If you have never used Pharmacy First before, you may wonder what happens when you speak to the pharmacist and what questions you will be asked.
A Pharmacy First consultation involves more than simply describing one symptom. The pharmacist needs to understand your health, how your symptoms have developed and whether the Pharmacy First clinical pathway is suitable for you.
NHS England explains that pharmacists may ask about your current symptoms, previous medical history, allergies and medicines you are taking before deciding on the most appropriate next step.
This guide explains the types of questions you may be asked and why the information matters.
Why Does the Pharmacist Need to Ask Questions?
The pharmacist needs enough information to understand whether your symptoms fit the relevant Pharmacy First clinical pathway.
The questions also help identify whether pharmacy treatment is appropriate or whether you may need another healthcare service.
If you have symptoms that may be covered by the service, you can find out more about Biscot Pharmacy’s NHS Pharmacy First service.
What Symptoms Are You Experiencing?
One of the first things the pharmacist is likely to ask about is your main symptom.
You may be asked:
- What symptoms are you experiencing?
- Where are the symptoms?
- When did they start?
- Are they getting better or worse?
- Have they changed since they began?
- Are you experiencing any additional symptoms?
Try to describe your symptoms as clearly as possible.
Even small details can help the pharmacist understand which clinical pathway may be relevant.
How Long Have You Had the Symptoms?
The duration of your symptoms can be important.
The pharmacist may ask exactly when the problem started and whether the symptoms have remained the same, improved or become worse.
For some conditions, how long symptoms have been present can influence the advice or treatment that may be appropriate.
If you are unsure of the exact date, give the best estimate you can.
How Severe Are Your Symptoms?
You may also be asked how much the symptoms are affecting you.
For example, the pharmacist may want to understand whether:
- Pain is mild or severe
- Symptoms interfere with eating or drinking
- You are sleeping normally
- Symptoms are affecting normal daily activities
- The condition appears to be getting rapidly worse
This helps the pharmacist assess whether Pharmacy First remains an appropriate route.
Have You Had This Problem Before?
The pharmacist may ask whether you have experienced the same symptoms previously.
If you have, explain:
- When it happened
- What treatment you received
- Whether the treatment worked
- Whether the symptoms keep returning
- Whether you saw a GP or another healthcare professional
Repeated or recurring symptoms may sometimes need a different type of assessment.
What Medicines Are You Taking?
Your current medicines can affect which treatments are appropriate.
You may be asked about:
- Prescription medicines
- Regular over-the-counter medicines
- Inhalers
- Creams or ointments
- Recently completed antibiotics
- Other treatments you currently use
If you take regular medication, it can be useful to know the names and doses.
NHS England confirms that Pharmacy First consultations can include questions about medicines a patient is currently taking.
Do You Have Any Medicine Allergies?
The pharmacist may ask whether you are allergic to any medicines.
This is especially important when treatment is being considered.
Tell the pharmacist about any known medicine allergies and explain what reaction you previously experienced if you know.
Do not assume that an allergy recorded several years ago is irrelevant.
Do You Have Any Medical Conditions?
Your wider health history can also affect the assessment.
You may be asked whether you have conditions such as:
- Diabetes
- Asthma
- Heart conditions
- Kidney or liver problems
- Immune system conditions
- Long-term skin conditions
- Other relevant medical conditions
Having a medical condition does not automatically prevent you from using Pharmacy First.
However, it may affect what treatment or healthcare route is most appropriate.
How Old Are You?
Age is an important part of Pharmacy First because the seven NHS clinical pathways have different age criteria.
For example, some pathways cover children as well as adults, while others apply only to certain adult age groups.
The pharmacist will therefore confirm your age before determining whether you meet the criteria for the relevant pathway.
You can read more about the conditions covered by Pharmacy First.
Are You Pregnant or Breastfeeding?
Where relevant to the treatment being considered, the pharmacist may ask whether you are pregnant, could be pregnant or are breastfeeding.
