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Starting from January 2024, it will be compulsory for medicine suppliers in the NHS supply chain in England to submit an Evergreen Sustainable Supplier Assessment each year. Suppliers who fail to submit the sustainability assessment will not be placed on medicines contracts, said NHS England. The NHS has taken this move as part of its ambition to reach carbon net zero by 2045. The Evergreen Sustainable Supplier Assessment is a self-assessment and reporting tool for suppliers to share sustainability information with the NHS. Chris McAleer, medicines net zero project delivery manager at NHS England, announced this new rule at the Guild of Healthcare Pharmacists' Procurement and Distribution Interest Group Autumn Symposium held in Birmingham on 2 November 2023.

The Royal Pharmaceutical Society (RPS) in England and 19 other organisations have written to health secretary Wes Streeting, calling for a cohesive cross-government strategy to tackle medicine shortages across the UK. The letter stresses the need for actions to build supply chain resilience, support UK manufacturing, improve data connectivity, protect access to life-critical medicines, and reduce duplication across the NHS. As the government works on its 10-Year NHS Plan, the signatories emphasise the importance of ensuring patients' continued access to vital medicines, which are "an investment in their health." They underscore that the strategy would require engagement by the government across the NHS and the whole of the medicines supply chain, including manufacturers, suppliers, health professions, and patients. The letter also highlights that delays in accessing medicines could be reduced by changing legislation to empower community pharmacists to make minor amendments to prescriptions when shortages occur.

NHS England has updated its 'Green plan guidance', outlining key actions for Integrated Care Boards (ICBs) and trusts to help achieve net zero carbon emissions. Among the recommended measures to reduce emissions from the medicines supply chain, organisations are asked to encourage patients to return used or expired inhalers to community pharmacies for appropriate disposal. Medicines account for approximately 25 per cent of NHS emissions, with a small number of medications contributing a large portion of this. For example, anaesthetic gases account for 2 per cent of NHS emissions, while inhalers contribute 3 per cent. The updated guidance says that organisations should build on ongoing progress in reducing these "point of use" emissions, while improving patient care and reducing waste. To address emissions from the medicines supply chain, the guidance recommends: Supporting high-quality, lower-carbon respiratory care Optimising inhaler choice by considering clinical appropriateness, the environmental impact of inhalers and patient preference Improving inhaler use and adherence Promoting the appropriate disposal of inhalers Addressing overprescribing and oversupply while ensuring support for patients in greatest need

A report released by the Independent Commission has blamed Brexit supply issues for medicine shortages. NHS is forced to pay extortionate prices to fulfil the demand for vital antibiotics, anti-depressants, Attention Deficit Hyperactivity Disorder (ADHD), and Hormone Replacement Therapy (HRT) drugs. The report highlights the impact of affected medicine supply issues on community pharmacies and patients. Janet Morrison, the chief executive of Community Pharmacy England, backed the report and said that the "medicine shortages and market instability appear to be as bad as they have ever been". She also explained how the Ukraine conflict, the COVID-19 pandemic, and broader economic instability also play a major factor in the situation.

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).

The British Generic Manufacturers Association (BGMA) has raised concerns over the rise in the VPAS rate for 2023 to 26.5 per cent. The Department of Health Social Care (DHSC) today announced that the 2019 voluntary scheme payment percentage for 2023 will be 26.5%. The 2019 voluntary scheme for branded medicines pricing and access is an agreement between the Department of Health and Social Care, NHS England and the Association of the British Pharmaceutical Industry. BGMA believes that the high VPAS tax for 2023 risks more medicines shortages, rising prices for the NHS via reduced competition, and new medicine launches to the UK being deferred. Mark Samuels, Chief Executive of BGMA, said: "Raising the VPAS tax to 26.5% will damage the UK's medicines supply because it will make some products lossmaking. It is more than a five-fold tax increase from 2021, and no industry can cope with this unpredictable and exceptional tax volatility.

Insuman Comb 50 100units/ml suspension for injection 3ml cartridges has been discontinued with stocks being exhausted imminently, notified Department of Health and Social Care (DHSC). The department has issued a medicine supply notification for Insulin isophane biphasic human 50/50 (Insuman Comb 50) 100units/ml suspension for injection 3ml cartridge. "Humolog Mix 50 remains available, as do other biphasic insulin preparations, and the manufacturers can support a full uplift in supply," said DHSC. A copy of this medicine supply notification, including further information, has been sent to all pharmacy NHS email addresses. DHSC and NHSE/I's newly launched online Medicines Supply Tool provides up to date information about medicine supply issues. The contents of these MSNs can now be viewed on the Tool.

