Pharmacy First referrals rise as NHS shifts more minor illness care away from general practice

Pharmacy First is handling a rapidly growing volume of patient consultations as the NHS expands the role of community pharmacies in treating common conditions and encourages general practices to make greater use of the service.

More than 3.3 million Pharmacy First consultations were delivered between March 2025 and February 2026, representing a 43% increase on the previous 12 months, according to the Department of Health and Social Care.

The government has described the expansion as part of a wider effort to move more care out of GP surgeries and hospitals and closer to patients' homes.

Pharmacy activity continues to climb

Pharmacy First launched in January 2024, replacing the Community Pharmacy Consultation Service for minor illnesses and introducing seven specific clinical pathways.

The pathways cover conditions including uncomplicated urinary tract infections, sore throat, sinusitis, infected insect bites, impetigo, shingles and acute otitis media in children.

Patients can access the service directly from a participating pharmacy, but referrals can also come from general practice, NHS 111 and urgent and emergency care services.

The growth in activity has been substantial.

NHS Business Services Authority data shows that the number of claimed Pharmacy First clinical pathway consultations increased steadily during the service's first two years.

There were 125,275 claimed consultations in February 2024. By July 2024, monthly activity had reached 186,190 consultations.

By the 12 months to February 2026, the government reported more than 3.3 million consultations, a 43% increase compared with the preceding year.

The latest NHS England figures indicate that the service has continued to become a routine part of community pharmacy activity, with more than 2.75 million clinical pathway consultations delivered between April 2025 and January 2026 alone.

GPs are increasingly being encouraged to refer

The expansion is not simply being driven by patients walking into pharmacies.

NHS England has been actively encouraging general practices and primary care networks to refer patients with suitable minor illnesses to community pharmacists.

Under the GP referral pathway, a patient contacting a GP practice can be clinically triaged and, where appropriate, referred electronically to a pharmacy of their choice.

The pharmacist can then conduct the consultation and, where clinically appropriate, supply medicines under the Pharmacy First clinical pathways.

Government figures show that this referral route still has significant room to grow.

In February 2025, around 75% of GP practices in England had made at least one referral into Pharmacy First.

The Department of Health and Social Care said there were significant regional differences in GP engagement and that NHS England was working with integrated care boards, GP stakeholders and the community pharmacy sector to increase referral rates.

That makes GP referral one of the clearest areas where the NHS is attempting to change how demand is handled.

The aim is to reduce pressure on general practice

The policy is based on a relatively simple proposition.

Where a patient's condition can safely be managed by a community pharmacist, the patient does not necessarily need a GP appointment.

NHS England's guidance specifically describes Pharmacy First as a route for lower-acuity minor illnesses that can be referred from general practice.

The service is intended to allow pharmacists to assess patients, provide advice and, where appropriate, supply medicines without requiring a GP prescription.

This is becoming increasingly important as the NHS attempts to shift routine and lower-acuity care away from traditional GP consultations.

The government's wider pharmacy strategy is explicitly built around this model.

In June 2026, the government announced a £340m funding package for community pharmacy and said the expansion would help patients receive more care on the high street while reducing pressure on NHS services.

But Pharmacy First is not simply replacing GP appointments

There is an important distinction between rising Pharmacy First activity and proving that the service has reduced GP demand by the same amount.

The available national data records consultations delivered through the pharmacy service, but does not establish that every consultation represents a GP appointment that would otherwise have taken place.

Patients can access Pharmacy First without a referral, and referrals can also originate from NHS 111 and urgent and emergency care settings.

That means the increase should be understood as evidence of care shifting towards community pharmacy, rather than definitive evidence that millions of GP appointments have been eliminated.

The distinction matters because the NHS is increasingly using pharmacies as an additional point of access rather than simply as a substitute for general practice.

Digital referrals are becoming part of the model

The NHS has also invested in making the referral process easier for practices and pharmacies.

NHS England's GP Connect Update Record allows community pharmacies to send consultation summaries, including medicines supplied and other clinical information, directly into general practice workflows.

The national rollout began in 2024.

By September 2025, more than 10,000 community pharmacies had sent over seven million consultation summaries to general practices using the system. NHS England says the digital process reduces the administrative burden on practices and supports safer follow-up by removing the need to manually transcribe information.

That infrastructure becomes increasingly important as pharmacy activity grows.

If more patients are being managed outside general practice, GPs still need visibility of what happened during the pharmacy consultation.

Pharmacists are taking on a broader clinical role

The expansion also reflects a wider change in the role of community pharmacy.

Pharmacy First was initially focused on seven common conditions, but the government is now extending the range of services delivered through pharmacies.

From autumn 2026, a national NHS prescribing offer is due to be introduced as an extension of Pharmacy First and the Pharmacy Contraception Service.

NHS England has also highlighted the fact that newly qualified pharmacists will join the General Pharmaceutical Council register as independent prescribers from September 2026.

The direction of travel is therefore clear.

Community pharmacy is increasingly being positioned as a clinical setting rather than simply a place where prescriptions are dispensed.

The next question is whether capacity can keep pace

The rapid increase in Pharmacy First activity raises another issue for the NHS.

If more demand is deliberately directed towards community pharmacy, pharmacies need sufficient workforce, consultation capacity and access to the clinical information required to manage patients safely.

NHS Business Services Authority data shows that payment caps have already been introduced for Pharmacy First clinical pathway consultations, with different monthly limits based on previous activity levels.

The NHS is therefore attempting to increase utilisation while operating within a structured funding model.

For general practice, greater use of Pharmacy First could help redirect suitable lower-acuity cases away from GP appointments.

For pharmacies, however, the expansion represents a significant increase in clinical responsibility.

A gradual redistribution of primary care

The evidence increasingly points towards Pharmacy First becoming an established part of the NHS's primary care model.

Consultation volumes have risen sharply since launch, GP referral pathways are being actively promoted, and digital infrastructure is being developed to connect pharmacy consultations back into general practice.

But the evidence does not yet justify saying that Pharmacy First has simply replaced millions of GP appointments.

Instead, the clearest conclusion is that the NHS is redistributing where some lower-acuity demand is managed.

For patients with suitable minor illnesses, that increasingly means the local pharmacy.

For GP practices, it could mean fewer consultations for conditions that can safely be managed elsewhere.

And for community pharmacies, it marks a significant expansion in their role at the front door of NHS care.