How to Use the NHS Pharmacy First Service

The NHS Pharmacy First service is designed to make it quicker and easier to get treatment for common health conditions without needing a GP appointment. 

Available across England, Wales and Scotland it allows trained community pharmacists to assess, advise, and in some cases treat certain illnesses, often on the same day.

If you’ve been struggling to get a GP appointment or aren’t sure whether your symptoms need a doctor, Pharmacy First could be the ideal first step.

What Is NHS Pharmacy First?

Pharmacy First enables community pharmacists to provide NHS consultations for a range of common conditions. These consultations are free, and where appropriate, pharmacists can supply NHS-funded treatment rather than simply offering over-the-counter advice.

The aim is to:

Reduce pressure on GP surgeries and A&E

Help patients get faster access to care

Make better use of pharmacists’ clinical expertise

Conditions You Can Be Treated For

Under Pharmacy First, pharmacists can assess and treat several common conditions, including:

For adults

Sinusitis

Sore throat

Earache

Infected insect bites

Impetigo

Shingles (early presentation)

For women and girls

Uncomplicated urinary tract infections (UTIs)

The pharmacist will check symptoms carefully to ensure the condition is suitable for treatment under the service. If not, they’ll advise on the next best step — such as contacting your GP or NHS 111.

How to Access Pharmacy First

1. Walk into a Participating Pharmacy

You don’t need an appointment. Simply visit a local pharmacy offering the service and ask for a Pharmacy First consultation.

2. NHS Referral

You may also be referred by:

NHS 111

GP practices

Urgent care or A&E services

This helps direct patients to the right care setting quickly.

What Happens During the Consultation?

Pharmacy First consultations are carried out in a private consultation room. The pharmacist will:

Ask about your symptoms and medical history

Check how long symptoms have lasted

Assess whether treatment can be safely provided

Supply NHS medication if appropriate

Give clear self-care advice and safety-net guidance

If symptoms suggest something more serious, the pharmacist will refer you onwards promptly.

What Treatment Can Pharmacists Provide?

Depending on the condition, pharmacists may:

Supply prescription-only medicines under NHS protocols

Recommend appropriate self-care measures

Advise on pain relief, symptom management, and recovery times

Any treatment supplied through Pharmacy First is recorded on your NHS record, ensuring continuity of care.

Who Can Use Pharmacy First?

You can use the service if you:

Are registered with a GP in England

Have symptoms that fall within the service criteria

Meet the age and clinical requirements for the condition

There is no charge for the consultation, and normal NHS prescription charges apply where relevant (unless you are exempt).

When Pharmacy First Isn’t Appropriate

Pharmacy First is not suitable for:

Severe or worsening symptoms

Chest pain or breathing difficulties

Serious infections

Children outside the age limits for certain conditions

In these cases, pharmacists will direct you to urgent or emergency care.

Why Pharmacy First Matters

For many people, Pharmacy First means:

Faster access to treatment

Less time waiting for GP appointments

Expert advice close to home

Early intervention that can prevent complications

Community pharmacies are often open during evenings and weekends, making them one of the most accessible parts of the NHS.

The NHS Pharmacy First service is a practical, patient-friendly way to manage everyday health concerns. 

If you’re unwell and unsure where to turn, your local pharmacy could be the quickest route to reassurance and treatment — without adding pressure to GP services.

If in doubt, step into your nearest participating pharmacy and ask. Help may be closer than you think.

I must point out that my wife and I have used the NHS Pharmacy First Service on a number of occasions and have received wonderful help and support. 

Why You Should Get the Shingles Vaccination – Even If You Have to Pay for It

Shingles isn’t just “a bit of a rash.” It’s an agonising, nerve-related condition caused by the same virus that causes chickenpox, the varicella-zoster virus. 

Once you’ve had chickenpox, that virus never leaves your body; it simply lies dormant, waiting for an opportunity to reactivate later in life. 

When it does, it reappears as shingles,  a painful, blistering rash that can lead to months (or even years) of nerve pain known as postherpetic neuralgia.

As a sufferer from shingles I can confirm that it is a nasty, painful condition. And it was my struggles to try to understand the NHS rules that prompted me to research and write this blogpost and to eventually fund my own shingles vaccination.

The NHS Rules: A Maze of Eligibility

In theory, the NHS offers a free shingles vaccination to protect people from this debilitating illness. In practice, the rules about who qualifies and when they qualify are bafflingly complex.

