Pharmacists in England will be able to prescribe treatments for five additional common conditions from this autumn, under a £340 million expansion of the Pharmacy First scheme announced by the government. The specific ailments have yet to be confirmed, but the move marks a significant broadening of a programme that already covers seven conditions and has seen more than 3.3 million consultations in the past year.
Expansion of the Pharmacy First scheme
Launched in January 2024, the Pharmacy First scheme currently allows patients to obtain advice, over-the-counter remedies and prescription-only medicines directly from their local pharmacy for seven conditions: sore throats, earaches, sinusitis, shingles, impetigo, infected insect bites and uncomplicated urinary tract infections in women. Age restrictions apply — for example, earache treatment is available for children aged one to 17, impetigo and infected bites from age one, sore throat from age five, sinusitis from 12, shingles from 18, and UTIs for women aged 16 to 64.
Between March 2025 and February 2026, more than 3.3 million consultations were conducted under the programme, according to the Department of Health and Social Care — a 43 per cent increase on the previous 12 months. The scheme was introduced as part of the primary care access recovery plan and replaced the earlier Community Pharmacist Consultation Service.
From this autumn, pharmacists who hold an independent prescribing qualification will be able to assess patients and prescribe medicines directly without GP approval for the five new conditions. This builds on legislation that first allowed pharmacists to train as independent prescribers in 2006. From 2026, all newly qualified pharmacists in England are expected to qualify as independent prescribers as part of their initial education, enabling them to diagnose and prescribe without a separate GP sign-off.
Government vision for community care
Health Minister Stephen Kinnock has championed the expansion as a means of making better use of what he described as Britain’s highly skilled pharmacy workforce. “Independent prescribing will play a major part in delivering this shift, easing pressures on GPs, cutting unnecessary red tape and helping patients get the right care closer to home,” he said.
The minister said the government is “making the most of our highly skilled pharmacists, while boosting access to services and giving patients more care right on their doorstep.” The initiative aims to reduce the burden on overstretched GP surgeries and hospital services by directing patients with routine ailments to their local pharmacy, aligning with the NHS Long Term Plan’s ambition to shift more care into community settings. Efforts are also under way to improve digital infrastructure between general practice and community pharmacies to streamline referrals and ensure GP records are updated after pharmacy consultations.
Pharmacy sector warns of funding shortfall
Despite the government’s optimism, pharmacy associations have expressed serious reservations about the financial basis of the expansion. The National Pharmacy Association (NPA) welcomed the direction of travel but said the deal fails to address the “crippling” financial pressures facing community pharmacies.
NPA chairman Dr Olivier Picard acknowledged the investment “points in the right direction,” but warned it “does very little to close the £2.5 billion funding gap that the NHS itself identified a year ago.” He added that the expanded scheme is “nowhere near ambitious enough to transform patient access to care, nor make full use of pharmacists’ skills.” The NPA highlighted that escalating business rates, employer costs and medicine prices remain unaddressed by the new investment. Dr Picard cautioned that current funding levels risk undermining the scheme’s success, stating: “Pharmacies cannot sustain yet more loss-making work.” The association is calling for urgent talks with the new Secretary of State for Health, James Murray, arguing that the NHS pharmacy contract is “broken beyond repair and not fit for purpose.”
The Independent Pharmacies Association (IPA), which represents approximately 5,000 pharmacies across England and Wales, has voiced similar concerns. Chief executive Dr Leyla Hannbeck told BBC Radio 4’s Today programme that while the changes represent “a step in the right direction,” the “funding on offer doesn’t cover the workload to do this.” She warned that “many pharmacists will find themselves in a situation where they’re really thinking about whether they can keep their heads above the water.” The IPA estimates that the new contract provides significantly less funding per pharmacy than is needed to keep pace with inflation, resulting in a substantial annual shortfall per branch. An IPA survey indicated that over half of pharmacies would consider limiting services if a sufficient funding agreement is not reached.
Community Pharmacy England (CPE), which represents approximately 10,000 NHS community pharmacies, agreed to the new Community Pharmacy Contractual Framework for 2026/27, which includes the £340 million funding increase — a 10.3 per cent rise that takes total funding to £3.64 billion. However, CPE also raised concerns during negotiations that the proposed funding for independent prescribing risked the initiative “being set up to fail.” The organisation said it is not persuaded that sufficient investment is being made to enable the full and effective introduction of independent prescribing, given the workload, enhanced clinical responsibility, and requirements for clinical governance and infrastructure. The concerns follow a history of funding reductions: in 2016 the government announced a cut of £170 million to the pharmacy budget nationally from 2017, including £113 million in England.
The warnings from pharmacy bodies come as the sector continues to provide a wide range of services beyond prescribing, including advice on coughs and colds, medicine usage and side effects, oral contraception initiation, blood pressure checks, chlamydia screening, smoking cessation support, cholesterol and blood sugar testing, weight management advice, and disposal of unwanted medicines. There are also ongoing discussions about the integration of GP and pharmacy records and potential impacts on antimicrobial stewardship, with earlier concerns about increased antibiotic prescribing through expanded pharmacy services. Some GPs have expressed the view that similar funding could have been directed to GP practices to address the root causes of demand. Dr Picard’s assessment remains stark: “Pharmacies cannot sustain yet more loss-making work.”