Andrea Smith, chair of Derbyshire LPC and superintendent pharmacist at Wilsons Pharmacy, talks to Saša Janković about running an NMS service in all six of the group’s branches in the county.
Service type: NMS
Name and location of pharmacy: Wilsons Pharmacy group, Derbyshire
Name of superintendent pharmacist: Andrea Smith
When did you start offering this service?
It really started ramping up since the pandemic and has been part of the Pharmacy Quality Scheme (PQS) for a while now.
Why did you start offering this service?
NMS provides some funding that is already available to pharmacy that we were not taking advantage of. Wearing my LPC hat, Derbyshire contractors – and contractors nationally – could be better at it, so we paid more attention to what we were delivering and realised that we could make more of it.
How much did it cost to set up the service?
There is no extra equipment so no extra cost. You need a system to know when to call people back for an initial intervention or a follow-up. This can be a paper-based diary or high tech IT system, and lots of PMR systems incorporate NMS features so there are plenty of different ways of delivering that.
What, if any, training did you or other team members have to undergo?
There does need to be training time to make sure the team understand which patients to look out for and actively engage with them.
In a nutshell, what does the service involve?
The PMR helps pick up a patient’s new medicines so the team can get all the NMS paperwork ready in advance. Staff then book the person into the diary for their appointment so they are not missed.
Each morning the dispensary team looks who needs phone calls and who will call in for their NMS. The majority are done by phone but it depends on how accessible we are for the patient to come back, and what their choice is. It’s our intention to look at adding in video consultations in future.
There’s a head office directive to branch managers and pharmacy teams saying how many NMSs they want us to deliver per day, and branches had to feed back to head office every week with how many engagements, intervention and follow ups we have done, to keep the service continued and embedded as practice.
Are there any opportunities to sell OTC or prescription products during or after the consultation?
Whenever we are talking to a patient it’s always an opportunity for something. We don't specifically use NMS for that but who’s to say somebody might not bring something up that we can help with, for them or a friend or family member. We are giving lifestyle advice to patients as well, such as tie-ins with the hypertension service, and there are pharmacies running weight management clinics that can also help.
How have patients responded to the service?
The patients I speak to value the service because they have got a friendly person they can ask questions of, and they trust us to be able to answer the things they are maybe afraid to ask their GP or practice nurse.
One example of a good intervention was a patient I phoned who was on holiday in Spain. When I called it turned out she was having an adverse reaction to the new medicines she was taking and didn’t realise that’s what it was. It ended up with me going back to the practice team and then helping her to source medical attention in Spain. Her medicines were stopped straight away and switched for something more suitable, and when she came back a couple of weeks ago she was singing our praises.
The biggest problem is being very successful at NMS means you have 10-15 patients needing a call in one day, and that time has to be taken from somewhere else so you will have to look at your team. It works best if you have an ACT in place to help with checking, and have a well-trained team generally.
Roughly how often each month do you carry out the service?
We do 50-60 NMS per month, per pharmacy.
Roughly how much a month do you make from offering the service?
The funding for the service ranges from £20-28 per completed NMS you provide, depending on the total number of patients who receive the service in the month.
Would you recommend offering this service to other contractors?
It’s an absolute no brainer for all community pharmacies to be delivering this service.
There’s lots of evidence of patients who don't engage with their medicines or take them properly, which is why the service was in the contract in the first place, and I think it’s a great service for patients. The funding is there, the service is straightforward, you have your systems and staff in place so it’s a huge opportunity and not to be missed.