Under current NHS guidelines in England, the free shingles vaccine is available to people aged 70 to 79, and now also those turning 65 on or after 1 September 2023. But if you’re 66, 67, 68 or 69, you’re expected to wait, even though your risk of shingles doesn’t magically disappear until the NHS sends an invite.

Worse still, these rules vary across the UK. In Scotland and Wales, eligibility criteria differ again. The result? Many people who would benefit from the vaccine find themselves excluded simply because of their birth date or postcode.

It’s a frustrating situation, and it leaves a huge number of adults in their 50s and 60s without protection, despite shingles being most common in older adults and those with weakened immune systems.

Why Paying for the Vaccine Is Worth It

If you’re not eligible for a free NHS jab, it’s well worth paying privately. Pharmacies such as Boots, Lloyds, and Superdrug offer the Shingrix vaccine, which provides excellent long-term protection and can be administered in two doses a few months apart.

Here’s why it’s worth considering, even out of pocket:

Avoid excruciating pain: Shingles can be intensely painful, often described as burning or stabbing.

Prevent complications: The condition can cause scarring, nerve damage, vision loss (if it affects the eyes), and in rare cases, serious neurological problems.

Reduce time off work or daily disruption: Shingles can leave sufferers exhausted and unable to function for weeks. My late father was so ill with shingles that his doctor ordered him to take bedrest for a week. 

Protect your long-term health: The older you get, the more severe shingles tends to be, so prevention is key.

The cost of the vaccine privately is typically around £200–£250 for the full course. That might sound steep, but compared to the months of pain, doctor visits, and medication that shingles can bring, it’s an investment in comfort and quality of life.

The NHS Needs Simplification

While it’s excellent that the NHS provides the vaccine for some, the staggered, age-based rollout has turned something simple into a bureaucratic nightmare. Many people eligible in theory are confused by the shifting rules or unaware they qualify at all. Others are left wondering why they must wait years to get protection that’s readily available in other developed countries for anyone over 50.

Until the NHS streamlines its approach and offers the shingles vaccine more widely, taking control of your own health and arranging a private jab may well be the most sensible move.

Bottom line: Don’t wait for a letter. Don’t risk weeks or months of unnecessary suffering. Whether free or paid for, the shingles vaccination is one of the smartest health decisions you can make.

It was one of the best decisions I have ever made. 

Shingles vaccine to be offered to hundreds of thousands more immunosuppressed adults

Around 300,000 more people will become eligible for a potentially lifesaving shingles vaccination from next week, as GP practices roll out the jab to protect all severely immunosuppressed adults.

People newly eligible for the shingles vaccination from Monday 1 September are those aged 18 to 49 who have a severely weakened immune system. 

They will be able to book an appointment for the vaccine with their GP surgery, with practices starting to contact people over the coming weeks.

This includes people with conditions like leukaemia or lymphoma or those who are undergoing chemotherapy, which put them at greater risk of becoming seriously unwell should they contract shingles.

The NHS has previously expanded the shingles vaccination programme to include all over 50s with a severely weakened immune system.

Patient organisations welcome the latest expansion that will see thousands more at risk people protected.

Shingles is caused by the reactivation of the varicella zoster virus (which causes chickenpox) and usually occurs decades after initial infection. 

The condition causes a painful rash and typically lasts between 2 and 4 weeks.

1 in 5 people will go on to develop shingles in their lifetime and although most people make a full recovery, it can cause serious problems including persistent pain known as post-herpetic neuralgia, eye problems, and even lead to pneumonia, hepatitis and inflammation of the brain.

Individuals who are severely immunosuppressed are most at risk of serious illness and complications from shingles.

The vaccine, Shingrix®, is currently available to people aged 65 to 79 and severely immunosuppressed individuals from 50 years of age, but eligibility is set to change from next week to include all severely immunosuppressed adults aged 18 years and over.

The roll out to all severely immunosuppressed adults follows advice from the Joint Committee on Vaccination and Immunisation (JCVI) who found that the risk of hospitalisation from shingles or those resulting in post-herpetic neuralgia was similar in younger immunosuppressed age groups to those who were already eligible.

Dr Amanda Doyle, National Director for Primary Care and Community Services at NHS England, told That's Health: “Shingles can be seriously debilitating for older people and those with a severely weakened immune system, so following the latest expert guidance, the NHS is now expanding the potentially lifesaving jab to all severely immunosuppressed adults.

