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Community pharmacy is at the heart of one of the most ambitious clinical trials ever undertaken by the UK's primary care network, says senior academic pharmacist Professor Mahendra Patel. The PANORAMIC trial has been designed to rapidly evaluate several antiviral treatments over time that could help people at high risk of Covid-19 recover sooner, prevent the need for hospital admission and so ease the burden on the NHS. The Platform Adaptive trial of NOvel antiviRals for eArly treatMent of Covid-19 In the Community (PANORAMIC) is a national priority trial led by Oxford University's Primary Care Clinical Trials Unit. Lead investigators say the study will enable early and rapid testing of novel antiviral agents and help repurpose existing drugs against Covid-19. As soon as the trial is set up for delivery, it will be open to eligible participants from across the UK. Prof Patel, a key member of the trial's core team, said: "I'm really excited with this news and also by the prospect that there is a huge potential for pharmacy teams to help play a vital role in supporting this highly ambitious trial, as they have with the PRINCIPLE trial, now the world's largest community based clinical trial for Covid19."

Pfizer's oral Covid-19 therapy will be evaluated as a potential treatment for patients hospitalised with the illness in a major British trial, scientists said on Monday, as cases rise in some parts of the world. The world's largest randomised study of potential medicines for Covid-19, dubbed the RECOVERY trial, will assess Paxlovid across hospitals in Britain, which has already approved the drug for early-stage treatment. "Paxlovid is a promising oral antiviral drug but we don't know if it can improve survival of patients with severe Covid-19," said Peter Horby, a professor at the University of Oxford and joint chief investigator of the RECOVERY trial. The scientists said they aim to mainly find whether Pfizer's Paxlovid reduces the risk of death among patients admitted to hospitals with Covid-19.

Pharmacy teams are being encouraged to support the ground-breaking Platform Adaptive trial of Novel antivirals for early treatment of Covid-19 In the Community (PANORAMIC) study by raising awareness among patients. The study aims to find out whether new antiviral treatments can help Covid-19 patients avoid hospital admission and support a quicker recovery. The PANORAMIC trial will allow researchers to gather data on the potential benefits of treatments to patients and will help the NHS to develop plans for rolling out the products to further patients in 2022. Anyone over the age of 50 or between 18 to 49 with certain underlying health conditions can participate in the trial after receiving a positive PCR or lateral flow test result for Covid-19. People who wish to participate in the trial can sign up themselves through the study's website and may be contacted by a member of the clinical team in a general practice that has been set up to deliver the PANORAMIC trial.

NHS moves a step ahead towards its efforts to address covid-19 backlogs by opening a new 'planned care' hospital in Berkshire dedicated to non-emergency treatment. Heatherwood Hospital in Ascot, part of Frimley Health NHS Foundation Trust, will focus on cutting waits for routine care with staff prioritising patients who have been waiting longest, including for orthopaedic and ophthalmology services. The hospital houses six operating theatres, 48 inpatient beds and 22 day-case cubicles and provides surgical, diagnostic and outpatient care, and will treat patients across Berkshire, Hampshire and Surrey. There will also be a range of outpatient services under the same roof including gynaecology, urology and cardiology services. These will be supported by services offering patients endoscopy, physiotherapy, phlebotomy and radiology checks and treatments.

The Community Pharmacist Consultation Service (CPCS) has been running as a national advanced service since October 2019 to relieve pressure on the National Health Service which aims to help with on the day demand in relation to minor illness and medicines. The NHS Community Pharmacist Consultation Service CPCS (NHS CPCS) aims to meet the objectives of the NHS Long Term Plan to use community pharmacists' skills to advise patients, and to build relationships with GP surgeries, primary care teams and wider NHS providers and to assist with urgent care system repeat prescription requests. Referrals from the GP referral pathway and urgent care systems and urgent treatment centres are digitally routed to community pharmacies so that patients can receive same-day appointments and have their queries resolved. The numbers Based on the estimated annual number of minor ailment GP appointments, the service was expected to save the NHS up to £640 million per year . Three years later, the nation has weathered the Covid 19 pandemic, which had widespread effects and put further strain on already overstretched NHS staff. The pandemic impact has resulted in higher numbers of GP appointments than initially anticipated. Nevertheless, this may offer an opportunity to proactively engage pharmacy teams in patient contact help ease strain across the wider NHS.

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.

More than 5,000 vulnerable people have enrolled for the ground-breaking Platform Adaptive trial of NOvel antiviRals for eArly treatMent of Covid-19 In the Community (PANORAMIC) study on life-saving antivirals. With this the UK is now one step closer to rolling out the innovative medicines, which would help reduce the severity of symptoms and the risk of hospitalisation or death. Success of the study would eventually help to ease pressures on the NHS. Anyone over the age of 50 or between 18 to 49 with certain underlying health conditions can participate in the trial after receiving a positive PCR or lateral flow test result.

