Can a Pharmacist Prescribe Antibiotics

Earls Barton Pharmacy | Updated 22 October 2026
If you’ve got a painful ear, a burning UTI or an infected bite, waiting days for a GP appointment can feel like the worst part. The good news is that in England you often don’t have to. A community pharmacist can now assess certain infections and, where it’s clinically appropriate, give you antibiotics or antivirals on the NHS, with no GP appointment needed.
There are rules, though. Pharmacy First has seven clinical pathways through which pharmacists can supply certain prescription-only treatments when appropriate. Each has age limits and other eligibility criteria. This guide explains who may qualify and what your options are if you fall outside the criteria.

Yes, for some infections. Since 31 January 2024, pharmacists in England can supply antibiotics or antivirals without a GP visit through the NHS Pharmacy First service. It covers seven conditions: sinusitis, sore throat, earache, infected insect bites, impetigo, shingles and uncomplicated UTIs in women aged 16 to 64.

Under Pharmacy First, prescription-only medicines are usually supplied under patient group directions (PGDs), rather than an individual prescription. These NHS-approved directions specify who can receive a medicine, which medicine can be supplied and when the pharmacist must refer you for further assessment.

Some pharmacists are also qualified independent prescribers. They can prescribe within their area of expertise, which is how some pharmacies offer private consultations for problems that fall outside the NHS service.

For you as a patient, this means a clinical assessment and, where appropriate, treatment without a GP prescription first. You can attend or contact a participating pharmacy directly, or be referred by NHS 111, your GP surgery or an urgent care service. The NHS consultation is free. Normal NHS prescription charges apply to medicines supplied under the service unless you are exempt.

This service is run in England. Scotland and Wales have their own pharmacy schemes with different rules, so check locally if you live there.

These are the seven clinical pathways available through NHS Pharmacy First in England and their headline age limits. Treatment also depends on your symptoms, medical history, medicines and the service’s eligibility criteria. The pharmacist may refer you for further assessment.

Pharmacy First also includes referred minor illness consultations and urgent repeat medicine supplies. The seven pathways below are the part of the service covered in this guide.

To get the best results from your appointment we recommend that you soften your ear wax by using Earol. This will help get the best results from the procedure by making it easier to remove very hard ear wax and reduce the need for repeated appointments.
You can purchase Earol from our pharmacy, when you pick it up we’ll explain how to use it and answer any questions you have.
Before your appointment you should also avoid ear cleaning tools. Don’t use cotton swabs or other objects to try and clean your ears, as these can push wax deeper into the canal and potentially cause injury.

At your appointment, before we start we’ll ask you some questions about your overall ear health. It’s important you let us know about any previous surgeries, perforated eardrums, or chronic ear infections so we can tailor the procedure to your needs.

• UTI antibiotics from a pharmacy for women aged 16 to 64
• sore throat and tonsillitis treatment for ages 5 and over
• sinusitis treatment for ages 12 and over
• earache in children for ages 1 to 17
• infected insect bite treatment for ages 1 and over
• impetigo treatment for ages 1 and over
• shingles antiviral treatment for adults

• Many sore throats and sinus infections are caused by viruses. Antibiotics do not treat viral infections.
• Recovery times vary. A sore throat often improves within a week, while sinusitis can take two to three weeks.
• Unnecessary antibiotics can cause side effects such as diarrhoea and thrush, and contribute to antibiotic resistance.

This is where a lot of people get stuck. The NHS service is free at the point of use but tightly defined. Common examples of people who fall outside it include:

• Adults with ear pain. NHS Pharmacy First earache only covers children and teenagers aged 1 to 17.
• Men with UTI symptoms, and women under 16 or 65 and over. These groups need a GP assessment because the risk of a more complicated infection is higher.
• Infections not on the list, such as chest infections or dental infections. These need a GP, NHS 111 or a dentist.

For adults with ear problems, our private ear infection service includes a pharmacist consultation and examination with a digital otoscope. Following examination, an antibiotic ear spray may be supplied for a suitable outer ear infection. Treatment depends on the cause of the ear pain, and other problems may require different treatment or referral. Where appropriate, otoscopy images can be shared securely with your GP or an ENT specialist to support further assessment. If wax is the cause, the pharmacist can advise whether our earwax removal service is suitable.

For other minor problems, our private pharmacy treatments clinic offers a consultation with a pharmacist for adults aged 18 and over. The pharmacist will tell you honestly if a GP is the better route.

A pharmacist will refer you if your symptoms suggest something more serious. Don’t wait for a pharmacy consultation, and call 999 or go to A&E, if you or someone you’re caring for has:

• Difficulty breathing, or a swollen tongue, lips or throat.
• A very high temperature with confusion, a stiff neck or a rash that doesn’t fade when a glass is pressed on it.
• Confusion, marked drowsiness or difficulty speaking when an infection is suspected.

Seek an urgent GP appointment or contact NHS 111 if:

• You have back or side pain, especially under the ribs, with a high temperature or shivering, as this may be a kidney infection.
• You’re pregnant and have symptoms of a UTI.
• You have a weakened immune system.
• A shingles rash affects your eye or nose, or your vision changes.

If your symptoms are not improving after treatment or keep returning, contact your pharmacist or GP for reassessment. Seek urgent advice if symptoms worsen or you become very unwell.

If you think you have shingles, seek advice promptly, ideally within three days of the rash appearing. Antiviral treatment works best when started early, although treatment may still be appropriate later in some cases.

A Pharmacy First consultation takes place in a private consultation room. The time needed depends on your symptoms and the assessment. The pharmacist will:

• ask about your symptoms, how long you’ve had them and your medical history
• check which medicines you take and whether you have any allergies
• examine you where needed, for example looking at your throat, ear or skin
• explain whether you need treatment, and supply it if you do
• let your GP practice know about the consultation so your records stay up to date

Bring a list of your current medicines. If you’re coming in for a child, they need to be with you so the pharmacist can assess them.

Pharmacists in England can assess seven common conditions through the NHS Pharmacy First clinical pathways and supply antibiotics, antivirals or other treatment when appropriate. If you meet the criteria, you may receive treatment without a GP appointment. If you do not, our team can advise on suitable private services or direct you to the right healthcare professional.
Not sure which service fits? Call us on 01604 812736, message us on WhatsApp, or pop into Earls Barton Pharmacy and our pharmacists will point you in the right direction.

Disclaimer: All information in this article has been checked for accuracy at the time of publication. However, we cannot guarantee that it is entirely free from errors or omissions and accept no liability for any inaccuracies or omissions. This information is intended for general guidance only and should not replace professional medical advice.