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NPA Essential: February 2021

This month's news from the National Pharmacy Association...

This month’s key notes:

NHS Community Pharmacy Home Delivery Service during the Covid-19 Outbreak has been restarted

Following the national lockdown that started on 5 January 2021, the NHS Community Pharmacy Home Delivery Service during the Covid-19 Outbreak has been restarted for people who are clinically extremely vulnerable (CEV) living in all areas of England.

For full details, please refer to the service specification and detailed guidance on the NHS England website: bit.ly/38BZfaY

The key points for all pharmacy teams in England are:
• The NHS Community Pharmacy Home Delivery Service during the Covid-19 Outbreak will apply to CEV patients living in all areas in England
• The service will run from 5 January 2021 until 11:59pm 21 February 2021
• All community pharmacies will receive payment under the Essential Service element
• Where possible, in the first instance, a friend, relative, carer or volunteer should be asked to collect the medicines
• Claims for delivering prescribed items to eligible patients under the Advanced Service element of the NHS pandemic delivery service must be made no later than the fifth day of the following month in which deliveries were made via the Manage Your Service (MYS) platform.


NPA support:
• NPA SOP “Community Pharmacy Home Delivery Service during the Covid-19 outbreak (England) can be access by going to:
bit.ly/3sj8sNf
• NPA volunteer training is available by going to: bit.ly/2LGZ98Y
• Delivering medicines to patients – posters can be accessed at: bit.ly/3iehBCc
News, views and must-dos: your update from the NPA
• FAQs including ones on volunteers can be found here: www.npa.co.uk/coronavirus-updates/faqs-covid-19/
• The dedicated COVID-19 section of the NPA website: www.npa.co.uk/coronavirus-updates/
For further information please contact the NPA Pharmacy Services team on 01727 891 800 or email pharmacyservices@npa.co.uk.

ALSO THIS MONTH
COVID-19: Employer support
HMRC will be holding live webinars on the Coronavirus Statutory Sick Pay Rebate Scheme on 16 February at 1:45pm. If you’re a pharmacy owner or contractor, you can find out if you can use the Coronavirus Statutory Sick Pay Rebate Scheme to claim back employees’ coronavirus-related Statutory Sick Pay (SSP).

You can claim back up to 2 weeks of SSP if:• you have already paid your employee’s sick pay (use the SSP calculator to work out how much to pay)
• you’re claiming for an employee who’s eligible for sick pay due to coronavirus
• you have a PAYE payroll scheme that was created and started on or before 28 February 2020
• you had fewer than 250 employees on 28 February 2020 across all your PAYE payroll schemes.

Employees do not have to give you a doctor’s fit note for you to make a claim. But you can ask them to give you either:
• an isolation note from NHS 111 – if they are self-isolating and cannot work because of coronavirus (Covid-19)
• a ‘shielding note’ or a letter from their doctor or health authority advising them to shield because they’re at high risk of severe illness from coronavirus.


The scheme covers all types of employment contracts, including:
• full-time employees
• part-time employees
• employees on agency contracts
• employees on flexible or zero-hour contracts
• fixed term contracts (until the date their contract ends).

Register for the HMRC webinar by going to bit.ly/2XBaB8P

Kickstart Scheme: apply for funding via the NPA
The Kickstart Scheme is a government scheme being introduced in the UK to fund the creation of high quality jobs for young people. It
is aimed at those who are on Universal Credit and deemed to be at the highest risk of long-term unemployment.
The NPA is working with Reed, a recruitment company which is also a gateway organisation for Kickstart. If you are looking to hire 29 or fewer employees, you can apply for funding and candidates with the NPA through Reed as a Kickstart Gateway. You can spread the
start date of the job placements up until the end of December 2021. For further information go to www.npa.co.uk/training/kickstart-programme

Key updates for pharmacy teams during the latest national lockdowns
The NPA has created a list of key actions for pharmacies during the current lockdown which are available here - bit.ly/39o83jS

