New Medicine Service (NMS)

The policy context for the service

In England, around 15 million people have a long-term condition (LTC) and the optimal use of appropriately prescribed medicines is vital to the management of most LTCs. However, reviews conducted across different disease states and different countries are consistent in estimating that between 30 and 50% of prescribed medicines are not taken as recommended. This represents a failure to translate the technological benefits of new medicines into health gain for individuals. Sub-optimal medicines use can lead to inadequate management of the LTC and a cost to the patient, the NHS and society.

It is therefore clear that non-adherence to appropriately prescribed medicines is a global health problem of major relevance to the NHS. It has been suggested that increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments.

Non-adherence is often a hidden problem, undisclosed by patients and unrecognised by prescribers. People make decisions about the medicines they are prescribed and whether they are going to take them very soon after being prescribed the new medicine.

Research has shown that pharmacists can successfully intervene when a medicine is newly prescribed, with repeated follow up in the short term, to increase effective medicine taking for the treatment of a long-term condition.

Service description

The service provides support to people who are newly prescribed a medicine to manage a LTC, which will generally help them to appropriately improve their medication adherence and enhance self-management of the LTC. Specific conditions/medicines are covered by the service, which are detailed below.

The service is split into three stages, which are:

1. patient engagement;
2. intervention; and
3. follow up.

Patient engagement – Following the prescribing of a new medicine for the management of a LTC, patients will be recruited to the service by prescriber referral (which could include referral for medicines prescribed to the patient as a hospital inpatient or outpatient) or opportunistically by the community pharmacy staff.

The new medicine will be dispensed as usual, with the provision of advice about its use  and the patient will be offered the opportunity to use the NMS. Where there is acceptance of the offer, the pharmacy staff and patient will agree a method and time for the Intervention stage, typically between seven and 14 days after patient engagement.

Intervention – The pharmacist and patient will have a discussion either face-to-face in the pharmacy’s consultation room or alternatively via telephone or video consultation. The pharmacist will assess the patient’s adherence to the medicine(s), identify problems and determine the patient’s need for further information and support. The NMS intervention interview schedule will normally be used to guide this conversation.

The pharmacist will provide advice and further support and where no problems have been identified, will agree a time for the follow up stage, typically between 14 and 21 days after the intervention stage. This is similarly the case, where problems have been identified, but the pharmacist and patient have agreed actions which may address the issues, without the need to discuss these with the patient’s prescriber.

If problems are identified and it is the clinical judgement of the pharmacist that intervention by the patient’s prescriber is required, the issue will be referred to them to consider.

Follow up – The pharmacist and patient will again have a discussion either face-to-face in the pharmacy’s consultation room or alternatively via telephone or video consultation. The pharmacist will assess the patient’s adherence to the medicine(s), identify problems and determine the patient’s need for further information and support. The NMS follow up interview schedule will normally be used to guide this conversation. The pharmacist will provide advice and further support where necessary. If a problem is identified, the pharmacist and patients will either agree a solution or, where necessary, the patient will be referred to their prescriber to consider the matter.

All stages of the service provide an opportunity for healthy living advice to be provided, as appropriate to the individual.

The service requirements are included in the service specification.

Download the service specification (Updated 1st September 2021)

Drug Tariff

The Secretary of State Directions provide the legal basis for the provision of the service.

Amendments to the Pharmaceutical Services (Advanced and Enhanced Services) (England) Directions 2013 (updated 1st September 2021)

Consultation room

Pharmacies must have a consultation room that will be used for the provision of the service which meets the requirements of the terms of service.

Where pharmacy premises are too small for a consultation room to be included, the pharmacy owner must apply to their NHS England regional team to request an exemption from this requirement using the published form (NHS England – Pharmacy regulations guidance forms). NHS England will consider the information provided by the pharmacy owner and where it is of the opinion that the pharmacy is too small for a consultation room, it will confirm this with the pharmacy owner and grant an exemption.

The pharmacy owner must then ensure that they put arrangements in place at the pharmacy which enable staff and patients to communicate confidentially by telephone or another live audio link and a live video link.

Where NHS England have agreed an exemption from the requirement of a consultation room and the pharmacy owner has met the additional arrangements to facilitates confidential conversations with patients, then the pharmacy owner can instead provide the service remotely or in the patient’s home.

