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

Warning of financial cliff edge

The National Pharmacy Association (NPA) is keeping up intense media activity to draw public and political attention to pharmacy financial pressures.

This includes a warning of a financial ‘cliff edge’ in April as rises in National Insurance and the National Living Wage take effect. We have calculated that pharmacies in England, Wales and Northern Ireland could face at least £280 million of unplanned costs. In addition, higher business rates will push up costs forsome.

As you know, unlike other businesses, pharmacies are unable to increase their prices in order to meet these sort of imposed rises. Go to the Trusted Partners section of the NPA Membership Hub to find expert support for your pharmacy’s finances and relatedservices.

NPA calls for immediate publication of NHS-commissioned economic analysis

The NPA has called on the NHS and the Department of Health and Social Care to publish immediately a long-awaited independent economic analysis of pharmacy underfunding.

The independent review, commissioned by NHS England, is expected to lay bare the sheer scale of the crisis facing community pharmacy, but there are now fears this won’t be published until after the government finishes current consultations on pharmacyfunding.

We argue that the public, and their elected representatives in Parliament, need to understand the fragile nature of the pharmacy network before any new deal can be agreed. It would be a scandal to keep that evidence buried and leave MPs, pharmacies and the public in the dark until it’s too late to make a difference.

New NPA board members

David Thomas, owner of LT Chemists in Newport, will be the next NPA board member for Wales, following an uncontested election this month, replacing Raj Aggarwal OBE.

Meanwhile, Baldev Bange, Aisling O’Brien, Sehar Shahid and Sanjay Ganvir have been returned to the board to represent areas in England and also Scotland.

They join Ashley Cohen, Sanjeev Panesar, Sukhi Basra, Salim Jetha, Olivier Picard and Nick Kaye, who did not have to stand for election this time and still have another two years to run on their terms as board members.

There are two more places to fill. The nomination process is still open in Northern Ireland and five NPA members are standing for the remaining place in England, which is open to any member in England with up to five pharmacies. The final meetings of the old board will be on 10th/11th March, with the new board taking over in April.

NPA chair, Nick Kaye, said: “We welcome David Thomas to the board and look forward to him becoming part of the dynamic, diverse and innovative national leadership of independent community pharmacy.”

David said: “I am delighted to be taking up the position of NPA board member in Wales. It’s a great privilege and I’ll do my utmost to ensure that NPA members in Wales are well represented and supported throughout my period on the board.”

Longstanding board member Raj Aggarwal OBE will step down from the position, having served with distinction for over a decade. In line with a modifi ed governance cycle, around half of the NPA board positions are up for election every two years.

Ramadan advice

Ramadan 2025 is expected to end on Sunday 30 March 2025. Muslims who are observing this month abstain from food and water for around 15hours. Please see the advice from the British Islamic Medical Association on how to get ready, or read the NPA Membership Hub (search ‘Ramadan’).

Our Thank Yous this month

Many of our members, partners and stakeholders go well beyond the call of duty to support independent community pharmacy.

This month we want to call out for special praise those NPA members who take part in media interviews at our request, telling the public about the vital work of our brilliant profession.

Also, a belated thank you to our trusted partners 9 Ways Media and Healthpoint TV, who ensured that last year’s Ask Your Pharmacist Week messages were widespread in pharmacies across the UK.

NPA support is available for independent prescribers

With pharmacists graduating with their independent prescribing (IP) qualification next year due to the changes in initial education and training standards for pharmacists, it’s a critical time to think about the support for these newly qualified pharmacists and for those already IP qualified, plus others thinking about going on the journey.

The NPA has been busily developing materials to support clinical governance including risk management, which are now housed on our independent prescribing website pages.

For newly qualified independent prescribers in England, there are currently limited NHS opportunities to utilise their IP qualification, apart from the pathfinder schemes, with most opportunities available through the private route.

Our ‘future pharmacy’ programme will enable our members to define their needs and embark confidently on the journey of private provision, deploying independent prescribing.

For members who are struggling to find Designated Prescribing Practitioners, the NPA has sourced a matching service – DPP Connect - to enable our members to fi nd a suitable DPP so they can enrol on an IP course of their choosing.

We always will ask members to see whether they can fi nd a suitable DPP in their local network speaking to their stakeholders as well as the regional NHSE teams. For more information, go to the NPA Membership Hub and search ‘prescribing’.

Bundling of Pharmacy First with the Pharmacy Contraception Service and Hypertension Case-Finding Service (England)

By 31st March 2025 at the latest, all pharmacy owners providing Pharmacy First will also have to provide the Pharmacy Contraception and Hypertension Case-Finding Services as well as meeting the relevant consultation threshold in order to continue to receive the monthly fixed payment. Full details on the NPA Membership Hub (search ‘Pharmacy First’).

