Things to do and things to know in community pharmacy across the UK
Community pharmacy interim funding arrangements
Interim community pharmacy funding arrangements will take effect
from 1 April 2019. These will continue until negotiations on future
pharmacy funding are settled.
The interim funding arrangements are as follows:
• The Single Activity Fee (SAF) remains at £1.26 - the level may be
adjusted later in the year
• Prices of Category M medicines will increase by £10 million per
month. This is a return to the position prior to November 2018
• Pharmacy contractors will be reimbursed for up to a maximum
of 200 Medicines Use Reviews (MURs) between 1 April and 30
• No more Quality Payments Scheme requirements or review points
have been set
• Commissioning for the NHS Urgent Medicines Supply Advanced
Service pilot will continue until 30 September pending further
• Pharmacy Access Scheme (PhAS) payments — pharmacies
already receiving PhAS payments will continue to receive them
on a monthly basis at the same rate as those received in the last
Negotiations on future community pharmacy funding are expected
to begin before Easter to enable implementation of any agreed
changes to the Community Pharmacy Contractual Framework from
The NPA welcomes anything that relieves our members’ perilous
fi nancial situation, so it is good that the recent period of reclaiming
excess margin has come to an end.
However this doesn’t change the fundamental position. We advise
our members to remain cautious about investment decisions, until
the longer term position is clearer.
A multi-year settlement, which incentivises quality and clinical
services over volume can’t come soon enough. This would give
pharmacies more confi dence to invest and take on the challenges
laid out for the sector in the NHS Long Term Plan.
Freestyle Libre Sensors will be more widely available
to patients with Type 1 diabetes across England
from April 2019
Pharmacy contractors and their teams should note that NHS England
has increased the funding available for Freestyle Libre sensors to
allow access to flash glucose monitoring for more patients with
Type 1 diabetes. There has previously been variability in access to
flash glucose monitoring to patients in some parts of the country;
pharmacy teams may notice an increase in prescriptions received for
Freestyle Libre sensors from April 2019.
NHS England has published guidance on patient eligibility criteria
for flash glucose monitoring and the maximum amounts that clinical
commissioning groups will be reimbursed for continuing costs of
flash glucose sensors.
Freestyle Libre sensors are only available from Abbott Diabetes
Care direct and are not distributed through any wholesalers.
To obtain the Freestyle Libre sensor, community pharmacies are
required to set up an account via the Abbott Diabetes Care website.
This will take 24 hours to activate and then orders can be placed
and an invoice will be sent direct to the pharmacy.
GPhC registration renewal fees are set to rise from
1 July 2019
General Pharmaceutical Council (GPhC) registration renewal fees
for pharmacists, pharmacy technicians and pharmacy premises will
increase from 1 July 2019 for the fi rst time since 2015. The Council
at the GPhC decided that the fees should be raised to refl ect the
increase in the organisation’s costs and workload.
The registration renewal fees from 1 July 2019 will be as follows:
|Register/registrant||New fee||Previous fee|
For further information please contact the NPA on 01727 891 800 or email email@example.com
Ramping up local NHS engagement
The NPA Board has approved a business plan for 2019/20 committing the NPA to delivering member-centric services and securing community pharmacy’s position as the front door to the NHS.
One key work stream in the plan is to help independent pharmacists engage with their local NHS on the planning and delivery of health services.
The NHS long term plan signalled that most new investment in primary care (in England) will fl ow through local primary care networks (PCNs). It will be crucial for community pharmacies to work together to engage with the PCNs, and the NPA is working with the other national pharmacy
organisations to support this, as well as providing our own specific support for independent pharmacists.
Michael Lennox, chief officer of Somerset LPC, will be working with the NPA, on a part time basis, to help independent community pharmacists get to grips with emerging NHS structures such as PCNs and integrated care system (ICSs) at local level. At the same time Michael will also take on a part time role at PSNC where he will be helping to shape its PCN strategy and support for LPCs.
This should facilitate further close working between the NPA and PSNC and ensure that our PCN support is all aligned. Michael will help the NPA to: support independent representatives on LPCs; inform and educate NPA members about the opportunities and threats that exist within the NHS long term plan, the GP contract and the development of ICSs; work cooperatively with the National Association of Primary Care and others on a joined up plan to help the sector make the most of the long term plan.
