Pharmacy First – Early experiences

Reena Barai is a community pharmacist and owner of the family business, SG Barai Pharmacy in Sutton in Surrey. In this series of short videos, she describes how she and her team prepared for and implemented Pharmacy First Services and how the first few weeks turned out

What is the Pharmacy First Scheme and how can pharmacies get started?

The Pharmacy First Service embraces several aspects including the emergency supply of medications after referral from NHS 111 and dealing with minor illness referrals from GPs. Probably the area that has attracted most attention is the management of seven common infections in accordance with clinical protocols and Patient Group Directions (PGDs). The PGDs now allow community pharmacists to supply antibiotics to certain patients so that uncomplicated minor infections can be treated promptly without the need to visit a GP. They represent a stepping stone towards a broader community pharmacy service, says Ms Barai.

Marketing of the new service to GPs and patients was a key element of the preparations for the Pharmacy First Service.

Practicalities – what worked well in Pharmacy First?

Ms Barai was in contact with her local GPs from an early stage.  “The fact that we’ve got good, open dialogue and good relationships with our general practice colleagues is really helping to implement the service”, she says. Her team has also made use of AccuRx software to create templates for the safety-netting information and leaflets that have to be given to patients treated under one of the seven clinical pathways. AccuRx has also been used (with patient’s permission) to look at health records when detailed medical information was required to satisfy exclusion criteria in PGDs.

Some 41 patients were referred in the first month and 10 of those met the clinical pathway gateway, says Ms Barai. For seven of these, treatment was supplied using the PGD and the remaining three were provided with support for self-care.

Pharmacy First – where is it going next?

Reflecting on what has worked well and what is needed to carry the developments forward Ms Barai advises community pharmacists to think differently about how services are organised.  For example, in her pharmacy she is training an accredited checking dispenser and has set up an appointments system – measures that will allow better organisation of time and personnel for Pharmacy First consultations.

Another important step is preparation for the arrival of the 2026 cohort of pharmacy graduates, all of whom will be independent prescribers.  These people will look for places where they can use their prescribing skills in satisfying jobs and well-developed Pharmacy First Services will contribute to an attractive working environment, she predicts.

About Reena Barai

Reena Barai started her career as a hospital pharmacist 25 years ago and then took over her family (community pharmacy) business 20 years ago. She works in the pharmacy six days a week, running the pharmacy. In addition, she is a co-founder and co-host of the Female Pharmacy Leaders Network and until recently she was the co-chair of an Integrated Neighbourhood Team. Previously  she has worked in primary care and as a GP practice pharmacist and has been a CPP tutor. She has also served as a  board member of the National Pharmacy Association and as a Committee Member of what was the Pharmaceutical Services Negotiating Committee (PSNC),  now Community Pharmacy England (CPE).

Read and watch the full series on our website or on YouTube.

This episode of ‘In Discussion With’ is also on Spotify. Listen to the full podcast now.