A recent analysis conducted by the Company Chemists' Association (CCA) has revealed stark disparities in patient engagement with the Pharmacy First
service across the country, likening the pattern to a 'patchwork quilt'.
It indicated that patients in the highest-performing Integrated Care System (ICS) received seven times more Pharmacy First consultations than those in the
lowest-performing regions.
As of April 21, more than 3,000 CCA member pharmacies had delivered 126,484 Pharmacy First consultations since the programme's launch.
However, the analysis found significant regional variations, with nearly 13,000 consultations completed in the North East and North Cumbria ICS, while only
948 were completed in Gloucestershire ICS.
The CCA calculated that if every ICS had as many consultations as the highest-performing ICS, there would have been an additional 600,000 Pharmacy First
consultations nationwide.
The Pharmaceutical Services Negotiating Committee (PSNC)'s 2022 Pharmacy Advice Audit revealed that more than 1.2 million consultations a week - or 65 million
a year - are now being carried out by community pharmacy teams in England.
This is an increase from 2021, when the audit results suggested that in total pharmacies were providing 58 million consultations per year.
PSNC has published the findings of the audit of over 4,000 community pharmacies carried out earlier this year. During the audit, 82,872 informal patient consultations
were recorded, with the average pharmacy completing 19 consultations per day.
This suggests that more than 1.2 million informal consultations are taking place in community pharmacies in England every week.
The audit helped to quantify the number of informal referrals being made to pharmacies by GPs and NHS 111, with 7,774 informal patient referrals into pharmacy
coming from these routes; grossed up to a national level that means 117,000 cases per week.
These are all referrals that could and should have been made by the NHS Community Pharmacist Consultation Service (CPCS).
Community pharmacies in Cornwall have delivered more than 8000 face-to-face consultations over last 12 months.
Walk In Consultation Service (WICS) began 12 months ago when pharmacies in Cornwall started offering face-to-face consultations for a wide range of minor ailments,
and NHS treatment as required - the first service of its kind in England.
Cornwall & Isles of Scilly Scilly Local Pharmaceutical Committee (LPC) Chief Officer Nick Kaye joined Operations Manager Drew Creek in Parliament recently by invite
of Steve Double MP, St Austell and Newquay to meet with Minister for Health Neil O'Brien MP to present the service to them and Senior Civil Servants from DHSC and
NHSE with a view to rolling this service out nationally.
The data from these consultations show that over 6000 GP appointments were averted as a result of the service being available. After each consultation a record was
sent to the patient's GP for information.
The Department of Health has published 'A Guide to Developing the Role of Consultant Pharmacists' in Northern Ireland on Thursday (22 June).
The guidance provides direction on supporting a consistent approach to the introduction of senior clinical pharmacy roles within and across HSC organisations.
The Chief Pharmaceutical Officer Professor Cathy Harrison said: "There is a recognised need for increased clinical pharmacy and medicines focussed leadership
across our HSC."
"Consultant Pharmacists have an essential role in healthcare as clinicians and as leaders who make a significant impact to medicines optimisation and clinical
governance, providing a vital link between clinical practice and service development by generating and disseminating evidence to drive improvements in care.
"I am delighted that this guidance has been published to take forward the strategic development and appointment of the Consultant pharmacy workforce in both
primary and secondary care and to enable pharmacy to be at the forefront of healthcare in NI".
The General Pharmaceutical Council (GPhC) has called for comments and views on the recently launched consultation on selecting the appropriate mode of consultation when assessing a person's needs by pharmacy professionals including pharmacist prescribers.
The guidance note sets out what the pharmacy professional or prescriber, in
agreement with the patient, needs to consider when selecting the mode of consultation - such as face-to-face; video-link, video-chat, or other online platforms;
telephone and online questionnaires - best suited to gaining the information needed to deliver safe and effective pharmacy care.
The principles outlined in the guidance apply to consultations undertaken in all pharmacy settings, including those undertaken by online pharmacy services providers.
"Our plan is to include the contents of this guidance note in the document: 'In practice: Guidance for pharmacist prescribers' when we undertake our next review," said the regulator.
NHS Greater Glasgow and Clyde has appointed Jennifer Laskey as Scotland's first consultant pharmacist, marking a significant step forward for pharmacy
profession in the country.
Laskey's new role involves providing support to the West of Scotland Cancer Network, where she will play a pivotal role in enhancing healthcare outcomes.
Her appointment underscores the commitment of NHS Greater Glasgow and Clyde to improving patient care and highlights the growing importance of pharmacist-led
initiatives in Scotland's healthcare landscape.
Laskey, a pharmacist from Scotland, will extend her expertise to bolster the West of Scotland Cancer Network, aiming to enhance outcomes and survival rates
across various healthcare settings.
As part of recruitment to become a consultant pharmacist, Laskey obtained credentials from the RPS serving in an accredited consultant post ensuring
standardisation across the UK for patients and the system.
