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Dr Rod Hughes sets out how pharmacists can play a pivotal role in steering people with joint pain towards a prevention programme… Joint health supplements are big business in the UK, with millions of pounds spent over the counter every year. People turn to these supplements for various reasons, but most are seeking relief from the symptoms of arthritis, a group of painful long-term conditions thought to affect around 10 million people in this country. Osteoarthritis (OA) is the most common form of arthritis, affecting around eight million people in the UK. The condition is generally age-related, with joint pain and stiffness developing as the cartilage between the bones gradually wears away. OA changes and the inflammation involved causes difficulty moving and considerable pain. Rheumatoid arthritis (RA) tends to affect younger people and is caused by the body's immune system attacking the joints. As a nation we tend to ignore our joints until they cause us problems, resulting in an increasing number of people taking long-term analgesics to control the pain or needing surgery to repair knees and hips. Treatment guidelines followed by doctors in the UK recommend that people with arthritis are advised to maintain a healthy weight and keep physically active, while strengthening their muscles and protecting any damaged joints during daily activities.

Pharmacists are a vital member of the multidisciplinary team (MDT) supporting older people to manage their pain. The pharmacist is uniquely positioned to holistically review drug interactions and potential risks associated with each patient's medication and has the expertise to suggest alternative treatment options to reduce the risks associated with polypharmacy or unwanted side effects caused by other medications. Chronic pain The International Association for the Study of Pain defines pain as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Although universally experienced by everyone, the perception of pain is a deeply personal experience influenced by biological, psychological, and social factors, and constitutes an essential behavioural feedback mechanism aimed at protecting us from harm. Pain may be perceived as either acute or chronic. Chronic pain, defined as pain that persists longer than the normal healing time, constitutes a substantial healthcare burden, affecting approximately 20 per cent of people worldwide and accounts for 15-20 per cent of physician consultations. Chronic pain is often associated with disrupted mood and sleep, substance misuse and other chronic conditions. Additionally, comorbidities of chronic pain may also lead to complex medication regimens that increase the risks of adverse drug interactions and unwanted side effects.

The Royal Pharmaceutical Society (RPS) has revealed the "differential attainment" gap among Black pharmacy students and Foundation trainees. Research conducted by pharmacy education has revealed unique challenges leading to lower attainment in the registration assessment and an undergraduate awards gap compared to white students. The organisation plans to work with new groups including BPSA, GPhC, NHS England, Pharmacy Schools Council and representatives from Schools of Pharmacy, to achieve a fair and equitable education and training experience for the students. They plan to reach out to student representative organisations to secure their participation in a quarterly meeting of the group. Differential attainment is the unexplained variation between groups who share a protected characteristic, for example, ethnicity, gender and disability.

IAM Healthcare and pharmacy labour activists have initiated a new worker empowerment project to help pharmacies unionise over unsafe staffing levels and increasing workloads. The campaign is coined "The Pharmacy Guild" to establish higher standards of practice in pharmacies to protect patients. The union issued a mission statement on Wednesday (8 November) highlighting three major demands and goals. They demanded that "staffing and workload standards should be set up to ensure safe patient care." There should be "representation and collective bargaining for pharmacy professionals in workplaces across the country."

The General Pharmaceutical Council (GPhC) has decided to increase the renewal fees of pharmacists, pharmacy technicians, and pharmacy premises by 7.5% from April 2024. The pharmacy technician's renewal fee will see an increase by £9 from £121 to £130, pharmacists fees from £257 to £276, and pharmacy premises from £365 to £392. The following decision came even despite the renewal fees being frozen for individual registrants since 2019 and for pharmacy premises since 2021. This move was facilitated through cost savings measures like using financial reserves and downsizing to a smaller office. However, the council confirmed that the fee hike is due to higher rates of inflation, increase in utility bills and supplier costs. Duncan Rudkin, Chief Executive and Registrar of the GPhC, said: "We know that these are challenging times and that this increase will come as unwelcome news to those we regulate. But to be effective in our role of protecting the public we need to make sure the fees we charge cover the cost of regulation going forward."