Sobha Sharma Kandel wants community pharmacy teams up and down the country to be super responsive to emerging needs of their patients - by always being pro-active rather than reactive. "We know that every patient benefits from our proactive approaches - listening, asking questions, providing information and making clinical interventions when appropriate. "At a time when general practice is overstretched, community pharmacy must be relied upon as the frontline of the NHS when it comes to providing diagnosis, treatment and continuous care in our communities to promote health and wellbeing of our patients." Sobha believes Covid-19 has helped shift public perception of community pharmacies from being a place where one goes to collect a prescription to a hub where one can access a range of healthcare advice and services. "We are way more than just a shop where you can collect your medicines," she said, giving examples of how her interventions have helped reduce medication errors, prevent harm and subsequently reduce cost of care. She once saved a baby from getting overdosed with omeprazole when they had issues with gastroesophageal reflux. On another occasion, she managed a lady's high blood pressure by finding equivalent medications to a combination dose prescribed by her doctor in another country.

To support NHS, clear the backlog created by the Covid-19 pandemic and help community pharmacies support more people, the Welsh government has announced an allocation of further £12.5 million funding. Of the total amount, £10mn will be distributed across the 22 local authorities to buy equipment to help people to live independently in their own homes post hospital stay. The remainder, £2.5mn, will be used to support community pharmacists and patients to improve access to treatment and advice for a range of common ailments. The move is aimed at alleviating waiting times and reducing winter pressures on the NHS. Commenting on the announcement, Elen Jones, Royal Pharmaceutical Society director for Wales said: "We are delighted that the Welsh government continue to recognise the value of pharmacists in patient care and we welcome this additional investment and support for Community Pharmacy teams across Wales.

Community pharmacists are readily accessible healthcare providers and medicine experts in the community setting and their counsel is often sought by patients and consumers on a number of subjects including the use of dietary supplements. Their role in the sale of and advice regarding natural health and drug alternatives has never been more relevant. The recent National Health Service (NHS) Interim People Plan calls for the NHS to put all staff front and centre of the way it operates and identifies pharmacists as a critical part of multidisciplinary teams, providing care across a wide range of increasingly complex patient needs. Despite existing demand to counsel patients on a vast range of medicines, more and more consumers are looking to their pharmacist to support and enhance their knowledge regarding the relevance of a growing range of supplementary nutrients now available. Nutritional supplementation is increasingly becoming the consumer's first choice for 'drug free' treatment or natural prevention that provides a true sense of taking control, which the prescription process often denies them. The vast and growing depository of information on the internet is certainly fuelling this, but as much of this is brand derived content, information, it can often be generic with a 'one size fits all' marketing message.

Three leading pharmacists - professor Mahendra Patel, Asif Aziz and Ade Williams - have been recognised in Queen Elizabeth's annual New Year's honours list. Professor Patel, an academic pharmacist from West Yorkshire, was awarded an OBE for his "services to pharmacy." He told Pharmacy Business: "I am truly honoured and deeply humbled by this highly prestigious award that I have always believed was more deserving for others. "That's not to say I'm not proud of it - far from it, although for me it's not necessarily about rewards and recognition but more the intricacies of the journey I embark on and the learning and joy that those encounters bring with it. Most recently, Professor Patel - who has had a broad ranging portfolio career spanning community pharmacy, health education and health promotion, academia, and research - has been involved in promoting clinical trials across community pharmacies in the UK. His latest work has seen him act as one of the national leads for the PRINCIPLE and PANORAMIC trials, run by Oxford University - both trials seek to pioneer repurposed and new drug treatments in the community to prevent hospitalisation due to Covid-19.

Prostate cancer is the most common cancer among men in the United Kingdom, affecting nearly 50,000 men yearly. Combined with the challenges faced across healthcare during COVID-19, new figures show that prostate cancer accounts for a third of cancers not treated due to the pandemic, with 14,000 'missing patients' believed to have not undergone treatment since April 2020. It is more urgent than ever that men are encouraged to get checked, as any set-backs in diagnosis can reduce the pathways available, in turn affecting health outcomes. Community pharmacy teams play a crucial role in signposting the help available for men who may be concerned about their health. Therefore, it is vital that pharmacy teams have access to the information they need to correctly direct men to seek prostate cancer guidance. By maximising the trusted relationship between patients and their pharmacists, more can be done to identify the warning signs, helping men to get an earlier diagnosis.

Usually as we head into winter, we can all predict what our patients will be asking us about. But, just like the rest of the year has been like no other in community pharmacy, I'd expect this winter to be different too. This will present us with challenges, but also some great opportunities too. One shift we have seen over the last seven months of Covid is that more and more people in the community are turning to their pharmacy for help, support and advice. With our doors remaining open throughout the height of the pandemic, we've established ourselves firmly at the heart of local healthcare - a trend I'd expect to see continue over the winter, especially now that a second wave, it seems, is upon us. I think there's three different types of patients who we'll be seeing this winter coming to us for help and advice. First, we'll see those with a simple winter illness - for example, a common cold. For these patients our advice will be focused around self-care and home treatments. There is a wide range of products that we can recommend in the pharmacy from decongestants to combination products such as Night Nurse and nasal sprays.