Pharmacy changes that come into force on 1 October

Today (1 October 2025) sees several regulatory changes coming into force and marks the beginning of various national services – here is everything pharmacists need to know.

Vaccination Services

As of today, pharmacies can begin providing the one-season pilot Childhood Flu Vaccination Service and the Covid Vaccination Service.

Around 4,000 communities have signed up to deliver flu vaccines to two- and three-year olds, according to NHS England. This works out at around a third of pharmacies across the country.

Vaccination of all eligible groups for the NHS Adult Flu Vaccination Service can also commence from today. Only pregnant women have been able to receive a flu vaccination in pharmacies since 1 September.

Eligible groups include people over 65 years, those aged 18-65 years in clinical risk groups, those in long-stay residential care homes, carers, close contacts of immunosuppressed individuals, and frontline workers in a social care setting without an employer led occupational health scheme.

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Pharmacy First pathways and PGDs

Pharmacy owners must also start using the updated Pharmacy First clinical pathways, protocol and Patient Group Directions (PGDs) as of today.

This was included in NHS England’s Primary Care Bulletin last week after IT system suppliers confirmed that the ‘necessary changes to the clinical IT systems will be made on schedule’.

The final updated clinical pathways and PGDs can be found on the NHS England website, as well as an updated master PGD authorisation sheet which pharmacists can choose to sign instead of signing each individual PGD.

Distance selling pharmacies (DSPs)

As of today, distance selling pharmacies (DSPs) can no longer provide Directed services – Advanced, National Enhanced, and Enhanced Services – face-to-face with the patient at the pharmacy premises.

They can only provide Directed services remotely from the DSP pharmacy premises or, if the service specification allows, in person with the patient off-site.

Hub and spoke changes

New hub and spoke dispensing terms of service also take effect today, as do the complementary Human Medicines Regulations 2012 (HMRs) hub and spoke changes announced in April this year.

Both apply to owners of NHS ‘spoke’ pharmacies/contractors when the ‘hub’ pharmacy is owned by a different legal entity and must be complied with.

The ‘spoke’ pharmacy is responsible for selling, supplying, or dispending medicine to patients, the hub having assembled or part assembled it. Only Model 1: patient – spoke – hub – spoke – patient, is permitted.

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The new terms of service state that contractors may not subcontract ‘core dispensing activities’ – the assembly of any prescription item, including labelling and bagging – via hub and spoke unless certain conditions are met.

This includes that contractors must ensure that the owner of the hub is ‘a fit and proper person’ to carry out the core dispensing functions on their behalf.

ABPM consultations 

The requirement to provide one Ambulatory Blood Pressure Monitoring (ABPM) consultation per month as part of the ‘bundling’ requirements to achieve a Pharmacy First fixed monthly payment will no longer go ahead from today as originally planned.

The delay follows representations from CPE and feedback from pharmacy owners and their teams, many of whom reported struggling to get patients to accept ABPM after a high clinic blood pressure reading.

Pharmacy First bundling requirements came into force on 1 June 2025, meaning pharmacies must be registered to deliver the Pharmacy Contraception Service, Hypertension Case Finding Service and Pharmacy First – in addition to delivering the minimum number of clinical pathway Pharmacy First consultations – to receive a fixed monthly payment.

The ABPM requirement, which was due to come into effect from 1 October 2025, would have added an additional monthly consultation target for contractors.

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‘While the decision by ministers provides little notice to pharmacy owners of this change, we hope the news will be welcomed by them,’ a spokesperson for CPE said.

Other regulatory changes

Several other regulatory changes, which were included in the amendments laid before parliament at the beginning of September 2025, apply from today. These include:

• The removal of the requirement to produce a practice leaflet for all pharmacies;
• The removal of the requirement to obtain references for all staff involved in the provision of NHS services.