This month’s key notes

Spring 2023 Covid-19 booster campaign

NHS England (NHSE) has published the updated Service Specification for the Community Pharmacy National Enhanced Service spring Covid-19 vaccination campaign. It details the service for community pharmacies that have agreed with their NHSE regional teams to continue to support the spring vaccination campaign.

The updated service specification has been extended from an original end date of 31 March to 31 August 2023 and includes an additional one-off Adult Care Home payment. Please note that as this is an extension of the autumn/winter 2022 (Phase 5), it continues to reflect the additional payment for activity to vaccinate in all adult care homes in place until 23 October 2022.

ALSO THIS MONTH

Nitrous oxide to be made a Controlled Drug

The Home Office has announced that nitrous oxide – commonly known as laughing gas – will be made a Class C Controlled Drug and be subject to control under the Misuse of Drugs Act 1971 by the end of 2023. Currently, nitrous oxide is regulated by the Psychoactive Substances Act 2016, so the production, supply and importation are illegal when used for its psychoactive effects. The Advisory Council on the Misuse of Drugs (ACMD) had reviewed the harms caused by non-legitimate use of nitrous oxide and made recommendations to deal with the problem of nitrous oxide misuse; this included nitrous oxide to remain under the Psychoactive Substances Act 2016. For further information, please refer to bit.ly/401jfex

Key changes to the Community Pharmacy Covid-19 spring booster programme

You can receive an additional one-of payment for completion of vaccinations in small and medium-sized older adult care homes up to and including 28 May 2023. To receive the additional payment, you are required to complete and submit a live time survey as soon as reasonably possible, and no later than seven calendar days after the visit (a survey for each visit made should be submitted).

Any surveys received after 4 June 2023 will not be eligible. For each completed older adult care home, the payment is: • £150 for each “small care home” (define as 1-10 registered beds) • £275 for each “medium care home” (defined as 11-49 registered beds).

There will be no additional payment for completed vaccinations for large and extra large older adult care homes (defined as those with 50+ registered beds), nor other types of care home of any size.

Following the JCVI statements on the Covid-19 vaccination programme for 2023 and on spring 2023 Covid-19 vaccinations, a revised version of the Green Book Chapter 14a was recently published. As a precautionary measure, the following groups, who are at higher risk of severe Covid-19, should receive an extra spring booster dose. This includes:

• Adults aged 75 years and over (including those turning 75 years by 30 June 2023)

• Residents in care homes for older adults

• Individuals aged five years and over who are immunosuppressed (as define by the Green Book (tables 3 and 4 in chapter 14a).

NHSE has issued a letter to NHS organisations, including community pharmacies, on preparing for a successful spring 2023 Covid-19 booster campaign. For more information, go to bit.ly/3zNX94F

Results of NPA Board elections

The National Pharmacy Association (NPA) has announced the results of its Board elections. The NPA Board meeting on 31 March confirmed 14 Board members to govern the association over the next two years. Four new Board members have been elected, while five previous members left the Board after serving their terms.

The full list of the new NPA Board is as follows;

• Raj Aggarwal (2-year appointment)

• Jay Badenhorst (2-year appointment)

• Sukhvir Basra (4-year appointment)

• Ian Cubbin (2-year appointment)

• Phil Galt (2-year appointment)

• Sanjay Ganvir (2-year appointment)

• Michael Guerin (2-year appointment)

• Salim Jetha (4-year appointment)

• Sri Kanaparthy (4-year appointment)

• Nick Kaye (4-year appointment)

• Andrew Lane (2-year appointment)

• Sanjeev Panesar (4-year appointment)

• Raj Patel (2-year appointment)

• Olivier Picard (4-year appointment)

The period until March 2025 will see the completion of the transition to the new Board structure. Gareth Jones, Returning Officer for the NPA Board elections, said: “The NPA has undertaken a process of significan modernisation of organisational governance over the past years. Key elements of this process include adopting modern new Articles of Association, reforming the structure of the Board and introducing term limits.

