How many Pharmacy First consultations have pharmacies done so far?

Short answer: pharmacies in England completed around 4.5 million Pharmacy First consultations between February 2024 and October 2025. That is a substantial new volume of clinical work delivered through community pharmacies—and a useful reminder that Pharmacy First depends on having enough trained people on the rota, not just enough patients who need care.

The figure is a cumulative total across the service period, not a count of consultations in October alone. Pharmacy First launched in England on 31 January 2024, with activity reported in monthly returns. When quoting a total, it is worth stating the end date and checking the relevant NHS or NHS Business Services Authority (NHSBSA) release: later monthly data can change the cumulative figure, and published totals may be revised.

This article explains what the 4.5 million figure represents, how Pharmacy First payments fit into the picture, and why recruitment alone may not be enough to sustain the service. It also looks at how apprenticeships can help community pharmacies build skills and capacity over time.

What does “4.5 million Pharmacy First consultations” mean?

Pharmacy First is an NHS service in England that lets community pharmacies provide advice and, where clinically appropriate, treatment for certain common conditions. It also includes referrals from NHS 111, general practice and urgent care settings. Pharmacies can assess patients under seven clinical pathways:

• Sinusitis
• Sore throat
• Acute otitis media, or ear infection
• Infected insect bites
• Impetigo
• Shingles
• Uncomplicated urinary tract infections in eligible women

The 4.5 million headline is a count of consultations reported over the period February 2024 to October 2025. It is not the number of unique patients: one person may have more than one consultation. Nor does every consultation mean a medicine was supplied. The pharmacist assesses the patient and decides what action is appropriate, which may include self-care advice, a prescription where the pathway allows it, or referral to another service.

That distinction matters when comparing Pharmacy First with GP appointments or counting the service’s impact. Consultation volume shows how much activity pharmacies have handled; it does not, by itself, tell us how many GP appointments were avoided or how quickly patients recovered. Those questions require different data.

Why Pharmacy First increased workload in primary care

Pharmacy First was designed to give patients another route to care and make better use of community pharmacy expertise. For patients, a local pharmacy may be more convenient than waiting for a GP appointment for a condition covered by a pathway. For the wider system, the service creates more capacity to assess common conditions outside general practice.

But new access does not mean the work happens automatically. Each consultation takes staff time, and that time includes more than speaking with a patient. A pharmacy team may need to:

• check the patient’s symptoms, history and eligibility against the pathway;
• carry out an appropriate assessment and explain the options;
• document the consultation and submit the required claim;
• arrange a referral when the patient needs care elsewhere; and
• fit the work around dispensing, advice, deliveries and other services.

That is why the 4.5 million total should be read as a workforce story as well as a service-use story. More consultations mean more clinical work to plan, record and deliver safely. The pressure can be especially noticeable at busy times, when an unplanned consultation arrives alongside a queue, a prescription query and a short-staffed shift.

Pharmacy First payments: what should pharmacies check?

Pharmacy First payments matter because the service uses staff time, clinical space, systems and training. But a headline payment figure does not show whether a particular pharmacy has recovered its costs. The answer depends on consultation volume, staffing, local operating costs and the current payment rules.

For accurate figures, pharmacies should use the latest NHS England and NHSBSA guidance rather than rely on an old article or a figure copied from the service launch. Payment arrangements and thresholds can change. The key points to check in the current guidance are:

• the fee payable for an eligible consultation;
• whether a fixed monthly payment applies and what conditions the pharmacy must meet;
• which consultations qualify for payment;
• the submission and claim deadlines; and
• how rejected or incomplete claims are handled.

In other words, “Pharmacy First payments” should be discussed with a date attached. A payment rate from the first year of the service may not describe the arrangements in October 2025. Pharmacies should also distinguish between the number of consultations completed and the number accepted for payment: they are related measures, but they are not automatically identical.

More clinical activity, a stretched community pharmacy workforce

Community pharmacies have taken on more clinical responsibilities while continuing to deliver their core services. At the same time, employers have faced challenges recruiting and retaining pharmacists and support staff. Workforce shortages do not affect every pharmacy in the same way, and vacancy rates vary by location and role. Still, a rota with little spare capacity can make each additional service harder to absorb.

When a pharmacy cannot fill a shift, the impact is practical: fewer people to cover the counter, answer calls, prepare prescriptions and make time for consultations. A service may be available on paper, but its real-world capacity depends on who is present, what skills they have and whether the team can protect time for clinical work.

