NHS treatment for sinusitis

If you've had sinusitis symptoms for around 10 days or more — facial pain, blocked nose, reduced sense of smell — our pharmacist can assess you free and supply treatment where clinically appropriate.

What is acute sinusitis?

Sinusitis is inflammation of the sinuses — the air-filled cavities in your forehead, cheeks, and behind your eyes. Most cases follow a common cold and are caused by viruses. A smaller minority go on to develop a bacterial infection that may benefit from antibiotics.

Typical symptoms:

Pain, pressure, or tenderness across your forehead, cheeks, or around your eyes
Blocked or congested nose
Reduced or lost sense of smell
Thick yellow or green mucus running from the nose or down the back of the throat
Headache, especially when bending forward
Mild fever
Cough, especially at night
Toothache (upper teeth)

Acute sinusitis usually clears within 2-3 weeks. The NHS Pharmacy First pathway specifically targets patients whose symptoms have lasted around 10 days or more without improving — the point at which bacterial cause becomes more likely.

Who can use this service?

Adults and children aged 12 and over
Symptoms lasting around 10 days or more (NICE NG79 threshold)
Symptoms have not significantly improved in that time
No red-flag features (see below)

If you're under 12, see your GP. If your symptoms have only just started, the pharmacist will likely advise self-care first because most cases resolve on their own.

If you are pregnant, think you might be pregnant, or are breastfeeding, please tell the pharmacist — some of the medicines used in this pathway are not suitable in pregnancy, and patients under 16 who are or might be pregnant are referred to their GP. We will choose a safe option for you or refer you on.

What treatment can be supplied?

The NHS Pharmacy First sinusitis pathway follows NICE NG79. Treatment options under the PGD:

High-dose nasal corticosteroid (mometasone or fluticasone) — first-line for adults with symptoms lasting more than 10 days with no improvement, to reduce inflammation and aid drainage
Phenoxymethylpenicillin (penicillin V) — antibiotic, usually only considered if symptoms continue after 14 days of nasal steroid (or where a nasal steroid is unsuitable) AND there are at least two bacterial markers: marked deterioration after an initial milder phase, fever above 38°C, persistent thick discoloured nasal discharge, or severe one-sided pain (especially over the upper teeth or jaw)
Clarithromycin, doxycycline or erythromycin — antibiotic alternatives for patients with penicillin allergy (erythromycin in pregnancy; doxycycline avoided in pregnancy and under 12)

The pharmacist may also recommend self-care alone — paracetamol or ibuprofen for pain (where appropriate), salt-water nasal rinses (made with cooled boiled, sterile, distilled or filtered water — never straight from the tap), plenty of fluids, and rest. Antibiotics are not the default answer.

How it works — fully online from your phone

Start the online assessment via the Digital Gateway link above — captures duration (10+ days threshold), symptom pattern, severity, and medical history. About 5 minutes.
Pharmacist reviews your record in our PharmOutcomes system — usually within 1-2 hours during opening hours. Sinusitis can usually be assessed remotely. If the pharmacist needs to see you in person to check for any signs that warrant urgent referral, they will ask you to come in or signpost you elsewhere.
Pharmacist phones you to discuss and confirm the plan. Usually a 5-10 minute call.
Clinical decision — nasal corticosteroid (first-line for adults), antibiotics (phenoxymethylpenicillin or alternative for penicillin allergy), or self-care advice. Most patients won't need antibiotics.
If a medicine is supplied: free delivery to your door — Royal Mail Tracked anywhere in England, same-day in Leeds LS postcodes — or collect from us. No prescription charge.
GP notified — a record is sent to your GP practice on the same day or the next working day, via the NHS-assured Pharmacy First IT system (or NHSmail if the digital channel is not available).
Follow-up: safety-netting advice on what to watch for; message or call if symptoms worsen or don't improve.

Go to A&E or call 999 if: you have severe headache, neck stiffness, sensitivity to bright light, or confusion (possible meningitis); a swollen, red, or painful area around the eye; double vision or vision changes; any sudden weakness, numbness, slurred speech, or sudden severe forehead pain; symptoms of sepsis (very high or very low temperature, rapid breathing, racing heart, confusion). These are rare but serious complications of sinusitis that need immediate hospital care.

Start your sinusitis assessment online

Open our NHS-assured Digital Gateway on your phone. The pharmacist will review your record and may supply a nasal steroid or antibiotics if clinically appropriate. Free NHS service, no GP appointment needed.

Start online assessment → Or call 0113 244 1551

Frequently asked questions

How long do I need to wait before coming to Pharmacy First?: The NHS pathway targets sinusitis lasting around 10 days or more without improvement. If you've only had symptoms for a few days, self-care (paracetamol, fluids, salt-water rinses) is usually the right first step.
Will I get antibiotics?: Most patients won't. The pharmacist often supplies a nasal steroid first, which is more effective than antibiotics for most cases. Antibiotics are reserved for cases with specific marker symptoms suggesting bacterial cause.
Is it free for everyone?: Yes — the consultation and any medicine supplied through Pharmacy First are free, even if you'd normally pay an NHS prescription charge.
Can I get nasal sprays without a Pharmacy First consultation?: Some nasal sprays (e.g. beclometasone) can be bought over-the-counter for hay fever. For acute sinusitis, the nasal spray is used at a higher total daily dose than the licensed hay-fever dose and for a different reason (to reduce sinus inflammation), so it has to be supplied by a pharmacist under the NHS Pharmacy First pathway — which is why the assessment is needed.
What if my child is under 12?: Sinusitis in younger children needs GP assessment. Book a GP appointment or call NHS 111.
What if I have asthma or COPD?: Tell the pharmacist. Sinusitis can sometimes flare asthma. The pharmacist will adjust assessment and may refer you to your GP depending on how your asthma is currently controlled.

About this service at Hyde Park Pharmacy

Hyde Park Pharmacy is a community pharmacy in central Leeds (premises 9011727, regulated by the General Pharmaceutical Council). Our superintendent pharmacist is Shoyab Umarji (GPhC #2065619, Independent Prescriber). The sinusitis pathway follows v1.1 NHS England Pharmacy First service spec (October 2025).

For an overview of all seven Pharmacy First conditions we cover, see our main Pharmacy First page. For a step-by-step explanation of the post-submission flow, see what happens next.