Paperless Distribution – HDA Position Paper

HDA UK – Facilitating Digitisation of the UK Medicines Supply Chain.  

The Healthcare Distribution Association (HDA UK), representing wholesale distributors of medicinal products in the UK, believes that in line with the ‘adoption of new technologies’ goals of the Government’s NHS 10 year plan that UK medicines legislation should be brought up to date to allow the adoption of paperless technologies in the distribution of medicines.

HDA members are committed to reducing the impact of their operations on our environment.

Government Policy

The government has recently announced a shake-up of tech and AI usage across NHS and other public services to deliver plan for change, it wants to ensure that technology will be better used to improve public services. Shake up of tech and AI usage across NHS and other public services to deliver plan for change – GOV.UK

HDA Believes that transitioning from paper to electronic delivery documentation would support this policy enabling increased efficiency and productivity.

Currently regulation mandates that a paper delivery note (or invoice) should accompany all medicines whether the customer wants them or not. These invoices are included in all wholesaler deliveries, whether from the wholesaler to another wholesaler, community pharmacy, dispensing doctor or other customer type.

The digital technology is in many cases already in place and the paper document is not used and simply discarded.

The MHRA is seeking views from stakeholders on its proposals to amend GDP Guidance to include the provision to transmit supply documentation from wholesalers electronically- Engagement on facilitating the use of digital packing notes to accompany medicinal products

Benefits of utilising paperless distribution

• Reduce waste and paper production
  • Many millions of paper delivery documents are produced every year, paperless technology would reduce this outdated demand on our natural resources.
• Reduce cost for customers and wholesalers
  • By reducing the reliance on paper documentation customers and adopting new technology customers (particularly in the NHS) would benefit from lower processing and paper transporting costs.
  • Wholesalers would use less paper and reduce their costs
  • The machinery to print delivery documents at scale and speed is very expensive, digitisation would reduce the requirements for such technology.
• Improve efficiency
  • Electronic methodology will allow for faster and more accurate processes in pharmacies, doctors and hospitals.
  • The adoption of paperless Controlled Drug Requisition documents will facilitate this process and avoid the challenges of lost or mislaid paper documents
• Improve accuracy of invoices
  • Electronic documents can be modified up to the point that a delivery leaves the wholesalers service centre- much later than can be achieved using paper documents. This means invoices will be more accurate and avoiding the uncertainty and inefficiency that comes with that comes with handwritten amendments to invoices.

Transition

Of course, as with any change to regulation or new technology a period of transition will be required, the fact that some customers are not yet ready to utilise new technology should not stand in the way of those who want to do so.

Wholesalers are adopting new returns/recalls/queries portals that avoid the need for customers to use paper documentation to perform these tasks.

Tried and tested electronic Proof of Delivery methodologies are already in use across the medicines supply chain.

Who we are

HDA UK represents businesses who store, manage, and distribute medicines, medical devices and healthcare services to community pharmacies, hospitals, and dispensing doctors. Our member companies are responsible for distributing 95% of the NHS’ medicines, enabling a safe, efficient, and high-quality supply chain for patients, the NHS, and the healthcare sector.

Ensuring the Future: 8 Policies to Reset the Healthcare Distribution Sector

After extensive engagement with relevant stakeholders and our members, the Healthcare Distribution Association (HDA) the representative body for wholesale distributors of medicinal products, distributing 95% of all NHS medicines, has developed a call-to-action outlining steps the new Labour Government can take to support the efficient and effective distribution of medicines to patients in the UK. This call-to-action outlines some ‘quick fixes’ which can be implemented within the first 100 days of Government to support the industry as well as some longer term, more institutional changes which will foster longer lasting and more impactful change.

HDA and its member companies believe that the current medicines supply chain is fit for purpose, having withstood COVID-19 shocks, and provides great service and delivers excellent value for patients, healthcare professionals and the UK taxpayer on a daily basis. Every year HDA members deliver 2.1bn packs of medicines to healthcare professionals across the UK, delivering twice per day on average.

A key issue for the sector is that of medicine availability and HDA member companies already dedicate significant systems and resources, working with government, regulators and other supply chain actors to identify, prevent and mitigate such challenges, whether caused by supply disruption, demand increases, or a combination of factors.

The First 100 Days for Action

The HDA urges the new Labour Government to implement measures under five categories within the first 100 days of Government to alleviate some of the most pressing issues facing the medicines distribution sector. The industry faces significant challenges including growing financial issues in community pharmacy, workforce pressures, and a transition to net zero.

Addressing these issues within the first 100 days is essential for ensuring the healthcare distribution industry’s continued resilience, efficiency, and viability.

