Services Database Pharmacy First
Service description/care pathway
- A patient who is registered with, or under the care of, a Liverpool GP is referred into the service through CPCS, or patient presents in person or virtually to request the service.
- The Pharmacist will gain consent for details of the consultation to be shared with the patient’s GP.
- The pharmacist will assess the patient according to the criteria specified in the relevant Patient Group Direction (PGD). The list of conditions and treatments available for use within this service are available in the PGDs
- Pharmacists will not have access to the full medical record when conducting Pharmacy First Service consultations, and will need to assure themselves that the patient (or patient’s representative) can provide a reliable history of the presenting condition and other relevant elements of the patient history (e.g. long term conditions, concomitant medication).
- The Summary Care Record (SCR) should be used, when available, to clarify / augment the patient history.
- Pharmacists can and should decline to provide medicines under the Pharmacy First Service where a reliable history cannot be obtained, in order to care for people in a safe environment and protect them from avoidable harm.
- If the patient is eligible for treatment under the specified PGD, the pharmacist will supply medication to the patient supported by advice on its use.
- If on assessment the patient is suitable for a delayed provision of treatment, the pharmacist will explain that a supply is not necessary at that point in time, and to attend the pharmacy at a specified timeframe if symptoms have not improved or deteriorate further. Appropriate self-care advice and safety netting will be provided.
- If the patient is ineligible for inclusion in the PGD, the pharmacist will provide self-care advice and safety netting to the patient. An over-the-counter product may be supplied if appropriate through the Care at the Chemist service or over the counter purchase.
- If the pharmacist believes a prescription medication is needed but are unable to supply under the respective PGD, a referral to another healthcare provider (e.g. GP/Out of Hours Service) will be made following pathways as set out in the CPCS.
- If medication is to be supplied, it will be dispensed and labelled in accordance with the respective PGD. A record of supply must be made on the patient PMR.
- A record of the consultation will be made on PharmOutcomes at the time of the consultation, or in case of IT issues at the soonest possible moment following its restoration.
- A notification will be sent from PharmOutcomes on completion of the provision on the system. In case of IT issue, the pharmacy will print this and send via secure NHSmail to the GP surgery, or via post.
- The service provider must keep all completed electronic consultation proformas for a period of 8 years (in adults) or until 25th birthday in a child (age 26 if entry made when the young person was 17) or eight years after death in line with NHS health records retention policies.
- The pharmacist will determine whether the patient is exempt from paying prescription charges or not. If the patient is not exempt and is supplied a medication, the pharmacist will charge the patient an amount equivalent to the prescription charge and will be reimbursed for the consultation fee/NHSBSA Drug Tariff price of medicines issued less the prescription charge.
- The service provider must advertise the service on nhs.uk and keep the Directory of Services up to date for NHS 111 etc.
Location of service
Clinical Commissioning Group (CCG)
Method of commissioning
Source of funding
Other organisations involved
- Pharmacists who deliver this service must complete a Declaration of Competence in Minor Ailments through the Centre of Pharmacy Postgraduate Education (CPPE).
- Pharmacists are expected to reflect on their knowledge, skills and competences before making the declarations, and to address any learning and development before starting to deliver the service. The PGDs are based on NICE clinical knowledge summaries and pharmacists should be familiar with these
- In addition to the Declaration of Competence, pharmacists providing the service need to read all the PGDs and sign the Pharmacist Self Declaration Form in each premises from which they provide the service. A signature on the Self Declaration form is a legal requirement for provision of medicines under PGDs and provides assurance that the pharmacist has personally read PGDs and addressed any learning and development needs.
- Contractors are responsible for ensuring that only pharmacists with a declaration of competence provide the Pharmacy First service within the pharmacy. Only appropriately accredited pharmacists will deliver the Service, and that accredited pharmacists are available whenever the branch is open.
- Contractors should retain a copy of the Pharmacist’s PGD Self Declaration Form, and Declaration of Competence certificate within the pharmacy for inspection.
- Prior to completing their first Pharmacy First provision, the pharmacist must complete an enrolment on PharmOutcomes declaring that they have completed a Declaration of Competence and have read and understood all PGDs within the service.
- The responsible pharmacist on each given day has overall responsibility for ensuring the service is delivered in accordance with this service specification.