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With Pharmacy First set to expand this autumn, Christie & Co’s Jonathan Board outlines the impact the service is having on the UK pharmacy market and what it means for business profitability

Launched on January 31, 2024, the Pharmacy First scheme marked a significant shift in primary care delivery in England. Initially announced by the Government in May 2023, the initiative empowers community pharmacists to supply prescription-only medicines for seven (soon to be 12) common conditions without the need for a GP appointment.

Since its inception, the service has expanded rapidly and is now available in the vast majority of pharmacies across England. With the potential to free up millions of GP appointments, Pharmacy First is fundamentally reshaping access to healthcare.

The service has clearly had a positive impact on the UK pharmacy market; it has strengthened financial foundations, enhanced clinical credibility, increased patient demand, and repositioned pharmacies as indispensable providers of accessible NHS care.

While challenges remain - including variability in referrals and ongoing awareness of the service - the scheme represents a decisive step towards a more clinically focused, sustainable, and strategically important pharmacy sector within the UK healthcare market.

Day-to-day impact

The scheme has materially increased patient footfall into community pharmacies, which has been significant from both clinical and commercial standpoints. This increase in patient interaction is driving engagement with a broader range of pharmacy services, including vaccinations, contraception, blood pressure checks, and over-the-counter sales.

Pharmacy First has also reinforced pharmacies’ role as first-contact healthcare providers, particularly during weekends and bank holidays when access to GPs is more limited. Data from NHS Business Services Authority shows that hundreds of thousands of consultations were delivered within months of the scheme’s launch, with particularly strong uptake for conditions such as urinary tract infections and sore throats.

Profits

After years of flat funding and rising operating costs, Pharmacy First represents a meaningful new income stream for community pharmacies. The service is supported by a £645m investment package announced in May 2023 and a new £340m tranche of investment announced in May this year.

By mid-2025, nearly 98 per cent of pharmacies in England had signed up to the scheme and delivered almost five million consultations between February 2024 and January 2025. Fixed monthly payments combined with per-consultation fees reward clinical activity and encourage service development beyond traditional volume-based dispensing.

For many pharmacies, particularly independents, this has helped offset financial pressures and enabled reinvestment in staff training, consultation facilities, and digital infrastructure.

The service is elevating the role of pharmacists in the eyes of the public, shifting perceptions from dispensers to clinicians. Under the scheme, community pharmacists can diagnose and treat conditions such as uncomplicated urinary tract infections, sore throat, sinusitis, and shingles using nationally agreed clinical pathways and patient group directions.

This development has strengthened professional confidence and made better use of Pharmacists’ clinical training, aligning with the long-standing ambitions set out in the NHS Long Term Plan to expand the clinical role of community pharmacy.

Looking ahead

Looking ahead, there is clear increased scope for Pharmacy First by covering additional conditions, expanding the use of patient group directions, and ultimately supporting independent prescribing.

This aligns closely with NHS England’s 10-Year Plan, which positions community pharmacy at the heart of delivering same-day care, reducing pressure on GPs and A&E departments, and improving access to healthcare in underserved areas.

If delivered effectively, Pharmacy First has the potential to become the front door to a more agile, preventative, and integrated model of primary care.

Jonathan Board is head of pharmacy at Christie & Co

 jonathan.board@christie.com