# Pharmacy First in England: conditions, access and costs https://www.med-easy.co.uk/guides/pharmacy-first-england/ Publisher: Med Easy Source material checked: 2026-10-20 Editorial information; no registered-clinician review is claimed. General UK healthcare information. Country-specific rules and provider examples retain the limits stated in the text. Fees are dated examples, not live quotes. ## Short answer Participating pharmacies in England can assess defined conditions through NHS Pharmacy First without a GP appointment. Eligibility depends on the pathway and individual assessment. The NHS consultation is free, while normal prescription charges can apply to supplied medicines unless exempt. Check local availability, especially for the more limited autumn 2026 prescribing expansion. Pharmacy First lets participating pharmacies in England assess common conditions without a GP appointment. An assessment may lead to advice, suitable medicine or referral elsewhere. Start with the seven established pathways below, and check local availability for the autumn 2026 prescribing expansion. ## Key points - Treat the condition and age table as a guide to accessing assessment. It does not diagnose the problem or guarantee a medicine; the pharmacist decides the appropriate next step. - Ask whether the appointment is NHS Pharmacy First, another NHS service or a private consultation. Similar pharmacy services can have different eligibility rules and patient charges. - Confirm the pharmacist and relevant pathway are available before travelling. The autumn 2026 expansion does not establish that every pharmacy provides every newly announced service. ## The seven established conditions and age ranges The established national pathways cover the following groups. These are entry criteria for assessment; the pharmacist also checks whether the pathway is appropriate for the individual. NHS England publishes the seven pathways . Condition pathway Published age group Earache associated with acute otitis media 1–17 years Impetigo 1 year and over Infected insect bites 1 year and over Shingles 18 years and over Sinusitis 12 years and over Sore throat 5 years and over Uncomplicated urinary tract infection Women aged 16–64 Do not use the table to diagnose yourself or decide which medicine to request. Describe the problem to the pharmacist. Someone outside an age range can still ask for pharmacy advice, although another service may need to assess or treat them. Read the NHS patient guidance . Section link: https://www.med-easy.co.uk/guides/pharmacy-first-england/#the-seven-established-conditions-and-age-ranges - [NHS England publishes the seven pathways](https://www.england.nhs.uk/long-read/launch-of-nhs-pharmacy-first-advanced-service/) - [Read the NHS patient guidance](https://www.nhs.uk/nhs-services/pharmacies/how-pharmacies-can-help/) ## What is changing in autumn 2026? NHS England announced five additional prescribing pathways starting at a smaller group of participating pharmacies: low-frequency episodic migraine in adults, seasonal allergic rhinitis in children, acute outer-ear infection in adults, mild to moderate acne in young people and adults, and mild skin or soft-tissue infections and scabies. Read the September 2026 announcement . Ask whether a pharmacy offers the relevant new pathway and which eligibility rules apply. The expansion announcement does not mean every Pharmacy First location provides every new service. Section link: https://www.med-easy.co.uk/guides/pharmacy-first-england/#what-is-changing-in-autumn-2026 - [Read the September 2026 announcement](https://www.england.nhs.uk/2026/09/patients-to-get-quicker-treatment-for-migraines-acne-and-3-other-everyday-conditions-at-pharmacies/) ## How to contact a participating pharmacy You can approach a pharmacy directly for these seven pathways; a GP or another service can also refer you. Check the pharmacy’s availability before travelling. Distance-selling pharmacies do not carry out the acute otitis media pathway. Check how Pharmacy First is accessed . For a parent arranging care around school or work, one short call can clarify whether the relevant pharmacist is available, whether the child needs to attend and what information to bring. Ask the pharmacy to explain the next step if it cannot offer that assessment. A pharmacy listing on a map does not tell you its consultation capacity today. Section link: https://www.med-easy.co.uk/guides/pharmacy-first-england/#how-to-contact-a-participating-pharmacy - [Check how Pharmacy First is accessed](https://www.england.nhs.uk/long-read/launch-of-nhs-pharmacy-first-advanced-service/) ## What is free, and what might cost money? The NHS Pharmacy First consultation has no patient consultation fee. When an NHS medicine is supplied through the service, the normal prescription charge applies per item unless you qualify for exemption. The NHS service specification sets out the medicine charge rules . Keep the NHS service separate from a private pharmacy appointment or an over-the-counter purchase. Ask which route is being offered and what you would pay before agreeing. For the current charge, exemptions and prepayment options, use our NHS prescription cost guide . A free assessment does not