NHS Pharmacy First
Get advice and treatment for seven common conditions at your local pharmacy.
NHS Pharmacy First lets our pharmacy team assess certain common conditions and, where it is clinically appropriate, provide NHS treatment — without you needing to see a GP first. Whether treatment is suitable is always decided at your assessment.
- Free NHS consultation
- No GP appointment needed
- 1,000+ consultations completed at Okus
The basics
What is NHS Pharmacy First?
Pharmacy First is a way to get help with everyday health problems quickly, without waiting for a GP appointment. Here’s how it works:
- Pharmacy First is an NHS service provided through participating community pharmacies.
- Our pharmacist can assess seven common conditions directly — you don’t need a GP appointment first.
- The pharmacist will ask about your symptoms and relevant medical history.
- Where clinically appropriate, they may examine you (for example, looking in the ear for an ear complaint).
- They check for warning signs (“red flags”) and give safety-netting advice.
- They’ll recommend self-care or, if you meet the pathway criteria, may supply an appropriate NHS medicine.
- If Pharmacy First isn’t suitable, they’ll advise you or refer you to the right service.
The seven conditions
Seven common conditions we can help with
This is a guide to the types of conditions that may be assessed through Pharmacy First — it isn’t a way to diagnose yourself. Your pharmacist will assess your symptoms and decide whether Pharmacy First is suitable for you.
Acute Otitis Media (ear infection / earache)Children aged 1–17
What is it?
A middle-ear infection. It’s common in children and often clears up on its own, but it can be painful. Not every earache is an ear infection.
Common signs and symptoms
- Ear pain
- Being unsettled or irritable (in young children)
- Difficulty sleeping
- Reduced hearing
- Feeling generally unwell
- A high temperature (fever)
Who can use this NHS pathway?
Children aged 1 to 17 years.
What will happen at Okus Pharmacy?
- Ask about the child’s symptoms and relevant medical history
- Assess the child and, where appropriate, look inside the ear with an otoscope to check for signs of infection
- Provide advice and, if the child meets the pathway criteria, appropriate treatment
- Give safety-netting advice and refer to another healthcare professional if needed
An ear examination helps the pharmacist’s assessment but does not guarantee a diagnosis.
What treatment or advice may be provided?
Often self-care and pain relief; sometimes appropriate NHS treatment where the criteria are met. The pharmacist will only supply a medicine where it is clinically appropriate and you meet the pathway criteria.
When to seek urgent help
Seek urgent medical help rather than waiting for a pharmacy consultation if you notice: Severe pain, swelling or redness behind the ear, a stiff neck, drowsiness, a baby under 1, or a child who is very unwell.
ImpetigoAge 1 and over
What is it?
A common and very contagious bacterial skin infection. It usually responds well to treatment.
Common signs and symptoms
- Red sores or blisters, often around the nose and mouth
- Sores that burst and form golden-brown crusts
- Itching
- Spreads easily to other areas of skin — or to other people
Who can use this NHS pathway?
Adults and children aged 1 year and over.
What will happen at Okus Pharmacy?
- Ask about your symptoms
- Look at the affected skin and assess whether it fits the pathway
- Where appropriate, recommend suitable treatment
- Give hygiene and self-care advice to help stop it spreading, plus safety-netting; refer if needed
Impetigo is contagious — avoid touching or scratching the sores, wash your hands often, and don’t share towels. Children may need to stay off school or nursery until the sores have crusted over or treatment has started.
What treatment or advice may be provided?
Hygiene and self-care advice and, where clinically appropriate, NHS treatment. The pharmacist will only supply a medicine where it is clinically appropriate and you meet the pathway criteria.
When to seek urgent help
Seek urgent medical help rather than waiting for a pharmacy consultation if you notice: Sores that are widespread or spreading quickly, feeling very unwell or feverish, or if you have a weakened immune system.
Infected insect bitesAge 1 and over
What is it?
Most insect bites cause a small, itchy reaction that settles within a few days. Occasionally a bite can become infected. A normal reaction improves over time, while an infected bite tends to get worse after a few days.
Common signs and symptoms
- Redness spreading out from the bite
- Swelling
- Warmth around the area
- Pain
- Pus or fluid
- Symptoms getting worse rather than better, or feeling unwell
Who can use this NHS pathway?
Adults and children aged 1 year and over.
What will happen at Okus Pharmacy?
- Assess the bite and whether it appears infected
- Check whether the Pharmacy First pathway is appropriate for you
- Recommend self-care or, where clinically appropriate, treatment
- Give safety-netting advice and refer if needed
What treatment or advice may be provided?
