Standard Operating Procedure
Pharmacy First
1st October 2014 – 31st March 2015
PURPOSE
This Standard Operating Procedure (SOP) describes the Pharmacy First local Enhanced
Service process in this pharmacy: (insert name of pharmacy/practice stamp)
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To ensure that the service is operated in a safe and secure way by pharmacists,
pharmacy staff and locums.
To ensure that pharmacists, pharmacy staff, locums, GP practice staff and
patients/ parents or guardians understand how the scheme works.
RESPONSIBLE PERSONNEL
The service will be delivered by accredited pharmacists, pharmacists (including
locums) working in this pharmacy, dispensary support staff and counter staff
involved in the dispensing process, who have been trained by the accredited
pharmacist and have been deemed competent to be involved in the delivery of
this service (e.g. to evaluate if a patient is eligible to participate in the service).
Name of Accredited Pharmacist:
_______________________________________________
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PROCEDURE
1. Presentation of Patient
Follow procedure as per section 3.2 of Service specification:
 When a general request is made relating to an ACUTE minor ailment covered
in the Service or when a patient has been referred to use the Service, the status of the
patient should be checked verbally to ensure suitability (age, exemption) and
registration with a participating GP practice
 If eligible, review patient history on Pharmoutcomes to ensure the patient is not
already registered elsewhere. If not yet registered, explain the service and consent
terms and conditions. Advise patient of self-help resources available from
www.selfcareforum.org If patient agrees to register, record details on Pharmoutcomes
then save and print copy. The patient or parent/guardian must sign this copy and the
copy retained by the pharmacy.
 Bank Holidays: where a patient is already registered to another pharmacy but that
pharmacy is closed, a consultation and supply may be made via Pharmoutcomes. Ensure
“Bank Holiday” is selected at Stage 2 form.
 If a patient presents more than 3 times within a 6 month period and there is no
indication for urgent referral, the patient should be provided with self-help advice or,
where appropriate, referred back to their surgery for a routine appointment. This must
be recorded on Pharmoutcomes as a Refusal
 If the patient presents with symptoms indicating the need for a consultation with the
GP, the pharmacist should (within surgery hours) contact the patient’s GP by phone to
arrange an appointment or if outside surgery hours to contact the on-call doctor, or
advise the patient to attend A & E immediately.
 If a patient presents with a prescription from a GP or has already taken up a GP
appointment for the symptoms they must NOT be transferred on to the Service for a
consultation. This must be recorded on Pharmoutcomes as a Refusal
 If a patient requests a named medicine contained within the Service formulary the
pharmacist must use their professional judgement to ascertain if this a self-referral or
product request. Product requests should not be referred into the service. The
service is not to be used to divert the sale of OTC medicines.
 If it is a self-referral as a result of using the service previously, professional
judgement is to be used to respond to these requests and assess the symptoms. The
pharmacist is clinically responsible for any treatment or advice given (whether directly
or via counter staff) and the patient is to be advised, treated or referred accordingly.
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 Referrals/requests for Service formulary products to treat conditions not covered by
the Service must either be referred back to the GP or an OTC sale recommended as
appropriate.
2. Assesment of the Patient
Where appropriate, use Consultation Room. Follow procedure as per Pharmacy First Service
specification includingQuestions must be asked to obtain the information required to allow the appropriate
recommendation of a medicine or referral to a GP if necessary as per the Service
specification particulars for each condition including, for example:
 Who is the patient and what are the symptoms?
 How long have the symptoms been present and any other symptoms?
 Action taken already?
 Medication taken for this condition or any other medicines regularly taken including
OTC, prescription or herbal remedies
 Any allergies or medical conditions?
 Pregnant or breastfeeding?
 Consider “alarm symptoms”.
Third Party Requests
A parent/guardian may access the service on behalf of a child who must also be present for
FACE-TO-FACE assessment of symptoms. Other third party requests for the service are not
permissible.
3. Provision of Advice
Where appropriate, use Consultation Room. Follow procedure as per Pharmacy First Service
specification including:
 If in the opinion of the pharmacist/Counter Staff the patient presents with symptoms
outside the Service they should be referred to the GP. This must be recorded on
Pharmoutcomes.
4. Provision of Supply of Medicines
Follow procedure as per Pharmacy First Service specification including:
 Per consultation, a supply of up to a maximum of two medicines can be made from
the set formulary and treatment guidelines
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5. Completion of the Consultation Record on Pharmoutcomes (and PMR where
appropriate)
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Pharmoutcomes must be completed at the time of consultation. Failure to do so or
check patient history may render some claims void if patient has already exceeded
maximum usage for scheme or is registered with another pharmacy.
Complete an individual or multiple consultation record (Stage 2) as appropriate e.g.
multiple consultation record should be completed for families requiring treatment
for headlice or threadworms.
The record must then be saved and printed and signed by the patient or
parent/guardian. This copy is to be retained in the pharmacy.
6. Assembly and labelling of required medicine or product

Follow normal procedure for labelling of dispensed medicines as per SOP
7. Checking procedure

Follow normal procedure as per SOP
8. Transfer of the medicine or product to the patient
Follow normal procedure as per SOP and Service treatment guidelines with the following
additions:

Advice to patient of when to consult GP if symptoms persist.

Issue of patient information leaflet where appropriate (eg. using NHS Choices or
patient.co.uk)
9. Retention of Records

Pharmacy must ensure records (including signed registration and consultation forms)
retained as per terms set out in Service specification
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10. Declaration by Pharmacy Staff involved in provision of Service
I have read and understood this SOP and the accompanying Pharmacy First Local Enhanced
Service Specification (Version 11) and declare that I am accredited as per Service
specification requirements.
Name
Role
Signature
Date
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