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NPA Essential: November 2020

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

New NPA resources to support the delivery of PQS 2020/21

Details of the Pharmacy Quality Scheme (PQS) 2020/21, which commenced in October 2020, have been released by NHS England and NHS Improvement. Completion of, and claiming for, PQS Part 1 is a gateway requirement for PQS Part 2. The declaration window for PQS Part 1 runs until 11.59pm on 29 January 2021. The declaration window for PQS Part 2 runs from 9am on 1 February 2021 to 11.59pm on 26 February 2021.

Declarations must be made on the NHS Business Services Authority (NHSBSA) Manage Your Service (MYS) portal

The NPA has created a suite of resources  to assist pharmacy contractors in delivering and completing the domains and criteria. Go to www.npa.co.uk/pharmacy-quality-scheme for more information.


NPA Winter Conference: Monday 9 November - Wednesday 10 November
Following the success of our summer conference, our winter conference focuses on resilience as its overarching theme and how community pharmacy - with the support of the NPA - can respond to the complexity of our changing environment.

We will have a series of webinars for you to join, including using technology in the light of the pandemic, and  new  business support opportunities. We will also look at the impact of the CPCF in England, virtual consultations and other changes in the operating environment that will shape the next year for community pharmacy.

Register by going to www.npa.co.uk/news-and-events/npa-winter-conference-2020/.


Are you ready for our new relationship with the EU?

There will be significant changes for businesses in all sectors of the economy from 1 January, 2021 following the end of the Brexit transition period. The Government is encouraging businesses to prepare by;

1. Visiting gov.uk/transition and using the checker tool.   

2. Signing up for updates.

3. Attending Department for Business, Energy and Industrial Strategy webinars.

ALSO THIS MONTH

Pharmacy technician vaccination training

The NPA has launched vaccination training for registered pharmacy technicians through its training provider, Charles Bloe Training.

This training has been made available to enable registered pharmacy technicians to administer vaccinations under Patient Specific Directions (PSD) but not for administration of vaccinations under a Patient Group Direction (PGD), unless there is a change in legislation in the future.

Registered pharmacy technicians will get access to a full face-to-face vaccination training session and the following online training modules:

• Immunisation

• Vaccination, anaphylaxis & basic life support

• Influenza.


To enrol onto the training course and see the locations and dates for the face-to-face sessions, visit: https://npa.cb-training.com/technicians


Provisionally registered/Pre-registration pharmacists – do you have a vacancy?

Do you currently have a vacancy in your pharmacy? Are you able to support the next generation of pharmacists? In September, the GPhC announced that the pre-registration exam will be held in the first quarter of 2021 (not including the first two weeks in January). There are currently many provisionally-registered pharmacists who find themselves out of work. Equally, there are many pre-registration students who did not meet the eligibility criteria to be provisionally-registered and now find themselves without a job.
If you have a vacancy in your pharmacy that would suit either of these candidates (or if you have a vacancy in your pharmacy for another role) then you can advertise the role on the NPA Pharmacy Vacancies page on our website for free. Go to www.npa.co.uk/services-and-support/pharmacy-job-vacancies/ for more information.


Interim Pharmacist Foundation Programme

The Interim Foundation Pharmacist Programme (IFPP) is a new 12-month education and training programme funded by Health Education England (HEE). It is not mandatory and is fully funded.

The programme is built around the needs of the 2019/20 cohort of pre-registration pharmacists, whose training and registration have been disrupted by the Covid-19 pandemic.

Resources are being developed and deployed as part of the IFPP to:

• Support provisionally registered pharmacists in England transition to full GPhC registration and beyond

• Develop pharmacists’ ability to achieve high-quality outcomes for patients and improve patient safety

• Inform the next stage of pharmacist education and reform.


If you wish to discuss this with the NPA, contact Helga Mangion, NPA’s Policy Manager at independentsvoice@npa.co.uk


For information relating to the CPPE Foundation Pharmacist programme 2020/21, email foundationpractice@cppe.ac.uk

NPA acts on concerns about misleading advertising of pharmacy services

Concerns have been raised with the NHS and pharmacy regulators about claims made in advertising by Pharmacy2U and Echo.

