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NMS should follow MURs and be passed to GP pharmacists, academics say

The new medicine service (NMS) should follow medicines use reviews (MURs) and be “integrated” into “clinical” pharmacists’ roles, a group of academics has suggested.

As part of the funding contract for England, the Department of Health and Social Care (DH) announced that MURs will be phased out by April 2021 and replaced by “structured medication reviews” carried out by “clinical” pharmacists working in recently created primary care networks (PCNs).

In a study evaluating the NMS, published last month, academics from the Universities of Manchester, Nottingham, and University College London suggested this service should also be passed to GP pharmacists.

Rachel Elliott, professor of health economics at the University of Manchester and lead researcher of the study, said: “The NMS helps people when the medicine is started and some effect lasts for quite a long time. However, reviewing medicines-taking, for example every six months, is probably needed to continue the support patients need around taking medicines.

“We think clinical pharmacists, now often based in primary care doctor’s practices, may be able to integrate NMS and follow-up support into their role.”

As NHS England has proposed a “more appropriate clinical use of community pharmacy” as part of its long-term plan, it is “essential to examine how NMS integrates with these primary care service developments”, the academics added.

Expand NMS to cover mental health and statins

Professor Elliott suggested “mental health medicines, eyedrops and statins could be candidates for the NMS”, as these are “medicines which we know patients are less likely to adhere to”.

This is echoed the DH's own plans to expand the NMS as part of the five-year funding contract for England to include further conditions.

NMS saves NHS £651m

According to the academics’ analysis of the NMS since it was introduced in England in 2011, the NHS could save £651 million as a result of patients’ increased medicines adherence from using the advanced pharmacy service.

Pharmacies delivered around 5.7m NMS consultations between 2011 and 2018, with pharmacists following-up with patients taking a new medicine for: asthma and chronic obstructive pulmonary disease (COPD); type 2 diabetes; antiplatelet/anticoagulant therapy; and hypertension, the academics said.

“The cost to the NHS of paying community pharmacists to deliver NMS” – between £20 and £28 – “[is] absorbed by small reductions in other NHS contact-related costs”, the academics added.

Professor Elliott said: “The NMS workload had been absorbed into busy community pharmacists’ daily routines alongside existing responsibilities with no extra resources or evidence of reduction in other responsibilities.”

Professor Matthew Boyd, co-project lead from the University of Nottingham, said: “The way patients access healthcare is changing. [Our study] highlights the valuable contribution pharmacists make in protecting valuable NHS budget and improving outcomes for patients.”

What conditions do you think should be included in the NMS?

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