The Health and Social Care Select Committee (HSCC) on Tuesday held the first session in their pharmacy inquiry, with a panel of experts discussing the key
issues facing community pharmacies in the country.
Representatives from community pharmacy associations highlighted some of their biggest challenges and their vision for the future, as well as actions that
government and NHS England can take to address those challenges for a better future for the sector.
Opening the session, the Committee's vice-chair, Rachel Maskell MP, asked the representatives if they felt the government was ambitious enough in what it
believes community pharmacy can do to address NHS pressures, or are pharmacists being held back by issues around workforce funding, contracting, and technological
changes.
Malcolm Harrison, Chief Executive, Company Chemists' Association (CCA), expressed that the government is not ambitious enough, saying "there's always opportunity
to be more ambitious".
The Scottish government has issued a circular to inform community pharmacy contractors that the Serious Shortage Protocol (SSP) for Clarithromycin 125mg/5ml
oral suspension, an antibiotic product, due to expire on 15 December 2023, has been extended until Friday 12 January 2024.
The extension is applicable to SSP053 which allows community pharmacists to substitute this product with Clarithromycin 250mg/5ml oral suspension for patients
presenting with an NHS or private prescription.
Scotland's chief pharmaceutical officer, Alison Strath, has advised health boards to spread this information to community pharmacy contractors on their
pharmaceutical lists and area pharmaceutical committees, as well as general practices.
Community pharmacists have been advised to review and familiarise themselves with the new end date for the noted SSP.
Royal Pharmaceutical Society (RPS) Scotland has submitted its evidence to the Health, Social Care and Sport Committee's inquiry into 'Healthcare in remote
and rural areas.'
The Committee had sought views on what policies and actions would be most effective in addressing the issues people face when accessing healthcare in these areas.
During the evidence session today (19 December), Laura Wilson, Director for RPS Scotland, highlighted the challenges faced by pharmacists and pharmacy in remote and
rural areas, as well as provided some of the solutions for ensuring a sustainable pharmacy workforce.
At present, people living in remote and rural areas of Scotland are required to travel to Glasgow or Aberdeen to undertake pharmacy training. Laura underscored the
need to develop alternative education and training pathways, such as "grow your own" models, to support remote and rural areas to develop and retain local pharmacists.
The National Institute for Health and Care Excellence (NICE) has recommended pembrolizumab in combination with chemotherapy (paclitaxel or nab-paclitaxel)
which is said to benefit people with triple negative breast cancer.
Clinical trial evidence shows that, compared with paclitaxel, pembrolizumab combination increases how long people have before their cancer gets worse and how long they live.
NICE already recommends atezolizumab in combination with chemotherapy for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer.
Atezolizumab combination is recommended by NICE for people with IC equal to or greater than 1%.
"This means that some people who can't have atezolizumab combination could be eligible for pembrolizumab combination," said NICE.
NICE's independent appraisal committee also agreed that the pembrolizumab combination meets the higher cost-effectiveness threshold for life-extending treatments for people with a short life expectancy.
Given by injection every 3 weeks, pembrolizumab (also called Keytruda and made by Merck Sharp and Dohme) is a type of immunotherapy that specifically targets triple
negative breast cancer. It works by blocking the activity of a protein known as PD-L1 which is produced in larger amounts on cancerous cells than normal cells. By blocking PD-L1 it helps the person's own immune cells to attack the cancer.
Community pharmacy teams in England have broken all previous records by a distance and delivered nearly five million flu jabs in the past season.
They have administered over 2.08 million more flu vaccinations under the national programme during 2021-22 than the previous year, which is a a 75 increase, the
Pharmaceutical Services Negotiating Committee has reported.
According to latest data published by the NHS Business Services Authority in its Advanced Service Flu report community pharmacy has administered 4.85 million
vaccinations under the national Flu Vaccination Service in 2021-22.
The total number of vaccines administered in community pharmacies in 2020-21 was 2.77 million.
Commenting on the end-of-season figures, PSNC chief executive Janet Morrison said: "I am thoroughly impressed to hear it confirmed that community pharmacy has
had another record-breaking year of flu vaccination provision. The ability of pharmacy teams to deliver the healthcare services that communities need, despite
the challenges and pressures this winter, is simply phenomenal.
Pharmaceutical Services Negotiating Committee (PSNC) has expressed its support for alterations in the Human Medicines Regulations 2012 to enable original pack dispensing (OPD) and supply of medicines containing sodium valproate by pharmacists.
PSNC's support for changes was in response to the consultation on OPD, initiated by the Department of Health and Social Care (DHSC).
The consultation had proposed regulatory changes to allow pharmacists to dispense (up to 10 per cent) more or less than the prescribed quantity of a given medicine in the manufacturer's original packs.