Pharmacy owners are advised to keep a copy of the NHS England decision confirming that the pharmacy is exempt from the requirement of having a consultation room on the premises.

Where NHS England are of the opinion that the pharmacy is not too small for a consultation room, the pharmacy owner will be advised of this and they will need to install a consultation room if they intend to provide the service.

Standard Operating Procedure

Pharmacy owners must have a Standard Operating Procedure (SOP) for the service, which all staff participating in provision of the service must be familiar with and follow.

Competency and training requirements

3) Pharmacists that will provide the service must have the necessary knowledge and skills to do so, with them assessing and declaring their competence by completing and signing the NHS self-assessment form.

NMS self-assessment form (June 2020) (Microsoft Word)

NMS self-assessment form (June 2020) (PDF)

The completed form should be retained by the pharmacy owner.

The Centre for Pharmacy Postgraduate Education (CPPE) has a range of NMS learning materials which are available for pharmacists to develop their knowledge and skills; these can be accessed via the CPPE NMS webpage.

Notifying local GP practice teams

Pharmacy owners are required to notify GP practices within their locality of their intention to provide the service. This is to encourage effective partnership working between GP practices and pharmacies to ensure the service delivers good outcomes for patients.

Signing up to provide the service

Having met the above requirements, pharmacy owners must then inform their local NHS contract management team of their intention to provide the service; this notification must be made using the NMS Pharmacy owner declaration form, which should be emailed to the local NHS contract management team:

NMS Pharmacy owner declaration Form (Microsoft Word)

NMS Pharmacy owner declaration form (PDF)

Patients eligible for the service and the NMS medicines list

From 1st September 2021, the following conditions are covered by the service:

1. Asthma and COPD: 
2. Diabetes (Type 2); 
3. Hypertension; 
4. Hypercholesterolaemia; 
5. Osteoporosis; 
6. Gout; 
7. Glaucoma; 
8. Epilepsy; 
9. Parkinson’s disease; 
10. Urinary incontinence/retention; 
11. Heart failure; 
12. Acute coronary syndromes; 
13. Atrial fibrillation;  
14. Long term risks of venous thromboembolism/embolism;  
15. Stroke / transient ischemic attack; and 
16. Coronary heart disease 

The antiplatelet/anticoagulant therapy eligibility continues, but it is now included in the above list by reference to the underlying condition/reason for prescribing.

Download a list of the NMS conditions

The NHS Business Services Authority (NHSBSA) has published a list of medicines that are suitable for NMS.

If a patient has been newly prescribed one of these medicines, they will be eligible to receive the service, subject to the pharmacist being able to determine that the medicine is being used to treat one of the above conditions in circumstances where a medicine can be used to treat multiple conditions. 

It is not generally appropriate for the service to be provided where there has been a formulation change. The rationale for this is that a change from one solid dosage form to another is unlikely to present major clinical issues for a patient and hence provision of the NMS in such circumstances would not provide value to the NHS. 

However, there may be circumstances, where in the professional opinion of the pharmacist, they believe the patient would benefit from the provision of the NMS where they are moving from one formulation of a medicine to another (for example the prescribing of the same inhaled medicine, but in a different inhaler device from that previously used by the patient).

Resources for patients before providing the service

The service specification requires information on the NMS to be given to the patient; this requirement may be fulfilled by providing a leaflet to the patient.

NMS patient leaflet (Microsoft Word)

NMS patient leaflet (PDF)

If an NMS item is dispensed for a patient, but the medicine is being delivered to the patient, or a representative is collecting the prescription, the following template leaflet may be used to offer the NMS to the patient:

Template NMS patient leaflet for use when the patient is not present in the pharmacy (Microsoft Word)

Template NMS patient leaflet for use when the patient is not present in the pharmacy (PDF)

Further guidance on creating your own patient communication materials can be found on the Communicating with patients page.

Providing the service

NMS consultations provided in the pharmacy will be undertaken in the consultation room. Alternatively, consultations can be undertaken by telephone or video consultation, where the patient has previously consented to this and it is clinically appropriate.

A pharmacist providing the NMS by telephone or video consultation can do so from the pharmacy premises or from another location, e.g. a pharmacist who is working from home.

In all circumstances where, with the patient’s prior consent, telephone or video consultations are used to provide parts of the NMS, the pharmacist must undertake the consultation in an environment where the conversation cannot be overheard by others (except by someone whom the patient wants to hear the conversation, for example a carer).

