Pharmacy Quality Scheme (PQS) – just weeks to go

There is less than a month to go before the window opens for

community pharmacy contractors to make a declaration for a PQS

payment. Contractors must use the NHS Business Services Authority

(NHSBSA) ‘Manage Your Service’ portal to make a PQS declaration

between 3 February and 28 February. On the day of making their

declaration, contractors will be required to declare that that they

meet the four gateway criteria and that they meet the domains they

are claiming payment for (except if they plan to meet the Sugar

Sweetened Beverage quality criterion by 31 March).

 

Primary Care Network Leads

To ensure that community pharmacy is embedded into the work

of PCNs as quickly as possible, Pharmacy PCN Leads need to be

appointed as soon as possible. Contractors need to make a PQS

payment claim between 3 February and 28 February; contractors

therefore need to have the information on the PCN, the name of the

lead and the pharmacy name and ODS code of the pharmacy where

they are based by 2 February 2020 at the latest.

 

Serious Shortage Protocol (SSP) for haloperidol (England and Wales)

An SSP for haloperidol (Serenace) 500-microgram capsules came

into effect 23 December 2019 with a scheduled expiry date of 23

March 2020. Under the SSP, when presented with prescriptions for

haloperidol 500-microgram capsules, pharmacists can instead supply

haloperidol 500 microgram tablets. For more information read NPA’s

advice on p50.

 

Dry January campaign

As part of the Community Pharmacy Contractual Framework

(CPCF), the Dry January campaign is a mandatory campaign

that all contractors in England must participate in. Pharmacy

contractors should have received resources for the campaign on

31 December 2019. Dry January calendars must be displayed and

can be provided to patients to use.

Pharmacy contractors are also encouraged to use digital resources

that can be used on social media, emails etc. If you have not received

campaign materials, you should email england.communitypharmacy@nhs.net

stating the pharmacy name, F-code, address and name of the campaign.

 

ALSO THIS MONTH

Read the NPA’s membership brochure

The turn of the year is traditionally a time to refl ect on the past and

to resolve to make changes for the future. Some people will take

small steps, others will attempt to adopt radically different mindsets,

behaviours and activities. Whatever changes you may wish

to make in your community pharmacy, you can be certain that the

NPA stands ready to help you, with practical advice and support. So

please make the most of your NPA membership in 2020! Take a look

at our membership brochure to ensure you’re not missing out on

any part of what we offer. If you are not already an NPA member,

why not talk to us how about how we can help?

Call 01727 795914 to get things rolling.

 

Healthy living pharmacy (HLP) leadership training -

Thursday 16 January

Places are filling fast for our interactive face-to-face workshop at

Mallinson House, St. Albans on Thursday 16 January 9.30am – 1pm.

This leadership training is suitable for anyone with management or

supervisory responsibilities in a community pharmacy, not only for

pharmacy contractors looking to achieve HLP Level 1 status. Places

available on a first-come, first-served basis - Call 01727 800 402 or

email training@npa.co.uk

 

NPA member forums: Birmingham, London and

Manchester

Stay up to date with upcoming forum events that are regularly

hosted throughout the year, discussing policy, business and practice

topics important to our members. The next forum will take place on

Manchester on 22 January. These events are free for NPA members.

To book your place go to www.npa.co.uk/npa-forums

 

Engaging with primary care

networks – begin your PCN

journey now!

The NHS long-term plan outlines a 10-

year strategy for the NHS and promises

to make more of the clinical skills of

community pharmacists.

Primary care networks - multidisciplinary

NHS structures based on populations of 30-

50,000 people - are intended to be a driving

force for delivery of the long-term plan.

They will have billions of pounds to invest in

community-based services.

To put it frankly, if community

pharmacies want a piece of the action,

they need to engage with PCNs and

offer value-for-money solutions to meet

locally identifi ed needs. These could

include services supporting urgent care,

patient safety, medicines optimisation and

prevention, depending on the priorities of

the local PCN.

