Maximising new medicine services can be a game changer for pharmacists

Adele Curran, chief operations officer at RWA Pharmacy Ltd, looks at the changes to NMS and the financial opportunities they offer for Community Pharmacies

English pharmacies have been delivering new medicine services (NMS) since October 2011. They have successfully increased the effective use of medicines across their communities and also increased their revenue through the claiming structure.

It has been seen as a win-win for both sides, as patients become empowered and more knowledgeable about the medicines they are taking, and pharmacies strengthen their relationship with patients and also receive payments under the scheme.

The conditions covered within NHS include:

- asthma and COPD

- diabetes (Type 2)

- hypertension

- hypercholesterolaemia

- osteoporosis

- gout

- glaucoma

- epilepsy

- Parkinson’s disease

- urinary incontinence/retention

- heart failure

- acute coronary syndromes

- atrial fibrillation

- long term risks of venous thromboembolism/embolism.

What’s New?

From August 2025 depression will also be added to the list. According to recent research conducted by YuLife, we know that every 0.3 seconds, someone in England is prescribed an antidepressant, and in 2024 alone, over 91 million antidepressant prescriptions were dispensed, marking the highest annual total on record. These are very substantial numbers, highlighting the reality of mental health across the nation. While we don’t know if all of these medications are continued long term, it does mean that community pharmacies will have a new opportunity to discuss these medications with a high number of patients, and as a result, have a new wave of NMS payment possibilities.

The inclusion of depression isn’t the only change coming into play though. The NHS has also changed the way payments are made. Before we go into payments in detail though, let’s remind ourselves of the different stages that make up an NMS:

Service Stage Timeline

Initial Engagement When medicine is first dispensed

Intervention Consultation Between 7-14 days after dispensing

Follow Up Consultation Between 21-28 days after initial follow up

Claim structure up until April 2025

Up until April of this year, pharmacy claims were based on completed NMS episodes. This meant, a pharmacy received a basis fee for dispensing the medicine and an NMS service fee once the NMS service was claimed i.e. the intervention/follow-up consultation was completed. The total payment per completed NMS was £28.

From RWA Pharmacy data, we can see that the average UK pharmacy completed 45 NMS consultations within Q1 of 2025 (January – March). As a result, we can say that the average pharmacy claimed back £3,800 through NMS within the first three months of this year. It is worth noting that average target is actually 90 so there is still plenty of scope for more revenue with this service.

Claim structure after April 2025

However, things have now changed, and a split-fee model has been introduced. This means that a pharmacy can claim £14 for each completed intervention and claim a further £14 separately for a completed follow up consultation. So, a pharmacy can now claim for a partial NMS.

In the past, if a pharmacy attempted a follow up consultation (i.e. calls were made but no answers were recorded), then the pharmacy could claim the full £28. Since the change in April, pharmacies must complete the follow up consultation (i.e. ring the patient and record notes) to be eligible to claim the second £14.

Looking at a six-month data trend (October 2024 – March 2025) we can see that at least 35-40% on NMS claimed did not complete a full follow up consultation. If that trend were to continue, it would be a loss of revenue to pharmacies, who were previously claiming the full amount. However, since April, we have seen an upwards trend in the amount of NMS follow up consultations completed, showing figures of between 60-90%. This draws its own conclusion.

For pharmacies who are struggling with staff shortages or who struggle to complete even 50% of their full consultation targets this change is a positive benefit. In Community Pharmacy England’s ‘Pharmacy Pressures Survey 2024’, it was stated that 71% of pharmacy businesses report experiencing shortages of staff.

Community pharmacies make best efforts to contact all required patients for their follow-ups, but sometimes despite best practice, it can be hard to reach the patient to complete the service.

By splitting out the payments into two parts, the pharmacy is rewarded for doing part of the service with their patients.

This, on top of the inclusion of depression medicines means that pharmacies could potentially move the needle on NMS claims substantially from August 2025.

What could the increase in claims look like for an average pharmacy?

RWA Pharmacy can use past data to predict what additional revenue these two changes may unlock for the average English pharmacy. Using the payment structure as of April 2025, we can guesstimate it looking something like the following:

Without depression medicines

Here, we take the average rate of NMS services per pharmacy completed. Our average shows that English pharmacies do roughly 45 NMS per week, with only 60% being done to completion (to March 25)

Activity Number of Claims for average pharmacy Claim Amount received for average pharmacy

Intervention 45 £630

Follow Up 27 £378

Total NMS Claim Per Month 72 £1008

With the positive swing to NMS claims showing a full completion rate in April 25 to 80%, the follow up average should move to 36. This will add further revenue to pharmacies than shown above.

With depression medicines

Based on the rate of depression medicines being prescribed daily across the UK. We are estimating that the average English pharmacy will grow their NMS potential dispensing's by 40+ patients each month, bringing the average up to 70+ (based on 50-60% Engagement Rate). Here, we’ll estimate that the rate of completion to Follow will stay at about 80% following the trend seen in April 2025.

Activity Number of Claims for average pharmacy Claim Amount received for average pharmacy

Intervention 70 £980

Follow Up Consultation 56 £784

Total NMS Claim Per Month 126 £1,764

This is a substantial difference in claim potential for English pharmacies at a potential increase of 75% per month. Pharmacy owners need to take serious note of the financial opportunity NMS will deliver for their branches.

What should pharmacies do to prepare?

Besides ensuring your staff are fully briefed on how to conduct an NMS, particularly with the addition of depression medicines, every pharmacy in England should now work on improving their processes and becoming more efficient at conducting NMS checks. If you are struggling to reach your minimum level of NMS checks now, this is an area to pay close attention to as your pharmacy could be missing out on thousands worth of claims.

It is also very important to remember that NMS consultations are capped within 1% of your monthly items, so bear this in mind when looking at your internal processes.

Finally, any pharmacy feeling the pinch with lost nominations via EPS ((Electronic Prescription Service) should focus heavily on NMS as a means to build personal, trustworthy relationships with their patients, in hopes to retain them for many years.

RWA Pharmacy provides business intelligence solutions to more pharmacies in the UK than any other BI company. Integrating with multiple data sources, RWA Pharmacy delivers actionable insights to their customers, removing manual work and providing a comprehensive view of their pharmacy business, enabling them to unlock previously hidden opportunities within their data. RWA Pharmacy is part of the parent company Real World Analytics.

For more information visit: www.rwapharmacy.com