A referral creates an opportunity, not a finished episode

Pharmacy First contains different service elements, governed by its specification and clinical documents. A review should distinguish a referral received, an attempted contact, a consultation, an eligible completed episode and an onward referral. Self-presenting demand should not silently enter a referral denominator. Agree these definitions across participating organisations so that a difference in recording practice is not mistaken for a difference in access or professional performance.

A proposed PHARMORIS assessment could examine referrals from an agreed local source into a small pharmacy cohort. Use a baseline and observation period, with aggregate outcomes categorised consistently. Test one operational change, such as clearer availability information or a more reliable non-clinical handover. Record the number of referrals in the defined cohort, reasons for non-completion, staff effort and changes in service availability. Avoid collecting identifiable consultation records if they are unnecessary for this question.

Start with referrals received within the defined source and period. Show contacted, appropriately progressed, unresolved and other explained outcomes as separate counts, retaining the original denominator. Report self-presenting clinical pathway demand separately. If an organisation changes how it records referral receipt during the trial, flag the break in comparability. This modest discipline prevents a completion percentage from rising simply because difficult referrals disappeared from the dataset.

For a pharmacy, workload, eligible remuneration and claim handling are connected but distinct. MYS is part of the existing claims environment; PHARMORIS should not be presented as an established replacement or approved integration (NHSBSA, n.d.). Count time spent on unsuccessful contacts and exceptions when estimating delivery effort. For the wider system, any reduction in GP work would require separate evidence. Pharmacy activity alone cannot establish displaced appointments, improved health outcomes or a cash-releasing NHS saving.

The result might justify a local handover change, a different service window or a larger comparative evaluation. Stop if records cannot support a consistent denominator, the change creates excessive administration or clinical teams identify an unsafe consequence. A short operational test cannot establish long-term effectiveness. Its value is to make the next implementation choice better informed and to show where the evidence is still too weak for a larger commitment.

NHS England | Pharmacy First service specification | NHSBSA | MYS for pharmacies

NHSBSA (n.d.) MYS for pharmacies. Available at: https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/dispensing-contractors-information/manage-your-service-mys/mys-pharmacy (Accessed: 14 October 2026).