The process of electing the Board has also been changed so that half of the Board will be up for election every two years – which supports continuity and reduces the risk of a loss of organisational memory.” Recognising that the Board would already be losing a lot of organisational memory in 2023 with five members standing down, the Board decided that three individuals should be co-opted onto the new Board as the process of transformation continues.

In March 2025, anyone that has served 12 years or more will be required to stand down. The Board met on 24 April to elect the Chair and other appointments. For further information go to www.npa.co.uk/elections

Save Our Pharmacies: update

The Save Our Pharmacies campaign petition has now been signed by 60,000 people. Are you one of them? Please do sign, even if you have signed similar petitions in the past: Go to bit.ly/3MN4o4i

A petition by itself cannot guarantee positive change, but it can be an important drum beat to a campaign. It is extremely easy to register your support by signing – it takes just a few seconds. Anyone can sign the petition – including your work colleagues, patients, friends and family, so please encourage them to add their names too.

There is no fixed target for the number of signatures gathered, but it is important in the early stages to show momentum, so please act ASAP. The petition is one of the outputs of a joint programme of work being co-ordinated by PSNC, CCA, AIMp and the NPA. All #SaveOurPharmacies campaign resources – such as posters, flyers, social media graphics, digital display graphics, MP briefings and key messaging – can be found on the campaign website saveourpharmacies.co.uk. Further new resources will be added as the campaign progresses.

NPA welcomes Budget announcements on VAT, but fundamental concerns remain

The NPA has welcomed two changes to VAT announced in the Chancellor’s March Budget. From 1 May this year, the VAT exemption on healthcare will be extended to include medical services carried out by staff directly supervised by registered pharmacists. The government will also extend the zero rate on prescriptions to medicines supplied through Patient Group Directions. This measure will be introduced in autumn 2023.

NPA Chief Executive Mark Lyonette said: “The NPA has raised these matters with government on several occasions and we are pleased now to have this positive response. These measures don’t touch the sides as far as the massive hole in pharmacy funding is concerned, but we should acknowledge that the government has listened to the sector on these specifi VAT matters.

“Although this is a positive signal, it is pennies rather than pounds, and another opportunity to fundamentally address the funding crisis in community pharmacy has been missed in this latest Budget."

NPA pleased at findings of ICS review

An independent review of Integrated Care Systems (ICSs) in England by former Health Secretary Patricia Hewitt has been published. It found that the recruitment of pharmacists into Primary Care Networks (PCNs) via the additional roles reimbursement scheme (ARRS) is worsening a shortage of pharmacists.

Responding to the review, NPA Director of Corporate Affairs Gareth Jones said: “The NPA has repeatedly highlighted that it is an own goal for the NHS to subsidise the employment of pharmacists in general practice at the expense of denuding the community pharmacy workforce.

“Hewitt has called this out as an example of silo thinking and we urge system leaders to respond accordingly by reviewing the wider workforce impact on their patch. The NPA has suggested that there should be a workforce risk assessment at system level before any new recruitment via ARRS. “We have also asked Integrated Care Boards to think creatively about what more they can do to optimise community pharmacy staffing for the delivery of locally identified priorities.

“We were pleased to take part in the consultative stages of the Hewitt Review and we welcome its straight-talking conclusions.”

NHS prescription charge update (England)

NHS prescription charges have increased by 3.21 per cent. The new charges and the cost of pre-payment certificates are:

• £9.65 per prescription item

• £31.25 for a three-month prescription pre-payment certificate (PPC)

• £111.60 for a 12-month PPC, which can be paid in instalments

• £19.30 for the newly introduced HRT PPC. PPCs can be obtained in several ways:

• Online, via the secure web application form at bit.ly/3ZVozjq

• By phone, calling 0300 330 1341

• From a pharmacy registered to sell PPCs – more information at bit.ly/40U6vYx

The Prescription Charge Card for 2023/24 is available to download and print from psnc.org.uk/our-news/psnc-issues prescription- charge-card-for-2023/. Please contact the NPA’s Pharmacy Advice and Support team if you have any queries: pharmacyservices@ npa.co.uk; 0172 789 1800 (Mon-Fri, 9am to 6pm).

