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

Prescription charge waiver for antiviral and clinical trial treatments for Covid-19

The Department of Health and Social Care (DHSC) has published guidance for prescribers, pharmacists and their teams on the procedures to allow eligible patients to receive free of charge trial medicines when prescribed in the community, using the NHS prescription form (FP10) or Electronic Prescription Service (EPS).

The arrangements to waive the prescription charges due to risks to public health are made in regulation 13 of The NHS (Charges for Drugs and Appliances) Regulations 2015 and they have been extended until 31 March 2024.

This prescription charge waiver applies to:

• Antiviral medicines supplied to patients who have tested positive for Covid-19 and who are eligible to receive antiviral treatments for Covid-19 via an NHS prescription

• Therapeutic treatments available through the following two trials: • HEAL-Covid clinical trial platform, treating patients who have been hospitalised for Covid-19 for long-term effects, when the participants require the drugs to be supplied for a longer period via repeat prescriptions from their GP

• STIMULATE ICP, a community trial treating community patients for long Covid; participants will need to access the trial/repurposed drugs on prescription from GPs.

Please note that the prescription charge waiver for antiviral medicines supplied to patients who have tested positive for Covid-19 and who are eligible to receive antiviral treatments for Covid-19 via Covid Medicines Delivery Units (CMDUs) ended on 31 March 2023. Please see the NPA website for further key details for pharmacy teams, including prescriptions needing to carry an ‘FS’ (Free Supply) endorsement, and processing prescriptions and EPS tokens.

Please contact the Pharmacy Advice and Support team if you have any queries: pharmacyservices@npa. co.uk; 01727 891800 (Mon-Fri 9am to 6pm).

ALSO THIS MONTH

NPA trainee pharmacists sit mock exam

During May, trainee pharmacists studying the NPA’s Foundation training programme undertook a full online mock exam under timed conditions in preparation for their common registration assessment. Trainees reported that the mock exam was very helpful in identifying where they need to brush up their knowledge and focus their revision ahead of the assessment. The NPA’s mock exam is available for all trainee pharmacists. See: www.npa.co.uk/training/foundation/mock-exam

National Pharmacy Association elects new chair

Nick Kaye has taken over the chair of the National Pharmacy Association from Andrew Lane, who stood down after serving his maximum term. Nick, who part-owns Hendra Pharmacy in Cornwall, will serve for two years as NPA chair, after being elected unopposed at the first meeting of the new NPA board in April.

Jay Badenhorst, managing director and superintendent pharmacist for Whitworth Chemists in the North East of England, is now vice-chair. Michael Guerin, the managing director and superintendent pharmacist of the Medicare group in Northern Ireland, continues as treasurer. The newly elected NPA nominees to PSNC are Ian Cubbin and Olivier Picard.

Andrew Lane will remain on the NPA board for a further two years. Attending their first formal meetings as NPA board members last month were Sukhi Basra, Sri Kanaparthy, Salim Jetha and Sanjay Ganvir.

NPA chief executive to serve on Health Select Committee expert panel

An expert panel established by the Health and Social Care Committee will scrutinise the progress the government has made on its commitments to pharmacy services in England. National Pharmacy Association chief executive Mark Lyonette (pictured) is one of six panel members with specialist expertise in pharmacy. They will work alongside five standing members who are all renowned healthcare policy experts and professionals. Professor Dame Jane Dacre will chair.

The panel will evaluate nine government commitments across five areas: • Community pharmacy • Integrated care (including patient safety) • Hospital pharmacy • Education, training and the pharmacy workforce • Extended services. It will produce a report which includes a CQC-style rating from ‘inadequate’ to ‘outstanding’ for each specific pledge, and an overall rating.

A spokesperson for the National Pharmacy Association said: “This is all about holding the government to account on its commitments. Mark’s appointment to the panel means that there will be expert insight into the commitments relating to community pharmacy.” The panel will invite written submissions from the public and stakeholders to inform their evaluation.

National Pharmacy Association welcomes ‘momentous’ NHS common illnesses scheme

The National Pharmacy Association has warmly welcomed the announcement of new investment in an England-wide, pharmacy-based common conditions service that will improve access to NHS care for common illnesses like coughs, colds and urinary tract infections.

The scheme was announced as part of a new government and NHS blueprint, which aims to reduce waiting times for primary care, including GP appointments. The plan also covers investment in pharmacy services for oral contraception and blood pressure checks.

NPA chief executive Mark Lyonette said: “We warmly welcome this commitment to invest in a nationwide, pharmacy-based common ailments service. It’s a long overdue step that will improve access to care and free up GP waiting lists. It’s something we’ve long been calling for, alongside other pharmacy leaders; successive health secretaries have talked with us about the benefits of a nationwide Pharmacy First scheme, as well as senior NHS officials.

This ongoing dialogue is at last bearing fruit. “Critically, the service will be backed by new funding, which we hope signals a better understanding both in government and NHS England about the value pharmacies bring to the health service. If so, it could have long-term significance and set us back on track for a sustainable, clinically-focused future, after years of decline.