The Pharmacy Quality Scheme in the new

community pharmacy contract incentivises

you to make a start – points are available

for pharmacies that between them

nominate a pharmacy PCN lead for their

area. The pharmacy PCN lead will act as a

single channel of communication between

the network and local pharmacies. Your

local pharmaceutical committee will be

supporting this process.

If you haven’t already reached out to your

LPC to discuss how PCN leads are being

recruited please do so now! Please also

take 10 minutes to watch the brief video

message we have created to explain the

importance of PCNs as we move ahead in

2020 – go to: youtu.be/n32FL1oc-QQ

We urge you to take an active interest

in who should be your local lead. Or even

talk to your LPC about stepping up to that

role yourself. This PQS criterion is very

signifi cant: it’s about building a foundation

for future integrated working with your

local NHS, without which community pharmacy

cannot hope to thrive. It’s about

your own professional and commercial

success and it’s about your local community

benefi ting from all that community

pharmacy has to offer.

Role of the pharmacy PCN lead

The role of the pharmacy PCN lead is crucial

as a single channel of communication with

a PCN. He or she should be able to lead

the development and implementation of a

collaborative approach to engaging with the

PCN, working together with key pharmacy

team members from other pharmacies

aligned to the PCN. The lead is also

expected to work closely with other relevant

individuals including pharmacy PCN leads

and clinical leaders of other primary care,

health and social care providers.

The NPA wishes to see independent

community pharmacy effectively represented

across the 1,259 PCNs in England. We

encourage you to put yourself forward for

your local PCN lead roles because we want

to see a signifi cant share of the available

posts occupied by independents.

To further support you, as you action your

PQS-PCN plans and in your considerations

to step up to be a PCN lead, please connect

with our NPA Local Integration Lead,

Michael Lennox via M.lennox@npa.co.uk

For further information go the NPA

website and search for ‘PCN.’

 

NPA PRODUCTS, SERVICES AND ADVICE

Pre-registration pharmacist advice

Sureena Clement, Learning and

Development Pharmacist at the NPA,

shares her top tips for pre-reg students.

 

NPA Learning Academy

Make sure to make the full use of NPA’s

Learning Academy - every month we

upload additional calculations, quizzes and

homework. The structure of our pre-reg

course is known as blended learning. This

includes face-to-face training study days,

webinars, as well as the content uploaded

on to the Learning Academy. Therefore,

to really make use of your year and the

resources at your fi ngertips, make sure

you complete the activities and cover

the content on the Learning Academy.

The same applies with the pre-work – to

maximise your study day ensure you cover

the pre-work content before attending

your study day.

 

Progress reviews

The time after the week 13 progress review

is the occasion to have a discussion with

your tutor regarding your progress and

their expectations of you, as well as giving

you an opportunity to demonstrate how

many of your competencies can already

be ticked off. It is also a chance for you to

tell your pharmacist which areas you feel

you need more support in. You are still

learning, so don’t feel disheartened if you

feel as though you aren’t making progress

at the desired speed. Ultimately, it’s not

a race, so focus on the strengths that

you have and take this as your chance to

improve and showcase your ability.

 

Placements

You may want to arrange work experience

within another clinical setting during your

pre-reg year (with the permission of your

tutor). This is a good way to broaden your

understanding of the role pharmacists can

have in different environments as well as a

great way to network with other healthcare

professionals. Examples of this include

hospitals, diabetes clinics, asthma clinics and

GP practices. Bear in mind your tutor may

want you to use your annual leave in order

to do this or you may be able to swap with

another student in the setting you would

like experience in.

Effective ways to revise at work

On the Learning Academy we have

produced a presentation of hints and tips

on how to effi ciently revise whilst you’re at

work. Make sure to take a look at this as it

also includes which calculators are allowed

to be brought into the exam and the style in

which questions should be answered.

