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.
Recent NHS data sheds light on the evolving landscape of fit note certification, indicating a gradual expansion of roles beyond traditional medical
practitioners to pharmacists and nurses.
This uptake in numbers coincides with the Department of Work and Pensions's (DWP) call for evidence in relation to fit note reform which will remain open
till 8 July 2024.
According to figures published by NHS Digital, during the nine-month period from April 2023 to December 2023, pharmacists certified a significant number of
fit notes.
Approximately 1.4 per cent of fit notes of the 8 million were issued by pharmacists while the rest were issued by the GP surgeries reflecting the impact
following legislative amendments in July 2022, which extended certification authority to pharmacists, nurses, occupational therapists, and physiotherapists.
In June 2022, the Pharmacists' Defence Association (PDA) advised pharmacists not to sign fit notes where the required therapeutic, diagnostic, or examination
skills lie outside their scope of competence.
The association remarked that healthcare professionals needed mandatory training under the Health Education England before they are fit to issue fitness notes
to the public.
Pharmacy owners can make their claims for February Pharmacy First consultations until 5pm on Friday 15 March 2024, the NHS Business Services
Authority (NHSBSA) announced on Monday.
The deadline for Pharmacy First submission was extended following a technical issue in the NHSBSA Manage Your Service (MYS) portal, which led to the claims
appearing incorrectly in the portal.
The NHSBSA has been working with suppliers and NHS England to investigate and address the problem.
While the problem has been resolved, the NHSBSA has advised pharmacy owners to check their submissions carefully before submitting. If any issues persist,
they are advised to contact their Pharmacy First IT system supplier helpdesk to escalate the matter and not to confirm their claims in MYS until the issue
has been resolved.
Pharmacy owners are informed that the extended deadline is for February only and it includes any consultations completed on 31 January 2024.
"Record long NHS waits are forcing huge numbers of people out of work, including doctors and nurses," said Wes Streeting MP, Labour's Shadow Health and
Social Care Secretary as Labour announced a new partnership with Nuffield Health today to tackle joint pain issues among NHS staff and reducing waiting lists.
Musculoskeletal problems, including back, knee, hip, and neck pain, are the second leading cause of NHS staff absences, surpassed only by mental health issues.
In December 2023 alone, NHS workers missed a record 198,000 days due to these issues, marking a 13 per cent increase from the 174,000 days recorded in December 2019.
Nurses and health visitors accounted for 52,000 of these days, up from 47,000 pre-pandemic, while doctors took 3,500 days off, a 9 per cent increase from 2019.
The partnership with Nuffield Health will provide up to 4,000 extra places for NHS staff in Nuffield Health's Joint Pain Programme at no cost.
The Government has been forced to intervene formally 50 times in the past two years to authorise the use of alternative drugs because of serious medicine
shortages hitting patients, new analysis by the National Pharmacy Association (NPA) has found today.
78 per cent of all Serious Shortage Protocols, produced by the Department of Health and Social Care (DHSC) due to medicine shortages, were issued in
2022/24 - more than three times the rate in the previous two years.
The NPA, which represents independent community pharmacies in the UK, is warning that shortages are leading to pharmacists having to increasingly turn
patients needing vital medication away.
Analysis by the NPA of the NHS's Serious Shortage Protocols (SSPs) issued to pharmacies and other providers over the last five years has found that:
The number of SSPs issued in the last two years is 3.5 times higher than in the previous two years.
The Department of Health and Social Care (DHSC) has issued Serious Shortage Protocols (SSPs) on three HRT medicines to limit dispensing supply to three months.
To ensure women across the UK will be able to more reliably access HRT products SSPs has been issued on the supply of Oestrogel, Ovestin cream and Premique Low Dose.
DHSC stated, "Women who have a prescription for more than three months but are only able to access three months' supply will not have to pay an additional
prescription charge."
"This means women will not incur any additional costs. Imposing a three month limit will mean more women are able to access the medication they want. Any woman
who is worried about access to HRT or is unable to access HRT should speak to her GP."
Recently, Vaccine Taskforce Director General Madelaine McTernan has been appointed to spearhead a new HRT Supply Taskforce, applying lessons learned from the
successful procurement seen during the Covid vaccination programme to identify ways to support the HRT supply chain ensuring it can meet both short and long
term demand. The move will save time for patients as well as pharmacists and prescribers who are working tirelessly to tackle the covid backlog.
The Department of Health and Social Care (DHSC) has issued a medicine supply notification for Temazepam 10mg and 20mg tablets.
"Temazepam 10mg and 20mg tablets are in limited supply until w/c 5th December 2022. Alternative benzodiazepines and non-benzodiazepine hypnotics remain available
and will be able to support increased demand," said DHSC.
Temazepam 10mg/5ml oral solution remains available but cannot support an uplift in demand. DHSC suggested: "Where the above options are not suitable, unlicensed
supplies of temazepam 10mg tablets may be sourced, lead times vary."
