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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).

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 regulators have reduced the notice periods for change to supplementary opening hours for community pharmacy contractors from 1 October 2022. Following the Pharmaceutical Services Negotiating Committee (PSNC)'s discussions with the Department of Health and Social Care (DHSC) and NHS England as part of Year 4 negotiations, it has been agreed that the required notice periods for changes to supplementary opening hours will reduce to five weeks. Community pharmacy contractors who want to change their supplementary opening hours are required by their terms of service to notify NHS England. "If a contractor wants to increase supplementary opening hours at the pharmacy, this can be done with no notice - but notification of the change must still be given to NHS England," said PSNC. "To decrease supplementary opening hours at the pharmacy, at least five weeks' notice must be given to NHS England prior to implementing the change."

NHS England has mandated a business continuity plan for pharmacies dealing with temporary closures from the end of this month. Community Pharmacy England (CPE) has put together a briefing and a template plan to help guide pharmacy owners through the process. It explains what is required in the plan, describes how and when to implement it, and outlines some additional considerations. "This could be added as an annex to your pharmacy's existing business continuity plan. A checklist has also been added, which may be used in the event of a temporary suspension," said CPE. "NHS England will be publishing the approved particulars shortly. NHS England is also still to publish guidance on the amendments to the Pharmaceutical Regulations that came into force on 25th May, which will include guidance on these requirements.

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.

The Pharmaceutical Services Negotiating Committee (PSNC) has been reminding contractors to complete the 2022/23 Community Pharmacy Assurance Framework (CPAF) screening questionnaire by midnight on Wednesday, 31 August 2022. As a result of NHS regulations introduced at the end of 2020, completion of CPAF is now a requirement of the Terms of Service. "Therefore, contractors must complete the screening questionnaire and, if required, the full CPAF questionnaire," said PSNC. It has also recommended that any contractor who has yet to do so takes immediate action. "It should only take approximately 10-20 minutes to complete." Information and instructions on how to complete the screening questionnaire has been shared either via an email from the NHS Business Services Authority (NHSBSA) or from their own Head Office. Contractors are advised to contact NHSBSA by emailing nhsbsa.cpaf@nhs.net if they have not received details of the questionnaire, or if they have any problems or queries completing the questionnaire.

Pharmaceutical Press, the Royal Pharmaceutical Society publishing arm, has announced its partnership with Datapharm Ltd. Under the new partnership, Electronic Medicines Compendium (emc) the latest product to be added to MedicinesComplete, the online medicines information platform from Pharmaceutical Press. MedicinesComplete users can easily search emc information, with direct links to the trusted, clinical guidance from the British National Formulary (BNF). "emc through MedicinesComplete will include printable, ready-to-use patient information leaflets written by manufacturers to use at the point of care, and users will have access to an unlimited number of searches. In addition, emc will also include the full Summary of Product Characteristics (SmPC) document, which accompanies all regulator approved medicines in the UK," said the RPS. Available to all countries outside the UK, emc will be launched early next year on subscription through MedicinesComplete. UK access is available on request.

The General Pharmaceutical Council (GPhC) is mulling over introducing "differentiated fees options to cover the increased regulation needed for online pharmacies." In papers published by the regulator ahead of its meeting on Thursday (December 9), it noted that with increase in number of online and distance-selling pharmacies, the regulation has become "potentially more complex and resource intensive." It highlighted that service provided by online pharmacies pose a high risk "in terms of professional care and professional standards". Only 63 per cent of the 187 inspections of online pharmacies since April 2019, met all standards, against the overall benchmark of 84 per cent, the GPhC said. The independent regulator informed that swift enforcement action has been taken against 48 online pharmacies to address patient safety risks, including 40 conditions notices and 11 improvement notices.

The Department of Health and Social Care has updated the list of community pharmacies eligible for the Pharmacy Access Scheme (PhAS) and approved 43 cases out of 63 applications, bringing the the total number of eligible pharmacies in England to 1,445. Earlier this year, NHS England and NHS Improvement (NHSE&I) invited community pharmacy contractors to apply for a review if they believed there were any inaccuracies in relation to pharmacy premises addresses or unforeseen circumstances affecting access, such as a permanent roadblock. Submitted applications were reviewed by the relevant NHSE&I regional pharmacy contract team, and determined by the relevant pharmaceutical services regulations committees (PSRC). Due to the workload pressures seen over winter, the review deadline was extended, giving contractors applying for a review two full months to complete their applications. This also pushed back the announcement of the outcome of the review, but where an application has been successful, PhAS payments will be backdated to the start of the scheme.