Pharmacist supervision has been the subject of debate for as long as I can remember. Strikingly, no one is sure what supervision requires. The Human Medicines Regulations 2012 say it is a criminal offence to sell or supply Pharmacy medicines or Prescription Only Medicines unless a pharmacist makes the sale or supply or, if the transaction is carried out by a non-pharmacist, that person acts under the supervision of a pharmacist. Over the years, some people have argued that supervision requires a clinical check. Others say it requires an accuracy assessment. Yet others have asserted that it requires a final check before a medicine leaves the pharmacy. Things are made more uncertain by the NHS terms of service which require prescription medicines to be supplied under the direct supervision of a pharmacist. No one knows what the word "direct" adds. The wording of the Human Medicines Regulations is not identical to the wording of earlier legislation. In particular, on the only occasions when the courts have been called upon to interpret the requirement for supervision, the Pharmacy and Poisons Act 1933 was in force. In cases decided in 1943 and 1953, the courts decided that a pharmacist who was upstairs when a supply was made could not have been supervising; and that a sale was supervised by pharmacist standing at the cash desk because the pharmacist could intervene if a sale would not be appropriate.

Community Pharmacy England (CPE) has cautioned that patients in the UK will continue to encounter difficulties in accessing medicines unless the government addresses supply problems and resolves the critical financial state of community pharmacies. CPE Chief Executive Janet Morrison and Mike Dent, Director of Pharmacy Funding, on Monday 19 February, gave evidence to the Health and Social Care Select Committee's Pharmacy Inquiry, highlighting the impact of ongoing medicines supply issues on pharmacies and patients. Morrison indicated that a combination of the ongoing "financial squeeze, operational pressures, and medicines supply and pricing issues" has left pharmacy businesses fighting for survival. "As the NHS continues to grapple with wider challenges, this is a battle that patients cannot afford for pharmacies to lose," she said. Morrison warned that if pharmacies continue to close, not only business owners and pharmacy teams will suffer, but patients and local communities will also face the consequences.

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.

The Equality Act (which replaced the Disability Discrimination Act in 2010) is often cited as a reason for supplying medicines in a compliance aid. This is a complex piece of legislation, but, in essence, provides a statutory duty on businesses to make "reasonable adjustments" in relation to the service that they provide to take into account any relevant disability of a service-users. This statutory obligation might include the provision of a compliance aid where a patient would be at a "substantial disadvantage" without. However, the need to provide medicines in a compliance aid under the Equality Act needs careful consideration and is a balancing exercise. The NHS Terms of Service for community pharmacies in England state that medicines should be provided in original packs save in certain circumstances, which include because of patient needs.

he Healthcare Distribution Association (HDA) and the Pharmaceutical Services Negotiation Committee (PSNC) have urged the NHS England and the Department of Health and Social Care (DHSC) to issue urgent communications requesting that all those involved in medicines supply do not hoard, stockpile or over-prescribe Strep A antibiotics. In a statement HDA said that the sudden spike in demand for antibiotics used for the treatment of Strep A has meant that there is not enough of these medicines in the supply chain currently to meet this increased demand. As a result, wholesalers are working extremely hard with manufacturers to increase the supply of antibiotics. It added: "As regards pricing, the prices charged to pharmacies by HDA wholesale distributors will directly reflect the increase in prices wholesalers are having to pay for these medicines from manufacturers at the moment, in order to be able to continue supplying these medicines to pharmacies. This will be the case until supply and demand are more in sync."

A policy brief, developed by researchers from the University of Bath and University of Strathclyde with funding from Sigma Pharmaceuticals, has recommended the Department of Health and Social Care (DHSC) and NHS to increase community pharmacy funding to avoid damaging closures and diminution of quality. The report launched on Wednesday (12 June) at an event in the House of Commons, attended by Members of Parliament, senior policymakers and the pharmacy industry, analysed community pharmacy policies and spoke to stakeholders to explore their opinions of the future of community pharmacy. It was found that patients value their community pharmacies, but staff feel demotivated, insecure and undervalued. Stakeholders and policies suggested that in the future, medicines should be supplied by automated 'hub and spoke' dispensing, enabling community pharmacy staff to provide services that relieve pressure on GP surgeries, such as long-term conditions management, urgent care and public health.

