Use of the Pharmacy First service in England in the first 12 months: geographic variation and health system context

The Pharmacy First service was introduced in England from 31 January 2024 to expand the clinical role of community pharmacies and improve access to primary care. In the first year of implementation, 2,205,731 consultations were recorded across 11,349 pharmacies with total funding of GBP123 million. Most consultations concerned acute sore throat (33%) and uncomplicated urinary tract infections (27%), with penicillin and nitrofurantoin being the most commonly supplied antibiotics. Self-referral was used by 74% of patients and 95% of consultations were resolved without further referral. Significant geographic variations were observed, with northern regions showing higher utilization. The service operates primarily as a direct-access model for common acute conditions and appears to improve care accessibility while shifting demand away from general practice.