England · Pharmacy First · Open access

Pharmacy First pathways

Seven current pathways, free to open in CRx Workspace. Read the inclusion and exclusion summaries, then open the interactive pathway. No account or payment card needed.

Summaries checked against NHS England clinical pathways v2.5 on 22 October 2026. These summaries are not a complete eligibility or referral checklist.

• Uncomplicated UTI

  Urinary symptoms and important mimics.

  Inclusion

  • Women aged 16 to under 65 years.
  • Suspected lower UTI.
  Exclusions

  • Diabetes, pregnancy or a urinary catheter.
  • Recurrent UTI: 2 episodes in 6 months or 3 in 12 months.
  • Possible kidney infection: urgent onward assessment.
  • PGD 1a supply: current breastfeeding is excluded; additional sex/anatomy criteria apply.
  Open uncomplicated UTI pathwayUncomplicated UTI overview

  NHS pathway (PDF)NHS PGDs & protocol
  Medicines & PGDs — Uncomplicated UTI

  Check each linked document for full medicine-specific eligibility and exclusions.

  • Nitrofurantoin · PGD 1a · v1.3 (PDF)

  Open uncomplicated uti pathway with PGD panel

• Acute sore throat

  Throat symptoms and reassessment.

  Inclusion

  • 5 years and over.
  • Signs and symptoms of acute sore throat.
  Exclusions

  • Pregnancy in individuals under 16 years.
  • Suspected serious throat illness, head/neck cancer or immunosuppression: onward referral.
  • PGD supply: previous tonsillectomy.
  • PGD supply: recurrent sore throat/tonsillitis — 7+ significant episodes in 12 months, 5+ a year in each of the preceding 2 years, or 3+ a year in each of the preceding 3 years.
  Open acute sore throat pathwayAcute sore throat overview

  NHS pathway (PDF)NHS PGDs & protocol
  Medicines & PGDs — Acute sore throat

  Check each linked document for full medicine-specific eligibility and exclusions.

  • Phenoxymethylpenicillin (penicillin V) · PGD 5a · v1.1 (PDF)
  • Clarithromycin · PGD 5b · v1.1 (PDF)
  • Erythromycin · PGD 5c · v1.1 (PDF)

  Open acute sore throat pathway with PGD panel

• Acute sinusitis

  Facial and nasal symptoms.

  Inclusion

  • 12 years and over.
  • Signs and symptoms of acute sinusitis.
  • Symptoms lasting 10 days or less follow the self-care branch.
  Exclusions

  • Immunosuppression.
  • Chronic sinusitis: symptoms lasting more than 12 weeks.
  • Pregnancy in individuals under 16 years.
  • PGD supply: recurrent sinusitis — 4+ episodes a year, with symptom-free intervals.
  • Eye/orbital or neurological complications: urgent onward assessment.
  Open acute sinusitis pathwayAcute sinusitis overview

  NHS pathway (PDF)NHS PGDs & protocol
  Medicines & PGDs — Acute sinusitis

  Check each linked document for full medicine-specific eligibility and exclusions.

  • Fluticasone furoate · PGD 6a · v1.1 (PDF)
  • Mometasone furoate monohydrate · PGD 6b · v1.1 (PDF)
  • Phenoxymethylpenicillin (penicillin V) · PGD 6c · v1.1 (PDF)
  • Clarithromycin · PGD 6d · v1.1 (PDF)
  • Doxycycline · PGD 6e · v1.1 (PDF)
  • Erythromycin · PGD 6f · v1.1 (PDF)

  Open acute sinusitis pathway with PGD panel

• Acute otitis media

  Middle-ear symptoms in children.

  Inclusion

  • Children aged 1 to 17 years.
  • Signs and symptoms of acute otitis media.
  Exclusions

  • Pregnancy in individuals under 16 years.
  • Recurrent acute otitis media: 3+ episodes in 6 months or 4+ in 12 months.
  • Systemically very unwell, serious illness or high risk of complications: onward referral.
  Open acute otitis media pathwayAcute otitis media overview

  NHS pathway (PDF)NHS PGDs & protocol
  Medicines & PGDs — Acute otitis media

  Check each linked document for full medicine-specific eligibility and exclusions.

