Welcome to NPA Essential, brought to you in close collaboration between Independent Community Pharmacist and the National Pharmacy Association. This regular supplement gives independent pharmacy teams the latest news and must-dos from your key representative body...

 

Monthly planner

Things to do and things to know in community pharmacy across the UK

 

Quality payments

NHS England has published updated “Quality Payments: Guidance for the February 2019 review point” (QP guidance). The NPA recommends that the full document be read as there have been many changes compared to previous quality payments (QP) review points. It can be found by going to www.england.nhs.uk/ commissioning/primary-care/pharmacy/framework/pqp/.

It is important to note that as with previous QP review points, NHS England will work with NHS Business Services Authority (BSA) to undertake validation checks. Submitting declarations — contractors are now required to submit QP declarations via NHSBSA Manage Your Service portal (previously you used the SNAP survey tool).

 

What contractors need to do

Contractors will need to register with the Manage Your Service portal by following instructions in the automated email received in your shared NHSmail account from nhsbsa.pharmacysupport@nhs.

net. The email will also include details on how to log in from their NHSmail account and if a multiple, how to access declarations for all pharmacy branches.

 

• If you have not received this, firstly, check your junk mail

folder, and if required, email NHSBSA Provider Assurance Team

(pharmacysupport@nhs.net) who will investigate and provide

support. Once declarations have been submitted no amendments can

be made therefore, the NPA recommends double-checking the

declarations before submitting. Once submitted, you will receive

a confirmation email to your the shared NHSmail account from

NHSBSA.

• Retain this email as proof of submission.

• If you have not received this email, email NHSBSA Provider Assurance Team (pharmacysupport@nhs.net) and provide your pharmacy name and ODS code, who will investigate and provide support.

 

Key Dates Details

First half of December 2018 - Email received to your shared NHSmail account confirming whether you have met the Gateway criteria, NHS Digital Warranted Environment Specification (WES).

Monday 5 November 2018 – Friday 15 February 2019 23:59 - Confirm/edit your pharmacy’s NHS 111 Directory of Service (DoS) entry.

Monday 3 December 2018 00:00–Friday 15 February 2019 23:59 - You must edit/validate your NHS.UK

profile entry

Monday 4 February 2019 at 09:00-Friday 1 March 2019 at 23:59 - Declarations window

Friday 8 February 2019 17:00 - Pharmacy contractors requesting NHS.UK website editing dates via

their shared NHSmail account prior to this date will be assured of having it enabled. After this deadline, or

if request made via a non-NHSmail account, may result in delays.

Friday 15 February 2019 - Review date

Friday 1 march 2019 at 23:59 - Declarations window CLOSES

Friday 29 March 2019 - Deadline for pharmacy contractors to email nhsbsa.pharmacysupport@nhs.net to provide corrective actions undertaken to meet the five Gateway criteria when the portal has not verified it.

 

• You have the option of providing an alternative email address if you prefer. ENGLAND

FMD goes live on February 9.

To support members the NPA has launched its first phase of updated standard operating procedures (SOPs). More FMD-version SOPs will be created in the coming weeks. Go to www.npa.co.uk/fmd for more information.

 

Representing you

 

High Court rules in favour of NPA in case brought by Pharmacy2U

 

The UK’s largest online pharmacy has failed in a legal bid to obtain the contact details of thousands of independent community pharmacies, after the High Court refused its request.

The legal proceedings arise from the NPA’s December 2017 information leaflet about Pharmacy2U (P2U).

P2U initially threatened to sue the NPA for defamation, malicious falsehood and trademark infringement arising from the content of the leaflet.

It demanded the NPA disclose the names and contact details of every NPA member who had received the leaflet and also sought a retraction and public apology, using wording P2U prepared themselves.

The NPA defended against P2U’s allegations and P2U were subsequently obliged to withdraw the threats of

defamation and malicious falsehood.

However, P2U then decided to claim that the NPA was guilty of trademark infringement for using the name

‘Pharmacy2U’ in the leaflet.

In particular P2U said the leaflet does not fairly compare its services with those offered by NPA members.

P2U has not disputed the truth of the statements in the leaflet but said its primary purpose is to disparage the services offered by [P2U].

