The NPA has published a new guide to the NMS to help pharmacists improve patient outcomes and increase income, says Leyla Hannbeck, head of pharmacy at the trade association.

It is a challenging time as far as pharmacy business and finance is concerned. Pharmacies are anticipating the impact of forthcoming changes to pension auto-enrolment and the introduction of the National Living Wage. For contractors in England, the prospect of substantial cuts to funding is also hanging over them.

The new medicine service presents an excellent opportunity for community pharmacies both to improve patient outcomes and to increase pharmacy income. Many pharmacies are falling well below their threshold for NMS interventions, which is calculated as 0.5 per cent of the pharmacy’s monthly prescription volume. The payment structure means the more that are completed, the higher the payment per NMS.

The NPA has published a new guide to the NMS for members, which includes advice on patient engagement. Here is a précis of one of the patient engagement case studies in the NPA guide:

Mr H is a 70-year-old male who has been newly diagnosed with atrial fibrillation. He presents in the pharmacy with a prescription for dabigatran etexilate capsules 150mg, one capsule to be taken twice a day. The pharmacist determines that dabigatran falls into the antiplatelet/anticoagulant category of the NMS and is therefore eligible for the service, provided that this is the first time the patient has been prescribed dabigatran. Mr H confirms that this is the case.

The pharmacist ascertains that Mr H has been diagnosed with atrial fibrillation and checks that the dose of one 150mg capsule twice a day is the correct dose for this indication. The pharmacist explains the importance of taking the capsules twice a day every day, in order to keep Mr H’s blood sufficiently anticoagulated.

The pharmacist also advises Mr H that the capsules should only be removed from the packet when needed and that they should be removed by peeling off the backing foil, not by pushing the capsules through the foil. The capsules should be swallowed whole with a glass of water, and can be taken with or without food. Mr H is also provided with information on what to do if he forgets to take a dose at the correct time.

The pharmacist then explains what the NMS is to Mr H who decides that he would like to receive this service. Mr H completes a consent form and agrees to the pharmacist phoning him in seven days.

Private services

Another opportunity to improve the pharmacy offering and bring in additional income is private services (e.g. private PGD services such as travel and flu clinics). The NPA has a number of PGD packages available which include training to deliver the services and promote to patients. For more information, contact pharmacyservices@npa.co.uk.

Many pharmacies are falling well below their NMS threshold