New Medicine Service: Delivering Effective Medicines Support

About this service

The New Medicine Service (NMS) is an NHS Advanced Service through which community pharmacists provide structured support to patients newly prescribed medicines for eligible long-term conditions. The service has been running since October 2011 and is one of the most evidence-based advanced services in the CPCF.

Research consistently shows that between 30 and 50 per cent of prescribed medicines are not taken as recommended. The NMS addresses this directly: evidence shows pharmacist-led follow-up in the weeks after a new medicine is started improves adherence and can improve clinical outcomes while reducing overall NHS costs.

The service was expanded in October 2021 and again from 29 October 2025, when depression was added as an eligible condition, consultation timings were revised, and the eligible drug list was updated to remove discontinued medicines and add newer agents. The current service specification is version 2.0 (October 2025).

Consultations must be provided by a pharmacist. Pharmacy staff may support the service, but the intervention and follow-up consultations must be conducted by a pharmacist who has completed the NMS self-assessment form and declared competence.

Who to offer the service to

Include

• Any patient newly prescribed an eligible medicine for one of the 18 eligible conditions (see below). If more than one eligible medicine is prescribed at the same time, a single NMS episode covers all those medicines.
• Eligible conditions: acute coronary syndromes, asthma, atrial fibrillation, chronic obstructive pulmonary disease (COPD), coronary heart disease, depression (aged 18 and over only), type 2 diabetes, epilepsy, glaucoma, gout, heart failure, hypercholesterolaemia, hypertension, long-term risk of venous thromboembolism or embolism, osteoporosis, Parkinson's disease, stroke or transient ischaemic attack (TIA), urinary incontinence or retention.
• The full list of eligible medicines for each condition is published on the NHSBSA website and is updated periodically. Always check the current NMS Eligible Drug List before recruiting a patient.
• Patients may be recruited by pharmacy staff, signposted by their general practice, or referred from secondary care (including as part of a Discharge Medicines Service referral).
• Patients not registered with a general practice are eligible. Advise them to register and make best endeavours to feed clinically relevant information back to the prescriber.

Exclude

• Depression: service is limited to patients aged 18 and over.
• Formulation changes only (for example, switching from one solid oral form to another): generally not eligible unless the pharmacist has professional reasons to believe the patient would benefit, which must be documented.
• The service covers new medicines, not established ongoing therapy. Patients already stabilised on a medicine are not eligible unless the medicine is genuinely new to them.
• NMS cannot be subcontracted to an external pharmacist or provider. The pharmacist conducting the service must be employed directly by the pharmacy or a company in the same group.

Stages at a glance

* Payment values as per the Drug Tariff (last confirmed October 2025 service update). Always check current NHSBSA guidance for updated fees and claiming rules. The number of payable NMS consultations is subject to a cap of 1% of monthly prescription items. Claims must be submitted by the 5th day of the month following the month in which the consultation was undertaken.

How to deliver the service

1. Patient engagement. When dispensing a new medicine for an eligible condition, identify suitable patients and explain the service. Confirm the patient's consent to receive the service and to relevant information sharing. Agree a method and time for the Intervention consultation.
   • Provide the patient with information about the service, verbally, via a leaflet, or by directing them to an online resource.
   • Record verbal consent at this stage, covering: provision of the service, sharing with the patient's general practice if clinically needed, and sharing with NHS England and NHSBSA for monitoring and post-payment verification.
   • Agree the Intervention consultation for between 7 and 14 days after today.
   • With the patient's consent, check the national care record and/or locally available clinical records as needed to provide the service safely.
2. Intervention consultation (7-14 days after engagement). Conduct a structured consultation with the patient (face-to-face in the consultation room, or remotely by phone, audio, or video). Use the NMS interview schedule to guide the discussion.
   • Reconfirm the patient understands and wishes to continue with the service.
   • Assess adherence: has the patient started taking the medicine? Are they taking it as prescribed? Have they missed any doses in the past 7 days?
   • Identify problems: side effects, concerns about effectiveness, negative feelings about the medicine, difficulty using the device or formulation, uncertainty about the purpose of the medicine.
   • Outcome A: no problems identified: agree the Follow-up consultation for 14 to 21 days from today. Claim the Intervention consultation fee.
   • Outcome B: problems identified but prescriber referral not needed: agree remedial steps with the patient. Schedule the Follow-up consultation. Claim the Intervention consultation fee.
   • Outcome C: problems requiring prescriber input: refer to the prescriber using the NMS GP Feedback form or the locally agreed method. If the NMS episode covers a single medicine, the service ends here. Claim the Intervention consultation fee.
   • If the patient cannot be contacted: make at least one further attempt. If still no contact, record this, end the service as incomplete, and do not claim.
3. Follow-up consultation (14-21 days after Intervention). Conduct a second structured consultation. Use the NMS interview schedule again. Assess whether problems have resolved and whether adherence has been maintained.
   • Outcome A: adhering, no problems: service is complete. Claim the Follow-up consultation fee.
   • Outcome B: problems identified: agree remedial steps. Service is complete. Claim the Follow-up consultation fee.
   • Outcome C: problems requiring prescriber input: refer to prescriber. Service is complete. Claim the Follow-up consultation fee.
   • If the patient cannot be contacted: make at least one further attempt. If still no contact, record this, end the service as incomplete, and do not claim the Follow-up fee.
   • Exceptional circumstances (for example, patient on holiday): consultations may occur outside the standard timeframes if the pharmacist believes the patient would still benefit. The reason must be documented contemporaneously.
4. Record and claim. Record the consultation in the pharmacy's clinical record on the day it takes place. Submit claims via the MYS portal by the 5th day of the following month.