For more information go to www.npa.co.uk/training

or call 01727 800 402.

 

Supplying Controlled Drugs as an emergency supply

Pharmacy teams are reminded of the strict rules that apply to

the supply of controlled drugs (CDs) under emergency supply

legislation - including under services such as CPCS.

• The only Schedule 3 CDs that may be supplied in an emergency

are phenobarbital and phenobarbital sodium for the treatment of

epilepsy; all other schedules 1, 2 and 3 CDs are not permitted to

be supplied in an emergency. This includes gabapentin, pregabalin

(including when they are being used to treat epilepsy) and

tramadol

• Emergency supplies of phenobarbital or phenobarbital sodium for

the treatment of epilepsy and Schedule 4 or 5 CDs are restricted

to a maximum of fi ve days treatment.

 

Emergency supplies of prescription-only medicines (POMs) are

governed by Chapter 3 of The Human Medicines Regulations

2012. This legislation also allows for emergency supplies to be

made to patients under services such as the Community Pharmacy

Consultation Service (CPCS). The rules for emergency supply of

POMs under such services are therefore the same.

Pharmacists and pharmacy teams may receive referrals requesting

Schedule 2 and 3 CDs though the urgent medicines supply strand

of CPCS. At the time of the referral, NHS 111 call advisors do not

assess whether or not the supply will be legal or appropriate for

the patient. Where a referral has been made and the pharmacist is

satisfi ed that there is an immediate need for the Schedule 2 or 3 CD

they must:

• Refer the patient to their own general practice.

• Contact the local GP out-of-hours on the patient’s behalf to agree

a solution and where appropriate ensure the patient is contacted

by another relevant healthcare professional.

 

The NPA Pharmacy Services team has published legal and practical

guidance for the emergency supply of POMs to support pharmacy

teams. Go to the NPA website for more information.

 

Domperidone – change in licensed age groups and

weight ranges

The Medicines and Healthcare products Regulatory Agency (MHRA)

issued a drug safety update which states that, domperidone is no

longer licensed to treat nausea and vomiting in children under 12

years and those who weigh less than 35kg due to its lack of effi cacy

in these patient groups. Domperidone is now only licensed in adults

and children aged over 12 years and who weigh 35kg or more.

Pharmacists should read the MHRA drug safety update

which covers this and other important patient safety aspects of

domperidone which include:

• Reminder of contraindications, for example use in patients who

have liver impairment or underlying heart disease and known preexisting

QT interval prolongation

• Reminder of recommendations on maximum daily dose and

duration of treatment – use at the lowest effective dose for the

shortest length of time possible

• Further information on lack of domperidone effi cacy in children

aged under 12 years.

For further information please contact the NPA Pharmacy

Services team on 01727 891 800 or email pharmacyservices@npa.co.uk

 

Whistleblowing: Is dismissal automatically unfair if the

real reason was concealed from the decision-maker?

When making the decision to dismiss,

it’s important to have all the facts. But

what happens if a manager deliberately

creates a false narrative around the

dismissal, and the decision maker acts

on this basis?

 

Royal Mail Group Ltd v Jhuti

The claimant in this case, Ms Jhuti,

approached her line manager with

concerns that a colleague was breaching

Ofcom regulations and company rules.

However, rather than investigate the claims,

the manager fabricated a performance

management problem, and a different

manager, who didn’t realise that these issues

were an invention, subsequently dismissed

Ms Jhuti for poor performance.

 

Ms Jhuti brought claims to an Employment

Tribunal for:

 

1. Automatically unfair dismissal. Under

Section 103A of the Employment Rights

Act (ERA) 1996, an employee is regarded

as having been automatically unfairly

dismissed if the principal reason for

the dismissal is the making of a

protected disclosure – a disclosure that

relates to certain categories of serious

wrongdoing.

2. Detriment on the ground that she

had made a protected disclosure.