P2U said the leaflet was an attempt to rubbish the value of [P2U’s] brand and divert business away from [P2U] to [NPA’s] members.

In July, P2U issued High Court proceedings asking the Court to require the NPA to supply the names and addresses of all NPA members who had received the leaflet. The NPA defended P2U’s claims.

Following a hearing, the High Court has now issued a Judgment denying P2U’s request. Pharmacy2U must also pay the NPA’s costs of the legal proceedings.

Commenting on the judgment, the NPA said: “The court has seen this for what it is, a completely unjustified and unreasonable attempt to obtain details of our members in order to intimidate them.

“We are confident there is no trademark infringement case to answer either. If P2U think otherwise they should challenge us and not our members, who we will defend to the hilt.

“Online pharmacies have a place within the health sector and we have a significant number within our membership, but all pharmacies must behave appropriately irrespective of their business model.

“Ultimately this is about patient choice and ensuring people have access to information that enables them to make an informed choice about their healthcare.”

Refusing P2U’s Application, the Court said there was a serious risk that P2U might use the NPA members’ details to “pick off” individual NPA members, threatening and intimidating them rather than pursuing the NPA.

The Judge noted “These concerns are reinforced to a degree by P2U’s conduct to date” and said that P2U’s threatening correspondence sent to the NPA may be “actionable groundless threats” meaning they might reasonably be the subject of a counter claim.

It is not yet known whether P2U will pursue the trademark infringement issue. The NPA is warning members that P2U might still contact them over the alleged trademark infringement and urges members not to reply to P2U, but instead to contact its legal team on 01727 858687.

 

Just how much pressure are you under?

Independent pharmacies currently face an array of challenges, not least a very pressured financial environment.

As we strive to help you through turbulent times and into a brighter future in which you can prosper professionally and commercially, help us to prioritise our efforts on your behalf. The survey should take no more than 10 minutes and your responses will be treated in strict confidence.

Please note that some of the questions in the survey are only suitable for Pharmacy Owners.

Go to www.npa.co.uk/news-andevents/news-item/help-us-shape-theservices-the-npa-provides-for-thecommunity-pharmacy-sector-nowand-for-the-future/ *Please note: youwill be directed to an external site; If you have any questions, contact us at communicationservices@npa.co.uk

 

Propery focus

The Perils of subsidence

 

After a prolonged hot summer last year, it may now not just be temperatures that are sinking!

As a result of the tropical climate this year your properties may be at risk of subsidence.

So what actually is subsidence and how can you spot the warning signs that your property may be affected?

Subsidence is the movement of a building’s foundations caused by downward movement in the ground, usually after soil under the building dries and shrinks in hot weather. This can lead to the foundations becoming unstable.

It occurs most often on properties built on shrinkable soils such as clay although the issue can also occur as a result of tree roots sucking the moisture out of the ground.

The long hot summer took its toll on water supplies, plants and gardens and could now be having an impact on your property.

 

So what do you look for as sign of possible subsidence?

All buildings move and settle over the years, sometimes leaving hairline cracks, but these are rarely cause for concern and are only cosmetic. The difference with subsidence is that large cracks appear both inside and

outside the property in a very short period of time.

Mike Prevot, Head of Insurance Services for NPAI said: “While it may sound dramatic talking about your property sinking, the telltale signs of subsidence are unlikely to be immediately obvious unless you know what

you are looking for”.

The common symptoms to look for include doors and windows getting ‘stuck’ and becoming harder to open or close, wallpaper buckling in the corners of the room where damp is not an issue, cracks appearing in plaster inside the house, often next to doors and windows, cracks appearing in brickwork outside the house and diagonal cracks that are wider than 1mm and wider at the top than the bottom.

There is little than can be done in relation to the effects of an extremely long and warm summer, however there are some steps you can take to lower the likelihood of subsidence. Trees and plants can dry out soil

further, so try to avoid planting any large shrubs within six meters of your home. Also ensure existing plants are pruned regularly.

This should curb growth and minimise the amount of water they require. Whilst NPAI mirror the market by

charging an excess of £1,000 for a subsidence claim for property owners and pharmacy, we do not charge an excess for subsidence for your home unlike the majority of other insurers where an average excess of £1,000 still applies.

