Prescription medication without GP appointment

The challenges of the GP shortage

The NHS England GP Patient Survey 2024 found that 34.1% of patients felt their wait time for a GP appointment took too long. Due to factors such as retirement, doctors leaving the profession and a struggle to recruit new GP’s, the NHS is seeing longer wait times for patients.

In September 2024, the NHS in England had the equivalent of 1,557 fewer full-time fully qualified GPs than in September 2015. The GP shortage has had consequences for the public such as a lack of continuity of care, longer waiting times and reduced access to services - particularly in areas of high socio-economic deprivation.

Patients are now seeing 8am telephone queues for appointments as the only viable option to see a GP. As expected, these appointments are limited, leaving those without appointments to attend a crowded Urgent Care Centre or an overrun Accident & Emergency Department.

Government pledge

In 2019, Boris Johnson pledged to hire 6,000 new GPs by 2024, however in February 2024, the then Prime Minister, Rishi Sunak, admitted the government has failed on a pledge to cut NHS waiting lists in England.

A year later in February 2025, current Prime Minister Keir Starmer said the government has met a key election pledge to deliver two million extra NHS appointments in England in its first year.

He said the "milestone is a shot in the arm for our plan to get the NHS back on its feet and cut waiting times", while Health Secretary Wes Streeting said there was still "a hell of a lot more to do".

With so many patients still waiting for GP appointments, the introduction of the Pharmacy First care reforms could see millions of people in England receive a diagnosis and treatment from a pharmacist, rather than a GP.

Treatment for seven common conditions ranging from infections to female contraception are set to fall under the new proposals aimed at reducing the burden on GPs and free up more appointments over the next two years. As well as the ability to self-refer for services such as podiatry, physiotherapy, and hearing tests. Though on paper this seems like a good idea, there are concerns this new service will be misused, or worse, cause more problems than solutions.

What is Pharmacy First?

The Pharmacy First scheme was launched by the government and NHS England in January 2024 to give patients quick and accessible care and ease pressure on GP services. It enables pharmacists to supply prescription-only medicines, such as antibiotics and antivirals, to treat seven common health conditions without the need to visit a GP. Considering the wait time for GP appointments, it is hoped that pharmacists being able to provide healthcare services would help patients be seen sooner, whilst also relieving some of the pressure from GP services.

What are the 7 conditions for Pharmacy First?

The seven conditions covered by the Pharmacy First scheme are:

• Sinusitis
• Sore throat
• Earache
• Infected insect bite
• Impetigo (a bacterial skin infection)
• Shingles
• Uncomplicated urinary tract infections in women.

Through the pharmacy first scheme, patients can receive care for ailments, such as earache, without battling the notorious wait times for GPs.

Pharmacy First: The concerns and considerations

Pharmacists would be responsible for prescribing medication for ‘less serious conditions’, however this would rely on patient’s knowing how serious their condition is. This could leave room for error, misdiagnosis, and a delay in the provision of more specialist treatment and referral. Some of the conditions that would fall under this reform would require antibiotics.

There is strict guidance for antibiotic prescriptions due to the growing number of antibiotic-resistant bacteria. Other common ailments are caused by viruses which are usually treated by allowing to run their course and which antibiotics would have no effect upon. While pharmacists are one of the professionals at the forefront of these prescription guidelines, there is concern that they are being turned to as ‘pill-dispensers’.

Others have concerns that the proposals don’t address the underlying issues of recruitment and retention that urgently need addressing to keep GPs within the NHS. It is thought that many pharmacies would be unable to offer these new services thus patients would not benefit and still have to wait for a GP appointment regardless. There is no doubt that being told to start from square one would upset and frustrate many people. Of course, there will be pharmacies that could offer these services, but they might not be your local one.

Could the Pharmacy First scheme worsen healthcare inequality?

Healthcare ‘postcode lottery’ has been recognised for many years. Areas of England have a higher rate of amputations, for example, due to a range of socio-economic factors. It’s a trend recognised in clinical literature and these reforms could certainly exacerbate the existing inequalities in healthcare provision across England.

Accessing healthcare faster is the main priority and for many conditions, is critical to the outcome. This ambitious package is welcomed as a step in the right direction to achieving faster and greater access to healthcare. A lasting change from the COVID-19 pandemic was telephone and video call consultations which has achieved the same.

It’s thought that these new proposals will free up staff so they can spend more time with patients. However, with concerns over the availability of this service across the country and a risk that such a scheme will reduce the pressure for increased GP funding, it is critical that the Pharmacy First scheme is managed correctly and for the benefit of patients. Many believe this is simply a short-term solution and over the long-term, and primary care needs as much investment and priority as reducing hospital backlogs.

How we can help

The increasing difficulty to secure GP and hospital appointments could cause a rise in delays of diagnosis and treatments. We’ve supported thousands of those who’s conditions have been worsened due to medical negligence. Alongside specialist clinical negligence solicitors, our team includes trained nurses and midwives who provide us with the expert industry knowledge required to support your case.

Even if you’re unsure of whether you have a claim, our solicitors are on hand to assess your individual circumstances and advise your next steps. Get in touch with us today on 0330 041 5869 or contact us here.