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In a recent meeting with the head of the government's HRT Taskforce, Madelaine McTernan, the National Pharmacy Association (NPA) board members gave a gist on the ongoing medicines supply issues in community pharmacy. The meeting, which explored possible solutions to end the nationwide shortage of some Hormone Replacement Therapies, took place on Friday (May 20). Independent contractors Reena Barai and Olivier Picard gave the so-called 'HRT tsar' an overview of the medicines supply issues in community pharmacy and discussed the new Serious Shortage Protocols (SSPs) which the government introduced in response to the on-going HRT disruption. Earlier this month, the NPA attended an HRT summit organised by the Department of Health and Social Care, alongside other pharmacy bodies, wholesalers and manufacturers. Health secretary Sajid Javid and pharmacy minister Maria Caulfield said they would be working collaboratively with manufacturers to meet demand and boost supply.

The Pharmacists' Defence Association has asked Boots UK to waive any restrictive clause that prevents pharmacists working with the multiple from working for other pharmacy employers, even after leaving the company. However, the firm is yet to respond to the formal request, PDA said in an update. This request follows demand from the association members shortly after the company announced it's plans to cut opening hours. On workforce shortages, the PDA stated if there was a genuine shortage, then preventing pharmacists from working for other pharmacy employers to make up for the lost hours would be counterproductive and it would further exacerbate any "shortage".

Too many unreasonable demands placed on pharmacists by employers affect their health and wellbeing at work, a stress and wellbeing survey conducted by The Pharmacists' Defence Association (PDA) Union revealed. The survey, conducted during Autumn 2021, covered views of over 2,000 pharmacists employed by big multiples - Lloyds, Boots, and Well. This survey used questions developed by the Health and Safety Executive (HSE), which enabled the union to understand more about stress and wellbeing in three of the largest community pharmacy multiples. Analysing the survey, the PDA said that some pharmacists working for each of the three employers highlighted "unachievable targets, unrealistic time pressures, and most worrying of all reported numerous instances of bullying and harassment." An overwhelming majority of the respondents reflected personal sacrifices made by the pharmacists to ensure patient services are not impacted by the poor conditions and environments in some pharmacies.

Covid-19 vaccine makers are shifting gears and planning for a smaller, more competitive booster shot market after delivering as many doses as fast as they could over the last 18 months. Executives at the biggest Covid vaccine makers including Pfizer and Moderna said they believe most people who wanted to get vaccinated against Covid have already done so - more than five billion people worldwide. In the coming year, most Covid vaccinations will be booster shots, or first inoculations for children, which are still gaining regulatory approvals around the world, they said. Pfizer, which makes its shot with Germany's BioNTech and Moderna still see a major role for themselves in the vaccine market even as overall demand declines. Upstart US vaccine maker Novavax and Germany's CureVac, which is working with GlaxoSmithKline, are developing vaccines they hope to target at the booster market. The roles of AstraZeneca and Johnson & Johnson, whose shots have been less popular or effective, are expected to decline in this market.

Pfizer has recalled all stocks of Accupro - including 5mg, 10mg, 20mg, 40mg film-coated tablets - as a precautionary measure due to the identification of a nitrosamine above the acceptable limit. "Following testing, N-nitroso-quinapril, has been observed at a level above the acceptable limit. Nitrosamines may increase the risk of cancer if people are exposed to them above acceptable levels and over long periods of time. The recall is at pharmacy and wholesaler level," the Pharmaceutical Services Negotiating Committees (PSNC) reported. The Department of Health and Social Care (DHSC) said: "All strengths of quinapril (Accupro) tablets have been recalled with a resupply date to be confirmed. Pfizer are the sole supplier of quinapril tablets in the UK. Alternative ACE inhibitors remain available and can support an uplift in demand."

Community pharmacists are readily accessible healthcare providers and medicine experts in the community setting and their counsel is often sought by patients and consumers on a number of subjects including the use of dietary supplements. Their role in the sale of and advice regarding natural health and drug alternatives has never been more relevant. The recent National Health Service (NHS) Interim People Plan calls for the NHS to put all staff front and centre of the way it operates and identifies pharmacists as a critical part of multidisciplinary teams, providing care across a wide range of increasingly complex patient needs. Despite existing demand to counsel patients on a vast range of medicines, more and more consumers are looking to their pharmacist to support and enhance their knowledge regarding the relevance of a growing range of supplementary nutrients now available. Nutritional supplementation is increasingly becoming the consumer's first choice for 'drug free' treatment or natural prevention that provides a true sense of taking control, which the prescription process often denies them. The vast and growing depository of information on the internet is certainly fuelling this, but as much of this is brand derived content, information, it can often be generic with a 'one size fits all' marketing message.

