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.
Maxwellia has revealed its plans to switch some of its medicines in the self-care category from prescription-only-medicine (POM) to a pharmacy (P) medicine.
After authorising the switch of Maxwellia's two brands of desogestrel contraceptive pills, Lovima and Hana, MHRA has opened a public consultation on reclassification of Aquiette (overactive bladder treatment) 2.5mg tablets manufactured by the company to be made available from pharmacies.
"Maxwellia is currently looking at a number of medicines which treat a range of conditions in major public health categories that can be 'switched' from needing a prescription to being conveniently bought at a local high street or supermarket pharmacy. With its foot firmly on the accelerator it has other applications under assessment with the MHRA, including women's health products," the company stated in a recent statement.
"Push to convert more prescription medicines to pharmacy medicines will firmly position pharmacists at heart of nation's public health, helping futureproof NHS," the medicine said.
Online pharmacies have to operate from bricks & mortar premises that are registered with the General Pharmaceutical Council, but recent cases show that, in
reality, the practices of online pharmacies are often very different to other pharmacies, and the regulation of online pharmacies is also different - and evolving
as issues arise.
For a start, the General Pharmaceutical Council (GPhC) is only one of the regulators taking an interest in online pharmacy services. Other regulators include the
Medicines and Healthcare products Regulatory Agency (MHRA) which enforces the advertising and promotion of medicines, and the Care Quality Commission (CQC) which
regulates prescribing services.
The different regulation of online pharmacies is attributable to the higher risk to patients and the public from medicines bought online. These risks often arise
from a combination of patients who do not tell the truth in order to obtain medicines and the nature of a transaction in which a pharmacist does not see patients
face-to-face.
"The GPhC has strong enforcement powers that it uses when it considers its premises standards have not complied with."
However, there are also things that go wrong because pharmacists have simply failed to act professionally or take sufficient care, as well as cases where things
have gone wrong through misfortune.
Boots has become the first community pharmacy in the UK to transport prescription medicines by a drone.
The pharmacy multiple completed a test flight transporting prescription-only medicines by drone from Portsmouth to the Isle of Wight earlier this month.
The flight departed from the British Army's Baker Barracks on Thorney Island near Portsmouth and arrived at St. Mary's Hospital on the Isle of Wight. The medicines
were collected by Boots personnel and transported to the multiple's pharmacies across the island, where they will be dispensed to patients with prescriptions for them.
Boots worked with medical drone start-up Apian to facilitate the test flight and is now assessing the future potential for drones in medicines delivery.
Rich Corbridge, chief information officer at Boots, said: "Drones have a huge potential in the delivery of medicines and it is incredibly exciting to be the first
community pharmacy in the UK to transport them in this way. An island location like the Isle of Wight seemed like a sensible place to start a trial of drones and
their value to the delivery of medicines to more remote locations is very clear.
A survey of over six thousands pharmacies has revealed that the community pharmacy sector is buckling under growing cost and capacity pressures.
The survey conducted by the Pharmaceutical Services Negotiating Committee, which also involved two thousand community pharmacy confirms, rising costs, patient
demand and
medicine supply issues continue to grip the sector.
PSNC's 2023 Pharmacy Pressures Survey, run as a follow up to the 2022 pressures survey, provides clear comparative data showing the worsening situation across
the sector.
Govt must act now
The result of the survey indeed paints a bleak picture for community pharmacies and it is clear that without urgent action from government and the NHS this will
only get worse: more community pharmacies will either be forced to reduce the number of services they provide or, in the worst-case scenario, will be left with
no option but to close their doors for good.
The PSNC has urged the government to act now "to save our pharmacies, before it is too late for patients, the public, and the rest of the NHS".
"This year's survey clearly shows that community pharmacies are buckling under growing cost and capacity pressures," said PSNC Chief Executive Janet Morrison.
