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The Department of Health and Social Care (DHSC) and NHS England last month issued a "safety critical" national patient safety alert, warning about the UK-wide shortage of a life-saving drug used to treat patients with chronic breathing issues. NHS trusts, health authorities, ambulance services, GP practices, private healthcare providers, and community pharmacy contractors were informed that salbutamol 2.5mg and 5mg nebuliser liquid unit dose vials are in short supply, with the latter likely to remain "out of stock" until mid-April 2024. As per the alert, the shortage of the drug resulted from a combination of manufacturing issues, leading to heightened demand for alternative suppliers. It was mentioned that while terbutaline, salbutamol with ipratropium, and ipratropium nebuliser liquids remained available, they could't meet the increased demand.

The World Health Organization (WHO) issued a warning on Thursday regarding falsified semaglutide medications used for treating type 2 diabetes and obesity in select countries. This WHO Medical Product Alert addresses three falsified batches of the specific brand Ozempic that were detected in Brazil (October 2023), the United Kingdom and Northern Ireland (October 2023), and the United States (December 2023). These falsified semaglutide products were distributed through the regulated supply chain. Novo Nordisk, the genuine manufacturer of Ozempic, confirmed that the three products mentioned in the alert are falsified and were not produced by the company. Healthcare professionals, regulatory authorities and the public are advised to remain vigilant regarding these falsified batches of medicines. Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products, urged stakeholders to stop any usage of suspicious medicines and report them to relevant authorities.

The Department of Health and Social Care (DHSC) has issued an alert to update healthcare professionals on the shortage of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which are used to treat type 2 diabetes. It has informed that the supply of the drugs continues to be limited, and is not expected to return to normal until at least the end of 2024. An increase in demand for these products for licensed and off-label indications is cited as the cause of the supply issues. "Rybelsus® (semaglutide) tablets are now available in sufficient quantities to support initiation of GLP1 RA treatment in people with type 2 diabetes (T2DM) in whom new initiation of GLP-1 RA therapy would be clinically appropriate," the DHSC's National Patient Safety Alert reads.

The Medicines and Healthcare products Regulatory Agency (MHRA) has reminded healthcare professionals prescribing aripiprazole to alert patients about its possible side effects, following a rise in the number of reports of gambling disorder associated with the drug. Patients taking aripiprazole, which is used for the treatment of schizophrenia and bipolar disorder, are at risk of developing unusual urges or cravings that they cannot resist, including behaviours such as addictive gambling, excessive eating or spending, or an abnormally high sex drive. The regulator has received 69 reports of gambling or gambling disorder suspected to be caused by aripiprazole in the last 14 years via the Yellow Card Scheme, out of which 32 were received between 1 January and 31 August this year. Alison Cave, MHRA Chief Safety Officer, said: "The number of reports for suspected gambling and other impulsive behaviours associated with aripiprazole are small in comparison to the frequency with which it is prescribed, but the consequences for any patient developing these conditions can be significant."

PCCA Limited has issued a recall for its Ketamine 50mg/5ml and 100mg/5ml oral solutions after a small number of bottles have been observed to contain crystalline material. The company said it is recalling impacted batches from patients, pharmacies and hospitals as a precautionary measure. "This recall is being issued as a company-led medicines recall, as this product is only supplied to a small number of customers and the company has traceability of the onward distribution by their customers to patients directly," the MHRA said in an alert. Check the website.

Hospitals and healthcare providers across the UK have been notified about the shortage of an anti-inflammatory medicine caused by a manufacturing failure. The Department of Health and Social Care (DHSC) on Friday (3 May) issued a National Patient Safety Alert stating that Erelzi 50mg solution for injection in pre-filled pen will be out of stock from early May until mid-July 2024. "The supply issues have been caused by a manufacturing failure resulting in delays in production and the implementation of global allocations," it said. However, it noted that homecare providers (Alcura, Healthnet and Sciensus) have sufficient stock to supply existing patients until mid/late May 2024. Although Erelzi 50mg pre-filled syringes (PFS) are still available, they cannot support a full increase in demand, the DHSC warned.

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The Medicines and Healthcare products Regulatory Agency (MHRA) has advised healthcare professionals to stop supplying a specific batch of Paroxetine 40mg Film Coated Tablets immediately. Crescent Pharma Limited is recalling a specific batch of Paroxetine 40mg Film Coated Tablets as a precautionary measure due to out of specification results for dissolution during routine stability testing. "Quarantine all remaining stock of the said batch and return it to your supplier, using your supplier's approved process," said MHRA. The agency alerted the patients that this is a precautionary Pharmacy and Wholesaler level recall, therefore no further action is required by patients.