“You hear a lot of platitudes about inclusion, but you have to turn those platitudes into action, and move from inclusion to influence,” Michael explained. “It’s through infl uencing the development of these [primary care] networks that we can achieve true integration, improving the operational interface between community pharmacy and general practice, as well as developing service innovations.
“You have to make sure you’re integrated in both the clinical services through the CCG and the public health interventions through the council.”
Michael added: “In Somerset, we’re working collaboratively on creating a system-wide commissioning plan that integrates community pharmacy into key service sectors, for instance urgent and emergency care. We’re also working with the local authority public health team on how we can be a co-ordinated and optimised contributor to the public health and prevention drive.”
He added: “An idea doesn’t have to be earth-shattering. It might be a better way of working together to triage patients, or a better way of communicating. A lot of positive things happen because we change things by one per cent. Ultimately, we need to get PCNs absolutely right, but that will happen because of lots of little changes.”
Health Secretary to speak at NPA conference
The Secretary of State for Health and Social Care, Matt Hancock, has been confirmed as the headline speaker at the NPA conference, Forwards in Partnership.
Mr Hancock will outline developments in health policy and his hopes for community pharmacy at an event in Manchester on June 20. He is the first of a stellar cast of speakers to be unveiled, with other senior names from the NHS, government and pharmacy to be announced shortly.
The conference is a collaboration between the NPA and Communications International Group, publisher of Pharmacy Magazine, Independent Community Pharmacist, P3 and Training Matters.
NPA chief executive, Mark Lyonette, said: “The NPA is working in partnership with others in the sector and with the NHS, to find a positive way forward for community pharmacy.
“The road to success is not a journey that can be taken alone. That is why we have chosen Forwards in Partnership as our theme. We are delighted that the Secretary of State has agreed to take part. We believe it demonstrates an eagerness to engage with the sector, and an understanding on his part that pharmacies are essential to the health of the nation.”
Are the cracks starting
With the continued prospect of a
changing climate, colder winters and
warmer summers, the risk to your
property from subsidence will become
Last year’s prolonged warm summer,
whilst a welcome change, has seen a
substantial increase in subsidence claims
across the insurance industry.
The Association of British Insurers (ABI)
reports that the number of claims jumped
from 2,500 (April-Jun 2018) to 10,000 (July-
Property is at an increased risk following
extended periods of dry and warm weather,
but there are many reasons why cracks
might appear so there is no need to panic.
The worst hit area was south-eastern
England, where buildings are well-known
for being constructed on subsidence-prone
Subsidence is the downward movement
of ground beneath a property which leads
to abnormal stress on the structure and
foundations, which can result in cracking
and property damage.
The fi rst sign of subsidence is the
appearance of cracks in a property’s brick
or plasterwork. In general, subsidence
cracks develop abruptly and exhibit different
characteristics to other cracks. They are
usually diagonal, tapered and present both
inside and outside a property.
To determine whether your property is
subsiding the ABI advises that cracks are
• Diagonal, and wider at the top than at
• Thicker than a 10 pence coin
• Found around doors and windows.
Subsidence may also cause doors and
windows to stick as the buildings structure
Quickly identifying and arresting the
cause of subsidence movement is critical.
These steps are integral to an insurer’s
claims solution which enables quicker, more
efficient and effective resolution of claims
that are unique to each event.
Mike Prevot, Head of Insurance Services
for NPAI said: “If you believe that your
property has exhibited any of the above
signs and you are concerned that there may
be the possibility of subsidence starting to
occur, I would strongly recommend that you
contact your insurer’s claims department in
order for them to arrange for someone to
investigate and take the corrective measures
Local primary care network and pharmacy integration events
Getting engaged with emerging local structures within
It’s now more important than ever for pharmacy owners to get to
grips with local networks in the NHS. Most of the new investment
provided for primary and community care, alongside the NHS Long
Term Plan, will be funnelled through local commissioning structures.
Primary care networks (PCNs) are at the heart of the NHS
Long Term Plan. The aim of these networks is to produce a more
personalised, co-ordinated and integrated model of health and
social care by bringing together a range of local providers, including
GP practices, mental health and social care services, pharmacies, and
some hospital and voluntary services.
They are based on GPs’ registered lists and each covers around
30,000 to 50,000 patients. PCNs are already up and running in
many areas of the country and the plan is for the networks to cover
the whole of England by the end of 2019.
