A report released today by the Company Chemists’ Association has called for Pharmacy First to be expanded with more treatment options and conditions to build on pharmacists’ roles in the battle against antimicrobial resistance.

The CCA said it collated data from over 3,000 pharmacies in August and September this year and used anonymised consultation records for more than 150,000 patient interactions for six of the seven conditions under the service and concluded pharmacists were “closely adhering to the pathways set out by patient group directions and only supplying antibiotics when appropriate.”

The CCA said shingles was not included in the study because it is a viral infection and cannot be treated by antibiotics. It found 66 per cent of about 117,000 people who were referred to pharmacies for one of the other six conditions were given antibiotics.

It said “actual antibiotic supply rates” are “even lower” because “many patients attending pharmacies are pre-screened before consultations.”

The supply of oral antibiotics was not the most common outcome for three conditions – ear infections, impetigo and sinusitis – during clinical pathway consultations.

The report said pharmacists are “strictly adhering to the treatment guidelines outlined to them,” with 88 per cent of antibiotics supplied as first-line treatments.

The rate of antibiotic supply through Pharmacy First, it said, was “lower than or in line with prescribing rates in general practice” for four of five conditions. The CCA said although general practice “is not directly comparable to community pharmacy for various reasons, it may provide a useful point of reference.”

Pharmacists can manage patient expectations for antibiotics

The report, which found 94 per cent of patients received treatment or advice without the need for referral, said less than half of patients received oral antibiotics when alternative treatments were available.

“Pharmacists can manage patient expectations for antibiotics and provide the most appropriate treatment,” it concluded, insisting “pharmacists are responsible providers of antibiotics.”

“The data shows that antibiotic supply is lower where there are a range of different treatment options available.”

The CCA urged NHS England to expand Pharmacy First to include lower back pain, respiratory tract infections, conjunctivitis and skin conditions such as acne, eczema and psoriasis. The CCA also called for more treatment options to be added to the service, such as simple analgesics and mouthwashes for sore throat.

CCA chief executive Malcolm Harrison insisted the integration of pharmacist prescribing into Pharmacy First must happen “as soon as possible” and said “the clock is ticking on the first cohort of prescribing pharmacist registrants in 2026.”

The CCA said integrating pharmacist prescribing into the service will ensure patients are prescribed the most appropriate treatment whether it is an antibiotic or not.

Harrison also said pharmacies must be commissioned to capture information on patients who do not meet Pharmacy First gateway criteria.

“This accounts for a large and rising, but ultimately unfunded workload to pharmacy teams,” he said. “Collection of this data will allow us to measure the impact of this unfunded work but also develop our understanding of antibiotic provision.”