  • Phenazone / lidocaine hydrochloride · PGD 7a · v1.1 (PDF)
  • Amoxicillin · PGD 7b · v1.1 (PDF)
  • Clarithromycin · PGD 7c · v1.1 (PDF)
  • Erythromycin · PGD 7d · v1.1 (PDF)

  Open acute otitis media pathway with PGD panel

• Shingles

  Rash pattern and complications.

  Inclusion

  • 18 years and over.
  • Suspected shingles.
  • Antiviral eligibility has separate additional criteria within 72 hours and later up to 7 days after rash onset.
  Exclusions

  • Pregnancy.
  • Head/neck or eye involvement, serious complications or severe immunosuppression: onward assessment.
  • Immunosuppression with severe/widespread rash or systemic illness: onward assessment.
  • PGD supply: breastfeeding with shingles lesions on the breast.
  Open shingles pathwayShingles overview

  NHS pathway (PDF)NHS PGDs & protocol
  Medicines & PGDs — Shingles

  Check each linked document for full medicine-specific eligibility and exclusions.

  • Aciclovir · PGD 2a · v1.1 (PDF)
  • Valaciclovir · PGD 2b · v1.1 (PDF)

  Open shingles pathway with PGD panel

• Impetigo

  Crusted skin lesions and spread.

  Inclusion

  • 1 year and over.
  • Non-bullous impetigo: localised (3 or fewer lesions/clusters) or widespread (4 or more).
  Exclusions

  • Bullous impetigo; pregnancy in individuals under 16 years.
  • Recurrent impetigo: 2 or more episodes in the same year.
  • Suspected deeper infection or serious illness: onward assessment.
  • PGD/protocol supply: breastfeeding with impetigo lesions on the breast.
  Open impetigo pathwayImpetigo overview

  NHS pathway (PDF)NHS PGDs & protocol
  Medicines & PGDs — Impetigo

  Check each linked document for full medicine-specific eligibility and exclusions.

  • Hydrogen peroxide · Protocol 3a · v1.1 (PDF)
  • Fusidic acid · PGD 3b · v1.0 (PDF) Expires 30 January 2027.
  • Flucloxacillin · PGD 3c · v1.1 (PDF)
  • Clarithromycin · PGD 3d · v1.1 (PDF)
  • Erythromycin · PGD 3e · v1.1 (PDF)

  Open impetigo pathway with PGD panel

• Infected insect bites

  Skin symptoms after bites and stings.

  Inclusion

  • 1 year and over.
  • Signs and symptoms of an infected insect bite or sting.
  • Antibiotic eligibility includes a check that at least 48 hours have passed since the initial bite/sting.
  Exclusions

  • Pregnancy in individuals under 16 years.
  • Human/animal bites, possible Lyme disease, unusual/exotic insects, or travel-related bites with concern about insect-borne disease: onward referral.
  • Systemically unwell, severe pain out of proportion, pus collection or complicating comorbidity: onward referral.
  Open infected insect bites pathwayInfected insect bites overview

  NHS pathway (PDF)NHS PGDs & protocol
  Medicines & PGDs — Infected insect bites

  Check each linked document for full medicine-specific eligibility and exclusions.

  • Flucloxacillin · PGD 4a · v1.1 (PDF)
  • Clarithromycin · PGD 4b · v1.1 (PDF)
  • Erythromycin · PGD 4c · v1.1 (PDF)

  Open infected insect bites pathway with PGD panel

Medicine documents checked on 22 October 2026 against the NHS England service index. PGDs and the hydrogen peroxide protocol have their own versions and validity dates. CPE medicines list (October 2025) is a cross-check; the linked NHS documents govern supply.