New Caps on Pharmacy First Clinical Pathways Consultations
From April 2025, changes have been introduced to the way Pharmacy First clinical pathways consultations are funded – with new monthly caps now in place for every pharmacy.
Each month, pharmacies are given a capped allocation of funded clinical pathway consultations. The cap is linked to their delivery history and band assignment. Consultations above this monthly cap will not receive the £17 fee per consultation.
These changes apply specifically to the clinical pathway element of the Pharmacy First service, not the common conditions or urgent medicines supply.
To address queries around these caps, CPE have written a series of FAQs
What’s Changed?
From 1 April 2025:
- Each pharmacy is assigned to a band (1–6) based on service delivery levels
- Each band has a corresponding monthly cap on the number of funded clinical pathway consultations
- The cap resets monthly and is updated by NHSBSA based on the pharmacy’s activity
- Any consultations delivered above the cap will not be funded
Pharmacies can check their assigned band and cap via the NHSBSA website. If a pharmacy’s ODS code is not listed, they are automatically placed in Band 1 (the lowest band)
Why Have the Caps Decreased Compared to Last Year?
During 2024/25, monthly caps increased over time due to a rolling allowance system – where unspent allocations from earlier in the year were added to later months. This led to growing caps in the second half of the year.
However, HM Treasury rules do not allow funds to roll over across financial years. So, from April 2025, the system has effectively been reset with caps for April 2025 are based on a fresh annual target volume set for the new financial year.
What You Need to Do
- Check your pharmacy’s band, and cap via the NHSBSA website.
- Monitor your activity
- Plan team workload and patient bookings accordingly
If you have any questions or need support interpreting the caps, get in touch with the CPGM team.