The department confirmed that Target Healthcare, a specialist importers, have confirmed they can source unlicensed Temazepam 10mg tablets.
"If there is currently no listing on dm+d for the imported product for prescribers to select using their prescribing systems an EPS prescription for unlicensed
Temazepam 10mg tablets cannot be issued."
A report released by the Independent Commission has blamed Brexit supply issues for medicine shortages.
NHS is forced to pay extortionate prices to fulfil the demand for vital antibiotics, anti-depressants, Attention Deficit Hyperactivity Disorder (ADHD), and
Hormone Replacement Therapy (HRT) drugs.
The report highlights the impact of affected medicine supply issues on community pharmacies and patients.
Janet Morrison, the chief executive of Community Pharmacy England, backed the report and said that the "medicine shortages and market instability appear to be
as bad as they have ever been".
She also explained how the Ukraine conflict, the COVID-19 pandemic, and broader economic instability also play a major factor in the situation.
Department of Health and Social Care (DHSC) has updated the final price concessions for June 2023, following a discussion by Community Pharmacy England
regarding medicine pricing issues reported by pharmacy owners (its members).
A price concession only applies for the month it is granted; any prices agreed for concessions requested late in the month will roll over into the following month.
Community Pharmacy England encouraged pharmacies to report any problems obtaining a Part VIII product at or below the stated Drug Tariff price, using the online
feedback form on the Community Pharmacy England website along with full details of the supplier and price paid for any products sourced above the Drug Tariff price.
The association will investigate the extent of the problem and, if appropriate, discuss the issue with DHSC.
Mental health has become a major concern worldwide and across all sectors,including pharmacy and pharmaceutical industry. The penetration of the issue exacerbated during the Covid-19 pandemic, due to mental fatigue, anxiety and most importantly the social distancing.
Therefore, building an environment of trust and comfort is utmost essential to understand and tackle mental health challenges, said panelists in a discussion on Mental Health And Wellbeing In The Workplace, held during the Pharmacy Business Diversity Conference on Thursday (December 9).Talking in context of workplace, Monika Misra, head of Employee Health and Wellbeing, Europe and MEA, said: "We really need to create an environment of trust where we a have the manager, really trying to understand the unique challenges and needs of the individual, but be also ensuring that the individual feels comfortable to open up and have that conversation with their manager."
Department of Health and Social Care (DHSC) has issued a medicine supply notification for three tablets- Meptazinol (Meptid) 200mg film-coated tablets,
Medroxyprogesterone (Provera) 2.5mg tablets and Lamotrigine 5mg dispersible tablets on Wednesday (15 February).
Meptid tablets will remain out of stock until late June 2023. DHSC suggested that an alternative analgesic products including non-opioids remain available.
Provera 2.5mg tablets are out of stock until mid-March 2023. "Medroxyprogesterone (Provera) 5mg and 10mg tablets remain available but cannot support an uplift in
demand," said DHSC.
"Norethisterone 5mg tablets remain available and will be able to support an increase in demand."
Branded lamotrigine (Lamictal) 2mg and 5mg dispersible remain available but are unable to support the increase in demand as Lamotrigine 5mg dispersible tablets
are out of stock until late March 2023.
An executive director of Day Lewis and also board director and member of Association of Independent Multiple pharmacies (AIMp) Jay Patel highlighted the key
issues and on ground challenges faced by the community pharmacies in a meeting hosted by Prime Minister Rishi Sunak and health secretary Steve Barclay in Downing
Street on Saturday (January 7) to tackle the NHS pressure.
In his interview with BBC, he said: "He (prime minister) was very engaging and trying to understand the key issues and practical challenges on the ground."
Patel described the meeting atmosphere as 'collaborative and proactive', and said, "people were genuinely asked their options and there were listeners too."
On BBC, answering to a question on 'how community pharmacies can alleviate the NHS pressure?', Patel said: "Pharmacies is the workplace for this. We have trust of
our patients; we have high skilled workforce both clinically and professionally. One of the opportunities we have is working around the acute treat
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.
A report released by Community Pharmacy England (CPE) has warned that pharmacies across England are grappling with daily medicine supply challenges, posing
significant risks to patients' health.
The Pharmacy Pressures Survey 2024: Medicines Supply Report, which is based on the views of the owners of over 6,100 pharmacy premises in England and 2,000 pharmacy
team members, has exposed some alarming trends concerning medicine supply problems in the country.
Almost all pharmacy team members surveyed (97 per cent) reported patients being inconvenienced due to medicine supply issues, and 79 per cent of the participants
said that the worsening situation is putting patient health at risk.
Nearly all respondents reported patient frustration stemming from medicine supply issues, with 84 per cent of them saying they had experienced aggression from
patients.
