Requirements for the new medicine service (NMS) were changed to “clarify that the service cannot be subcontracted to another provider” as part of the new 2025/26 pharmacy contract announced last month.
“This will stop NMS being provided via a remote consultation...by a pharmacist working off the pharmacy premises who is not employed by the pharmacy owner,” Community Pharmacy England (CPE) said at the time.
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The NMS service directions will be amended to reflect this “as soon as practically possible”, according to the negotiator.
But pharmacists have warned that the restriction will impact patient safety and lead to significant financial losses – particularly for small independents.
Up to £5,600 loss
Pharma Services’ managing directors Tahmid Zaman and Arbaz Mohammed, who are both pharmacists, said the regulatory change will mean “a big dip” in the number of NMS completed.
The remote NMS service provider works with over 100 community pharmacies, helping thousands of patients every month, they told C+D last week (April 14).
“We provide the pharmacies with a tool that helps them hit their targets because it’s very difficult if you’re a single pharmacist working in a 10,000-item store,” Zaman said.
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He told C+D that the pharmacies they work with will struggle to hit the number of completed NMS they achieved before without subcontracting, meaning they will be claiming for less money.
“You’re not going to get many NMS and at the end of the month, you’re not going to be submitting anything,” he added.
Pharma Services predicts the monthly loss for a “low-claiming pharmacy” could be around £1,030 based on an estimated 37 completed NMS.
But losses could be as high as £5,600 per month for a “high-claiming pharmacy” that can do 200 NMS per month, depending on the number of eligible NMS patients and the pharmacy’s operational capacity, it said.
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Mohammed added that pharmacy owners are subcontracting their NMS because they are too busy and it takes “the burden off them”, while patients are “very happy” a healthcare professional is chatting to them about their medication.
“The burden will go back on” pharmacy owners and financial pressures and stress that they were already facing are “only going to increase”, he added.
And Zaman stressed that the impact “will always be patient safety” as “these are patients who would never be spoken to about their medications”.
“Came as a surprise”
C+D spoke to another remote NMS provider Encon Pharma, which also works with around 100 community pharmacies.
Operations director Awais Hussain estimated the average monthly loss for the pharmacies it works with would be around £2,240 for 80 lost NMS claims a month – although some could lose up to £7,000.
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He said the change “came as a surprise” and that there is a “lack of clarity” on why “third party subcontractors cannot do it”.
“The main thing is looking at patient care and what that will mean for patients,” Hussain told C+D.
“So many of our clients are going to be at a huge loss”, he said, adding that a client survey revealed that “quite a lot” of the pharmacies he works with “would not be able to offer the service to their patients” at all following the changes.
“Disproportionate” impact on indies
National Pharmacy Association (NPA) vice chair Olivier Picard last week said the NMS “provides a crucial benefit to patients” by reducing avoidable waste and hospital admissions.
But he added that pharmacies “operate under a range of models” and “any changes must preserve the flexibility needed to support these variations”.
“Until we see the full detail of the proposed regulations, it’s difficult to assess their impact - however, there’s a risk that these changes could disproportionately affect some independent pharmacies,” Picard told C+D.
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“In particular, we don’t want unnecessarily to curtail the output of those small independent pharmacies that make use of the current provisions to meet the demands of the service,” he added.
And Royal Pharmaceutical Society (RPS) England board chair Tase Oputu said “data collection of NMS delivery will be vital to monitoring whether changes are working as intended and ensuring that patients continue to benefit from pharmacists’ expertise”.
“Never permitted”
CPE FAQs on the change set out that subcontracting “results in provision of the service by a different legal entity” and the “provision of NMS offsite by a legal entity other than the pharmacy owner/contractor is not permitted”.
It added that locums can provide NMS at a pharmacy’s premises they are contracted to work at, but self-employed locums cannot provide NMS offsite “when not at the pharmacy premises”.
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It said that the “discretion” for off-site NMS provision was introduced during the COVID-19 pandemic to allow isolating pharmacists to provide NMS from home but that “there was no provision or discretion given” for subcontracting it to a separate legal entity.
CPE declined to comment further.
And the DH last week (April 16) told C+D that contractors who provide the NMS “have never been permitted to subcontract the delivery of this service to other providers” and the regulatory change offered “further clarification on how to conduct the NMS appropriately”.
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It comes as antidepressants will be added to the NMS from October under the 2025/26 funding deal, while the service’s payment structure has been “simplified” to a split fee of £14 for each intervention or follow up consultation provided from this month.
The NMS launched in 2011 to support patients with long-term conditions and improve their medicines adherence when prescribed a new medicine.
