There is clear evidence that the majority of distance selling pharmacies are operating in breach of their NHS contracts, and a failure to properly
regulate 'pseudo' distance selling pharmacies is leading to local pharmacy closures, the Company Chemists' Association has reported.
According to the CCA's recent findings, 72 per cent of DSPs dispense over 50 per cent of their prescriptions to patients within a single postcode area within
10 miles of the pharmacy.
"Operating within constrained geographical regions, pseudo-DSPs achieve reduced overheads and operational costs by focusing on localised marketing and medicine
delivery. They compete against local brick-and-mortar pharmacies, causing them to lose vital trade," the CCA claimed, based on its recent survey - The Impact of
Pseudo Distance Selling Pharmacies.
"As per their terms of service, DSPs are obligated to provide prescription delivery nationwide, extending beyond local patients," said the CCA, adding that the
financial savings resulting from the lack of patient access are balanced by the necessity to function on a national scale.
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 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 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 NHS claims that it's been able to save taxpayers £1.2 billion in just three years by procuring hundreds of hospital medicines at a better price.
The adoption of cheaper versions of a single drug - adalimumab - which is used to treat more than 45,000 patients with rheumatoid arthritis, inflammatory bowel
disease and psoriasis, has accounted for about one third of the savings.
After the exclusive patent on the drug - originally known as its brand name Humira - expired in 2018, the NHS struck cost-saving deals to bulk-buy generic versions,
which have the same quality, safety and efficacy of a branded one.
Since then, tens of millions of pounds have been saved by buying cheaper generic versions of other medicines for conditions ranging from severe skin infections to
aggressive blood cancers.
Four in five medicines prescribed in the NHS are now non-branded, helping the NHS to achieve significant savings while ensuring the continuity of high-quality
patient care.
NHS chief executive Amanda Pritchard said: "Smart deals by the NHS mean patients are getting the best medicines and taxpayers are getting best value.
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.
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 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.
As the deadline for the frontline healthcare workers to get fully vaccinated approaches, tens of thousands of NHS staff who have not yet taken the Covid-19
vaccine face termination in just a fortnight.
Although it is estimated that the majority of NHS staff have been fully jabbed, health and social care providers in England will soon be needed to ensure that all those working in areas regulated by the Care Quality Commission (CQC), are fully vaccinated against Covid-19 before the April 1, 2022.
Those who are exempted from taking the vaccination do not fall under this purview.
According to the NHS England guidance around Vaccination as a Condition of Deployment (VCOD) for healthcare workers, all frontline staff must have had both the doses by April 1, meaning that by February 3 the first must have been administered and the second by March 31.
All unvaccinated frontline workers will be called into formal meetings from February 4 and given a warning of dismissal. Notices will then be issued from that day, with March 31 marking the end of the notice period
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.
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.
Novo Nordisk, the Danish drug manufacturer, has launched Wegovy, a weight-loss drug, in the UK market. This semaglutide injection will be available
through specialist NHS weight management services for those who meet the National Institute for Care and Excellence (NICE) criteria or privately through
registered healthcare professionals.
Novo Nordisk allocated a portion of the available supply of Wegovy for NHS services, while confirming the existing shortage of semaglutide and projecting
continued constraints in the foreseeable future. The drug can be obtained through the NHS and is additionally accessible for private purchase at pharmacies in the UK.
The pricing for a one-month supply varies, ranging from £73.25 to £175.80, depending on the dosage.
"We are committed to expanding treatment options for individuals with obesity and share the Government's goal of improving access to obesity care in areas of high
unmet medical need," the company said in a statement. "We are closely monitoring Wegovy demand and collaborating with regulators and providers to ensure access
to and continuity of treatment for people living with obesity."
The UK government will lay legislation today (13 December 2023) to allow the General Medical Council (GMC) to begin the process of regulating medical
associates to expand their roles in the NHS.
This will support plans to reduce pressure on doctors and GPs and improve access for patients, the Department of Health and Social Care (DHSC) said.