To understand more about these local structures, NHS England has
organised various events for healthcare professionals to attend.
For more information on events in your local area go to the
NHS England events website: www.events.england.nhs.uk
Partnership with Qube Learning
The NPA can now help members deliver non-clinical
apprenticeships after signing up Qube Learning, an Ofsted
approved training provider, as a business partner.
The partnership with Qube Learning helps pharmacy owners
who are considering taking on a customer service apprentice or
upskilling an existing employee with a leadership or management
Meanwhile NPA’s own pharmacy apprenticeship offering is also
making progress – the new Level 2 Standard for Pharmacy Services
Assistant was approved by the Institute of Apprenticeships in late
2018. The NPA plans to run a pilot later this year for their Level 2
apprenticeship. The Level 3 Standard for Pharmacy Technician has
been submitted to the Institute of Apprenticeships for approval.
Organisations with an annual salary bill of less than £3 million and
more than 50 employees can have 95% of the training costs of an
apprentice funded by the government from April 2019 onwards –
currently the funding is 90%.
For more details on apprenticeship funding for organisations
paying into the Apprenticeship Levy and for firms with less than 50
employees, view the NPA’s apprenticeships page on www.npa.co.uk/apprenticeships
More information about the full range of apprenticeships
on offer by Qube Learning can be found on their Business
Partner page on www.npa.co.uk/servicesandsupport/businesssupport/
Three questions employers
often ask about shared
Introduced in 2015, Shared Parental
Leave (SPL) allows new parents to
share time off work in the fi rst year
of their child’s life, or in the fi rst
year after adoption. It is intended
to give parents greater fl exibility in
their childcare arrangements, while
still maintaining their profession.
Importantly, SPL allows both parents
to play an active role in caring for new
arrivals, and is another step towards
helping employees achieve a better
Managing SPL can be complex, but
it’s important for pharmacy owners to
understand good practice so that you can
support employees and minimise disruption
to your business.
We’ve compiled a list of three key
questions employers often ask.
1. How much leave are employees
entitled to, and how should they be
paid during this time?
By law, women must take a minimum of
two weeks’ maternity leave after giving
birth. After this, new parents can take a
maximum of 50 weeks’ SPL, of which 37
weeks is paid, known as Shared Parental
Pay (ShPP). The statutory pay for shared
parental leave is £145.18 or 90% of the
employee’s average weekly earnings,
whichever is lower. You may wish to
offer additional pay above the statutory
minimum, which should be set out in an
employee’s contract of employment.
2. How can employees choose to
Employees can take SPL in the way
that’s best for them. It can be taken at
the same time as their partner, or at a
different time, meaning a woman can
take maternity leave while her partner is
on SPL. SPL also doesn’t have to be taken
in one go; employees can book up to
three blocks of leave during their child’s
first year. However, they must give you at
least eight weeks’ notice. Employers must
accept requests for one continuous period
of leave, but for employees requesting
discontinuous blocks of leave, you have
14 days to accept, put forward other
suggestions or refuse. Keep in mind that
shorter blocks of time may be preferable,
as it means employees won’t be away from
work for an extended period, keeping
them in the loop with what’s going on.
3. What’s in it for me?
Rather than seeing SPL as an
inconvenience, remember that there
are benefi ts for employers too. Greater
fl exibility around childcare is proven to
create happier, more loyal and more
productive workforces, and will make it
easier to attract and retain staff. Gone
are the days where employees are solely
focused on money – work fl exibility is now
high on people’s list of priorities when job
hunting. Ultimately, by embracing SPL,
employees will feel valued, appreciated
and supported, which can only be good
For advice, contact the NPA employment
advisory service on 0330 123 0558 or
New style GPhC inspections
Two of the biggest changes in the new inspection regime
which started from April 2019 are undoubtedly the move
towards unannounced inspections and the publishing of
The general rule is that all inspections will be unannounced so
that inspectors witness the level of service patients and the public
experience on a day-to-day basis. Pharmacies can expect the
subsequent reports, including improvement action plans and details
of any enforcement action, to be published on a new website. These
new measures bring pharmacy broadly in line with other healthcare
providers inspected by the Care Quality Commission (CQC), but one
notable difference is the outcomes.