To provide a portable access of Pharmacy Support and Advice Service to pharmacists and technicians, the National Pharmacy Association (NPA) has launched an 'Associate Pharmacist' subscription. The service, comprising priority news-feed and email alerts, also includes NPA Learn - the association's Learning and Development hub. The offering to associates includes an annual online flu refresher or discounted full face-to-face vaccination training programme. NPA director of membership, Simon Tebbutt, said: "Associate Pharmacist is an offer to individuals, not to pharmacy businesses. We find that many pharmacists and technicians come into contact with NPA resources and like them, experiencing their quality as they move from pharmacy to pharmacy, either as a locum or as part of their career-building.

Britain on Monday (January 10) put the biggest private health companies on high alert to deliver crucial treatments such as cancer surgery should Omicron overwhelm National Health Service hospitals in England. The United Kingdom's death toll from the Covid-19 pandemic stands at 150,154, the world's seventh worst official Covid toll after the United States, Brazil, India, Russia, Mexico and Peru. Prime minister Boris Johnson has bet on refraining from lockdowns to deal with the Omicron variant which in recent weeks has swept across the UK, albeit with death rates significantly lower than previous waves. In a sign of just how stretched the NHS could become, health secretary Sajid Javid ordered England's NHS to strike a three-month deal with private health companies to allow patients to get treatments such as cancer surgery outside. "Millions of patients have already got their tests and treatment quicker thanks to our existing deal with independent providers," said David Sloman, NHS England chief operating officer and Covid incident director.

Hypovase (prazosin) 500 microgram tablets, manufactured by drug major Pfizer, will remain out of stock until mid-January 2022 due to a manufacturing issue. The Department of Health and Social Care (DHSC) and NHS England and Improvement (NHSE&I) have issued a supply disruption alert for the medicine that is used to treat heart-related troubles. Pfizer, the sole supplier of prazosin 500mg tablets in the UK, is out of stock from late November 2021, and had discontinued the Hypovase® (prazosin) 1mg tablets in May 2021. Advice for healthcare professionals In the given situation, prescribers need to review all affected patients to discuss management plans. Meanwhile, alternative medicine alpha blockers remain available to support an uplift in demand.

Teva UK has alerted the Secretary of State for Health and Social Care to the problem posed by steep energy prices. Teva's UK General Manager Kim Innes wrote to the minister seeking assurances that the distribution of medicines to patients will be safeguarded over what's likely to be a difficult winter. The problems posed by steep energy prices and the potential for power rationing is putting pharmacies under pressure from increased costs and the risk of losing power supplies as a 'non-domestic' energy user, said the company. Kim said: "In our letter to the Secretary of State we acknowledged that the government knows that medicines manufacture is strategically important and that it's a vital component in maintaining patient health." "But I wanted to make sure that the Secretary of State also realises the consequences of the energy crisis further down the supply chain - for example, the need for a pharmacy to have a fridge switched on at all times for storing cold chain products."

Lapses in strategies to tackle COVID-19 this year continue to create the perfect conditions for a deadly new variant to emerge, as parts of China witness a rise in infections, the head of the World Health Organization said on Friday (December 2). The comments by WHO Director-General Tedros Adhanom Ghebreyesus mark a change in tone just months after he said that the world has never been in a better position to end the pandemic. "We are much closer to being able to say that the emergency phase of the pandemic is over, but we're not there yet," Tedros said on Friday. The global health agency estimates that about 90% of the world's population now has some level of immunity to SARS-COV-2 either due to prior infection or vaccination. "Gaps in testing … and vaccination are continuing to create the perfect conditions for a new variant of concern to emerge that could cause significant mortality," Tedros said. COVID-19 infections are at record highs in China and have started to rise in parts of Britain after months of decline.

A polio vaccine booster campaign is being launched for almost a million children in London aged between 1 and 9 after confirmation that poliovirus is spreading in the capital for the first time since the 1980s. The UK Health Security Agency has identified 116 polioviruses from 19 sewage samples this year in London, after first sending an alert about finding the virus in June. The levels of poliovirus found and genetic diversity indicated that transmission was taking place in a number of London boroughs, the agency said on Wednesday (Aug 10). Health secretary Steve Barclay said: "I recognise parents and guardians will be concerned about the detection of polio in London, however I want to reassure people that nobody has been diagnosed with the virus and the risk to the wider population is low… "Vaccines offer the best defence to children, and those around them, so I would encourage families to ensure they are up to date with their routine jabs, and to come forward for the polio booster as soon as they are contacted by the NHS."