“The vaccine is safe and effective and significantly reduces the chance of developing shingles and becoming seriously unwell, so I’d urge anyone newly eligible to come forward for their protection as soon as possible.

“The NHS will be contacting you to let you know you are eligible, but you can also make a booking through your local GP – and even if you’ve had shingles before, you can develop it again so please still come forward for the offer.”

Health Minister Ashley Dalton said: “Expanding shingles vaccination will protect even more people at greatest risk from this painful condition.

“This government is committed to preventive healthcare and ensuring those who are most vulnerable receive the protection they need.

“I encourage all those eligible for the vaccine to come forward for their jab”.

Severely immunosuppressed people will be offered 2 doses of the non-live shingles vaccine, Shingrix®, with the second dose given 8 weeks to 6 months after the first dose.

A JCVI report estimates that prior to the introduction of a shingles vaccination programme in 2013, there were over 4,500 hospital admissions per year due to shingles, most of which could have been prevented through vaccination.

Within the first 3 years of the vaccination programme, there were an estimated 17,000 fewer episodes of shingles and 3,300 fewer episodes of post-herpetic neuralgia among the eligible population.

Dr Gayatri Amirthalingam, Deputy Director of Immunisation at the UK Health Security Agency: “Shingles can be a very painful infection and may cause complications that lead to hospitalisation. It can affect people at any age, but the risk and severity of shingles increases with age. 

However, following a review of the evidence, it was discovered that younger adults who are severely immunosuppressed are also at higher risk of severe illness and hospitalisation, and from September the shingles vaccine programme will now be expanded to include this group who are aged 18 and over.

“The NHS will continue a phased roll out of the vaccine for older people and your GP should be in touch once you become eligible, currently when you reach 65 or 70 years.

“Shingles can be a nasty, painful disease, so I strongly recommend you have the vaccine, given as 2 doses, as soon as you become eligible, and if you are unsure, please do check with your GP surgery”.

NHS services were contacted about the expansion in July to ensure that they are ready to roll out the vaccine from September, and Shingrix® can be given alongside other seasonal and routine vaccines, including flu and COVID-19.

Susan Walsh, Chief Executive Officer of Immunodeficiency UK, said: “We welcome the widening of the age eligibility criteria for the shingles vaccination programme for immunosuppressed individuals. 

"It means that people most at risk will be able to have protection against the worst effects of having shingles and will help reduce the risk of being hospitalised from its complications. We are encouraging everyone eligible to take up the offer."

When Shingles Leaves More Than Scars: Understanding Excessive Sweating After Nerve Damage

Can shingles cause excessive sweating on the head or face? Learn how post-shingles nerve damage can lead to abnormal sweating and what treatment options are available.

Shingles, also known as herpes zoster, is a painful viral condition caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. 

Most people associate shingles with a blistering rash and sharp nerve pain, but some are surprised to find that sweating changes, particularly excessive sweating on the head or face, can also occur.

So what’s going on? Can shingles really lead to such a strange and uncomfortable symptom?

Shingles and Nerve Damage: More Than Skin Deep

Shingles tends to affect sensory nerves, causing a painful rash in a specific area of the body—usually limited to one side. However, the virus can also impact autonomic nerves, which control involuntary functions like blood pressure, digestion… and sweating.

When shingles affects areas like the face, head, or neck, the damage can disrupt normal sweating patterns. The nerves that usually regulate temperature and sweat production can begin misfiring, leading to excessive or abnormal sweating, even without heat or exertion.

Why Excessive Sweating Happens

This type of symptom is a form of autonomic dysfunction. It may happen because:

Damaged nerve fibres are sending the wrong signals to sweat glands.

The body is trying to "compensate" for reduced sweating elsewhere.

There’s cross-talk between nerves that previously had separate roles (a bit like crossed wires after an electrical fault).

In some cases, people develop a condition known as Frey’s syndrome, a type of gustatory sweating triggered by eating, but other times, the sweating is random, excessive, and unrelated to meals.

Is This Dangerous?

