Resources for community pharmacists

A community pharmacy triage guide to recognising diabetic ketoacidosis, including ketone thresholds, the SGLT2 inhibitor trap, sick day rules, and when to call 999.

Why flu-like symptoms in winter may not be flu, and how to recognise when a patient presenting at the pharmacy counter could be suffering from carbon monoxide poisoning.

How to recognise an opioid overdose in or near the pharmacy, when and how to use naloxone, and the pharmacist's role in take-home naloxone supply and harm reduction.

How to tell when a patient presenting with infection may be developing sepsis, and when to seek urgent medical help without delay.

How community pharmacists can rapidly recognise anaphylaxis, act on airway, breathing, and circulation signs, and escalate to 999 without delay.

Concise guide to distinguishing more likely viral illness from red flags for meningitis or meningococcal disease, with practical pharmacy actions for urgent escalation, emergency referral, and safety-netting.

What to do when a patient records a very high blood pressure reading on the pharmacy machine, and how to tell the difference between a hypertensive emergency and a reading that can wait.

Every stroke symptom is a 999 call: recognise FAST, act immediately, and never give aspirin in the pharmacy before hospital assessment.

How to distinguish cellulitis from deep vein thrombosis and dependent oedema, when to call 999 for necrotising fasciitis, and why compression stockings must not be advised before DVT is excluded.

How to distinguish cardiac from gastrointestinal chest pain at the pharmacy counter, and when to call 999, refer to a GP, or advise self-care.

Brief guide for community pharmacists on distinguishing benign exercise-related symptoms from cardiac red flags, including exertional syncope, concerning palpitations, and features that justify urgent same-day referral or emergency escalation.

How to assess asthma severity at the pharmacy counter, when to call 999, when to refer to a GP, and when emergency supply or supply via Patient Group Direction (PGD) is appropriate.

Why any head injury in a patient taking warfarin or a direct oral anticoagulant requires Accident and Emergency assessment, and how to identify features that require calling 999.

How to distinguish benign migraine from serious secondary headaches, including subarachnoid haemorrhage and meningitis, and when to call 999.

How to distinguish benign conjunctivitis from sight-threatening acute glaucoma, uveitis, or keratitis, and when to refer patients urgently.

A community pharmacy triage guide to recognising upper gastrointestinal bleeding, distinguishing melaena from iron-induced dark stools, and identifying who needs 999.

A community pharmacy triage guide to recognising acute appendicitis, including the classic pain migration pattern, atypical presentations, key differentials, and when to call 999.

How to identify patients at risk of undiagnosed liver disease, which symptoms require urgent action, and how to navigate referral pathways for MASLD, cirrhosis, viral hepatitis, and drug-induced liver injury.

How to recognise testicular torsion in the pharmacy and why sudden scrotal pain in a young male must always be treated as a surgical emergency until proven otherwise.

How to spot a UTI in older adults when classic symptoms are absent, and when to escalate to urgent care or call 999.

How to use the NICE NG143 traffic light system to distinguish a self-limiting viral illness from a potentially life-threatening infection in a febrile child, and when to call 999, refer urgently, or safely advise home care.

Renal and electrolyte monitoring, sick day rules, first-dose hypotension, angioedema recognition, and key drug interactions for ACE inhibitor dispensing in community pharmacy.

Narrow therapeutic index, interaction-driven toxicity, electrolyte monitoring, blood sampling timing, and toxicity recognition for digoxin dispensing in community pharmacy.

Point-of-dispense safety checks for statins: muscle toxicity risk, critical dose caps and interactions with simvastatin, monitoring requirements, and red flag symptoms.

Point-of-dispense safety checks for warfarin and direct oral anticoagulants (DOACs): first dispense essentials, repeat dispense screen, and red flag bleeding symptoms.

Brand switching, valproate Pregnancy Prevention Programme requirements, drug shortage protocols, and monitoring checks for antiepileptic medicines.

Monitoring requirements, brand safety, key drug interactions, and toxicity recognition for lithium dispensing in community pharmacy.

Weekly dosing safety, day-of-week labelling, folic acid co-prescription, key drug interactions, and monitoring requirements for methotrexate dispensing in community pharmacy.

How to assess acute otitis media under the NHS Pharmacy First service, when antibiotics are actually indicated, when ear drops are appropriate, and why most children should receive watchful waiting with analgesia.

How to assess infected insect bites and stings under the NHS Pharmacy First service, when antibiotics are indicated, and the key exclusions including tick bites and signs of Lyme disease.

How to assess and treat impetigo under the NHS Pharmacy First service, including the topical-versus-oral decision, when to use hydrogen peroxide versus fusidic acid, when to refer, and essential contagion advice.

How to assess and treat shingles under the NHS Pharmacy First service, including the treatment time windows, when to choose valaciclovir over aciclovir, ophthalmic red flags, and the v1.1 update excluding head and neck shingles.

How to assess and treat uncomplicated lower urinary tract infections under the NHS Pharmacy First service, covering age limits, upper UTI exclusion, the nitrofurantoin dose, and the many exclusions pharmacists commonly miss.

How to assess acute sinusitis under the NHS Pharmacy First service, when to supply antibiotics, and the clinical features that distinguish bacterial from viral infection.

A step-by-step guide to delivering the NHS Discharge Medicines Service, covering the three clinical stages, referral handling, timeframes, payment, and common pitfalls.

A practical guide to the NHS Pharmacy Contraception Service, covering eligibility, the POP vs COC decision, product selection, measurements, counselling, emergency contraception, and common pitfalls. Updated for the October 2025 service expansion.

Step-by-step delivery guide for the NHS Community Pharmacy Hypertension Case-Finding Advanced Service, including clinic readings, ABPM, referral thresholds, and submission requirements.

A practical guide to the NHS New Medicine Service, covering the three consultation stages, all 18 eligible conditions including the October 2025 addition of depression, the consultation framework, claiming, and common pitfalls.

What to record, when to record it, and why accurate PharmOutcomes documentation is the foundation of a safe and compliant Pharmacy First service.

How to use the FeverPAIN scoring tool to assess sore throat under the NHS Pharmacy First service and decide when to supply antibiotics, offer a delayed supply, or advise self-care.