1. Digital First Regulation – Ensure Parliamentary time to allow debate and endorsement of paperless invoicing throughout the medicines supply chain (by laying appropriate Statutory Instruments). This will create a safer, more efficient and environmentally sustainable record of transactions.

2. A Strong Medicines Supply Chain – Greater financial support for the sector should be considered, including long-term, sustained and appropriate funding for community pharmacies. Incentives for global manufacturers to supply the UK are also critical in ensuring that our sector has enough medicines to distribute to an ever-increasing number of patients. NHS Hospitals should be mandated to pay for medicines in a timely manner.

3. Accelerating The Transition to Net Zero – Re-evaluate regulatory requirements regarding the temperature control of ambient medicines during transportation, balancing patient safety with the imperative to reduce energy consumption.

4. Immediate action to unlock Controlled Drug regulation – healthcare distributors are currently experiencing significant delays to the Controlled Drug licensing process, potentially putting the supply of critical treatments to patients at risk.

5. Business Rates – Companies responsible for medicines distribution should be treated as a special case during any reforms of business rates and not conflated with other warehouse-based sectors, who do not provide life-saving treatments for high-street pharmacies, patients and the NHS. HDA members support the retail sector rather than compete with it.

Institutional Actions for Longer-Term Change

Alongside the above ‘quick fix’ actions, longer-term, more sustained change is essential to secure and maintain a robust and effective pharmaceutical supply chain. The measures outlined below list the actions that HDA believes the Government should consider in order to foster long lasting and impactful change within the industry.

1. An Adaptive and Risk-Based Approach to Regulation – Regulators to place an enhanced focus on a risk-based approach to regulating the sector which is consistently compliant with regulations, including a greater focus on businesses and organisations with higher-risk operating models. 

2. Funding The Transition to Net Zero – Consider incentives and financial support for healthcare distributors, as they transition on behalf of the NHS, to practices and operations which enable the move to Net Zero, in particular the electrification of delivery fleets. More specifically, an intensive and frequent medicines distribution network, operating across the four countries of the UK, urgently requires robust electric vehicle charging infrastructure.

3. Staffing and Workforce– Consider additional funding, incentives and support for regulation-mandated training to underpin the upskilling of medicines supply chain staff, to match rising demand and increase training-related requirements.

These immediate and sustained actions are crucial to revitalising the medicines distribution sector and ensuring that the UK retains its resilient, efficient, and sustainable healthcare system.

Note to Editors:

The Healthcare Distribution Association (HDA) represents businesses who supply medicines, medical devices and healthcare services to patients, pharmacies, hospitals, dispensing doctors, and the pharmaceutical industry.

HDA members operate across the four nations of the United Kingdom, enabling a safe, efficient and high-quality supply chain for the healthcare sector, delivering 95% of the NHS’s medicines.

As the trade body representing all leading companies that provide pharmaceutical wholesaling services across the UK, the HDA has always supported proportionate regulation to ensure the resilience of the UK’s healthcare supply sector while promoting innovation and adaptability.

Further Questions

If you have further questions about the HDA’s ‘Ensuring the Future: 8 Policies to Reset the Healthcare Distribution Sector’ please contact our Executive Director Martin Sawer, at msawer@hdauk.co.uk.

Media Contact

For all media inquiries, please contact secretariat@hdauk.co.uk

London, 25 October 2023: The HDA has signed a joint letter to Health Secretary Steve Barclay MP calling on the Department of Health and Social Care, the UK Health Security Agency and NHS England to begin planning the 2024/2025 winter vaccination programme as soon as possible in order to ensure that plans are well established ahead of the 2024/2024 flu season.

The letter was also signed by the Royal Pharmaceutical Society, vaccine manufacturer CSL Seqirus, NHS Confederation Primary Care Network, and the Dispensing Doctors’ Association.

Alastair Buxton, Director of NHS Services at Community Pharmacy England, said:

“Community pharmacy teams always plan their winter vaccination provision many months before the autumn. This year their efforts were hampered in August when NHS England moved the goalposts on the flu vaccination service start date, only to change its mind again a couple of weeks later. This was a shambolic start to the vaccination programme and caused unnecessary work and hassle for pharmacy owners and their teams. This sort of policy to-ing and fro-ing must not be repeated and we hope to begin constructive conversations with NHS and the Government very soon to help next year’s programme run more smoothly for all.”

Will Quince MP, the Minister of State for Health and Secondary Care opened the HDA Annual Conference 2023 by video. He thanked HDA members for the “indispensable part” they played during the COVID-19 pandemic, as well as their efforts in tackling hormone replacement therapy supply challenges and soaring demand for antibiotics.

