Home / Pharmacy First
Pharmacy First: what this means
Pharmacy First lets you get advice, and treatment where it is needed, straight from a community pharmacy for seven common conditions, without seeing a doctor first. The pharmacist can supply certain prescription medicines, including some antibiotics, under an agreed NHS protocol. From 29 October 2026, some pharmacies can also prescribe for five further conditions — see below.
The 7 conditions
A pharmacist can assess and treat these. For anything else, they will still give advice or point you to the right service.
Sore throat
Age 5 and overMost sore throats are viral. The pharmacist uses a scoring system to decide whether an antibiotic is likely to help.
Read more about sore throatSinusitis
Age 12 and overUsually improves without antibiotics. Treatment may be offered if symptoms are severe or have lasted a long time.
Read more about sinusitisEarache (acute otitis media)
Age 1 to 17Pain relief is the main treatment. Antibiotics are only for certain children who are more unwell.
Read more about earache (acute otitis media)Infected insect bites
Age 1 and overMost bites are just inflamed. Antibiotics are for bites that have become genuinely infected.
Read more about infected insect bitesUrinary tract infection
Women aged 16 to 64, uncomplicatedA short course of antibiotics is often given. The pharmacist checks who is excluded, such as men, pregnant women, people with a catheter or repeated urine infections, and anyone with signs of kidney infection, and refers them on.
Read more about urinary tract infectionImpetigo
Age 1 and overA crusty, golden skin infection. Small patches are usually treated first with hydrogen peroxide 1% antiseptic cream. An antibiotic cream or tablets are used only if needed.
Read more about impetigoShingles
Age 18 and overAn antiviral, not an antibiotic. It works best when started within 72 hours of the rash appearing, so go early.
New from October 2026: five prescribing pathways
From 29 October 2026, some pharmacies in England can also prescribe treatment for five further conditions. This is only available at pharmacies registered to provide prescribing, which must employ a pharmacist prescriber, so check with your local pharmacy first.
Outer ear infection (acute otitis externa)
Age 18 and overAn itchy, painful ear canal, often after water gets into the ear. Treatment usually starts with drops or a spray that do not always contain an antibiotic; antibiotic drops are used if it is not settling. Read more
Mild skin and soft tissue infections, and scabies
Mild skin infections are covered on our skin infection and impetigo pages. Scabies is treated with a cream or lotion that kills the mites, not an antibiotic.
Mild to moderate acne
Antibiotics are not the first step. Skin treatments come first, and antibiotic tablets are only for moderate to severe acne or when skin treatments have not worked well enough. Read more
Seasonal allergic rhinitis (hay fever)
Children aged 4 to 11Hay fever is not covered in this guide, because it is not an infection. Your pharmacist can assess your symptoms and suggest suitable treatment, such as antihistamines or a steroid nasal spray.
Migraine (low frequency, episodic)
Adults aged 18 to 64Migraine is not covered in this guide, because it is not an infection. Your pharmacist can assess your symptoms, suggest suitable treatment, or refer you to a pharmacist prescriber, doctor or nurse if needed.
How can you access it?
- Walk into any pharmacy offering the service, or phone ahead to check.
- NHS 111, your doctor's practice or the NHS App can also refer you to a pharmacy.
- No appointment is usually needed, and there is a private room for the consultation.
- The pharmacist records the outcome and sends it to your doctor record.
Do you need to pay?
- The consultation itself is free on the NHS.
- If a prescription medicine is supplied you pay the normal NHS prescription charge, unless you are exempt (for example under 16, aged 60 or over, aged 16 to 18 in full time education, or holding a valid maternity or other exemption certificate).
- Medicines you buy over the counter are charged at the usual shop price.
Is the pharmacist qualified?
- Yes. Pharmacists complete a four year degree plus a year of supervised training, pass a registration assessment and are registered with the General Pharmaceutical Council.
- They are experts in medicines, doses, interactions and side effects.
- For Pharmacy First they follow national clinical protocols based on NICE and UKHSA guidance, with extra training for the service.
- They must refer you to a doctor or urgent care if you fall outside the protocol.
What to expect
- Questions about your symptoms, how long you have had them and your other medicines.
- Simple checks such as looking in your throat or ear, or taking your temperature.
- Tell them about any allergy, and about pregnancy or breastfeeding.
- You may be given self care advice only. That is a proper outcome, not a brush off.
Where Pharmacy First is available
The seven condition service runs across England, and from 29 October 2026 the additional prescribing pathways also run in England at pharmacies registered to provide them. Scotland has NHS Pharmacy First Scotland, Wales has the Common Ailments Service and Northern Ireland has Pharmacy First Northern Ireland. These cover a different list of conditions, so ask your local pharmacy what it can treat.
When not to use Pharmacy First
Go to A&E or call 999 if someone is struggling to breathe, has a rash that does not fade when pressed, is very drowsy or confused, or has a swollen face, lips or throat. See the warning signs page.
Useful links
Been treated at a pharmacy? Record it in your Consultation Notes and track how you feel in your Symptom Diary.