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The 2025/26 pharmacy contract consultation will include a review of the medicine margin and reimbursement arrangements, health and care minister Stephen Kinnock has confirmed. Kinnock made this statement in response to a written question from Nick Timothy, Conservative MP for West Suffolk, who asked the secretary of state for health and social care, if he will review the reimbursement system for pharmacies and GP practices dispensing medicines. Kinnock stated that consultation with Community Pharmacy England (CPE) for the 2025/26 Community Pharmacy Contractual Framework (CPCF) has started and will include "reviewing the allowance for medicine margin as part of funding, and any further changes to the reimbursement arrangements." However, he clarified that there are currently no plans to review the reimbursement system for general practices (GPs) dispensing medicines. Kinnock said: "Dispensing practices receive a dispensing fee, approximately £2.00 to £2.30 per item, which is intended to cover dispensing costs. "This fee is calculated based on forecasted volumes of prescriptions to be dispensed and the size of the funding envelope, according to a methodology agreed by the Department, the General Practitioners Committee (GPC), NHS Employers, and the Welsh Government."

The regulatory amendments proposed will enable pharmacists to dispense medicines in their original packaging for private prescriptions starting this Autumn, according to the Department of Health and Social Care. In the recently published draft OPD regulations, the DHSC has indicated that the alterations, permitting pharmacists to vary the dispensed quantity by up to 10 per cent to avoid splitting medicine packs, will be implemented for private prescriptions 'immediately upon the enforcement of the Human Medicines Amendment Regulations in the autumn,' as highlighted in a briefing by Community Pharmacy England. CPE stated that the regulations related to NHS prescriptions will come into effect when the pharmaceutical terms of service regulations expressly apply the OPD amendments. Moreover, new directive mandating the dispensing of sodium valproate products solely in their original packaging (except when an assessment of risk necessitates an alternative approach) will align with the rollout of the private prescription regulations during the autumn. CPE further noted that these regulations are currently in draft, indicating that they are not currently in effect and may undergo revisions prior to their implementation.

Pharmaceutical Services Negotiating Committee (PSNC) has expressed its support for alterations in the Human Medicines Regulations 2012 to enable original pack dispensing (OPD) and supply of medicines containing sodium valproate by pharmacists. PSNC's support for changes was in response to the consultation on OPD, initiated by the Department of Health and Social Care (DHSC). The consultation had proposed regulatory changes to allow pharmacists to dispense (up to 10 per cent) more or less than the prescribed quantity of a given medicine in the manufacturer's original packs. Key aims of the proposal are to "support increased patient safety by ensuring patients receive the necessary information that is included in the original manufacturer's packaging about the safe and effective use of a product," DHSC said.

The Department of Health and Social Care (DHSC) has commenced a consultation on allowing pharmacists to dispense prescription medicines in original packaging. The consultation, closing on December 13, 2021, proposes changes to the Human Medicines Regulations (HMRs). It would allow pharmacists to dispense more or less than the 10 per cent of the prescribed quantity in original packs, except where this would affect the patient's clinical treatment. The change would not apply to controlled drugs. The second proposed change is to supply sodium valproate in original packaging regardless of the conditions set around Original Pack Dispensing (OPD). Currently, contractors have to supply the exact quantity prescribed, unless certain exceptions apply.

Recognising the changing practices in healthcare, the Royal Pharmaceutical Society (RPS) has revised and updated its position on the separation of prescribing and dispensing or administration of a medicine by the same healthcare professional. It's previous guidance, published in March 2020, restricted prescribing and dispensing by the same healthcare professional only in exceptional circumstances. The new guidance, jointly developed with the Royal College of Nursing (RCN), has made prescribing and dispensing of medicines more flexible. It clarifies that "where there is a risk assessment in place and in the best interests of the patient, the same healthcare professional can be responsible for the prescribing and dispensing / supply / administration of medicines." The change in the position statement follows an extensive year-long engagement exercise with medical associations, members, fellows, expert advisory groups, patient groups and the RPS Country Boards.

While responding to the consultation on hub and spoke dispensing, trade unions for pharmacists have emphasised that the patient safety and care must be the priority in hub and spoke dispensing. The Royal Pharmaceutical Society (RPS) has welcomed the opportunity provided by a change in legislation to enable community pharmacies to make use of hub and spoke dispensing but reaffirmed that patient care must be at the heart of future changes. With regards to patient safety, the Pharmaceutical Services Negotiating Committee (PSNC) considers that only Model 1 is appropriate, with manageable risks related to patient safety, and is a model that has the potential to allow the whole sector to benefit fairly. In its response to the consultation on Hub and Spoke dispensing, PSNC highlighted that Model 2 in the consultation, a hub direct to patient supply of dispensed medicines, raises patient safety issues and it cannot be supported. RPS President Professor Claire Anderson said: "In all models, patients need to continue to have access to a pharmacist at the time of supply of medicines so they have the opportunity to discuss, ask questions or raise concerns, and receive appropriate information with counselling and advice.

