Focus on antidepressants in PCN and pharmacy contracts

Both the new primary care network (PCN) contract and the new community pharmacy contractual framework include a focus on antidepressants.

For pharmacists working in PCNs and GP surgeries, antidepressants have been added to the list of medicines where patients might benefit from a Structured Medication Review (SMR).

And community pharmacists will be funded to speak to patients newly prescribed antidepressants about medicines adherence, as part of the New Medicine Service (NMS).

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Antidepressants added to SMR guidance

The PCN network directed enhanced service (DES) guidance for 2025/26 states that 'PCNs should use appropriate tools to identify and prioritise patients who they deem high risk from their population, and would benefit from a SMR'.

This could include patients 'using one or more medicines associated with dependence or withdrawal symptoms, from the following groups: antidepressants; opioids; gabapentinoids; benzodiazepines; and Z-drugs'.

The new guidance around SMRs also says that pharmacists should 'ensure the patient understands the purpose of the SMR appointment'.

And they should consider whether the patient has been given 'sufficient information about the available alternatives'.

This may include non-medical interventions where appropriate, such as social prescribing.

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Community pharmacists to help with antidepressant adherence

Medications used to treat depression will be added to the community pharmacy NMS from October 2025, as per the 2025/26 community pharmacy contract.

This advanced (opt-in) national service sees community pharmacists in England commissioned to support patients with medicines adherence.

It already applies to medication for several long-term conditions, including type 2 diabetes and atrial fibrillation.

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Community Pharmacy England (CPE) director of NHS services Alastair Buxton said antidepressants were 'a beautiful example of medicines where people get side effects to begin with and don't get the benefits of the medicines immediately, and people need to stick with them and adhere to the medicines, which is, of course, at the heart of what the New Medicine Service seeks to achieve in terms of increasing adherence to medicines for long term conditions'.

‘[This] then has a major impact at an individual level, positively for the individual patient, but then has massive health economic benefits for the NHS and the state overall.'