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The 2025/26 flu season in the UK is predicted to be both early and potentially severe, echoing the experience of Australia, which just experienced its worst winter for flu in seven years.
Public health authorities are already seeing a surge in flu and flu-like illness cases, particularly among children and younger adults, with England seeing a rise in GP consultations for flu to 5.4 per 100,000 in mid-October 2025 up from 4.2 per 100,000 just a week earlier. Hospital admissions for flu have also increased, reaching 1.27 per 100,000 nationally.
What’s the difference?
Since most people in England live within a 20-minute walk of a pharmacy, many of which are open during evenings and weekends, pharmacy teams can expect to see customers asking for help and advice to manage respiratory illnesses. Here is how you can tell them apart:
Cough
A cough is a reflex action to clear the airways of phlegm and irritants such as dust or smoke. It’s rarely a sign of anything serious (see boxout further down for more), and most coughs clear up within three weeks without any treatment.
A dry cough means it’s tickly and doesn’t produce any mucus (phlegm). A chesty cough means phlegm is produced to help clear the airways. For customers who smoke, quitting is likely to help improve their cough, and pharmacy teams should be well briefed to provide information on stop smoking services locally.
Cold and flu symptoms
Cold and flu symptoms are similar, but flu tends to be more severe. “Many of the symptoms of colds and flu are similar, although the onset of flu is usually quite sudden and people tend to feel really unwell, even taking to bed for a few days,” says Dr Nisa Aslam, GP and an adviser to Combogesic.
“A fever, chills, headache, aching muscles and a feeling of total exhaustion are common with flu, whereas a cold is more likely to just have a sore throat, sneezing, cough, nasal congestion and general congestion in the head and your airways.”
“Community pharmacies administered over four million flu vaccines across England in the 2024/25 winter flu season”
Tackling treatment
Customers can tackle coughs, colds and – usually – flu themselves using a range of over-the-counter (OTC) products designed to treat different symptoms, as well as with simple self care advice.
Treatment isn’t always necessary for short-term coughs because it’s likely to be a viral infection that will get better on its own within a few weeks.
Strategies that can help include getting rest, drinking plenty of fluids, and taking age-appropriate doses of painkillers such as paracetamol or ibuprofen.
Coughs can also be treated with cough syrups or simple linctus, depending on the type of cough, although it’s worth telling customers that there’s no evidence that cough medicines work.
Treating the underlying cause of a cough may also help. For example, pharmacy teams can make sure that customers living with asthma are using the correct inhaler technique.
Allergies can be treated by avoiding the allergen where possible, and taking antihistamines. Reflux, also known as gastro oesophageal reflux disease (GORD), can be treated with antacids to neutralise the stomach acid and medication to reduce the amount of stomach acid produced. And, COPD can be treated with bronchodilators to widen the airways.
“Symptom management for colds and flu is very similar,” says Dr Aslam.
“NICE recommends paracetamol or ibuprofen in colds and flu, both for pain relief and to help reduce a fever, although at-risk groups such as those aged 65 or over, anyone who is pregnant, has heart disease, diabetes, asthma, lung disease, a weakened immune system or another long-term medical condition, should see a GP [if they are experiencing symptoms].”
Decongestants taken orally, as drops or a nasal spray, may help relieve a blocked nose. “Nasal congestion is common to both colds and flu and can be extremely troublesome, with swollen nasal tissues and a flood of mucus combining to block your nose and make it more difficult to breathe,” says Iain Laing, senior marketing manager for Ceuta Healthcare.
“Congestion is often worse when lying down, so customers could try adding an extra pillow or two in bed; rest as much as they can and make sure to stay hydrated.”
Dr Ketan Mehta, founder and CEO of NeilMed Pharmaceuticals Inc., advises: “If a customer says their nose is mildly blocked or dry — suggest a saline spray, but if they say they’re really bunged up with thick mucus or sinus pressure — a rinse kit will do a much better job.”
Cold medicines containing a combination of painkillers and decongestants may also help. These are generally safe for older children and adults to take, but might not be suitable for babies, young children, pregnant women, people with specific underlying health conditions, and people taking certain other medications.
For most healthy people, flu is self-limiting and recovery is generally quite speedy.
Symptoms of flu can usually last between two to three days, and during this time sufferers should stay hydrated, rest, take paracetamol or ibuprofen to lower body temperature and to soothe aches and pains, keep warm, eat plenty of fruit and vegetables and avoid going into work and spreading the illness.
Pharmacy teams are still finding they need to tackle the common misconception that antibiotics can help treat colds and flu.
Antibiotics are only suitable for the treatment of bacterial infections and do not work on viruses that cause colds and flu.
Pharmacy teams can remind customers who think they or their child has the flu to ask for an urgent GP appointment or get help from NHS 111 if they are worried about their baby’s or child’s symptoms; they are 65 or over; are pregnant; have a long-term medical condition – for example, diabetes or a condition that affects the heart, lungs, kidneys, brain or nerves; have a weakened immune system – for example, because of chemotherapy or HIV; or if symptoms have not improved after seven days.
“Antibiotics do not work on viruses that cause colds and flu”
When to worry about a cough
Coughs are common with colds and some other health conditions, but an ongoing or persistent cough can be a sign of a more serious underlying condition such as lung cancer or chronic lung disease.