Mike advised: “The time to take action is now, inspect your property and if you notice that any of the tell-tale signs are starting to occur then contact your insurer to raise a potential claim and they will arrange, if necessary, to have your property inspected and any remedial work to take place”.

 

FMD Connect

The NPA has managed to negotiate a deal that will give independent pharmacies access to a cost-effective,

simple, standalone FMD solution. The NPA-negotiated package with FMD IT includes FMD installation and ongoing technical support and advice. Registration is via a website and there is access to client portal for software downloads and help guides.

The system offers: stock control, expiry date checker, FMD compliance and management Information dashboards.

Cost to NPA members:

• £25 per month software license and

support fee.

Hardware options:

• Windows 10 Tablet £200

• Newland HR22 Barcode scanner £75

• Pre-printed aggregation labels £65 (covers

60,000 scripts)

• Ethernet USB Hub £20

For more information, visit npa.co.uk/fmd-it-limited

 

Delivering medicines safely

There could be “horrendous” implications for patients if their medications are not handled correctly when delivered to them.

It’s one of the reasons why the NPA provides GPhC accredited training to upskill and develop staff who deliver medicines to patients’ homes.

The Delivering Medicines Safely & Effectively course is the first of its kind for delivery drivers and those who deliver by foot and the only such resource to be accredited by the GPhC.

As well as covering rules and regulations, the course provides drivers with critical knowledge to ensure the safety of patients and reduce the risk of errors. It also aids development of soft skills such as how to build relationships with GPs and managers.

Sureena Sharma, Education and Training Pharmacist at the NPA said a “key part” of the course was to provide drivers with basic medicine information.

“A lot of people who come onto this course don’t come from medical backgrounds. A key part of this course provides them with information on the medicines they’re dealing with. Those delivering medicines could be handling control drugs or fridge items. With regards to control drugs some of them have strict storage regulations so it is imperative that drivers understand the implications if it isn’t stored and handled in the correct way.”

There could be “horrendous” consequences if medicines were not handled appropriately explained Sureena.

“Incorrect storage temperature for a fridge item could mean that the medication won’t work as effectively and ultimately could cause detrimental effects to the patient.”

She added: “If the driver had something like morphine in their van and they kept it in an area where it was visible to the public they could pass by an individual who might want to try stealing it.

“They might also be a situation where the driver couldn’t deliver that medicine because the patient wasn’t in their house and they decided that they would take this medication back to their home – this could have horrendous implications.”

Those who enrol on their course get up to three months to complete it and this may be extended for a further 6 months and at the discretion of the Course Lead up to 12 months.

The estimated study time for the course is a total of 15 hours and requires learners to, complete workbook activities and submit the completed workbook to a marker, including the marking form completed by the supervising pharmacist.

The activities and scenarios throughout the workbook will form the assessment. This will be sent to the allocated internal NPA marker who will grade and provide feedback on the quality of the work.

Upon successful completion of the course a certificate of completion will be provided.

For more information about the course go to www.npa.co.uk/training/enrolment-form/

 

Look out for the NPA Insurance January 2019 survey

NPA Insurance has committed investment in a major programme to deliver new products and related services for members and customers in the years ahead.

This is your opportunity to shape the products and services we provide so please take part when the survey reaches you. The survey will arrive by email.

In advance of the survey, if members have any thoughts they’d like to share about NPA’s insurance offerings or how business support services can help you please get in touch via our Twitter handle which is @NPA1921, Facebook page, www.facebook.com/nationalpharmacyassociation and LinkedIn page, www.linkedin.

com/company/nationalpharmacyassociation/.

By taking part in the survey not only will you help shape the future, but you’ll also be entered into a prize draw to win:

• One of 10 £100 vouchers towards the cost of NPA training

courses

OR

• One of 10 £25 M&S vouchers.

 

EMPLOYMENT LAW

Under the EU Settlement Scheme, EU workers will be able to obtain settled or pre-settled status. This will allow them to live and work in the UK after 31st December 2020.

