Redesigning Access to Self-Care (ASC) to reduce health inequalities in Leeds

NHS West Yorkshire Integrated Care Board (Leeds Place) – Medicines Optimisation Team Delivered in partnership with Community Pharmacy West Yorkshire and Leeds community pharmacies

The Leeds Access to Self‑Care (ASC) service is a long‑established community pharmacy service that supports people to manage minor, self‑limiting conditions through timely access to pharmacy advice and, where appropriate, free over‑the‑counter medicines. The service was previously known locally as Pharmacy First and has operated in Leeds for many years in partnership with Community Pharmacy West Yorkshire (CPWY) and local community pharmacies.

The Leeds Access to Self‑Care (ASC) service is a long‑established community pharmacy service that supports people to manage minor, self‑limiting conditions through timely access to pharmacy advice and, where appropriate, free over‑the‑counter medicines. The service was previously known locally as Pharmacy First and has operated in Leeds for many years in partnership with Community Pharmacy West Yorkshire (CPWY) and local community pharmacies.

When the term Pharmacy First was later adopted nationally for a different service model, Leeds undertook a deliberate review and redesign of its local service. At the same time, increasing demand and rising costs meant the service was at risk of becoming financially unsustainable, with a real possibility that it could be reduced or withdrawn altogether.

Rather than disinvesting, the NHS West Yorkshire Integrated Care Board (Leeds Place), working closely with CPWY and community pharmacies, took a strategic commissioning decision to refocus ASC around health inequalities and need. This redesign ensured the service was not only protected, but better utilised and more impactful.

The revised ASC model applies the principle of proportionate universalism:

• All patients can access high‑quality self‑care advice from community pharmacies.

• Free medication support is prioritised for those most likely to experience health inequalities, particularly children and families where cost is a barrier to early treatment.

Community pharmacies deliver structured consultations, self‑care advice, printed information and, where clinically appropriate, medicines supplied from a locally agreed formulary. CPWY plays a central role in supporting delivery, consistency and engagement across the pharmacy network, while the ICB commissions and oversees the service to align with population need and system priorities.

By redesigning ASC with a clear health inequalities focus, the service has been stabilised, better targeted and more sustainable. It reduces avoidable GP and urgent care demand, supports earlier intervention, and ensures community pharmacy is fully utilised as an accessible, trusted healthcare setting—rather than allowing a valuable service to be lost due to affordability pressures.