NPA meets Equalities Minister to discuss Covid vaccines

The National Pharmacy Association met with Kemi Badenoch MP, Minister for Equalities, about reaching out to patients and communities who might otherwise miss out on vital care, such as the Covid vaccine.
NPA chair, Andrew Lane, who chaired the discussion on 7 January, said: “It is great to be talking to the Equalities Minister about a range of issues concerning our sector and the patients we serve. As employers, anchors for local economic activity and providers of healthcare
to people in deprived communities, community pharmacists have an important role in supporting equality.
“What’s more, many pharmacy owners and staff are from Black and Minority Ethnic groups.
“The Minister is aware that people have a high level of trust in their local pharmacists, which could be an important factor in overcoming doubts and misapprehensions about vaccines for Covid-19.
“We also took the opportunity to remind her of the current economic pressure on family-owned pharmacies, many of which are owned by people from BAME backgrounds and between them employ thousands of staff.”
Kemi Badenoch told the meeting: “Throughout this pandemic our medical and frontline staff, including pharmacy teams, have been working tirelessly and you have done a tremendous job.
“I want to reassure you that we are committed to building on the work I have undertaken on Covid-19 inequalities and learning from the Commission for Race and Ethnic Disparities.
“I also want to thank you in advance for the critical role that community pharmacists all over the country will be playing in the vaccination programme and continue to play throughout the pandemic. Your skill and insight is vital to ensuring those most in need of this protection feel well informed and confident to access this support.”
Joining the NPA and Kemi Badenoch at the virtual roundtable were a number of BAME pharmacists and a GP from inner-city London.
Pharmacy Minister Jo Churchill MP and Vaccine Deployment Minister Nadhim Zahawi MP also took part in the discussions.

National Pharmacy Association centenary year begins
The National Pharmacy Association is 100 years old this year. To mark the centenary, the NPA plans a series of activities throughout the year, including special recognition for some of its longest serving members.
The NPA began life as the Retail Pharmacists Union in 1921 and has since grown to become the leading voice of independent community
pharmacy across the UK.
NPA chair Andrew Lane said: “The NPA has been at the heart of community pharmacy for a hundred years and our members have
touched the lives of millions of people over that time. It’s a privilege to be so embedded in
the community pharmacy story – a story about which we can all be very proud.
“Over these 100 years, the NPA has brought community pharmacists together, to pool resources, to learn from each other and to deliver fantastic patient services at scale. We’ve also stood together at times of adversity and challenge, as right now.
“As well as commemorating the past, we also want to use this centenary year as a springboard to the future. Community pharmacy must constantly evolve to meet the ever-changing needs of the population and the NPA will be with our members on that change
journey.”
Visit our dedicated page by going to www.npa.co.uk/100-years - NPA members who would like to share the history of their own pharmacy, as part of the NPA’s centenary celebrations, are invited to contact press@npa.co.uk

MHRA guidance on the Distance Selling Logo

Following the end of the transition period, the requirement to display the EU distance selling logo will be different for all UK countries...

The Medicines and Healthcare Regulatory Agency (MHRA) has issued guidance on the use of the Distance Selling Logo for each UK country.
The MHRA has become the UK’s standalone medicines and medical devices regulator following the end of the Brexit transition period on 31 December 2020.
Pharmacies in Great Britain (GB) will no longer be required to use the Distance Selling Logo; however the current distance
selling system will still apply to pharmacies in Northern Ireland.

For pharmacies in GB (England, Scotland and Wales)
The MHRA will remove the Distance Selling Logo from its server and any links for registered websites which display the logo in GB.
Pharmacy owners who sell/supply medicinal products via the internet or at a distance should ensure that the relevant staff are aware of the following:
• The pharmacy will no longer require
registration with the MHRA in order to
sell/supply medicinal products online via
the internet or at a distance
• The Distance Selling Logo will no longer
be required to be displayed on each page
of the website which offers the sale/
supply medicinal products to the public
• The contact details and hyperlink to the
MHRA will no longer be required to be
displayed on the website which offers
to sale/supply medicinal products to the
public

Developers should also be contacted to discuss the removal of the logo and the MHRA details from the website following the end of the Brexit transition period.
The MHRA will be looking in the future to consider an alternative, to the use of the logo.
The MHRA will continue to use enforcement activity to disrupt illegitimate online retailers and promote guidance via public health campaigns to inform public choices when purchasing healthcare products online.