After a month of intense talks, the British government and unions representing consultant doctors in England have reached an agreement, potentially ending
six months of disruptive strike action.
The Department of Health and Social Care (DHSC) has put forward an offer to reform the pay structure for senior doctors from January 2024, reducing the number of
pay points and the time it takes to reach the top.
As part of this offer, consultants will also be entitled to enhanced shared parental leave, bringing them in line with other NHS staff.
New arrangements will ensure a clearer link between pay progression and evidence of skills, competencies and experience, the DHSC said.
The British Medical Association (BMA) and Hospital consultants and Specialists Association (HCSA) agreed to put the offer to their members for a vote in the coming
weeks, with no further strike action to be called during that time.
The Department of Health and Social Care (DSHC) has launched a consultation to seek views on changes to pharmacy supervision, which is being considered as
part of the Primary Care Recovery Plan.
Plans set out in the consultation include making better use of pharmacies, improving access to primary care and maximising the contribution of pharmacy
professionals across healthcare.
In the consultation, the DSHC has set out proposals to amend the Medicines Act 1968 and The Human Medicines Regulations 2012.
The proposals aim to allow pharmacists to authorise registered pharmacy technicians to carry out the preparation, assembly, dispensing, sale and supply of
pharmacy and prescription only medicines in their absence. Currently, these services can only be carried out by, or under the supervision of, a pharmacist.
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.
In a significant development, the British Medical Association's (BMA) consultants committee has voted to accept the government's offer on pay for senior
doctors in England, along with proposed reforms to the Review Body on Doctors' and Dentists' Remuneration (DDRB).
This decision follows a prolonged dispute between consultants and the government, which spanned over a year, involving unprecedented industrial actions.
Committee Chair Vishal Sharma described the agreement as "the end of the beginning" in consultants' endeavors to restore their pay levels to those of 2008.
Stressing the importance of the review body's independence in averting future pay disputes, Sharma emphasized the imperative role of utilizing this autonomy
effectively.
A staggering 83% of consultants participating in the three-week referendum voted in favor of accepting the offer, signaling a widespread endorsement of the
agreement within the profession.
The government has launched a consultation into radically changing the Statutory Scheme for branded medicines (known as the Statutory Scheme).
The consultation comes as delicate negotiations for replacing the alternative Voluntary Scheme are underway, potentially undermining these talks, while also further
damaging industry confidence in the UK as a viable place to research, launch and supply medicine.
The government proposals seek to hold average revenue clawback rates under the Statutory Scheme at historic highs of between 21-27%, compared to the pre-pandemic
averages of 9.4% for the Statutory Scheme (2019-2021), and 6.88% for the Voluntary Scheme (2014-2021). The accompanying cost-benefit analysis ignores any negative
impact this may have on medicine supply and wrongly claims it will boost investment.
The consultation comes on the heels of government data last week showing UK life sciences foreign direct investment (FDI) fell by 47% between 2021 and 2022, down
by £900m year on year. This large fall in investment coincided with a rise in the main UK clawback rate under the Voluntary Scheme from 5% to 15%, and led to the
UK falling from 2nd to 9th out of 18 comparator countries for life sciences FDI in 2022. The Voluntary Scheme clawback rate now sits at a record 26.5% in 2023.
The Department of Health and Social Care (DHSC) has finally published its response to the 2022 consultation on hub and spoke dispensing.
Considering the consultation evidence and further discussions, the government has expressed its intention to progress the proposals for enabling hub and spoke models
across different legal entities as soon as possible.
This will be achieved by using the enabling powers outlined in Part 2 of the Medicines and Medical Devices Act 2021 (MMDA) to amend the Medicines Act 1968 and the
HMRs.
Furthermore, the DHSC has decided to proceed with the implementation of the two models of hub and spoke dispensing that it consulted on.
The government response to the consultation reads: "Having considered the responses, the government intend to proceed to implement the necessary changes to medicines
legislation to remove the current restrictions that prevent the hub and spoke dispensing models from operating across different legal entities found in section 10 of
the Medicines Act 1968.
NHS England has launched a cloud-based platform that links recently-retired consultants, who still hold a licence to practice, with secondary care providers
who need additional help with their waiting lists.
It has been developed to make it easier and more flexible for retired doctors to return to the health service as part of the Long Term Workforce Plan.
NHS chief executive Amanda Pritchard in June 2023 announced the NHS Emeritus pilot scheme, which is expected to help reduce long waits for elective care.
Initially, the scheme will run for a year across England, and if successful, it may be expanded to cover other work areas.
Health Minister Andrew Stephenson commented: "Returning consultants will bring invaluable experience and knowledge, and the new digital platform will match
highly-skilled consultants with the NHS trusts that require their expertise, providing high quality care and alleviating pressures on high demand areas.
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The Pharmaceutical Services Negotiating Committee (PSNC) has invited pharmacy contractors, LPCs and others in the sector to share their views on an open
consultation on the "future of community pharmacy".