"Only around half of ICSs have a Chief Pharmacist," indicating a significant gap in leadership that hampers the pharmacy sector's ability to influence
critical healthcare decision, a report on medicine optimisation by the Public Policy Projects (PPP) highlights.
In PPP's latest report, a notable concern highlighted is the inadequate representation of pharmacy leadership within Integrated Care Systems (ICSs) despite the
role of pharmacy being "central in the delivery of system priorities, with pivotal roles in improving population health and tackling inequalities".
In recent years, the role of pharmacy within the NHS has evolved significantly with recent developments including Pharmacy First Services and legislative
amendments that allows pharmacy technicians under PGDs to administer and supply medicines.
In a decisive move highlighting the financial strain faced by community pharmacies, the National Pharmacy Association (NPA) submitted a £108 million invoice
to the Department of Health and Social Care (DHSC) today (16 May).
According to the NPA, this substantial sum represents the amount that pharmacies in England personally covered for the dispensing of NHS medicines last month, as a
result of inadequate funding.
"The £108m figure is an average monthly figure based on the loss to pharmacy incomes over the past decade," it said.
The association believes that mass closures can be prevented only when the government stops expecting pharmacies to subsidise the cost of delivering NHS care.
NPA chief executive Paul Rees, said: "The soaring costs of dispensing medicine coupled with declining real terms funding has led to community pharmacies in
England having to subsidise the dispensing of drugs to the tune of £108m a month.
A BBC investigation has found 20 UK online pharmacies selling prescription-only medicines without adhering to the regulatory standards, such as checking
for GP approval or patient's medical records.
The news organisation was able to purchase over 1,600 restricted pills, including anti-anxiety drug, painkiller and sleeping medication, from these regulated
online pharmacies easily by providing false information.
However, the report didn't mention the names of the drugs as "they can be dangerous when taken without medical guidance."
Some pharmacies were also found selling high-risk and potentially addictive medicines, including benzodiazepines and antidepressants, based on online questionnaires
and did not require further checks.
The General Pharmaceutical Council (GPhC), which regulate online pharmacies in the UK, states that selling and supplying medicines at a distance brings
"different risks which need to be appropriately managed to protect patient safety."
A couple in Maidenhead, Berkshire has been handed suspended sentence for illegal possession and supply of £1.6m of unlicensed medicines.
Following investigations initiated by the MHRA, Karina Filimonova and Andrejs Stolarovs were caught with the unlicensed medicines which included prescription-only
medications. Southwark Crown Court sentenced each "to eight months imprisonment suspended for 18 months and 150 hours unpaid work" for possessing and intending to
supply medicinal products contrary to the Human Medicines Regulations 2012.
"This was a sophisticated operation illegally bringing unlicensed medicines into the UK from Singapore and India, and then distributing them across the country and
abroad," said Andy Morling, MHRA Deputy Director of Criminal Enforcement. "Criminals trading in medicines illegally like this are not only breaking the law, but
they also have no regard for your safety. These are powerful medicines that can lead to serious adverse health consequences if taken without appropriate medical
supervision."
In 2020, the Royal Mail Group (RMG) informed the MHRA about parcels containing unlicensed medicines discovered during their investigation into suspicious parcel
activity. Following this, the MHRA's Criminal Enforcement Unit, in cooperation with local police, launched an investigation and apprehended the couple at their
residence in Kidwells Close, Maidenhead.
The Medicines and Healthcare products Regulatory Agency (MHRA) has launched a consultation on the reclassification of codeine linctus to a prescription-only
medicine after considering multiple Yellow Card reports for its opioid effects, rather than for its intended use as a cough suppressant.
This medication is currently licensed as a pharmacy medicine, which means that it is available to purchase over the counter in pharmacies. If reclassified as a
prescription-only medicine, all strengths of codeine linctus will only be available upon presentation of a prescription.
Dr Alison Cave, MHRA Chief Safety Officer, said: "Codeine linctus is an effective medicine, but as it is an opioid, its misuse and abuse can have major health
consequences.
