What is the New Medicine Service in 2026, and does it pay?

What is the New Medicine Service?

The New Medicine Service (NMS) is an NHS England advanced service in which a pharmacist supports a patient who has just started a medicine for a long-term condition. It is structured, not ad hoc. The patient is recruited, has an intervention consultation one to two weeks later, and a follow-up two to three weeks after that. Any pharmacy in England that meets the terms of service can provide it, and most do.

It has run since October 2011, which is where NHSBSA's monthly data series begins. The evidence behind it is stronger than for most pharmacy services. A randomised trial evaluated by Elliott and colleagues found adherence of 70.7 per cent with the NMS against 60.5 per cent with usual care, a gain of 10.2 percentage points. Their 2017 economic evaluation in PharmacoEconomics estimated 0.05 extra quality-adjusted life years per patient and projected £517.6m of long-term NHS savings.

The scale is now large. The Pharmaceutical Journal reported in October 2025 that NMS claims passed 7 million in the year to July 2025, about 590,000 a month, worth nearly £156m. The same piece noted that around half of NMS episodes involve only one consultation rather than two. That gap matters for the money, as the sections below show.

Which conditions are eligible?

Eighteen. The list grew on 29 October 2025 when NHS England added depression, for adults aged 18 and over, alongside a full review of the eligible drug list. The table lists the conditions in the specification. NHSBSA publishes the eligible medicines for each condition as a spreadsheet, and only medicines on that list qualify.

The depression expansion is the one to watch for volume. The Pharmaceutical Journal reported that eight antidepressants joined the list, and that 66.2 million items of those drugs were dispensed in 2024. A pharmacy that was not recruiting patients on sertraline or mirtazapine last year has a new stream this year.

Three eligibility points catch people out. The medicine must be new to the patient, and the specification says the service "is not generally appropriate" where only the formulation has changed. Hospital-initiated medicines are fine if a hospital professional refers the patient, even if your pharmacy did not dispense the first supply. And patients can arrive three ways: recruited by your own staff, signposted by general practice, or referred from secondary care.

How do the three stages work?

Engagement, intervention, follow-up, on a fixed clock. The specification, version 2.0 published on 20 October 2025, tightened the timings from "typically" to "must". The intervention consultation must take place between 7 and 14 days after engagement. The follow-up must take place between 14 and 21 days after the intervention. Miss the window and the episode does not meet the specification.

Consent is not a formality. Before the service starts, informed verbal consent must be sought and recorded in the clinical record. The patient must be told that information is shared with their GP practice, with NHS England for monitoring, and with NHS England and NHSBSA for post-payment verification.

The follow-up rule is where episodes fail. If the follow-up does not happen at the agreed time, staff must make at least one additional attempt. If the patient still cannot be reached, that is recorded, the service ends as incomplete, and the follow-up fee cannot be claimed. The intervention fee stands.

Who can deliver it, and can it be remote?

Only a pharmacist can hold the intervention and follow-up consultations, and the consultations can be remote. The specification says consultations "must only be carried out by a pharmacist" who has assessed and declared their competence on the NMS self-assessment form. Pharmacy technicians and other staff can do the engagement stage, which is recruitment, consent and information.

Location is flexible. Consultations may be in-person face to face, by telephone or another live audio link, by live video link, or in the patient's home. Text-based methods can support a consultation but cannot replace one. For a working patient on a new statin, a ten-minute phone call in the evening is a valid follow-up.

What is not allowed is outsourcing. The 2025 specification says contractors "are not permitted to use sub-contracting arrangements at a location other than the pharmacy premises" for the service. The remote model where an outside pharmacist phoned your patients on your behalf is closed.

What does the NMS pay in 2026?

£14 per completed intervention and £14 per completed follow-up, unchanged by the 2026/27 settlement. The split fee started on 1 April 2025. Before that, the fee was banded from £20 to £28 per completed NMS, depending on how close you got to a target set by your prescription volume. The 2025/26 settlement called the new structure a simplification, and it is, but it also moved money from the intervention to the follow-up.

