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Frontline pharmacists’ concerns about Pharmacy First implementation shared with DHSC and NHS England officials

The PDA has ensured that the Chief Pharmaceutical Officer for England and senior DHSC civil servants have heard the views of employed and locum pharmacists on how PFS is being introduced.

Fri 19th January 2024 The PDA

NHS England and Community Pharmacy England agreed the terms for the introduction of a Pharmacy First Service (PFS) to commence on 31 January 2024. However, these discussions did not invite the views of those pharmacists at the coal face as collectively represented by the PDA. In response to feedback from members, the PDA conducted a survey to understand the reality of the sector’s preparedness for the introduction of the scheme.

More than 3,500 employed and locum pharmacists who work in England’s community pharmacies responded to the survey which ran between Friday 5 and Sunday 14 January. The PDA believes this makes it the most substantive and recent report of frontline pharmacist experience on the topic and thanks all those members who replied. All the data and comments have been reviewed and this has enabled the PDA to present the evidence directly to the CPhO for NHS England and senior DHSC officials in a meeting on Wednesday 17 January.

Survey Responses

68% of respondents strongly agree/agree with the principle of Pharmacy First, with 84% strongly agreeing/agreeing that it could improve patient care and a similar 77% saying that it could improve professional fulfilment for pharmacists. However, 87% strongly agreed/agreed that if the Pharmacy First Service is not introduced or resourced properly, it could damage the already fragile workforce situation.

In summary, 66% of respondents said that they were not confident that their pharmacy would be able to deliver PFS on 31 January given the current workload, a further 29% were unsure. Only 4% said that they had confidence the sector could deliver the PFS in addition to the existing workload on 31 January.

Many members were worried that the hurried launch, which will be widely promoted by a marketing campaign and referrals from the NHS will result in an increase in their exposure to violence and abuse from members of the public whose expectations will have been raised.


The PDA shared these results with NHS England and the Department of Health and Social Care and suggested changes to the introduction of PFS to support the patient and pharmacist experience in the early stages, such as phasing in the seven new services, giving the sector more time to get ready and managing the associated marketing campaign and in this way reducing their exposure to abuse. As a UK body, the PDA was also able to share the positive experience of our members in Scotland, where a similar service has been in operation for several years and has been introduced more gradually.

The PDA supports the PFS concept and believes that listening to those involved in service delivery and taking the time to ensure the scheme launches correctly will be better for patients and also for pharmacists’ wellbeing.


The PDA raises the issue of insufficient staffing levels in community pharmacy constantly, for example in recent evidence to the Commons Health and Social Care Select Committee inquiry on Tuesday 16 January. Many pharmacists report that they have inadequate staffing to safely deliver existing services, and this is one of the factors behind the current severe recruitment and retention challenges facing community pharmacy.

The PDA recognises that funding for community pharmacy has been cut by the government and this has led to a reduction in pharmacy staffing levels. This vicious cycle needs to be broken and reversed if pharmacy is to reach its full potential.

Community pharmacies will receive funding for extra staff needed for the delivery of PFS. However, use of the funding for extra staff is not being monitored by NHS England and to date, members have said that they have seen little in the way of extra resources being made available. The PDA believes that the staffing levels issue should have received far more attention during the formative discussions around the service.



Many members wanted to check the position of their indemnity cover if they begin to deliver the additional PFS services. Having their own indemnity, rather than being reliant on the employer or any government indemnity scheme, is an important part of the PDA membership benefit.

The PDA can confirm that the current indemnity protection provided automatically as part of their PDA membership will cover pharmacists for their involvement in PFS. This is because the Pharmacy First Service in Scotland which has already existed for several years has operated successfully. However, in light of the hurried launch of the scheme in England and the lack of staff to support it, in the event that there are a large number of claims against pharmacists, it may result in future premium increase.

Act now

As the discussion with NHS England and DHSC did not result in any changes to the national launch plans, the PDA believes that it is important that local Members of Parliament become aware of the staffing levels situation and has therefore produced a template letter which members are encouraged to read, amend as appropriate, and then send to their MP.

click here to Contact your local mp

The PDA will continue to bring to the attention of all policymakers the severe staffing level shortages situation and its likely impact on the safety of patients, pharmacists, and their staff and will continue to press for remedies to be put in place urgently over the course of the next few weeks.


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