NMS consultation: what to assess and how to respond

The NMS interview schedule guides both consultations. Use these areas to structure the conversation. Not all topics will be relevant to every patient or every condition.

Depression: additional guidance for NMS consultations

• Depression was added to the NMS from 29 October 2025, for patients aged 18 and over. Eligible antidepressants are defined in the NHSBSA NMS Eligible Drug List, which should always be checked before recruitment as the list may be updated.
• No mandatory training is linked to the depression expansion, but pharmacists are strongly encouraged to develop confidence in mental health consultations before undertaking them. Recommended resources include: CPPE Consulting with people with mental health problems (approximately 120 minutes) and Zero Suicide Alliance Suicide Awareness Training (approximately 30 minutes).
• Key areas to cover in NMS consultations for antidepressants: early side effects are common (nausea, sleep disturbance, agitation) and often reduce after the first 1 to 2 weeks. Patients frequently stop antidepressants in the first few weeks due to side effects or a perception that the medicine is not working. Realistic expectations about the timeline to therapeutic benefit (typically 2 to 4 weeks or longer) are important to address.
• Always ask sensitively about mood and how the patient is feeling. If the patient expresses thoughts of self-harm or suicide, follow local safeguarding and signposting pathways. The Zero Suicide Alliance training provides a practical framework for these conversations.
• Reinforce that antidepressants should not be stopped abruptly without prescriber guidance. Discuss the planned duration of treatment and the importance of a planned review with the prescriber.
• For all NMS consultations, offer opportunistic public health advice in line with the Healthy Living promotion essential service, and signpost to relevant local or national support resources where appropriate.

Recording and submission

• Record verbal consent at the engagement stage, covering provision of the service and information sharing.
• Record the date and method of entry to the service (pharmacy identified, GP signposted, secondary care referral).
• Record the patient's NHS number, date of birth, registered GP practice, and relevant demographic details.
• Record the name and GPhC registration number of the pharmacist conducting each consultation.
• For each consultation: record the eligible condition, medicine(s) covered, matters identified during the discussion, and outcome (including any referral made and reason).
• If a patient does not engage or cannot be contacted: record the reason (for example, prescriber stopped medicine, patient withdrew consent, patient could not be contacted).
• Record any healthy living advice provided at each stage.
• Retain records for 3 years from the closure of the NMS episode for post-payment verification.
• Submit claims via MYS by the 5th day of the month following the month in which each consultation was undertaken.

Key takeaways

• NMS normally consists of three stages: Engagement, Intervention, and Follow-up. The service may appropriately end after the Intervention in defined circumstances, including prescriber referral in a single-medicine episode. All consultations must be conducted by a pharmacist.
• Always check the NHSBSA NMS Eligible Drug List before recruiting: not every medicine in an eligible condition qualifies, and the list is updated periodically.
• Depression was added from 29 October 2025 for patients aged 18 and over. Pharmacists are strongly encouraged to complete CPPE mental health consultation training before undertaking these consultations.
• A referral to the prescriber at the Intervention stage ends the NMS episode for a single-medicine case; no Follow-up consultation is needed and the Intervention fee can be claimed.

Download the checklist