In 2018, employers had to grapple with the introduction of the GDPR and gender pay reporting.

 

So what can pharmacies expect in 2019?

March 2019 - Brexit

Under the EU Settlement Scheme, EU workers will be able to obtain settled or pre-settled status. This will allow them to live and work in the UK after 31st

December 2020.

To achieve settled status, EU citizens will be required to have lived continuously in the UK for a period of five years. If an EU citizen has less than five years’ continuous residence, they will be issued pre-settled status. The scheme will be open fully in March 2019. At the time of writing it is not yet known how non-UK resident EU Citizens will be affected by Brexit.

April 2019 - National Minimum Wage

The National Living Wage (the rate for those who are 25 or over) will rise from £7.83 to £8.21 per hour.

The National Minimum Wage (for those aged under 25), the hourly rates will increase as follows:

• From £7.38 to £7.70 for those between 21 to 24 year olds.

• from £5.90 to £6.15 for between 18 to 20 year olds.

• from £4.20 to £4.35 for 16 and 17 year olds.

• from 3.70 to £3.90 for apprentices.

 

April 2019 - Payslips

As of April 2019, the right to an itemised pay statement will be extended to cover workers, not just employees.

Furthermore, changes are coming into effect with regards to what needs to be shown on the pay statement. Employers will need to state the number of hours for which they are paying the employee on the pay

statement in cases where the employee’s wages vary in accordance to how much they have worked. The employer must either show the total number of hours worked for which payment is being made or provide the

figures for different types of work worked or different rates of pay.

 

What else is on the horizon?

A new right to paid leave and pay for bereaved parents is expected to enter into force in 2020.

Finally, there may be some movement following the recent consultations on the Taylor Review of Modern Working Practices, which considered the definitions of workers and employees in light of recent gig economy cases.

This is particularly interesting for pharmacies in light of their use of locums.

To discuss this further, contact the NPA Employment Law Advisory Service Team on 0330 123 0558 or employmentadvice@npa.co.uk

 

NEWS IN BRIEF

A pharmacy delegation from Japan visited the NPA offices to learn about UK community pharmacy practice...

 

Over 20 delegates who consisted of pharmacy owners and pharmacists from the Japan Management of Pharmacy Society (JaMPs) visited the NPA headquarters in St Albans, Hertfordshire on 21 November.

Led by Kohdai Komagata, Director at KAE management who runs JaMPs, the delegation used the visit as part of their research to see how they could incorporate aspects of UK pharmacy into Japanesepractice.

Helga Mangion, Policy Manager at the NPA addressed the delegates with a presentation about the role of the NPA and how it supports its members.

“I also spoke to them about the community pharmacy contractual framework including the education and training of pharmacists and their staff,” she said.

“It was interesting to learn that community pharmacy in Japan is only 40-years-old, and it was good to gain an understanding of the challenges facing community pharmacy in Japan which really are no dissimilar to those in the UK.”

Maiko Kokubun, Senior Pharmacist in the Pharmacy Department at Epsom and St Helier University Hospitals NHS Trust acted as an interpreter for JaMPs. She said: “All of the Japanese delegates were very delighted to visit the NPA. They found the session very informative. They have been doing research on UK pharmacy

practice for several years now but never encountered a pharmacy organisation who gave such a warm welcome as the NPA did. We wish to continue a further working relationship with the NPA.”

 

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 www.fmdsource.co.uk and www.npa.co.uk/fmd. Follow the NPA: @NPA1921

 

Will this mean that I get paid for (exactly) what I

scan? 

The Delegated Regulation gives Member States

the flexibility to use information derived from

unique identifiers for the purposes of reimbursement,

pharmacovigilence and pharmacoepidemiology. At

present, the Department of Health and Social Care do not

intend to use the flexibility for the purposes of pharmacy

reimbursement.

 

How will I deal with liquids? 

These will be decommissioned whenever the antitamper

device has been broken, i.e. when the bottle

has been opened.

 

Do I have to authenticate vaccines? 

Yes, it is expected that vaccines will need to be

authenticated before they are administered.

 

Will I still be able to do MDS? 

Yes. Packs of medicines will have to be verified and

decommissioned before they are opened to be repacked

in an MDS.

