What is the three-month claim window for Pharmacy First?

What is the three-month claim window?

It is a two-month late-claims period bolted onto the existing one-month deadline for Pharmacy First and New Medicine Service claims. The 2026/27 Community Pharmacy Contractual Framework (CPCF) settlement, announced on 29 May 2026, introduced it. The government's wording is precise. The one-month window "will be retained". But "a new late claims process will be introduced for these services to allow submissions up to 2 months after the window closes, recognising the operational pressures on contractors".

Community Pharmacy England (CPE) negotiated it. Its Pharmacy First page describes "a 2-month late claim window, giving pharmacy owners a total of 3 months to claim". Chemist+Druggist reported on 2 June 2026 that the extension came "partly in response to outcry over missed payments". That outcry is covered below.

So the headline "three months" is really one month plus two. The standard deadline does not move. What changes is what happens when you miss it. A late claim will be paid instead of refused, for two further months.

When does the three-month window start?

Not yet, as far as the Drug Tariff is concerned. CPE's Pharmacy First and NMS pages, updated in June 2026, say the late-claim period "will be introduced later in 2026". The Pharmaceutical Journal's contract explainer of 3 June 2026 reported it as "to be introduced from June 2026". Those two statements are compatible if the mechanism arrives later but covers June consultations. Nobody has confirmed that.

The evidence points one way for now. Part VIC of the June 2026 Drug Tariff, which sets the Pharmacy First payment rules, still carries the 1 June 2025 wording. CPE's Drug Tariff Watch for July 2026 lists no change to Pharmacy First or NMS claiming. NHSBSA's Pharmacy First page still describes the one-month rule.

The practical position is simple. Until NHSBSA publishes the new process, treat the current deadline as the only one that counts. If the late-claim window is later applied to June and July 2026 consultations, you lose nothing by having claimed on time.

What is the Pharmacy First claim deadline today?

You must submit the claim by the 5th of the month after the consultation, through the MYS portal or an NHS-approved IT system that sends claims by API. Late submissions are accepted only until the final day of the month after the consultation month. After that, the Drug Tariff says later claims "will not be paid" unless IT failure outside your control caused the delay.

CPE's payment timetable and deadline tracker, updated on 3 July 2026, sets out the rule. The table below shows how it works for this summer's consultations, and how the same months would look once the three-month window is live. The figures come from Drug Tariff Part VIC and the CPCF 2026/27 statement.

The last column is illustrative. It assumes the late-claim period runs for two calendar months after the current cut-off, which is how CPE and the government have described it. Check the Drug Tariff wording when it is published.

Bank holidays matter at the margin. CPE's tracker notes that where one or more bank holidays fall in the first five days of a month, the MYS deadline moves to the 6th. Do not build a routine around that extra day.

How do you submit a Pharmacy First claim?

Two routes exist, and both end at NHSBSA. The first is the Manage Your Service (MYS) portal, which you access with a personal NHS.net Connect account rather than a smartcard. The second is an NHS-approved clinical IT system that sends the claim to NHSBSA through its API. Most pharmacies use the second and check the first.

The claim covers the consultation fee, but the supply still has to reach NHSBSA in the usual way. NHSBSA's guidance says paper tokens for clinical pathway supplies must be separated in the month-end batch and marked "PF CP". Urgent supply tokens are marked "PF UMS". EPS tokens for exempt patients still go to NHSBSA to be scanned and kept for post-payment verification.

Payment then follows the normal cycle. NHSBSA reimburses items supplied under Pharmacy First within the main drug advance payment. The consultation fees and any fixed payment appear on the FP34 Schedule of Payments. That schedule is where a missed claim first shows up, and by then the standard deadline has passed. This is the trap the National Pharmacy Association (NPA) described to MPs, and it is why the weekly routine below checks claims, not just consultations.

How did the window shrink in June 2025, and why?

Pharmacy First launched on 31 January 2024 with a generous window. CPE's original claiming schedule said claims had to be made "within one month of, and no later than three months from the claim period". Miss the 5th and you had until the third month. February 2024 consultations, for example, could be claimed until 5 June 2024.