While not life-threatening, excessive facial or scalp sweating can be:

Embarrassing in social settings

Uncomfortable during daily activities

A clue that your nervous system is still under strain following shingles

This symptom can occur alongside other long-term effects of shingles such as:

Post-herpetic neuralgia (nerve pain that lingers after the rash has healed)

Itching, tingling, or burning

Numbness or altered sensation

What You Can Do About It

If you're experiencing excessive sweating following shingles, it’s wise to speak to your GP or a neurologist. You may be offered one of the following treatments:

Topical treatments – Clinical-strength antiperspirants or creams like glycopyrrolate

Botox injections – Can reduce sweating for several months by blocking nerve signals

Oral medications – Anticholinergics may help, though they come with side effects like dry mouth

 Pain management – If you also have nerve pain, medications like gabapentin or pregabalin might help regulate nerve activity overall

Self-Care Tips

Use absorbent headbands or face cloths discreetly during flare-ups

Stay cool indoors with fans or cooling towels

Avoid hot or spicy foods, which can trigger sweating episodes

Keep a symptom diary to track patterns and triggers

Shingles can leave a lasting impact on the body, but excessive sweating on the head or face doesn’t have to be something you live with in silence. With the right support and treatment, you can manage the symptoms and regain control over your comfort and confidence.

If you're struggling with post-shingles symptoms, don’t hesitate to seek medical advice—your experience is valid, and help is available.

Have you experienced unusual symptoms after a bout of shingles? Share your story in the comments below or get in touch—we'd love to hear from you.

Understanding Shingles: Symptoms, Complications, and Treatment

Shingles, also known as herpes zoster, is a viral infection caused by the varicella-zoster virus, the same virus that causes chickenpox. 

While chickenpox is often associated with childhood, the varicella-zoster virus can lie dormant in your nerve tissues for years and resurface later in life as shingles. In this blog post, we will delve into what shingles is like, potential complications, and how it can be treated.

What is Shingles Like?

Shingles typically manifests as a painful rash that develops on one side of the body, often in a band-like pattern. The rash is usually accompanied by itching, tingling, or burning sensations. Before the rash appears, some individuals may experience flu-like symptoms such as fever, headache, and fatigue. 

The rash typically progresses into fluid-filled blisters that crust over within a few weeks. The pain associated with shingles can range from mild to severe and may persist even after the rash has healed, a condition known as postherpetic neuralgia.

Potential Complications:

While shingles itself can be uncomfortable and debilitating, it can also lead to various complications, especially in older adults and individuals with weakened immune systems. Some of the potential complications of shingles include:

Postherpetic Neuralgia: This is the most common complication of shingles, characterized by persistent pain in the affected area long after the rash has healed. The pain can be severe and debilitating, impacting daily activities and quality of life.

Vision Problems: If shingles affects the nerves around the eye, it can lead to complications such as vision loss, glaucoma, or inflammation of the eye.

Neurological Complications: In rare cases, shingles can lead to inflammation of the brain (encephalitis) or spinal cord (myelitis), which can cause neurological problems such as paralysis, weakness, or cognitive impairment.

Skin Infections: The blisters caused by shingles can become infected, leading to complications such as cellulitis or impetigo.

Ramsay Hunt Syndrome: This is a rare complication of shingles that affects the nerves in the face and ear, leading to facial paralysis, hearing loss, and vertigo.

Treatment:

While there is no cure for shingles, prompt treatment can help alleviate symptoms, speed up recovery, and reduce the risk of complications. Treatment options for shingles may include:

Antiviral Medications: These medications, such as acyclovir, valacyclovir, and famciclovir, can help reduce the severity and duration of the shingles rash if started within 72 hours of the rash appearing.

Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen may help alleviate pain associated with shingles. In some cases, prescription medications such as antidepressants, anticonvulsants, or topical numbing agents may be recommended to manage nerve pain.

Antiviral Creams: Applying antiviral creams or ointments directly to the rash can help speed up healing and reduce pain and itching.

Corticosteroids: In some cases, corticosteroid medications may be prescribed to reduce inflammation and pain associated with shingles, especially in older adults or individuals with severe symptoms.

Vaccination: The shingles vaccine, known as Shingrix, is recommended for adults aged 50 and older to prevent shingles and reduce the risk of complications.

Shingles can be a painful and uncomfortable condition, but prompt treatment can help alleviate symptoms and reduce the risk of complications. If you suspect you may have shingles, it's essential to seek medical attention promptly to receive appropriate treatment.

Additionally, getting vaccinated against shingles can help prevent the onset of the disease and reduce its severity in those who do develop it. By understanding the symptoms, complications, and treatment options for shingles, individuals can take proactive steps to protect their health and well-being.