automatically make every product on the pharmacy shelf free. Section link: https://www.med-easy.co.uk/guides/pharmacy-first-england/#what-is-free-and-what-might-cost-money - [The NHS service specification sets out the medicine charge rules](https://www.england.nhs.uk/wp-content/uploads/2023/11/PRN00936-i-Community-pharmacy-advanced-service-specification-NHS-pharmacy-first-service-November-2023.pdf) - [NHS prescription cost guide](https://www.med-easy.co.uk/guides/nhs-prescription-costs/) ## Make the assessment easier to follow Prepare your current medicine list and any relevant information you already have. Explain what has happened so far and whether another service has assessed the problem. If you are unsure what a question means, ask the pharmacist to rephrase it instead of guessing. Is this assessment being provided through NHS Pharmacy First? Is there anything you need to know about my existing medicines? What happens after today’s consultation? If another service is needed, who arranges that contact? How will I receive the advice or a record of the discussion? Leave with a clear understanding of the next step. If a medicine is supplied, ask the pharmacist to explain the directions and any questions you have about it. This guide helps you access a service; it does not replace that conversation. Section link: https://www.med-easy.co.uk/guides/pharmacy-first-england/#make-the-assessment-easier-to-follow ## Find the correct service for your nation This page describes England’s Pharmacy First programme. Services with similar names elsewhere in the UK have their own rules. Start with our four-nations guide before applying these age ranges or charge rules to another nation. Use Find care to explore the appropriate starting point, or browse the free healthcare information hub . If costs remain a concern, the NHS Low Income Scheme guide explains help that can extend beyond prescriptions. Section link: https://www.med-easy.co.uk/guides/pharmacy-first-england/#find-the-correct-service-for-your-nation - [four-nations guide](https://www.med-easy.co.uk/guides/uk-healthcare-four-nations/) - [Find care](https://www.med-easy.co.uk/find-care/) - [free healthcare information hub](https://www.med-easy.co.uk/healthcare-information/) - [NHS Low Income Scheme guide](https://www.med-easy.co.uk/guides/nhs-low-income-scheme/) ## Questions to ask - Does this pharmacy provide the relevant NHS Pharmacy First pathway for the person and age group needing assessment? - Is the appropriate pharmacist available today, and should I book or attend during a particular period? - Is any offered consultation NHS-funded, and could medicine or other product charges apply after the assessment? - What existing medicine information or details of previous assessment should I bring to help the pharmacist? - If this pathway cannot meet the need, who explains the next service and whether a referral is being arranged? ## Frequently asked questions ### Does Pharmacy First mean the pharmacist will supply antibiotics? No. The service provides an assessment under the relevant clinical pathway. The outcome may be advice, suitable treatment or a referral elsewhere. Describe the problem and answer the pharmacist’s questions rather than arriving with a medicine demand. Meeting an age range alone does not determine what treatment will be appropriate. https://www.med-easy.co.uk/guides/pharmacy-first-england/#faq-1 ### Are medicines free because the consultation is free? The NHS consultation has no patient fee, but normal prescription charges can apply when medicines are supplied unless an exemption applies. Ask which charge rules apply to the proposed supply. Keep that separate from an over-the-counter purchase or a private appointment, which may use different prices and conditions. https://www.med-easy.co.uk/guides/pharmacy-first-england/#faq-2 ### Can I use the new autumn 2026 services at any pharmacy? The expansion began with a smaller group of participating pharmacies. Ask the pharmacy whether it offers the specific new pathway and which eligibility rules apply. A general Pharmacy First sign or an old directory entry does not confirm that every additional service is available there on the day you attend. https://www.med-easy.co.uk/guides/pharmacy-first-england/#faq-3 ## Sources - [NHS: how pharmacies can help](https://www.nhs.uk/nhs-services/pharmacies/how-pharmacies-can-help/) — NHS or public authority - [NHS England: Pharmacy First clinical pathways](https://www.england.nhs.uk/long-read/launch-of-nhs-pharmacy-first-advanced-service/) — NHS or public authority - [NHS England: Pharmacy First service specification](https://www.england.nhs.uk/wp-content/uploads/2023/11/PRN00936-i-Community-pharmacy-advanced-service-specification-NHS-pharmacy-first-service-November-2023.pdf) — NHS or public authority - [NHS England: autumn 2026 pharmacy prescribing expansion](https://www.england.nhs.uk/2026/09/patients-to-get-quicker-treatment-for-migraines-acne-and-3-other-everyday-conditions-at-pharmacies/) — NHS or public authority ## Related guides - https://www.med-easy.co.uk/guides/nhs-prescription-costs/ - https://www.med-easy.co.uk/guides/nhs-low-income-scheme/ - https://www.med-easy.co.uk/guides/uk-healthcare-four-nations/