Pharmacy teams should advise customers to see their GP if a cough lasts longer than three weeks or if it’s accompanied by other red flag symptoms that raise concern, including:
- Coughing up blood (haemoptysis), even in small amounts
- Unexplained weight loss, fatigue, or loss of appetite
- Persistent or worsening shortness of breath
- Chest or shoulder pain that doesn’t go away
- Voice changes or hoarseness
- Recurring or non-resolving chest infections
- Swelling in the neck or finger clubbing
- A new or changing cough in someone aged over 40, especially if they smoke.
Cancer Research UK stresses that while “these symptoms do not necessarily mean cancer, anyone experiencing them should contact their GP for assessment and possible referral”.
Similarly, other serious causes of chronic cough include asthma, COPD, bronchiectasis and GORD, so early recognition of red flag symptoms and prompt investigation can significantly improve outcomes.
The whole family should be regularly washing their hands, especially before meal time, to limit the spread of cold and flu germs.
Putting prevention first
While it’s not possible to avoid coming into contact with everyone who might be harbouring a cold or flu virus, there are plenty of ways to advise customers on how to guard against infection through healthy living and hygiene measures.
The best defence is a strong immune system, achieved through healthy diet and exercise or, for the times when this is simply not enough, taking a good quality immune supplement such as those based on vitamin D, echinacea, zinc and vitamin C.
Gut health is also key to a healthy immune system, so a supplement containing pre and probiotics and live cultures is also very good at this time of year.
Maintaining high hygiene standards is another way to avoid winter bugs. A proper hand-washing technique is an essential way to minimise transferring the viruses from hands to face, especially as the flu virus can live on surfaces for up to two days, and cold viruses can survive for as long as seven days.
Flu vaccinations
Data shows that vaccination offers the best protection against flu, and is especially recommended for people at higher risk of getting seriously ill.
The NHS offers flu vaccinations every year in autumn or early winter, which is free for people who:
- Are aged 65 or over (including those who will be 65 by 31 March 2026)
- Have certain long-term health conditions (see nhs.uk/vaccinations/flu-vaccine/ for the full list)
- Are pregnant
- Live in a care home
- Are the main carer for an older or disabled person, or receive a carer’s allowance
- Live with someone who has a weakened immune system
- Frontline health and social care workers.
Many people who are not eligible for free NHS vaccines choose to pay privately for a flu jab from their community pharmacy – for which the Drug Tariff pays the pharmacy a fee of £9.58 each to deliver.
The Company Chemists’ Association data shows community pharmacies administered over four million flu vaccines across England in the 2024/25 winter flu season – nearly 10 per cent more than in 2023/24 – and in July, Community Pharmacy England announced that community pharmacies will be able to deliver flu vaccinations to children aged two and three under a one-season pilot study from October, following negotiations with NHS England.
As a result, community pharmacies play an important – and increasing – role in the annual flu vaccination campaign. Pharmacy staff are also helping to protect many patients throughout winter and reduce the impact of all kinds of seasonal illness on other parts of the NHS, particularly hospitals.
Throat to the top
Understanding the causes, symptoms, OTC treatment and self care advice for sore throat.
Common causes
Most sore throats are viral and self-limiting, with common causes including rhinovirus, coronavirus, influenza A & B, adenovirus, Epstein-Barr virus leading to glandular fever, and the herpes simplex virus.
Bacterial causes are less common but include Group A Streptococcus (GAS) – the main bacterial cause, especially in children; Groups C & G Streptococcus; and fusobacterium necrophorum.
There are also non-infectious causes, including irritants such as smoke and dry air, allergies, gastro-oesophageal reflux disease (GORD), and medication-induced mucositis.
“For most people, a sore throat will improve on its own within a few days and can be managed effectively at home,” says Jacquie Lee, Numark medication safety officer and information pharmacist.
“It’s important to stay well hydrated by drinking plenty of fluids, which helps keep the throat moist and supports recovery. Simple pain relief such as paracetamol or ibuprofen can ease discomfort and reduce any associated fever. It is important to make sure the chosen medicine is appropriate for the individual’s age and health conditions.”
To soothe a sore throat, Jacquie says customers can try “medicated lozenges, throat sprays, or even just sucking on hard sweets, which can help keep the throat lubricated. Adults may also find relief by gargling with warm salty water, and eating soft, cool foods like yoghurt, soup, or ice lollies can be more comfortable and may help ease irritation”.
There are also some lifestyle tips which can help. “Rest allows the body to fight off the infection,” adds Jacquie.
“Customers should avoid smoking and smoky environments, as these can worsen symptoms. Alcohol-based mouthwashes should also be avoided, as they may irritate the throat further.”
OTC treatments and self care advice
“There’s lots of advice and over-the-counter solutions that pharmacies can provide to treat sore throats at home,” adds Jacquie.
“Pharmacies can recommend pain relief such as painkillers and the use of local anaesthetics sprays or lozenges, to help with pain by numbing the area. They should not be used longer than five days. Local antiseptic throat lozenges can be used and sucking the lozenge also stimulates saliva production. Demulcents, such as glycerin, honey and lemon are useful for children, pregnant and breastfeeding women.”
Within the home, Jacquie advises that “using a humidifier in dry rooms or taking a warm shower to add moisture, can relieve throat dryness and irritation”.
And again, she says: “Stay away from smoke, pollution, and harsh cleaning agents, which can worsen irritation and ensure adequate rest and sleep which boosts the immune system and speeds up recovery.”
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