NHS Pandemic Delivery Service for those self-isolating has been extended The Community Pharmacy Home Delivery Service will be commissioned from 1 October 2021 to 31 March 2022 for anyone living in England who has been notified by NHS Test and Trace to self-isolate.

Community pharmacies, excluding distance selling pharmacies, can use this service to deliver prescription medicines and appliances to individuals during their ten day self-isolation period who provide their NHS Test and Trace account ID reference when requesting for the service; if alternative arrangements cannot be made.

Pharmacy contractors can claim payment for the service under the Community Pharmacy Home Delivery Service on the Manage Your Service (MYS) portal. Claims must be made by the fifth of the month after the service was provided. Claims made after this time will not be accepted.

For further information go to bit.ly/3iJheRg

GPhC revalidation

Pharmacists and pharmacy technicians due to submit their revalidation records from 1 January 2021 to 30 November 2021 only need to submit a reflective account along with the required declarations and pay the applicable fee to renew their registration. The GPhC has also announced that changes to revalidation requirements have been extended for registered pharmacy professionals due to submit their revalidation records from December 2021 to February 2022.

Changes to NMS

NHSE&I have published an updated NMS Service Specification. Summary of these changes include:

• Additional eligible conditions: a full list of medicines suitable for the NMS can be found on the National Health Service Business Service Authority (NHSBSA) website.
• Eligible patients: the service has been expanded to support parents/guardians/carers of patients who could benefit from the service but who are unable to provide informed consent.
• Number of NMS: the cap on the number of NMS that can be provided by a pharmacy contractors has been increased from 0.5 per cent to 1 per cent of monthly prescription volume and additional bandings have been included.
• Remote consultations: contractors can provide the service remotely or in the patient’s home where necessary.
• Catch-up NMS introduced: pharmacy contractors can offer the NMS to patients who were prescribed a new, eligible medicine during the COVID-19 pandemic (1 April 2020 to 31 August 2021) but did not receive the NMS at that time. This can be offered between 1 September 2021 and 31 March 2022.

Updated and new resources to support our members in providing the NMS will be available soon here www.npa.co.uk/information- and-guidance

ALSO THIS MONTH 

Kickstart Scheme - resources to support your recruitment 

If you were approved for a kickstart placement and are beginning to see referrals coming through from the job centre for your vacancy, do remember that there are plenty of resources to support you on the NPA website. From the main landing page, you can access a poster for your window, interview guidance, FAQs, Employer hiring process guide, a pre-recorded guidance webinar and more. 

Learn more by going to www.npa.co.uk/kickstart-scheme

Health secretary gets flu jab in community pharmacy

The Secretary State for Health and Social Care, Sajid Javid, had his flu jab at a community pharmacy in London. 

In a visit to Keencare Pharmacy, part of the Green Light Pharmacy Group and a National Pharmacy Association (NPA) member, the health secretary met with pharmacist Cynthia Langworthy and NPA chair Andrew Lane. The visit was organised by the NPA and the Department of Health and Social Care (DHSC). 

Cynthia said: “It was great to host the health secretary Sajid Javid here at our pharmacy and vaccinate him against flu. 

“We spoke about the wide range of services pharmacies provide. He recognised our efforts during the pandemic and was very appreciative of the key role of pharmacy in the NHS and we discussed how pharmacy is often the ‘front door’ of the NHS for many of our patients.” 

NPA Chair Andrew Lane said: “We are delighted to have helped arrange for NPA member Green Light Pharmacy to vaccinate the Health Secretary against flu. 

“It also gave us the opportunity to have an initial conversation with him about how pharmacies can help meet the backlog challenge facing the NHS.” 

Andrew gave the health secretary a copy of NPA’s How We Can Help report. For more information go to www.npa.co.uk/representing-you/how-we-can-help/

MP introduced to new NHS services at Lanarkshire pharmacy 

Dr Lisa Cameron MP attended Abbeygreen Pharmacy in Lesmahagow, Scotland to find out more about the services they offer. 

The MP who is Chair of the Health All Party Group in the House of Commons said: “It was a pleasure to visit my local pharmacy and catch up on the latest clinical developments and the new NHS services available to my constituents and people right across Scotland. 

“They are ‘health hubs’ for the community and a vital part of fabric of the healthcare system.” 

Stephen McDermott, pharmacist and owner of Abbeygreen Pharmacy said: “We were delighted to welcome Lisa to our pharmacy and show her the care we provide to people here every day. She was very positive and acknowledged the vital work of pharmacy teams. My team and colleagues all around the country have worked incredibly hard to serve patients during the covid-19 pandemic and it’s great to see our efforts and services being recognised.” 

