Pharmacy First Service operational update 

The A number of updates to the Pharmacy First clinical pathways service have now gone live:

• for all seven of the clinical pathways, an additional gateway point has been established, recognising the level of care and workload required to safely and efficiently manage patients who require urgent escalation
• for the Acute Sinusitis, Impetigo, Infected Insect Bites, Shingles and Acute Otitis Media pathways, the gateway point is now triggered earlier in the pathway, recognising consultations that have gone beyond routine care 
• for the Acute Sore Throat pathway, a clearer gateway point has been introduced for patients who return following an unsuccessful few days of self-care. In addition, a gateway point for patients with FeverPAIN scores of 2-3 has been introduced to recognise consultations that have gone beyond routine care.

Community pharmacy teams providing the NHS Pharmacy First Service should read the updated documents and sign the patient group direction and protocol authorisation sheet(s). For queries relating to this update, please contact ENGLAND.CommunityPharmacy@nhs.net.