Jean-Marc Pierard/ Alamy Stock Photo
Community pharmacist prescribers will be able to supply treatment to patients who were not previously eligible for the existing seven Pharmacy First patient group directions (PGDs) in England because of their age, a senior NHS England figure has said.
Speaking at the Pharmacy Show, held in Birmingham on 12 October 2026, Kirsty Armstrong, senior policy lead for clinical strategy for pharmacy at NHS England, told delegates that while a clear age range for available services will still be communicated to the general public “to manage expectations”, a prescriber would be able to use their clinical judgement if a patient falls slightly outside the age range or needs an alternative medicine.
Currently, there are limits on who can receive some Pharmacy First treatments, such as sore throat for a child aged under five years, but Armstrong suggested that while some red lines will still be in place, there will be flexibility for independent prescribers.
Prescribers will also be able to supply an alternative to a prescription issued by a GP if it is in the patient’s best interest and there are no other suitable options, such as supply through a serious shortage protocol.
According to draft prescription management guidelines shared by Community Pharmacy England (CPE) on 9 October 2026, prescribers may also be able to correct a prescribing error, synchronise prescriptions or participate in local medicines optimisation switches.
Armstrong said that flexibility within prescribing would be a “cultural change” for pharmacists working as prescribers.
“We’ve worked with very defined principles, as pharmacists, for a really long time. We’ve got to kind of unlearn those behaviours a little bit,” she added.
“Ultimately, as a prescriber, you are making a clinical decision yourself, and you will document why you have made that decision, and what you’ve excluded, and what your differential diagnosis thought process has been.”
Armstrong also outlined more detail about the five new Pharmacy First prescribing pathways, including steroid nasal spray for children with allergies, otitis media in adults, topical treatments for acne, treatment for defined mild skin infections and NHS treatment of scabies.
Permethrin cream to treat scabies can currently be bought from a pharmacy, but Armstrong said it had been commissioned for community pharmacist supply for public health reasons.
In addition, she noted that instances of scabies were increasing, while enabling community pharmacists to supply an NHS prescription for permethrin would help improve access to treatment in more deprived areas of England.
Armstrong also set out other ways that independent prescribers will be able to expand treatment, including enabling additional contraception products, such as vaginal rings, patches and oral medicines for contraception.
New pathways will also enable migraine treatment for those who haven’t been diagnosed yet, she continued.
An independent community pharmacy prescribing service was announced as part of the ‘Community pharmacy contractual framework’ in May 2026, which allows qualified pharmacists to prescribe within existing Pharmacy First and contraception services, as well as in additional pathways and prescription management.
Wasim Baqir, head of pharmacy integration at NHS England, said pharmacies could sign up to deliver prescribing services but begin with the pathways that they felt comfortable providing and then upskill to work towards providing the rest.
He also said that a prescribing pharmacist could be linked to multiple pharmacies.
The prescribing services would not be promoted nationally, as they would not be available in every pharmacy, but NHS England would produce templates for local communications, Baqir added.
Around one in five community pharmacies in England could offer a prescribing service, but not all will choose to do so because of limited funding for the service, CPE has warned.
