Derm summary 6

Question 1

What is Pharmacy First and when was it launched?

Answer 1

An NHS England Advanced Service launched in January 2024 to allow community pharmacists to diagnose and treat minor conditions under PGDs.

Question 2

What are the key pharmacist roles under Pharmacy First?

Answer 2

1. Diagnose and treat minor conditions
2. Supply POMs under PGDs
3. Act as first NHS contact for 7 clinical pathways

Question 3

What are the three tiers of the Community Pharmacy Contractual Framework (CPCF)?

Answer 3

1. Essential services – provided by all pharmacies
2. Advanced services – optional, accredited (e.g., Pharmacy First)
3. Locally commissioned – tailored by ICBs/Local Authorities

Question 4

What dermatology conditions are covered under Pharmacy First and their age criteria?

Answer 4

1. Impetigo (non-bullous): ≥1 year – fusidic acid cream
2. Infected insect bites: ≥1 year – oral antibiotics
3. Shingles: ≥18 years – aciclovir
   All via PGDs

Question 5

When should a patient with dermatological symptoms be referred under Pharmacy First?

Answer 5

Refer if: bullous impetigo, systemic symptoms, or not within PGD scope

Question 6

What tools and frameworks support clinical decision-making in Pharmacy First?

Answer 6

Use ICE, SOCRATES, red flags, TARGET Toolkit, BNF App, CKS; consider lesion site/severity, age, immune status, antibiotic history

Question 7

What are key legal and consultation practices in Pharmacy First?

Answer 7

1. Introduce self and role
2. Obtain informed consent
3. Offer chaperone if needed
4. Document clearly
5. Ensure patient understanding

Question 8

In Pharmacy First, what action is taken for a toddler with a crusty rash?

Answer 8

Diagnosis: Impetigo
Action: Supply fusidic acid under PGD, hygiene advice

Question 9

What is the Pharmacy First approach for an infected insect bite with no systemic signs?

Answer 9

Diagnosis: Infected bite
Action: Oral flucloxacillin, elevation, safety-netting

Question 10

What action should be taken in a shingles case under Pharmacy First?

Answer 10

Patient: ≥18 years, chest rash and pain
Action: Aciclovir if within 72h; avoid ibuprofen

Question 11

How is tinea cruris managed under Pharmacy First?

Answer 11

Topical terbinafine and hygiene advice

Question 12

What is the management for teenage acne under Pharmacy First?

Answer 12

Start topical combination therapy; refer if severe or scarring

Question 13

Why is Pharmacy First important for pharmacy practice?

Answer 13

Recognises pharmacists as clinicians, reduces GP pressure, improves access and care, supports development of IP skills

Question 14

What significant change is coming for pharmacy qualifications in 2026?

Answer 14

All new pharmacists will qualify as Independent Prescribers (IPs)