While responding to the consultation on hub and spoke dispensing, trade unions for pharmacists have emphasised that the patient safety and care must be the priority in hub and spoke dispensing.
The Royal Pharmaceutical Society (RPS) has welcomed the opportunity provided by a change in legislation to enable community pharmacies to make use of hub and spoke
dispensing but reaffirmed that patient care must be at the heart of future changes.
With regards to patient safety, the Pharmaceutical Services Negotiating Committee (PSNC) considers that only Model 1 is appropriate, with manageable risks related
to patient safety, and is a model that has the potential to allow the whole sector to benefit fairly.
In its response to the consultation on Hub and Spoke dispensing, PSNC highlighted that Model 2 in the consultation, a hub direct to patient supply of dispensed medicines, raises patient safety issues and it cannot be supported.
RPS President Professor Claire Anderson said: "In all models, patients need to continue to have access to a pharmacist at the time of supply of medicines so they
have the opportunity to discuss, ask questions or raise concerns, and receive appropriate information with counselling and advice.
Two weeks prior to the closing of the hub and spoke consultation, issues around patient safety, costs and competition as well as practicalities such as what
to do with uncollected medicines were discussed in a webinar on hub and spoke dispensing on Wednesday (May 26).
The webinar was organised by Sigma Pharmaceuticals in association with the National Pharmacy Association (NPA).
NPA director of corporate affairs Gareth Jones chaired the event and was joined by Sigma's Hatul Shah and Raj Haria as well as NPA vice chair Nick Kaye and NPA
head of advice and support services Jasmine Shah.
Kaye said: "There are still many 'unknown unknowns' with hub and spoke and the jury's still out on any potential benefits. I have lots of reservations about cost
and it worries me how efficient this is for the business and the long term sustainability for the sector as a whole. Above all we need to think about the patient
at the centre of all this and the potential confusion for them."
Jasmine Shah felt patient safety was going to be the key in regards to whether the spoke and the hub would hold the ultimate responsibility and "who is going to
take the accountability as far as patient care goes".
She added: "It is most important that GPhC standards and NHS requirement are both met in identifying all the risks associated with the arrangement with hub and
spoke and ensuring that (patient safety) measures are in place. Everything that needs to be looked at is by putting the patient at heart of the arrangement and
seeing what is the safest way for them to receive care from both spoke and hub."
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.
There has been extensive national media coverage today (August 11) on how medicine shortages have forced patients to visit multiple pharmacies to get their
prescriptions filled or return to their GP to be prescribed alternative drugs.
These media reports have been based on a survey involving more than 1,500 pharmacists in the UK, in which over a half of those polled said that their patients'
health had been put at risk in the last six months.
In response to a query from Pharmacy Business, the Department of Health and Social Care (DHSC) said it monitors the medicines supply chain closely to prevent any
shortages and acts swiftly when any issue arises.
A DHSC spokesperson told Pharmacy Business: "We take patient safety extremely seriously and we routinely share information about medicine supply issues directly
with the NHS so they can put plans in place to reduce the risk of any shortage impacting patients, including offering alternative medication.
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.
Travelling with medical cannabis can be a complex and often confusing experience, given the diverse legal regulations across different countries and states.
Patients who rely on medical cannabis for their wellbeing need to be well-informed and prepared to ensure a smooth and hassle-free travel experience. This
comprehensive guide covers essential aspects, legal considerations, and practical tips for individuals who use medical cannabis and wish to travel.
Know the Laws
The first and most crucial step before travelling with medical cannabis is to understand the laws and regulations of both the departure and destination locations.
Laws regarding medical cannabis use vary significantly from one country, state, or even city to another. Some places have legalised medical cannabis, while others
strictly prohibit its use. Researching and familiarising oneself with the specific regulations of the destination, transit countries, and the home country is
essential.
Travelling Within the Same Country
When travelling within a country where medical cannabis is legal, patients generally need to carry their prescription information issued by a licensed healthcare
provider. It's advisable to keep medical cannabis in its original packaging, clearly labelled with the patient's name, prescribing physician, and dosage instructions.