Owners and managers know the familiar pressure points. A colleague calls in sick; a delivery arrives late; the queue builds just as a referral comes in. A recruitment plan that assumes every shift will be fully covered does not account for those ordinary disruptions. Pharmacy First adds value, but it also makes workforce planning more important.

Why recruitment alone often fails in a tight labour market

Recruitment matters. Pharmacies need to advertise roles clearly, respond to applicants promptly and offer employment terms that can compete locally. But a vacancy advert cannot create qualified staff where the local labour market has few available candidates. If several employers are chasing the same people, relying only on external recruitment can leave a pharmacy repeatedly starting from zero.

Recruitment-only strategies also overlook retention and development. A new hire still needs induction, support and a manageable workload. Existing staff may be ready to take on more responsibility, but they need structured training and protected time to do it safely. Without that support, employers can lose people just as quickly as they recruit them.

A more resilient approach combines recruitment with development: bring in experienced staff where possible, support current employees to gain relevant skills and create routes for new entrants to grow into future roles. That is not an instant fix for a vacant pharmacist post. It is a way to reduce dependence on a single route to staffing over the longer term.

How apprenticeships can create a staffing pipeline

An apprenticeship is a paid job with structured training. It gives an employee a chance to develop skills while contributing to the workplace, with learning and assessment linked to an approved apprenticeship standard. For a community pharmacy, the value is not simply “extra hands”. The employer needs to choose a suitable programme, provide supervision and give the apprentice time to learn.

That makes apprenticeships a planned workforce option rather than a quick response to tomorrow’s rota gap. Employers can use them to develop support staff and build capability within the team, while being clear about what the apprentice can and cannot do at each stage. The pharmacy remains responsible for safe practice, appropriate supervision and complying with service requirements.

For providers and course options, employers can review the Tend Training pharmacy apprenticeship training category page. Before enrolling, check the relevant apprenticeship standard, eligibility, programme content, delivery arrangements and funding rules with the training provider. Match the training to a real role and a realistic supervision plan, rather than choosing a course because the word “apprenticeship” sounds like a workforce solution by itself.

What a workable apprenticeship plan looks like

1. Identify the role. Decide which skills the pharmacy needs and what duties the apprentice may take on as they progress.
2. Choose the right programme. Confirm that the apprenticeship standard fits the job and the learner’s starting point.
3. Name a supervisor. Allocate someone who can coach the apprentice and check their work—not just sign forms.
4. Protect learning time. Agree how training will fit around the rota, and avoid treating every learning hour as spare capacity.
5. Review progress regularly. Set practical checkpoints with the apprentice and provider, and adjust support when the workload changes.

Apprenticeships take time, so they will not immediately solve a staffing shortage or replace the need for qualified clinicians. Their benefit comes from building skills in a planned way and giving people a supported route to develop within the sector. That can make a pharmacy less reliant on finding every skill in the external labour market at exactly the moment it needs it.

Turning consultation volume into sustainable capacity

The headline of 4.5 million Pharmacy First consultations from February 2024 to October 2025 shows how thebusinessdesk.com much activity community pharmacies have delivered. It also raises a practical question for owners: can the team keep providing the service alongside everything else the pharmacy does?

A useful workforce review starts with actual local numbers, not a national headline alone. Look at consultations by month, staffing hours, missed or delayed work, sickness cover, claim outcomes and the time needed for documentation. Then ask where training, retention changes or recruitment would make the biggest difference. If you compare activity with payments, use the payment rules that applied during the same period.

Question What to check How much Pharmacy First work is coming in? Monthly consultation volume, referral source and pathway mix. Can the rota absorb it? Staffing hours, cover arrangements, consultation space and pressure points by day or shift. Are claims being paid as expected? Current NHS guidance, eligible activity, submission dates and rejected claims. Where could development help? Roles that could be supported through training, supervision and a suitable apprenticeship.

The bottom line

By October 2025, pharmacies had completed around 4.5 million Pharmacy First consultations since the service began. That is a meaningful contribution to primary care, but consultation totals do not remove the need to plan for staff, time and safe delivery.

Pharmacy First payments should always be checked against the rules and dates that apply to the period being discussed. And while recruitment remains essential, it is a fragile strategy if it is the only one. A combination of recruitment, retention and structured development—including well-supported apprenticeships—offers pharmacies a more realistic way to build capacity for the work patients are already asking them to do.