NHS Pharmacy Contraception Service

• The is an Advanced Service allowing the ongoing supply of oral contraception (OC) that was initiated in primary care or a sexual health clinic; the service was expanded from 1 December 2023 to include initiation of OC

• If your pharmacy is registered to provide the service, consultations for both initiation of OC and for ongoing supply of OC must be provided - if you are only undertaking ongoing supply, this is in breach of the service specifi cation

• The Patient Group Directions (PGDs) must be followed when deciding if it is appropriate or not to supply OC; professional discretion cannot be used to make a supply of OC outside the provisions of the PGDs

• Currently only pharmacists can provide the consultations and supply OCs via PGDs

• Pharmacy staff can provide blood pressure and BMI measurements, if they are suitably trained and competent

• Remote consultations are allowed if considered clinically appropriate by the pharmacist

• There is a mandatory training requirement for pharmacists to complete one of the recommended Safeguarding Level 3 training options or have direct access to professional advice from someone who can advise on Safeguarding at Level 3

• An NHS-assured clinical IT system must be used for clinical records and payment claims. NHS

Hypertension Case-Finding Service

• The Hypertension Case-Finding Service is an Advanced Service that has two stages:

• Stage 1 – Identifying people at risk of hypertension and offering them a blood pressure measurement (a ‘clinic check’)

• Stage 2 – Offering ambulatory blood pressure monitoring (ABPM) where clinically indicated

• Pharmacies are required to have both a clinic blood pressure monitor and an ABPM device which are validated by the British and Irish Hypertension Society

• If your pharmacy is registered to provide the service, both stages of the service must be provided, where clinically required – if you are only offering to provide a clinic check, this is in breach of the service specifi cation

• Suitably trained and competent pharmacy staff may provide the service under the supervision of a pharmacist

• An NHS-assured clinical IT system must be used to make clinical records and payment claims.

Knowledgearticle: Supplying weight management medicines as an independent prescriber

Medicines used for weight management are considered ‘high-risk’. This is partly due to the inappropriate use, abuse and overuse of such medicines to achieve aesthetic weight loss.

Pharmacist Independent Prescribers (PIPs) prescribing GLP1- RAs must be vigilant for vulnerable patients, including those who may have a mental health illness such as body dysmorphia and/or an eating disorder, who may abuse and misuse GLP1-RAs for aesthetic reasons or inappropriate weight loss.

Effective safeguards must be integrated into the service to support PIPs in identifying those at risk. Many GLP1-RAs are currently Black Triangle medicines, where additional monitoring and reporting of suspected adverse reactions to the MHRA is required.

During consultations, PIPs must provide sufficient safety netting advice, including details on common side e ects and how to manage these in order to prevent serious complications and possible hospitalisation, such as hypoglycaemia, pancreatitis, GI side-effects leading to severe dehydration, kidney damage and death.

Wegovy (semaglutide) and Mounjaro (tirzepatide) are both currently listed as Black Triangle medicines, therefore pharmacists have a duty to report any suspected adverse effects to the Yellow Card scheme. Appropriate patient follow up may help identify adverse effects that require reporting and contribute to the ongoing surveillance of these new medicines.

GLP1-RAs are currently licensed for patients who are obese (with a BMI above 30kg/m2) or overweight with weight related comorbidities (with a BMI above 27kg/m2) such as cardiovascular disease.

In such patients, GLP1-RAs are known to be an effective and safe treatment option for weight loss. Outside of these licenced patient groups, there is limited evidence on the safety of GLP1-RAs and it is believed many of the reported adverse effects and serious incidents associated with GLP1-RAs are in cases where GLP1-RAs were used outside of the licenced indication and approved patient groups.

As always, PIPs must only undertake prescribing in a clinical area which they are trained, have appropriate experience in and are competent.

This does not simply refer to clinical knowledge on GLP1-RAs, but competence in assessing a patient’s condition (including physical examinations, relevant investigations and interpretation of any results); ensuring the prescribing of a GLP1-RA is appropriate, with consideration to any comorbidities; competence in training patient’s how to administer an injectable GLP1RA; able to undertake appropriate follow up and monitoring; and deprescribing GLP1-RAs.

Read the rest of this knowledge article by searching ‘weight’ on the NPA Membership Hub.

NEWS IN BRIEF

LFD Service Reimbursement update

From March 2025, the reimbursement price of LFD test kits provided as part of the LFD service has been reduced to £4.74 per fi ve LFD tests (+applicable VAT).

GPhC Standards Distance selling

The General Pharmaceutical Council has updated the guidance for registered pharmacies providing pharmacy services at a distance, including on the internet.

Flu immunisation letter released

The National Flu Immunisation Programme plan 2025 to 2026 has been released, please review the recommended infl uenza vaccines andtimings.

Foundation pharmacist training (England)

Do you have a foundation trainee pharmacist starting with you in 2025?

There are some key changes for foundation pharmacist training this year, including those highlighted below:

• All trainees (and their designated supervisors) must use the ePortfolio to record evidence throughout the year

• Training plans should be submitted via the ePortfolio to NHSE when the trainee starts in July/August (not to the GPhC)

• The training plan needs to detail how the assessment strategy requirements will be met over the year and tailored to the trainee

• NHSE will be offering a set, core training programme to all foundation trainee pharmacists. This does not include sector specific training, face-to-face teaching on clinical topics or any registration exam preparation/mocks

• Trainees working to the full learning outcomes will work under the supervision of a Designated Prescribing Practitioner during their year and then qualify as an independent prescriber on successful completion of their foundation training year. The NPA is currently reviewing and updating its training programme and trainee support packages for 2025-2026.

The NHSE webpage is updated regularly. Keep an eye out for furtherinformation.