HRT prescription prepayment certificate

The government has introduced a new prescription prepayment certificate (PPC) for hormone replacement therapy (HRT) medicines. This is now available for patients to purchase and use. The HRT PPC can be used against a list of specified HRT prescription medicines licensed to treat the menopause or for other purposes during its 12 months validity. The Department of Health and Social Care (DHSC) has published guidance for GPs, prescribers and pharmacy staf at www.nhsbsa.nhs.uk/hrt-ppc guidance. The PSNC has published guidance and FAQs at psnc.org.uk/our-news/hrt-ppc-guidance and- faqs-now-available/.

HRT PPC cost and validity:

 • £19.30 (equivalent to two prescription charges from 1 April 2023), but may change from 1 April each year

• The validity of the HRT PPC is 12 months and there is no limit to the number of times it can be used while it is valid; renewal is not automatic

• HRT PPCs are not refundable.

How to apply:

• The HRT PPC is available to purchase (digital or paper format) through the NHS Business Services Authority and from pharmacies registered to sell PPCs from 1 April 2023.

HRT PPC start date:

• Up to one calendar month before the purchase date. For example, if an application is made on 1 May 2023, the start date must be on or after 1 April 2023 (this is the earliest date the HRT PPC can start), or

• Up to one month after the purchase date. For example, the start date can be no later than 1 May 2023 if the application is made on 1 April 2023, or

• If no start date is specified on the application, the HRT PPC will start from the purchase date.

HRT medicines in scope for the HRT PPC:

• The HRT PPC can be used only against a list of specified medicines; the list (correct at the time of writing) can be accessed at bit.ly/3KlySrv. The up to date list will be published in Part XVI of the Drug Tariff

• An HRT PPC covers the list of HRT prescription items prescribed for the treatment of menopause or for some other purpose.

HRT medicines not in scope for the HRT PPC:

• HRT medicines not included in the list of specified medicines

• Medicines prescribed off-label to treat certain symptoms of the menopause (for example, testosterone)

• HRT medicines prescribed on private prescriptions.

NPA’s Foundation training programme is open for enrolments

Our training programme for the 2023/24 cohort of trainee pharmacists is open for enrolments. The programme encompasses 10 days of study from September 2023 through to June 2024, which includes four face-to-face study days and webinars as well as self-directed learning throughout on our intuitive eLearning platform.

Full Part 1 and 2 mock exam papers are covered in May 2024. Within the member price are the following extra opportunities for your trainee to increase their skills:

• Enrolment onto the NPA’s medicines counter assistant course

• Vaccination training (practical and online sessions)

• Leadership training

• Clinical skills training.

To find out more about our programme, how former trainees have rated it and to enrol, go to: www.npa.co.uk/training/ foundation.

Mock exam open for enrolments by trainee pharmacists

The NPA’s mock exam is open for enrolment by any trainee pharmacist who wishes to practise for their common registration assessment (including those re-sitting) this summer.

By purchasing the mock exam, your trainee will be able to:

• Familiarise themselves with the online assessment process under timed conditions prior to the actual assessment.

• Apply knowledge to a full-length assessment reflecting the GPhC structure. Part 1 consists of 40 calculation questions, part 2 consists of 90 single best answer questions and 30 extended matching questions

• Understand how to work out the Part 1 answers by accessing our webinar

• Identify knowledge gaps, as answers are received immediately, and take steps to fill these gaps before the actual assessment.

The exam fee, unchanged from previous years, is £60 (including VAT). Find out more, see how helpful former students have found the mock exam and enrol via www.npa.co.uk/training/ foundation/mock-exam.

