What can a pharmacist treat without seeing a GP?
Under Pharmacy First in England a pharmacist can now assess and, where appropriate, supply prescription-only medicines for seven conditions without a GP appointment. What they are, what else a pharmacy does, and how the other UK nations differ.
- Difficulty
- beginner
- Time
- 8 min
- Read
- 4 min
- Safety
- caution
Short answer
In England, Pharmacy First covers seven conditions: sinusitis, sore throat, earache, an infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women. You can walk in without a referral. Pharmacies in England also offer free blood pressure checks and contraception services. Scotland, Wales and Northern Ireland run their own equivalent schemes with different scope.
The mental map most people carry is out of date. A pharmacist is now the right first stop for a much wider range of things than a decade ago, and for the seven conditions below they can assess you and supply a prescription-only medicine where it is appropriate — without you seeing a GP at all.
Safety
Step by step
- Know the seven Pharmacy First conditions.Sinusitis, sore throat, earache, an infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women. For each of these a pharmacist follows a defined clinical pathway rather than simply selling something over the counter.
- Understand what the pathway means.The pharmacist assesses you against agreed criteria, gives self-care and safety-netting advice, and only where it is appropriate supplies a restricted set of prescription-only medicines. If you do not fit the pathway, they refer you on — which is a useful outcome rather than a wasted trip.
- Walk in, or arrive by referral.You can attend or ring a pharmacy directly without any referral. You may also be referred by a GP practice, by NHS 111 or from urgent care, and arriving that way is the same service.
- Use the other services while you are there.Pharmacies in England offer free blood pressure checks and an oral contraception service. Many also do flu and other vaccinations, emergency contraception, stop-smoking support and new medicine reviews.
- Ask about an emergency supply of a regular medicine.If you have run out of something you are already prescribed, a pharmacist can often make an emergency supply at their professional discretion. Take the packaging or a repeat slip and go before the weekend rather than during it.
- Use the consultation room.Every pharmacy providing these services has a private consultation area. You do not have to describe a urinary infection or a rash across the counter, and asking to speak privately is completely routine.
- Know where the boundary is.A pharmacist is not the route for anything that could be an emergency, for a long-term condition getting worse, for a new lump or an unexplained symptom, or for anything in a child that is making them very unwell. NHS 111 will direct in any of those cases.
- Check what applies where you live.Pharmacy First is an England service. Scotland has its own long-established pharmacy service, Wales has a common ailments service, and Northern Ireland has its own arrangements. The principle is the same and the covered conditions are not identical.
Tips
- Pharmacies have no appointment system and long opening hours, which makes them by far the fastest route for the conditions they cover.
- Take a list of your regular medicines. It is the first thing you will be asked and it shapes what can be supplied.
- If a pharmacist refers you to a GP, that referral carries weight. Say a pharmacist sent you when you ring the practice.
Common mistakes
- Waiting for a GP appointment for one of the seven conditions — The pharmacy route exists precisely so you do not have to. For shingles in particular the treatment window matters, and a same-day pharmacy assessment beats a next-week appointment.
- Expecting antibiotics as the outcome — The pathways include not supplying an antibiotic where it is not indicated, which is the point of them. A viral sore throat treated with reassurance and self-care advice is a correct outcome.
- Using a pharmacy for something that is getting rapidly worse — Deterioration changes the question. Anyone becoming very unwell needs NHS 111 or 999, not a queue at a counter.
If it doesn't work
The pharmacy says they cannot help under the scheme
Cause: You do not meet the pathway criteria, or that pharmacy does not offer the service — Fix: Ask them what they recommend and whether another local pharmacy provides it. Not every pharmacy signs up to every service, and they will know which nearby ones do.
You are not sure whether to use a pharmacy or a GP
Cause: The boundary is genuinely unclear for many symptoms — Fix: Ring NHS 111 or ask the pharmacist. Both will direct you, and a pharmacist telling you to see a GP is a useful triage rather than a failed visit.
You have run out of a regular medicine on a bank holiday
Cause: A prescription that did not get ordered in time — Fix: Go to any open pharmacy with the packaging and ask about an emergency supply. Outside pharmacy hours, NHS 111 can arrange an urgent prescription.
Questions people ask
Do I have to be registered with that pharmacy?
No. You can use any pharmacy offering the service, and you do not need to be a regular customer.
Does it cost anything?
The consultation is free. Where a medicine is supplied, the usual prescription charge rules apply — and prescriptions are free in Scotland, Wales and Northern Ireland, and for exempt groups in England.
Will my GP know?
Yes. The pharmacy sends a record of the consultation to your GP practice, so it appears in your record.
Can a pharmacist treat a child?
For some of the pathways and within defined age ranges, yes. The pharmacist will say. A child who is very unwell, drowsy, or has a rash that does not fade under pressure needs urgent assessment rather than a pharmacy.