"The consultation - which takes the form of an online survey - is the first opportunity within PSNC's vision project for individuals and organisations to share
their thoughts with Nuffield Trust and The King's Fund," said PSNC.
The survey is happening in addition to an extensive programme of research, interviews and initial meetings of the vision Steering Group, Advisory Panel, and Working
Groups, all of which have contractors, LPCs and other representatives of the sector at their heart.
The online survey, asks five questions on topics such as Future policy goals; Why previous reviews and policies may not have fully achieved their objectives; Design
principles that should underpin the service offer made by community pharmacy; and Blocks and enablers for change.
The Pharmacists' Defence Association (PDA) has raised concerns over "certain elements" of the Pharmaceutical Society of Northern Ireland (PSNI)'s consultation
on pharmacy staffing levels.
PSNI recently consulted on its draft guidance for pharmacy staffing levels which sets out to explain what pharmacy owners and superintendents must do to ensure that
each pharmacy has enough skilled and qualified staff. This includes having an appropriate skill mix, to provide safe and effective pharmacy services which comply
with the standards.
PDA said that the role of the 'responsible pharmacist' has not been "fully acknowledged" and that more clarification is needed.
The association has made a few recommendations to PSNI that includes: the guidance must explicitly recognise the statutory role of the responsible pharmacist and
their authority in securing the safe operations within the pharmacy.
"The guidance should specify that pharmacy owners and superintendents must ensure that they do not set incentives or targets which may compromise the professional
judgement of staff."
It also recommended that unregistered staff (including unregistered managers) are accountable firstly to the responsible pharmacist for any activity involving the
clinical care of patients (for example unregistered managers must not interfere in diary bookings for vaccinations).
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.
There is no doubt that the pandemic has changed the way healthcare professionals work within the primary care setting. The advent of Covid-19 meant that we all
had to rapidly modify the way we supported and met the needs of patients, some of whom saw the services they usually took for granted, virtually cease overnight.
There are around 15 million people in England living with long-term health conditions including asthma. These people have the greatest healthcare needs of the whole
population with 50 per cent of all GP appointments and 70 per cent of all bed days taken by this cohort of patients, and their treatment and care absorbing 70 per
cent of acute and primary care budgets in England.
This situation isn't going to improve any time soon. In the past, most people had a single condition, today multi-morbidity is becoming the norm. At the start of the
pandemic, the Royal College of General Practice and British Medical Association issued guidance to practices on prioritising workload. This included the importance
of maintaining long-term condition reviews in asthma, COPD and diabetes, along with appropriate transition of at-risk warfarin patients. These reviews were deemed as
essential workstreams for patients considered to be at high risk.
Traditionally, the unique skills set of a pharmacist has meant that we have played a major role in supporting these patients. I work with a team of over 90 clinical
pharmacists who, in partnership with individual practices, PCNs, CCGs and STPs, help with the long-term management of people with chronic conditions. But the onset
of Covid-19 meant that we now had to plug a potential gap in service provision, and quickly.
In its response to NHS England's consultation on 'the future of vaccination services', the Pharmaceutical Services Negotiating Committee (PSNC) has suggested
that a wider range of NHS vaccinations being available from community pharmacies could support the achievement of increased vaccination levels.
PSNC said: "Any additional services that contractors could provide can only be considered with additional remuneration above the current global sum in the community
pharmacy contractual framework to ensure that the services are adequately resourced."
Alastair Buxton, director of NHS Services at PSNC, said: "We've always known, and the evidence supports this, that community pharmacies are one of the most popular
and accessible places for people to receive a range of vaccinations.
"The NHS was slow to take advantage of this at the start of the Covid-19 pandemic, so we welcome this consultation from them to bring together a wide range of views
on the topic.
"In the longer-term, if the right funding and support is in place, many pharmacies could help deliver a much wider range of NHS vaccination programmes - giving the
public the convenience and service that they want, and taking pressure off our general practice colleagues. It makes perfect sense, and we look forward to the NHS
response to this consultation."
The new data from NHS England has revealed that more than 100,000 patients were treated for minor illness by their high street pharmacist in just one month.
According to new NHS figures, in June, 118,123 people with minor illnesses such as a sore throat or constipation, or those in need of medicine urgently, received
a same-day consultation with their local pharmacist after calling NHS 111 or their GP practice - an increase of more than four-fifths (83%) on the number in the same
month last year (64,512).
The data comes alongside expanded roles for community pharmacies ahead of winter, announced at the NHS England board meeting today.
"From this week, NHS 111 online can directly refer people to their high street pharmacist for a same-day consultation, rather than patients needing to call the
phone line," said NHS England.
Amanda Pritchard, NHS chief executive, said: "Our local pharmacies ensure hundreds of thousands of people every week get the support and medication they need and
today's figures show that in just one month, over 100,000 patients have also had consultations with their local pharmacist for minor illnesses - this means patients
are getting the care they need quickly but also in a convenient way that can fit in with their busy lives.