Pharmacy First: seven conditions a pharmacist in England treats without a GP appointment
Earache, sore throat, sinusitis, shingles, impetigo, an infected bite and uncomplicated UTI in women — for these seven a pharmacist in England consults and supplies prescription medicines directly. No referral needed, the consultation is free, the medicine costs £9.90 or nothing if you are exempt.
The most common complaint about healthcare here is simple: you cannot get an appointment. The GP has a waiting list, 111 tells you to wait some more, and it hurts now. Yet England has had a service running for over two years that many people have never heard of: Pharmacy First — a pharmacist treats seven common conditions themselves, antibiotics included, with no GP appointment and no referral.
The service launched on 31 January 2024 and covers England. Scotland has its own version (NHS Pharmacy First Scotland); Wales and Northern Ireland run their own schemes.
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The list is closed. The pharmacist follows an approved clinical pathway and, where needed, supplies a prescription-only medicine — an antibiotic or an antiviral:
Earache (acute otitis media) — ages 1 to 17.
Impetigo — age 1 and over.
Infected insect bites — age 1 and over.
Shingles — age 18 and over.
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Sore throat — age 5 and over.
Uncomplicated urinary tract infection — women aged 16 to 64.
Anything outside the list is not treated under this service — but the pharmacist can give self-care advice or refer you to a GP, to 111 or to urgent care. That is part of the pathway, not a brush-off.
How it works in practice
No referral is needed — you can walk into a participating pharmacy and ask for a Pharmacy First consultation. A GP surgery, NHS 111 or urgent care can also refer you, but there is no need to wait for that.
The conversation happens in a private consultation room rather than at the counter. The pharmacist works through the pathway questions and checks the "gateway point": whether your case meets the criteria. If it does, you are treated on the spot. If it does not, they explain where to go next, and the outcome is recorded in your medical record.
An appointment is usually unnecessary, though at busy times you may be asked to come back later — it is worth phoning ahead to ask whether the pharmacy offers Pharmacy First and whether the pharmacist is free.
What it costs
The consultation itself is free. If the pharmacist supplies a prescription-only medicine, the standard NHS prescription charge applies: in England £9.90 per item, frozen for 2026/27.
Around 89% of prescriptions in England are dispensed free. You pay nothing if you are under 16, 16–18 and in full-time education, 60 or over, pregnant or have given birth in the past 12 months (MatEx certificate), have certain long-term conditions (MedEx certificate), or receive some benefits. If you need prescriptions regularly, a 3-month or 12-month prepayment certificate works out cheaper — those are frozen for 2026/27 too.
Worth knowing for newcomers: the prescription charge does not depend on immigration status, and a pharmacist consultation requires neither GP registration nor insurance.
What else a pharmacy can do
Beyond Pharmacy First, a pharmacy can check your blood pressure free (for adults aged 40 and over), supply and continue contraception, give flu and covid vaccinations in season, and help with stopping smoking.
One more thing worth knowing: the urgent supply of a repeat medicine. If you have run out of a regular medicine and the GP appointment is far off, the pharmacy can supply a stock under the same service without a new prescription. For anyone caught out while travelling or between moves, that is the fastest lawful route.
When not to go to the pharmacy
Pharmacy First is for conditions that are not serious. Severe chest pain, trouble breathing, confusion, a high temperature in a baby, suspected stroke, heavy bleeding — that is 999 or A&E, not a queue at the chemist. If you are unsure, 111 is free and open around the clock, online as well as by phone.
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