Carrying a copy of the relevant laws and regulations can also be helpful in case of any inquiries from authorities. What can be easier than carrying around paperwork,
which could get easily damaged or lost during your travels, is to get a medical card that has a unique QR code on it from Releaf Cannabis, which, when scanned, can
present their prescription information digitally - it has revolutionised the way patients manage their healthcare. This eliminates the need for physical documents
and streamlines the process but also ensures the security and confidentiality of sensitive medical information, offering patients a more efficient and organi
"Our main concerns are that the use of what they call an asynchronous supply, where the prescriber neither sees nor talks to the patient at the time they
issue the prescription, does lay itself open to perhaps people getting hold of medication that they shouldn't," the Head of Policy, PDA said.
The Pharmacists' Defence Association (PDA) engages in a critical conversation on BBC Radio 4's Woman's Hour, shedding light on the online prescribing of weight
loss drugs and advocating for safer practices.
The PDA's spokesperson, Head of Policy Alima Batchelor, emphasised the importance of adhering to professional guidelines to ensure patient safety and mitigate
regulatory concerns.
During the feature, the PDA highlighted the complexities and risks associated with online supply chains, stressing the necessity for direct clinical consultations
and pharmacist involvement in medication management.
""There are guidelines and advice about verification within the DiCE guidance, but it doesn't go quite far enough for us. We are concerned when patients decline
to allow the online prescriber to advise their GP of what they're taking," Batchelor highlighted.
Long waits for an ambulance or surgery led to the death of 112 people, and nearly 8,000 more people suffered harm while waiting for help in England last year.
The data from NHS England, obtained by The Guardian, show that patient deaths arising directly from care delays have risen more than fivefold over the last
three years.
In 2019, there were 21 patient deaths due to NHS care delays, and 96 people suffered "severe harm" as compared to 152 last year.
Adult mental health care was mostly affected with 471 patients experiencing harm due to delays, followed by childbirth care (253), eye problems (221), and
trauma and general surgery (207).
There has been increase of 97 percent in the overall number of people suffering some degree of harm, from 3,979 in 2019 to 7,856 in 2022.
The Medicines & Healthcare products Regulatory Agency has initiated a recall of three batches of Quantum Pharmaceutical's Diltiazem HCl 2% Cream, which is an
unlicensed medicine. MHRA issued a precautionary recall of the cream due to a change in the product's appearance that affected its thickness.
Pharmacists are instructed to halt supply, quarantine remaining stock, and contact Quantum Pharmaceutical to return affected batches M1402497, M1402574, and M1402680.
Patients using this product may encounter application issues with the cream due to its consistency. However, MHRA said that this has not impacted the product's
effectiveness or posed any risk to patient safety.
The MHRA also reported that medac GmbH (t/a medac Pharma LLP) is conducting a recall of two batches of Sodiofolin 50 mg/ml solution for injection/infusion
(400mg/8ml vial) with batch numbers G220393B and G220393C. This class 2 medicines recall is a result of particles detected during long-term stability tests.
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.
Pharmaceutical recalls are complicated and expensive, just like in any other business. Pharmaceutical recalls, however, pose a further risk because they might
change both short- and long-term health effects. To ensure smooth recalls with few negative effects on public health, it is crucial to understand the pharmaceutical
product recall procedure and the roles of each key player. Throughout the recall procedure, patient safety is crucially ensured by the FDA, pharmaceutical companies,
pharmacy technicians, and other healthcare professionals.
Learning about pharma recalls, procedures, and responsibilities is essential for guaranteeing patient safety for key actors like the Food and Drug Administration
(FDA), manufacturers, and other medical specialists.
RECALL CLASSIFICATIONS
Recalls can fall into one of three categories-class I, II, or III-with class I being the most serious and lethal. Products that have the potential to result in
serious, permanent complications or death are subject to Class I recalls.
Class II recalls are recommended for product flaws that have a low likelihood of harmful events or that can result in reversible side effects.
Last but not least, class III recalls typically arise from problems with packaging that do not pose a risk. Since they are frequently issued out of an abundance of
prudence rather than due to any negative impacts, many people may even describe this kind of recall as benign.
Following the publication of a new study by the British Medical Journal (BMJ) that estimates the economic impact and prevelance of hazardous NSAID
prescribing in England, the Royal Pharmaceutical Society (RPS) has underscored the pressing need for enhanced safety measures in medication management.
The study, led by RPS Fellow Rachel Elliott, reveals significant health and financial costs associated with the high-risk prescribing of oral non-steroidal
anti-inflammatory drugs (NSAIDs) among vulnerable populations.
James Davies, Director for England at the RPS, emphasised the critical findings of the research.