Pharmacy owners can also provide the NMS in patients’ homes, but they must ensure appropriate safeguarding arrangements are in place, including ensuring pharmacists have a valid DBS certificate, and there are appropriate procedures and indemnity arrangements in place.

Patient consent

Prior to provision of the service, verbal consent must be sought from the patient and a record of that made in the pharmacy’s clinical record for the service. In seeking consent, pharmacy owners need to ensure that the patient is made aware that the consent enables:

• The provision of the service;
• The sharing of information between the pharmacy and the patient’s GP practice if needed, to enable the provision of appropriate care;
• The sharing of information about the service with NHS England as part of service monitoring; and
• The sharing of information about the service with NHS England and the NHS Business Services Authority (NHSBSA) as part of post-payment verification (PPV).

The General Pharmaceutical Council’s Guidance on Consent provides information on consent for pharmacists and their teams.

The consultations with the patient – using the NMS interview schedule

The NMS interview schedule should be used by pharmacists to help shape the conversation they have with patients at the intervention and follow up stages of the service. The interview is based on the approach used in the proof of concept research and members of the original research team helped to design it.

Interview schedule with notes

Interview schedule without notes

Record keeping requirements

Pharmacists providing the service must make records to support ongoing provision of the service to patients, their future care and audit of the service. The records must be kept for at least two years from the date on which the service is completed or discontinued.

Pharmacy owners must also provide to the NHSBSA a summary of the NMS conducted on a quarterly basis; further information on this is provided in the section below.

The minimum requirements for record keeping are detailed in the service specification. If you do not have access to a computer in the consultation room, or do not wish to use it during your discussion with the patient, the following NMS Worksheets can be used to record notes during the Intervention and Follow up stages of the service and then summarise your discussion with the patient (to support the creation of summary data for submission to the NHSBSA).

NMS Worksheet

Coding to be used to record the ethnic group of people

Referring patients to their GP practice

There may be occasions during the provision of the NMS when pharmacists will need to refer patients to their GP practice, where an issue has arisen that cannot be solved by the pharmacist and patient.

In these circumstances pharmacists can use the NMS GP Feedback form to communicate with the GP practice.

NMS GP Feedback Form (Microsoft Word)

NMS GP Feedback Form (PDF)

It is best practice to phone the GP practice where a referral is urgently required, following this up by sending a copy of the NMS GP Feedback Form to the GP practice.

Where the information to be fed back to the GP practice is less urgent, the form should be sent to the practice, with the patient being advised that the GP practice will contact them about the information in the NMS Feedback form where necessary.

Community Pharmacy England is sometimes contacted by pharmacy owners or LPCs because local GPs have queried the wording in the NMS Feedback form which puts the responsibility to follow up with the patient on the GP practice, rather than the patient being asked to make an appointment with their GP. The NMS Feedback Form was designed by Community Pharmacy England, the GP Committee (GPC) of the British Medical Association and NHS Employers and the wording regarding referral back to the GP practice was proposed by the practising GPs representing the GPC.

The rationale for this approach is that it allows the GP practice to deal with the issue as they see fit, which may require an appointment with the patient’s usual GP, or it may involve another practice team member, such as a practice nurse, dealing with the query. It also provides flexibility for the GP practice to manage the issue by telephoning the patient if that is deemed an appropriate alternative to an appointment in the practice. The GPC view was that this approach provided more flexibility for practices to manage queries in the best way for their patients and using the full range of skills within their team, rather than requiring all queries to be dealt with via a face to face appointment with a GP.

Working with PCN clinical pharmacists

The development of Primary Care Networks (PCNs) has resulted in the employment of clinical pharmacists within PCNs, based at general practices; in many cases the clinical pharmacist may be able to assist the community pharmacist and patient with the matter identified during the NMS.

NHS guidance for PCNs on the provision of Structured Medication Reviews includes referrals being made to the patient’s community pharmacy  for provision of the NMS.

The guidance outlines how PCNs should work with community pharmacies to connect patients appropriately to the NMS.

NHS England announced that NHS approved IT systems for recording NMS consultations and sharing data with the NHSBSA would be ready from 1st December 2023.

This development followed negotiations with NHS England and the Department of Health and Social Care where it has previously been agreed that IT support for CPCF clinical services would be updated to allow information on services provided and payment claims to automatically flow from pharmacy IT systems to the NHSBSA.

