The Complete Guide to NHS Pharmacy First: 7 Conditions Your Pharmacist Can Treat

Getting timely healthcare advice when you feel unwell has become significantly easier across England. Under the NHS Pharmacy First service, patients can walk straight into their local community pharmacy to receive expert clinical assessments and, where appropriate, prescription-only medicines for seven common conditions—all without needing to book an appointment with a GP.^{1 2}

Launched to expand primary care access and make better use of pharmacists' extensive clinical training, Pharmacy First enables high street pharmacies like Chemist Near Me to provide convenient, evidence-based care right in your neighbourhood.^{2 3} This guide explains how the service works, details the seven conditions covered, and outlines what you can expect during your consultation.

What is NHS Pharmacy First?

NHS Pharmacy First is an advanced clinical service designed to offer quick, walk-in consultations for specific minor health conditions.¹ Rather than waiting days for a routine doctor's appointment or sitting in urgent care waiting rooms for a minor ailment, you can consult an experienced community pharmacist directly.²

You do not need a doctor's referral to use the service. You can simply walk into your local pharmacy, or you might be referred directly by NHS 111, GP reception teams, or emergency departments.³ Consultations take place inside a private consultation room, ensuring that your health discussions remain strictly confidential and discreet.³

The 7 Conditions Covered Under Pharmacy First

Pharmacists follow robust clinical pathways established by NHS England and the National Institute for Health and Care Excellence (NICE) to assess your symptoms safely.^{2 3} Depending on your age and clinical assessment, pharmacists can provide self-care advice, recommend over-the-counter remedies, supply prescription-only medicines via Patient Group Directions (PGDs), or refer you onward to your GP or hospital if your symptoms require further investigation.³

Here is an in-depth breakdown of the seven clinical conditions managed under the service:

1. Uncomplicated Urinary Tract Infections (UTIs)

Eligible age group: Women aged 16 to 64 years.³

Lower urinary tract infections cause uncomfortable symptoms such as a burning sensation when passing urine, a sudden urge to urinate, or needing to pass urine more frequently than normal.⁴ During your consultation, the pharmacist will check for classic signs of a localized infection and rule out red-flag symptoms (such as high fever, severe loin pain, or pregnancy) that require medical escalation.⁴ If appropriate, your pharmacist can supply a targeted short course of antibiotics directly.^{3 4}

2. Shingles

Eligible age group: Adults aged 18 years and older.³

Shingles is caused by the reactivation of the chickenpox virus, leading to a painful, tingling sensation followed by a distinctive blistering rash typically restricted to one side of the body or face.³ Prompt assessment is critical, as antiviral medicines are most effective when started within a few days of the rash appearing.³ Your pharmacist will examine the rash, assess pain levels, and supply oral antiviral treatment where clinically indicated.³

3. Impetigo

Eligible age group: Adults and children aged 1 year and older.³

Impetigo is a highly contagious superficial bacterial skin infection characterised by red sores or blisters that burst and leave golden, honey-coloured crusts, most commonly around the nose and mouth.³ Pharmacists assess the extent of the lesions and can supply topical antibiotic creams or oral antibiotics, alongside practical hygiene advice to prevent spreading the infection within households and schools.³

4. Infected Insect Bites

Eligible age group: Adults and children aged 1 year and older.³

While insect bites are normally harmless, scratching them can break the skin barrier and introduce bacteria. Signs of secondary infection include spreading redness, localized warmth, swelling, increasing pain, or pus discharge.³ If a secondary bacterial infection is identified, your pharmacist can provide oral antibiotics and symptomatic relief such as antihistamines.³

5. Acute Sore Throat

Eligible age group: Adults and children aged 5 years and older.³

Most sore throats are viral and resolve on their own with rest, hydration, and simple pain relief.⁵ Pharmacists use structured clinical scoring tools (such as FeverPAIN or Centor criteria) to assess the likelihood of a bacterial infection, checking for high fever, tonsillar exudate, absence of a cough, and tender neck glands.^{3 5} When criteria suggest a higher likelihood of bacterial origin, an antibiotic may be supplied; otherwise, supportive self-care guidance is provided.⁵

6. Acute Sinusitis

Eligible age group: Adults and children aged 12 years and older.³

Sinusitis involves inflammation of the sinus cavities, causing facial pain, pressure around the forehead and cheeks, nasal congestion, and reduced sense of smell.⁶ Because acute sinusitis usually lasts between two and three weeks and is commonly viral, initial management focuses on symptom relief with nasal decongestants, saline rinses, and pain management.⁶ Pharmacists evaluate the duration and progression of symptoms to identify persistent or worsening cases that may benefit from prescription treatments.^{3 6}

7. Acute Otitis Media (Middle Ear Infection)

Eligible age group: Children and young people aged 1 to 17 years.³

Middle ear infections are common in young children and can cause sharp ear pain, fever, irritability, and ear pulling.⁷ Most uncomplicated ear infections improve within several days without antibiotics.⁷ Using an otoscope, the pharmacist can examine the tympanic membrane (eardrum) for redness, bulging, or fluid.³ They will recommend appropriate analgesia, such as paracetamol or ibuprofen, and supply antibiotics when specific clinical thresholds or signs of severity are met.^{3 7}

Summary of Conditions and Age Criteria

The table below provides a quick reference to the eligibility criteria and conditions covered under NHS Pharmacy First:

What to Expect During Your Pharmacy Consultation

When you visit a pharmacy for a Pharmacy First consultation, you can expect a structured, professional healthcare experience:

• Private Consultation: You will be invited into a dedicated, confidential room where you can discuss your health concerns in complete privacy.³
• Clinical Evaluation: The pharmacist will ask questions regarding the onset and duration of your symptoms, review your medical history, check your current medications, and perform relevant physical checks (such as inspecting your throat, skin, or inner ear).³
• Tailored Action Plan: Your pharmacist will explain the likely cause of your symptoms, discuss treatment choices, provide clear instructions, and explain what to look out for in case your condition does not improve.^{2 3}
• Shared Records: With your consent, details of your consultation and any medications provided will be shared securely with your GP practice to ensure your medical records remain up to date.³