NPA Essential: December 2023 - check it out!
This month’s key notes
New Pharmacy First agreement announced
A new advanced service in England – Pharmacy First – and expansion of existing blood pressure and contraception services has been announced following an agreement reached between the Department of Health and Social Care (DHSC), NHS England (NHSE) and Community Pharmacy England (CPE). The announcement includes some other changes to pharmacy funding and services too. The NPA has launched a Pharmacy First hub page, which will be updated regularly with further information, resources and guidance as more details become available.
Initial content includes red flag referral support sheets, resources to ensure effective antimicrobial stewardship, and NICE clinical knowledge summaries for each of the seven common conditions included within Pharmacy First. For details, see www.npa.co.uk/pharmacy-first-service-england/NPA resources to help members deliver the expanded NHS Pharmacy Contraception Service include:
• Update: NHS Pharmacy Contraception Service (PCS) (England)
• SOP: NHS Pharmacy Contraception Service (PCS) (England)
• NPA Infection prevention and control SOP
• NPA Chaperone policy and resources
• NPA Consent resources
• NPA Delegation of responsibilities
• NPA Remote consultation resources
• NPA Medical History Taking Template
For details, see www.npa.co.uk/nhspharmacy-contraception-service/
Cancer hub created
The NPA has created an online hub to help pharmacists provide best advice and support for patients with early diagnosis of cancer and during their cancer treatment. Designed by the Let’s Communicate Cancer team, the hub contains information including about cancer treatments, support for patients, help organisations and other factsheets.
Aimed at the whole pharmacy team, the hub will help pharmacists prepare for conversations with customers and contains easily accessible information to support patients undergoing cancer treatment. It also contains learning materials to help pharmacist spot and identify signs of cancer and encourage early treatment for patients. For more information and to access the hub, visit www.npa.co.uk/communicate-cancer-hub
NPA public affairs manager Neil Bhayani recently attended the New Statesman’s Future of Healthcare Conference, continuing the organisation’s ongoing e orts to highlight the importance of independent community pharmacy. Topics including health inequalities, the role of data and technology in the NHS and combatting health misinformation featured at the important event, which aims to address some of the UK’s most important current health and social care issues.
MPs, experts and various other notable figures from policy, business and academia attended October’s event. In addition, our NHS integration lead Michael Lennox arranged an exhibition at the recent annual conference hosted by The King’s Fund to highlight current challenges facing community pharmacy.
The event in November united stakeholders and advocates in various fields and featured debates around several healthcare and social issues. Michael emphasised the ongoing efforts of the NPA to shape the future of the sector, as set out in our Making Changes, Meeting Needs prospectus earlier this year.
This continued recent NPA advocacy, which included representatives from the organisation exhibiting and speaking at the annual Best Practice conference as well as attending the PPP think-tank’s launch of the ICS report on Driving true value from medicines and pharmacy. On the political sphere, the NPA had an impactful presence at both the Conservative and Labour party conferences in October, meeting with Government ministers and senior Opposition figures.
NPA welcomes Pharmacy First investment
The National Pharmacy Association has warmly welcomed the announcement of new investment in an England-wide Pharmacy First service that will improve access to NHS care for common illnesses like sore throat, earache and urinary tract infections.
The association, however, also repeated its calls for an increase in core funding for the community pharmacy contract, to support pharmacy services in the short term and provide a more sustainable underpinning for the future.
The details of Pharmacy First were published after Community Pharmacy England voted in favour of a deal with NHS England by which pharmacies will begin providing the service from 31 January 2024. “We welcome this commitment to invest in a nationwide Pharmacy First service for common conditions,” NPA chair Nick Kaye said. “The new funding, whilst welcome, will not in itself solve the fi nancial crisis in community pharmacy, but it is a substantial investment in a key service that could be a stepping stone to more.
“Having been amongst those to deliver a locally commissioned walk-in common ailments service, I’ve seen fi rst-hand how improving access to advice and treatment works for GPs, pharmacists and, above all, patients. Today’s deal means that people across the whole country will soon be able to benefit from pharmacists’ prompt and expert support in supporting patients to manage common conditions.
“NHS England has put its faith in us, having seen community pharmacy successfully deliver other clinical services at scale. I’ve no doubt that pharmacies will once again deliver an impressive return on investment for the health service.
“The NPA will be providing a range of resources to support independent pharmacies to ensure this service is a success.
“The funding for this service is not going to be enough to address the serious shortfall in core funding, and many independent pharmacies are still going to be operating at a loss. The combined issues of contract reform, core funding and pharmacy closures must therefore stay on the negotiating table.