 

Will I still be able to use PI products? 

Yes. Parallel traded products will have to re-packaged

and re-labelled for the intended country of use. This

will include applying a new unique identifier and 2D barcode

(linked at batch level to the original UI) and replacing the ATD

if it has been broken. They will then be treated in the same

way as a pack originally manufactured for the UK market.

Note that the position of parallel traded products after the UK

leaves the EU has yet to be clarified.

 

What happens if the pack doesn’t have a 2D barcode? 

There will still be many packs without 2D barcodes in

the supply chain when the FMD requirements come into

effect on 9th February 2019. These packs will still be able to

be dispensed and supplied but they will not be required to be

decommissioned. Some packs are already appearing with 2D

barcodes as manufacturers make changes in advance of the

FMD requirements.

 

What happens if the ATD gets broken? What if I need to break the ATD to assemble a medicine? 

If you need to open a pack, either to split the quantity or to prepare or label the product, you will need to

check the ATD and decommission the pack before it is opened.

The pack can then be dispensed and supplied to patients in the normal way, including in MDS. When checking the anti-tampering device at the time of dispensing, pharmacy staff will be looking to see that the product does not appear to have been tampered with.

This will depend on the nature of the device or format used to seal or secure the packaging. Products with packaging where the anti-tampering device has clearly been broken cannot be supplied to patients (unless this was done by the dispenser as part of the process of assembling the medicine).

Wholesalers have to verify products that are returned to them, including inspecting anti-tampering devices. It is unlikely that they would accept back products which have broken ATDs.

 

Will I still be able to use split packs? 

Yes. Packs that are going to be split will have their ATD checked and be decommissioned at the point at

which they are first opened. The remainder of the pack can be dispensed without further checking at a future point, as it will have already been decommissioned.

 

Superintendent update on the launch of the first phase of “Essential SOPs – FMD versions”

The Falsified Medicines Directive (FMD) comes into force on the 9 February 2019. To support you in preparing for implementation of FMD, the NPA has launched the first phase of “Essential SOPs – FMD versions”.

FMD-updated SOPs – Phase 1

• SOP – Dispensing prescription items –

FMD version

• SOP – Handing out dispensed

prescriptions – FMD version

• SOP – Owing prescriptions – FMD version

• SOP – MDS – FMD version

• EPS – Dispensing pharmacy items

(England) – FMD version

• EPS – Owing prescriptions (England) –

FMD version

• CD SOP – Dispensing Schedule 2 and 3

CD prescriptions – FMD version

• CD SOP – Dispensing CD instalment

prescriptions – FMD version

• CD SOP – Handing out Schedule 2 and 3

CD prescriptions – FMD version.

 

The FMD-version SOPs can be accessed from the NPA Essentials SOPs website: www.npa.co.uk/services/sops.

The Pharmacy team will be launching more FMD-version SOPs in a further two phases over the next few weeks, including:

• Delivering pharmacy items (patient safety) / Delivery of Schedule 2 and 3 CD prescriptions

• Repeat dispensing / Serial prescriptions (Scotland) / EPS – repeat dispensing

• Sale of medicines

• Disposal of pharmacy stock / Destruction of Schedules 2, 3 and 4 (Part 1) CD pharmacy stock

• Receipt and storage of pharmacy stock / Receipt and Storage of Schedule 2 and 3 CD stock

• Requisitions for Schedule 2 and 3 CDs.

 

Summary of FMD elements

• Anti-tamper device (ATD) – it is mandatory to visually check the ATD to ensure it is intact before dispensing

• FMD verification – this is not a mandatory requirement; however, it is useful to ensure item(s) is not falsified, or the unique identifier (2D barcode) does not respond with an error alert/message.

• FMD aggregate scan – scan individual pack barcodes to generate information to create aggregate barcode(s) for one or more items.

• FMD decommissioning – this is a mandatory requirement and must be undertaken “at the time of supplying it tothe public”.

Go to the dedicated NPA FMD website www.npa.co.uk/fmd for further information on FMD.

For further information please contact the NPA Pharmacy team on 01727 891800 or email at pharmacyservices@npa.co.uk.