Janice Oman of the National Pharmacy Association (NPA) accompanied Dr Cameron during her visit to Abbeygreen Pharmacy, which is an NPA member. 

In April, Dr Cameron signed a parliamentary motion congratulating the NPA on its centenary and thanking pharmacies for their work during the covid-19 pandemic. 

Workforce, retention and recovery – what’s your experience? 

The NPA has been working hard to address the workforce issues that currently affect the sector. We have been successful in petitioning the Migration Advisory Committee at the Home Office for pharmacists to be added to the Shortage Occupation List (SOL). We are also a key stakeholder in all policy workforce discussions that have been taking place. 

We are acutely aware that NPA members are continuing to face a growing crisis in the retention of community pharmacists and skilled support team members. 

We would like to understand these issues further, so we can ensure that we are having the appropriate conversations with various bodies on your behalf – with regards to future planning and funding - and also ensure that we are producing the appropriate resources. 

Please email any concerns about workforce and retention issues in your pharmacy to either your NPA country representative manager* or the NPA Policy Manager, Helga Mangion at independentsvoice@npa.co.uk (see below for email addresses). 

If you prefer to talk over the phone, please let us know and we will arrange a suitable time with you to discuss the issues. 

*NPA country representative manager details: 

• Members in Scotland should contact Janice Oman: j.oman@npa.co.uk 

• Members in Northern Ireland should contact Anne McAlister: a.mcalister@npa.co.uk

• Members in Wales should contact Jonathan Rees: J.Rees@npa.co.uk

Legal mechanisms – Community Pharmacy Seasonal Influenza Vaccination Advanced Service (CPSIVAS) – PGD and the national protocol

Under a PGD, the entire process from patient/ clinical assessment through to vaccine preparation, administration and record-keeping must be carried out by the named, authorised registered pharmacist. Activities under the PGD cannot be delegated to any other individual. All the activities under the PGD must be completed by the named, authorised pharmacist. Legislation underpinning PGDs as a legal mechanism comes from Regulation 233 and Schedule 16 of the Human Medicines Regulations 2012 (HMR 2012). 

• Please note that pharmacy technicians are not permitted to operate/ work under PGDs. 

Under the national protocol, the entire process from patient/ clinical assessment through to vaccine preparation, administration and record-keeping can be carried out by the named, authorised pharmacist. Alternatively, after the registered pharmacist has conducted the clinical assessment of the individual presenting for vaccination, provided information and obtained informed consent (Stage 1), the activities of vaccine preparation, vaccine administration and record-keeping (stages 2-4) may be undertaken by suitably trained and competent individuals (who may be registered healthcare professionals (HCPs) or non-registered HCPs), strictly in accordance with the requirements of the national protocol, and the CPSIVAS service specification. 

Legislation underpinning the national protocol as a legal mechanism comes from the amendment to the Human Medicines Regulations 2012 (HMR 2012) that inserted Regulation 247A through The Human Medicines (Coronavirus and Influenza) (Amendment) Regulations 2020. 

Community Pharmacy Seasonal Influenza Vaccination Advanced Service (CPSIVAS) – PGD and the national protocol 

We have received many queries from NPA members concerning the difference wbetween the CPSIVAS PGD and national protocol, and when to use them. The NHS wflu PGD and the national protocol are both legal mechanisms for administering flu vaccines under the CPSIVAS. Pharmacy contractors should familiarise themselves with both legal mechanisms, understand the key differences and them make an informed decision on which legal mechanism they wish to utilise in their pharmacy to provide the CPSIVAS. All those involved in the provision of vaccination services should also understand the difference between these wtwo legal mechanisms. 

Clinical supervision 

Under the requirements of the flu national protocol: 

• The service provider/contractor is responsible for ensuring that there is a clinical supervisor present at all times and that persons are trained and competent to safely deliver the activity they are employed to provide under this national protocol. As a minimum, competence requirements stipulated in the national protocol must be adhered to. 

• A clinical supervisor, who must be a registered doctor, nurse or pharmacist trained and competent in all aspects of the national protocol, must be present and take overall responsibility for provision of vaccination under the national protocol at all times and be identifiable to service users. 

The service specification for the NHS CPSIVAS requires that: 

• Vaccinations should be administered under the supervision of a pharmacist trained in vaccination (including a clear understanding of this service). 

• A record should be maintained of who that person is at each premises at any given time. 

• The Responsible Pharmacist at the registered pharmacy premises is professionally responsible for the safe delivery of this service. If the Responsible Pharmacist is unable to provide sufficient supervision, for example due to workload or where vaccinations are undertaken off the pharmacy premises, an onsite pharmacist supervising delivery of the service must be linked and work closely with the Responsible Pharmacist and Superintendent Pharmacist through an appropriate governance framework. 

