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The Pharmacists' Defence Association (PDA) has issued an advisory information to community pharmacy contractors about Paxlovid antiviral treatment for non-hospitalised patients. "Patients will be assessed to see if they meet the criteria for inclusion and will need careful checking to see if Paxlovid therapy is safe due to the significant number of drug interactions. Assessment and prescribing are provided via dedicated services with dispensing and supply arranged by the central supply service or via participating community pharmacies," said the PDA. Every pharmacist can support this service by making themselves familiar with the service set up in their area. This is so that they can provide advice and signpost to healthcare colleagues and patients. Pharmacists working in general practice may also be able to help with identifying newly diagnosed highest risk patients. Whilst most of this group should have already been identified and contacted, no system is entirely foolproof. The PDA's advisory note provides information around indemnity and links to information about the prescribing and administration of Paxlovid since it is being provided under a temporary authorisation, and is subject to numerous drug-drug interactions, and is a recommended first-line treatment.

Amendments to the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 along with introduction of a new type of pharmaceutical service come into effect from Tuesday (December 21) and from January 1, 2022. PSNC will be consulted on the new type of enhanced service - the National Enhanced Service (NES), where NHS England and NHS Improvement (NHSE&I) commissions an enhanced service with a service specification that sets standard conditions nationally. Other amendments to the regulations include: Changes in the contractors' terms of service, allowing NHSE&I to introduce a pandemic response programme, by which contractors are required to have various premises and other arrangements for responding to a pandemic. An alternative route to supply pandemic treatments, via a listed prescription items voucher (LPIV). This is a further option for the community pharmacy for supply of treatments or medicines during or in anticipation of pandemic disease;

The Scottish government has issued a circular to inform community pharmacy contractors that the Serious Shortage Protocol (SSP) for Clarithromycin 125mg/5ml oral suspension, an antibiotic product, due to expire on 15 December 2023, has been extended until Friday 12 January 2024. The extension is applicable to SSP053 which allows community pharmacists to substitute this product with Clarithromycin 250mg/5ml oral suspension for patients presenting with an NHS or private prescription. Scotland's chief pharmaceutical officer, Alison Strath, has advised health boards to spread this information to community pharmacy contractors on their pharmaceutical lists and area pharmaceutical committees, as well as general practices. Community pharmacists have been advised to review and familiarise themselves with the new end date for the noted SSP.

The Pharmacists' Defence Association (PDA) has raised concerns over "a prominent pharmacist's call to create a sector 'blacklist' for locums regarding disputes over rates." A few contractors took it to the Twitter to share screenshots of the messages by locums demanding more pay, which led to the call for 'blacklisting' those locums. "The motivation regarding the current talk of creating a blacklist seems intrinsically tied to hourly rates. Although there are occasional and isolated anecdotal reports on social media of alleged incidents of locums seeking higher rates than already agreed, these are far outstripped by reports of pharmacy businesses unwilling to negotiate and who do not want to pay the necessary rate to engage a locum and instead have set capped or fixed rates," said the PDA. It added that all parties should honour agreements they enter into, including a pharmacy's commitment to the NHS that it will open at set times to provide pharmaceutical services to patients and the public.

The Pharmaceutical Services Negotiating Committee (PSNC) has reminded Community pharmacy contractors to ensure that the correct flu vaccines are being used for each patient cohort. The pharmacies have also been asked to ensure that they recorded accurately in the patient's clinical record for the NHS Flu Vaccination Service. The move was followed by PSNC after the cases where the standard egg-cultured quadrivalent influenza vaccine (QIVe) was administered in the 65 years and over patient cohort. PSNC said: "On investigation, it appears that a number of these errors are due to data input errors; however, it is important to be careful when selecting a flu vaccine for this patient cohort as there is no provision for the use of the QIVe vaccine in patients aged 65 years and over in the NHS Flu Vaccination Service." The Joint Committee on Vaccination and Immunisation has advised it is not an effective intervention for patients aged 65 years and over.