“Of course, we will want to look carefully at the details, but from the initial information, this appears to be a momentous development which has the potential to radically change the outlook for our sector.” The NPA’s new chair, Nick Kaye, has been among those delivering a walk-in minor ailments service in Cornwall, the success of which many people have seen as a proof-of-concept for a national scheme.

Nick said: “I’ve seen first-hand how improving access to advice and treatment for common conditions works for GPs, pharmacists and, above all, patients. This nationwide scheme means that people across the whole country will soon be able to benefit from pharmacists’ prompt and expert support.”

Former Secretary of State for Health Sajid Javid announced the government’s intention to introduce a nationwide scheme at an NPA event in 2021. Since then, the NPA and others have lobbied hard to ensure that the promise was delivered. The funding package for the pharmacy service developments in the plan amounts to £645 million over two years.

Knowledge article: Modern Slavery Act

Applicable legislation requirements:

The term ‘modern slavery’ covers slavery, servitude, forced or compulsory labour, and human trafficking

The Modern Slavery Act 2015:

• Consolidates existing legislation regarding human trafficking and slavery

• Seeks to address the role of businesses in preventing modern slavery from taking place in their organisations and supply chains. Under legislation, organisations are required to produce a slavery and human trafficki statement for each financial year. The aim is for organisations to be transparent and for organisations to promote ethical business practices and policies to protect workers.

Who this applies to:

The legislation is applicable to every organisation in the UK that has an annual turnover of £36 million or more, and:

• Is a body corporate or a partnership

• Carries on a business, or part of a business, in the UK

• Supplies goods or services.

Key considerations:

• Although small businesses do not legally need to produce a statement, they can do so voluntarily

• If your business has a turnover of less than £36 million, you may still be affecte by requirements under section 54 of the Modern Slavery Act 2015, such as being asked to provide assurances that your business complies.

Slavery and human trafficki statement:

The statement is a public-facing document and must state either the steps taken to ensure that human trafficking and slavery are not taking place within the organisation/ supply chain, or that no such steps have been taken.

• The statement must be approved by the board and signed by a director (or equivalents)

• The detail and quality of information should show year-on-year progress

• The statement must be published on the company’s website, and a link to it must be placed in a prominent place on the website’s home page (in the future, it will need to be added to the government modern slavery registry – this is currently voluntary)

• If the company does not have a website, a copy of the statement should be supplied within 30 days of receiving a written request for it

• Keep the statement succinct and specifi to modern slavery

• Provide links to relevant documents for your organisation

• Use simple language and write it in English. (It can also be provided in other relevant languages)

• The Home Office has produced guidance for businesses about how to write a slavery and human trafficking statement, and the table in the link below summarises some of the content that should be included

• There isn’t a template available from the Home Office, but the Ethical Trading Initiative (www.ethicaltrade.org) has developed a framework.

For more information, including a table with details about what needs to be included in a statement, go to: bit.ly/3LIcn0v

NPA awards first technicians qualifying with BTEC Level 3 Diploma

Representatives from the NPA have presented three pharmacy technicians around the UK with their BTEC Level 3 Diploma certificate in recognition of their successful completion of the qualification.

The NPA launched its new Level 3 BTEC Diploma – principles and practices for pharmacy technicians – in the summer of 2020 and is proud to award the first qualifiers Anne McAlister, the NPA’s manager in Northern Ireland, visited Andersons Pharmacy in Portadown to congratulate Ruth Parkes on qualifying as a pharmacy technician. NPA Assessor Linda MacDonald visited Bradshaw Street Pharmacy in Wigan to present another qualifier, Bethany Keen, with her certificate. Janice Oman, NPA manager in Scotland, took the opportunity to present Laura Smith of Townhead Pharmacy with her certificate on a visit to Kirkintilloch.

Louise Baglole, director of Professional Services and Development at the NPA, said: “It is really inspiring to see pharmacy technicians qualifying with our diploma. We recognise the huge commitment they have made to succeed, not least during the last three years. It is also rewarding for the teams here at the NPA who have been involved in the development and management of this programme and to receive such positive feedback on the support the students received is most satisfying.”

Student testimonial:

“It was hard work and a big commitment to complete the BTEC, but really worthwhile for the personal and professional development. I found the modules very interesting and it was good to apply your learning as you went along.”

Read more testimonials from students and supervisors, and find out more about our BTEC Diploma at www.npa. co.uk/training/btec/diploma

NPA’s 2023 vaccination training & service support programme is open for bookings

This year’s programme offers NPA members more service/PGD options than before – to help pharmacists decide on the training and packages that are most suitable to help them deliver services to their patients. Full details are available on the NPA website. Highlights of the 2023 programme are summarised below:

ECG flu packages with a paper PGD included.