There has been a lot of coverage in the national and pharmaceutical press of the prices being charged to pharmacy owners for certain medicines. Leaving aside the reasons for steep price rises, I have been asked on social media and elsewhere whether pharmacy owners can refuse to supply prescribed medicines if they would make a significant financial loss. Legal obligation The first thing to point out is that the National Health Service Act 2006 imposes a legal duty on the Secretary of State and NHS England to make arrangements for people to receive sufficient prescribed drugs. These arrangements involve the publication of the Drug Tariff. The Drug Tariff includes reimbursement prices or a method for determining prices. Various factors can be taken into account in determining reimbursement prices. The Drug Tariff does not provide a pound for pound reimbursement for medicines that pharmacies supply on NHS prescriptions.

In the parliamentary drop-in-event hosted by Community Pharmacy England last week, Members of Parliament (MPs) questioned the Health Secretary on the rising issue of medicines supply. "Eighteen community pharmacists in my constituency are reporting challenges on medicine supplies. What more is the Minister going to do to get a grip of this situation?", Mike Amesbury MP for Weaver Vale, who was present at the event last week, asked the Health Secretary. In his response, the Health Secretary, Steve Barclay MP said: "We have a long-standing team in the Department focused on medical supplies, which are a continual issue; as a matter of routine business, there are often challenges in that area." The Shadow Pharmacy Minister, Karin Smyth MP, also asked: "People across the country rely on local, accessible pharmacies, but whether it is high street closures or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and other drugs…They have repeatedly announced plans to expand the role of community pharmacies but have failed to update legislation that could possibly help. … Why will they not do so?

NHS England has announced the expansion of Electronic Prescription Service (EPS) to Detained Estate health services in England, starting next month. This means prescribers working in prisons would be able to issue EPS 'To Take Out' (TTO) and urgent prescriptions electronically to community pharmacies, eliminating the need for paper FP10 forms. Currently, around 6,000 of these types of FP10s are issued annually by prisons, according to the NHSBSA. However, with the introduction of EPS, the reliance on this method for supplying medicines to people upon release from prison may change. The NHSE noted that EPS rollout will "significantly improve access to urgent medicines and medicines needed by released patients."

Amendments to the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 along with introduction of a new type of pharmaceutical service come into effect from Tuesday (December 21) and from January 1, 2022. PSNC will be consulted on the new type of enhanced service - the National Enhanced Service (NES), where NHS England and NHS Improvement (NHSE&I) commissions an enhanced service with a service specification that sets standard conditions nationally. Other amendments to the regulations include: Changes in the contractors' terms of service, allowing NHSE&I to introduce a pandemic response programme, by which contractors are required to have various premises and other arrangements for responding to a pandemic. An alternative route to supply pandemic treatments, via a listed prescription items voucher (LPIV). This is a further option for the community pharmacy for supply of treatments or medicines during or in anticipation of pandemic disease;

The growing issue of medicine shortages is posing significant challenges for both patients and pharmacy teams across the UK. According to new data from the Office for National Statistics, 20 per cent of adults who used pharmacy prescription services in the last 28 days experienced delays in receiving their medications. The survey, Experiences of NHS healthcare services in England, revealed that over 13 per cent of patients had to return to the same pharmacy at a later time to obtain their prescriptions. Many patients were forced to visit multiple pharmacies or seek alternative services such as a GP or urgent care due to medicine shortages. Pharmacy teams were added with extra burden to manage and resolve these issues. Despite these challenges, 85 per cent of patients expressed satisfaction with pharmacy services, reflecting the dedication and value of pharmacists and pharmacy teams in the community.

There has been extensive national media coverage today (August 11) on how medicine shortages have forced patients to visit multiple pharmacies to get their prescriptions filled or return to their GP to be prescribed alternative drugs. These media reports have been based on a survey involving more than 1,500 pharmacists in the UK, in which over a half of those polled said that their patients' health had been put at risk in the last six months. In response to a query from Pharmacy Business, the Department of Health and Social Care (DHSC) said it monitors the medicines supply chain closely to prevent any shortages and acts swiftly when any issue arises. A DHSC spokesperson told Pharmacy Business: "We take patient safety extremely seriously and we routinely share information about medicine supply issues directly with the NHS so they can put plans in place to reduce the risk of any shortage impacting patients, including offering alternative medication.

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."