As whooping cough cases rise sharply across the UK, the NHS has reactivated the serious shortage protocols (SSPs) for clarithromycin - a commonly prescribed antibiotic to treat this bacterial infection. Pharmacy bodies had recently warned that community pharmacies were struggling to obtain source clarithromycin for patients. Two SSPs, covering clarithromycin 125mg/5mL and 250mg/5mL oral suspensions, were reactivated on 22 May 2024, and extended until 21 June 2024. These protocols state that for every 5mL of clarithromycin 125mg/5mL oral suspension, pharmacy contractors must supply 2.5mL of clarithromycin 250mg/5mL oral suspension; and for every 5mL of clarithromycin 250mg/5mL oral suspension, one clarithromycin 250mg tablet must be supplied. The SSPs apply to cross-border prescriptions, both NHS and private.

Despite being relatively new to the dispensing doctor market as a short-liner, Bestway Medhub is seeing exponential growth in the market in addition to the 3,500 independent pharmacies that we service and deliver to. We have however been servicing the dispensing doctor market for well over 40 years through our dispensing appliance contractor (DAC) Wardles. Wardles service and supply more than 55% of all dispensing sites with dressings, bandages, appliances, ostomy, wound care and hosiery. Graham Burford-Row To meet the needs of dispensing practices and surgeries we carry a large range of more than 10,000 Generics, PI's and OTC products. We offer net pricing so the practice can see straight away what price they are paying for their products - with no hidden fees. We offer all our practices 24-hour online ordering via our Bestway Medhub ordering portal and our recently launched Wardles FP Portal. Additionally, we have the backup of a telesales department with personal service from myself and a dedicated Internal Dispensing Dr Account Manager. We offer daily, weekly or monthly calls to those customers wishing to hear our special offers. Our deliveries are done daily via our third party full-line logistics partner for efficient deliveries, which no other short-line wholesaler offers. Bestway Medhub understands that dispensing practices are not only in the business of offering superior care to their patients and community, but they also offer numerous other services like clinics, nursing and referrals. By enabling practices to cost save, the funds could be used elsewhere instead.

Department of Health and Social Care (DHSC) has increased the rate of discount deduction for generics from 17.52 per cent to 20 per cent. The Drug Tariff for April 2023 will contain changes to the discount deduction arrangements for pharmacy contractors, which will include- all concession lines to be considered as Group Items for Discount Not Deducted i.e. DND or zero discount (ZD) items; and rate of discount deduction for generics to increase from 17.52% to 20% The Pharmaceutical Services Negotiating Committee (PSNC) and DHSC agreed on the changes for all concession lines to be considered as Group Items for Discount Not Deducted. Therefore from 1 April 2023, a new category will be introduced into Part II of the Drug Tariff 'Drugs for which discount is not deducted'. However, the committee had rejected the changes in the rate of discount deduction for generics. It said, "Following pressure from NHS England, Ministers have now chosen to impose changes to the previously agreed discount deduction arrangements, which come into effect from 1 April, and will be kept under review."

The Department of Health and Social Care (DHSC) will introduce new arrangements for the setting of Drug Tariff Category A reimbursement prices from April 2024. Driven by ministers, DHSC's decision aims to equalise access to margin on Category A medicines and it's part of a series of drug reimbursement reforms proposed by the department following a public consultation in 2019. Currently, prices of medicines in Category A are subject to monthly adjustment. From 1 April 2024, these will be updated quarterly based on sales and volume data obtained by DHSC under the Health Service Products (Provision and Disclosure of Information) Regulations 2018. The transition will conclude in July 2025 when the reimbursement prices will be exclusively determined by the new method. Advance notice for contractors regarding the 'new arrangements' has been outlined on the NHSBSA website. However, Community Pharmacy England (CPE) did not support the introduction of the changes at this time as pharmacies are currently grappling with "wider challenges" and there is uncertainty about the potential impact of these changes on the already "turbulent" medicines supply chain

The Department of Health and Social Care (DHSC) has redetermined the December 2023 concessionary prices for four medicines following requests made by Community Pharmacy England (CPE) on behalf of community pharmacy owners. For Ezetimibe 10mg tablets (pack size 28), the price has been fixed at £17.78, up from £9.44. Other drugs included in the list are Aripiprazole 5mg (£8.52), Digoxin 125microgram (£3.70) and Digoxin 250micrgram (£3.70) tablets. Contractors would be reimbursed at the new prices only for prescriptions submitted for payment for the dispensing month of December 2023. CPE said they are still working with DHSC to agree price concessions for January. Check the final the December 2023 price concessionary here. Additionally, DHSC on Friday confirmed that there's now sufficient stock of Clarithromycin 125mg/5ml oral suspension to meet normal demand, and the Serious Shortage Protocol (SSP), SSP053 for the antibiotic expires on 12 January 2024.

