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The number of GP referrals to the Pharmacy First clinical pathway service in England has varied widely between integrated care boards (ICBs), NHS England data have shown.
The data, obtained by The Pharmaceutical Journal following a freedom of information request to NHS England, revealed that GPs made a total of 167,497 referrals to community pharmacy for Pharmacy First between 31 January and 30 September 2024,.
However, the volume of referrals varied between ICBs, with GPs in NHS Greater Manchester ICB making 11,683 referrals, while 612 referrals were made in NHS Cornwall and the Isles of Scilly ICB.
The Pharmacy First clinical pathway service, which launched on 31 January 2024, provides treatment in community pharmacies for seven common conditions and offers community pharmacies a £15 fee per consultation.
The data from NHS England only include referrals that led to consultations that were completed and claimed for by pharmacists and do not include referrals where the patient did not attend or the consultation was not completed — for instance if a clinical pathway outcome was not reached.
Pharmacists have not yet claimed for all activity undertaken during August and September 2024.
When accounting for the population in each ICB, the data show GPs in NHS North West London ICB made the fewest referrals per 100,000 people at 65 referrals (see Figure).
Meanwhile, GPs in NHS Bristol, North Somerset and South Gloucestershire ICB made the highest number of referrals at 939 per 100,000 people.
NHS England has not previously released data on GP referrals to the Pharmacy First service.
However, the NHS’s 2024 GP Patient Survey revealed in July 2024 that of the 515,642 respondents in England, fewer than 5% were referred to community pharmacy by their GP practice.
A spokesperson for NHS Norfolk and Waveney ICB, which had one of the lowest rates of GP referrals per 100,000 people at 71 referrals, said the ICB recognised that “GP referrals to the Pharmacy First service in Norfolk and Waveney are lower than some areas”.
“Many referrals do happen through verbal signposting though, and these aren’t reflected in the figures,” they said, adding that the ICB is actively working to improve integration and will shortly be launching a GP toolkit to support the promotion of Pharmacy First.
Alison Mundell, community pharmacy clinical lead at Bristol, North Somerset and South Gloucestershire ICB, said that the ICB and Community Pharmacy Avon (CPA) had worked closely together to support surgeries in feeling confident about referring to Pharmacy First.
“CPA has provided one-to-one surgery support to ensure surgeries understand the scope of clinical practice the pharmacies can support, which has in turn led to the pharmacies being able to support and treat a greater proportion of patients,” she said.
Commenting on the NHS data, Alastair Buxton, director of NHS services at Community Pharmacy England, said: “The variability in GP referrals to Pharmacy First across the country is a matter of ongoing concern for us.”
Buxton added that it was “unhelpful and disappointing that so many practices are choosing to signpost patients to pharmacies, rather than making formal referrals,” noting that there is still significant scope for many more referrals to be made from general practices to the Pharmacy First service.
Malcolm Harrison, chief executive of the Company Chemists’ Association, said: “It’s clear that all ICBs can do more to drive Pharmacy First activity. The opportunity to free up GP capacity at a critical time for the NHS is one that must not be missed.”
Kamila Hawthorne, chair of the Royal College of GPs, told The Pharmaceutical Journal that it would be “useful to see further exploration as to whether there are barriers for practices in certain ICBs looking to engage with the scheme and how these can be overcome”.
“The Pharmacy First scheme has the potential to support GPs and provide patients with a convenient pathway to care. But its success hinges on proper implementation, which includes having the right IT systems in place, as well as adequate training for both GP and pharmacy teams,” she added.
A spokesperson for NHS England said that the introduction of the Pharmacy First service “marks a significant expansion” in the offering from pharmacies “with hundreds of thousands of consultations already delivered since its launch”.
