First national online pathway for headache care supports GPs and pharmacists with assessment, management and treatment

NHS England’s Getting It Right First Time (GIRFT) programme has launched the first national online pathway and decision-making tool for the care of patients presenting with headache symptoms, supporting GPs and pharmacy colleagues to offer good headache management and care.

GIRFT has worked with a large multidisciplinary group of expert clinicians to develop the interactive standardised pathway, which has been co-badged by the Society of Acute Medicine. There has also been extensive input from organisations including The Migraine Trust, the Royal College of General Practitioners, the British Association for the Study of Headache, the Royal College of Pharmacy, the Association of British Neurologists and the Royal College of Emergency Medicine. 

The simple click-through format guides GPs, pharmacists and pharmacy counter staff through assessment, management and treatment options (where appropriate), based on national standards and best evidence. It includes reg flag signs for urgent escalation and how to identify headache caused by the overuse of painkillers.

Click to access the GIRFT national online headache pathway >

In accordance with the ‘digital-first’ approach to healthcare, this online pathway will form the basis of an upcoming digital-first headache pathway. A further online pathway for patients presenting in urgent and emergency care settings is also in development.

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Join webinar to learn more

GIRFT is hosting a national webinar on 4th November 2026 (12.30pm – 1.30pm) to demonstrate the headache pathway in action. Colleagues in primary care, pharmacy and secondary care will discuss the importance of the pathway, and attendees will also hear the patient perspective.  Click here to register

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Dr Niranjanan Nirmalananthan, GIRFT’s joint clinical lead for neurology, said: “This is the first nationally approved clinical headache pathway tool in England, offering one single point of reference for non-specialists to support evidence-based and optimal headache management and care.

“Widespread adoption of the pathway by GPs and pharmacy colleagues has huge potential for improving the patient experience, helping to ensure earlier diagnosis, equity of access to services but also ensuring only those who need the support of secondary care are referred.

“I’d urge everyone involved in the initial care of patients with headache to look at the pathway and bookmark it so they can access it quickly and easily to assess the best course of action.”