Recording of Pharmacy First consultations in general practice records in England: an observational study of the service's first year using OpenSAFELY

Background: Pharmacy First, a national community pharmacy service, launched in January 2024 to improve access to primary care for patients with minor conditions facing backlogs caused by the COVID-19 pandemic. Pharmacies are required to share details about their consultations with general practices. We aimed to describe how and what clinical activity was recorded in general practice during the first year of the service. Methods: With the approval of NHS England, we conducted a retrospective cohort study using OpenSAFELY-TPP including Pharmacy First consultations between 31 January 2024 and 30 January 2025. We described patient demographics, consultation trends, and the clinical conditions and medications coded with Pharmacy First consultations. Results: A total of 402,165 Pharmacy First consultations were recorded for 340,710 patients from a general population of 26,142,380 registered patients in OpenSAFELY-TPP. Acute pharyngitis (28.9%) and uncomplicated urinary tract infection (28%) were the most frequently recorded conditions. By January 2025, 36.3% of Pharmacy First consultations were recorded with a clinical condition, medication, or both. Females, younger adults and those living in more deprived areas were observed more often in Pharmacy First records compared to the general population. Conclusion: Increasing recording of the Pharmacy First community pharmacy service was observed in general practice records during its first year, particularly among younger and more deprived populations. However, structured recording of consultation details remains incomplete, limiting evaluation and integration of the service into routine general practice workflows. Keywords: Pharmacy First; general practice; community pharmacy