Community pharmacy is stuck in a Covid-induced limbo but that might soon be replaced by a Brexit quagmire, says Patrick Grice…
In an inspired move, my sons got me a 12-month subscription to Beer52 for Christmas last year. Every month you get sent a box of eight themed beers – mild, stout, IPA, lager – name a variety and it will be there. The grapefruit-flavoured IPA in a recent ‘New York’ box was quite pleasant but the peanut butter stout was truly revolting.
October celebrated the cancelled Oktoberfest in Germany, so I’m currently sampling something a little more traditional. Who knows what November will bring - part of the fun is that you can never be sure what is coming next. The big picture - more beer - that bit is clear: what is missing are the details of what is in the box.
It's the same with Covid-19, the virus that keeps on giving, although no subscription required! The big picture has been clear for a while.
A second wave of infection was predicted at some point after the lockdown that tamed the first wave was lifted, as was a breakdown of the political ‘coronavirus consensus.’ Now the second wave is here, and the politicians are once again creating dissent and causing confusion.
The ‘fun’ with Covid-19 are the unpredictable niggles that crop up as the pandemic rolls on.
Last month pharmacies had to learn how to manage the NHS Covid app in workplace settings. This was fairly straightforward – turn it off when at work. Then came the misguided activities of NHS contact tracers whose script did not recognise that a pharmacy is a healthcare setting. This seems to be a consistent blind spot for the NHS.
Contact tracers were not taking into account national advice on the use of personal protective equipment and other mitigations which seek to prevent the spread of infection, said PSNC. This resulted in cases where one pharmacy staff member testing positive meant the whole team was then told to go into self-isolation, which effectively closed the pharmacy for a fortnight.
PSNC was concerned that the community pharmacy network might become a little patchy if all pharmacy staff were asked to self-isolate every time one member of staff tested positive for COVID-19. The solution? Ask your staff not to give their colleagues’ names to NHS Test and Trace if they test positive for coronavirus, but to provide the contact details of the pharmacy.
Then there was the looming shortage of flu vaccine towards the end of October. It is ironic that Covid may be the root cause of the most successful vaccination programme to date.
The Department of Health and Social Care was quick to explain that further batches of vaccine were on the way. GP practices in England were told how to access to DHSC centrally supplied vaccines on October 9.
The letter did say a pre-set proportion of this additional stock would be made available to community pharmacy. But at this point PSNC was still working with the DHSC on the details of how community pharmacies would be able to access vaccines, and stressing the need for details to be confirmed so that contractors could plan their vaccination programmes for November and December. At the time of writing details were still awaited.
And what about the DHSC’s reluctance to compensate pharmacies for their Covid-related costs? The reasons for this are unclear but will do little to rebuild trust in what is still a shaky relationship.
There will be further niggles before the year comes to end. They might be little things but they are all additional frustrations to already stretched pharmacy workforce.
The news that PSNC has reconvened its Brexit Forum heralds what could well be the next bump in the road.
There are concerns about the lack of clarity around supplies of medicines from Great Britain to Northern Ireland after 31 December, and the potential for prescribing periods to be extended ahead of the Brexit deadline (although given past experience you could substitute ‘certainty’ for ‘potential’).
Unsurprisingly, the key focus for the group is ensuring the continuity of medicines supply. The government has asked manufacturers to stockpile six weeks’ supply but the worry is the coronavirus pandemic has removed the factors that allowed the supply chain to be resilient during the previous round of Brexit brinkmanship.
Brexit – hard or soft – means the Christmas period is likely to be even busier than usual. It really is time to ban GPs from prescribing for more than 28 days at a time and make electronic repeat dispensing (eRD) mandatory!
A ray of sunshine?
It's not all bad news though. Just over a year after the Community Pharmacy Consultation Service was launched this referral route is being rolled out to GP practices. If you haven’t watched it yet, the video produced by Avon LPC, showing the results from its pilot and explaining how the service was implemented in its area, is well worth 15 minutes of your time.
This is a great opportunity for LPCs to step up and there is a lot for them to do to make sure GP referrals get off to a good start.
After the mixed reviews LPCs got in the Wright review, this will be a time when the real effectiveness of local representation will be put to the test, with the number of GP referrals a tangible measure of success.
It is worth noting that the anticipated funding profile for the CPCS is £4 million this year, £9 million in 2021/22 rising to £19m by 2023/24. There is a lot riding on getting the CPCS working well.
Patrick Grice is the contributing editor of Independent Community Pharmacist.