England
The flu vaccine is given free on the NHS to adults who:
✚ Are aged 65 years and over
✚ Have certain health conditions
✚ Are pregnant
✚ Are in long-stay residential care
✚ Receive a carer’s allowance, or are the main carer for an older or disabled person who may be at risk if you get sick
✚ Live with someone who is more likely to get a severe infection due to a weakened immune system, such as someone living with HIV, someone who has had a transplant, or is having certain treatments for cancer, lupus or rheumatoid arthritis.
You should talk to your doctor if you have a long-term health condition that is not included in one of the health conditions eligible for the vaccine. They should offer you a flu vaccine if they think you’re at risk of serious health problems if you get flu. Also, your pharmacy might be able to provide a vaccine under a private service.
This is not the complete list of eligible groups. More information is available via www.nhs.uk/conditions/vaccinations/flu-influenza-vaccine
Scotland
NHS Scotland recommends a person has the flu vaccine if they:
✚ are aged 65 years and over
✚ are aged 18–64 with an eligible health condition
✚ work in social care and deliver direct personal care
✚ are a frontline healthcare worker
✚ are a carer (including unpaid carer)
This is not the complete list of eligible groups. For more information on eligibility and how to receive a vaccination, visit the NHS Inform website (www.nhsinform.scot).
Wales
In Wales you are advised to have a flu vaccine if:
✚ You are pregnant
✚ You are aged 65 or over
✚ You are aged six months to 64 years and have a long-term health condition that puts you at increased risk from flu, including but not limited to:
Diabetes
A heart problem
A chest complaint or breathing difficulties, including chronic obstructive pulmonary disease (COPD) and asthma that requires
regular steroid inhalers or tablets
Kidney disease (from stage 3)
Lowered immunity due to disease or treatment (and also close contacts of people in this group)
Liver disease
Had a stroke or mini stroke
A neurological condition like Parkinson’s disease, or motor neurone disease
A missing spleen or a problem with it
Learning disability
Severe mental illness
Morbidly obese (class III obesity). This is defined as those with a Body Mass Index (BMI) of 40 or above,
aged 16 or over.
Epilepsy
✚ You live in a care home or you are
a carer or a health or social care
worker
✚ You are homeless
Vaccinations are available
from GPs and community
pharmacies, in most cases.
For full information on
eligibility in Wales, visit the
Public Health Wales website (phw.nhs.wales )
Northern Ireland
In Northern Ireland you should get a flu vaccination if you:
✚ Are pregnant
✚ Are aged 65 or over, even if you are
fit and healthy
✚ Live in a residential or nursing home
✚ Have and illness or underlying
condition (including children from
six months of age)
The annual fl u vaccination programme also includes:
✚ all preschool children aged two year to four years old on 1 September
✚ children at primary school andsecondary school (up to and including Year 12)
✚ carers – if you care for another person, you should be vaccinated so you can continue caring for them
✚ frontline health and social care (HSC) workers
✚ staff in independent care homes,
hospices and domiciliary care providers
✚ close contacts of immunocompromised individuals
✚ Children over six months old and adults with underlying health conditions as specified.
This is not the complete list of eligible groups. People living in Northern Ireland should visit www.nidirect.gov.uk/articles/flu-vaccine for more details. All eligible adults can receive their vaccine from their community pharmacist or GP.
Who should not have the flu vaccine?
Anyone who has had a serious allergic reaction to a flu vaccine (or any part of it) in the past should avoid it. Some flu vaccines are made using eggs, so anyone with an egg allergy may be a risk of an allergic reaction to the flu vaccine. You can ask your pharmacist for a low-egg or egg-free vaccine.
If you have a high temperature, wait until you’re better before having the flu vaccine.
Flu will often get better on its own, but it can make some people seriously ill. It’s important to get the flu vaccine if you’re advised to.
