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NHS England's director for pharmacy, Ali Sparke, indicated at the Pharmacy Show earlier today that his team ultimately wants patients to be able to access Pharmacy First consultations without needing a GP referral. 

NHSE wants "patients to be turning up, walking in to access those services," Mr Sparke said as he explained that the referral model currently in place was "never a goal" or an "endpoint". 

But he said "it remains really important" that for now work continues to establish close working relationships between pharmacy and general practice through embedding the existing pathways, commenting: "We've got a lot more work to do on that." 

Mr Sparke acknowledged that a quarter of GP surgeries in England are still not making Pharmacy First referrals, adding that a new marketing campaign will be launched in "probably a week or two... to help raise patient awareness of the service as well".

He welcomed the "enormous sign-up" from pharmacies for other services like contraception, hypertension and the New Medicine Service, saying: "We're getting towards the point that we always hope to get to - where we can genuinely say some of these services are national services.

"We've got 90 per cent plus of contractors who are signed up to go to Pharmacy First, contraception, and blood pressure.

He described this as "a brilliant thing to be able to say to governments" and said it helps clarify for patients that the role of community pharmacy is evolving.

However, he said that at present these commissioned services are "quite rigidly defined" and "don't make it easy" for pharmacies to navigate between different systems. 

Mr Sparke said there is "a lot of opportunity" to simplify some of the service pathways to "improve that experience for patients". 

He suggested that as prescribing becomes mainstream practice, pharmacists will have more autonomy to deliver care outside of "rigid" and "carefully set algorithms" and will be able to treat illness without "having to send the patient back to their GP for a slightly different script".

"We know that we're spending lots of time managing patients in different situations with different types of medicines; we don't have as many opportunities to start the medicines as we would like to," said Mr Sparke. "With prescribing, our opportunity around optimisation becomes huge."