The latest news from the National Pharmacy Association...
This month’s key notes
Engage with CPCS
Independent community pharmacies are urged to engage with the NHS Community Pharmacist Consultation Service (CPCS), whilst recognising the many challenges they already face and the pressures on their time. The NPA has resources to support our members to deliver CPCS effectively. Go to www.npa.co.uk/ communitypharmacist-consultation-service/
EPS Phase 4 rollout
NHS Digital has rolled out EPS Phase 4 to additional GP practices using the TPP SystmOne GP system so all community pharmacy teams should be aware that they could start to receive EPS Phase 4 tokens from patients to process.
NPA flu information chart for flu season 2019/20
The NPA flu vaccine information chart will help to support you in delivering flu vaccination services either under the NHS or against a private Patient Group Direction (PGD). Go to www.npa.co.uk/information-and-guidance/flu-information-pack-vaccine-information/ for more info.
ALSO THIS MONTH
Healthy Living Champion qualification
As a mandatory requirement of the new CPCF all community pharmacy contractors will be required to become an accredited Healthy Living Pharmacy (HLP) Level 1 by Wednesday 1 April 2020.
A Healthy Living Champion is a crucial requirement to become HLP accredited, so at least one member of the pharmacy must achieve a Level 2 qualification in Understanding Health Improvement. Additionally, achievement of the HLP Level 1 status forms part of one of the quality criteria for the 2019/2020 Pharmacy Quality Scheme, formerly known as Quality Payments Scheme.
Go to www.npa.co.uk/learning-and-development for more info.
Primary Care Networks (PCN) engagement guidance
The NPA wishes to see independent community pharmacy effectively represented across the 1,259 PCNs in England. We encourage you to put yourself forward for your local PCN lead roles. To further support you please connect with our NPA Local Integration Lead, Michael Lennox, via M.firstname.lastname@example.org.
Resources to support improved patient safety
The cross-sector Community Pharmacy Patient Safety Group (of which NPA is a member) has worked with PSNC to develop two new resources that give contractors supplementary advice and guidance to complete some of the patient safety components of the 2019/2020 Pharmacy Quality Scheme (PQS).
The resources can be found by going to www.npa.co.uk/information-and-guidance/patient-safety-pqs-resources/
NPA PRODUCTS, SERVICES AND ADVICE
From April 2020, all community pharmacies in England will need to become an accredited Healthy Living Pharmacy (HLP), as a mandatory
requirement of the new pharmacy contract.
This means that those pharmacies who are yet to achieve HLP Level 1 status must now be making a concerted effort to become one.
The achievement of the HLP status forms part of one of the quality criteria for the 2019/2020 Pharmacy Quality Scheme (PQS), formerly known as the Quality Payments Scheme.
However, this is not the only benefit – pharmacy staff will gain the opportunity to get upskilled and the HLP qualification gives pharmacy teams the knowledge to empower communities when it comes to their own health and wellbeing.
According to Public Health England, a Healthy Living Pharmacy is one which has been recognised as consistently demonstrating “a proactive approach to health and health improvement.”
Janita Patel and Heenal Malde, both Learning and Development Pharmacists at the NPA, help to deliver the HLP Leadership Training course which is for members of the pharmacy team carrying out the HLP scheme. It provides participants with the inspiration to deliver the HLP initiative with their teams.
“The designated leader could be the pharmacist or a suitable member of the pharmacy team,” says Janita. She adds: “The leader has to ensure there is a healthy living action plan in place, a schedule for the pharmacy, detailing what they’re going to be doing throughout the year. They also have to look at the most prevalent diseases in the area.”
Pharmacies also have to be “actively” showing that they are a HLP. “You’re not waiting for people to come and see you, you’re actively promoting healthy living,” explains Janita.
There are a number of things a pharmacy must do in order to have HLP status, including a “healthy living zone” in the pharmacy, says Heenal.
“It could be a noticeboard where you have information about local health-related sessions, the local dementia group and Public Health England campaigns. If pharmacists go to their area’s relevant public health websites regularly they should find monthly schedules of different campaigns they can get involved in.
“Ethically for pharmacists, prevention is important. This drive to get pharmacies a HLP status is moving towards where pharmacy needs to go.”
Meera Majithia, also a learning and development pharmacist at the NPA, is the lead for the Healthy Living Champion (HLC) course which is mandatory for pharmacy staff who are taking part in the HLP initiative.
The course can be undertaken by any member of the pharmacy team, including technicians, dispensers and counter assistants. It helps develop the knowledge and skills of the HLC to support patients, signposting them to relevant healthcare services to maintain healthier lifestyles.
“It is important that the healthy living champions in the pharmacy feel more confident in giving lifestyle advice and healthy well-being advice. With the introduction of the new Community Pharmacy Contractual Framework (CPCF), the role of community pharmacies is expanding significantly with pharmacists and the pharmacy team being the first port of call for health and lifestyle advice, as well as minor ailments.“
These NPA courses are available in paper and online. Visit www.npa.co.uk/training or call 01727 800 402.
Phase 4 of the Electronic Prescription Service (EPS) was rolled out nationally from 18 November 2019.
The NPA has produced a template standard operating procedure (SOP) and guidance to support you and your team if a patient presents an EPS Phase 4 token at your pharmacy.
What is EPS Phase 4?
In this phase of the Electronic Prescription Service (EPS), the electronic prescription, rather than the paper prescription, will be the default method of prescribing, dispensing and reimbursing NHS prescriptions in England. Previously, only patients who have set up a nomination with their chosen pharmacy can use EPS; however in EPS Phase 4, prescriptions will be generated electronically even for patients who have not set a nomination.