Payment is capped by prescription volume. From June 2026 consultations the cap is 0.9 per cent of monthly prescription items, down from 1.0 per cent. Community Pharmacy England (CPE) published the new bands on 5 June 2026. The table shows the combined maximum of interventions and follow-ups you can be paid for, and the monthly income that implies at £14 each. The income column is our arithmetic.

CPE says the change "is unlikely to impact the majority of pharmacy owners", because most pharmacies sit well below their cap. That is true, and it is also the point. A 6,000-item pharmacy could bill £1,512 a month from the NMS and most bill a fraction of it.

Does the NMS pay?

Yes, when it is built into dispensing rather than run as a separate project. The fee is modest per patient but the marginal cost is low. If an intervention takes 15 minutes and a follow-up 10, a full episode earns £28 for 25 minutes of pharmacist time. That is about £67 an hour before admin, on an assumption you should test against your own timings.

The national data shows where the money is left. Around half of episodes stop after the intervention, which means half of pharmacies' potential follow-up fees are never claimed. The follow-up is the cheaper consultation, usually a phone call, and the specification allows it by telephone or video. A diarised call three weeks after the intervention is the highest-margin ten minutes in the service.

Recruitment is the other lever. The service does not depend on GP referrals; your own team can recruit at the point of dispensing. Every new prescription for an eligible medicine is a candidate, and your PMR can flag them. Pharmacies that wait for the surgery to send patients wait a long time. Those that check the eligible drug list against each day's new items find candidates on every shift. See our note on reminders and recalls for how the dates can be diarised.

The cap sets a ceiling, not a target. For most pharmacies, the constraint is pharmacist time and the discipline of the 7-to-14 and 14-to-21 day windows, not the 0.9 per cent. For a fuller view of where the NMS sits against the other services, see how to make Pharmacy First pay.

How do you claim NMS payments?

Through the NHSBSA Manage Your Service (MYS) portal, by the 5th of the month after the consultations. You report the number of completed intervention and follow-up consultations for the month. A £14 fee can only be claimed where a consultation actually took place; a patient who declined or could not be contacted is not claimable. Payment appears on the FP34 Schedule of Payments under prescription fees.

There is currently no grace period. CPE's payment timetable lists the NMS deadline as the 5th of the following month, or the 6th when bank holidays fall in the first five days. It contains no sentence accepting later claims. That is stricter than Pharmacy First, which accepts late claims to the end of the following month. Our guide to the three-month claim window explains what is changing for both services.

Records matter because claims are verified after payment. The clinical record must show consent, the dates of each stage, the medicine and condition, and the outcome. Pharmacies may use an IT system that sends NMS data to NHSBSA by API, and most do. Keep the record complete enough to survive a post-payment verification query a year later.

What changed in the 2026/27 settlement?

Two things: the cap and the claims window. The 2026/27 Community Pharmacy Contractual Framework, announced on 29 May 2026, said "the existing cap methodology will be retained but contractor caps will be adjusted down to 0.9% of monthly prescriptions". The Drug Tariff update applying it from June 2026 consultations followed within a week.

On claims, the settlement said the one-month window for Pharmacy First clinical pathways and the NMS "will be retained". A "new late claims process" will allow submissions up to two months after the window closes. CPE's NMS page, updated on 5 June 2026, says this "will be introduced later in 2026". Until it is, the 5th of the month is the deadline.

The context is over-commissioning. The Pharmacist reported on 4 June 2026 that CPE had pushed for caps because "the NHS is trying to commission more activity from the pharmacy sector than its budget allows". The NMS cut is small. Pharmacy First minor illness and hypertension case-finding are getting high-level caps of their own, with details to be agreed during the year. The NMS fee was not touched, and the service is not part of the Pharmacy First bundling requirement. For the whole settlement, see what the 2026/27 contract actually pays.

Key takeaways

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