“Receiving timely data from the sector [on these issues] has been critical,” Mr Quince continued, as it allowed the Government “to better understand what is happening and how best to manage it”.

“No matter the challenge, we see HDA members rise to the occasion,” the Minister said. “You are the experts and, in Government, it’s our job to enable you to deliver.”

“We know there is more to do to increase the resilience of our medicines supply chains and I pledge our wholehearted support and a commitment to work ever closer with you,” he added.

For the full video, please contact the HDA Secretariat.

London, 20 June 2022: The Healthcare Distribution Association (HDA UK) will be an official partner of Generation Logistics, a major new awareness and recruitment campaign launched on 15^th June. It will showcase the varied range of rewarding career options the logistics sector offers and is coordinated by the Chartered Institute of Logistics and Transport (CILT) and Logistics UK, in partnership with the Department for Transport.

The HDA will support Generation Logistics in their efforts to attract talent to the sector, which will be key to fill vacancies industry-wide and future-proof the sector. A strong workforce is crucial in the development of a resilient pharmaceutical supply chain, and ultimately ensuring that the right medicine is in the right place, at the right time for patients across the four nations of the UK. This means recognising and celebrating the crucial work that is being done in the industry, something the HDA has been a strong advocate for, exemplified in the achievement of key worker status for those working in the medicines supply chain during the COVID-19 pandemic.

Commenting on the launch, the HDA’s Executive Director, Martin Sawer noted:

“The HDA is very proud to be an official partner of this government-supported initiative focusing on careers and employment in the logistics sector, on which we all rely so much. We encourage our members to support Generation Logistics’s efforts and we will be doing our part to facilitate awareness of the medicines distribution sector as part of the broader Generation Logistics programme of activity.”

Phil Roe, Logistics UK President comments:

“Generation Logistics will provide our industry with the capability to attract and retain the skilled and ambitious workforce which it needs as our role in society continues to flourish.”

Phil Roe and Bethany Windsor, Programme Manager at CILT, presented the Generation Logistics campaign at the HDA Business Day on the 26^th May, highlighting the synergies between the logistics sector and the aims of the HDA’s member companies, including issues around retainment, job satisfaction, training and future-proofing the supply chain.

The Secretary of State for Transport, Grant Shapps MP said:

“We have a new challenge facing us as we look to the future of freight. We need to attract a diverse and skilled workforce to play a key part in a new, exciting era transforming an industry at the forefront of innovation and technology. There are thousands of logistics roles available to people from all backgrounds, experience and skills. This campaign will showcase those opportunities in artificial intelligence, advanced robotics, autonomous vehicles and the decarbonisation of the supply chain. This industry campaign is integral to not only supporting growth of this vital sector but also ensuring we have the workforce needed for now and the future.”

About the Healthcare Distribution Association

The Healthcare Distribution Association (HDA UK) represents those businesses who supply medicines, medical devices and healthcare services to patients, pharmacies, hospitals, doctors, and the pharmaceutical industry. HDA UK members operate across the four nations of the United Kingdom enabling a safe, efficient, and high-quality supply chain for the healthcare sector. They are responsible for distributing over 90% of NHS medicines and provide wholesaling services including stock management and IT systems to their supply chain partners. The HDA and its members are at the forefront of the constantly evolving healthcare supply chain, which is seeing innovative practices and technologies make new services possible for manufacturers and to those who dispense medicines, reflecting the needs and choices of individual patients.

Contact Information

Will Browne – wbrowne@hdauk.co.uk

Rebecca Vestager – rvestager@hdauk.co.uk

Dear HDA members,

We were pleased to have Lord Kamall, the Minister for Technology, Innovation and Life Sciences open the HDA Annual Conference 2021 by video.

On behalf of the Department of Health and Social Care, Lord Kamall recognised the HDA and the HDA’s members’ “incredible efforts in ensuring that medicines reach patients”, “despite the challenges over the past two years”.

HDA members, he emphasised, were crucial in the effort to fight coronavirus: “From the very start in the first lockdown when we saw huge increases in demand, this created extreme pressures on wholesalers, required lots of flexibility to keep up with demand and to thank you for the great efforts that we saw in sourcing PPE for pharmacies. You managed all this while navigating complex policies and adopting covid-securing working practices”.

He said that there was a need to work “closely and in collaboration together”. He continued: “We appreciate the need for the Department, the MHRA, and others in the health family to engage as early as possible. The close liaison that has developed through Martin, the HDA’s Executive Director and the HDA, working week to week with officials, demonstrates the strong cooperation which has been built up.”

