The Pharmacy First service, launched in January in England, extended the range of services chemists can provide, including treatment of sinusitis, earache and shingles.

Members are not being asked to pull out of the scheme, the NPA said, but a reduction in opening hours and the stopping of locally commissioned services would affect it.

The NPA says urgent funding talks with the government are needed to guarantee patient safety and services for vulnerable people.

Pharmacy funding is set by devolved governments but the medicine funding arrangements – known as the drug tariff – are decided by Westminster for pharmacies in England, Wales and Northern Ireland.

Scottish pharmacies have a separate system, and are not involved in the current ballot.

In England, community pharmacies are independent businesses that provide services under contract with the NHS. They get paid a fee for delivering certain core activities, like dispensing prescriptions.

They also receive payment for advanced services, like flu vaccinations and stop smoking support.

They can then supplement their income through retail sales and private services.



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