Increased cooperation between countries is needed to ensure better regulation of online pharmacies, said authors of a new report - 'Online pharmacy operations and distribution of medicines', published by the International Pharmaceutical Federation's (FIP) Community Pharmacy Section.
The report presents findings of a global survey of pharmacy organisations covering various aspects, such as type of medicines supplied by these pharmacies in different countries, how the authenticity of online pharmacies can be verified, and the usage of e-prescriptions and shared patient health records.
Of the 79 countries responding to the survey, 51 per cent acknowledged that no regulation of online pharmacies exists.
A quarter of the respondents reported cases of irresponsible self-medication by consumers who had purchased medicines through online pharmacies.
A lack of regulation creates "an avenue for illegal pharmacies and may impact the overall quality of medicines and services offered to consumers," authors of
the report said.
Lars-Åke Söderlund, immediate past president of FIP's Community Pharmacy Section and co-editor of the report, said that the pandemic has increased preference for online services, including in the pharmacy sector.
E-pharmacy, a digital platform also known as internet pharmacy or online pharmacy, has emerged as an escape route to longstanding queues at pharmacy stores
across almost all regions of the world, especially during the Covid-19 health crisis realm.
They have long been recognised to act promptly in public health response, like ensuring an effective medicine supply system, resolving and monitoring drug shortage
issues, educating about the proper use of PPE, promoting remote pharmacy services, and conducting drug evaluation and active surveillance.
These factors will support in easing the load on healthcare facilities during the ongoing pandemic, eventually adding value to patients and the healthcare system.
Overall, the e-pharmacy market size is expanding in terms of valuation on the back of regulations and standards laid by the respective governments.
As per a recent study by Global Market Insights, the global e-pharmacy industry accounted for a business share of $68 billion in 2021 with an anticipated growth
rate of 16.8 per cent through 2028.
Lloyds Pharmacy's closure of all its 1,300 branches will wake-up the ministers and NHS officials to the reality of community pharmacy sector in England has
reached crisis point, expressed Nigel Swift Managing Director of Rowlands pharmacy and Deputy Managing Director of PHOENIX UK.
On Friday, The SUN reported that the UK's second largest pharmacy provider - is allegedly in the process of selling its entire estate of 1300 branches. Lloyds
Pharmacy will no longer be a High Street presence following its decision to put all its pharmacy branches at the risk of closure. In January it has announced to
close its 237 Sainsbury-based pharmacies.
Nigel highlighted the fact that community pharmacy is struggling due to insufficient government funding and immense pressures on GPs and A&E departments - an ongoing
issue which poses a very real threat to the sector.
Commenting on the announcement, he said: "It's not just Lloyds - an independent analysis by Ernst & Young estimated that 75% of community pharmacies will be in
financial distress in the coming years. £750 million has been taken out of the English contract due to inflation since it began."
Superdrug has announced a pay increase for newly qualified pharmacists, in a move that will see wages rise to £50,000 - ensuring that Superdrug Pharmacists
continue to receive the strongest renumeration package on the high street today.
Superdrug is also enhancing its patient experience and operational structure, with the introduction of a new role of Pharmacy Team Leader to selected pharmacy stores.
Pharmacy Team Leaders will be dispenser trained and provide a clear line of accountability for day-to-day dispensary activity including adhering to legal and
clinical frameworks whilst supporting, coaching, and developing a high-performing pharmacy team.
The role also allows Superdrug to offer a clear line of progression for talented Pharmacy Dispensers and Technicians who want to do more in their career and recognises
the valuable contribution Pharmacy Dispensers & Technicians play in community pharmacy.
In addition, the appointment of two new Heads of Pharmacy Operations sees the high street retailer driving and improving Superdrug's pharmacy performance to offer the
best possible care for patients. Craig Watt, Pharmacist and previously Area Manager, has been appointed to Head of Pharmacy Operations North and will be responsible
for the operation of Superdrug's central distribution hub serving its e-pharmacy and Online Dr team.
The Pharmacists' Defence Association has called on the Scottish government to end unnecessary pharmacy closures and introduce emergency regulations to force
companies that operate Scotland's pharmacies to open on the days and hours they have agreed.
It is concerned that decisions made by some health boards in Scotland have now allowed pharmacy owners to close their pharmacies on Saturdays.
The PDA is worried that a pharmacy closure could have negative impact on patients and other parts of the NHS, including neighbouring pharmacies, addiction and mental
health services, and minor injury and A&E units.
The association claims that there are record numbers of registered pharmacists who are available to work and therefore a decision to close a pharmacy over staff
shortages is misleading.