This work has already been completed for several of the Advanced services, with the development of application programming interfaces (API) between pharmacy IT systems and the NHSBSA’s Manage Your Service (MYS) portal.

The New Medicine Service (NMS) is next in line for completion of this work and NHS England issued an email update to pharmacy owners, stating the target go-live date for updated pharmacy clinical IT systems and the API was 1st December 2023.

This work is still ongoing; further details on when this change will be implemented will be announced by NHS England in due course.

Transition to the mandatory use of approved IT systems for NMS

Changes need to be made to NHSBSA systems before data being sent from approved pharmacy clinical IT systems via the API to MYS can be used to populate end of month claims for NMS provisions.

Plans are in place for these changes to be made. Once that work at the NHSBSA is completed, pharmacy owners providing the NMS will need to use an approved clinical IT system to keep their clinical records for the service and to submit data on the provision of the service and payment claims to MYS. At that time, the current manual MYS claim process for the service will be retired.

Notice of this change will be communicated to pharmacy owners in advance, once a target go-live date has been set.

However, until that time, pharmacy owners can choose to use one of the approved pharmacy clinical IT systems (once available) to maintain their clinical records and voluntarily provide data on the provision of NMS via the MYS API.

Alternatively, they can continue to use other NMS records systems, for example in their PMR system.

Find out more about which IT systems are developing updated modules for NMS

Once it becomes mandatory to use an approved IT system with an API, some pharmacy owners may have to change the system in which they keep their NMS records.

We suggest pharmacy owners check with their current NMS IT system provider to see whether they are planning to meet the new IT standards and implement the API.

The previous quarterly NMS data submission system

The mandatory requirement to submit quarterly summary data on the NMS to the NHSBSA was suspended in 2020 due to the COVID-19 pandemic.

In February 2023, Community Pharmacy England agreed with NHS England to restart submissions of this quarterly data on a voluntary basis to support long-term monitoring. The final quarter for which pharmacy owners could submit their NMS quarterly summary data was Quarter 2 of 2023/24.

Further information on clinical services IT systems and APIs: CPCF clinical services IT requirements

Pharmacy owners claim payments by stating on their monthly FP34C submission, on the MYS portal, the number of completed NMS they have undertaken in a given month. Claims for payment must be submitted via the MYS portal by the 5th day of the month following the month in which the service was provided.

Changes to the NMS payment structure and fees in April 2025

As part of the contractual settlement for 2025/26 it was agreed that from 1st April 2025, the payment structure for NMS would be simplified to a £14 fee for each Intervention or Follow up consultation provided to the patient, i.e. a total fee of £28 will be paid if the pharmacy has undertaken both the Intervention and Follow up consultations.

This change to the funding structure does not change the existing service requirement to undertake the Intervention consultation and to try to contact the patient to undertake the Follow up consultation.

A £14 payment can only be claimed if a consultation has been undertaken with the patient.

If the patient cannot be contacted by the pharmacy to undertake a consultation, the fee for that consultation cannot be claimed.

For example, two £14 fees can be claimed in the end of month MYS claim once the Intervention consultation and Follow up consultation have been provided to the patient.

Similarly, one £14 fee can be claimed in the end of month MYS claim if the Intervention consultation has been provided and the pharmacy tries, but fails to contact the patient for the Follow up consultation (which does not take place and hence can’t be claimed for).

Resource: New Medicine Service – when are payments claimable?

When can I include an NMS provision in my claim?

The fee or fees for the provision of NMS consultations for an individual patient should be claimed once the overall service provision has been concluded for that individual.

If the provision of the service straddles two months, the claim for fees should be submitted in the MYS claim relating to the second month.

For example, an Intervention consultation is provided in May, but the Follow up doesn’t take place until June, so the fees for both consultations should be claimed in the MYS claim for June.

Making your end of month claim

There was no change to the timelines for making a claim for NMS: pharmacy owners must claim payments by stating within the MYS portal, the number of completed NMS they have undertaken in a given month, with claims for payment being submitted by the 5th day of the month following the month in which the service was provided.

Later in 2025, the NHSBSA will amend the MYS module which pharmacy owners use to claim for their provision of NMS to allow the number of Intervention consultations and Follow up consultations to be separately entered.

