Pharmacy First Service Referral Guide

PFS allows patients to access a consultation with a pharmacist for these seven common conditions. To access these, patients need to meet the ‘Gateway Point’. Here we have summarised the seven conditions and the triggers for referral to the pharmacist for assessment for PFS. Normal OTC practice still applies and remember to always ask the pharmacist if you are unsure or spot any red flags. 

Pharmacy First Service Referral Guide

Suitable for over 18s

Symptoms

• Tingling or painful feeling in an area of skin
• Headache
• Feeling generally unwell
• A rash (normally only on one side
  of body) which progresses to
  blisters.

OTC Management

No treatment available OTC

PFS Referral

All cases of suspected shingles

Suitable for 1 year +

Symptoms

• Red sores or blisters
• Sores or blisters quickly burst and leave crusty, golden-brown patches.

OTC Management

Can be treated with hydrogen peroxide 1%

PFS Referral

All cases of suspected impetigo

Suitable for 1-17 years old

Symptoms

• Pain inside ear
• Discharge
• Itchiness and irritation around ear
• Feeling pressure within ear
• Small children may rub and pull ear, be off food and be restless

OTC Management

Majority will recover without antibiotics and may just require pain relief

PFS Referral

Refer all cases 1-17 years old for ear examination

Suitable for: 12 years +

Symptoms

• Pain, swelling and tenderness around your cheeks, eyes or forehead
• Blocked nose
• Reduced sense of smell
• Green-yellow mucus
• Sinus headache
• Fever
• Toothache

OTC Management

Most sinusitis will resolve within 2-3 weeks with pain relief and decongestant treatment.

PFS Referral

When patient has had symptoms
for ten or more days with no
improvement.

Suitable for 1 year +

Symptoms

• Red and swollen around bite
• Skin hot to touch
• Painful

OTC Management

Most cases can be treated with oral antihistamines and  topical hydrocortisone.

PFS Referral

48 hours post-bite and redness and
swelling surrounding bite spreading

Suitable for 5 years +

Symptoms

• Dry and painful throat especially when swallowing
• Swollen neck glands

OTC Management

Most cases are viral and resolve within a week. Patient can use pain relief, lozenges and anaesthetic spray to ease symptoms.

PFS Referral

Where patient meets at least 4 of the 5 criteria – fever, pus on tonsils, inflamed tonsils, onset in the last 3 days and no cough. 

Suitable for Women 16-64

Symptoms

• Pain or a burning sensation when passing urine
• Needing to pass urine more often than usual
• Urine that looks cloudy

OTC Management

Paracetamol for pain and advice around fluids and rest.

PFS Referral

When symptoms are not mild and do not indicate thrush (discharge)