The Pharmaceutical Services Negotiating Committee has announced that the Department of Health and Social Care (DHSC) has granted final price concessions to further items for the month of November 2021. A price concession only applies for the month in which it is granted. No additional prescription endorsement are required as the new price is automatically applied by the NHS BSA to all items submitted for payment in the same month for which a price concession is granted. Contractors can find information and learn about the process involved on PSNC's website. Check pharmacy business website for price concession list november 2021.

The Pharmaceutical Services Negotiating Committee (PSNC) has announced the margin delivery rates will increase from October as the agreed £100m write off is implemented. "The baseline margin allowance will remain £800m per year in 2022/23 and 2023/24," said PSNC. "Margin levels in the last two full years (2020/21 and 2021/22), as measured by the Margin Survey of independent pharmacies, were in excess of the baseline allowance, meaning that an excess was accrued." As new services have been introduced and take up of these has accelerated, the amount of unallocated funding left in the CPCF is now less than it previously was. As such, the value of the Transitional Payments will decrease from its current level. Some of the unallocated funding remaining in 2023/24 will be repurposed into a Flat Payment for all contractors (see details below). Over the course of the second half of 2022/23, the value of the Transitional Payments will be phased down. This will start in October 2022 with a reduction in payment levels to approximately 85% of the current level, as shown in the following table:

To help the pharmacists understand the Serious Shortage Protocols (SSPs) for three Hormone Replacement Therapy (HRT) products that was recently announced by the Department of Health and Social Care (DHSC)'s, the Pharmaceutical Services Negotiating Committee has shared top tips on the correct SSP endorsement and submission requirements. Top Tips by PSNC for pharmacists on HRT SSPs: Always double check that endorsements reflect the requirements outlined in the supporting guidance published for each SSP on the dedicated page of the NHSBSA's website. When endorsing using EPS, contractors are reminded to select the SSP endorsement and input the correct three-digit reference number leaving a space in between 'SSP' and the three-digit reference number for example, SSP 019. Remember to insert the leading zero in the three digit reference number. Each of the affected HRT medicines has its own SSP reference number. Check that the correct SSP number is endorsed for e.g. for Oestrogel® Pump-Pack 0.06% gel the SSP endorsement should be 'SSP 019'. Please note the 'NCSO' endorsement is no longer accepted for SSPs. Endorse the SSP product dispensed including the quantity. Ensure your endorsements are accurate and clear - NHSBSA processing staff must be able to determine what has been supplied. Contractors should note that SSP claims submitted using EPS tokens are no longer permitted.

A recent Pharmacists' Defence Association (PDA) survey revealed that 80 per cent of its member working in the NHS in England, Wales, and Northern Ireland rejected the NHS pay award. "For the first time in the history of our union, members have told us they are so angry that they would not rule out industrial action in conjunction with other NHS unions," said Paul Moloney, PDA Union national officer. "It is important that, whoever is to lead the government, they listen to this message and act now to ensure our members and others in the NHS do not face swinging cuts to their standard of living." PDA members were asked whether they would support industrial action if they had rejected the award and if other NHS unions would be taking industrial action. 58 per cent of those responding said they would support the PDA Union taking industrial action if members of other unions were also planning to take action on this issue. For now, however, the PDA Union will wait for other unions to publish the outcomes of their own consultations. As a union dedicated to representing the needs of only pharmacists, the PDA has been able to quickly survey members immediately after the pay award was announced.