The Federation of Small Businesses (FSB) on Thursday (4 December) announced a new strategic partnership with the Bank of England to protect small businesses from the risks associated with accepting counterfeit banknotes. Cash is still the number one customer payment method for 25 per cent of small high street businesses, and cash payments are expected to increase during the festive period, according to FSB. By becoming a Strategic Partner of the Bank of England's Banknote Checking Scheme, the organisation is trying to help its members become aware of the use of counterfeit notes, which has reputational and financial impacts. The FSB is encouraging its members to sign up to the Scheme, which offers training materials to staff so they can identify a counterfeit note at point of sale and know what to do with it, as well as stay up to date with best practice and bank note developments.

Prime Minister, Rishi Sunak, has backed pharmacists to play a greater clinical role in the health and well-being of the nation, describing them as "valuable and trusted" members of the community. Pharmacists have faced a difficult year with 222 community pharmacies closing in just the first six months. Boots alone will be closing 300 branches over the next 12 months. Sunak, however, insisted that his government knows the "hard work of pharmacy teams", and that he wants to "enable them to do more to support the NHS." Speaking at the annual Sigma Conference in London on Sunday (5 November), the prime minister reiterated that community pharmacy is in line for a much-needed boost in funding. "Earlier this year, the government announced plans for further investment of up to £645 million over the next few years to support the Pharmacy First service for patients," Sunak said in a letter read out at the conference by Lord Dolar Popat. "This means that community pharmacies will be able to assess patients and provide some options to protect them without a GP appointment."

Pharmacists, councillors and NHS leaders came together at Portsmouth's first Community Pharmacy Summit to address some of the challenges facing community pharmacy locally. They explored ways to reduce the huge pressures on pharmacy, tackle abuse towards staff, enable pharmacists to undertake training to treat more illnesses, and to protect the current and future workforce. Portsmouth City Council, which hosted the Summit on Wednesday 15 November, also invited representatives from Hampshire and Isle of Wight Constabulary, University of Portsmouth, Hampshire and Isle of Wight Integrated Care Board and businesses to discuss new opportunities to work together. Held at Portsmouth Guildhall, the event was chaired by Cllr Matthew Winnington, Cabinet Member for Community Wellbeing, Health and Care, and Cllr Gerald Vernon-Jackson, Cabinet Member for Transport.

The NHS England has developed and published a new vaccination strategy with an aim to increase national uptake of lifesaving vaccinations, and protect people against a range of diseases. Getting vaccinations will become easier than ever before, as the NHS App is being expanded with more additional features. Improved booking features such as new in-App bookings, invitation alerts and appointment notifications will make "booking a jab as easy as booking a cab," NHS leaders said. The NHS App overhaul will also include improved access to medical records, meaning users will be able to see their routine vaccination status over the coming months and years, making it easier for them to identify any missed vaccinations in their history.

Recently launched generic version of Apixaban by Teva UK is said to bring savings to the NHS drug bill while making sure patients get the medicine they need. The generic apixaban is available for the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation (NVAF), with one or more risk factors, such as prior stroke or transient ischaemic attack (TIA) and treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults. Previously there was only a 'branded' product available, but Castleford-based Teva UK succeeded in invalidating the apixaban patent and SPC (supplementary protection certificate) in the UK High Court and so is now able to launch its own 'generic' version - which will bring savings for the NHS while making sure patients get the medicine they need. "We've always said that we stand up for the patient", said Kim Innes, General Manager of Teva UK and Ireland. "The launch of generic apixaban emphasises Teva's commitment to doing the right thing by putting patients at the heart of everything we do by giving them and the NHS access to affordable treatments." Apixaban is an anticoagulant which directly inhibits factor X (factor Xa), inhibiting thrombin formation and the development of thrombi (blood clots). For at-risk patients, such as those with, or at risk for DVT, or NVAF, the risk of stroke related to blood clots forming in the body and traveling to the brain is a serious concern. Each year, DVT affects around 1 person in every 1,000 in the UK and if left untreated, about 1 in 10 people with a DVT will develop a PE.

