Pharmacy First, one year on: a survey of community pharmacist perceptions and experiences in South London

Abstract Introduction Pharmacy First,1 introduced in England in 2024, provides consultations and treatments for common health conditions (acute sore throat, sinusitis, otitis media, shingles, impetigo, infected insect bites, uncomplicated urinary tract infections). It also integrates the minor illness consultations and urgent medicines supply elements of the previous Community Pharmacist Consultation Service (CPCS). Clinical pathways for the seven conditions support decision-making, while patient group directions allow the supply of prescription-only medicines.2 There is limited research about service implementation by community pharmacists in England. Aim To assess community pharmacists’ experiences regarding training, workload changes, and perceived challenges associated with the implementation of Pharmacy First in South London. Methods A survey with quantitative and qualitative components was employed from October–December 2024 to explore perceptions and experiences of community pharmacists, following the introduction of Pharmacy First. The target population was community pharmacists working in South London (N = 1016). Convenience sampling was used, with recruitment focused on pharmacists in three boroughs (Hounslow, Lambeth, Sutton), purposively selected to ensure a broad geographical representation across the region. The survey was created on Microsoft Forms and administered in two ways: (1) in-person, with a researcher visiting pharmacies and offering pharmacists the opportunity to complete the survey on a researcher-provided tablet during their visit or later using a QR code, online survey link or paper-based version; and (2) remotely, with survey links shared by email, social media and professional networks. Survey completion implied consent. The survey consisted of 14 items, including open-ended and Likert-type questions. Quantitative data were analysed using SPSS, primarily using descriptive statistics (frequencies, percentages, means). Responses to open-ended questions were analysed using thematic analysis to identify key themes and experiences. Results Of 153 approached, 111 pharmacists responded to the survey (response rate = 72.5%). Over half (60.4%, n = 67/111) viewed Pharmacy First positively, with most of these highlighting its potential benefits for patient care and the public (62.7%, n = 42/67). However, several implementation barriers were identified. Concerns were raised about the initial training offered to deliver Pharmacy First. 53.2% (n = 59/111) felt this was inadequate. Over half felt that public engagement with the service was less than expected (55.9%, n = 62/111). Workload increases and restrictive patient eligibility criteria were also noted as concerns by 79.3% (n = 88/111) and 63.1% (n = 70/111), respectively. Workload concerns were reiterated in open-ended responses, often related to time-consuming administrative tasks and the absence of adequate funding for back-up support staff. Conclusion Pharmacy First is viewed positively, particularly in terms of patient benefits, but implementation barriers such as inadequate initial training, restrictive eligibility criteria, and increased workload may threaten its sustainability. A strength of this study is its timely evaluation of a novel community pharmacy service and recruitment of a reasonable sample of pharmacists, given their busy work settings. However, the findings are limited to one geographical location and more nationally representative research across England is needed. In addition, baseline data on respondent characteristics and consultation activity were not recorded, restricting correlation analyses; future studies should incorporate these metrics to better understand factors influencing Pharmacy First uptake and sustainability.