What to do if you get flu
If you have flu, there are some things you can do to help get better more quickly:
✚ rest and sleep
✚ keep warm
✚ take paracetamol or ibuprofen to lower your temperature and treat aches and pains
✚ drink plenty of water to avoid dehydration (your pee should be light yellow or clear)
A pharmacist can give treatment advice and recommend flu remedies. Do not take paracetamol and flu remedies that contain paracetamol at the same time as it’s easy to take more than the recommended dose. Antibiotics do not work for viral infections such as flu. They will not relieve your symptoms or speed up your recovery.
he ‘NHS Pharmacy First’ service in England includes the appropriate supply of medicines for seven
common conditions including earache, sore throat and urinary tract infections, aiming to address health issues before they get worse. Previously, NHS patients in England had to visit their GP to access prescription only medication, sometimes meaning delays in treatment. Community pharmacies offer a more convenient way to access healthcare. The Pharmacy First service builds on the NHS Community Pharmacist Consultation Service which has run since October 2019. The consultation service enables patients to be referred into community pharmacy for a minor illness or an urgent repeat medicine supply. The new Pharmacy First service, launched in 2024, adds to the existing consultation service and enables community pharmacies to complete episodes of care for seven common conditions.
It frees up GP appointments for patients who need them most and gives people quicker and more convenient access to safe and high quality healthcare.
Accessing Pharmacy First services
The following table shows the seven conditions local pharmacists can manage across various age ranges.
Clinical pathway Age Range
Acute otitis media 1 to 17 years
Impetigo 1 year and over
Infected insect bites 1 year and over
Shingles 18 years and over
Sinusitis 12 years and over
Sore throat 5 years and over
Uncomplicated urinary tract infections women 16-64 years
Patients can be referred to the pharmacy by the general practice, urgent and emergency care settings and NHS 111. In addition, for the common conditions consultations, you can attend or contact the pharmacy directly without the need for referral.
Providing high quality health and care services
Most pharmacies have consultation rooms and an appointment is not always necessary.
Every pharmacist trains for five years in the use of medicines and managing minor illnesses, so they are well equipped to provide health and wellbeing advice to help people stay well. They are also experienced in spotting warning signs, otherwise known as red flag symptoms, which may warrant a referral to a doctor. After a consultation with the pharmacist, the pharmacy will send a notification to the patient’s GP on the same day or on the following working day.
Can I still see my GP?
You can still choose to visit your GP if you prefer. Pharmacy First simply offers an alternative route for getting treatment for these specific conditions.
Will I have to pay for my advice or medication?
The appointment and advice from a pharmacist are free of charge. If you are recommended an over-the-counter medication, you will pay the costs of buying this. If you are supplied with a prescription-only medication, usual prescription charges would apply unless you qualify for free prescriptions. ✚
“If your condition requires further investigation a pharmacist may refer you to another NHS service”
Scotland
NHS Pharmacy First Scotland
This replaced the Minor Ailments Service at the start of the covid-19 pandemic and covers a variety of common ailments where you should visit your local pharmacy first to seek help.
A member of the community pharmacy team will assess you, offer self-care advice and, where appropriate, a pharmacist may supply medicines. If your condition is more serious or requires further investigation, the pharmacist may refer you to another healthcare professional or NHS service. This referral may sometimes be to a pharmacist who can prescribe treatments for common conditions within a pharmacy, which is known as the Pharmacy First Plus service. Pharmacy First Plus is not available in all pharmacies yet, but is getting more frequent.
You can get advice and treatment with the Pharmacy First Scotland service for minor illnesses such as the following: Acne, head lice, allergies, haemorrhoids (piles), athlete’s foot, hay fever, backache, impetigo, blocked or runny nose, indigestion, cold sores, mouth ulcers, constipation, pain, period pain, cystitis, diarrhoea, threadworms, earache, thrush, eczema, warts, headache, verrucas and shingles.
NHS Pharmacy First is available from all pharmacies in Scotland that dispense NHS prescriptions. You are able to choose which pharmacy to go to and, in most cases, you won’t have to make an appointment. When you visit the pharmacy, you will be asked for some information including your name, date of birth and postcode. You will also need to provide details about your symptoms. The pharmacy team will then give advice on your condition; provide medication (if appropriate); and refer you to another healthcare professional if they think it necessary.
A Patient Medication Record will be set up to make a note of any advice and treatment. You can ask to use the pharmacy’s consultation area or room if you want to speak to the pharmacy team without anyone else overhearing.
Medicines Care and Review
MCR is a service for people who take medication for long-term conditions and is available at all community pharmacies across Scotland.