The Royal Pharmaceutical Society (RPS) in England and the National Pharmacy Association (NPA) have jointly released a report addressing the challenges faced by community pharmacy when accessing designated prescribing practitioners (DPPs). This report is the outcome of a multiprofessional roundtable event held in June, which brought together representatives from employers, unions, regulators, and NHS England. The report proposes solutions and collaborative actions to build on the current work to support pharmacists and trainees in securing access to a DPP, enabling more of the pharmacy workforce to become prescribers. James Davies, RPS Director for England, said: "The report published today demonstrates the importance of working collaboratively across employers, education training providers and the NHS to ensure that we can create the prescribers that our patients need for the future. "While there is significant work to continue to do by all parties, this helps us come closer to addressing some of the current DPP challenges for community pharmacy."

The Royal Pharmaceutical Society (RPS) has called pharmacy employers and pharmacy trade unions to come together to a round table meeting to agree on principles for a way forward that ensures patients benefit consistently from access to high quality, adequately staffed, safe pharmacy services. It has also urged the governments, NHS organisations and individual pharmacy teams to define clear prioritisation plans, which can be embedded in organisational business continuity plans which set out the pharmacy services that are essential and must always be provided and can be de-prioritised at specific levels of pressures. The challenges for pharmacies are compounded by the escalating cost of living crisis. With unprecedented levels of burnout among pharmacists, pharmacy closures and the potential for strike action, RPS has called for three things- 'professionalism, respect and prioritisation.'

The Pharmacists' Defence Association (PDA) has begun conciliation with 86 pharmacy companies to safeguard the interests of former LloydsPharmacy pharmacists. The Advisory, Conciliation and Arbitration Service (Acas), a government agency, serves as a mediator between companies and employees to resolve disputes. If the ongoing mediation prove unsuccessful, individual employees retain the option to file claims in the employment tribunal, the PDA has said. The ongoing dispute centres around employers potentially failing to conduct the required consultation under the Transfer of Undertakings (Protection of Employment) regulations (TUPE) with employees and their representatives during employee transfers, the PDA said. The TUPE legislation, known for its complexity and technical nature, applies when a section of the company, like a pharmacy sold as an asset using standard disposal, undergoes a transfer. According to NHS England's recent pharmaceutical list, LloydsPharmacy has either sold or shuttered 461 branches since September 2022. According to NHSE data, as of June 30, the pharmacy chain operates approximately 512 pharmacies in England. This positions it as the third-largest chain after Boots UK and Well Pharmacy.

The Pharmaceutical Services Negotiating Committee announced last week that it is in discussions with the Department of Health and Social Care (DHSC) and NHS England about relieving capacity pressures, such as a relaxation of pharmacy opening hours requirements. PSNC is also scheduling webinars to talk with contactors about the steps they might be willing to take in future, to cut costs, should emergency financial relief fail to materialise. The pharmacy regulator reported that many of its members felt that it was no longer tenable for pharmacies to keep offering all of the free and non-core services to patients that they would like to, and that all contractors should consider what steps they could take to try to safeguard their businesses and their core services for patients. PSNC is also keen to talk to contractors about their current situation and the steps they might be willing to take in future, should emergency relief not be forthcoming.

The Pharmaceutical Defence Association (PDA) has urged health ministers of the UK to take a strict and necessary action against the unnecessary closures of pharmacy. Concerned over the rising number of pharmacy closures, PDA has written an open letter to health secretary Steve Barclay; Robin Swann, health minister for Northern Ireland; Eluned Morgan, minister of health and social services for Wales; and Humza Yousaf, the Scottish health secretary. In its letter, PDA said: "The minister of health must now ensure the regulation of poor business behaviours and be prepared to take over rogue pharmacies, however large their corporate owner may be. If patients' access to NHS services is to be protected from the consequences of avoidable full or part-day pharmacy closures." The association believes it is only a matter of time before serious harm to patients' health will be caused by the decisions of mainly large chains of pharmacies to close some of their branches for all or part of a day, instead of engaging an available pharmacist to cover their agreed opening hours. "While a small number of unforeseen closures have always occurred from time to time in pharmacies for genuine reasons, the indiscriminate scale at which closures have now become commonplace seems to have evolved over the last 20 months."

The Royal Pharmaceutical Society (RPS) and Pharmacist Support hosted a roundtable on the impact of pharmacy workforce wellbeing on patient safety on Wednesday (17 May). It also released its annual Workforce Wellbeing Survey which showed continued pressures on pharmacy teams. The discussion explored the actions needed to support staff so they can continue providing safe and effective patient care and included representatives from the NHS, professional bodies, employers, trade unions, education and regulators. A report of the roundtable will be published in the summer. Amandeep Doll, RPS Head of Professional Belonging, said: "We know that pharmacy teams go above and beyond for their patients, but are also under enormous pressure. "Now more than ever, we need to strive to make the pharmacy profession more inclusive and ensure that everyone's wellbeing is supported. "It is vital that we do all we can to encourage people into pharmacy and to support them so they can enhance their skills, develop their careers, and continue to deliver high-quality patient care. "This discussion was a welcome step and showed that making a difference for staff wellbeing requires a concerted effort from stakeholders across the whole of pharmacy.