Paper prescriptions will only be issued in exceptional circumstances such as when one, or more, of the following criteria are met;
• The product is not listed in the NHS dictionary of medicines and
• Instalment prescribing
• The patient usually has their prescriptions dispensed in Northern
Ireland, Scotland or Wales
• The GP is unable to use EPS because they are experiencing
technical or other difficulties
• The welfare of the patient is at risk
• The patient specifically requests to receive a paper prescription.
Consent and nominations
Patient consent is not needed for EPS Phase 4 prescriptions but remains a requirement for a nomination to be set up. All existing
nominations set by patients will remain valid and pharmacy staff do not need to do anything with these.
Patients who receive regular medication and frequently get their prescriptions dispensed at the same pharmacy, should continue to have nominations set; the decision of setting up a nomination lies with the patient.
EPS Phase 4 prescriptions will not be included in the scheduled or manual nominated release requests from the NHS Spine. Waiting times for patients using EPS Phase 4 will be similar to those of signed paper prescription ‘walk-ins’ as the electronic prescription is not available to download until the patient presents at the pharmacy with the EPS Phase 4 token and the prescription cannot be prepared in advance.
How to dispense an EPS Phase 4 token
• Patients without an EPS nomination will present to the pharmacy
of their choice with an EPS Phase 4 green prescription token
which is issued by the prescriber.
• Patients may refer to this as a ‘paper copy’ of their prescription.
• The token’s unique barcode can be scanned or the 18 digit
Prescription ID can be manually entered to download the
prescription from the NHS Spine and retrieve details of the
medicine or appliance.
Positive discrimination - Can employers prioritise black, female or disabled applicants?
Most of us can agree that treating somebody unfairly on the basis of their sex, race or disability isn’t acceptable – but is it ever justified for employers to prioritise marginalised groups?
No matter your personal viewpoint, the law makes a clear distinction between positive discrimination and positive action. In short, treating one person more favourably than another because they have a protected characteristic is generally prohibited under the Equality Act (EqA) 2010, unless it relates to a genuine occupational requirement.
What you can do: Positive action
Under the EqA, employers are permitted to take positive action in situations where a group of people with a shared protected characteristic (such as gender, race or disability) are disadvantaged or under-represented in connection to that characteristic. In other words, in cases where there is a clear imbalance of opportunity, employers can take proportionate measures to address the disadvantage and encourage participation without leaving themselves exposed to discrimination claims.
Since April 2011, positive action can also be exercised within recruitment and promotion in cases where the employer reasonably believes that there is a lack of representation. This allows an employer, when making hiring decisions, to select a candidate from a group that is disadvantaged or underrepresented in its workforce if the candidates are of equal merit.
What you can’t do: Positive discrimination
While positive action is lawful (provided the employer meets the conditions set out in the EqA), positive discrimination, generally speaking, is not. While positive action creates a level playing field to enable people to compete on equal terms, positive discrimination occurs when an employer:
• Decides to hire a candidate purely
on the basis of a relevant protected
characteristic, regardless of their
ability to do the job; and/or
• Sets quotas to recruit or promote
a specific number of people with a
For example, encouraging people
from a particular ethnic background
to apply for a position is a permitted
form of positive action, and provided
recruitment decisions are based on merit
alone and no quota is set, then positive
discrimination will not have occurred.
I’m looking to take positive action – what’s the first step?
To find out, go to the NPA website and search ‘positive discrimination’. To discuss your situation contact the NPA Employment Advisory Service on 0330 123 0558 or email email@example.com
Medication safety officer report
The NPA holds the Medication Safety Officer (MSO) role for all community pharmacies in England with fewer than 50 branches. Here are some of the
findings from the July to September (quarter three) report.
There was a 25 per cent increase in the total number of patient safety incidents reported in quarter three of 2019, compared to quarter two.
Origin of patient safety incidents
A total of 92 per cent of incidents originated from the pharmacy. Prescribing errors accounted for 5 per cent of the errors reported – this is a 3 per cent increase from quarter two. It is important to report prescribing errors because increased reporting allows identification of trends and increases learning. The most common type of error reported during quarter three were “dispensing errors” which accounted for 86 per cent of all reported incidents.
Medication error categories
The main categories of error reported were those involving medication errors such as wrong strength, drug or formulation. These accounted for 62.7 per cent of errors.
“Wrong strength” accounted for 26.2 per cent of errors. “Wrong drug/medicine” accounted for 25 per cent and “wrong formulation” 11.5 per cent. Errors involving insulin were reported in both the “wrong drug/medicine” and “wrong formulation.”
“Wrong formulation” incidents were mainly due to pre-filled pens and cartridges being mixed up. There have been multiple “wrong drug/medicine” incidents reported with different brands of insulin. Insulins should be prescribed by brand name as different brands often have different instructions for use. Patient training is required.
Degree of harm caused to patients
The degree of harm caused to patients reported as “none” (56 per cent) and “near miss” (30 per cent) made up the majority of reports. The data over quarter three highlighted good and poor reporting. All reports where the degree of harm was reported as “death” or “severe” were incomplete.
There was no analysis on the root cause of these incidents or follow up with the pharmacies. Due to poor reporting, it is not known if these incidents actually caused death or severe harm or if reports were completed incorrectly. When documenting harm to patients, the actual degree of harm should be documented, not the potential harm that could have arisen.