All children aged five to 11 in England will be offered a Covid-19 vaccine, the government said on Wednesday (February 16) - following similar announcements in the rest of the UK. The move, coming nearly two months after British regulators approved Pfizer and BioNTech's shot for use among the age group, sees Britain following the lead of the United States, the European Union and other countries. It has only been vaccinating at-risk under-12s and those who live with immuno-suppressed people, using a lower-dose formulation of the jab that was found to be "safe and effective". However, health secretary Sajid Javid - who has responsibility for England only - said he had now accepted guidance from the Joint Committee on Vaccination and Immunisation, which advises UK health departments, to expand the rollout. "The NHS will prepare to extend this non-urgent offer to all children during April so parents can, if they want, take up the offer to increase protection against potential future waves of Covid-19 as we learn to live with this virus," he said in a statement.

Britain has approved Novavax's Covid-19 vaccine for use in those 18 years of age and older, the country's medicines regulator said on Thursday (February 3), bringing a fifth coronavirus shot to its roster amidst the rapid spread of the Omicron variant. The vaccine, Nuvaxovid, was approved as a first and second dose as it met the required safety, quality and effectiveness standards, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) said in a statement. The British approval for Nuvaxovid comes days after the drugmaker filed for US authorisation of the vaccine following months of struggles with development and manufacturing problems, and follows a German backing earlier in the day. "We are continuing our vital safety work in monitoring the use of all Covid-19 vaccines, to ensure that their benefits in protecting people against Covid-19 disease continue to outweigh any risks," MHRA chief executive June Raine said.

The Scottish government has announced funding to help community pharmacy contractors purchase air extraction equipment for their premises. The funding will be available to pharmacies that have fitted or committed to fit air extraction equipment on or after 1 April 2020. The funding is aimed at supporting both staff and patient safety, as pharmacists in Scotland provide face to face healthcare services to people every day. The investment is seen as an important protection measure against respiratory infections, including Covid-19 transmission, as Scotland begins to open-up again following the pandemic.

Northern Ireland's health minister Robin Swann has condemned the act of violence experienced by pharmacy teams, stating such acts "will not be tolerated." His statement follows an ugly incident that took place on Saturday (March 5) at the Teagues Pharmacy, Antrim Road in Belfast, Northern Ireland. Conor McAreavey from Teagues Pharmacy told the BBC that on Saturday a man entered the shop at about 17:30 GMT and used a hammer to break through a Covid protection screen, and stabbed him in hand before fleeing the premises. He added that such attacks on pharmacists had become a "trend". Condemning the attack, Swann said: "Abuse or assaults of any kind on health and social care staff will not be tolerated. I was appalled to hear of the assault on the community pharmacist at the weekend.

Gisela Abbam today (March 14) officially succeeded Nigel Clarke as new chair of the General Pharmaceutical Council (GPhC). She was appointed in mid-Feruary. The council paid tribute to its outgoing chair for his major contribution to pharmacy regulation and his focus on patient safety for the past eight years on the role. During his tenure Clarke has overseen significant changes to how the GPhC regulates pharmacists, pharmacy technicians and pharmacies to help drive improvements in professional practice and protect patient safety. Chief executive of the GPhC, Duncan Rudkin, said: "I would like to pay tribute to Nigel for everything he has done to support continuous improvement and assure the quality and safety of pharmacy for the benefit of patients and the public.