The NPA believes that certain claims made by Pharmacy2U may contravene GPhC standards which require advertising to be accurate, truthful and not exploitative of any lack of knowledge among the public.

“By using Pharmacy2U, you’re helping the NHS” in isolation is a claim that cannot be substantiated, we believe. When all the additional benefits to the NHS of accessing face-to-face support from a bricks and mortar pharmacy is taken into account, arguably the opposite is true.

Their statement “We’ve been paid over £9,000,000m less in NHS fees than an average high street pharmacy” may be intended to provide some justification to the earlier statement. However, the NHS agrees a global sum with community pharmacy and then distributes this funding to through fees. This means that regardless of what level of fees Pharmacy2U claims, the overall cost to the NHS will remain the same.

This statement is likely to confuse the public, who understandably do not know the detail of community pharmacy funding arrangements, and that there is no saving to the NHS if people use Pharmacy2U.

Meanwhile, advertising material for Echo states: “Help protect the NHS – Get your medicine delivered.” It’s our view that there is no evidence that going to a pharmacy to collect medicines has a damaging effect on the NHS.

Neighbourhood community pharmacies are playing a hugely positive role in maintaining health services throughout the Covid-19 pandemic.

If you see misleading advertising – by any provider of pharmacy services – please draw it to our attention by emailing independentsvoice@npa.co.uk

Migration Advisory Committee shortage occupation list

Following representations made by the NPA, the Migration Advisory Committee (MAC) fulfilled its promise to conduct a review of the shortage occupation list (SOL) and now recommends pharmacists should be included. (https://www.gov.uk/government/news/migration-advisory-committee-reviews-shortage-occupation-lists.)

The SOL shows which occupations are in ‘shortage’ and where migration is a sensible response to that shortage. These occupations are then subject to different, more favourable, migration arrangements, enabling employers to access a wider pool of suitable workers, more quickly.

In coming to this recommendation, the MAC refers to formal evidence submitted by the NPA in 2019. It also acknowledges that pharmacists have played an important role in addressing the ongoing challenges of the Covid-19 pandemic and that this is a high-risk occupation in terms of its exposure to disease.

We are pleased that the contribution of pharmacists to the health of the nation has been recognised in this way, and that the MAC has given weight to the arguments we presented.

Pharmacy Coronacasts

If you haven’t done so already, make some time to listen to NPA’s podcast series ‘Pharmacy Coronacasts,’ where high profile figures discuss life on the NHS frontline during the pandemic.

In episode six, where the theme is ‘Pharmacy and the second wave’, former health minister Steve Brine MP calls on government ‘from the top down’ to back community pharmacy, as pharmacies brace themselves for a second wave of Covid-19. He is joined by fellow guests Peter Horrocks, superintendent pharmacist of Knights Pharmacy in Durham, Ali Sparkes, pharmacist and owner of The Health Dispensary in Wales and our own Olivier Picard.

Is the sector ready for the challenges of the next weeks and months and what can politicians do to help pharmacy teams do their vital work? Go to www.soundcloud.com/national-pharmacy-association to listen.

The supply of flu vaccines for the NHS flu service 2020/21

The Department of Health and Social Care (DHSC) and Public Health England (PHE) have issued a leaflet to reassure patients eligible for a NHS flu vaccine that there is a sufficient supply of flu vaccines.

The leaflet explains the phased delivery of these vaccines, before and during the flu season, which usually starts in December. Information is also given about the several types of flu vaccines available and how flu vaccination providers are required to offer the patients the recommended vaccine based on their age. Hence an eligible person may be asked to wait for the right vaccine to become available at their local pharmacy or GP.

