Community Pharmacy England (CPE) has urged pharmacy owners to maintain the safety of their services while managing the additional workload brought on
by the collective action of GP services, starting today (Thursday, 1 August).
General practices across England have begun implementing a work-to-rule strategy indefinitely, following a ballot of GP partners conducted by the British
Medical Association (BMA).
Under this approach, GP practices will strictly adhere to contracted hours and duties, performing only the tasks specified in their NHS contract.
With fewer GP appointments available, it is anticipated that more patients will turn to their community pharmacies for help and advice.
Therefore, CPE has stressed the importance of pharmacy owners maintaining the safety of their services, with a focus on the safe supply of medicines, during
this period of GP collective action.
A Lake District pharmacy is grappling with significant medication supply issues, affecting its ability to provide essential drugs to customers amidst
nationwide drug shortages.
According to Simon Butterworth, whose family has operated Collins & Butterworth Pharmacy in Hawkshead for nearly 40 years, voiced his concerns to the ITV stating
that the staff is "having to spend time hunting for (medications), looking for it or doing our best to find ways to solve that problem" for distressed patients.
"They've got to know when they can get the medications they need," he added.
Butterworth also highlighted the financial strain pharmacies face due to the NHS's fixed tariff system.
"Certain items are actually costing more to buy than we get paid for them by the NHS. An item we were trying to get this morning was 250 per cent higher than the
tariff price, which is significant and builds up over lots of items," he explained.
The Department of Health in Northern Ireland has announced an immediate intervention worth over £5.3m in value, and a commitment to progress wider reform
arrangements in collaboration with the Community Pharmacy NI (CPNI) to support pharmacies to deal with the ongoing pressure.
The Minister and Department are 'very aware of the pressures facing community pharmacies'. They discussed the situation with CPNI representatives at a meeting last
week. The scale of the unprecedented budgetary pressures and uncertainty currently facing the Department were spelt out.
The Department said: "Notwithstanding these pressures, CPNI were informed that a support package for their sector was being finalised. This package includes immediate
interventions worth over £5.3m in value, plus a commitment to progress wider reform arrangements in collaboration with CPNI."
Recently, the CPNI highlighted that community pharmacists have issued a stark warning that shortages and skyrocketing prices of many medicines could result in
pharmacies being unable to supply important prescription medicines to patients.
The Department of Health and Social Care (DHSC) has issued a medicine supply notification for Dioralyte oral rehydration sachets.
"Dioralyte oral rehydration sachets are expected to be in limited supply until late December 2022. St Mark's solution is available as an unlicensed special and can
support an uplift in demand," said DHSC.
"Kidderminster formula is available as an unlicensed special and can support a partial uplift in demand. As an alternative to the unlicensed specials, the individual
components can be purchased from community pharmacies and supermarkets or prescribed, but there have been intermittent supply issues with glucose powder."
Diluted apple juice has been reported to be a potential alternative to electrolyte maintenance fluids in children with mild gastroenteritis and minimal dehydration.
If there is currently no listing on dm+d for the imported product for prescribers to select using their prescribing systems an EPS prescription for unlicensed St
Mark's solution cannot be issued.
Instability in the supply chain network is frequently undermining the profit margins in community pharmacies, former Pharmacy Minister and Chair of the Health
and Social Care Committee Steve Brine has said.
Brine emphasised that community pharmacies often lack information about the prices wholesalers charge for essential generic medications. "They lack visibility
into scarcity, and the pricing of these products is often significantly higher compared to other European countries," the former minister remarked during a
parliamentary debate focused on the future of community pharmacies on September 14.
From financial pressures to workforce crisis and pharmacy closures, the debate delved into critical challenges faced by pharmacies, aiming to propose tangible
solutions for a sustainable future in the sector.
Chaired by Sir Mark Hendrik, the debate was initiated by Conservative MP Peter Aldous and featured contributions from a host of participants including Labour MPs
Taiwo Owatemi and George Howarth among others.
Considering the shortage of Fluoxetine 10mg tablets, the Department of Health and Social Care (DHSC) has extended the serious shortage protocol (SSP) for the medicine to February 11, 2022.
Earlier the SSP for Fluoxetine 10mg tablets was set to expire on November 12.
Extension of the transition period will enable use of No Cheaper Stock Obtainable (NCSO) endorsement and use of EPS tokens to claim for supplies made in accordance
with SSPs.
The NHS Business Services Authority (NHSBSA) has accepted that either the new 'SSP' or existing 'NCSO' endorsement for any SSP claims can be submitted using electronic prescriptions (EPS) tokens of FP10 paper prescriptions, during the period.
The Pharmaceutical Services Negotiating Committee (PSNC)'s members are seeking immediate rescue packages for the sector to help with energy bills and to ease
capacity constraints.
In a meeting held on 14th and 15th September, the committee members expressed their anger and frustration on the reluctance of NHS England and government to fund
pharmacy sustainably.
