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With GP waiting times on the rise and the secondary NHS care system under pressure, there is a further opportunity for pharmacy to support the general public with self-care. The men's health category is one category where pharmacists can play a leading role - specifically Erection Problems (EPs) where pharmacists can be key to building awareness, destigmatising the condition, and providing support and solutions for the patient. Training for pharmacists is essential - helping them to understand how they can assist those looking for treatment whilst also breaking down barriers and normalising the conversation around EPs. EPs are when a man regularly cannot get and keep an erection. EPs can happen to any adult man, not limited to the older generation, though they are particularly common in men over the age of 40. EPs may happen in some situations over others and so it is increasingly important for men to speak about and identify the cause of their symptoms, particularly because EPs can often be an indication of other serious health conditions like cardiovascular disease, high blood pressure or diabetes. If pharmacies can encourage men to seek help with their EPs, they may also be able to identify additional serious and undiagnosed conditions earlier, thereby supporting men's health more widely.

The Digital Medicines Transformation Portfolio (DMTP) was able to deliver the electronic prescription service (EPS) in Wales - just 20 months after starting the project - with support from key partners in the NHS and industry. Patients in Rhyl were the first to benefit from the new service, which allows GPs to send prescriptions electronically to the patient's choice of community pharmacy, without the need for a paper form. The new EPS service is currently in a live testing phase, with a phased roll out across Wales expected from January 2024. DMTP, which is hosted by Digital Health and Care Wales (DHCW) has worked closely with NHS England, who provided the core EPS platform that has been developed for use in Wales. NHS Wales Shared Services Partnership has also made a major contribution in the project, incorporating digital reimbursement to pharmacies and putting security measures in place.

Wales launched the new electronic prescribing service (EPS) last week, with the country's first electronic prescription sent and dispensed on 17 November. The new service allows prescriptions to be sent digitally to a patient's nominated pharmacy, thus eliminating the need for paper forms. It is part of a wider plan to introduce digital medicines and e-prescribing in all hospitals and primary care in the country. Wellington Road Pharmacy and Lakeside Medical Centre in Rhyl became the first community pharmacy and GP practice to use the EPS, which is expected to be rolled out across Wales in January 2024.

NHS England will collaborate with "a number of system suppliers" to increase the number of trusts using electronic prescription service (EPS) over the next few years. Nishali Patel, clinical lead for digital medicines at NHS England, announced it during the Clinical Pharmacy Congress, held at the Excel, London, on Friday, 10 May 2024. According to Nishali, at least half of all NHS secondary care trusts could be using EPS by 2026. This digital service allows prescribers to send prescriptions electronically to a patient-nominated pharmacy. It is widely used in primary care, where over 95 per cent of prescriptions are now electronically generated. NHS recently extended the service to secondary care settings.

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.

Online pharmacy Pharmacy2U, acquires LloydsDirect in a merger for a single digital-first pharmacy. The companies issued a statement on 9 October and confirmed that they would operate as Pharmacy2U. It would also have a total of 1.4 million EPS nominations, as confirmed by NHS recent data. They are planning to enhance patient accessibility to online pharmacy and healthcare services through their combined services. Kevin Heath, Chief Executive Officer of Pharmacy2U, said: "We are delighted to welcome the LloydsDirect team into the Pharmacy2U family. Combining the best of both of our businesses, we can provide patients with greater access and convenience.

Titan PMR has been accredited by the NHS to provide electronic prescription services (EPS) to dispensing doctors. Over 1,000 of these doctors, who provide a vital service to almost 10 million people in rural communities, can now offer their patients the same level of benefits and efficiencies that electronic prescriptions and Titan PMR have brought to pharmacies around the UK. These features will also increase efficiency for dispensing doctors, who will reduce dispensing errors and improve organisation, increasing their capacity while enjoying the ability to integrate with other technologies. After a full year of testing, including six months of compliance testing at a practice in Cumbria, the new accreditation for Titan also has potential to help the NHS fulfil its target of all prescriptions being issued electronically. Currently written paper prescriptions from dispensing doctors account for around seven per cent of the total prescriptions in England - around 6.5 million each month. "Until now dispensing doctor surgeries have basically been in the digital dark ages when it comes to dispensing medicines," said Tariq Muhammad, a tech entrepreneur and CEO of Bristol-based Invatech Health, which developed Titan PMR.