The massive increase in demand for flu vaccinations seen in community pharmacies during the first month of the NHS flu vaccination service 2020/21 has led to many pharmacies running out of stock of the vaccines early in the season. Further supplies of the vaccines are due to be delivered to service providers, including community pharmacies, in phases, as agreed many months before the start of the Covid-19 pandemic. As part of the government’s response to the coronavirus pandemic, the Department of Health and Social Care (DHSC) has secured additional supplies of vaccines for the UK from four manufactures who extended their production beyond the original final cycle. Due to these ‘extra’ production cycles, the extra vaccines will be available to pharmacy contractors throughout November and December. The arrangements for community pharmacies to obtain this stock are currently underway and will be confirmed as soon as possible to help them manage the flu vaccination demand from patients.


Key points for pharmacy teams:

• Ensure you have copies of the DHSC/PHE leaflet: download the leaflet from the GOV.UK website: www.healthpublications.gov.uk/Home.html or order paper copies from Health Publications via telephone on 0300 123 1002, using product code 2020274F

• Highlight the information in the leaflet to your patients via your website or social media.

Update for pharmacies providing pharmacy services at a distance, including online pharmacies

A number of pharmacies have been approached by online prescribing services to dispense private prescriptions regularly. The NPA has also been made aware of a number of issues recently with regards to the way pharmacy services are provided in some cases. Examples of areas of concern include:

• How prescriptions originating from online prescribing companies are being processed and dispensed

• Prescribing and dispensing high-risk medicines, or those requiring ongoing monitoring

• Circumstances where the patient has refused consent for the prescriber or pharmacist, to contact their regular GP, or no consent has been obtained

• Dispensing and supplying medicines against private prescriptions issued by online prescribing services for patients under 18 years of age without appropriate safeguards.

We would like to highlight the following key points to members to ensure that services you provide at a distance are delivered in a safe manner and are compliant with expected standards:

• Before engaging in provision of these services, pharmacy owners/superintendent pharmacists must have in place robust processes and safeguarding measures to ensure online pharmacy services can be provided safely and effectively, in-line with the current GPhC guidance: www.pharmacyregulation.org/registration/internet-pharmacy

• Certain treatment conditions prescribed on private prescriptions including, for example, gender dysphoria, may require ongoing monitoring or management. In such cases, the pharmacist needs to ensure that the medicines are clinically appropriate by carrying out relevant checks, for example, hormone therapy used in treatment of gender dysphoria may involve licensed products being used off-label

• All members are strongly advised to ensure that they have read, understood and implemented the requirements of the GPhC guidance on delivering pharmacy services at a distance: www.pharmacyregulation.org/standards/guidance/buying-medicines-safely-online

• Furthermore, it is also advisable to review the GPhC clarification on a number of key points from the guidance on how pharmacies can meet those requirements: www.pharmacyregulation.org/standards/standards-registered-pharmacies/meeting-online-pharmacies-guidance-faqs


The NPA has published a factsheet on considerations that need to be addressed for the provision of online pharmacy services safely: www.npa.co.uk/information-and-guidance/providing-online-pharmacy-services-safely/

Contact the NPA’s advice and support services team for further information on 01727891800 or email pharmacyservices@npa.co.uk

Pro Delivery Manager – new and improved

Originally designed for pharmacies who run their own delivery service, Pro Delivery Manager (PDM) enabled pharmacies to improve the efficiency of their local delivery service, by monitoring GPS, and providing an audit trail for the pharmacy.

It has now evolved to benefit pharmacies further, by becoming a tracking app for all tasks inside the pharmacy, not just deliveries.

Developed by Gary Jones, the owner of an independent pharmacy in Aberystwyth, Wales, the new version of PDM has 148 tweaks and upgrades to provide a more rounded user experience for pharmacy teams.

“I started PDM back 2014 when smartphones were just starting and it was all a new playing field,” explains Gary.

“Within a couple of years we developed version 2 of PDM which became commercially available and is being used today” he says.

“In the technology world, four years is a long period. During the first two years of running version 2 we set up a suggestion box, allowing pharmacies to vote on what upgrades they required.”

