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Talk of hub and spoke models has been rumbling on for as long as I can remember. The topic has once again hit the headlines as the government announced a fresh consultation for its proposed changes, calling on all interested parties to submit their views by 8th June. The argument for hub and spoke is to allow independents to have the same level playing field as the larger groups who have been operating this model for some time. The government also sees significant efficiency gains in centralisation, arguing this will free pharmacists time away from dispensing to focus on clinical services. The latest consultation advocates two models being created. In the first model, the dispensed medication is sent back to the spoke. In the second model, the completed medication can be sent out directly to the patient. The latter is a new concept which could open up new opportunities in how services are delivered. Pharmacies could effectively outsource the entire dispensing and delivery to housebound patients and care homes allowing pharmacies to take on new business without having to worry about logistics and geography.

In a move to make healthcare more accessible, the Department of Health and Social Care (DHSC) has announced plans to empower pharmacy technicians, dental therapists, and hygienists with enhanced authority following two public consultations run by the government in 2023. Revealed by Primary Care Minister Andrea Leadsom on Thursday 28th March, this strategic decision promises to usher in "a faster, simpler, and fairer access to primary care" by granting pharmacy professionals "the ability to both supply and administer medications". Based on the public consultations that garnered widespread support, with 97% backing the empowerment of dental hygienists and therapists and 84% favouring similar rights for pharmacy technicians, the new reform is aimed to cut through bureaucratic red tape and bolster efficiency in patient care. Dental hygienists and therapists, under the proposed change, will be empowered to administer select medications, including pain relief and fluoride, without the need for dentist approval.

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Pharmacists are a vital member of the multidisciplinary team (MDT) supporting older people to manage their pain. The pharmacist is uniquely positioned to holistically review drug interactions and potential risks associated with each patient's medication and has the expertise to suggest alternative treatment options to reduce the risks associated with polypharmacy or unwanted side effects caused by other medications. Chronic pain The International Association for the Study of Pain defines pain as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Although universally experienced by everyone, the perception of pain is a deeply personal experience influenced by biological, psychological, and social factors, and constitutes an essential behavioural feedback mechanism aimed at protecting us from harm. Pain may be perceived as either acute or chronic. Chronic pain, defined as pain that persists longer than the normal healing time, constitutes a substantial healthcare burden, affecting approximately 20 per cent of people worldwide and accounts for 15-20 per cent of physician consultations. Chronic pain is often associated with disrupted mood and sleep, substance misuse and other chronic conditions. Additionally, comorbidities of chronic pain may also lead to complex medication regimens that increase the risks of adverse drug interactions and unwanted side effects.

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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 Department of Health (DoH) is inviting the public to share their views on a new Regional Obesity Management Service and a new Obesity Strategic Framework. A public consultation has been launched on the Healthy Futures strategic framework, which aims to prevent the harm caused by obesity, and improve diets and levels of physical activity of people. The Department is also seeking views on its plans to introduce a new service that would focus on the introduction of specialist support, weight loss medication, and bariatric surgery to help people living with obesity. Northern Ireland is seeing an increase in obesity rates, with the latest Health Survey NI data showing that 65 per cent of adults and 26 per cent of children in the country are either obese or overweight.

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"Our main concerns are that the use of what they call an asynchronous supply, where the prescriber neither sees nor talks to the patient at the time they issue the prescription, does lay itself open to perhaps people getting hold of medication that they shouldn't," the Head of Policy, PDA said. The Pharmacists' Defence Association (PDA) engages in a critical conversation on BBC Radio 4's Woman's Hour, shedding light on the online prescribing of weight loss drugs and advocating for safer practices. The PDA's spokesperson, Head of Policy Alima Batchelor, emphasised the importance of adhering to professional guidelines to ensure patient safety and mitigate regulatory concerns. During the feature, the PDA highlighted the complexities and risks associated with online supply chains, stressing the necessity for direct clinical consultations and pharmacist involvement in medication management. ""There are guidelines and advice about verification within the DiCE guidance, but it doesn't go quite far enough for us. We are concerned when patients decline to allow the online prescriber to advise their GP of what they're taking," Batchelor highlighted.

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In a recent survey of 2,000 UK adults, 34 per cent preferred consulting pharmacists for health advice after researching symptoms, while for those surveyed specifically from Wales, this figure increased to 35 per cent, according to 2San - a global supplier of healthcare products and solutions. The survey said women had a higher tendency, with 39 per cent seeking their pharmacist's guidance compared to 29 per cent of men surveyed. According to the survey findings, over one-fifth of people in the UK are turning to pharmacists instead of their primary care physician or doctor for guidance and advice with medical symptoms. "With more than 38 million patients in the UK waiting more than two weeks for a GP appointment, it is unsurprising that 34 per cent of people surveyed asked a pharmacist for advice over their primary care physician/doctor in the last 12 months," 2san said. In Wales, over a third of people prefer their community pharmacist for support and advice, while those aged 65 and above still tend to consult their primary care physician.

The Medicines and Healthcare products Regulatory Agency (MHRA) has launched a consultation on the reclassification of codeine linctus to a prescription-only medicine after considering multiple Yellow Card reports for its opioid effects, rather than for its intended use as a cough suppressant. This medication is currently licensed as a pharmacy medicine, which means that it is available to purchase over the counter in pharmacies. If reclassified as a prescription-only medicine, all strengths of codeine linctus will only be available upon presentation of a prescription. Dr Alison Cave, MHRA Chief Safety Officer, said: "Codeine linctus is an effective medicine, but as it is an opioid, its misuse and abuse can have major health consequences. Every response received will help us to develop a broader view on whether codeine linctus should be restricted to prescription-only status. We want to hear from members of the public, health professionals and others who would be affected by this potential change so we can make a properly considered decision for the benefit of patients, carers, and healthcare professionals across the UK.

Superdrug has unveiled its new fertility test service to help women to easily access information about their own fertility and enables them to take greater control of their reproductive health. The service comprises a Superdrug online doctor consultation and personalised fertility test recommendations to help women make more informed decisions about the options available to them. Superdrug's fertility test initial consultation requires customers to fill out a quick online questionnaire. This is then reviewed by Superdrug's team of online doctors, who will work with the patients to identify which fertility tests are best suited to the individual. The new service also sees Superdrug introduce three new fertility blood tests to its portfolio, ensuring greater choice and accessibility. Dr Sara Kayat, Superdrug's medical ambassador comments, "For women that have been trying to get pregnant and not succeeding, or for those who are just curious about their fertility, easy access to blood tests may help provide answers and signpost them in the right direction."

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