The 2025/26 settlement, published on 31 March 2025, cut that. It said "the claim window for Pharmacy First will be reduced to one month from June 2025". From 1 June 2025, late submissions were accepted only "by the final day of the month following the month in which the Pharmacy First consultation was conducted". Consultations from March to May 2025 had to be claimed by 11.59pm on 30 June 2025.

The reason was the new payment banding. From June 2025 the £1,000 monthly fixed payment split into two bands: £500 for 20 to 29 clinical pathway consultations in a month, and £1,000 for 30 or more. NHSBSA needs each month's claims in quickly to work out which band you reached. Health minister Dr Zubir Ahmed told MPs on 12 February 2026 that the government agreed the shorter window with CPE in the 2025/26 deal. It came alongside the new £500 band.

In other words, the one-month rule was the price of the interim payment. The 2026/27 deal keeps the banding and the one-month window, and adds the grace period as a separate late-claims process. That is why the settlement describes it as "retained" rather than reversed.

What does a missed claim cost?

A missed clinical pathway consultation costs £17, and it can cost the fixed payment too. Drug Tariff Part VIC pays £17 for each clinical pathway consultation that crosses the gateway. The fixed payment depends on the consultations NHSBSA can count, which means the ones you claimed. If you delivered 32 consultations in a month and claimed 28, you drop from £1,000 to £500. Four unclaimed consultations cost £68 in fees and £500 in fixed payment.

The table sets out three scenarios using the Part VIC fees and bands. It assumes you remain registered for the hypertension case-finding and contraception services, which is a condition of the fixed payment.

The losses are real, not theoretical. Pharmacy Magazine reported on 16 January 2026 that a Shrivenham contractor, Graham Jones, had missed more than £1,600 for completed consultations. NPA chair Olivier Picard said: "Many pharmacies don't even realise they're missing money." On 12 February 2026 Dr Luke Evans and Helen Morgan raised withheld payments in the Commons. NHSBSA's position was quoted in that debate. It "is directed by the DHSC to make payments for NHS Pharmacy First consultations that meet the criteria set out in the Drug Tariff".

For a pharmacy near the 30-consultation line, the deadline is the difference between the service paying and not. Our guide on making Pharmacy First pay covers the volume side, and our two-year review of the service covers the referral problem. This article covers the paperwork.

Does the three-month rule apply to the New Medicine Service?

Yes. The settlement names both services, and CPE's NMS page carries the same "later in 2026" wording. The NMS position today is tighter than Pharmacy First's. CPE's tracker lists the NMS deadline as the 5th of the month after the consultation, with no sentence accepting later claims. Pharmacy First at least has its end-of-following-month grace.

The money is smaller per patient but adds up. Since 1 April 2025 the NMS has paid £14 for a completed intervention consultation and £14 for a completed follow-up, so £28 for a full episode. Payment can only be claimed when the consultation actually happened. For 2026/27 the contractor cap comes down to 0.9 per cent of monthly prescription items. Our New Medicine Service guide covers eligibility and the three stages. For claims, the rule is the same as Pharmacy First: report the month's consultations in MYS by the 5th.

Can late claims be appealed?

No. There is no appeal route for a claim that simply missed the deadline. The only exception written into the Drug Tariff is IT failure outside your control, such as a fault in the NHS-approved API system or in the MYS portal itself. In that case NHSBSA can accept a claim within twelve months of the original deadline, but only with evidence that the fault caused the delay.

That exception is narrow. Staff sickness, a locum who did not know the process, or a PMR that recorded the consultation but never sent the claim are not IT failures outside your control. NHSBSA's advice to Pharmacy Magazine was blunt: submit claims "as soon as possible".

The NPA's account in the Commons debate shows why. Payment statements "appear successful, yet Pharmacy First payments are absent, and contractors are only discovering the issue after the window is closed". The lesson is to check that the claim went in, not just that the consultation happened.

What claims routine never slips?

A weekly one. Month-end is too late, because a claim that fails on the 4th leaves you one day to fix it. Reconcile once a week instead, and the 5th becomes a formality. The routine below takes about twenty minutes in a pharmacy doing 30 to 60 consultations a month.

Our guide to the numbers to check every week shows where claims sit in a broader owner's routine. For the wider settlement, including the new prescribing payments, see what the 2026/27 contract actually pays.

Key takeaways

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