"Improving the safety of NSAID prescribing requires a multi-pronged approach, that educates and supports prescribers on the risk, as well as uses the skills
of pharmacists in the primary care team to help identify higher risk patients and prescribing scenarios," Davies remarked.
The study highlights that NSAIDs, while effective in managing pain and inflammation, are associated with serious adverse events, including gastrointestinal
bleeding, renal dysfunction, and cardiovascular issues.
Errors of any kind in medical settings can have dire consequences for patients and healthcare systems. Unfortunately, negligence, misdiagnosis, and
medication errors aren't uncommon in the UK.
In this article, we discuss the nature of medication errors in the NHS, outline potential causes, and delve into how and why technology could be turning the tide
on the issue.
Prevalence and consequences of medication errors
Medication errors are incidents involved with the administering, prescribing, dispensing or monitoring of medicine to patients. It can happen at many different
steps in the healthcare process and by any medical professional in the system. Many cases are avoidable.
According to analysis from BMJ, there are an estimated 237 million medication errors made in England every year. The majority of these are minor errors, but 1 in 4
cases has the potential to cause moderate to serious harm to patients.
Not only do these errors cost the NHS significantly, at almost £100 million every year, but there is a shocking cost to public health. Lives are being lost because
of medication errors which is unforgivable and tragic for the families involved.
Drains on NHS resources have widespread impacts on public health and the operations of healthcare organisations up and down the country. Individual errors and
mistakes may seem inconsequential (in minor cases), but they all add up in the big picture to a significant concern for policymakers.
The General Pharmaceutical Council's Investigating Committee took decisive action on March 25, 2024, by issuing a warning to Dilsha Kiran Shah,
registration number: 2049787, for her conduct as Superintendent Pharmacist of Jhoots Healthcare Ltd.
Miss Shah's failure to uphold the Medicines Act 1968, specifically in ensuring the proper management of medicinal products, triggered this warning.
The Act mandates supervision in "keeping, preparing, and dispensing medicinal products other than those on a general sale list."
Moreover, pharmacies are inspected on five principles - Governance, Staff, Premises, Services including medicines management, and Equipment and facilities to
meet the right standards.
The alarm was initially raised in August 2021 when a Jhoots Healthcare Ltd pharmacy branch under Miss Shah's supervision operated without a responsible pharmacist.
Despite explicit instructions, pharmacy staff were allegedly instructed to proceed without proper supervision, raising grave concerns regarding patient safety.
A judicial review claim launched by the British Medical Association (BMA) against the General Medical Council (GMC) has parallelly intensified Pharmacists'
Defence Association's (PDA) scrutiny over the use of the term 'pharmacy professionals'.
PDA has criticised the evolving definition of 'pharmacy professionals,' and the potential risks to patient safety amidst regulatory ambiguity as part of "a far
wider agenda."
Concerns stem from what the PDA perceives as a blurring of distinctions between pharmacists and pharmacy technicians as "attempted homogenisation" by bodies like
the General Pharmaceutical Council (GPhC), NHS, and Royal Pharmaceutical Society (RPS).
Raising similar issue as the BMA against the GMC over its use of 'medical professionals for doctors and Medical Associate Professions (MAPs), Mark Koizol,
Chairman of the PDA has said:
The Pharmacists' Defence Association (PDA) says the pharmacy regulator should maintain a two-year post qualification eligibility criteria, in addition to
the qualitative measures being introduced which would be in the best interest of patient safety, before a pharmacist is allowed to commence an IP course.
The association was responding to an announcement by the GPhC's move to scrap the two year requirement for Independent Prescribing (IP) course.
"The PDA accepts that the qualitative approach could mean greater individual consideration of potential IP course candidates and the two-year measure could have
sometimes been a blunt tool. However, the PDA is already seeing cases of patient harm and allegations around fitness to practice arising from IP," the association
said.
The association also said that it supports individual pharmacists with near misses, as well as actual incidents, giving the organisation possibly the most
comprehensive understanding of risk.
Frontline pharmacists also recognise these issues and in a survey of over 1,000 pharmacists undertaken by the PDA in late 2021, of those who had 2+ years'
experience of practice and who were already independent prescribers, 90 per cent said the qualifying period should be two years or more.
Pediatric Wheelchair is designed especially for children and offers the maximum in safety and comfort that is sure to put smiles on the faces of parents and children alike.The precision crafted reclining mechanism provides ultra smooth reclining performance and comes standard with swing away detachable elevating legrests.
