Pharmacy First in England: conditions, access and costs

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.

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.

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.

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.

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.

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.

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.