The meeting was held to consider practical steps to ease the pressures on the community pharmacy sector, and to oversee the progress of negotiations on the Community
Pharmacy Contractual Framework (CPCF) and other work.
Committee members, as pharmacy contractors, shared their experiences of the current pressures on all contractors, including the inability to deliver some services
and to maintain core service levels; the capacity and workforce crises facing the sector; the critical need for funding support this winter; and the urgent need for
Government to adapt the Price Concessions system to meet the needs of contractors.
"The Price Concessions system is no longer working for contractors in the current volatile medicine supply environment and PSNC is clear this is not acceptable,"
said the committee.
Amid the ongoing furore over shortages of Lateral Flow Device (LFD) test kits that led pharmacy staff to bear customers' wrath, the National Pharmacy Association (NPA) and Company Chemists Association (CCA) have jointly appealed the public to be "patient and courteous to pharmacy teams".
In an open letter, the two organisations have urged patients and customers to be patient, courteous and safe while visiting their local pharmacies.
Highlighting the efforts put in by healthcare workers to keep everyone safe through this tough winter, the two organisations said the pressure of Covid-19 and shortage of LFD kits have sometimes led to verbal abuse of pharmacy staff.
Mark Lyonette, NPA chief executive said: "The vast majority of pharmacy customers and patients are polite and understanding. The supply situation with Lateral Flow Tests is stretching people's patience, but that's no excuse for abusive behaviour and people need to understand the constraints on pharmacy teams at this time."
Alongside their routine job of providing medicines, health advice and a range of NHS services, pharmacies have put in extra effort to protect people during the pandemic.
A full CPE Committee Meeting was organised in London on April 17 and 18, 2024, to discuss crucial sectoral issues.
Key topics discussed during the two-day meeting included intolerable pressures on pharmacy owners, the ongoing Community Pharmacy Contractual Framework (CPCF)
negotiations, implementation of the Pharmacy First service, and governance changes.
Committee Members reviewed the progress of CPCF negotiations with the Department of Health and Social Care (DHSC) and NHS England. These critical negotiations
are being led by the Negotiating Team (NT), which includes independent pharmacy owners and representatives of CCA and non-CCA multiples.
The CPE has been advocating for an uplift to the core global sum, margin write-offs, an agreed mechanism for regular funding increases linked to activity and
inflation, annual uplifts to service fees, more fundamental reform of the margin delivery framework and an economic review of the medicines supply chain.
The Committee also discussed the results of the 2024 Pharmacy Pressures Survey, which was conducted during March and April.
In a recent announcement, the British supermarket chain, Asda has launched its first online prescription service becoming the first self-serving shop
to offer prescribed medicine supply at the doorsteps through its latest healthcare accessibility venture.
The NHS certified online pharmacy service, Asda Online Pharmacy, is set to offer patients a digital platform designed to simplify the prescription process for
patients, offering the convenience of online management and home delivery with their partnership with Pharmacy2U.
Effective immediately, new patients can register for an account on the platform via pharmacy.asda.com.
Once registered, they gain access to a seamless prescription ordering system that facilitates home delivery, along with the ability to monitor the progress of
their orders.
Prescriptions submitted through Asda Online Pharmacy will undergo rigorous scrutiny by qualified pharmacists before being dispatched directly to patients'
doorsteps, all without any additional charges.
The Pharmacy First service, set for launch in England at the end of January, is expected to help reduce some of the pressure on the National Health Service (NHS).
But the question is - Are pharmacists ready to take the extra workload amidst many issues community pharmacies are currently facing?
Nearly 50 per cent of pharmacy workers surveyed by ITV News said they do not feel confident they can provide the new services.
Pharmacy leaders told the British news channel that the industry is already in crisis, and they are facing a "potentially fatal cocktail" of rising prices, major
supply problems and a lack of funding.
Following concerns raised about cracked cartridges and insulin leaks, the Medicines and Healthcare products Regulatory Agency (MHRA) has issued a national
patient safety alert for the NovoRapid PumpCart prefilled insulin cartridge and the Roche Accu-Chek Insight Insulin pump system.
The regulator have asked patients to check the pre-filled glass insulin cartridge for cracks before use. It advised against using the cartridge if it has been dropped even if no cracks are visible and urged to closely follow the updated handling instructions in the pump user manual when changing pre-filled glass insulin
cartridges.
In some of the reported leakage incidents, the cartridges were found to be cracked and provided an inadequate supply of insulin to patients. Leakages also occurred in cases where no cracks in the cartridge were visible, the regulator said.
In some patients there were consequences of not receiving enough insulin from their pump system, including reports of severely high blood sugar and diabetic ketoacidosis, a serious complication of diabetes when the body produces high levels of blood acids called ketones.
Healthcare professionals are being advised to contact patients over the next six months using said device to discuss their individual needs and source an alternative pump where appropriate.
"Because of the rare risk of insulin leakage from the Roche Accu-Chek Insight Insulin Pump, patients should check the pre-filled glass insulin cartridge for any cracks prior to usage," Dr June Raine, MHRA chief executive, said.