All patients registered for MCR can access a medication review. This will help identify any potential care issues but also aid suitability and selection for a serial prescription. The pharmacist will look at how you take your medicines. You can discuss with them any problems you may have with your medicines and decide if a care plan would help you get the most benefit from them. The pharmacist will complete a review of your medicines at least once a year. The care plan helps the pharmacist record what needs to happen to help you get the most out of your medicines, especially if you have been having problems. The pharmacist can give you a copy of your care plan and may, if you agree, contact your doctor about it if necessary. You may be able to get serial prescriptions from your doctor so you can get your medicines on a long-term, repeat prescription without having to place orders regularly.
Northern Ireland
Discharge medicines service
Hospitals refer recently discharged patients to their community pharmacists. The pharmacist makes sure they understand their new medicines or any changes to their medicine routine. This is an additional layer of safety for patients and ensures that medicine is taken correctly at the right dose and at the right times. This is currently being implemented as a local/service-specific programme rather than a single national roll-out, so availability depends on local participation.
Pharmacy First and minor ailments
Northern Ireland’s Pharmacy First Service has recently expanded. Participating community pharmacies can now offer assessment and treatment if appropriate for urinary tract infections and sore throats. This is in addition to NI’s long running (but recently rebranded) Pharmacy First service for Everyday Health Conditions which covers 13 other common conditions, from ear wax to haemorrhoids.
Medicines adherence service
This service will help to ensure that people at high risk of harm from poor adherence to their medication will receive tailored support to assist them to take their medicines on time and as prescribed.
Emergency hormonal contraception
The service ensures that women and young people aged 13 years and over have timely access to sexual health advice and free EHC (including the provision of bridging contraception) when clinically indicated.
The aims of the service include:
1) Increasing the knowledge, especially among younger women, of the availability of EHC and bridging hormonal contraception from community pharmacies.
2) Ensuring treatment is in line with best practice.
3) Increasing the knowledge of risks such as Sexually Transmitted Infections (STIs).
Wales
Independent prescribing is when a pharmacist can write a prescription for a patient without having to send them to a GP. Independent prescribing is expanding rapidly in Wales, but it is not yet universally available. Health Education Improvement Wales are supporting up to 100 pharmacists a year to undertake prescribing training and from 2026 it is expected that all newly qualified pharmacists will be qualified prescribers at the end of their university courses. This will mean that, in time, all pharmacies will be able to offer these services.
The Wales Clinical Community Pharmacy Service continues to increase access to contraception, common ailments and emergency supply of medication, where locally available. It offers people faster access and greater choice of services in situations where they might otherwise have to wait for a GP appointment.
England
Pharmacy First
The ‘NHS Pharmacy First’ service in England includes the appropriate supply of medicines for seven common conditions including earache, sore throat and urinary tract infections, aiming to address health issues before they get worse. Previously, NHS patients in England had to visit their
GP to access prescription only medication, sometimes meaning delays in treatment. You might also be referred to pharmacies for self care advice on a much wider range of minor illnesses. New Medicine Service Patients who have been prescribed a medicine to treat a long-term condition for the first time may be able to get extra help and advice about their medicine from their local pharmacist through a free scheme called the New Medicine Service. People often have problems when they start a new medicine. The pharmacist will support patients to use the medicine safely and to best effect. The service is only available to people using certain medicines for certain conditions.
NHS Community Pharmacy Blood Pressure Check
This identifies people aged 40 and above who have previously not been diagnosed with hypertension (high blood pressure) and refers those with suspected hypertension to their GP to confirm the diagnosis and for appropriate management. The pharmacist will also promote healthy behaviours.
Oral contraception
A pharmacy contraception service has been introduced to allow pharmacists to supply oral contraception. The aim is to offer people greater choice and access when considering starting or continuing their current form of oral contraception.
Since 2023, people have had the option of having a confidential consultation with a participating community pharmacist to request a supply of the contraceptive pill directly from their pharmacist, rather than from their GP or sexual health clinic. The service will expand in Autumn 2025 to include Emergency Hormonal Contraception.
Stop smoking
Inpatients who start a stop smoking attempt in hospital will be able to be referred to a community pharmacy to continue their stop smoking journey once they are discharged. People can choose the community pharmacy they wish to be referred to.