Self-care advice and, where clinically appropriate, NHS treatment. The pharmacist will only supply a medicine where it is clinically appropriate and you meet the pathway criteria.
When to seek urgent help
Seek urgent medical help rather than waiting for a pharmacy consultation if you notice: A severe allergic reaction — swelling of the face, lips, tongue or throat, difficulty breathing, or feeling faint — is an emergency. Call 999.
ShinglesAdults 18 and over
What is it?
A painful rash caused by the chickenpox virus becoming active again. It usually affects one side of the body.
Common signs and symptoms
- Pain, burning, tingling or sensitivity in an area of skin
- A rash that turns into fluid-filled blisters
- Usually only on one side of the body
- Feeling generally unwell
Who can use this NHS pathway?
Adults aged 18 years and over.
What will happen at Okus Pharmacy?
- Assess your symptoms, the timing and appearance of the rash, and your medical history
- Check whether you meet the Pharmacy First pathway criteria
- Provide advice and, where appropriate, treatment, plus safety-netting; refer if needed
Prompt assessment matters because any antiviral treatment works best when started early — please don’t delay. Not everyone with a rash will be eligible.
What treatment or advice may be provided?
Advice and, where you meet the criteria, appropriate NHS treatment. The pharmacist will only supply a medicine where it is clinically appropriate and you meet the pathway criteria.
When to seek urgent help
Seek urgent medical help rather than waiting for a pharmacy consultation if you notice: A rash near or around the eye, very severe symptoms, or if you have a weakened immune system — seek urgent, same-day medical advice.
SinusitisAge 12 and over
What is it?
Swelling of the sinuses — the spaces behind your cheeks and forehead — often following a cold. It usually clears up by itself.
Common signs and symptoms
- A blocked or runny nose
- Pain, pressure or tenderness around the cheeks, eyes or forehead
- Headache
- A reduced sense of smell
- Thick nasal mucus
- A cough, and sometimes a fever
Who can use this NHS pathway?
Adults and children aged 12 years and over.
What will happen at Okus Pharmacy?
- Assess your symptoms and how long you’ve had them
- Check whether the Pharmacy First pathway applies
- Recommend self-care and symptom relief or, where appropriate, treatment; give safety-netting and refer if needed
Sinusitis doesn’t usually need antibiotics — self-care and symptom management are often the best approach.
What treatment or advice may be provided?
Self-care and symptom-relief advice and, where clinically appropriate, NHS treatment. The pharmacist will only supply a medicine where it is clinically appropriate and you meet the pathway criteria.
When to seek urgent help
Seek urgent medical help rather than waiting for a pharmacy consultation if you notice: A severe headache, swelling or redness around the eyes, changes to your vision, a stiff neck or confusion.
Sore throatAge 5 and over
What is it?
A common problem, usually caused by a viral infection, that often gets better on its own within about a week.
Common signs and symptoms
- Pain or discomfort when swallowing
- A red throat
- Swollen tonsils
- Swollen glands in the neck
- A fever
- Feeling generally unwell
Who can use this NHS pathway?
Adults and children aged 5 years and over.
What will happen at Okus Pharmacy?
- Ask about your symptoms and use a recognised clinical assessment to help decide whether treatment may be appropriate
- Provide advice and self-care recommendations
- Where you meet the criteria, supply appropriate NHS treatment, with safety-netting
Most sore throats don’t need antibiotics and settle with self-care.
What treatment or advice may be provided?
Advice and self-care and, where you meet the criteria, appropriate NHS treatment. The pharmacist will only supply a medicine where it is clinically appropriate and you meet the pathway criteria.
When to seek urgent help
Seek urgent medical help rather than waiting for a pharmacy consultation if you notice: Difficulty breathing or swallowing, drooling, a muffled voice, difficulty opening your mouth, or severe pain on one side.
Urinary tract infection (UTI)Women aged 16–64
What is it?
An infection in part of the urinary system — most commonly the bladder.
Common signs and symptoms
- Burning or stinging when passing urine
- Needing to pass urine more often or more urgently
- Passing only small amounts of urine
- Lower tummy discomfort
- Cloudy or strong-smelling urine
Who can use this NHS pathway?
Women aged 16 to 64 years, subject to the pathway criteria. Not everyone with urinary symptoms will be eligible.
What will happen at Okus Pharmacy?
- Ask questions to check whether your symptoms fit an uncomplicated UTI and whether Pharmacy First is appropriate
- Provide advice and, where you meet the criteria, appropriate treatment
- Give safety-netting advice and refer if needed
What treatment or advice may be provided?
Advice and, where you meet the criteria, appropriate NHS treatment. The pharmacist will only supply a medicine where it is clinically appropriate and you meet the pathway criteria.