Pharmacies in Northern Ireland
Pharmacies that sell/supply medicinal products online via the internet or at distance will remain registered with the MHRA.
Pharmacies must continue to have in place the following:
• Visibly display the Distance Selling Logo on
each page of the website which offers to
sale/supply medicinal products to the public
• Website which offers to sale/supply
medicinal products to the public, have on
display the contact details and hyperlink
to the MHRA website

MHRA: www.gov.uk/guidance/registerfor-the-distance-selling-logo#sellingmedicines-from-the-uk-via-the-internet

Face Covering Dilemma

The issue of face masks being worn in retail outlets has become increasingly contentious in recent weeks and is having a significant impact on community pharmacies. Noting the announcement by several major supermarkets that they will ban customers from entering the store unless they have a valid medical exemption, NPA Insurance’s Alex Buchanan, General Counsel, has prepared this advice for our members.

For months, pharmacies have been working flat out to support their local communities by providing a vital service in the provision of medicines and advice during the pandemic. In July 2020, the English government made it mandatory for face coverings to be worn when visiting a pharmacy unless someone has a ‘reasonable excuse’ not to wear one, with similar positions being adopted in
Wales, Scotland and Northern Ireland.
One such ‘reasonable excuse’ is the inability to wear a face covering because of a physical or mental illness or impairment, or disability
within the meaning of the Equality Act 2010. Where pharmacies adopt a policy of not letting people into a pharmacy without a face
covering, claims for disability discrimination can follow and the question arises over whether such claims are likely to bear fruit?
There is is no simple to answer and there are a number of points to be considered that pharmacies should be aware of, so they
understand the risk of claims and can mitigate that risk.
The first point to be considered in a legal context if a claim for compensation for disability discrimination is made is whether the claimant has a disability within the meaning of the Equality Act 2010. That is do they have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on the ability to do normal daily activities.

Minor illnesses/conditions are unlikely to exceed this bar but conditions like chronic asthma would likely be covered.

The second consideration is whether the claimant has actually suffered any discrimination as the result of a policy which targets all those who refuse to wear a face covering and not just those who have a disability. Indeed, there are other ‘reasonable excuses’ when it is not mandatory to wear a face covering, such as when this causes severe distress or there is a need for identification.
The third consideration is whether reasonable adjustments have been put in place by the pharmacy to ensure those who are disabled receive the same service as those without a disability. Claimants will argue the adjustment would be allowing them not to wear a face covering, but it is arguable in the case of dispensing that a reasonable adjustment is providing medication at the pharmacy door.
Lastly comes the argument that if someone has suffered discrimination it is justified, and proportionate means have been taken to justify a legitimate aim; in this case the health, safety and welfare of individuals (staff and other members of the public) from contracting Covid-19. Therefore it is not clear cut whether discrimination claims will be successful.
Claims of this nature have yet to pass through the courts in order to assist in providing a precedent for future claims. From a legal and practical point of view, blanket policies refusing entry to all those not wearing a face covering risk impassioned complaints and possible compensation claims with lengthy litigation.

If someone enters a pharmacy without a face covering it is OK to ask them to put one on, but if they say they are exempt then it may be best to trust their word and not push any further.

Home Office launches codeword scheme in pharmacies to offer ‘lifeline’ to domestic abuse victims

The Home Office launched the ‘Ask for ANI’ codeword scheme on 14 January to enable victims of domestic abuse to discreetly request immediate help from the police or other support services from the safety of their local pharmacy...