"The business owners may claim there is a shortage of pharmacists, but when they actively cancel agreed hours of work it does not suggest there is a shortfall of
workers," said the PDA, adding: "These business decisions often include closing their pharmacies at very short notice, even when pharmacists are available and willing
to work."
In a recent interview with The Telegraph, health secretary Steve Barclay stated that he has asked his officials within DHSC to look at a "pharmacy first"
approach to alleviate pressures on A&E departments in order to avoid the widely predicted NHS winter crisis.
On the face of it, this a welcome if long overdue recognition that community pharmacy is an essential part of our national healthcare infrastructure alongside our
GP and A&E colleagues. But let's not get carried away - we have had lots of praise from politicians in the past which have not then been backed by firm commitments
for a sustainable future for the network.
Could this be a turning point? I hope so, but I am not confident it will be. I fear this may turn out to be another emergency stop-gap measure which does nothing to
secure the long-term viability of the sector in England.
The role of community pharmacy during the recent Covid pandemic demonstrated clearly how important we are to ensure people have easy access to essential healthcare
support, advice and services. The NHS winter crisis can only be avoided or at least mitigated if the potential of the community pharmacy network to provide more
patient care services is unlocked and that Barclay requires you to end pharmacy funding austerity and start investing.
The Treasury will no doubt say there is no more money, but what then the alternative other than a NHS winter crisis? And, of course, treating people in secondary care
settings is far more costly than community pharmacy based interventions.
In its response to the Health and Social Care Committee inquiry into 'Digital Transformation in the NHS', the Community Pharmacy IT Group (CP ITG) has
highlighted issues concerning the NHS community pharmacy.
CP ITG, of which PSNC is a member, has urged that pharmacy teams should have access to up-to-date records information, e.g. from Shared Care Records, GP Connect
and Summary Care Records with Additional Information.
It has also stated that the Booking and Referral Standards (BaRS) should be extended so that future referrals into and from pharmacy can be communicated seamlessly.
In its written response, CP ITG said: "Ensure that BaRS is expanded and aligns with other referral IT standards such as GP Connect referrals. Ensure it is used across
community pharmacy, the GP sector, other health care sectors and across the NHS, and by all health IT suppliers, so that messages and referrals can flow smoothly
within and across sectors and patients can have a seamless experience and safe care."
The group has asked the Health and Social Care Committee to create a framework for the development of pharmacy IT to ensure IT suppliers are better equipped to
support pharmacy teams and their delivery of services.
The English health secretary has fumbled the opportunity to prevent a crisis in the NHS this winter. She either does not understand or value the role of
community pharmacy as the third pillar of patient access to essential healthcare.
Her announcement that she wants community pharmacy to provide more services to take the strain off A&E departments and GP surgeries comes on the same day DHSC
announces no new long-term investment to sustain the sector.
Does she not understand that as a result of years of government underinvestment in England the network is in decline with random closures across the country? Too
many pharmacies are temporarily closed every day due to workforce shortages beyond the control of pharmacy owners.
Adding a new service here and there, even with some additional funding, does not address the longer term viability of the network which needs to know which patient
services it will be expected to provide over the next 10 years - not just the next few months - and how those will be adequately remunerated.
Asking more from our sector with no new investment is a strategy which is bound to fail. The pharmacy contract remains economically illiterate. The sector's finances
need open heart surgery not a couple of paracetamol tablets.
Will Quince, MP for Colchester and Health Minister visited Rowlands pharmacy on Friday (20 January) in Nayland Road in his constituency.
The important role played by pharmacies in providing NHS care, support, and advice helping the local community to live healthier lives and manage long-term conditions
were discussed among the pharmacy teams.
Mr Quince said: "Community pharmacy is playing an increasingly important role in ensuring people in Colchester have convenient walk-in access to the healthcare
support and advice they need.
Pharmacies are not simply places to collect prescriptions, they provide a wide range of services and are the third pillar of access to primary care alongside GPs and
A&E. I would urge people to think pharmacy first if they have a minor ailment; need advice on taking their medication; want to stop smoking or want to check their
blood pressure."
Recently, the English Health Secretary has talked about introducing a 'Pharmacy First' model similar to that which exists in Scotland. This would be a win-win
outcome providing people with better access to essential healthcare support, advice and treatment whilst relieving strain on other parts of the NHS, not least GPs
and A&E.
It is a no-brainer and yet despite a few media headlines there are still no firm proposals on the table to make this a reality. It surely cannot be right that you
can receive a broad range of patient care services in Scotland which are not available in England. It works well in Scotland, Wales is keen to develop more
pharmacy-based services and Northern Ireland, leaving aside the current funding dispute, has had a minor ailments service for many years.