Until that change is made to MYS and starting with claims for NMS provided in April 2025, pharmacy owners need to claim the total number of Intervention consultations and Follow up consultations they have provided in the month. For example:

Number of completed Intervention consultations                                20

Number of completed Follow up consultations                                     11

Number of NMS provisions to be claimed in the MYS module             31

Once the NHSBSA have updated the MYS module, pharmacy owners will be able to separately report on the number of Intervention consultation and Follow up consultations, with the NHSBSA making payment based on the total number of each. We will alert pharmacy owners ahead of that change to MYS taking place.

Cap on payments for NMS

The number of NMS consultations that each pharmacy will be paid for is subject to an overall cap of 1% of their monthly prescriptions, set out in the table below (taken from the April 2025 Drug Tariff). The numbers in the previous version of the table (within the Drug Tariff) have been doubled to allow both types of consultations to be claimed using the current MYS functionality as an interim measure.

Post-payment verification

Further information on post-payment verification of NMS can be found on our Post-payment verification process for community pharmacy services and activity page.

Archive information: NMS funding structure prior to April 2025

Pharmacy owners earned between £20 and £28 for each completed NMS they provided depending on the total number of patients who receive the service in the month. The structure rewarded each completed NMS provided whilst also encouraging the provision of the service to the greatest number of patients.

Payments were based on the number of prescription items dispensed, i.e. the actual count of physical items processed by the NHSBSA. Certain items where multiple fees are paid, e.g. FP10MDA items, ACBS flavoured food items and combination packs, only counted as one item when assessing the NMS volume. Pharmacy owners claimed payments by stating on their monthly FP34C the number of completed NMS they had undertaken in a given month.

There were a number of target payment levels. Under the payment structure the price per completed NMS increased at certain target levels. Where a target level was reached, all of the full-service interventions provided up to that point were paid at the rate corresponding to the target.

• All completed NMS provided by a pharmacy owner that fell below the 10% target were paid at £20 each;
• Once a pharmacy owner reached the 10% target, all completed NMS (including those which fell below the 10% target) were paid at £25 each;
• Once a pharmacy owner reached the 20% target all completed NMS (including those which fell below the 20% target) were paid at £26 each;
• Once a pharmacy owner reached the 30% target all completed NMS (including those which fell below the 30% target) were paid at £27 each;
• Once a pharmacy owner reached the 40% target all completed NMS (including those up to the maximum target) were paid at £28 each.

The number of completed NMS that each pharmacy owner needed to provide in order to reach each of the target levels, and the maximum number of interventions for which payment would be received, is outlined in the table below.

Visit the New Medicine service FAQ page

Resources for pharmacy owners

NMS Pharmacy owner declaration Form (Microsoft Word)

NMS Pharmacy owner declaration form (PDF)

Resources for pharmacists

NMS self-assessment form (June 2020) (Microsoft Word)

NMS self-assessment form (June 2020) (PDF)

Information for pharmacy teams

List of the NMS conditions

Resources to use during consultations

Interview schedule with notes

Interview schedule without notes

NMS Worksheet

Coding to be used to record the ethnic group of people

NMS GP Feedback Form (Microsoft Word)

NMS GP Feedback Form (PDF)

Promotion of the service to patients

NMS patient leaflet (Microsoft Word)

NMS patient leaflet (PDF)

Template NMS patient leaflet for use when the patient is not present in the pharmacy (Microsoft Word)

Template NMS patient leaflet for use when the patient is not present in the pharmacy (PDF)

Community Pharmacy England clinical service statistics dashboard
The dashboard presents data on the NMS (as well as other Advanced services) at three levels (national, LPC and individual pharmacy) for each quarter. The dashboards are based on  the NHS Business Services Authority’s (NHSBSA) Dispensing contractors’ data.

NHSBSA Dispensing contractors’ data
Data on the NMS (as well as other Advanced services) can be found by clicking on the ‘Pharmacy and appliance contractor dispensing data’ dropdown tab.

Evaluation of the NMS (August 2014)

NMS statistics – historic

At Community Pharmacy England, we are always keen to hear from pharmacy owners and their teams about how the provision of national pharmacy services is going, be that niggles with the way services are commissioned, a success story you want to share or something else. 

Please click on the link below to share a success story where you have helped achieve a good outcome for a patient following a consultation for a national pharmacy service or to provide feedback on one of the services. 

Provide feedback on national pharmacy services