NHS England considers adding depression to the new medicine service

NHS England is looking at how to make the new medicine service more flexible, to include depression, as well as involving pharmacy technicians in consultations.
Woman in a consultation with a pharmacist

Depression may be added to the list of conditions covered by the new medicine service (NMS), NHS England has said.

The possible addition follows the service’s expansion in September 2021 to cover a total of 16 therapeutic conditions, including the addition of osteoporosis, gout, heart failure and glaucoma.

The NMS, which launched in 2011, previously only enabled pharmacists to support patients newly prescribed medicines in four therapy areas: asthma and chronic obstructive pulmonary disease (COPD); type 2 diabetes; antiplatelet/anticoagulant therapy; and hypertension.

Both the Royal Pharmaceutical Society (RPS) and the Pharmaceutical Services Negotiating Committee (PSNC) have previously called for community pharmacists to be able to support people with mental health conditions by including depression in the NMS.  

Speaking to delegates at The Pharmacy Show on 17 October 2021, Anne Joshua, head of pharmacy integration at NHS England, said the service’s expansion presented a “massive opportunity” for the sector, with NHS England “in the process of also looking at adding in depression as a therapeutic area and looking at the model”.

She added that NHS England has “tried this out with a focus group… and one of the areas that we’re particularly keen to do is to look at how flexible the NMS model can be”.

“It’s a very tight timeframe at the moment and if you think about depression, it doesn’t quite fit therapeutically.

“It takes a few weeks for that therapy to kick in — so it doesn’t quite fit. And perhaps there are other treatments where it doesn’t quite fit,” she continued.

Joshua added that NHS England was also looking at how a longer timeframe could work with general practice and other specialists.

Under the current model, eligible patients are offered the opportunity to use the NMS when their medicines are dispensed, with a consultation scheduled between 7 and 14 days later.

At this appointment, the pharmacist assesses the patient’s adherence and offers advice or support before scheduling a follow-up consultation between 14 and 21 days later, in which adherence is again assessed. If problems arise, the patient can be referred back to their prescriber if necessary.

The consultation is currently conducted by the pharmacist; however, Joshua told delegates that NHS England is “seriously looking at what could be the role of pharmacy technicians in this”.

“It doesn’t have to necessarily be the pharmacist delivering this and that’s something we definitely want to look at and test,” she said.

Thorrun Govind, chair of the Royal Pharmaceutical Society’s English Pharmacy Board, said the discussion around potentially including depression in the NMS was “very positive”.

“Optimal use of prescribed medicines is vital to the management of depression and we want to see people with mental health problems benefit from the service like other patients,” she said.

“We hope NHS England and NHS Improvement engage with professional bodies on any proposals regarding further changes to the service.”

NHS England spent an additional £139m on antidepressant prescriptions during 2020, according to prescribing data from the NHS Business Services Authority.

In the month of April 2020, at the peak of the COVID-19 pandemic, antidepressant prescriptions cost the NHS in England £35m — more than double the cost recorded during the same month in 2019.

Read more: Formal referrals from pharmacy to mental health specialists are needed following COVID-19 pandemic says RPS

Last updated
Citation
The Pharmaceutical Journal, PJ, October 2021, Vol 307, No 7954;307(7954)::DOI:10.1211/PJ.2021.1.110991