If the English Health Secretary is sincere in his interest in adopting an English version of the Scottish model, then there are critical aspects he needs to
consider.
Firstly, start with the patient journey through the healthcare ecosystem from illness prevention through to long-term condition management. What is the role of
community pharmacy and how do we guide people to seek support from the most appropriate healthcare professional?
What is the vision for community pharmacy delivering patient care in the next decade?
The lesson from Scotland is that the government needs to sit down with the sector and map that out together. There are no quick fix overnight solutions. This needs
to be a long-term commitment backed by adequate funding. Supervision regulations need to change and there needs to be a thought through workforce strategy which
avoids community pharmacy shortages as that does nothing to deliver improved patient outcomes.
The Royal Pharmaceutical Society (RPS) and the National Institute for Health Research (NIHR), supported by the Association of Pharmacy Technicians UK (APTUK),
have launched the first e-learning module in a series for pharmacists and pharmacy technicians to develop their skills and knowledge in research.
A total of nine e-learning modules will be released by the end of 2022 to improve research awareness, knowledge and skills for pharmacists and pharmacy technicians
with little or no experience of research or research opportunities.
The aim is to improve the capacity of pharmacy professionals to provide the evidence base to improve the practice of pharmacy and the health of the public.
RPS President Professor Claire Anderson said: "Many pharmacy professionals are rather daunted by getting involved in research. Indeed, we have heard from
pharmacists undertaking our post-registration credentialing assessments that the Research domain can present a real challenge.
The Scottish Government and Community Pharmacy Scotland have agreed to roll out next month a new national service to provide emergency access to supplies
of naloxone.
An NHS circular signed by Alison Strath, Chief Pharmaceutical Officer of Scotland, advises that the emergency supply service will be added to the community
pharmacy Public Health Service from 30 October 2023. It states that community pharmacy contractors and pharmacy teams should ensure they are familiar with the
new arrangements.
Community pharmacy contractors have been asked to ensure that pharmacy teams complete the e-learning module for naloxone emergency supply. They are also encouraged
to join webinars to support the implementation of the service which will be held on Wednesday 4 October and Tuesday 14 November at 19:30. Details of how to register
can be found at on NHS Scotland's Turas platform.
Community Pharmacy England (CPE) is aiming to reach an agreement with the Department of Health and Social Care (DHSC) and NHS England (NHSE) on negotiation
with regards to expanded services and payment model in the pharmacy sector.
Chief Executive Janet Morrison, said: "We are working at pace in negotiations with DHSC and NHSE. The process remains on track with the Government's original
timescale - i.e. aiming for agreement in July, with cross-government clearance later in July, and implementation from July through to September."
CPE is involved in working groups on service expansion of Hypertension Case-Finding and the Pharmacy Contraception Scheme and service design for the Common
Conditions Service; and are in in-depth negotiations on Payment models.
These discussions critically look at the balance between funding core capacity and activity payments, how the funding streams will be distributed and how CPE
will measure delivery and impact.
NHSE has been leading on the development of the PGD pathways for each of the 7 conditions, with external medical, pharmacy and other experts feeding into the
process - pharmacy owners from the Community Pharmacy England Committee have also been involved but the discussions are clinically led to ensure they comply with
NICE principles and concur with Antimicrobial Stewardship policy.
In many cases, a pharmacy's most valuable asset is its NHS contract. This is what buyers are paying for - the right to provide pharmaceutical services
commissioned by the NHS and be reimbursed for the medicines dispensed.
However, a pharmacy consists of more than just an NHS contract and when buyers look for a pharmacy to buy, they will also examine these other areas - the pharmacy's
customer base, its staff, the property it operates from - to name a few - because these are all also crucial to a successful pharmacy.
In this day and age, another important consideration is the pharmacy's intellectual property (IP) i.e. the pharmacy's rights to certain types of information, ideas,
and forms of expression. At the most basic level, this includes the trade mark in the name of the pharmacy, because all pharmacies will have a name by which they
distinguish themselves from other pharmacies. The more well-known the name, the more valuable this form of IP is - mention 'Boots', for example, and most will have
an instant association with the largest pharmaceutical retailer in the UK.
In a first, NHS England and NHS Improvement (NHSE&I) has appointed a pharmacy technician to the chief pharmaceutical officer's team.
Liz Fidler, president at the Association of Pharmacy Technicians UK (APTUK), will join the team in March 2022 in the newly created post of senior professional advisor: pharmacy technician practice NHSE&I.