“This new service improves access to healthcare closer to home and improves primary care access, but it can only work for as long as there is a vibrant network of pharmacies left to provide it. Hundreds of pharmacies have been forced to close in the past year alone.”
The NPA will now support its members wishing to engage in the NHS Contraception service, as it has been confi rmed that there will be funding attached for delivery of that service. The new arrangements also include a write-off of funding over-delivery worth £112 million for Community Pharmacy Contractual Framework years three, four and five – a welcome step, in the NPA’s view.
Paul Rees takes over as NPA chief executive
At the time of writing, Paul Rees MBE is about to start his employment as NPA chief executive. He most recently served as chief executive of the Royal College of Psychiatrists and has held various other important roles in his professional career. Paul, who has succeeded retiring NPA chief executive Mark Lyonette in the job, began his career as a journalist at The Times, Sunday Telegraph, and the BBC.
He later transitioned to communications, co-leading the right-to-roam campaign at the Ramblers Association, which led to the 2000 Countryside and Rights of Way Act. He has held key positions at prominent organisations, including the Ramblers Association, National Housing Federation, Charities Aid Foundation and Association of University Teachers, besides being head of communications at the Home Office.
During his tenure at the National Housing Federation, Paul successfully removed pre-payment meter tariffs imposed by ‘Big Six’ energy companies on low income households, resulting in annual savings of £100 million. As director of communications at the Charities Aid Foundation, he persuaded the Chancellor in 2012 to withdraw the proposed ‘charity tax’ on large donations.
He was also involved in the Victoria Climbié and Zahid Mubarek public inquiries, leading to the Children Act 2004 through the Climbié inquiry. He worked directly with Ministers during his stint as head of communications at the Home Office. At the Association of University Teachers, he co-led a successful national campaign to safeguard university lecturers’ pay and conditions.
As director of policy and engagement at the Royal College of General Practitioners, Paul played a crucial role in the Put Patients First: Back General Practice campaign, which led to increased funding and the commitment of 11 per cent of the NHS budget in England to general practice. The campaign also led to increased funding for general practice in Scotland, Wales, and Northern Ireland.
Nitrous oxide is now Class A drug
Possession of nitrous oxide, also known as ‘laughing gas’, was made illegal on 8 November. The ban, part of the Government’s Anti-Social Behaviour Action Plan, makes nitrous oxide a controlled Class A drug under the Misuse of Drugs Act 1971. Secondary legislation also lays out other possible punishments for possession of nitrous oxide.
NPA offers clinical placements support for undergraduates
The NPA offers support to pharmacies interested in offering clinical placements to undergraduate pharmacists. For initial assistance, email Helga Mangion at firstname.lastname@example.org
VAT on PGD medicines supplies set to zero
Pharmacy teams are reminded that the VAT rate for supplies of medicines made to patients using a PGD was set at the zero rate from 9 October 2023. This change, which applies until 31 March 2027, only applies to PGD supplies where the patient is given the medicine to use, not the administration of medicines.
Great support for AYP week 2023
The NPA wishes to thank all members and pharmacy stakeholders who participated in this year’s Ask Your Pharmacist Week. The campaign, which this year had the theme of Meet Your Local Pharmacy Team and ran from 31 October until 6 November, highlighted the important contribution of independent community pharmacies and the wider community pharmacy workforce to safe and effective patient care and NHS clinical services.
Among the highlights of this year’s initiative was broadcast coverage across 100 outlets, including on local BBC radio stations. Several organisations engaged with the campaign on social media, including regional NHS organisations, patient representatives, pharmacists and local authorities. Widely shared were promotional resources created by the NPA, including a lively animation urging patients to make use of the convenient clinical care available at their local pharmacies.
Thanks to the help of HealthPointTV and 9-Ways Digital Media, the animation was played in hundreds of pharmacies UK-wide, throughout the week. All sorts of other promotional activities go on during Ask Your Pharmacist week, from MP visits to columns in parish magazines and poster exhibitions in community centres.
The NPA wishes to thank NHS England for its contribution to the campaign. Remember: a week is just a week – so keep those conversations with your local community and stakeholders going! NPA members can still download resources from the NPA, which can be used all year round.
