Pharmacy First budget ‘shockingly underspent’ in first half of financial year

The government had spent £82m on Pharmacy First in the 2024/2025 financial year as of 26 November 2024, despite an earmarked budget of £645m to expand community pharmacy clinical services over two years, a health minister has indicated.

In 2023, the previous government promised a £645m investment in community pharmacies over two years to support the new Pharmacy First service, which launched in January 2024, along with the NHS pharmacy contraception and NHS hypertension case-finding services.

However, in response to a written question submitted to the Department of Health and Social Care by Sarah Olney, Liberal Democrat MP for Richmond Park, on 11 March 2025 asking what proportion of the funding had been spent as of 26 November 2024, health minister Stephen Kinnock said that “£82m had been spent in the 2024/2025 financial year on the seven common clinical pathways and associated incentive payments, and on expanding blood pressure and contraception services”.

Kinnock added that a comprehensive view of all spending against the Pharmacy First budget would be available after the end of the current financial year.

Nick Kaye, chair of the National Pharmacy Association, said: “This is a shocking underspend, with only a small percentage of funding earmarked for the scheme actually being delivered to community pharmacies.

“This is not helped by other services informally signposting patients to pharmacies rather than through formal referral mechanisms and a lack of understanding about the minor illness and urgent medicines elements of the service from other health care professionals.”

In December 2024, The Pharmaceutical Journal revealed that the number of GP referrals to Pharmacy First in England varied widely between integrated care boards (ICBs), with GPs in the NHS Bristol, North Somerset and South Gloucestershire ICB making the highest number of referrals, with 939 referrals per 100,000 people.

On the other hand, the NHS North West London ICB made the fewest, with 65 referrals per 100,000 people.

Kaye said that that the government must “urgently clarify how the remaining hundreds of millions of pounds will be invested into pharmacies”.

“We also need clarity about the scheme’s future, with pharmacies currently in the dark about whether Pharmacy First will continue beyond April [2025],” he added.

Data analysis conducted by The Pharmaceutical Journal revealed that 9,600 pharmacies in England missed the Pharmacy First consultation threshold to qualify for the monthly fixed payment of £1,000 between February and May 2024, totalling £9.6m in lost funding.

In February 2025, The Pharmaceutical Journal reported that that pharmacies were still struggling to provide enough consultations to meet the Pharmacy First thresholds.

After March 2025, pharmacies will also need to provide the NHS ‘Community pharmacy contraception service’ and NHS ‘Blood pressure checks service’, in addition to Pharmacy First, to qualify for the £1,000 payment.