The appointment signaled "a new era for the profession, leading the step-change needed to build on and fully realise the benefits of the pharmacy technician clinical role for patients across the NHS system," said Dr Keith Ridge, chief pharmaceutical officer.
In the new role, Fidler will provide leadership and professional advice in relation to the pharmacy technician profession in England.
The Centre for Pharmacy Post-Graduate Education (CPPE) has launched Menopause - an introduction for pharmacy professionals e-learning programme.
The new Menopause: an introduction for pharmacy professionals e-learning programme aims to support pharmacist's to increase their knowledge and awareness of
menopause and perimenopause, helping them to have initial conversations with those who need support.
The programme teaches how to equip people experiencing menopausal symptoms with evidence-based information that allows them to make decisions about their own
health management.
This e-learning programme considers a range of topics, including the signs and symptoms associated with menopause and perimenopause, how a diagnosis is made
and the national context supporting a growing role for pharmacy professionals in menopause care.
It also discusses the benefits and risks of treatment options available, the common misconceptions that people may have about menopause and how to apply the
evidence base to practice in order to help support decision making.
Simon Harris bought an average-sized store from a national chain and turned it into a profitable business in just over a year - a great example of how to
start up a pharmacy and become successful. His formula was quite simple - recognise the available opportunities, take some calculated risks and reap the rewards.
Simon went into pharmacy because he felt it was a profession that would allow him to "help people" and have a direct impact on their lives. "I also thought it was
a profession which would allow me to have my own business one day."
Since qualifying as a pharmacist from Bath University in the late 90s, Simon did his pre-reg at a large Boots store in Broadmead, where we had some "great experience"
as a pharmacist manager.
He decided to take a year out and went around the world with his "now wife" and ended up working as a pharmacist for a pharmacy group Down Under which had a contract
with the sports industry, i.e. Australian Open and the Australian Football League.
"It was quite an experience because at the time I knew nothing about Aussie football but I ended up being their pharmacist after a short conversion course."
Community pharmacy could play an important role in proactive detection of heart valve disease (HVD), which remains under-recognised and under-detected in
England, suggested a new report published by Wilmington Healthcare.
Pharmacy bodies, including Royal Pharmaceutical Society (RPS), National Pharmacy Association (NPA) and Community Pharmacy England (CPE), have also endorsed the
report, which encourages Integrated Care Boards (ICBs) to consider the innovative approach of detecting HVD with the help of community pharmacists.
Despite HVD detection being a priority listed in the NHS Long Term Plan, a large number of people with HVD remained undiagnosed and untreated in the country due
to lack of awareness of the disease prevalence.
In June 2022, a pilot study was launched in Farnborough Primary Care Network (PCN), Hampshire, to evaluate the feasibility of using e-stethoscopes
(digital auscultation) to detect this heart condition by a community pharmacist.
The NHS plans to train hundreds of pharmacy staff, expanding their ability to provide advanced clinical services and assume wider roles in dispensing medicines.
With a targeted launch in September, up to 840 pharmacy technicians can join in the training programme. The online modules will cover consultation skills,
therapeutics, clinical decision-making, assessment skills, and service improvement.
"Community pharmacies are pivotal in local communities, and this novel training scheme empowers them to extend their service offerings to a wider patient base,"
said Health Minister Neil O'Brien. "Through our investment in the workforce, we're bolstering the implementation of the Pharmacy First initiative with £645 million,
ensuring patients have access to expert assistance for various common ailments, including urinary tract infections and earaches."
NHS said the training will offer flexibility to align with the working schedules and prior experience of community pharmacy technicians. It will combine independent
online e-course study, educational supervision, and clinical skills training. Facilitated workshops will concentrate on enhancing clinical assessment skills and
applying knowledge and skills through case studies, practice activities, and group discussions.
The Pharmaceutical Services Negotiating Committee (PSNC) has developed a webtool to help community pharmacy contractors estimate the impact on their payments
under the new discount deduction system.
The calculator aims to illustrate the changes to discount deduction that a pharmacy could experience during the transition to the new arrangements from October 2022
to January 2024, when the new system will be fully in place.
PSNC's calculator requires contractors to input information about their individual pharmacy dispensing mix (i.e. split of reimbursement by appliances, brands and
generics) to provide an estimate for the level of impact the new discount deduction system will have.
"The impact on individual pharmacies cannot be estimated without using dispensing mix data, meaning that any estimates which do not take this into account will not
be reliable," said PSNC.
For years many contractors have been frustrated by how discount is applied to their accounts and have often raised concerns about the blanket nature of its
application to PSNC.