Approved pharmacist prescribers in England can now prescribe treatment for acne and mild skin infections through NHS Pharmacy First, although only a small number of pharmacies are expected to start at first. For online pharmacies, the bigger change may begin before a consultation, when people first visit a website or app with a skin concern.
On 10 September 2026, NHS England confirmed five new prescribing pathways for the NHS Pharmacy First service. The service allows people in England to receive treatment for common conditions at a pharmacy without seeing a GP first. Two of the new pathways focus on skin conditions: mild to moderate acne, and mild skin and soft tissue infections and scabies.
Most reports have focused on high street pharmacies. However, the changes also matter to online pharmacies. As more people are directed to pharmacies for skin concerns, websites and apps may become their first point of contact. This creates an opportunity to make it easier for people to understand their symptoms and find suitable next steps.
To offer the pathways, a pharmacy needs a pharmacist with a prescribing qualification and must be approved as a prescribing pharmacy. Both the pharmacy and each pharmacist prescriber must be approved by the local integrated care board
Prescribing within the pharmacy contract began on 29 October 2026. From that date, approved community pharmacists can prescribe
The start is phased. NHS England’s September announcement said hundreds of pharmacies would offer the service from autumn. Pharmacy leaders have since said that only a small number of pharmacies are likely to begin prescribing soon, with more expected to sign up in the new year.
Prescriber numbers also shape how quickly the service can spread. NHS England’s 2025 community pharmacy workforce survey counted 3,154 pharmacists with an independent prescribing qualification
The longer-term plan is much larger. Once the service is fully rolled out, NHS England says evidence suggests the five new pathways could support 2 to 3 million consultations each year. This would expand the role of community pharmacies in managing common health conditions.
NHS Business Services Authority figures
The addition of acne and mild skin infections increases the number of skin-related pathways from three to five out of twelve.
This shows a clear direction. The NHS is expanding the role of pharmacies in treating common skin conditions. As a result, pharmacies may need to consider how they help people identify their concerns and understand which services are suitable for them.
These pharmacies can provide six of the seven existing clinical pathways through video consultations
This means online pharmacies can already play a role in supporting patients through digital consultations, including for impetigo, infected insect bites and shingles. The expansion creates a further reason to review how people move from identifying a health concern to accessing the appropriate service.
The challenge begins with how people describe their concerns. A person may find it difficult to explain a rash, spot or change in their skin using words alone. A photograph can provide a more direct way to show what they are experiencing. Yet many digital journeys still begin with a search box, a list of categories or a questionnaire. People must describe their concern before they can find relevant information or services.
Skin photos submitted to digital health services image quality
These suggestions can help users explore their concerns, but they do not replace a professional assessment or determine whether someone qualifies for a Pharmacy First pathway. The pharmacy decides what happens next. Depending on the person’s needs, it might provide relevant products, offer self-care information or direct the person towards an appropriate service.
The main point is that the pharmacy retains control of the customer journey. Autoderm provides the dermatology technology, while the pharmacy decides how to use it within its existing website or app.
More information is available through Autoderm’s dermatology API for online pharmacies clinical evidence
Where do people with skin concerns enter your website or app, and what information do they see first? Can users submit a photograph of their skin concern? If so, what happens to the image after it is uploaded? What next steps are available, including products, self-care information and pharmacy services? If you offer the NHS Pharmacy First service, is it clear which skin conditions are covered? What data protection and technical requirements must a new skin-related feature meet? The dermatology API integration checklist
The expansion of the NHS Pharmacy First service has begun on a small scale, but it reflects a wider move towards managing more common conditions through community pharmacies. Skin conditions are an important part of this change.
For online pharmacies, preparing for this shift involves more than supporting consultations. A clear and accessible digital journey can help users understand their options before they reach a consultation. As the service develops, online pharmacies have an opportunity to review their websites and apps and make sure they are ready to support people seeking help for skin conditions.
References NHS England. Patients to get quicker treatment for migraines, acne and 3 other everyday conditions at pharmacies Community Pharmacy England. Prescribing within the CPCF The Pharmacist. Pharmacies can begin providing new NHS prescribing services The Pharmacist. Drop in community pharmacist numbers sparks ‘alarm’ NHS Business Services Authority. NHS Pharmacy First clinical pathways data Community Pharmacy England. Pharmacy First service