When to seek urgent help
Seek urgent medical help rather than waiting for a pharmacy consultation if you notice: A high temperature, pain in your sides or lower back (kidney area), blood in your urine, feeling very unwell, being pregnant, or urinary symptoms in a man or a child — these need a different medical assessment rather than the Pharmacy First UTI pathway.
Age ranges are set by NHS England and were checked against NHS guidance in September 2026.
Step by step
What happens during your Pharmacy First consultation?
A Pharmacy First consultation is private and usually quick. Here’s what to expect.
Tell us about your symptoms
The pharmacist will ask about what you’ve been experiencing.
Clinical assessment
They’ll assess your symptoms and medical history. Where appropriate, they may carry out a physical check — for example, looking inside the ear with an otoscope for an ear complaint.
Treatment or advice
If appropriate, they may recommend self-care, give advice, or supply an NHS medicine under the relevant Pharmacy First pathway.
Safety-netting
You’ll be told what to look out for and when to seek further medical help.
Referral if needed
If Pharmacy First isn’t appropriate, the pharmacist will advise you on the most suitable next step.
Our pharmacy team
What can our pharmacist do?
- Assess your symptoms
- Ask about your medical history
- Check for warning signs (red flags)
- Examine you where appropriate
- Look inside the ear with an otoscope when clinically indicated
- Give self-care advice
- Recommend appropriate treatment
- Supply eligible NHS medicines under the relevant pathway where clinically appropriate
- Provide safety-netting advice
- Refer you to another healthcare professional if needed
Important information
Pharmacy First treatment is subject to a clinical assessment. Not everyone with these symptoms will be eligible for treatment under the NHS Pharmacy First pathway, and the pharmacist will only supply a medicine where it is clinically appropriate.
If your symptoms are severe, rapidly worsening, or you are worried about your health, please seek urgent medical help rather than waiting for a pharmacy consultation. For a medical emergency, call 999. For urgent advice when we’re closed, call NHS 111 or visit 111.nhs.uk.
Good to know
Frequently asked questions
What is NHS Pharmacy First?
NHS Pharmacy First is a free NHS service that lets trained community pharmacists assess and, where clinically appropriate, treat seven common conditions — without you needing to see a GP first.
Do I need a GP appointment?
No. You can come to us directly. You can also be referred to Pharmacy First by NHS 111 or your GP practice.
Can I walk into Okus Pharmacy for Pharmacy First?
Yes — you can walk in during our opening hours. Because the consultation is private and takes a little time, at busy periods you may be asked to wait or come back. Calling ahead can help.
Is Pharmacy First free?
The consultation is free. If the pharmacist supplies an NHS medicine and you normally pay for prescriptions, the standard NHS prescription charge applies unless you are exempt — the same as a GP prescription.
What conditions can Pharmacy First treat?
Seven: earache (ages 1–17), impetigo (1+), infected insect bites (1+), shingles (18+), sinusitis (12+), sore throat (5+), and an uncomplicated urinary tract infection in women aged 16–64. Whether treatment is suitable is decided at your assessment.
Can children use Pharmacy First?
Yes, for some conditions — for example earache from age 1 and sore throat from age 5. Each condition has its own age range, which the pharmacist will check.
Can I get antibiotics from a pharmacist?
Not automatically. The pharmacist follows an NHS clinical pathway and will only supply a medicine if it is clinically appropriate and you meet the criteria. Many of these conditions are best managed with self-care.
What happens if my condition is not suitable for Pharmacy First?
The pharmacist will give you advice and explain the most suitable next step — for example self-care, or a referral to your GP or another NHS service.
Think Pharmacy First
Not sure where to start? Ask us.
If you have one of the seven conditions above, speak to our pharmacy team — we’ll assess whether Pharmacy First is right for you and help you get the care you need.
Visit Okus Pharmacy & Health Clinic
The Health Centre, Curie Avenue, Okus Road,
Swindon SN1 4GB
Opening hours
- Monday–Friday
- 9:00am – 6:15pm
- Saturday
- 9:00am – 1:00pm
- Sunday
- Closed
Related NHS services: NHS Prescriptions · All services
Prepared by the Okus Pharmacy team and based on current NHS England and NHS.uk Pharmacy First guidance (checked September 2026). Okus Pharmacy & Health Clinic is a GPhC-registered pharmacy. Meet our pharmacist.
This page provides general health information to help you understand the conditions that may be assessed through Pharmacy First. It is not a diagnosis or a substitute for personalised medical advice — your pharmacist will assess whether Pharmacy First is suitable for you.