We continue to work with ECG to deliver face-to-face vaccination training and online refresher training packages that include a free paper flu PGD from ECG. 2023 flu options and pricing can be viewed at: www.npa.co.uk/flu-training-and-pgds/

Pharmadoctor partnership.

NPA members can now go directly to Pharmadoctor and get a 10 per cent discount on any Pharmadoctor package (e.g. flu eTool, Unlimited Package) using a discount code.

What’s new for 2023?

A greater selection of training (both face-to-face and online options) can be purchased from ECG, such as vaccination training, online clinical or sore throat assessment skills, PGDs and service packages, which will enable you to upskill your team and offe enhanced services in your local community. You can purchase paper PGDs and training packages from ECG or go directly to Pharmadoctor to purchase service packages.

Travel, vaccination and non-vaccination (clinical) services

Now that travel is booming, you may wish to expand into these services and/or offe a variety of vaccination and non-vaccination services to support your patients.

More information is available on Pharmadoctor, ECG Training, the training and PGD options, as well as links to make purchases from the overall programme page, at: www.npa.co.uk/pgd

Knowledge article: NHS fraud checking (England)

Applicable legislation requirements and regulatory guidance. The Terms of Service of NHS Pharmacists require pharmacy teams to advise patients claiming an NHS prescription charge exemption, without showing evidence of such, that the NHS routinely checks claims to verify exemption status, as part of detecting and preventing error or fraud. The Pharmaceutical Services Negotiating Committee has published briefing guidance, including FAQs, to ensure this requirement is followed.

Actions for pharmacy teams. All members of the pharmacy team involved in handing out dispensed NHS prescriptions should be aware of the legislative requirements and trained appropriately to have conversations with patients and their representatives. The pharmacy’s standard operating procedures (SOPs) for taking in and handing out prescriptions should be reviewed and updated where necessary to reflect this.

What message must be given to patients/ representatives when evidence of an NHS prescription charge exemption is not shown?

The legislation states: “Checks are routinely undertaken to ascertain entitlement to non-payment of NHS prescription charges, where this is claimed, as part of the relevant arrangements for preventing or detecting fraud or error.” The way patients/representatives are advised is at the discretion of the pharmacist and their team. However, the information should be verbally provided in ‘appropriate terms’, delivered in a sensitive and professional manner, and with no suggestion of fraud or wrongdoing. Posters or leaflets are not considered sufficie advice, but can be used to initiate conversations.

Do all patients need to be informed of NHS fraud checks? Not all patients claiming NHS prescription charge exemption will need to be advised about NHS fraud checks.

Patients who do not need to be informed of NHS fraud checks:

• Age-exempt patients (under 16 or 60 and over), where the date of birth is printed on the prescription

• The item prescribed is free of charge (for example, contraceptives or treatment for a sexually transmitted infection)

• Real Time Exemption Check confirmation of exemption

• Prisoners on release patients, as long as the practice address box on the front of the prescription is printed with the letters ‘HMP’.

Patients who must be advised about NHS fraud checks:

• Where the date of birth is hand-written on the prescription or not included in the electronic prescription message

• When exemption from NHS prescription charges is claimed and evidence is required but not provided

• If the ‘evidence not seen’ box needs to be crossed (or the equivalent in an electronic prescription message).

What if the patient/representative is not sure about the NHS prescription charge exemption?

The patient/representative can pay for the prescription and have an FP57 refund form issued at the same time – it cannot be provided later. Once the patient/representative has evidence of their NHS prescription charge exemption, they can present it, along with the issued FP57 refund receipt, to any community pharmacy in England, within three months of the date the prescription charge(s) were paid.

When issuing the refund, it is important to check the serial number, ensure there are no alterations to the amounts or quantities, and that the form appears genuine. If there is doubt, the NHS Counter Fraud Authority can be contacted on 0800 028 4060 (applicable for England). FP57 forms should be locked away when not required so that they cannot be accessed by the public. Only authorised staff can process prescription refunds.

Real time exemption check (RTEC)

The NHSBSA holds data on people’s prescription charge exemption status. RTEC enables the pharmacy PMR system to automatically find out whether a patient has a known exemption, which it can auto-apply to their EPS prescription at the time of dispensing. RTEC does not determine the specifi exemption category – it will either mention that an exemption is present, or status is unknown.

The patient does not need to make a written exemption if the PMR system confirm the exemption. If the status is unknown, the exemption category and evidence need to be requested from the patient/representative.

Consequences for incorrectly claiming NHS prescription charge exemption

The NHSBSA conducts checks on patient claims. If during this check it cannot be confirmed whether a patient was eligible for free NHS prescriptions or NHS dental treatment, they will be sent an enquiry letter asking them to confirm their entitlement. If the patient does not respond within 28 days, they will be sent a penalty charge notice.

Within the penalty charge notice they will be asked to pay the original prescription charge(s), as well as an additional penalty charge. The penalty charge is five times the original amount owed, up to a maximum of £100. A surcharge may be added if no payment has been made 28 days after the penalty charge has been issued.