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More than 1 million people in England with acute headaches and migraines could be supported through community pharmacies, an analysis published by the Company Chemists’ Association (CCA) and Pfizer UK has suggested.
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.
In England, headaches account for around 2.5 million primary care appointments and 100,000 hospital referrals each year, the report noted.
Pharmacy First was introduced in England at the end of January 2024 and currently offers seven clinical pathways: acute otitis media, acute sore throat, impetigo, infected insect bites, shingles, sinusitis, and uncomplicated urinary tract infections in women.
Malcolm Harrison, chief executive of the CCA, commented: “Headaches are the cause of millions of NHS appointments every year and have contributed to sharp increases in A&E attendances. Pharmacists are ready and willing to ease that pressure by supporting up to 1.25 million patients annually through the Pharmacy First service.”
Rob Music, chief executive of national charity the Migraine Trust, said: “We know that pharmacy can play an important, yet often underutilised role, in migraine care… equipping community pharmacies with the information and confidence to support patients to manage their migraine will have benefits for patients, by enabling them to receive care closer to home, as well as reducing the capacity impact on secondary care.”
Music also highlighted a two-year project undertaken by the Migraine Trust and NHS Grampian in Scotland, which trained community pharmacists to identify and manage migraine.
Also responding to the report, Henry Gregg, chief executive of the National Pharmacy Association, said: “In England, pharmacists can only treat 7 conditions [under Pharmacy First], but in Scotland, it is 27.”
By expanding the number of conditions under Pharmacy First in England, “the government has a once-in-a-generation opportunity to turbo-charge the role of community pharmacy, who have a vital part to play in creating a redesigned neighbourhood health service,” he said.
The CCA’s suggestion was also welcomed by other community pharmacy bodies, but all stressed that expanding Pharmacy First would need to come with adequate funding.
A spokesperson for the Pharmacists’ Defence Association said: “Many pharmacists and their teams are under significant pressure themselves and are already operating at or beyond safe capacity.
“Further expansion of Pharmacy First would pose significant risks unless the underlying workforce constraints are addressed.”
Leyla Hannbeck, chief executive of the Independent Pharmacies Association, added: “Pharmacy First will only reach its true potential — and deliver maximum benefits for patients and the NHS — if it becomes a pull service and not a push service. Too many GP surgeries are failing to properly refer patients to their local pharmacy when that is the quickest and most effective treatment path.”
Amandeep Doll, director for England at the Royal College of Pharmacy, commented: “As the government looks to shift care from hospital into the community, there is a clear opportunity to build on Pharmacy First and ensure the future NHS makes the most of the new generation of pharmacist prescribers in all care settings.
“Any expansion of services must be supported by sustainable investment in community pharmacy, alongside appropriate training, clinical governance and referral pathways to support safe, high-quality patient care.”
In response to a question in the House of Lords about adding migraine care to Pharmacy First, delivered on 23 March 2026, health minister Baroness Merron said: “We constantly review and discuss with pharmacists the range of conditions they cover. It has been one of the highly successful ways of making community based care available, and we certainly want to continue to work with pharmacists.
“It is also important to note that more modern treatments are available now on prescription, which will also support people to manage their condition and will reduce unnecessary A&E admissions.”