The National Pharmacy Association (NPA) has raised its concerns over rising cost of rent for its members. The association highlighted that pharmacy spending is shrinking, and therefore, the NHS Property Services must ensure viability of health centre pharmacies. In May, the NPA wrote to NHS Property Services to voice its concerns over the rising cost of rent after some of its members reported demands for a three-fold increase in rent. Many pharmacies operate in premises of which NHS Property Services is the landlord. In a letter last month to chief executive Martin Steele, NPA said: "The past years have seen far fewer patients in health centres and therefore using the on-site pharmacy - whilst the situation will change somewhat as we move out of the pandemic we expect a permanent impact on workload as practices handle more of their interactions virtually. "The NPA encourages NHS Property Services to review lease agreements involving community pharmacies and consider favourable changes to terms that are in line with current financial realities affecting the sector. This could avoid the loss of a pharmacy service to communities and the resulting loss of rental income to NHS Property Services."

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.

The National Pharmacy Association (NPA) highlighted the role played by community pharmacies during pandemic to provide urgent care and vital support to people with long-term medical conditions at its opening remark in the Covid-19 public inquiry held on Tuesday (28 February). NPA is the core participant in the Covid-19 public inquiry. lawyer Brian Stanton made an opening statement on the NPA's behalf which focused on three areas- health inequalities and the needs of vulnerable patients; the impact of medicine shortages and medicine price increases and the challenge that community pharmacy faced in responding to the pandemic and maintaining patient services following long-term under investment. Stanton said: "The UK's community pharmacies were on the frontline of efforts to limit the impact of coronavirus and to keep people well, and as well as handling a massive increase in demand for healthcare advice and medicines, they also continued to provide urgent care and vital support to people with long-term medical conditions. "However, there are now very many at risk of closure during to underfunding and when the Inquiry comes to consider its recommendations the NPA would encourage you [the presiding judge] to think about how resilience can be built into future plans." The statement included a compelling account of the commitment typical of so many pharmacies during the pandemic - from husband and wife Pete and Sukhi Johal, both NPA members and pharmacists, who co-own Calow Pharmacy in Chesterfield.

Community pharmacy workforce is in a fragile condition and faced a shortfall of 3,000 pharmacists in England over a period of five years, a recent research conducted by the Company Chemists' Association (CCA) has revealed. It noted that over the last five years, the net growth of community pharmacists in England a year stood at 733. This is much lower than the required average growth of 1,025, based on data reported by the Health Education England workforce survey from 2021. Acknowledging the discrepancies in the data calculation, the paper published by the association has used "the best available data" to highlight recent changes to the community pharmacy workforce in England. The report noted that despite an increase in the number of pharmacists, many contractors reported an increase in pharmacist vacancies. They also reported a significant increase in locum hourly pay rates, indicating demand exceeds supply.

Levomepromazine 25mg/1ml solution for injection will remain unavailable until the week commencing March 7,2022, Department of Health and Social Care (DHSC) said in an update. While alternative medicines for use in palliative care remain available in ample supply to support an uplift in demand, the date supply resumption of Levomepromazine is yet to be confirmed. The DHSC has sent a copy of this medicine supply notification to all pharmacy NHS email addresses. It further informed primary care providers that prescription validation has been temporarily implemented at wholesaler level.

It's no secret that as pharmacists we are navigating a new and more demanding healthcare landscape. Our role has changed significantly since the start of the 21st century due to increased expectations from the public, advances in science and technology and changing workforce pressures. The Community Pharmacy Contractual Framework for England has placed a higher focus on clinical service. In addition, the Covid-19 pandemic resulted in significant acceleration in changing how we work day-to-day and the public perception of our role. Community pharmacy owners and staff have been under relentless pressure for the last two years. Dispensing volumes are continually increasing but dispensing revenues are being replaced by launching new services. We must find solutions to reduce the time it takes to dispense medication so we can focus on these new revenue generating services. To not just succeed, but to thrive, it is becoming increasingly important to understand and embrace the technology available.

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.

The new Hormone Replacement Therapy (HRT) prescription pre-payment certificate (PPC) has witnessed more than 37,000 purchases both via online website and in-person in pharmacies since its launch on Saturday (1 April). As of 12pm today (4 April), 37,240 HRT PPCs have been bought online and 501 in-pharmacy, totalling 37,741 certificates. Department of Health and Social Care (DHSC) estimated women have saved over £1.13 million in prescription charges for the year, with the average person saving £30 for a year's supply. The new prescription pre-payment certificate is also predicted to enable around 400,000 women to have cheaper access to menopause support. On the launch of the scheme on Saturday, the huge demand for the much-anticipated certificate meant some patients were unable to access the website on the morning of 1 April. "The NHS Business Service Authority has ensured that the site has been working, allowing thousands of women to continue to successfully purchase a prescription for a year's worth of hormone replacement therapy products which help treat the menopause," said DHSC. Minister for Women's Health Strategy, Maria Caulfield said: "Over 37,700 women have come forward to claim cheaper HRT this weekend alone, showing what happens when we listen to what women want.