A pharmacist will meet with the person stopping smoking or carry out consultations over the phone to discuss their quit progress for up to 12 weeks. They will review the nicotine replacement therapy (NRT) prescribed by the hospital team and make any necessary adjustments to support the continued quit attempt and provide ongoing supplies free of charge as required.✚
It is 14 years since pharmacy technicians became a registered profession in England, Scotland and Wales. Over that time they have become valued members of the pharmacy team and provided safe and effective care to patients and the public. But many people may still be unaware of what exactly they do.
Key members of the pharmacy team, they play an important role in helping patients get the most out of their medicines. Working on the frontline of healthcare, they are often the first point of contact to deliver services and care directly to patients.
They are registered healthcare professionals who, under the supervision of a pharmacist, work directly with patients and other members of the healthcare team.
Alongside pharmacists, they work to ensure patients receive their medicines safely and effectively and make sure they understand how to take their drugs. In a community pharmacy, their work involves a variety of aspects of pharmacy practice including managing the supply of medicines.
They help to provide safe and effective pharmacy services, supply medicines and medical devices to patients, whether on prescription or over the counter, and information on symptoms and products.
In a community pharmacy, they may also give health advice to people about stopping smoking, losing weight or sexual health.
They will respond to patients’ questions, either face-to-face or over the phone. If there are any problems or queries, they can refer them to the pharmacist.
The qualities pharmacy technicians need include being confident to work with all sorts of people. They also need good communication skills, including listening and explaining clearly, and, in a busy environment such as a community pharmacy, they need to be well organised.
The roles and responsibilities of pharmacy technicians have continued to develop to meet the needs of patients and the public and no doubt the profession will continue to evolve.
As community pharmacy teams increasingly deliver clinical consultations and services to patients, the role of the pharmacy technician will change. Pharmacy technicians are sure to have a greater role in pharmacy in the future.
There is even a World Pharmacy Technician Day that is held every October when the profession is celebrated. ✚
The NHS ‘Check Before You Tick’ campaign, launched in 2018, was created to encourage patients in England to check whether they are entitled to free prescriptions before claiming them. There are no charges for NHS prescriptions in Scotland, Wales and Northern Ireland.
As part of the NHS ‘Check before you tick’ campaign, materials and guidance have been developed to raise awareness of the online eligibility checker and to help pharmacists support their patients to claim correctly.
Anyone incorrectly claiming a free prescription risks a penalty charge of up to £100 from the NHSBSA which carries out prescription checks each month.
Check your entitlement
Patients are entitled to free prescriptions if they are under 16 years old or 16, 17 or 18 and in full time education, or 60 plus. Certain illnesses can also exempt a patient from prescription charges as well as being pregnant or having a baby under one year.
Certain benefits, but not all, qualify people for free prescriptions, so it’s important that patients check their entitlement, and your pharmacist should support you with this and ask to see
up-to-date proof of eligibility.
Pregnant women and new mothers, although eligible to claim free prescriptions, may not always realise they need a valid Maternity Exemption Certificate. Without a valid certificate, they too could receive a penalty charge.
For individuals who experience financial difficulties but are not eligible for free prescriptions, there are other means of support available to them and your pharmacist should help advise, such as prepayment certificates and the NHS low income scheme.
The online eligibility checker can be accessed on the NHS website at:
www.nhs.uk/checkbeforeyoutick
If you need support, ask someone you trust to help you go online and get the information you need. This could be a family member, partner, friend or support worker.
Further information about NHS help with health costs can be found at www.nhsbsa.nhs.uk/healthcosts
What to do at the pharmacy
✚ If you have an exemption certificate or prescription prepayment certificate, always check the date to see if you can still use it.
✚ If you claim for a benefit, always check whether that benefit means you can get free prescriptions.
If you are not allowed free prescriptions
✚ If you are not allowed free prescriptions, don’t claim.
✚ If your exemption certificate or prepayment certificate is out of date, don’t claim. Pharmacy staff will tell you how much you need to pay.
✚ If you claim free prescriptions that you’re not allowed, you might have to pay £100 as well as the cost of your prescription.
What to do if you’re unsure
✚ If you are not sure whether you are allowed free prescriptions, you should pay and ask the pharmacy staff
for an NHS receipt. This is also called an FP57 form.
✚ If you are waiting to find out whether you’re allowed free prescriptions, you should also pay.