This means that when using the flu national protocol as a legal mechanism to provide the NHS CPSIVAS, the clinical supervisor must be a registered pharmacist and must: 

• Be present at all times 

• Be identifiable to service users 

• Take overall responsibility for provision of vaccination under the national protocol 

Please note that a pharmacist who is provisionally registered with the GPhC can work under all stages of the national protocol; however, they cannot act as the clinical supervisor for the national protocol. 

For further information go to bit.ly/3FLACHz

Students register high satisfaction of NPA’s training courses 

Over three quarters of students who took part in NPA’s training courses during the first eight months of 2021 were pleased with their experience. 

The association’s Learning and Development (L&D) team has analysed course evaluation forms from a sample of over 550 students who completed a range of its training courses in paper and eLearning formats between January – August 2021 to establish that 86% of students were Very Satisfied/ Satisfied with their course. 

The analysis also revealed the following key metrics: 

• 94% of students strongly agreed/agreed that the course was beneficial to their role in community pharmacy 

• 90% of students strongly agreed/agreed that they received adequate support from the NPA (via the L&D and Member Services teams 

• 87% of students were very likely/likely to use the NPA for future training needs. 

The NPA’s L&D pharmacists review the course evaluation ratings to ensure that the training is consistently meeting student requirements. By considering the comments provided by students, the team is able to develop the training content to improve the learning for students in the future. 

Feedback from the trainees who studied NPA’s Foundation training programme between September 2020 and June 2021 was also promising, even with the programme being delivered virtually due to the social distancing rules and the pandemic situation. 

It is encouraging that: 

• 81% of students rated the training materials on the NPA’s Learning Academy as Very useful/ useful 

• 80% of students felt that the materials were covered Very well/well on the study days 

• 80% of students rated the L&D pharmacist’s style of delivery as Very good/good. 

Louise Baglole, Head of Learning and Development at the NPA, commented: “It is very important for us to understand how students find our courses. Not only because it is rewarding for the team that works so hard to deliver them, but so we improve them for future students. We continue to take steps to improve our student experience and hopefully this will be reflected in even greater satisfaction ratings going forwards.” 

Joint report recommends steps to help make community pharmacy a vital part of PCNs and ICSs 

A report looking at how community pharmacy will work as part of Integrated Care Systems (ICS) lists key requirements to help bring the best out of the sector. 

Co-authored by the NHS Confederation, the National Pharmacy Association and the Primary Care Pharmacy Association, the report highlights the key themes of a roundtable discussion in July, involving Primary Care Networks (PCNs), primary care federations and other stakeholders in local systems. 

Dr Graham Jackson, GP and Senior Clinical Advisor at the NHS Confederation who chaired the discussion said: “It is critical that all available clinical capacity is used effectively. Our report examines the opportunities of collaboration with community pharmacy and identifies key enablers available to local systems, as well as addressing barriers. 

“We urge PCN clinical directors, primary care federation leaders and others locally to support community pharmacists to navigate the emerging NHS structures and thoroughly consider what pharmacies can bring to the table in terms of urgent care, public health, medicines optimisation and more.” 

Andrew Lane, NPA chair said: “The covid-19 pandemic has shone a bright light on the value of working collaboratively across systems. Community pharmacy can deliver most as an integral part of the system rather than being seen as an adjunct to the main action. The sector has an important role to play as a full partner within PCNs, with primary care federations and Integrated Care systems. 

“Medicines safety and optimisation is widely recognised as part of pharmacy’s unique skill set but increasingly community pharmacy will collaborate with partners in primary care to deliver integrated clinical services to the population. 

“This report shows that community pharmacists are not a voice in the wilderness within the NHS. It is fantastic to have the NHS confederation weighing in with their encouragement.” 

To read the report go to bit.ly/3amFjJ6

Goodbye Ellis Whittam, hello WorkNest

The providers of the NPA’s Employment Law and Health and Safety Advisory Service is changing its name, and adding new services. 

By bringing Ellis Whittam, Law At Work and HRSP together under one name, WorkNest represents even greater expertise, can offer even more services, and is backed by even more powerful technology than ever before – enabling the NPA to further empower members, to manage all of their employment, safety and wellbeing challenges. 

Their new name, WorkNest, embodies our commitment to protecting members, nurturing them, and helping them to fly. This will enhance support to members, managing their risks across the compliance spectrum. The bespoke services offered will continue and importantly members can continue to access this valuable s§ervice will not change. They will continue to be responsive to members’ needs, developing strong outcomes and enable you to be compliant, confident and risk-aware. 

