The PDA highlighted to NHS England and DHSC the results of an extensive survey of members which saw over 3,500 pharmacists provide their feedback on their readiness to deliver the pharmacy first service. As a further action, the PDA is reiterating its guidance around the role of the Responsible Pharmacist (RP) after continuing feedback from workplace and regional representatives, and individual members across England.
On Thursday 25 January, NHS England wrote to all community pharmacy contractors, general practice contractors and commissioners, and primary care network clinical directors to confirm that the start date of the new Pharmacy First service will be 31 January 2024. The letter outlines aspects of the service and what contractors should do to prepare for the service including:
- Ensure staff review the CPPE Pharmacy First self-assessment framework to assess their competence to provide all elements of the service
- Ensure they comply with the service specification
- Order an otoscope (this does not apply to distance selling pharmacies); guidance on selecting a suitable otoscope is available in Annex C of the service specification
- Pharmacies may start to deliver the Pharmacy First service without being able to provide the otitis media clinical pathway if they have evidence that they have ordered an otoscope and are awaiting delivery
- From 1 April 2024 an otoscope must be available, and all clinical pathways must be provided
The PDA encourages members who are being asked to deliver PFS to read PDA guidance on the role of the RP. This outlines how pharmacists can comply with their professional responsibilities towards patients when faced with the demand for Pharmacy First consultations to be delivered alongside existing pharmacy services.
The PDA is aware of one major employer issuing advice that if employed pharmacists are not able to confirm that they are competent, as they may not have completed some of the training, they should temporarily suspend the service for the days that it cannot be provided until competent staff are available.
However, this approach is not universal, and the PDA has received other reports of approaches that may place pharmacists under pressure to say they are competent prematurely. These include the threats of the cancellation of existing bookings and no future bookings for locums that do not declare that they will be competent to deliver the service in advance.
The PDA reiterates that operating the Pharmacy First Service is at the sole discretion of the RP each day in each pharmacy, as the Medicines Act places a legal duty on the RP to secure the safe and effective running of the pharmacy. The pharmacy owner is also required under the legislation to enable the RP to exercise his/her professional judgement, as appropriate, in relation to the safe and effective running of the pharmacy concerned.
PDA members are therefore advised that if as the RP they are not confident or competent around the provision of the seven clinical pathways and Patient Group Directions (PGDs), or if they do not have the necessary resources, including sufficient, competent staff, to safely do so, they should follow their employer’s business continuity plans and consider the protocol outlined in the Pharmacy First service specification as follows:
If the service must be temporarily withdrawn by the pharmacy contractor due to circumstances beyond the scope of the business continuity plan, they must inform the NHS Directory of Services (DoS) Provider and Commissioner Helpline (0300 0200 363) as soon as possible to stop referrals being made to the pharmacy. GP practices and UEC settings within the local primary care network (PCN) must also be contacted to prevent them making further direct referrals. The pharmacy contractor must also inform the local commissioner of the service of their temporary withdrawal from the service.
Members who require further assistance can contact the PDA Member Support Centre.
In the meantime, the PDA is liaising with NHS England and others to ensure the experience and views of frontline pharmacists continue to be heard. The PDA will continue to engage members after the PFS launch happens tomorrow.
Learn more
- Frontline pharmacists’ concerns about Pharmacy First implementation shared with DHSC and NHS England officials
- PDA members can contact their local MP about their concerns
- PDA advice to Responsible Pharmacists about managing the PFS workload
- PDA welcomes announcement of PFS if implemented appropriately
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