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The Department of Health and Social Care (DHSC) has issued a medicine supply notification for Dioralyte oral rehydration sachets. "Dioralyte oral rehydration sachets are expected to be in limited supply until late December 2022. St Mark's solution is available as an unlicensed special and can support an uplift in demand," said DHSC. "Kidderminster formula is available as an unlicensed special and can support a partial uplift in demand. As an alternative to the unlicensed specials, the individual components can be purchased from community pharmacies and supermarkets or prescribed, but there have been intermittent supply issues with glucose powder." Diluted apple juice has been reported to be a potential alternative to electrolyte maintenance fluids in children with mild gastroenteritis and minimal dehydration. 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 St Mark's solution cannot be issued.

Department of Health and Social Care (DHSC) has issued a medicine supply notification for Clomifene (Clomid) 50mg tablets on Monday (5 June). It said: "Sanofi will be out of stock of clomifene (Clomid) 50mg tablets from w/c 12 June 2023 until w/c 18 September 2023." "Generic clomifene 50mg tablets remain available from Wockhardt who are able to partially uplift supplies until the end of July 2023. Unlicensed supplies of clomifene 50mg tablets may be sourced, lead times vary. Alternative medicines for use in infertility remain available," it added. The specialist importers- Orifam and Target Healthcare have confirmed to DHSC they can source unlicensed clomifene 50mg 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 clomifene 50mg tablets cannot be issued," said Community Pharmacy England.

The Pharmaceutical Services Negotiating Committee (PSNC) has advised the pharmacy contractors to check that their PMR systems supports correct and complete SSP endorsements. Several tips has been shared by the PSNC with pharmacy contractors after NHSBSA received several electronic EPS SSP claims which did not meet the requirements for a valid SSP between 1 April 2022 and 31 May 2022. PSNC has been working with NHS Business Services Authority (NHSBSA) to understand whether claims for HRT SSPs are being submitted correctly and in accordance with the specific supporting guidance for each SSP. "For any invalid SSP claims, contractors will continue to receive the usual dispensing fee but will not receive any SSP fee (£5.35). Reimbursement for invalid SSP claims will also be in accordance with the prescribed product rather than the alternative product or quantity supplied in accordance with an SSP," said PSNC.

More than 80 per cent of pharmacy organisations have received the Department for Work and Pensions (DWP) functionality for Real Time Exemption Checking (RTEC). The NHS Business Services Authority (NHSBSA) has confirmed RTEC has been rolled out gradually, in phases. Contractors first received RTEC for use with processing NHSBSA exemptions. RTEC allows pharmacy teams to digitally check if patients are eligible for free NHS prescriptions because they hold a specific exemption. The rollout of the DWP inclusion in RTEC means patients found to be exempt via RTEC no longer need to complete an exemption declaration on an EPS token, saving time for patients and pharmacy teams. David Broome, a community pharmacy contractor in Leeds and PSNC regional representative said: "The rollout of the DWP for our pharmacy team has been a positive development, helping reduce the amount of paperwork that my team and patients have to deal with and in turn the environmental impact of our operations. Whereas I used to send my paperwork bundle to the NHSBSA in a large box, I now send this in an envelope!" Contractors can access and confirm their acceptance of the RTEC user agreement via the RTEC registration form in the NHSBSA's Manage Your Service (MYS) portal.

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."

The Serious Shortage Protocol (SSP), for Estradot 50mcg patches will expire at 23.59pm on Friday 24 February 2023. Department of Health and Social Care (DHSC) has confirmed that sufficient stock of Estradot 50mcg patches are now available to meet normal demand. "After 24th February, any prescriptions for Estradot 50mcg patches must be dispensed in accordance with the prescription, and SSP048 will no longer be valid for use," said DHSC. Top tips for SSP claims by PSNC: Where available, use the claim amend facility on the PMR system to rectify any incorrect EPS claims already submitted this month. For any supplies made in accordance with SSPs, check that the correct number of patient charges are collected and declared on the end of month FP34C submission. 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.

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