Every response received will help us to develop a broader view on whether codeine linctus should be restricted to prescription-only status.
We want to hear from members of the public, health professionals and others who would be affected by this potential change so we can make a properly considered
decision for the benefit of patients, carers, and healthcare professionals across the UK.
The Medicines and Healthcare Products Regulatory Agency (MHRA) is considering the reclassification of Aquiette 2.5mg tablets contains oxybutynin hydrochloride that is used to treat women with milder symptoms of overactive bladder from Prescription-Only-Medicine (POM) to Pharmacy (P) medicine.
The agency is encouraging pharmacists, GPs and other health care professionals, the public and women to take part in the reclassification consultation to make a
treatment for overactive bladder available for women without the need for a prescription.
Public consultation on a set of proposals to make Aquiette 2.5mg Tablets (oxybutynin hydrochloride) available from pharmacies will close on 13 May, 2022.
It would be the first time a medicine for the treatment of overactive bladder would be available without prescription, if the reclassification consultation receives positive responses.
After the decision is made to reclassify this treatment, pharmacists will have access to training materials and a checklist to enable them to identify women who can be supplied this medicine safely.
A Company Chemists' Association (CCA) analysis has shown that 'Pharmacy First' service in England could free up 30m+ GP appointments each year.
It has urged the Government and NHS to be even 'bolder in their ambition and go further and faster'.
The recent 'Delivery plan for recovering access to primary care' announced a 'Pharmacy First' service for England, mirroring similar approaches in Scotland and
Wales.
The association has estimated that with the added capability to supply non-prescription medicines and prescribe additional prescription-only medicines, an ambitious
'Pharmacy First' service could free up 30m+ GP appointments annually.
Harnessing community pharmacies to deliver care for minor health conditions will effectively create 11,000 urgent care centres in England.
Researchers from the London School of Hygiene & Tropical Medicine (LSHTM) have been tasked to evaluate the impact, safety and effectiveness of the
Pharmacy First service, which was launched across England in January 2024.
They have been awarded £2.4million by the National Institute for Health and Care Research (NIHR) to generate evidence on the new service that allows
pharmacies to provide advice and treatment for seven common conditions without the need for a GP appointment.
After consultation, if necessary, a community pharmacist can supply some prescription-only medicines to treat earache, sore throat, sinusitis, impetigo,
shingles, infected insect bites or uncomplicated urinary tract infections in women.
The LSHTM researcher team will be working together with experts at the UK Health Security Agency (UKHSA) and the Universities of Oxford, Manchester and
Nottingham on the project.
Dr Rebecca Glover, assistant professor in Antimicrobial Resistance at LSHTM, who will lead the three-year project, said they will evaluate "Pharmacy First's
impact on GPs and the wider NHS, pharmacy services and patients."
The much-awaited Pharmacy First service has been launched in England, enabling patients to get treatment for seven common conditions from their community
pharmacists without needing to see a GP.
According to NHS England, a total of 10,265 community pharmacies, which is equivalent to more than nine in ten community pharmacies in the country, will be
offering the ground-breaking initiative.
The new scheme allows highly trained pharmacists to give advice and prescription-only medicines for minor ailments including sinusitis, sore throat, earache,
infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women (under the age of 65).
With this major expansion of pharmacy services, the NHS is aiming to free up 10 million GP appointments a year while giving the public more choice in where and
how they access care.
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.
Maxwellia has appointed Ian Adamson as strategic advisor to shape the next phase of pharmacy medicine launches - a process which involves identifying and converting suitable prescription only medicines into versions people can choose to buy under the supervision of a pharmacist.
Ian brings over 30 years' international consumer health and personal care experience to the Maxwellia team. He is currently an advisor to the board of the UK
independent pharmacy chain Day Lewis plc, an advisor to the board of Spanish healthcare company ReVa Europe S.L and board advisor to East Midlands Pharmaceuticals
Ltd.