Key aims of the proposal are to "support increased patient safety by ensuring patients receive the necessary information that is included in the original manufacturer's packaging about the safe and effective use of a product," DHSC said.
The Pharmaceutical Services Negotiating Committee has announced that the Department of Health and Social Care (DHSC) has granted further price concessions for the month of December 2021.
A price concession only applies for the month in which it is granted. No additional prescription endorsement are required as the new price is automatically applied by the NHS BSA to all items submitted for payment in the same month for which a price concession is granted.
Contractors can find information and learn about the process involved on PSNC's website.
Considering the challenges being faced by pharmacies and involvement of their workforce in the ongoing Covid-19 vaccination programme, the requirement to report New Medicine Service (NMS) data for Quarters 3 and 4 of 2021/22 has been paused.
This follows an agreement reached between the NHS England and NHS Improvement and Pharmaceutical Services Negotiating Committee (PSNC).
Attempts to deal with record waiting lists for hospital treatment caused by the Covid-19 pandemic are at risk of being derailed by a staffing crisis, which is being exacerbated by the Omicron wave, a cross-party lawmakers' report said on Thursday (January 6).
The report entitled 'Clearing the backlog caused by the pandemic' calls for a broader national health and care recovery plan - one that would embrace A&E, mental health, GPs, community and social care.
Hospitals are facing extreme pressure as they try to catch up on months of operations that have been delayed and suspended during the pandemic, as Covid-19 hospitalizations rise once more and self-isolation hits staffing levels.
There is a record 5.8 million waiting list for elective care, the Health and Social Care Committee said, adding that a recent surge in the Omicron variant has pushed cases to record highs and intensified pre-existing issues.
A fourth dose of Covid-19 vaccine is not needed at present, as latest data shows first booster provides high levels of protection against Omicron variant among older adults, says the Joint Committee on Vaccination and Immunisation (JCVI).
After analysing latest data from the UK Health Security Agency (UKHSA), JCVI said: "There is no immediate need to introduce a second booster dose, or fourth jab,
to the most vulnerable".
Data from UKSHA revealed that single booster dose provides around 90 per cent protection against hospitalisation to those aged 65 and over, even after three months of jab.
However, protection against mild symptomatic infection is short-lived and drops to around 30 per cent by about three months.
The study, which looked at booster doses in those aged over 65, showed that with two vaccine doses, protection against the infection drops to around 70 per cent after three months and to 50 per cent after six months.
To ease pressure on community pharmacies, the deadline to meet the requirements of the Pharmacy Quality Scheme will be extended, Pharmaceutical Services Negotiating Committee (PSNC) announced today (December 15).
This follows an agreement reached between the negotiator and the NHS England and NHS Improvement (NHSE&I) and the Department of Health and Social Care (DHSC).
Recognising the challenges faced by pharmacies and their contribution towards the Covid-19 vaccination programme, following additional changes have been agreed upon:
Contractors will not be required to complete the Community Pharmacy Patient Questionnaire for 2021/2022;
The requirement for pharmacy teams to complete a national audit (intended to be on valproate) in 2021/22 will be waived; and
The requirement for pharmacy teams to complete a contractor-chosen clinical audit in 2021/22 will be waived.
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.
From April 2022, contractors will have to make all monthly FP34C submissions only through the Manage Your Service (MYS) portal, the Pharmaceutical Services Negotiating Committee (PSNC) said in an update.
This will be for prescriptions dispensed from March 2022.
The last paper FP34C submission document will be posted out to contractors this month.
Contractors who have not yet registered for MYS, can do so by completing the form on the NHSBSA's website.
While encouraging contractors to switch to the MYS, the negotiator stated that nearly 1,500 pharmacy contractors still depend on the paper FP34C submission document.
The NHS on Sunday (January 30) expanded its Covid-19 vaccination programme to include vulnerable children aged five to 11 years.
Eligible children include those with diabetes, immunosuppression, learning disabilities, and other conditions as outlined by the UK Health Security Agency in the Green Book.
Besides, children living with someone immunosuppressed will be eligible to get the first dose of the Covid vaccine in line with advice issued by the Joint Committee on Vaccination and Immunisation (JCVI).
According to the NHS there are around 500,000 eligible children in the latest cohort.
GP and deputy lead for NHS vaccination programme Dr Nikki Kanani, said: "We know vaccines give significant protection against severe illness from Covid - including the omicron variant, so it is important that our youngest and most at-risk get protected.
The Pharmaceutical Services Negotiating Committee (PSNC) is encouraging community pharmacy contractors and their teams to take part in the negotiator's latest Pharmacy Advice Audit.
The audit has been extended but results must be submitted by 23.59 on Friday (March 11).
Under the audit, pharmacy teams need to record information about the informal healthcare advice that they give in a single day, which would provide a critical check on how people continue to rely on community pharmacies.