This information can affect whether certain medicines are appropriate.
Answer these questions accurately so the pharmacist has the information needed to make a safe treatment decision.
Have You Already Tried Any Treatment?
You may be asked what you have already done to manage the problem.
This can include:
- Over-the-counter medicines
- Pain relief
- Creams
- Antihistamines
- Home treatments
- Previous prescription medicines
- Advice from another healthcare professional
Tell the pharmacist whether the treatment helped and when you last used it.
Have You Recently Taken Antibiotics?
If antibiotics may be relevant to the condition being assessed, the pharmacist may ask whether you have recently taken them.
This helps provide a fuller picture of your treatment history.
Pharmacy First does not mean antibiotics are automatically supplied. Pharmacists follow defined NHS clinical pathways and only supply prescription-only medicines where clinically appropriate.
Are There Any Other Symptoms?
Sometimes another symptom can change the assessment.
The pharmacist may therefore ask whether you have experienced symptoms beyond the main problem you initially mentioned.
These additional questions help identify warning signs and determine whether Pharmacy First is still the correct healthcare route.
Pharmacists are trained to identify red-flag symptoms that may require referral to another healthcare professional.
Will the Pharmacist Examine the Problem?
Depending on the condition, a face-to-face clinical assessment may sometimes be needed.
The exact assessment depends on the Pharmacy First pathway.
For example, some conditions may require the pharmacist to look at an affected area or carry out an appropriate clinical examination before making a treatment decision.
The pharmacist should explain what they need to assess and why.
What Happens After the Questions?
Once the pharmacist has gathered the relevant information, they will consider whether your symptoms fit the appropriate Pharmacy First pathway.
Possible outcomes can include:
- Self-care advice
- Advice about symptom management
- Over-the-counter treatment
- Prescription-only medicine where clinically appropriate
- Safety-netting advice
- Referral to another healthcare service
NHS England states that Pharmacy First pathways include self-care and safety-netting advice, with prescription-only medicines supplied only when appropriate.
What Is Safety-Netting Advice?
Safety-netting means explaining what you should do if your condition does not improve or becomes worse.
The pharmacist may tell you:
- What changes to watch for
- How long symptoms might reasonably last
- When to seek another assessment
- When you should contact your GP
- When NHS 111 may be appropriate
- When urgent medical help may be needed
This is an important part of making sure you know what to do after the consultation.
What If Pharmacy First Is Not Suitable?
Sometimes the answers you give or the pharmacist’s assessment may show that Pharmacy First is not the right route.
You may then be directed towards your GP, NHS 111, urgent care or another healthcare service depending on your symptoms.
This does not mean the consultation has failed. Identifying when another level of care is needed is part of the pharmacist’s role.
Read more about when Pharmacy First may not be suitable.
Is the Pharmacy First Consultation Private?
Pharmacy First consultations can be carried out confidentially, and NHS England notes that pharmacies have private consultation rooms available for clinical services.
If you need to discuss something sensitive, you can speak openly with the pharmacist so they have the information needed to assess your symptoms safely.
Will Your GP Be Told About the Consultation?
After a Pharmacy First consultation, the pharmacy sends information about the outcome to the patient’s GP.
NHS England states that the notification is sent on the same day or the following working day.
This helps keep your healthcare record updated.
How Should You Prepare for Pharmacy First?
You do not need to prepare extensively before speaking to the pharmacist.
However, it can help if you know:
- When your symptoms started
- Medicines you currently take
- Any medicine allergies
- Relevant health conditions
- Treatments you have already tried
- Whether you have experienced the problem before
- Whether your symptoms are improving or worsening
Providing accurate information helps the pharmacist make a more informed assessment.
Speak to a Pharmacist About Your Symptoms
If you think your symptoms may fit one of the NHS Pharmacy First clinical pathways, a pharmacist can assess the problem and explain the most appropriate next step.
Your consultation may result in self-care advice, treatment where suitable or referral when another healthcare service would be more appropriate.
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