As the landscape of community pharmacies was changing “from supply to services”, Gary says there was a need to create something that would help pharmacy teams accommodate this.

“It became apparent that users were asking for more flexibility in the product. We decided to build a complete new version rather than adapting the current version 2.

“The main feature in the new version of PDM is a multiple task system enabling the pharmacy not only to schedule deliveries but also collections or any task that needs to be carried out in the pharmacy. We have also made layout similar to version 2 to make it a seamless and more rounded experience for previous users.”

Other key features in the new version of PDM include the ability to create a sequence of tasks that instructs the delivery driver to collect scripts from the surgery or pharmacy and deliver to a hub, then collect from the hub and deliver back to the pharmacy or directly to the patient.

“Also delivery patients’ addresses are GPS mapped so if the driver scans and delivers a package to the wrong address a warning will appear on the app informing the driver,” says Gary.

The use of PDM has provided to be even more useful during the Covid-19 restrictions. Both governments in Northern Ireland and Wales endorsed the app for pharmacies in their respective countries to ensure people in who are self-isolating can continue to get their prescription medicines.

“We launched the new version of PDM six months sooner than planned to provide a logistic application to the Welsh Government.  This enabled a volunteer network to be set up to help pharmacies to deliver medication to isolating vulnerable patients. This was a great success.”

Simon Tebbutt, Head of Membership at the NPA, said: “The team at the NPA is closely involved with the development and the day to day support of PDM.

“This has helped shape the product for today as we look too simplify things for our customers. We are always listening to members and customers to help ensure it will be fit for the future as well.

“We are so involved with PDM that when you speak to a support agent it is most likely a NPA team member and we are passionate about the product and ensuring our members and PDM customers alike have great experience. So you can be assured, we have your needs at the heart of what we do.”

NPA members will receive a £10 discount on their monthly PDM bill compared to the standard price. For more information go to www.npa.co.uk/business-support/pdm

Schools and self-isolation: Can parents attend work if their child is sent home due to Covid-19? (England only)

According to the official NHS Test and Trace guidelines, individuals who have had recent contact with someone who has tested positive for coronavirus will be required to self-isolate for a period of 14 days.

The guidance goes on to say that “if you live with other people, they do not need to self-isolate”. However, it also states that they “should avoid contact with you as far as possible and follow advice on hygiene”.

Though the guidance appears clear on this, it does not acknowledge that parents will be unlikely to avoid contact with young children, which raises the question as to whether they should also be self-isolating.

The government’s guidance is clearer on what to do if a child is showing symptoms of Covid-19 at school. Emergency guidelines published by the Department for Education state that if anyone in a school becomes symptomatic (continuous cough, high temperature, changes to taste or smell), they must be sent home immediately, self-isolate for at least 10 days, and seek a Covid-19 test.

The Test and Trace guidelines note that in this scenario, all members of the same household must self-isolate for a period of 14 days. This is also confirmed in the government’s self-isolation guidance. However, unless the child or the parent have symptoms, the parent does not appear to be required to self-isolate if the child is sent home though Test and Trace.


Can I go to work if my child has Covid symptoms?

Though the lack of clarity has brought about a general confusion, there is scope for employees who are unable to work remotely to be particularly hard hit.

In the event of the above scenarios, parent workers may be unable to attend their workplaces due to self-isolation and/or a need to look after their child, and there is uncertainty as to whether this would entitle them to statutory sick pay (SSP).

For more information contact the NPA Employment Advisory Service on 0330 123 0558 or email employmentadvice@npa.co.uk

NPA and Home Office work together on codeword scheme to help victims of domestic abuse

The National Pharmacy Association has been working with the government to create a codeword scheme to enable victims of domestic abuse to access support from the safety of their local pharmacy.

Ask for ANI” (Action Needed Immediately), developed by the Home Office, provides a simple and discreet way for victims to signal to pharmacy staff that they need help accessing support from the police or other domestic abuse support services.

The voluntary scheme has already seen 160 NPA members register their interest.

