Kingsley et al have identified more than a recording problem. By January 2025, only 36.3% of recorded Pharmacy First consultations contained a structured clinical condition, medication, or both.1 This raises a more fundamental question: what does it mean to ‘complete an episode of care’ if the clinical story does not reliably travel with the patient?
As pharmacists take on greater clinical responsibility, should this be matched by an equally ambitious approach to continuity? Is sending a consultation message to general practice enough, or should the next clinician be able to see clearly what was assessed, supplied, and safety netted?
This matters because Pharmacy First is not simply a signposting service. Acute pharyngitis and uncomplicated urinary tract infection were the two most frequently recorded conditions, while phenoxymethylpenicillin and nitrofurantoin were the most frequently recorded medicines.1 If a patient returns with persistent symptoms or requires another antibiotic shortly afterwards, can the next clinician fully see what happened in pharmacy, or are we asking patients themselves to reconnect the clinical story? Incomplete information transfer therefore becomes a question not only of data quality, but also of continuity and antimicrobial stewardship.
International experience makes this harder to ignore; US pharmacy leaders have called for bidirectional electronic health record access as pharmacists assume greater clinical responsibility.2 Australia’s My Health Record offers a more shared model of access to medicines and other clinical information,3 while Canadian experience with pharmacist prescribing highlights both improved access and the importance of integration.4 Yet, New Zealand provides a useful counterpoint: its minor-conditions pharmacy pilot improved access, but did not show strong evidence of reducing pressure elsewhere in the health system.5
Perhaps the next evaluation of Pharmacy First should therefore ask more than whether the consultation was recorded. Did it prevent duplication? Was follow-up visible? Did it support antimicrobial stewardship? And did workload genuinely disappear from general practice, or simply return later in another form?
In my view, Pharmacy First should not create pharmacy care running parallel to primary care. Success should mean that patients experience one connected system, regardless of which door they enter.
- © British Journal of General Practice 2026
References
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