Prior to this Ian was Chief Commercial Officer and a main board director at SSL International plc (prior to its sale to Reckitt Benckiser) with responsibility for a $1bn portfolio of brands, which included Durex and Scholl.
Ian's appointment follows the landmark reclassification of the progestogen only pill by the MHRA, a change spearheaded by Maxwellia, and the company's subsequent
launch of its first product Lovima in July 2021; and the current MHRA public consultation on the reclassification of Maxwellia's new pharmacy brand, Aquiette 2.5mg Tablets (Oxybutynin Hydrochloride) for the treatment of overactive bladder symptoms which are not adequately controlled by bladder training alone.
Laganside Crown Court, on Friday, sentenced Gerard Cullinan, a 48-year-old pharmacist and Director of Castlereagh Pharmacy Ltd in East Belfast, for
unlawfully supplying controlled prescription medicines, including co-codamol and fentanyl, and for failing to maintain controlled drugs registers.
Cullinan was sentenced to 11 months imprisonment, suspended for three years, and his pharmacy was fined £8,000.
The sentencing follows an investigation by the Department of Health's Medicines Regulatory Group (MRG), which uncovered that Cullinan's pharmacy on Castlereagh
Road had illegally supplied over 300,000 co-codamol tablets between January 2017 and June 2020.
Additionally, the MRG investigation identified significant breaches in record-keeping for Class A controlled drugs such as fentanyl, tapentadol, methylphenidate,
morphine, and oxycodone.
"It is a serious criminal offence to sell or supply prescription only medicines without a prescription," said Peter Moore, Senior Medicines Enforcement Officer at
the MRG, who led the investigation.
From over-the-counter flu tablets to crucial antibiotics and antidepressants, medicines are running scarce in UK pharmacies this year, causing concerns among
patients, the government, and the wider pharma industry.
Drug shortages have accelerated over the past year due to a clutch of problems including the after-effects of the pandemic on supply chains, the war in Ukraine,
and soaring input costs weighing on manufacturers. More recently, a sudden spike in respiratory infections - another by-product of Covid-19 that neither pharma
companies nor the government were able to predict - has deepened the crisis, with 70 commonly taken drugs out of stock in Britain as of February.
The problem is not unique to the UK. In a recent survey of groups representing pharmacies in 29 European countries, three quarters said shortages were worse this
winter than a year ago, with a quarter reporting more than 600 drugs in short supply. The US is also facing significant shortages of popular prescription drugs like
amoxicillin and Adderall, an ADHD medication.
To some extent, the current disruption is laying bare wider challenges facing the industry for several years that were only exacerbated by the pandemic.
The over-reliance on foreign suppliers for most active pharmaceutical ingredients (APIs) is one of them. This model has left companies more susceptible to supply
shocks, which have in turn increased in frequency and severity due to pandemic lockdowns, the war in Ukraine and other issues such as the shortage of shipping
containers.
Pharma's long and opaque supply chains, alongside regulatory complexities, also mean it is taking longer for drugmakers to reconfigure manufacturing and distribution
in times of additional need.
The only way to overcome the challenges facing the medicines supply chain in the UK is through close cooperation - the government, pharmacies, and the
industry all working together in tandem - said Andrew Stephenson, Minister for Health and Social Care.
The MP for Pendle, Lancashire made the statement while addressing the Healthcare Distribution Association's (HDA) Annual Conference at the Institute of Directors
in Pall Mall, London on Thursday (25 January), where over 130 leaders from the pharma industry gathered.
As the keynote speaker, Stephenson acknowledged the crucial role wholesalers, manufacturers, and retail pharmacy chains, play in the wellbeing of the nation.
He said: "In the first few months that I've been in this job, it's become immediately obvious to me just how important this sector is and just how important the
work that all of you do is for our country."