British health officials on Wednesday (September 28) warned that increased circulation of flu and a resurgence in Covid-19 could lead to a difficult winter that increases pressure on the already stretched NHS. Warnings over a possible "twindemic" of Covid-19 and flu have been issued each winter since the start of the coronavirus pandemic in early 2020, but Covid restrictions that limited social contact have meant flu levels stayed low. However, the government ended coronavirus restrictions earlier this year, meaning that social contact rates have returned to near pre-pandemic norms while immunity to flu is relatively low. The UK Health Security Agency (UKHSA) said that given the risk it was important those eligible took up vaccines against Covid and flu. "There are strong indications we could be facing the threat of widely circulating flu, lower levels of natural immunity due to less exposure over the last three winters and an increase in Covid-19 circulating," said Susan Hopkins, chief medical advisor at UKHSA.

NHS England has launched a prescription savings campaign, particularly for those living with long-term conditions. The campaign is specifically for individuals residing in deprived areas as they receive more prescriptions than people in affluent areas. It is also known that people with low income could be entitled to help with costs or free prescriptions depending on their circumstances. The Pharmacists' Defence Association (PDA), an active member of the Prescription Charges Coalition, is actively striving to eliminate prescription charges in England as well. They are focussing on "NHS England's current efforts to minimise charges so that members practising in England can alert patients to this possibility".

The NHS England has developed and published a new vaccination strategy with an aim to increase national uptake of lifesaving vaccinations, and protect people against a range of diseases. Getting vaccinations will become easier than ever before, as the NHS App is being expanded with more additional features. Improved booking features such as new in-App bookings, invitation alerts and appointment notifications will make "booking a jab as easy as booking a cab," NHS leaders said. The NHS App overhaul will also include improved access to medical records, meaning users will be able to see their routine vaccination status over the coming months and years, making it easier for them to identify any missed vaccinations in their history.

Following concerns raised about cracked cartridges and insulin leaks, the Medicines and Healthcare products Regulatory Agency (MHRA) has issued a national patient safety alert for the NovoRapid PumpCart prefilled insulin cartridge and the Roche Accu-Chek Insight Insulin pump system. The regulator have asked patients to check the pre-filled glass insulin cartridge for cracks before use. It advised against using the cartridge if it has been dropped even if no cracks are visible and urged to closely follow the updated handling instructions in the pump user manual when changing pre-filled glass insulin cartridges. In some of the reported leakage incidents, the cartridges were found to be cracked and provided an inadequate supply of insulin to patients. Leakages also occurred in cases where no cracks in the cartridge were visible, the regulator said. In some patients there were consequences of not receiving enough insulin from their pump system, including reports of severely high blood sugar and diabetic ketoacidosis, a serious complication of diabetes when the body produces high levels of blood acids called ketones. Healthcare professionals are being advised to contact patients over the next six months using said device to discuss their individual needs and source an alternative pump where appropriate. "Because of the rare risk of insulin leakage from the Roche Accu-Chek Insight Insulin Pump, patients should check the pre-filled glass insulin cartridge for any cracks prior to usage," Dr June Raine, MHRA chief executive, said.

One evening whilst I was watching TV, my phone pinged with an all too familiar WhatsApp alert with a message preview saying "Can you help". I recognised the name as one of our Titan pharmacy customers who was clearly in a state of panic. I replied offering my assistance and asked him what was up. What followed over the next 24 hours was an interesting case study of how innovative technology can genuinely solve real challenges in pharmacies. Mr P (let's call him that) had booked a locum to cover in his dispensary on the next day so he could focus on his vaccination service. The problem - his locum had just called to cancel his booking (no reason given) and now he had no cover. Meanwhile, he was fully booked with back to back appointments and could not cancel them. He had phoned round his usual network of pharmacists and no one was available at short notice. He was asking if there was anything that Titan could do to reduce his workload and said he had heard about Titan's artificial intelligence module. Unfortunately, Titan. X had not been installed at this site and was not an option at this late stage. Equally, Titan's digital workflow cannot be circumvented so there was no way steps could be taken out of the process.

The Pharmaceutical Services Negotiating Committee (PSNC) has shared materials to help community pharmacy in communicating relevant advice to people during this heatwave. The UK Health Security Agency (UKHSA) has issued a heat-health alert for the next few days. It has also published a beat the heat poster, along with its heatwave guidance, which could be used in pharmacies to raise awareness. "During this heatwave, the public may turn to community pharmacy teams for advice about staying well during the hot weather or to seek assistance when feeling unwell because of the heat," PSNC said. It has previously developed materials that may be used by community pharmacy teams to communicate relevant messages contained in the Heatwave Plan for England and the NHS website guidance on how to cope in hot weather.