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NHS Community Pharmacy New Medicine Service (NMS) Expansion Pilot: Inclusion of Depression as a Therapeutic Area and Revised Service Delivery Model

This pilot will run from August 2022 until 31 March 2024, or before, if sufficient data has been collected to evaluate the service and commission nationally. Contractors will be notified of the end of the pilot with one month's notice of final consultation dates and claims submissions deadline.

The New Medicines Service (NMS) was launched in 2011 to help tackle the harm caused by non-adherence, which includes poor health-related quality of life, increased hospitalisations, and premature mortality.

As part of the Community Pharmacy Contractual Framework (CPCF) for 2019/20 to 2023/24, a commitment was made to “discuss and agree any expansion of the New Medicine Service to other therapeutic areas” and subsequently the service was significantly expanded from 1 September 2021 to now cover:

  • Asthma and COPD
  • Diabetes (Type 2)
  • Hypertension
  • Hypercholesterolaemia
  • Osteoporosis
  • Gout
  • Glaucoma
  • Epilepsy
  • Parkinson’s disease
  • Urinary incontinence/retention
  • Heart failure
  • Acute coronary syndrome
  • Stroke/transient ischaemic attack
  • Coronary heart disease
  • Atrial fibrillation
  • Long term risks of venous thromboembolism/embolism

From 2017 to 2018, approximately 7.3 million people (17 percent of adults) were prescribed antidepressants in England. It is estimated that about a third of these are newly prescribed. This represents a large cohort that could benefit from the NMS service. There is evidence to suggest that community pharmacists may have a role in improving adherence in the context of depression; therefore, a Pharmacy Integration Programme pilot has been developed to evaluate the potential inclusion of antidepressants in the NMS.

To support the inclusion of depression, a revised NMS service model will also be tested to ensure flexibility and a patient-centric approach with patients able to decide when, how and where they receive the service, and introduces the option of an additional longer-term follow-up as part of a shared decision making process.

Aims

The aim of the pilot is to test the inclusion of depression as a therapeutic area in the NMS and to test a revised NMS service model that would align more closely with the treatment of depression in primary care as part of an integrated clinical pathway. The service will also provide an opportunity to better utilise community pharmacists in supporting patients with mental health conditions.

Subject to the results of the pilot evaluation, this work will inform the further expansion of NMS therapeutic areas and a more flexible, patient-centric service model that aims to be better integrated into local care pathways, enabled by enhanced local signposting and data sharing.

Objectives

The objectives of the pilot are to:

  • test the expansion of NMS to include people newly prescribed antidepressants for depression
  • test a more patient-centric service model, with an emphasis on greater flexibility and shared-decision making around how and when service stages are initiated or scheduled and subsequently delivered
  • test the extension of NMS support through optional additional follow-up stage, up to maximum of 6 months
  • understand the training and support requirements for community pharmacists to be able to support patients with mental health needs
  • understand and support opportunities for greater integration of NMS into local primary care provision/pathways
  • identify the data set that should be shared with the registered GP practice and/or referrer/prescriber where appropriate
  • encourage signposting, promote collaborative working and the development of peer support networks involving community pharmacy around depression/mental health 

What the service will provide

The service will provide this cohort of patients with enhanced support in managing their medicines regime and adherence. This includes supporting patients to manage expected side effects, to understand the side effect profile of that medicine, and to understand that their medicines will take time to have an effect.

Pharmacy staff will recruit patients or receive referrals for patients newly prescribed eligible antidepressants for depression into and deliver the service as per the pilot service specification.

A key part of the pilot will enable a review of training and clinical support needs for the pharmacist for this cohort of patients. Individual pharmacists delivering the service will be required to have undertaken the mandatory learning.

SLA & service specification document (PDF: 572KB)

Eligibility for Pharmacy Contractors to provide the service

This service will be piloted in selected Primary Care Network (PCN) footprints in the following ICS areas only:

  • East of England
    • Mid & South Essex ICS
    • Cambridgeshire and Peterborough ICS
  • London
    • North West London ICS
  • Midlands
    • Black Country and West Birmingham ICS
  • North East & Yorkshire
    • TBC
  • North West
    • Greater Manchester ICS
  • South East
    • Frimley ICS
  • South West
    • Devon ICS

Pharmacy contractors can register to participate in this if they are:

  • located within an agreed pilot area and invited by email to participate by their NHS England Regional team
  • intending to provide the service from August 2022 until 31 March 2024
  • compliant with the Essential Services elements of the Community Pharmacy Contractual Framework (CPCF)
  • in good standing with NHS England
  • already registered to deliver the NMS as an Advanced Service within the CPCF for a minimum of six months and claimed payment for at least 20 completed NMS interventions in 2021/22
  • able to comply with all the elements described in the service specification
  • able to offer face to face appointments inside a confidential consultation room that complies with relevant standards and regulations

Register to provide the service