Winter hub is available
NPA members are reminded that a helpful resource is now available to provide the best possible service to patients this winter. Our recently launched Winter Health hub includes a range of training materials and resources that enable teams to deliver the most efficient flu vaccination service, and to provide reliable advice to customers and patients about winter health conditions. Materials in the hub include:
• Immunology, fl u and vaccine hesitancy training modules
• Guidance on setting up a flu vaccination service
• Support resources – common myths about vaccinations and the benefi ts of vaccinating patients over 50 years old
• PGD and e-tool purchase information, including NPA member discount
• NHS flu vaccination service information and support material (e.g. SOPs and guidance)
• Marketing material and assets. For more information, visit the hub’s website at npa.co.uk/winter-health
Help with PQS requirements
The NPA is continuing to support members in meeting the Pharmacy Quality Scheme (PQS) 2023-24 requirements. A comprehensive package of online resources includes action plan templates, data collection forms and checklists.
The NPA PQS pack also includes a Staff training Tracker to help pharmacy team members progress through the various training elements of the necessary criteria. For full information on the PQS and the resources available, visit www.npa.co.uk/ information-and-guidance/113671/
Pharmacists are asked to note impending changes to the recruitment and training of pre-registration students. NHS England is reforming the standards for the initial education and training of pharmacists (IETP) in England from the 2025/26 academic year.
This means that all foundation training sites will be required to meet the same quality standards and use the Oriel portal for recruitment. This process starts in January 2024 and action is required now to learn how to prepare pharmacies for the new guidelines. Areas affected by the new regulations include recruitment, the Designated Prescribing Practitioner (DPP) and payment for foundation trainee pharmacists.
The NPA has compiled a comprehensive set of online resources to help users navigate and understand the changes. Visit www.npa.co.uk and search for ‘change is coming’. (Information applicable to England only.)
Self care and referral support sheets
The NPA has developed several self care and red fl ag referral support sheets to assist pharmacyteams. Back pain, coughs, constipation and infection and fever are among the illnesses and conditions covered by the factsheets, as well as various other common conditions and minor ailments.
The sheets, available from the NPA website, contain condition information and self care advice. They also highlight symptoms that may be indicative of more serious conditions requiring further investigation or referral. To see the full list and for more information, visit www.npa.co.uk/red-flag-factsheet-hub
New Health Secretary makes early visit to community pharmacy
The new Secretary of State for Health and Social Care, Victoria Atkins MP, has visited NPA board member Sukhi Basra at CliniChem pharmacy in Central London. It was one of Victoria Atkins’ fi rst appointments since being promoted in a Cabinet reshuffle.
The Minister met with staff and patients to learn about the range of clinical services on o er and to discuss the evolving role of the community pharmacy sector.
Sukhi said: “It is always a pleasure to welcome politicians and officials to my pharmacy because I am extremely proud of what we do here for our local community and I get to describe the fantastic work of pharmacy teams across the whole country. This was a great opportunity to brief the Health Secretary on latest developments, including Pharmacy First.”
Guidance for collection and delivery services
If your pharmacy has a driver or other pharmacy support staff who provide a collection or delivery service to patients in their own homes/nursing or care homes, they now need to complete approved training. This training, which is in line with requirements introduced in October 2020, is as follows:
• New staff must be enrolled onto a GPhC accredited training course within three months of commencing their role
• Existing pharmacy support staff who provide these services need to have completed approved training
• You may be asked for evidence of their training during a GPhC inspection. The NPA’s Delivering medicines safely and effectively course is GPhC accredited and available in blended (paper course workbooks with online assessment) and e-learning formats. For more information, visit www.npa.co.uk/training/training-a- z/trainingtraining-a-zdelivering medicines-safely-effectively/
Support for dispensing valproate-containing medicines
Community pharmacists are reminded that the NPA has published a series of documents to support independent community pharmacists and their teams in adhering to new regulations for dispensing valproate-containing medicines.
From 11 October 2023, amendments to the Human Medicine Regulations 2012 – as amended by The Human Medicines (Amendment Relating to Original Pack Dispensing) (England and Wales and Scotland) Regulations 2023 – mean that pharmacists are now required to supply sodium valproate, valproic acid and valproate semisodium (valproate containing medicines) in the manufacturers’ original packaging.
In-utero exposure to valproate is associated with developmental disorders and congenital malformations, including spina bifida, malformations of the face, kidney and heart, late development in speech, lower intelligence and memory problems. The changes, which came in recently, will ensure that all patients (of any gender) are provided with the specific warnings and pictograms on the package label and the detachable patient card, patient booklet and the required patient information leaflet.
