Liam Hawkins, pharmacist manager at Darling’s Dean Road, South Shields, talks to Saša Janković about running a NMS service.
Service type: NMS
Name and location of pharmacy: Darling’s Dean Road, South Shields
Name of pharmacist: Liam Hawkins
When did you start offering this service? 2019
Why did you start offering this service?
It’s an advanced service and we realised there was a need for it in our community.
How much did it cost to set up the service?
It required relatively little set up in terms of equipment and investment – you just need phones and a consultation room and you can do it.
In a nutshell, what does the new medicine service involve?
It’s a three-part service which starts with recruiting the patient (patient engagement); then the intervention (currently done by phone) where we have a discussion with the patient to assess their adherence to the medicine(s), identify problems and determine their need for further information and support; and the third part is a follow-up phone call two weeks after the first.
For the recruitment stage we use Proscript which is good at flagging up new prescriptions for any item that is eligible, which then prompts us to invite the patient onto the service if they want to be enrolled. Proscript PMR is the best I've found at flagging up these patients and it has a diary system as well so we can record our interactions with them.
As it’s an advanced service, prior to the pandemic we needed written consent from patients to enrol them, but when the pandemic hit these restrictions were lifted for NHS advances services. That has enabled me to actively recruit rather than waiting for patients to come in to the shop and has meant, for example, that I could recruit delivery patients onto the service as well.
Are there any opportunities to sell OTC or prescription products during or after the consultation?
Only certain new medications are eligible for the service, in four categories including cardiovascular or respiratory, so I can tailor my advice as necessary and talk about lifestyle and so on outside of just the medication.
Often I've rung a patient to talk about their new drug and the conversation has veered off onto other medication issues they are having that wouldn’t have been mentioned on the service.
How have patients responded to the new medicine service?
The majority of the time they learn something new about their medicine and I have been able to give them some general advice that they didn’t know that improves their condition as a whole. For example, there have been instances where a patient is using their inhaler incorrectly and I can talk them through it – especially elderly patients who find it hard to coordinate movement and an inhaler – and since they have started using it right they tell me they have noticed a dramatic improvement in their condition.
In some cases I’ve been able to make some potentially life-saving interventions at times. I saw one patient who had been prescribed celiprolol, which gets flagged up for the NMS. When I started speaking to them it became clear this was not intended for them as it’s a beta blocker, and what they actually needed was celecoxib which is a painkiller. Luckily they hadn’t take any of the drug when I called them, but I didn’t want to panic them so all I said was that I wanted to chat with their GP before they started taking the medication. The GP was grateful that I’d spotted the error, cancelled the wrong script and issued the correct one, and I was then able to explain to the patient what happened.
Roughly how often each month do you carry out the service?
Before these challenging times, when I had cover for doing in-person NMS consultations, I could do 30-35 a month, which is not to be sniffed at. When the pandemic kicked off I gave it a break until we got back on top of everything, and it has dropped because there other priorities at the moment. I’m now doing about 15-20 a month, which is not as many as I would like.
How much do you charge for the service?
It’s free to the patient.
Roughly how much a month do you make from offering the service?
We get paid £28 per NMS but we have to complete all three stages to qualify for payment.
Would you recommend offering this new medicine service to other contractors?
Yes. It’s more proactive than reactive so you don’t have to drop what you are doing like with other services where someone walks in off the street. Because you are making the call to the patient you can fit it in around what you are doing in the pharmacy.