Anyone can be a victim of domestic abuse, regardless of gender, age, ethnicity, ability, socio-economic status, sexuality or background. This is why pharmacies, used by people from all walks of life, are being invited to volunteer to take part in this important initiative.
As part of the scheme, pharmacy owners will be required to ensure staff are familiar with the training information provided. The training resources include a short video and two guidance documents on adopting the scheme and responding to the codeword.
Prime Minister Boris Johnson said: “As we once again have to ask people across the country to stay at home to tackle this virus, it’s vital that we take action to protect those for who home is not a safe space.
“That is why we have launched this scheme, supported by pharmacies up and down the country, to give some of the most vulnerable people in society a critical lifeline – making sure they have access to the support they need and keep them safe from harm.”
Chief executive of the National Pharmacy Association, Mark Lyonette, said: “Community pharmacies are about people, not just pills. There is a clear and urgent need to support victims of abuse and we want to play our part.
“The ‘Ask for ANI’ alert mechanism is a discreet and sensitive way to help support some of the most vulnerable people in our society.”

Resources and further support
Given the nationwide publicity it is possible that people will come to your pharmacy for help even if you have not yet registered to take part. Therefore you might wish to avail yourself of the training materials via the links below.
To inform customers that staff are ready to respond, you will also be required to display ‘Ask for ANI’ posters in your pharmacy. The ‘Ask for ANI’ training and promotional resources are available by going to bit.ly/3qfCsHO online.
The ‘Ask for ANI’ and the existing Safe Spaces initiative can work together. If your pharmacy is already running Safe Spaces, please use the dual training resources and co-branded posters available by going to bit.ly/3nIUT6m to adopt ‘Ask for ANI’ too. To confirm your participation in the codeword scheme go to bit.ly/39uETjb. If you have any questions, please email the Home Office at AskforANI@homeoffice.gov.uk

NPA members are also welcome to contact Helga Mangion, NPA Policy Manager, at independentsvoice@npa.co.uk for any further queries.

Indemnity arrangements for the Covid-19 vaccination programme

Clinical negligence indemnity will be provided for Covid-19 vaccinations under the Clinical Negligence Scheme for Coronavirus (CNSC) where vaccinations are administered by community pharmacies in line with the Community Pharmacy Local Enhanced Service (LES) agreement until 31 March 2021...

Following the roll out of the Covid-19 vaccination programme, NHS England and NHS Improvement (NHSE&I), the Department of Health
and Social Care (DHSC) and NHS Resolutions issued a joint letter on 22 December 2020 to reassure healthcare professionals and others working and volunteering in the NHS in England about the indemnity arrangements that are in place. Access the full letter by going to bit.ly/3qlMUxD.

The key points for community pharmacies are:
• Clinical negligence indemnity will be provided under the Clinical
Negligence Scheme for Coronavirus (CNSC) where vaccinations
are administered by community pharmacies in line with the
Community Pharmacy Local Enhanced Service (LES) agreement
until 31 March 2021
• This cover includes all pharmacy staff and extends to any
additional staff brought in to help with vaccine administration
under the national protocol, provided they are engaged under the
LES.
• The cover under the scheme excludes:
• Non-clinical vaccination activity undertaken by staff or locally
recruited volunteers in community pharmacy; this should be
covered under the pharmacy contractor’s own third-party
liability insurance. It is recommended that pharmacy contractors
put in place a local volunteer agreement for locally recruited
volunteers
• Non-clinical vaccination activity undertaken by staff or locally
recruited volunteers in General Practice; this should be covered
under the General Practice’s own third-party liability insurance
• Volunteers who are deployed through the arrangements
established centrally by NHSE&I with St John Ambulance. These
individuals are intended to be covered by the existing insurance
policies of St John Ambulance.

The cover under CNSC is for clinical negligence only. Please contact the pharmacy’s and individual pharmacist’s existing insurance and/or indemnity arrangement for all other risks such as Public Liability, Employer’s Liability and Professional Indemnity.
Healthcare professionals are reminded that they are covered by Regulation 345 of the Human Medicine Regulations (HMR) which provides immunity from civil liability in respect of claims in relation to the safety or efficacy of the temporarily authorised vaccine itself.
NHS Resolutions have produced a frequently asked questions document regarding the clinical negligence indemnity cover for community pharmacy administering Covid-19 vaccine which can be accessed by going to bit.ly/2LUoZGQ online.
The information here is correct at the time publishing. For further information please contact the NPA Pharmacy Services team on 01727 891 800 or email pharmacyservices@npa.co.uk




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