Physician associates (PAs) and anaesthesia associates (AAs) will have the same levels of regulatory oversight and accountability as doctors and other regulated
healthcare professionals once the regulations come into force, which is expected at the end of 2024.
The GMC will design and deliver detailed regulatory processes for registration, education, standards and fitness to practise for both professions.
Paydens Pharmacy Group, one of the first multiple pharmacies to adopt hub and spoke model last year, revealed that the move has resulted in significant time
savings in store.
Centralising dispensing of repeat prescriptions relieves pressure in pharmacy branches and releases time to deliver revenue generating services, the group said.
The group created a hub in Maidstone, Kent, to service its highest dispensing branches. The hub uses Centred Solution's FLOWRx Hub Auto to dispense their original
pack repeat prescriptions. The group put in the first FLOWRx Hub production line in spring 2022 and then added in a second line in the autumn as they increased
production and moved more stores to the hub and spoke model.
The innovative solution interfaces with EMIS PMR, Omnicell's Robotic Dispensing System and Universal Logistics Management software as well as Victoria OS ordering
software.
The hub operation runs during the day Monday to Friday and produces an average of 33,289 packs per week for just under 9,000 patients, leaving plenty of scope to
ramp up. The hub is currently dispensing 79.7% of repeat prescription original packs requested by the group's busiest stores.
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.
All children aged five to 11 in England will be offered a Covid-19 vaccine, the government said on Wednesday (February 16) - following similar announcements
in the rest of the UK.
The move, coming nearly two months after British regulators approved Pfizer and BioNTech's shot for use among the age group, sees Britain following the lead of the
United States, the European Union and other countries.
It has only been vaccinating at-risk under-12s and those who live with immuno-suppressed people, using a lower-dose formulation of the jab that was found to be "safe
and effective".
However, health secretary Sajid Javid - who has responsibility for England only - said he had now accepted guidance from the Joint Committee on Vaccination and
Immunisation, which advises UK health departments, to expand the rollout.
"The NHS will prepare to extend this non-urgent offer to all children during April so parents can, if they want, take up the offer to increase protection against
potential future waves of Covid-19 as we learn to live with this virus," he said in a statement.
Britain's Covid booster campaign is set to kick off this September, after the country became the first in the world to approve an Omicron-adapted shot.
Around 26 million people in Britain are estimated to be eligible for an autumn Covid-19 booster, having had at least two Covid vaccine doses already, a UK Health
Security Agency (UKHSA) spokesperson said.
The preference is to deploy what is known as a "bivalent vaccine" that targets both the original virus and the Omicron variant through the autumn campaign, but that
will depend on the health regulator (MHRA) approving such shots and the state of vaccine supplies.
The UK's Joint Committee on Vaccination and Immunisation (JCVI) has advised boosters should be given to over-50s, individuals in clinical risk groups, frontline
workers and care-home staff ahead of the winter, when respiratory viruses are typically at their peak.
On Monday (August 15), the MHRA gave Moderna's bivalent shot conditional approval.
The endorsement of the vaccine is based on data that showed it produced a marginally better immune response against some Omicron variants, versus the original novel
coronavirus - although whether that translates into stronger protection against serious disease is unclear.
To help manage the ongoing supply disruptions, the health regulators have extended to 28 October 2022, serious shortage protocols (SSPs) for 12 of the 13
hormone replacement therapies (HRT).
"The only HRT SSP set to expire on 29 July 2022 is for SSP021 Premique low dose 0.3mg/1.5mg modified-release tablets. After 29 July, there will be no need to
restrict quantities of Premique tablets as its supply situation has now stabilised," said PSNC.
In addition, the dose equivalence advice and endorsement guidance for SSP024 and SSP025 have been updated.
SSP024 and SSP025 have been updated by DHSC to provide greater clarity to pharmacists on the dose equivalences to determine the appropriate quantity to supply.
Pharmacists are asked to refer to the latest SSP versions and endorsement guidance published on NHSBSA's website.