Pediatric wheelchairs are provided unsurpassed quality and style, specializing in compact-folding, lightweight wheelchairs for children of all ages - from toddlers to teens! Custom built to your child's specific needs, our mobility aids offer rehabilitative benefits for physical disabilities from Cerebral Palsy to Autism.
Cerebral palsy (CP) is a group of conditions caused by medical abnormalities in the development of a fetus or the early life of a child. These lead to damage or delayed development in the brain. The disorder is permanent and, though it does not worsen with age, the level of functionality of a person with cerebral palsy varies widely: in some cases, effects may be very minor, while in others, movement is impaired to the extent that a wheelchair is required. Common complications associated with CP vary by the type of CP disorder but can include vision problems, seizures, learning disabilities, and issues speaking, writing, and performing other tasks. Cerebral palsy causes problems with muscle tone, movement, balance and/or coordination. Symptoms and effects range from mild to severe. In some infants, problems are evident soon after birth. In others, diagnosis comes in later infancy or toddlerhood.
Cerebral Palsy Wheelchair Description:
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Cerebral Palsy Wheelchair Recline system:
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Children with cerebral palsy require special assistance of mobility devices in order to make it easier to move around and carry out daily tasks. Wheelchairs are often a popular choice for children with mobility issues as they come in different sizes and different accommodations, which makes it easier to find one that fits individual lifestyles and needs.
Cerebral Palsy Wheelchair
Cerebral palsy-also known as CP-is a condition caused by injury to the parts of the brain that control our ability to use our muscles and bodies. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. Often the injury happens before birth, sometimes during delivery, or soon after being born. Physical symptoms typically appear in the first few years of life. Cerebral Palsy are frequently slow to reach developmental milestones such as learning to roll over, sit, crawl, smile, or walk. Cerebral Palsy occurs in 1 in every 300 children (Source: Center for Disease Control).
CP can be mild, moderate, or severe. Mild CP may mean a child is clumsy. Moderate CP may mean the child walks with a limp. He or she may need a special leg brace or a cane. More severe CP can affect all parts of a child's physical abilities.Child with moderate or severe CP may have to use a wheelchair and other special equipment.
Children with CP can also have learning problems, speech, problems with hearing or seeing (called sensory problems), intellectual differences, and behavioral or emotional challenges. Cerebral palsy does not always cause serious disabilities. Usually, the greater the injury to the brain, the more severe the CP. However, CP doesn't get worse over time, and most children with CP have a normal life span.
Wheelchair Pediatric
Pediatric Wheelchairs we offer are designed specifically for a wide range of children. All pediatric wheelchair can be configured with many accessories to meet your specific needs. Comfortable, sporty, and relia
The disability rights movement is the movement to secure equal opportunities and equal rights for people with disabilities. The specific goals and demands of the movement are: accessibility and safety in transportation, architecture, and the physical environment; equal opportunities in independent living, employment, education, and housing; and freedom from abuse, neglect, and violations of patients' rights.Effective civil rights legislation is sought in order to secure these opportunities and rights.
For people with physical disabilities accessibility and safety are primary issues that this movement works to reform. Access to public areas such as city streets and public buildings and restrooms are some of the more visible changes brought about in recent decades. A noticeable change in some parts of the world is the installation of elevators, automatic doors, wide doors and corridors, transit lifts, wheelchair ramps, curb cuts, and the elimination of unnecessary steps where ramps and elevators are not available, allowing people in wheelchairs and with other mobility impairments to use public sidewalks and public transit more easily and more safely.
General practitioners (GPs) across England have made a resolute stand against proposed alterations in the 2024/25 national GP General Medical Services (GMS)
contract put forth by the Department of Health and Social Care (DHSC) and NHS England.
This firm opposition coincides with the declaration of an extended six-month strike by 33,869 junior doctors within the NHS, advocating for full pay reinstatement
and reforms in the pay recommendation process.
The latest survey conducted by the British Medical Association (BMA) has revealed that an overwhelming 99.2% of GPs in England are against any changes to the
existing contract.
The proposed amendments, slated for implementation from April 1st, 2024, encompass a meagre national practice contract baseline funding uplift of just 1.9%,
notably falling short of recent inflation rates.
This corroborates with GP Online poll that recently unveiled widespread GP dissatisfaction with proposed changes to the national GMS contract. 83% of GPs in
favour of strikes cite pay and funding concerns, while burnout, high workloads, and patient safety also fuel discontent.