The Pharmacy Quality Scheme (PQS) will now include a clinical audit of Pharmacy First consultations and peer discussion to support “safe, high-quality care as pharmacy services become more clinically complex”, NHS England (NHSE) has announced. 

The PQS “rewards community pharmacies for delivering quality criteria that support clinical effectiveness, patient safety and patient experience” by awarding funding based on the number of points a qualifying pharmacy receives.  

As part of negotiations on the pharmacy contract for 2026/27, NHSE and Community Pharmacy England have agreed that the total budget for this year’s PQS will be £20m. 

To receive a share of the funding, contractors choosing to undertake “Domain 2: Professional Practice” will now be expected to complete an audit and peer discussion focused on “the quality of clinical pathways consultations delivered under the NHS Pharmacy First service”. 

Audit sample 

To complete the audit and “develop an action plan for improving practice”, contractors must submit the consultation records of ten patients seen under Pharmacy First. 

The record should cover why the patient was eligible for the clinical pathway, what was found on assessment, why the treatment decision was reached and what the patient was advised to do if their condition did not improve. 

Read more: ‘Smaller than usual’ PQS reinstated under new funding deal 

The audit spans all of Pharmacy First’s seven pathways and can be completed prospectively at the time of a consultation or retrospectively in relation to a consultation undertaken between April 1, 2026 and March 31, 2027. 

According to NHSE, the audit has the following aims: 

• To assess the quality and completeness of the clinical records made for Pharmacy First clinical pathways consultations 

• To identify which elements of the consultation record are recorded least consistently 

• To measure how often a consultation record states that a safeguarding concern was identified 

• To reflect on what the record review shows and to test that reflection through a structured peer discussion with a buddy pharmacist 

• To agree at least one specific change or improvement to practice – or a way to strengthen what already works well – and put it into effect 

Read more: Tech training ‘immediate opportunity’ for Pharmacy First 

NHSE said multiple pharmacists can contribute to the audit sample, which must be anonymised and shared with NHSE through the Manage Your Service data collection tool. 

Contractors should use the audit standards section of the data collection and analysis form to “collate and then review” their findings and assess whether their pharmacy met audit standards, identifying any learning points that can be implemented in the future. 

Peer discussion 

For the peer discussion element of the PQS, a pharmacist must arrange a conversation of approximately one or two hours with a “buddy pharmacist” to review the findings of the audit and action plan, jointly reviewing “a sample of anonymised consultation summaries”.  

They must then submit the buddy’s name, the name and F code of their pharmacy and the date in which the discussion took place to NHSE. 

Read more: Awareness ‘biggest barrier’ to wider Pharmacy First use 

All information must be submitted to NHSE before 11.59pm on March 31, 2027. 

It comes after the Pharmacy First claim window was extended to three months as part of the new pharmacy contract, partly in response to outcry over missed payments. 

And it follows the “first-ever large-scale analysis” of Pharmacy First consultations, which revealed that uptake is highest in the “most deprived quintile”.