✚ If you find out later that you are allowed free prescriptions and have proof, you can get your money back. The NHS receipt will tell you what to do.
✚ If you are unsure about what to do, ask the pharmacy staff to help you.
If you are allowed free prescriptions
✚ Make sure you tick the right box on the back of the prescription.
✚ If someone else collects the prescription for you, make sure they know which box to tick.
✚ If pharmacy staff ask for proof that you don’t have to pay, you can show your:
➣ Benefit entitlement or award letter
➣ Exemption certificate ✚
Here are some of the things that make your local harmacies special:
✚ Pharmacies provide a range of NHS services and take
pressure off GPs and hospitals.
✚Pharmacies are a convenient setting to get help for coughs and sneezes and all manner of other health concerns which don’t necessarily require a GP or hospital appointment.
✚ Your local pharmacy is one of the few places in the health service where you can simply walk in off the street and get treatment and healthcare professional advice without an appointment.
✚ The concentration of community pharmacies is higher in deprived areas, meaning that pharmacy-based services can reduce health inequalities between affluent and less well-off areas.
✚ Conversations with your local pharmacist can help you get the best use from your medicines and minimise your risk of harm. Many people underestimate the risks of taking medicines inappropriately. At least 6% of emergency re-admissions to hospital are caused by avoidable adverse reactions to medicines.
✚ Pharmacies perform a vital function in society which is as much about community as it is about healthcare. They should never be taken for granted – use them or lose them.
Like GPs, community pharmacists are part of the NHS family.
The traditional role of the community pharmacist as the healthcare professional who dispenses prescriptions written by doctors has changed. Community pharmacists provide clinical services in addition to the traditional dispensing role to allow better integration and team working with the rest of the NHS.
A survey in 2020 revealed that only 29% of people are “definitely aware” that pharmacists are part of the NHS; 39% wrongly think that the majority of pharmacy income comes from sales of health and beauty products.
In fact, your local pharmacy is a key part of the NHS team, aiming to provide seamless NHS care for patients. They:
✚ Talk frequently to local GPs
✚ View shared patient records in order to ensure safe medicines interventions
✚ Refer people to GPs or hospitals if they see danger signs
Part of the NHS family
Doctors, nurses, pharmacists and other highly qualified healthcare professionals make up the NHS team in your neighbourhood – alongside many other dedicated staff.
Your local pharmacy is the NHS on the high street, providing a range of NHS services and support, including urgent care.
Local doctors may refer you to the pharmacy for advice and treatment for minor ailments such as coughs, colds and tummy aches. In turn, the pharmacist will refer you for a GP or hospital appointment if something needs checking out further.
The best patient care is usually based on partnership between healthcare professionals, who may work in different settings and have different skill sets, but who come together to provide seamless care for the individual.
The NHS says it wants to make greater use of community pharmacists’ skills and opportunities to engage patients. So please make the most of your local community pharmacy: proudly part of the NHS family.
“My relationship as a GP is with the pharmacist across the road and it is much more mature now – the pharmacist across the road does minor injuries, minor illnesses, takes part in the flu vaccination programme, we have pharmacists within the surgery.
“It is a vital relationship between what I would say are the two most visible and prevalent health professionals in the community – your local GP and your local pharmacist.” Dame Clare Gerada, GP and former head of the Royal College of GPs.
Royal tribute to pharmacists on the NHS frontline
Nearly 200 pharmacists from across the UK met King Charles III – then The Prince of Wales – at a special reception at St James’s Palace in May 2022.
The event recognised the work of pharmacists across the country in the light of their extraordinary contribution to the health of the nation during the coronavirus pandemic.
In a speech, King Charles paid tribute to the work of pharmacies on the NHS frontline. He praised “the dedication and professionalism of pharmacy staff” during the Covid-19 pandemic and said, “I very much hope that this evening’s event will help, a little bit, to highlight the marvellous work you do in your communities day in and day out.
“At the same time, you are a very familiar fixture in the nation’s high streets and neighbourhoods – something that people have come to rely on and value tremendously over generations. As well as providing prompt access to advice and treatment, of course the great thing is you are also a friendly and reassuring presence in our communities. A place where science, as it were, meets society. As I have said once before, pharmacies are about people and places, not just pills.” ✚