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NHSE&I considers expanding NMS to include depression

NHS England and NHS Improvement (NHSE&I) is considering a further expansion to the NMS, which could see the addition of depression as another therapeutic area.

Speaking at the Pharmacy Show at the NEC in Birmingham yesterday (October 17), NHSE&I head of pharmacy integration Anne Joshua said that the national commissioner is in the “process of looking at adding depression as a therapeutic area” covered by the new medicine service (NMS).

The commissioner might also consider relooking at the NMS delivery model, Ms Joshua added.

“One of the areas we’re particularly keen to do is look at how flexible the model can be. Is this something that is delivered over a specific time frame? Should we be looking for a longer time frame? Should we do longer follow ups,” she asked.

“It’s a very tight time frame at the moment and, if you think about depression, it doesn’t quite fit therapeutically, it takes a few weeks for that therapeutic evidence,” she added.

The current service model does not quite suit the specifics of this condition. “Perhaps there are other treatments” for which this model is also not suited, Ms Joshua added.

Under the current NMS model, which is split into three stages – patient engagement, intervention and follow up – patients are either identified opportunistically by community pharmacy staff or referred to a pharmacy.

The pharmacist’s intervention should take place between seven and 14 days after patient engagement session. A follow-up takes place “typically between 14 and 21 days after the intervention stage”, according to a Pharmaceutical Services Negotiating Committee NMS webpage.


Upskilling pharmacy technicians to support NMS


Ms Joshua told delegates that NHSE&I is also looking at the role pharmacy technicians could play when it comes to offering the NMS service.

“I also think there's some really interesting areas in here, if you're going to [provide a] NMS [for] glaucoma, [you could have] some fantastic discussions on how to administer eye drops,” Ms Joshua said.

“Osteoporosis tablets are massive”, so patients might need support with guidance on how to swallow them, she added.

“It sounds sort of trivial, but we're seriously looking at what could be the role of pharmacy technicians in this, it doesn't have to necessarily be the pharmacist on this. And that's something we definitely want to look out and test,” she said.

She later told C+D that the role pharmacy technicians could play in adding depression to the NMS service could also be “an element” of the pilot.

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