Viveca Biomed has launched an innovative and clinically-proven bladder support device that offers women immediate relief from stress urinary incontinence (SUI) and provides community pharmacy contractors with a way to build a new consumer base, customer loyalty and sales margins. The product, named 'Contrelle Activgard', has already recorded millions of sales in Scandinavia over a decade. The company behind the UK launch is female healthcare business Viveca Biomed, founded in 2019 by Andrew Tasker who has spent 30+ years in senior roles within the OTC and pharma industry. Contrelle is manufactured, packed and distributed in the UK at Viveca Biomed's factory near Newcastle, with no outsourcing, and thus offering the best possible continuity of supply. Ahead of the launch, the company commissioned a large consumer lifestyle survey with 500 women over 40 years of age who experience bladder leaks, to reveal the extent of its detrimental impact. Contrelle Activgard is a safe, discrete, easy-to-use and highly effective, single-use vaginal device, designed to immediately prevent SUI rather than just deal with the leakage.

The Department of Health and Social Care (DHSC) has commenced a consultation on allowing pharmacists to dispense prescription medicines in original packaging. The consultation, closing on December 13, 2021, proposes changes to the Human Medicines Regulations (HMRs). It would allow pharmacists to dispense more or less than the 10 per cent of the prescribed quantity in original packs, except where this would affect the patient's clinical treatment. The change would not apply to controlled drugs. The second proposed change is to supply sodium valproate in original packaging regardless of the conditions set around Original Pack Dispensing (OPD). Currently, contractors have to supply the exact quantity prescribed, unless certain exceptions apply.

The Pharmaceutical Services Negotiating Committee has announced that the Department of Health and Social Care (DHSC) has granted the following price concessions for November 2021. Contractors can find information on the price concessions and learn about the process involved on PSNC's website. A price concession only applies for the month in which it is granted. No additional prescription endorsement are required as the new price is automatically applied by the NHSBSA to all items submitted for payment in the same month for which a price concession is granted. PSNC is still working with the DHSC to agree further concessionary prices on other drugs reported to be unavailable at the stated November 2021 Drug Tariff price.

Any prescription for Promethazine hydrochloride 10mg tablets x 56 submitted for payment to the NHSBSA for July 2022 will be reimbursed at the new price of £17.77 not as per the price concession of £13.45 announced in the 4th concessions update published on 29 July 2022, said the Pharmaceutical Services Negotiating Committee (PSNC). In July 2022, PSNC received several reports from contractors unable to obtain Promethazine hydrochloride 10mg tablets (56) at the published Drug Tariff price of £4.24. Therefore, it submitted a request for a price concession, which was granted and subsequently published but this was later withdrawn after confirmation from the Department of Health and Social Care (DHSC) that due to the price change mechanism, the reimbursement price for Promethazine hydrochloride 10mg tablets has increased from £4.24 to £17.77 for July 2022. PSNC said, "Following the price change mechanism rules, for generic drugs (excluding drugs in Category M), a price change up to and including the 8th of the month takes effect for prescriptions dispensed in that same month. Any price change after the 8th takes place in the following month."

Pharmacists can dispense Paracetamol 120mg suppositories in accordance with the prescription, as the Department of Health and Social Care (DHSC) has confirmed that sufficient stocks are available to meet normal demand. This means the Serious Shortage Protocol - SSP033 - for Paracetamol 120mg suppositories has now expired since 26 August 2022. Top tips for SSP claims NHSBSA advise that contractors must follow the specific endorsement guidance issued with each SSP and endorsements should be clear and unambiguous - NHSBSA processing staff must be able to determine what has been supplied. NHSBSA have published information on common SSP endorsing errors they see when processing claims. Any paper prescriptions with SSP claims need to be placed in the red separator provided by the NHSBSA. Although an SSP cannot be used outside its period of validity, claims can be submitted up to three calendar months after expiry or withdrawal of the SSP to help manage any owings for other items issued on the same prescription form. For example, for SSP033 Paracetamol 120mg suppositories, which expires at 23.59pm on Friday 26 August 2022, the NHSBSA would continue to look for the "SSP" endorsement on prescriptions for Paracetamol 120mg suppositories that are submitted with the August batch (submitted by 5 September), September batch (submitted by 5 October) and October batch (submitted by 5 November).

The Pharmaceutical Services Negotiating Committee has announced that the Department of Health and Social Care (DHSC) has granted further price concessions for the month of December 2021. A price concession only applies for the month in which it is granted. No additional prescription endorsement are required as the new price is automatically applied by the NHS BSA to all items submitted for payment in the same month for which a price concession is granted. Contractors can find information and learn about the process involved on PSNC's website.