Additionally, 98 per cent indicated an increase in 'owings,' where patients receive only part of their prescription and must return to the pharmacy for the
remaining medication(s) at a later time."
Community Pharmacy England (CPE) has cautioned that patients in the UK will continue to encounter difficulties in accessing medicines unless the government
addresses supply problems and resolves the critical financial state of community pharmacies.
CPE Chief Executive Janet Morrison and Mike Dent, Director of Pharmacy Funding, on Monday 19 February, gave evidence to the Health and Social Care Select
Committee's Pharmacy Inquiry, highlighting the impact of ongoing medicines supply issues on pharmacies and patients.
Morrison indicated that a combination of the ongoing "financial squeeze, operational pressures, and medicines supply and pricing issues" has left pharmacy
businesses fighting for survival.
"As the NHS continues to grapple with wider challenges, this is a battle that patients cannot afford for pharmacies to lose," she said.
Morrison warned that if pharmacies continue to close, not only business owners and pharmacy teams will suffer, but patients and local communities will also
face the consequences.
As Prime Minister Rishi Sunak announces the forthcoming UK general election, pharmacy bodies are calling on all political parties to commit to solving the
issues facing the sector.
The next UK general election will be held on 4 July, Sunak announced it on Wednesday afternoon during a press conference outside 10 Downing Street.
"As the election is called it's imperative that any incoming government addresses the crisis in primary care and the looming cliff edge facing pharmacies, which
for millions of people are the front door to the NHS and a crucial source of frontline health care," said Paul Rees, Chief Executive of the National Pharmacy
Association (NPA).
Noting that the first responsibility of the government is to keep its people safe and healthy, he emphasised the importance of addressing the "deep funding gap
that is pushing record numbers of pharmacies to the edge of closure and beyond, exacerbating the issues of waiting lists for GPs and hospital care."
"Not possible for pharmacists to check whether prescriptions issued from overseas registered prescribers have been issued in a similarly safe and effective
way," the new Minister of State (Department of Health and Social Care) Karin Smyth said during a recent parliamentary written response.
At a recent session on Monday, July 29th, at the House of Commons, MP Cat Smith raised an important question directed at the Secretary of State for Health and
Social Care.
Smith, who represents Lancaster and Wyre, and has been an MP continually since 7 May 2015, inquired about whether the Department of Health and Social Care had
conducted a comparative assessment of the UK's stance on prescribing puberty blockers for treating gender incongruence in comparison to other European countries.
Responding to the questions, MP Karin Smyth emphasised on the significance of the Cass Review and described it as one of the most thorough examinations
conducted across the globe on gender identity services for children and young people.
Kent Pharma UK has announced a precautionary recall of multiple batches of Itraconazole 10mg/ml oral solution following the identification of
out-of-specification appearance in the solution, particularly the presence of suspended particles or clusters of crystals.
Itraconazole is an antifungal medication prescribed for treating fungal or yeast infections in different parts of the body. Its oral solution form is
specifically intended for treating oropharyngeal or esophageal candidiasis, commonly known as thrush or oral thrush.
The Medicines and Healthcare products Regulatory Agency (MHRA) has advised the recall following initial investigations, which indicated a solubilisation
issue of the active ingredient, itraconazole.
This problem may result in some doses containing lower amounts of the active ingredient.
The root cause of the issue is currently under investigation. However, due to the potential for underdosage, the affected batches are being recalled as a
precautionary measure.
Britain called on Sunday (November 21) for international action on the issue of medical devices such as oximeters that work better on people with lighter skin, saying the disparities may have cost lives of ethnic minority patients during the Covid-19 pandemic.
Health secretary Sajid Javid said he had commissioned a review of the issue after learning that oximeters, which measure blood oxygen levels and are key to assessing Covid patients, give less accurate readings for patients with darker skin.
"This is systemic across the world. This is about a racial bias in some medical instruments. It's unintentional but it exists and oximeters are a really good example of that," Javid said during an interview with the BBC.
Asked whether people may have died of Covid-19 as a result of the flaw, Javid said: "I think possibly yes. I don't have the full facts."
He said the reason for the discrepancies was that a lot of medical devices, drugs, procedures and textbooks were put together in white majority countries.
The Department of Health and Social Care has issued a Serious Shortage Protocol (SSP) in response to a significant ongoing disruption to the supply of Paracetamol 120mg and 240mg suppositories.
Effective from Tuesday (Jan 25), SSP015 provides that for every Paracetamol 120mg or 240mg suppository originally prescribed, one Paracetamol 125mg or 250mg
suppository must be supplied.
SSP015, authorised by the Secretary of State, has been developed by clinicians and provides pharmacists with procedures to follow in providing either of these suitable alternative products to help reduce the number of patients having to return to their prescriber for a replacement prescription.
The SSP may be amended or revoked at any time but currently expires on 18 February 2022 - PSNC will update contractors on any changes.
