One major employer has advised its pharmacists to ‘temporarily suspend’ the Pharmacy First service if they do not feel competent to deliver it, the Pharmacists’ Defence Association (PDA) has claimed.

However, other approaches are potentially putting some pharmacists ‘under pressure’ to deliver the service prematurely, it added.

The union said it was aware of ‘threats’ from some employers around the cancellation of existing bookings or for no future bookings for locums ‘that do not declare that they will be competent to deliver the service in advance’.

Though the PDA was also ‘aware’ of one pharmacy employer advising that if an employed pharmacist was unable to confirm they were ‘competent’ – as they may not have completed training, for example – they should ‘temporarily suspend the service for the days that it cannot be provided until competent staff are available’.

A total of 10,265 community pharmacies in England have signed up to offer the new Pharmacy First service from today, NHS England (NHSE) has announced.

Operating under a nationally commissioned patient group direction (PGD), pharmacists will be able to treat sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women.

To begin offering the service, contractors must ensure that their staff review the CPPE Pharmacy First self-assessment framework to assess their competence to provide all elements of the service and ensure that they comply with the service specification, according to a letter sent by NHSE last week.

But the PDA has highlighted that operating Pharmacy First ‘is at the sole discretion of the Responsible Pharmacist (RP) on the day, as the Medicines Act places a legal duty on the RP to secure the safe and effective running of the pharmacy’.

‘The pharmacy owner is also required under the legislation to enable the RP to exercise his/her professional judgement, as appropriate, in relation to the safe and effective running of the pharmacy concerned,’ the PDA added in a statement last week.

It noted that a ‘safe and effective service’ can only be delivered if the pharmacist and other team members are trained and competent to provide the service being offered, and if it is sufficiently resourced ‘without compromising the delivery of essential services and safe care for other patients’.

And in a statement released yesterday, the PDA advised RPs that if this was not possible, they should follow their employer’s business continuity plan and consider enacting the protocol outlined in the Pharmacy First service specification to temporarily suspend the service.

This involves informing the NHS Directory of Services (DoS) Provider and Commissioner Helpline as soon as possible to stop referrals being made to the pharmacy; contacting local GP practices and urgent and emergency care settings to stop them making further direct referrals; and informing the local commissioner that the service is being temporarily withdrawn.

Earlier this month the PDA asked NHSE and the Department of Health and Social Care (DHSC) to make the Pharmacy First rollout ‘more gradual, allowing more of the workforce to get prepared’.

This came after its member survey raised concerns about the impact of the new service on workload and workforce.

But this request was refused, the PDA said last week.

One concession made by NHSE around the launch allows pharmacies to delay offering the otitis media (earache) pathway until 1 April if they had ordered otoscope equipment that had not yet arrived.