Pharmacy apprenticeship videos

We have created a mini-series of videos to illustrate the Level 2 and Level 3 pharmacy apprenticeships delivered by our partner, Skills 4 Pharmacy. NPA member and Skills 4 Pharmacy Managing Director Amerjit Singh introduces this form of learning for community pharmacy.

The video lasts just over five minutes and introduces our programme, highlights the benefits for pharmacy and details what is covered by each apprenticeship. We have also broken the key topics into bite-sized video snippets so you can choose to view for a shorter duration.

The videos are avialble at www.npa.co.uk/ apprenticeships/apprenticeship programme- videos/. To find out more about our programme funding and the benefits of an apprentice, go to www.npa.co.uk/apprenticeships/.

Educational supervision training sessions summer 2023

As pharmacy roles develop within the NHS, the need for educational supervision sessions for pharmacy technicians and pharmacists from all sectors of pharmacy becomes ever more important.

Health Education England is running a series of online educational supervision events via Microsoft Teams to support this agenda. Contact Helga Mangion, NPA Policy Manager, at independentsvoice@npa.co.uk should you wish to discuss this further. Register your interest at bit.ly/3KKNdyX.

Knowledge article: EEA and Swiss prescriptions and emergency supplies

There is an NPA knowledge article on guidance on dispensing and dealing with EEA and Swiss prescriptions and emergency supply requests following the UK leaving the European Union and the subsequent changes to legislation. See www.npa.co.uk/information-and-guidance/eea-and-swiss-prescriptions/.

What sets the NPA’s programme apart?

• Our mix of training formats accommodates different learning styles. The face-to-face study days are very popular with trainees as they enable practical training and interaction with other trainees. See how helpful former trainees have found these days at www.npa.co.uk/training/ foundation-testimonials/

• Our programme is designed to support your trainee to develop into a confident and competent pharmacist, rather than just helping them to pass the common registration assessment

• Designated supervisors are kept in the loop throughout the training and we even provide them with a trainee report at about week 26, so they can monitor how their trainee is progressing with their studies.

Bank holiday reminder

Community pharmacies are not required to remain open during named bank holidays, as set out in the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013. Community pharmacies can remain closed without the need of notice, unless directed by NHS England & NHS Improvement (NHSE&I) to open their pharmacies. The table on the right indicates when a pharmacy can close without direction to remain open by NHSE&I.

Key points for pharmacy teams:

• Review your NHS 111 Directory of Services (DoS) and NHS website profiles ahead of the bank holidays to ensure your pharmacy’s opening hours are accurate. Go to www.nhs. uk/about-us/manage-provider-profiles

• If a pharmacy contractor intends to remain open on a bank holiday and has not yet updated their opening hours in the ‘temporary changes to opening times’ section of the NHS Profile Manager, they should action this ahead of the bank holidays to indicate the pharmacy will be open. Go to www.nhs.uk/our-policies/profile-editor-login/

• Check, in advance, any controlled drug (CD) prescriptions received to ensure they are clinically suitable and legally valid to dispense. To read the rest of the advice, go to the NPA’s information and guidance hub at bit.ly/3yqhJat.

NPA members can contact the Pharmacy Advice and Support Team for further information, advice and/or support on any pharmacy topic/matter by emailing: pharmacyservices@npa.co.uk

Update on the introduction of the flat fee payment (England)

As part of the Community Pharmacy Contractual Framework five-year deal, the monthly flat fee payment to pharmacy contractors has been introduced from 1 April 2023. The payment and conditions are set out in the Drug Tariff Part VIA, paragraph 5; pharmacy contractors will receive a monthly flat fee payment of £533 if they dispense 101 or more prescription items.

Please note that the amount of the flat fee is subject to change during the year. We have launched a new hub, ‘Pharmacy funding and Drug Tarif (England)’ bringing together all relevant information, guidance, documents and NPA support on pharmacy funding topics in one place. You can find it at www.npa.co.uk/pharmacy-funding-and-drug-tariff england/.