The Pharmacists' Defence Association (PDA) has expressed disappointment at the omission, once again, of the promised Employment Rights Bill omitted from the Queen's Speech earlier this week. The Bill is pledged to strengthen day one employment rights and increase the productivity of businesses. It set out plans which would protect and enhance workers' rights and aim to make the UK the best place in the world to work at. This included plans to introduce the right to request flexible working for around 2.2 million people in Great Britain - regardless of time served in a bid to modernise the way employees work. The PDA said: "The Employment Rights Bill would have presented an opportunity to improve the ability for workers to obtain redress in the event of poor treatment or discrimination through the development of a single labour market enforcement body. "Poor employment practices, such as insecure work through long-term zero-hours contracts, unilaterally changing workers' terms and conditions by terminating their contracts and re-hiring them on new terms and conditions (also known as fire and rehire), and the sacking of workers without notice, as recently demonstrated by P & O Ferries, could have been outlawed under new legislation."

The General Pharmaceutical Council (GPhC) has removed a pharmacist from its register who black-marketed 'zolpidem' along with another pharmacist between 2015 and 2016. Dean Zainool Dookhan, a pharmacist first registered with the Royal Pharmaceutical Society of Great Britain on 18 October 2004 and whose registration was later transferred to the General Pharmaceutical Council under registration number 2059808, was jailed last year for exporting 20,000 packets of zolpidem to the Caribbean. While hearing the case on 24-25 May, GPhC's Fitness to Practise Committee stated that "removal of the Registrant's name from the register is the appropriate and proportionate response to his convictions." "The public interest includes protecting the public, maintaining public confidence in the profession, and maintaining proper standards of behaviour. The Committee is entitled to give greater weight to the public interest than the Registrant's own interest in remaining on the register." "The Committee recognises the sanction has a punitive effect in that the Registrant's ability to practise and earn an income as a pharmacist and 28 his professional reputation will be curtailed; it will be five years before he can seek restoration to the register. However, that is the price he must pay for failing to comply with the fundamental tenets of his profession."

The government has previously committed to introducing several new family-friendly rights following numerous consultations over the last few years. These include: neonatal leave and pay; carer's leave; and extending redundancy protection for pregnant women and new parents. The government confirmed it would implement these reforms in the long-awaited Employment Bill, first announced in the Queen's speech back in 2019. However, the Employment Bill was not referred to in the Queen's speeches in both May 2021 and May 2022 therefore it remains unclear when these reforms will be prioritised. Nevertheless, at this stage, it is helpful for pharmacy business owners and managers to have an understanding of the direction of travel when it comes to family friendly rights in the workplace.

The UK Health Security Agency (UKHSA) has said that monkeypox is to be listed as a notifiable disease in law from Wednesday (June 8). The new legislation means all doctors in England are required to notify their local council or local Health Protection Team (HPT) if they suspect a patient has monkeypox. Laboratories must also notify the UKHSA if the monkeypox virus is identified in a laboratory sample. Wendi Shepherd, monkeypox incident director at UKHSA, said: "Rapid diagnosis and reporting is the key to interrupting transmission and containing any further spread of monkeypox. This new legislation will support us and our health partners to swiftly identify, treat and control the disease. "It also supports us with the swift collection and analysis of data which enables us to detect possible outbreaks of the disease and trace close contacts rapidly, whilst offering vaccinations where appropriate to limit onward transmission."

Superdrug has reported more than 400 per cent spike in sale of the chickenpox vaccines in the UK. To protect children against the disease during chickenpox season, nearly nine out of 10 patients (87 per cent) have taken their wards under the age of five for vaccination in the last eight weeks. Chickenpox can be a seasonal disease with children usually catching it in the winter and spring, with UK peaks often between March and May. The last two years of spending time in and out of various lockdowns have meant less interaction between people, and so less transmission across the general population. Caris Newson, head of healthcare services at Superdrug, said: "One of the knock-on effects of Covid is that people have a greater awareness and understanding of the benefits that vaccines can offer. "We launched the chickenpox vaccination service five years ago in 2017 and it's now that we're beginning to see greater interest in how it can support family health. In fact, our fully qualified nurses have told us that they've had more parents ask about the chickenpox vaccination service, and word of mouth has then spread amongst parents and schools."