The Dispensing Doctors' Association (DDA) is advising patients left deserted due to pharmacy closures in rural areas to consult their general practice about accessing the GP dispensing service. This recommendation comes in response to concerns that England's rural areas are increasingly becoming pharmacy 'deserts', posing challenges for residents to access essential medications and healthcare services. DDA chairman Dr Richard West said: "The GP dispensing service is designed to ensure NHS medicine supply in areas where people have little or no access to a pharmacy service. "People in rural areas who now live more than a mile from a pharmacy should speak to their GP about whether they can receive the NHS GP dispensing service."

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.

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.

Dispensing activity by community pharmacy in England has witnessed a 4.2 per cent increase across the year 2021 till March 2022, the Pharmacy Market Review 2022 report revealed. The report launched by Christie & Co, said: "All pharmacy settings saw improvements in dispensing numbers, with standard community settings seeing the highest increase of 4.2 per cent, with the average moving to 7,173 items, albeit still below the combined average." "The independent sector fared better than corporate pharmacy, with a combined average increase of 3.5 per cent versus a 1.8 per cent increase in corporate dispensing. Despite some improvement, integrated pharmacies remained the lowest at 1.9 per cent, in part due to the continued restrictions on patient access." Dispensing activity for England across the year to March 2022 increased by 4.5 per cent to an average of 7,765 items per month, reversing the decline witnessed in 2021.

Pharmacies in England will soon be allowed to dispense up to 10 per cent more or less than the quantity prescribed for NHS prescriptions, thanks to the introduction of new original pack dispensing (OPD) rules. These changes are part of regulatory amendments laid on Tuesday, 3 September, and will come into effect over the coming months. The amendments are being made to the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2024 (PLPS). Starting 1 January 2025, pharmacies will have the option to adjust the prescribed quantity by up to 10 per cent for NHS prescriptions so medicines can be supplied in their original manufacturer's pack. Earlier in October 2023, changes to the Human Medicines Regulations (HMRs) permitted pharmacies to dispense up to 10 per cent more or less than the prescribed quantity for private prescriptions of Prescription Only Medicines (POMs).

Centred Solutions has been at the forefront of the pharmacy hub and spoke dispensing in England over the last few years. We have already demonstrated that hub and spoke dispensing is a realistic model of dispensing for pharmacy groups of all sizes. We've seen the massive difference that hub and spoke can make to community pharmacy. With pharmacies struggling to survive, the time has come to stop delaying and to now push ahead with model one of hub and spoke dispensing. In our experience, there is no risk with moving ahead with model one of hub and spoke legislation which would allow medicines to be returned from the hub to the pharmacy ready to be dispensed to the patient. We do however understand the need for more policy discussion around the second model of hub and spoke, where the hub sends the medication directly to the patient. This should not delay the implementation of model one. This model would immediately level the playing field for smaller and independent pharmacies, allowing them to use a hub and spoke model of their choice now to create capacity for clinical services. We feel strongly about this issue and that's why we are working alongside HubRx and PillTime to raise awareness.

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.

The General Pharmaceutical Council (GPhC) has published updated guidance on online pharmacy services in Great Britain, introducing additional safeguards to prevent unsafe supply of high-risk medicines, including weight loss injections. Under the new rules, medicines used for weight-management and medicines requiring physical examination before a prescribing decision is made have been added to the list of high-risk medicines. When prescribing these medicines, prescribers can no longer rely solely on online questionnaires. Instead, they must independently verify patient information, either through timely two-way communication with the person, accessing the person's clinical records, or contacting the person's GP, their regular prescriber, or a third-party provider. These measures aim to prevent individuals from providing false information to obtain medicines that may not be clinically appropriate for them, reducing potential harm. The pharmacy regulator updated its guidance in response to concerns identified relating to unsafe prescribing and supply of medicines online.

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.

