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Independent prescribing pharmacists in England will be able to prescribe for migraine, rhinitis, ear infections in adults, acne and scabies as part of the Pharmacy First scheme, NHS England has announced.
In a press release published on 10 September 2026, NHS England said that the five conditions will be added to the existing seven clinical pathways available via Pharmacy First for pharmacies that employ an independent prescriber.
NHS England noted that from autumn 2026, these pharmacists will be able to provide prescriptions for all Pharmacy First conditions, including the additional five, and the pharmacy contraception service.
Once fully rolled out, up to 3 million pharmacy appointments for the five new conditions could take place in community pharmacies each year, it added.
The government committed to commissioning a national NHS prescribing service from community pharmacy — as an extension of Pharmacy First — in the ‘Community pharmacy contractual framework’ (CPCF) for 2026/2027 agreement published in May 2026.
To offer the prescribing service, pharmacies must be registered with NHS England as a ‘prescribing pharmacy’.
After the prescribing service was announced as part of the CPCF for 2026/2027, the negotiator warned that there was “not enough money in the contract to really set it up with a solid foundation”, adding that contractors “should think really carefully about whether to actually engage with the service”.
Janet Morrison, chief executive of Community Pharmacy England, said: “Community pharmacists already play an important role in helping people to manage minor illnesses, and we welcome plans to further develop the well-received Pharmacy First service.
“The expanded offering will make better use of pharmacists’ expertise and give patients quicker access to advice and treatment for a wider range of ailments. It also paves the way for pharmacists to be core community clinicians, cementing their role in neighbourhood health services.”
The new prescribing pathways will cover low-frequency episodic migraine in adults, seasonal allergic rhinitis in children, acute otitis externa in adults, mild-to-moderate acne in young people and adults, as well as mild skin and soft tissue infections and scabies.
Rob Music, chief executive of The Migraine Trust, said the charity was “delighted” to see migraine added to Pharmacy First in England.
“Following a successful project in Scotland highlighting the opportunities that better migraine support at a local pharmacy level can have, The Migraine Trust has been calling for a wider roll-out of migraine care within pharmacy settings,” he said.
“Our recent research highlighted that people with migraine can struggle to access timely care, and NHS England patients being able to have this support through their local pharmacy is a wonderful opportunity for a faster and improved care pathway.”
Yvette Cooper, secretary of state for health and social care, commented: “Pharmacy First is helping millions of people across the country get faster, easier care, closer to home already. Being able to go to your local pharmacy for more everyday conditions will make it easier for people across the country to get advice and care when they need it.
“Community pharmacies are vital to shifting care into the community, and this initiative makes the most of our skilled pharmacists so patients can get on-the-spot treatment. It also helps ease pressures on other parts of the NHS with early intervention.”
Henry Gregg, chief executive of the National Pharmacy Association, said: “This is a really significant announcement, and it is great to see patients being able to be treated for more conditions on their doorstep at their local pharmacy, without having to see a GP.
“We want to see the government turbo charge the role of pharmacies, including rolling out more prescribing services to patients on the NHS.
“In Scotland, patients can be treated for 27 different conditions at their pharmacy, with a third of the population accessing this service last year, many steps ahead of England.
“Pharmacies are still under significant financial pressures and this just shows why the government should go much further and invest in our pharmacy network that has the power to transform people’s experience of everyday health issues.”
Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA) also welcomed the announcement.
“Expanding to more pharmacy first conditions is an important step towards making better use of pharmacists’ clinical expertise and giving patients greater access to more convenient NHS care,” he said.
In a report published on 20 May 2026, the CCA and Pfizer said that expanding Pharmacy First to include migraine would reduce pressure on other healthcare settings, ensure faster access for patients and enable people suffering from migraine to get back to work sooner.
“However, success will depend on implementation at scale, allowing patient behaviours to change at a national level. The funding identified is likely insufficient for the wider adoption needed for change. Independent prescribing services need to be sustainable and enable enough pharmacies to take part that allows the whole workforce to evolve,” Harrison added.
“Independent prescribing is a landmark opportunity to change how patients access care. Funding and implementation must now match that ambition and opportunity.”
Leyla Hannbeck, chief executive of the Independent Pharmacies Association, said: “Being able to access consultations for additional common, but painful, conditions at local high-street pharmacies — without the need for a GP appointment — will ensure quicker access to treatment.”
She added: “By utilising the potential of pharmacies to treat more straightforward conditions, millions of GP appointments can be freed up, making this a true win-win for both patients and the NHS.
“But pharmacies can only help take the strain if they can keep their doors open. More than 600 local pharmacies have closed over the past twelve months alone. To stop the tsunami of closures, ministers need to treat pharmacies fairly and deliver the business rates relief that other NHS high-street providers, such as GP practices and dental surgeries, already enjoy.”
Mahendra Patel, chair of the Royal College of Pharmacy’s English Pharmacy Advisory Council, said: “The expansion of clinical services not only empowers patients with greater choice on where and how they receive care but also makes the most of the valuable skills of pharmacists and their teams.
“It reinforces the value of the clinical expertise that pharmacists bring to patients, communities and the wider NHS, through providing services that are convenient, accessible and trusted by the public.”
