Services and Regulatory changes coming into force today

Today (Wednesday 1st October 2025), several service and regulatory changes have come into effect, as well as today being the start date for several national services.

Below is a summary of all these service developments and regulatory changes.

Commencement of services

From today, pharmacies registered to provide the services, can start to provide the Childhood Flu Vaccination Service and COVID-19 Vaccination Service.

Vaccination of all eligible groups for the Adult Flu Vaccination Service can also start (only pregnant women have been able to get vaccinated since 1st September 2025).

Updated clinical pathways, protocol and PGDs for Pharmacy First

Today is also the day for pharmacy owners to start using the updated Pharmacy First clinical pathways, protocol and Patient Group Directions (PGDs).

NHS England confirmed this in their Primary Care Bulletin last week, after receiving confirmation that the necessary changes to the clinical IT systems will be made on schedule.

IT system suppliers have amended their existing systems to incorporate the updates to the service so that from today, the updated service can be provided in accordance with the updated service documentation.

NHS England has published on their website the final updated clinical pathways, protocol and PGDs, as well as an updated master PGD authorisation sheet, which pharmacists can choose to sign instead of having to sign each individual PGD.

Directed services can no longer be provided at distance selling premises (DSP) pharmacies

From today, DSP pharmacies can no longer provide Directed services (Advanced, National Enhanced and Enhanced Services)* face-to-face with the patient at the pharmacy premises.

DSP pharmacies can now only provide Directed services remotely from the DSP pharmacy premises, similar to the delivery of Essential services or if the service specification permits, face-to-face with the patient off-site.

Read more about the changes of provision of services at DSP premises

* DSP pharmacies can continue to provide COVID-19 and Flu vaccination services at the pharmacy premises, as part of an Advanced, National Enhanced, or Enhanced service, until 31st March 2026.

Hub and Spoke dispensing NHS Terms of Service

New hub and spoke dispensing regulations come into force today, as do the Human Medicines Regulations 2012 (HMRs) hub and spoke changes announced in April this year. They complement each other and apply to owners of NHS spoke pharmacies/pharmacy owners when the hub pharmacy is owned by a different legal entity.

Read more about the new Hub and Spoke dispensing NHS Terms of Service

Additional regulatory changes

Several other regulatory changes come into effect today, having been included in the amendment regulations (The National Health Service (Pharmaceutical and Local Pharmaceutical Services) (Miscellaneous Amendments) Regulations 2025) laid before Parliament at the beginning of September 2025.

These include:

• the removal of the requirement to produce a practice leaflet for all pharmacies; and
• the removal of the requirement to obtain references for all staff involved in the provision of NHS services.

Read more about the additional regulatory changes

NMS subcontracting will no longer be permitted

Changes will be made to the New Medicine Service (NMS) Service Directions to clarify that NMS may not be provided via a remote consultation with the patient by a pharmacist working off the pharmacy premises who is not employed by the pharmacy owner. The changes to the Directions are expected to be made later this month.

 ABPM bundling requirement delayed

As announced yesterday, DHSC, NHS England and Community Pharmacy England have agreed that the requirement to provide one Ambulatory Blood Pressure Monitoring (ABPM) consultation per month as part of the ‘bundling’ requirements to achieve a Pharmacy First fixed monthly payment will not go ahead from 1st October 2025 as originally planned.