The Medicines and Healthcare products Regulatory Agency (MHRA) has reclassified codeine linctus, a medicine used for the treatment of dry cough, from a pharmacy-only medicine (P) to a prescription-only medicine (POM) owing to the risk of dependence, addiction, and overdose. This implies that the dry cough syrup, which is also known as codeine oral solution, can only be dispensed upon the submission of a prescription at a pharmacy, rather than being accessible over the counter upon request. Patients are cautioned that as an opioid medicine, codeine can be addictive, and the risk of addiction may increase, particularly with prolonged use over an extended period. According to the medicines regulator, codeine is converted into morphine by the liver enzyme CYP2D6. In individuals identified as ultra-rapid metabolizers, this conversion from codeine to morphine occurs at a faster rate than in others. "If you want to stop taking it and have been taking codeine linctus for a long time, then it is important to reduce the amount you take slowly with the help of your prescriber," the agency said in its drug safety update issued on Tuesday, 20 February.

The Medicines and Healthcare products Regulatory Agency (MHRA) has cautioned against buying weight-loss medicines without a prescription from beauty salons, unregistered pharmacy websites or social media platforms as such products could pose "serious health risks." Consumers are reminded that the only safe way to obtain genuine weight-loss medication is through a legitimate pharmacy, including licensed online pharmacies, with a prescription from a qualified healthcare professional. To combat the illegal sale of these medicines, the MHRA's Criminal Enforcement Unit is working closely with social media platforms, technology companies, the police and Border Force. Andy Morling, MHRA deputy director of Criminal Enforcement, highlighted the dangers of purchasing these medications from unverified sources: "At this time of year, with many of us thinking about shedding a little excess weight, we see people offering weight loss medicines for sale as a quick fix, without a healthcare professional's prescription, from beauty salons, websites and on social media. "These are not cosmetic treatments; they are powerful medicines that can only be legally and safely dispensed against a prescription issued by a healthcare professional."

Our Totton branch has an incredibly high volume of original pack dispensing, roughly 45,000 items. As we became busier and busier in the dispensary we were finding that our pharmacists, dispensers and other technicians simply didn't have capacity to deliver the services that we needed them to. We all know there is a real emphasis right now on pharmacies doing more services and we knew we had to change the way we operate to survive. So we decided it was time to look into a sound automation solution for our medication dispensing process, one that would allow us to free up the time of the pharmacists and the rest of the team so they could better support patients. After a lot of research we invested in Centred Solutions FLOWRx Hub and InStore solutions which were installed late last year. It provides us with the whole package and has automated our entire dispensing process from picking to packing and labeling to checking. Our situation was quite unique as we bought the system initially for our existing high-volume pharmacy in Totton so the hub and the spoke are actually on the same site. People wouldn't usually look at a hub and spoke solution for that kind of set up but it has allowed us to significantly free up time in store for more services. What it has also done is allow us to look at other opportunities to grow and expand. The pharmacy landscape is changing and there are lots of opportunities coming up. We have found that having your technology and the right infrastructure in place to support your existing footprint before you expand is the ideal way to grow in a safe and controlled way. We never thought that five years ago we would buy another pharmacy, yet we have already bought one and are now in the process of buying two more. I'm not worried about the increase in volume this expansion will bring because I know our technology is going to be able to support it. The pharmacies we are buying are struggling but having our solution already in place m

In response to a recent Parliamentary question regarding pharmacy reimbursement, pharmacy minister Stephen Kinnock stated that pharmacies were permitted to retain £850 million from the medicine margin for 2023/24. The medicine margin represents the difference between the product price reimbursed by the National Health Service (NHS) and the price at which pharmacies buy them. Rebecca Smith, the Conservative MP for South West Devon, inquired about the number and proportion of community pharmacies that had dispensed medications at a loss over the past three years. Kinnock replied that they do not hold this information, and explained that community pharmacy reimbursement arrangements "do not aim to ensure that every pharmacy is paid as much or more than it paid for every product, but aims overall to reimburse as much as they were bought for, plus the allowed medicine margin." Additionally, the minister highlighted that as part of the Community Pharmacy Contractual Framework (CPCF) for 2023/24, pharmacies are allowed to retain "£850 million from the medicine margin, on top of what they are paid for the medicines they purchase as part of providing NHS services."

The All-Party Parliamentary Group (APPG) on Pharmacy has launched an inquiry into the ongoing issue of medicines shortages in England, focusing on their impact, contributing factors and potential solutions. As part of this inquiry, the APPG has issued a call for written evidence from key stakeholders across the healthcare sector, including pharmacists, pharmacy teams, GPs, prescribers, patient groups, professional organisations and medicines manufacturers and distributors. This inquiry comes in response to the growing concerns about the impact of medicines shortages on patient care and the challenges faced by pharmacy teams in dispensing medicines in a timely way. The APPG aims to develop practical recommendations to address this ongoing challenge and its impact.