Section 47B(1) of the ERA states that a

worker has the right not to be subjected

to any detriment by any act, or any

deliberate failure to act, by his employer

done on the ground that the worker has

made a protected disclosure.

 

The Tribunal upheld the second part of

Ms Jhuti’s claim in view of the detrimental

treatment she had received from her

manager as a direct result of her disclosure.

However, in order to determine whether

the dismissal was unfair, the Tribunal

had to identify what the real reason

for dismissal was: performance, as the

dismissing manager genuinely believed,

or revenge for whistleblowing, the

hidden reason?

This was contested through various

stages of appeal, with the case

eventually making its way to the

Supreme Court. Ultimately, the court

concluded that by section 103A,

Parliament had clearly intended to

provide that, where the real reason

for dismissal was whistleblowing, the

automatic consequence should be a

fi nding of unfair dismissal. Despite the

decision maker acting in good faith,

the real reason for dismissal was in

fact the protected disclosure made by

Ms Jhuti.

 

What does this mean for

employers?

The Supreme Court acknowledges

that this is an extreme case; it is rare

to fi nd such an obvious example of a

line manager deliberately manipulating

a situation in order to engineer the

dismissal of one of their team.

However, it reinforces the need to

deal with whistleblowing complaints

properly and thoroughly. Managers

need to be trained on how to respond

in these situations and ideally a

whistleblowing policy will exist, giving

clear reporting lines to a designated

senior manager who can oversee

complaints of that nature.

 

Facing a difficult problem?

To discuss your situation with a

professional and receive clear,

pragmatic advice, contact the NPA

Employment Advisory Service on

0330 123 0558 or email

employmentadvice@npa.co.uk

 

PATIENT SAFETY

Serious Shortage Protocol –

haloperidol (England

and Wales)

 

The Department of Health and Social

Care (DHSC) advised in December that

- following a supply disruption alert

aimed at primary care practitioners for

haloperidol 500 microgram capsules - a

Serious Shortage Protocol (SSP) for

haloperidol (Serenace) 500 microgram

capsules received ministerial approval.

The SSP came into effect on 23 December

2019 and is scheduled to expire on 23

March.

Under the SSP, when presented with

prescriptions for haloperidol 500 microgram

capsules, pharmacists can instead supply

haloperidol 500 microgram tablets.

The NHS Business Services Authority

(NHS BSA) and NHS England Improvement

(NHSEI) emailed all pharmacy and GP

contractors to alert them to the introduction

of the SSP. Further information is available

from the NHS BSA website, including the

SSP documents.

Here is a summary of recommended

actions to prepare for dispensing in

accordance with an SSP:

• Ensure that all staff, including locums,

who will be involved in dispensing an item

in accordance with an SSP are trained and

competent to do so.

• Ensure that an SSP Standard Operating

Procedure (SOP) is in place and other

relevant SOPs are updated, read,

understood, signed and implemented

by all members of the pharmacy team

involved in service delivery.

• Ensure that the pharmacy team know

where they can find new SSPs and/or

changes to an existing SSP.

• Ensure that the pharmacy has access to

an NHSmail account so that it can receive

notifi cation when an SSP is issued.

• Ensure that the pharmacy has access

to the NHS Summary Care Record as

applicable.

 

NPA professional indemnity insurance

will cover NPA members, customers (and

the pharmacists they employ/engage) when

supplying medicines/appliances under

the relevant enabling legislation and the

SSPs which apply. It is acknowledged that

pharmacists will be expected to exercise

professional judgement to determine the

appropriateness of making each supply.

The NPA has produced a template

SOP and guidance resource to support

pharmacists and pharmacy teams in

ensuring compliance with relevant

requirements when supplying medicines or

appliances under an SSP.

These resources are available to access from

the NPA website: www.npa.co.uk/information-and-guidance/

npa-serious-shortage-protocol-resources/

Contact the NPAfor further information

and advice on 01727 891800, or email

pharmacyservices@npa.co.uk