Learning from Wales and Scotland

Wales provides an established treatment model through the Common Ailments Service, where bacterial conjunctivitis is included within a nationally commissioned service based on a PGD. Pharmacists undertake structured assessment and, when PGD criteria are met, supply chloramphenicol eye drops.

The service is funded, standardised and embedded within NHS pathways, demonstrating how pharmacy can manage conjunctivitis at scale.

Scotland has had a pharmacist independent prescriber-led common clinical conditions service (NHS Pharmacy First Plus) since 2020. This service allows community pharmacists to treat common clinical conditions beyond the scope of the standard Pharmacy First service, which would otherwise require referral to another healthcare professional. 

Pharmacy First Plus includes managing eye infections in conjunction with local optometry services. There is a nationally agreed two-way pathway between community pharmacies and optometrists. Guidance issued to optometrists states: “Where the outcome of an eye examination by an optometrist is that a patient requires treatment for a minor eye condition, it would be appropriate for optometry practices without an independent prescriber optometrist to refer these patients to a pharmacy, rather than their GP practice, to obtain a supply of medication.”