider. We usually offer Pharmacy First consultations Monday to Sunday from 7:30am to 10pm, excluding bank holidays.

Our extended opening hours make us one of the most accessible Pharmacy First providers in the Medway area. If you develop a UTI on a Saturday evening or wake up with earache on a Sunday morning, you can come straight to us without having to wait for a GP surgery to open. Please check current hours before travelling on bank holidays.

To book a Pharmacy First appointment, you can use our online booking system at medwaypharmacy.simplybook.it. Alternatively, you are welcome to walk in — our team will fit you in as soon as a consultation room is available. If you have any questions before attending, call us on 01634 575805.

Our pharmacists, Sukhdip Bahia and Emmanuella Torto-Doku, are both GPhC-registered and trained in all seven Pharmacy First clinical pathways. You will always be seen by a qualified pharmacist, not a healthcare assistant, for your Pharmacy First consultation.

Frequently asked questions