Illustration of a checklist with a tick and a speech bubble, representing an NHS Pharmacy First consultation

Can a pharmacist prescribe antibiotics? What NHS Pharmacy First covers

ByZain Rajabali

It’s one of the questions we hear most at the counter, usually from someone who’s already tried to get a GP appointment: “Can you just give me antibiotics?” Since January 2024 the honest answer in England has been “sometimes, yes”. Pharmacists can now treat seven common conditions on the NHS, and that can include prescription-only medicine such as antibiotics, without you seeing a GP first.

But it isn’t a free-for-all, and a lot of people are surprised by where the line sits. Here’s what a pharmacist can and can’t treat, the age limits, what it costs, and when you still need a GP, a dentist or 111.

This is general information, not a diagnosis or a personal recommendation. Whether you need treatment, and which treatment, is decided at the consultation.

The short answer

  • Yes, for seven conditions. Under NHS Pharmacy First a pharmacist can give you prescription medicine, including antibiotics where they’re needed, for sinusitis, sore throat, earache, infected insect bites, impetigo, shingles and urinary tract infections (UTIs) in women.
  • Each condition has an age range. Outside it, the pharmacist can still advise you, but you may need a GP for treatment.
  • You won’t always get antibiotics. Many of these infections clear up on their own, and antibiotics don’t work for viruses. The pharmacist decides what you actually need.
  • The consultation is free. If you’re given medicine, the normal NHS prescription charge applies unless you’re exempt.
  • Some things aren’t covered, including chest infections and tooth infections.

What is Pharmacy First?

Pharmacy First is an NHS service that started across England on 31 January 2024. It lets community pharmacies complete a whole episode of care for seven common conditions, following set clinical pathways. You can walk in or contact the pharmacy directly for these seven. You don’t need a GP referral, though GP practices and NHS 111 can send you to us too.

The idea is simple. For straightforward infections, you shouldn’t have to wait for a GP appointment just to get a treatment a pharmacist is trained to give. We see the difference every week: people who’d been told the next GP slot was days away, sorted in one visit.

The seven conditions, and who they cover

These are the conditions and age ranges the NHS sets for Pharmacy First:

If you’re outside the age range for your condition, the NHS says a pharmacist can still offer advice and help you choose over-the-counter treatment, but you may need to see a GP for anything more. A man with UTI symptoms, for example, or a 70-year-old woman, falls outside the UTI pathway and should be seen by a GP.

Will you actually get antibiotics?

Not always, and that’s deliberate. The NHS is clear that many mild bacterial infections get better on their own, and that antibiotics don’t work for viral infections such as colds, flu and most coughs. It also says antibiotics are no longer routinely used for things like sore throats and ear infections in children.

So a Pharmacy First consultation can end in one of three ways:

  1. Advice and self-care, often with something from the shelf to ease the symptoms while it settles.
  2. Prescription medicine, which may be an antibiotic or another treatment, when the pathway says it’s needed.
  3. Referral, to a GP or another service, if it’s more than a pharmacy can safely handle.

We’d rather tell you honestly that you don’t need antibiotics than hand over a course that won’t help. Taking antibiotics you don’t need makes them less likely to work when you really do.

Does it cost anything?

The consultation itself is free on the NHS. If the pharmacist gives you prescription medicine, the standard NHS prescription charge applies, exactly as it would with a GP prescription, unless you’re exempt from charges. You can check whether you’re exempt on the NHS page about prescription charges. If you have a prepayment certificate or an exemption, bring the details with you.

What a pharmacist can’t treat under Pharmacy First

A few things people often expect us to treat, but that fall outside the seven conditions:

  • Chest infections and coughs. Not one of the seven. See your GP, or use NHS 111 if you need help sooner. Call 999 if you’re struggling to breathe.
  • Tooth infections and dental abscesses. The NHS advises asking for an urgent dentist appointment, or getting help from NHS 111 if you can’t. It also says not to go to a GP surgery, because they can’t give dental treatment. A pharmacist can help with pain relief advice while you arrange that.
  • UTIs in men, and in women outside 16 to 64. These need a GP.
  • Anything that looks more serious. Every pathway has warning signs that mean we refer you on, sometimes urgently. That’s part of the check, not a failure of it.

If you feel very unwell, or you’re worried the problem is getting worse quickly, don’t wait for a pharmacy appointment: call NHS 111, or 999 in an emergency.

What happens at the appointment

At our branches it goes like this. You tell us what’s going on, and a pharmacist takes you into a private consultation room. We’ll ask about your symptoms, how long you’ve had them, your medical history, medicines and allergies, and we may examine you, for example looking at your throat, ear or skin. Then we explain what we think it is and agree the next step with you.

The NHS says the pharmacy updates your GP record after the consultation, so your GP knows what happened. Your information isn’t shared with anyone else.

Common questions

Can a pharmacist prescribe antibiotics without seeing a GP? Yes, for the seven Pharmacy First conditions within their age ranges, if the pharmacist decides an antibiotic is needed. For anything else, antibiotics still need a GP or another prescriber.

Do I need an appointment? Not for the seven conditions. You can walk in or contact the pharmacy directly. The NHS suggests checking with the pharmacy before you go, since most, but not all, pharmacies offer the service.

Can a pharmacist give antibiotics for a tooth infection? No. Dental infections aren’t part of Pharmacy First. Ask for an urgent dentist appointment, or contact NHS 111 if you can’t get one.

Can I get antibiotics for a chest infection from a pharmacy? No, chest infections aren’t one of the seven conditions. See your GP or contact NHS 111.

Is Pharmacy First free? The consultation is. Medicine you’re given carries the normal NHS prescription charge unless you’re exempt.

My child is 3 and has earache. Can you help? Yes. Earache is covered for children aged 1 to 17, and we’ll check whether treatment is needed or whether it’s likely to settle on its own.

Getting help in Oxford

All four of our branches offer NHS Pharmacy First. You can walk in, or book to guarantee a slot in the consultation room:

Full details of the service and booking are on our NHS Pharmacy First page. Not sure it’s one of the seven? Get in touch or just ask at the counter, and a pharmacist will tell you straight away.

Sources

  1. How pharmacies can help – NHS. https://www.nhs.uk/nhs-services/pharmacies/how-pharmacies-can-help/ (accessed 25 September 2026)
  2. Pharmacy First – NHS England. https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/ (accessed 25 September 2026)
  3. Antibiotics – NHS. https://www.nhs.uk/medicines/antibiotics/ (accessed 25 September 2026)
  4. Dental abscess – NHS. https://www.nhs.uk/conditions/dental-abscess/ (accessed 25 September 2026)
  5. NHS prescription charges – NHS. https://www.nhs.uk/nhs-services/prescriptions/nhs-prescription-charges/ (accessed 25 September 2026)

Written by Zain Rajabali, Superintendent Pharmacist – GPhC #2219769
Medically reviewed by Zain Rajabali, Superintendent Pharmacist, Independent Prescriber – GPhC #2219769
Last reviewed: 25 September 2026 · Next review due: September 2027

This article is general health information and is not a substitute for a consultation. It does not recommend any specific medicine for you. Whether you need treatment is decided at an individual assessment with a pharmacist, GP or dentist.

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