The GPhC has chosen a binary outcome that requires all standards
to be met to receive an overall ‘standards met’ outcome. Naturally
that means if any standard is found not to be met, this will result
in a ‘standards not all met’ outcome overall. The NPA would have
preferred graded outcomes similar to those used by the CQC, such
as inadequate, requires improvement, good and outstanding. We
understand pharmacies must keep pace with the public’s rising
expectations around transparency and open access to information,
in order to maintain the public’s confi dence.
The NPA has also sought assurances that the reports will not
contain any commercially sensitive information or information
that could present a security risk. In addition, while we agree that
patients should not be identifi able in the reports, neither should
The GPhC has published the following principles that will
underpin the new regime:
• To be fl exible, agile and responsive to the information it holds,
intelligence it receives and issues it identifi es within pharmacies.
• Inspections should refl ect as closely as possible how patients and
the public experience pharmacy services day to day.
• The overall outcome of an inspection is clear and understandable
to members of the public and enables pharmacy owners to be
held to account against the standards.
• All standards for registered pharmacies need to be met every day.
Fluoroquinolone antibiotics: new restrictions
and precautions for use following rare
reports of serious side effects
The Medicines & Healthcare products Regulatory
Agency (MHRA) has published a drug safety update on
fluoroquinolone antibiotics highlighting rare reports of their
harmful and potentially irreversible or long-lasting adverse
effects on the musculoskeletal and nervous system.
The MHRA has issued advice for healthcare professionals,
including pharmacists as follows:
• Fluoroquinolones, when administered systemically (by inhalation,
injection or mouth), may rarely cause harmful, long-lasting (up to
months/years) and possibly irreversible side effects that may affect
numerous body systems, organ classes and systems.
• Patients should be advised to stop treatment at the fi rst sign of a
serious side effects, including muscle pain/weakness, joint pain/
swelling and tendonitis or tendon rupture, and immediately
contact their doctor for advice. An information sheet for patients
is included in the drug safety update.
• Unless other commonly recommended antibiotics are considered
unsuitable, fluoroquinolones should not be prescribed for mild/
moderate/non-severe or self-limiting infections – Summaries
of Product Characteristics will be updated following an EUwide
review of safety to show new restricted indications.
Ciprofl oxacin and levofl oxacin should no longer be prescribed for
• Avoid use of fluoroquinolones/quinolone antibiotics in patients
who have previously experienced severe side effects.
• Exercise particular caution in patients with renal impairment, solidorgan
transplants and those aged over 60 years.
• Concomitant use of a corticosteroid with a fluoroquinolone could
increase the risk of tendon rupture and should be avoided.
Reporting adverse reactions
The MHRA are reminding healthcare professionals to report all
suspected adverse drug interactions (ADRs) to the Yellow Card
Scheme – this is via the Yellow Card website or Yellow Card App
available on iOS devicesand Android devices
• The Yellow Card App has been updated with an easy login,
increased stability, new features, and questions on medicines in
NPA advice for pharmacists
• Ensure any side effects experienced with fluoroquinolone
antibiotics are queried with the patient’s prescriber.
• Highlight potential serious side effects to patients so they know
what to look out for and what steps to take.
• Make necessary notes on the patient’s medication record.
• Report suspected ADRs to the Yellow Card Scheme.
For further information please contact the NPA on 01727 891
800 or email firstname.lastname@example.org
Your FMD questions answered
A selection of questions taken from the
UK FMD Working Group for Community
Pharmacy website. For more FMD
related guidance go to fmdsource.co.uk
How will FMD help identify dispensing errors?
If an integrated PMR / FMD system is used, the
software will be able to check whether the products
scanned match the items on the prescription/dispensing
label. If there is a mismatch, the user will be alerted by
the software, thus reducing the likelihood of incorrectly
selected products being dispensed to patients.
What happens if a counterfeit is detected?
You will get a message to say the medicine is
not in the UK hub (and therefore a suspected
counterfeit). The UK hub will automatically alert the
MHRA; however, you should also contact the MHRA by
completing a Yellow Card report. It is also good practice
to notify the wholesaler/supplier. Physically check
all stock (shelves, fridge, controlled drugs cupboard,
returns area, prescriptions waiting for collection) for
medicines with the same batch number and quarantine
them until further instructions are issued by the MHRA.
Are food supplements, such as Ensure, and
gluten-free foods covered by FMD?
