Public Holiday Friday 3rd June 2022

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NHS Pharmacy First Scotland

NHS Pharmacy First Scotland will allow community pharmacies to give people expert help for treating conditions such as sore throats, earache and cold sores, along with common clinical conditions such as urinary tract infections (UTI’s). Pharmacy teams offers advice, treatment or referral to other healthcare teams if required. 

This service will help people access the right care in the right place, without having to go to their GP practice or local Accident and Emergency Department for non-urgent treatment.

What is it?

NHS Pharmacy First Scotland (NHS PFS) is a consultation service designed to encourage the
public to visit their community pharmacy as the first port of call for all minor illnesses and
common clinical conditions. It is available in every Community Pharmacy in Scotland and
replaces the Minor Ailments Service.

Who is eligible?

Everyone registered with a GP practice in Scotland or the Defence Medical Services on a
permanent or temporary basis (including care home residents).
People who live in Scotland (including gypsy or travellers / asylum seeker or dependent of an
asylum seeker).

Visitors to Scotland are excluded.
The narrative around the service nationally is intentionally designed not to set the
expectation that a consultation will result in supply of medication, and this messaging
should be carried through locally as well.

What are the possible outcomes?

The patient (or patient representative) will consult with a member of the pharmacy team,
this can be in person or over the phone. The pharmacy team will assess their symptoms
resulting in one or more of the following outcomes:

  • Providing self-care advice to allow patient to manage their symptoms themselves
  • Supply treatment for symptoms either via NHS or for the patient to purchase
  • Refer the patient to another appropriate healthcare professional

There are some medicines available via PGD for the treatment of UTI, skin infections,
impetigo and shingles as below.

  • NB there are strict exclusion criteria so please do not refer patients who will be excluded (see Table 1 below)

Unlike the Minor Ailments Scheme only those medicines that appear on the Pharmacy First
Approved List are available to be supplied as part of the patient’s treatment (see Table 2 for
the conditions included).

Table 1 – Conditions where a PGD exists for treatment

ConditionPatients potentially suitable for referral to NHS Pharmacy First Scotland
Cystitis (UTI)Women ages 16 – 65 except:
Pregnant or breastfeeding women
Catheterised patients
Immunocompromised patients
Vaginal itch/discharge
Blood in the urine
Confused patients
Symptoms for more than 7 days
Had antibiotic treatment for UTI in last month
2 or more UTI episodes in last 6 months
3 or more UTI episodes in last 12 months
Taking a regular antibiotic to prevent UTIs
Symptoms suggesting an upper urinary tract infection such as: Fever, chills, nausea, vomiting, acute onset back pain, loin pain, flank tenderness or systemically unwell
ImpetigoAll patients over 2 years old except:
Impetigo in last 3 months
Multiple sites of skin infection
Underlying skin condition at same site as impetigo
Systemically unwell
ShinglesAll patients over 18 years except:
Rash affecting head, neck, arms or legs (only rash on torso can be treated on NHS PFS)
Rash involving multiple adjacent or non-adjacent dermatomes or where the rash spreads across both sides of the body
Rash present for more than 72 hours
Pregnant or breastfeeding women
Systemically unwell including symptoms of headache or fever
Recurrent shingles (2 or more episodes in patient’s lifetime)
Severe pain not responding to OTC analgesics There are additional PGD exclusions for aciclovir but are relatively rare. Community pharmacists will refer a patient presenting with these back to the practice for assessment.
Skin Infections

Infected insect bite
Cellulitis (patient afebrile and healthy other than cellulitis)

Acute paronychia with signs of cellulitis  
All patients over 18 years except:  
Cellulitis where patient has features suggestive of systemic infection e.g. febrile/feeling unwell
Cellulitis related to animal or human bite
Cellulitis related to surgical wound or chronic wound/leg ulcer/burns
Any sign of cellulitis on the face / around the eye (periorbital/ pre-septal/orbital cellulitis)
Cellulitis on arms or torso NOT linked to an insect bite
Recurrent cellulitis (more than one episode in 12 months)
Acute paronychia with signs of cellulitis AND a collection of pus requiring drainage AND/OR in severe pain
Diabetic foot infection

Table 2 – General Conditions

ConditionPatients potentially suitable for referral to NHS Pharmacy First Scotland


All patients unless severe

All patients over 1 year old

All patients (caution if diabetic)
BBacterial ConjunctivitisRefer to optometry as first option if available
All patients over 2 years old without pain or visual disturbance
DDry Eyes    

Dry Skin
Refer to optometry as first option if available
All patients over 18 years old without pain or visual disturbance or chronic symptoms

All patients except those who have failed to respond to treatment or have symptoms indicative of infection
EEaracheAll patients except:
Systemically unwell
Fluid leaking from ear
Swelling around ear
Hearing loss/change in hearing
Something stuck in the ear
Children under 2 with pain in both ears
H    Haemorrhoids (piles)


All patients over 18 years old except:  
Duration longer than 7 days despite treatment from pharmacy
Blood mixed in stool rather than on surface  

All patients over 1 year old  

All patients unless inflammation of scalp is present
MMouth UlcersAll patients except:
Ulcer present for foe than 3 weeks
Systemically unwell
Significant symptoms (multiple/large lesions)
NNappy RashAll patients except:
Standard treatment fails or symptoms persist
Signs of infection or eczema
RRingwormAll patients except:
Symptoms persist despite treatment
S Scabies

Sore Throat
All patients over 2 years old

All patients except:
Systemically unwell
No improvement in symptoms for more than 7 days
Difficulty swallowing liquids or associated breathing problems


Oral Thrush
All patients over 2 years old except:
Pregnant & breastfeeding women    

Women between 16 – 60 years old except:
Pregnant women
More than 2 episodes in 6 months
Symptoms still present 7-14 days after treatment
Immunocompromised patients
Other symptoms eg frequent urination/vaginal bleeding etc

All patients over 4 months
WWarts & VerrucaeAll patients except:
Warts on face or anogenital region