The new amendment applies – with two exceptions – to NHS and private supplies under all legal mechanisms. The legislative changes do not apply to Northern Ireland. Pharmacists, however, can consider the guidance to dispensing valproate containing medicines in original packaging as good practice.
For full information on the changes and to access the supporting documents, visit www.npa.co.uk/information-and guidance and follow the ‘Knowledge Article: Supplying Valproate-Containing Medicines UK’ link.
New report calls for transformation of health and care
The National Pharmacy Association has welcomed the new Public Policy Projects report calling for a pharmacy led transformation of health and care. The report, Driving true value from medicines and pharmacy, calls for the value of pharmacy to be recognised beyond its potential to produce fi nancial savings, among other important recommendations.
It also emphasises the need to leverage pharmacy’s diverse workforce, locally situated premises and unique patient knowledge in the delivery of system-level priorities. As one of the stakeholders involved in the development of this report, the NPA welcomes its publication, said NPA local integration lead Michael Lennox.
“The NPA has always stressed that community pharmacy should be involved in key decisions in neighbourhoods and systems to help increase patient access and tackle healthcare inequalities,” he said. Among its key fi ndings, the report stresses the need to support and empower the pharmacy sector so that it can align its priorities with system-level health and care objectives.
It also highlights how community pharmacy has signifi cant potential for the delivery of integrated care system (ICS) objectives, including those linked to population health management and health inequality.
“You can draw a straight line from key NHS reports like Fuller and Hewitt to this excellent new document about engaging community pharmacy in integrated care systems,” Michael said.
“The NPA has been involved in all of these strategically signifi cant reports and our recently published prospectus for future services features prominently in this latest document.
“This report has some useful recommendations for NHS England, including that the impact of the Additional Roles Reimbursement Scheme is placed under constant review for each region, ensuring that the local community pharmacy workforce is not unnecessarily depleted.
“There are challenges for pharmacy leaders too – for example, the need to focus on improving health outcomes in partnership with the wider primary care team.
“This is a tool that LPCs can use to deepen their relationships with ICBs. It’s also further evidence that the direction of travel we are on – towards locally integrated clinical care – is set firm.” To view the report, visit www.publicpolicyprojects.com
New isotretinoin regulatory changes
Following the recently published MHRA guidance on the introduction of new regulatory changes to strengthen the safe use of isotretinoin and pending clarifi cation from MHRA on several points raised by the NPA onthe implementation of these changes, the NPA is fi nalising the update of its existing resources.
A new template SOP for supplying isotretinoin is available now. The changes include additional safeguards when prescribing isotretinoin to patients under 18 years old, along with closer monitoring of a patient’s mental health and sexual well-being during treatment.
Further details on the updates are available from the NPA’s Pregnancy Programmes page: www.npa.co.uk/pregnancy-prevention programmes/.
This page is a hub of key information and resources to support pharmacy teams in supplying medicines that are highly teratogenic. More information is also available via the Drug Safety Update section of www.gov.uk
Early career leadership programme
Developing good leadership behaviours from the outset is crucial for pharmacists and other members of the team, helping them contribute to the effective running of their pharmacy and its future development. Pharmacists also play a key role as leaders in making decisions that support patient safety, optimise the use of medicines and many other areas of pharmacy practice.
Many pharmacists, however, enter the profession after passing their foundation year with little or no formal training in leadership skills and behaviours. They are expected to lead pharmacy teams as they navigate new waters as newly qualifi ed pharmacists.
To help cover this skills gap, the NPA now includes leadership training in the NPA Foundation Training programme. The training will also enhance patient care and outcomes by strengthening the leadership skills of pharmacy professionals. For more information, visit www.npa.co.uk/training/training-a-z/npa-leadership-training/
Community pharmacy workforce survey still open for responses
There is still time to respond to this year’s Community Pharmacy Workforce Survey. The survey will provide a full picture of the community pharmacy workforce, including identifying the number of vacancies and regions where these are particularly hard to fill. It will also help to assess current workforce challenges adversely affecting the community pharmacy sector and provide data to inform potential solutions. All pharmacy contractors will need to submit data to support workforce planning for the sector. Conducted by North of England Commissioning Support Unit (NECS) on behalf of NHS England, the 2023 survey maintains a consistent approach to the 2022 and previous surveys, focusing on the number of staff, the number of full-time equivalents (FTE) and any vacancies in each of ten staff categories employed in community pharmacy. Deadline for responses is 17 December 2023.
For more information, visit www.npa.co.uk/login/?r=information-and-guidance/superintendent-update-the-community-pharmacy-workforce-survey