Pharmacy First – When can you claim?

We have received queries about when it is appropriate to make a claim for a Pharmacy First consultation and when a clinical record needs to be created.

There are many scenarios within the Pharmacy First service therefore to help pharmacy owners and their teams know when you can make a claim for a payment, we have published a resource to assist with this. The below resource lists the different scenarios, whether you need to make an entry in your Pharmacy First IT system for that scenario and whether you can claim payment:

The Pharmacy First service – When can you claim?

Ensuring that you are claiming for all appropriate consultations is especially important going forward as the minimum number of clinical pathway consultations that cross the Gateway point increases to ten per month from May 2024; this is the minimum number that needs to be achieved for pharmacy owners to be eligible for the monthly fixed payment of £1,000.

Further information on the Pharmacy First service can be found on our Pharmacy First webpage.

FAQs

We have included some of the most common FAQs we have been asked about the different scenarios and whether payment can be claimed for these below:

Q. Will the consultation fee be paid for clinical pathway consultations which pass the Gateway point, but where a medicine is not supplied, as it is not clinically appropriate?
Yes, a consultation fee will be paid for consultations which pass the Gateway point, but where it is not clinically appropriate to supply an NHS medicine. In some cases where a medicine is not supplied, the clinical pathway may advise that the patient returns to consult a pharmacist after several days if the condition has not been resolved.

Q. Where a clinical pathway advises that the patient should return for a further consultation in certain circumstances (e.g. Sore throat FeverPAIN score 2 or 3) will another consultation fee be paid for the second consultation?
Yes.

Q. If I receive a referral but cannot contact the patient, can I claim the consultation fee?
No.

Capture healthcare advisory work not being covered by Pharmacy First to inform our negotiations with Government and NHS.

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