The Department of Health in Northern Ireland has advised pharmacies to continue providing rota services on Easter after learning that many pharmacies are unwilling to provide the services on Easter holidays. "It is extremely regrettable that community pharmacy representatives have advised that access to rota pharmacies in some parts of Northern Ireland will be reduced over the Easter holidays," department said. They have also stated that despite a commitment of recurrent investment, support for new patients assessed by Trusts as requiring blister packs may be restricted. These actions have the potential to impact on patients and other parts of the Health and Social Care system. The department has also called the CPNI's demand to increase the funding up to 50 per cent in the sector "unrealistic" in the current financial climate. It said: "Financial pressures across the entire NI public sector are severe with an extremely challenging health budget anticipated for 2023/24." "The Department is therefore facing a significant funding gap just to maintain existing services and the whole Health and Social Care system is an extremely unpredictable and fragile position. The core funding envelope available to community pharmacies in NI has increased by 16% over the past three years."

The Competition and Markets Authority (CMA) has launched an investigation following 'rocketing prices of antibiotics in the wake of Strep A cases', Sky News reported on Wednesday (December 14). On Monday, the Department of Health issued a medicine supply notification for antibiotics for the treatment of Strep A. "Supplies of antibiotics for the treatment of Group A Strep have seen a surge in demand and may be temporarily in limited supply at certain wholesalers and pharmacies. Supplies are available with manufacturers, and deliveries into wholesalers and pharmacies are being expedited and are expected in the coming days" said DHSC. Sky quoted a spokesperson for the CMA as saying: "People have got real concerns about the price of antibiotics used to treat Strep A, and we want companies to be clear about their obligations under the law.

The Department of Health and Social Care (DHSC) has issued a medicine supply notification for antibiotics for the treatment of Group A Strep. "Supplies of antibiotics for the treatment of Group A Strep have seen a surge in demand and may be temporarily in limited supply at certain wholesalers and pharmacies," said DHSC. "Supplies are available with manufacturers, and deliveries into wholesalers and pharmacies are being expedited and are expected in the coming days." If the formulation of antibiotic prescribed is unavailable, DHSC has asked clinicians and local pharmacy teams to consider prescribing an alternative form or strength of the antibiotic where appropriate, ensuring the patient is not intolerant to any of the excipients in the alternative and is counselled on the appropriate dose (and volume) required.

The Pharmacists' Defence Association (PDA) has urged the community pharmacies to complete a short survey on the availability of commonly prescribed medicines. PDA is hearing from members working in community pharmacy about challenges they are facing in fulfilling prescriptions for some of the most common medicines, including antibiotics. It wants to hear from pharmacists on the front line about their recent experiences. The association said: "Whilst at this time of year the incidence of infections and illnesses can be heightened, demand is seemingly higher than usual, and we would like to hear more about how this is impacting on you and the patients in your care,"

The Department of Health and Social Care (DHSC) has issued a medicine supply notification for Sulfasalazine 250mg in 5ml oral suspension sugar free; Pilocarpine hydrochloride 4% eye drops; Fluticasone 50microgram / Salmeterol 25microgam (Combisal) pressurised metered dose inhaler (pMDI); and Dalteparin (Fragmin) 10,000units/1mL solution for injection ampoule on Wednesday (21 December). "Sulfasalazine 250mg/5ml oral suspension sugar free is out of stock from w/c 19th December until early June 2023. Sulfasalazine 500mg non-enteric coated tablets remain available "IPS Pharma, Nova Labs, and Rokshaw have currently confirmed they can manufacturer sulfasalazine 250mg/5ml oral suspension," said DHSC. Pilocarpine 4% eye drops are out of stock until w/c 26th December 2022. Alternative strengths of pilocarpine (1% and 2%) eye drops remain available and will be able to support increased demand. Specials of pilocarpine 4% preservative free eye drops are available if the licensed alternatives are not suitable. For off-label use of the 4% drops in the treatment of xerostomia (dry mouth) in palliative care, pilocarpine 5mg tablets are available and are licensed for this indication.

The Royal Pharmaceutical Society (RPS) England Chair Thorrun Govind has called for Government action to support pharmacy teams experiencing huge demand for their services. "Pharmacy teams are under immense pressure at the moment, in common with other NHS services, and working extremely hard with health service colleagues to provide the right care for patients," said Govind. "As winter pressures mount, pharmacies see increased numbers of patients seeking support with illness and also because they have heard other areas of the health service are struggling to cope. The society has also stated staffing pressures, alongside an increase in workload has created an extra burden which takes a toll on the wellbeing of pharmacy teams. Govind added: "Issues such as medicine shortages can also take up many hours of time for pharmacy teams tracking down medicines when they could be directly helping patients. In community pharmacies, rising costs and fairly static funding are adding to business pressures. "However, pharmacies remain the most accessible part of the health service and provide expert advice to patients without the need for an appointment and are open long hours and at weekends."