Will we need two types of scanners – one for
“normal” 1D barcodes and one for 2D barcodes?
No. 2D barcode scanners will also scan normal
Do I have to verify and decommission medicines
I supply via a Patient Group Direction or as an
Yes, supplies of any prescription medicines will
need to be verified and decommissioned before
they are supplied to the patient.
How does FMD work if stock is “loaned” to
another pharmacy to fulfill a prescription or stock
is transferred from one pharmacy to another (within the
same body corporate)?
If a full, active pack, ie. one which has not been
decommissioned, is to be loaned or transferred,
the pack should be decommissioned by the receiving
pharmacy when they supply the medicine to the patient.
The pharmacy that loans or transfers the item does not
need to use the FMD system in relation to the medicine
prior to the loan or transfer, but they could choose to
verify the product.
If a split pack of medicine, which has already been
decommissioned, is loaned or transferred, the receiving
pharmacy should be notified of this, so they do not
attempt to decommission the product.
Do I need a separate internet connection for FMD?
FMD systems will not specifi cally need a separate
internet connection from the pharmacy’s main
connection (eg. HSCN or N3), but the systems could
operate on a separate connection if desired.
My internet/broadband is slow. Will that affect the
No. The system is designed to work on a very low
Will FMD impact on the way pharmacies use the
English Electronic Prescription Service (EPS)?
There will be no direct impact on the way EPS
operates, but PMR systems with integrated
FMD functionality may be configured to link the
decommissioning of products, as they are handed to
a patient, to also trigger the sending of the dispensed
message to the Spine.
Pre-registration Pharmacist Training Programme
The NPA’s Pre-registration Pharmacist
Training Programme focuses on
the GPhC assessment syllabus and
The course is written and delivered by a
team of experienced pharmacists who will
fully support and guide pre-registration
students to develop into confident and
competent pharmacists. This programme
provides students with an invaluable
opportunity to interact, network and share
experiences with other pre-registration
pharmacists – all vital attributes for building
a future multidisciplinary workforce.
Pharmacy graduates undertaking their
pre-registration training year.
This blended learning programme is
delivered primarily through monthly
face-to-face study days at venues across
the UK. Further learning is provided
through webinars. Additional resources
are available online, including interactive
modules. Newsletters incorporating
support tools are also provided. Students
benefit from regular practice of exam-style
questions throughout their training and
a mock assessment mapped to the GPhC
assessment framework towards the end of
the year. Course topics covered include:
• GPhC registration assessment syllabus.
• Clinical pharmacy topics.
• Objective Structured Clinical Examination.
• Responding to symptoms.
• Law and ethics.
• Pharmaceutical calculations.
• First Aid.
• Measuring and fitting compression
• Public health.
How the NPA delivers the course
The NPA’s pre-registration training
programme incorporates a variety of
learning formats, as we recognise that
people learn in different ways and at
different speeds. By delivering in this way,
theoretical learning can happen at a time
and place to suit the student, practical
training can be accommodated within the
workplace and your student will be inspired
and fulfi lled by the mix of studying. The
majority of the course content is delivered
across three formats – e-learning, webinars
and study days.
Tutorials in the form of webinars are
offered to students on several occasions
throughout the course. If the trainee
is unable to attend during the live
presentation, they can view it at a time
that suits by logging on to the e-learning
platform and view the content ‘on
demand.’ With an average duration of one
hour, a webinar provides an interactive, fun
way of learning but without the need for
the trainee to be away from the pharmacy.
The NPA’s e-learning system provides
an engaging and intuitive platform for
students to get to grips with the theoretical
aspects of the course. Access is available
24/7, so study can take place at a time
that suits them. There is also an app
that trainees can download, if they wish
to study ‘on the go’ or at times when
computer access within the pharmacy
may be limited. The NPA’s dedicated tutors
will be able to communicate directly with
students via the platform, so reminders of
forthcoming study days and pre-work, for
example, will appear as a notifi cation when
students log onto the platform or they
can arrange to receive text notifi cations.
Their supervising pharmacist, will also be
able to log onto the system and review
the student’s progress, as well as accessing
the Tutor Training programme and online
resources – free to all NPA members who
enrol a student on our pre-registration
Pharmacy owners and students can
download a brochure from the NPA
website which contains more information
about the course including the schedule
of learning and student testimonials.