Helga Mangion, Policy Manager at the NPA, 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.”


What to do if someone uses the codeword?

The scheme has been designed to enable pharmacy staff to respond to the use of the codeword using a simple and straightforward process:

1. Offer to accompany the person to the consultation room or private space.

2. Ask if they are in danger or in need of immediate help and want the police to be called.

3. a. If yes, call 999 and inform the call handler that a codeword ‘ANI’ response is required. They will assess the situation and dispatch help.

4. b. If no, share helpline details and offer a private space and a phone for the person to make this call themselves.

You can register your interest in adopting the Ask for ANI scheme at www.homeofficesurveys.homeoffice.gov.uk/s/anipharmacy

You will receive information, including further details on how to implement the scheme, via the Home Office and NPA.

Ban on the supply of single-use plastic straws and plastic stemmed cotton buds (England)

The Environmental Protection Regulations (Plastic Straws, Cotton Buds and Stirrers) (England) Regulations 2020 came into force on 1 October. It bans the supply of plastic straws and plastic stemmed cotton buds to customers in England after a transitional period unless exemptions apply. The ban applies to all businesses supplying these products including community pharmacies and has been introduced to reduce single-use plastic waste in order to protect the environment and marine wildlife.


What does this mean for community pharmacies?

After 1st October, the following exemptions have been applied for community pharmacies to allow supply of single-use plastic straws and plastic stemmed cotton buds. The exemptions that apply to community pharmacies are:

1. Registered pharmacies exemption

Community pharmacies (including distance selling pharmacies) can supply these at the premises or online, as long as the below criteria are met:

• Must not be advertised on the pharmacy premises but if a pharmacy has an online presence products can be shown online.

• Must not be visually placed or freely accessible to customers

• Must not be offered or provided unless requested by a customer.


2. Medical devices and purposes exemption

• Community pharmacies can supply these if they are being used by a health professional, or under the direction of a health professional, for medical purposes, or if they are defined as a relevant device

• A health professional includes a registered pharmacist or registered pharmacy technician

• A relevant device, is defined in Regulation 3 of The Environmental Protection Regulations (Plastic Straws, Cotton Buds and Stirrers) (England) Regulations 2020, and Regulation 2 of The Medical Devices Regulations 2002.


3. Exemptions for forensic or scientific purposes

Community pharmacies can supply these to a forensic service provider, or for scientific purposes (diagnostic, educational or research purposes).


Transitional period for community pharmacies

Until 1 April 2021: Single-use plastic straws and plastic stemmed cotton buds can be supplied/sold to customers if they were purchased by the community pharmacy before 1 October.

Until 3 July 2021: Single-use plastic straws attached to drinks packaging can be supplied/sold and the exemptions do not apply.

• The ban on the supply of single-use plastic straws and plastic stemmed cotton buds applies to end-users, pharmacies can continue to supply businesses requesting these products

• Single-use straws and plastic stemmed cotton buds made from other material or reusable alternatives can still be sold. Some paper straws use adhesives containing plastic in the inner lining which are an acceptable alternative to plastic drinking straws

• Community pharmacies may receive inspections from their local authority and fines may be imposed if found in breach of the regulations.

FAQs

Can I supply nutritional drinks which come with an attached straw, for example, Ensure plus liquid?

Yes, nutritional drinks which come with an attached single-use plastic straw can still be supplied to customers, if they are supplied as products with a medical purpose, and under the direction of a registered pharmacist or registered pharmacy technician.. This supply can be made beyond 3 July 2021.

I have existing stock of single-use plastic straws and plastic stemmed cotton buds; do I have to dispose of them now that these products are banned from supply to customers?

Products obtained prior to 1 October 2020 can be supplied to end-users until 1 April 2021; however, after this date, they can be supplied only to other businesses, or under the specific exemptions which apply to community pharmacies.

For further information on this or any other query, please contact the NPA Pharmacy Services team on 01727 891 800 or email pharmacyservices@npa.co.uk




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