The results of the audit will provide key evidence for use in funding discussions with the government and the NHS.
Last year's Advice Audit highlighted the scale of the informal consultations that took place in pharmacies during the pandemic, and helped the PSNC to persuade MPs to support the case for Covid-19 costs.
While responding to the consultation on hub and spoke dispensing, trade unions for pharmacists have emphasised that the patient safety and care must be the priority in hub and spoke dispensing.
The Royal Pharmaceutical Society (RPS) has welcomed the opportunity provided by a change in legislation to enable community pharmacies to make use of hub and spoke
dispensing but reaffirmed that patient care must be at the heart of future changes.
With regards to patient safety, the Pharmaceutical Services Negotiating Committee (PSNC) considers that only Model 1 is appropriate, with manageable risks related
to patient safety, and is a model that has the potential to allow the whole sector to benefit fairly.
In its response to the consultation on Hub and Spoke dispensing, PSNC highlighted that Model 2 in the consultation, a hub direct to patient supply of dispensed medicines, raises patient safety issues and it cannot be supported.
RPS President Professor Claire Anderson said: "In all models, patients need to continue to have access to a pharmacist at the time of supply of medicines so they
have the opportunity to discuss, ask questions or raise concerns, and receive appropriate information with counselling and advice.
Community pharmacy should be involved in key decisions in neighbourhoods and systems to help reduce workload and increase patient access, a roundtable
organised by the National Pharmacy Association to discuss a recent review on primary care integration has concluded.
The NPA said it would be sending the recently published report on the roundtable to local pharmaceutical committees (LPCs) and other local pharmacy leaders as a
tool to help them engage with Integrated Care Systems (ICSs) which will become statutory bodies from July 1.
The 'Fuller Stocktake: Community Pharmacy Roundtable' report, published on June 13 by the NPA, is based on a meeting hosted by the association on behalf of the NHS
team running a key review of primary care integration, the so-called 'Fuller Stocktake'.
NPA integration lead, Michael Lennox, said: "The NPA recognises the critical importance of our LPC network colleagues being there for contractors at the 42 local
systems level and influencing to fulfil the laudable ambitions of the Fuller Report.
"We ensured that community pharmacy voices were heard in the stocktake process and now that conversation needs to be amplified locally."
Pfizer has recalled all stocks of Accupro - including 5mg, 10mg, 20mg, 40mg film-coated tablets - as a precautionary measure due to the identification of a
nitrosamine above the acceptable limit.
"Following testing, N-nitroso-quinapril, has been observed at a level above the acceptable limit. Nitrosamines may increase the risk of cancer if people are
exposed to them above acceptable levels and over long periods of time. The recall is at pharmacy and wholesaler level," the Pharmaceutical Services Negotiating
Committees (PSNC) reported.
The Department of Health and Social Care (DHSC) said: "All strengths of quinapril (Accupro) tablets have been recalled with a resupply date to be confirmed. Pfizer
are the sole supplier of quinapril tablets in the UK. Alternative ACE inhibitors remain available and can support an uplift in demand."
The Joint Committee on Vaccination and Immunisation (JCVI) on Thursday (May 19) said that an anticipated autumn Covid booster campaign would be aimed at
people aged over 65, care home residents, frontline health and social care workers and all adults in a clinical risk group.
The UK is offering a spring booster to the over-75s, care home residents and immunosuppressed people, and ministers have spoken openly of plans for a further
booster campaign in the autumn.
In interim advice, the JCVI stopped short of recommending another shot for all adults, though said the advice would be reviewed and updated.
"The JCVI's current view is that in autumn 2022, a Covid-19 vaccine should be offered to: residents in a care home for older adults and staff; frontline health
and social care workers; all those 65 years of age and over; and adults aged 16 to 64 years who are in a clinical risk group," the UK Health Security Agency said
in a statement.
Prime minister Boris Johnson, who was fiercely criticised for his handling of the early stages of the pandemic, lifted Covid restrictions in England in February,
crediting Britain's quick initial vaccine rollout and the rollout of boosters with breaking the link between cases and deaths.
The Pharmaceutical Services Negotiating Committee (PSNC) has shared materials to help community pharmacy in communicating relevant advice to people during
this heatwave.
The UK Health Security Agency (UKHSA) has issued a heat-health alert for the next few days. It has also published a beat the heat poster, along with its heatwave
guidance, which could be used in pharmacies to raise awareness.
"During this heatwave, the public may turn to community pharmacy teams for advice about staying well during the hot weather or to seek assistance when feeling
unwell because of the heat," PSNC said.
It has previously developed materials that may be used by community pharmacy teams to communicate relevant messages contained in the Heatwave Plan for England
and the NHS website guidance on how to cope in hot weather.