We know that change invites questions, so Worknest have pulled together a comprehensive FAQ that you can access here: bit.ly/3apr7PE

NHS community pharmacy hypertension case-finding Advanced Service (England)

Key points of the Brief overview of the NHS Community pharmacy hypertension case-finding Advanced Service 

• The service is comprised of two stages – initial engagement of the patient and blood pressure (BP) measurement, followed by ABPM as required to confirm hypertension. 

• The service will also involve a brief discussion on promoting healthy lifestyles. 

• The NHS Community pharmacy hypertension case-finding Advanced Service can only be provided by pharmacists; this is due to current VAT rules. If the VAT rules change, it may be possible for other members of the pharmacy team to support provision of this service under the supervision of the pharmacist. If this happens, we will keep you updated. Until then, the service must be provided by a pharmacist only. 

• Pharmacy contractors must complete the Manage Your Service (MYS) portal declaration to sign-up to provide the service. 

• The blood pressure monitors used for the service must be included in one of the two lists of the blood pressure monitors validated by the BIHS – ‘Validated BP Monitors for Home Use’ and ‘Validated BP Monitors for Specialist Use’. 

• Pharmacy contractors are required to have a SOP in place to deliver this service. The NPA has produced a template SOP to support members; access it via the NPA’s hypertension service hub. 

• Pharmacy contractors are required to notify local GP surgeries and/or Primary Care Networks (PCN) colleagues that the pharmacy is providing the service. 

• The service can also be provided at premises outside of the pharmacy with NHSE&I regional team approval. 

• All BP/ABPM results must be sent to the patients’ registered GPs via NHSmail or other secure electronic process; the timescale for sending the notification will be dependent on patients’ test results. 

• Test results cannot be sent by fax to GPs. 

• Eligible patients who are not registered with a GP can undergo the service; the pharmacist would need to provide them with their results and signpost them to register with a GP. 

Blood pressure monitors for clinic and ABPM 

If you are considering providing the Hypertension Case-Finding Advanced Service, you are strongly advised to take the following actions to ensure that you are able to make an informed decision regarding the type of BP monitor and ABPM device to procure: 

1) Read the NICE guideline NG136 on “Hypertension in adults: diagnosis and management” to inform yourself on the requirements of how to provide the service in line with the NICE guideline. 

2) Read the MHRA guidance “Blood pressure measurement devices” which will inform you about the different types of BP monitors and ABPM, as well as the requirements to look for when procuring this equipment. 

• The MHRA document reviews the following to “help to ensure the most appropriate technology is selected for use. 

o the advantages and disadvantages of mercury 

o aneroid 

o electronic manual sphygmomanometers 

o automated blood pressure measuring devices” 

The topics covered are: 

• types of blood pressure measurement equipment 

• sources of error and other issues purchase 

• training and maintenance 

• mercury 

3) Review the two lists of the blood pressure monitors validated by the British and Irish Hypertension Society (BIHS) – ‘Validated BP Monitors for Home Use’ and ‘Validated BP Monitors for Specialist Use’ 

• Apply the filters in the respective lists for the upper arm BP monitors and ABPMs. 

o Please note that many types of BP monitors are listed including manual BP monitors and wrist monitors that require additional training, operational and clinical considerations. 

o The BIHS recommend that upper arm monitors are used in preference to wrist devices due to the position of the arm in relation to the heart, potentially resulting in inaccurate readings. 

o ABPMs should be battery operated to allow the patient to move around freely. 

o How often will the BP monitor and ABPM need to be calibrated? Maintained? 

• Consider whether the blood pressure monitor: 

o Is capable of detecting an irregular pulse 

o Has compatible cuffs in different sizes to accommodate patients with various upper arm measurements (e.g. obese patients)? 

4) In addition to the cost to purchase the blood pressure monitor, also consider the costs to maintain and calibrate the machine. 

• Contact your insurance provider to ensure that the BP monitor and ABPM equipment is covered for theft, damage, loss due to patient failure to return the equipment 

How is the service funded? 

• A setup fee of £440 has been agreed by PSNC. 

• Pharmacy contractors will be paid £15 for each clinic check (stage 1). 

• A fee of £45 will be paid for each ABPM provided (stage 2). 

Additionally, pharmacy contractors will receive incentive fees in Years 3, 4, and 5 of the 5-year CPCF deal if a threshold number of ABPMs provided is reached: 

• £1000 if 5 ABPMs are provided in 2021/22 

• £400 if 15 ABPMs are provided in 2022/23 

• £400 if 20 ABPMs are provided in 2023/24 

The incentive fees are intended to support pharmacy contractors to fund procurement of a suitable BP monitor and an ABPM. However, please note that the initial cost of procurement of the clinic check BP monitor and ABPM to start the service may exceed the £440 setup fee. Claims must be submitted via the NHSBSA’s MYS portal every month. 

For further information go to: bit.ly/3lvsBhN