He thanked members for their support in ensuring a consistent medicines supply following Brexit, and reiterated the Government’s commitment to futureproofing the supply chain. He was furthermore pleased to hear that the HDA had chosen carbon net zero as the focus of the Conference’s afternoon programme.

For the full video, please contact the HDA Secretariat.

HDA member companies are currently experiencing challenges in accessing fuel like many other critical sectors across the UK.

As you would expect, individual medicines wholesale distribution companies have ongoing business continuity plans to provide resilience to ensure medicine deliveries are maintained to community pharmacies, hospitals and doctors across the country.  The sector as a whole has withstood the ravages and demands of Covid-19 and is well-placed to be flexible and is very used to working collaboratively with other supply chain partners.

These arrangements are currently being severely tested, as fuel supplies are not as available as we would like from normal sources.  HDA knows that some normal delivery schedules for medicines could be disrupted for most of this week, but every effort will be made to fulfil orders. HDA members are grateful for the patience and understanding being displayed by their customers.

HDA believes successful maintenance of patient supply will be dependent on two critical issues:

• priority access for distributors’ transport fleets to fuel, principally at petrol stations – HDA is in urgent talks with the UK Government on this specific issue
• continued regular deliveries into our warehouses of medicines, that themselves are being impacted by fuel shortages

 

Dear HDA members,

Please see Lord Bethell’s written response to the HDA’s letter expressing concern over increasing delays in the COVID-19 testing regime. The Parliamentary Under Secretary of State for Innovation took this opportunity to thank the pharmaceutical distribution sector for its crucial role in ensuring that medicines reach patients, and the HDA for its ongoing work around COVID-19 and in raising important issues with the Department of Health and Social Care.

28 October 2020

Dear Martin,

I was sorry to read about the difficulty members companies of HDA have raised about their getting a test for Covid-19 (Coronavirus). I would like to take this opportunity to reiterate what I set out in my letter to you on 17 June, we appreciate the crucial role of pharmaceutical distribution in ensuring that medicines reach patients. I would also like to take this opportunity to thank the HDA for their ongoing work around Covid-19 and in raising important issues with the Department.

We have provided access to testing for millions of essential workers, where they are selfisolating because either they, or a member of their household is symptomatic, and are committed to ensuring all symptomatic essential workers get access to a test.

Essential workers and members of their households, including those working in the medicines supply chain, can access priority testing at https://www.gov.uk/applycoronavirus-test-essential-workers, individuals using the portal can enter their details and will then receive a text or email the same day inviting them to either book an appointment at one of more than 70 drive through testing sites across the country, or receive a home testing kit.  Essential workers can order five test kits for themselves and other symptomatic members of their households. However, for households of more than five, the Contact Centre (119) can raise an order on their behalf. Essential workers remain those which were listed under guidance published earlier in the year, this includes those working as part of the health and social care supply chain, including producers and distributors of medicines, and medical and personal protective equipment. This guidance can be found at https://www.gov.uk/guidance/coronavirus-covid-19-getting-tested.  

We continue to expand testing capacity doubling the daily COVID-19 testing capacity to 500,000 by the end of October.  We are also increasing the number of testing sites to 500 by the end of October to help ensure everyone who needs a test can access one.  We are also aware of an issue with the booking portal that resulted in some users being directed to

tests sites a long distance from them. This has now been resolved, and we have introduced a travel restriction to receive a test at 75 miles to ensure that this does not happen again.

We are also taking actions to make it clear that only symptomatic people should be accessing tests in order to reduce inappropriate demand, including focused communications across the media and the 119 Call centre, and updating guidance at test sites.

Thank you again for raising this important issue, the continued safe supply of medicines to patients remains a priority and we are grateful to all the efforts being made by your members.

I hope you have found this response helpful.

Yours,

Lord Bethell

Dear HDA Members,

The HDA’s Executive Director, Martin Sawer, wrote to Parliamentary Under Secretary of State for Innovation Lord Bethell, relaying concerns from HDA member companies over the cumulative impact of the increasing delays in the COVID-19 testing regime. Mr. Sawer highlighted that the HDA and its members were concerned that if not addressed, this could begin to affect their operational performance and ultimately the certainty that medicines can get to patients as required.

17 September 2020

Dear Minister,

On behalf of the medicines distribution sector, I am writing to express growing concerns from our member companies about the cumulative impact of the increasing delays in the COVID-19 testing regime.  HDA and its members are concerned that if not addressed, this could begin to affect their operational performance and ultimately the certainty that medicines can get to patients, as required.

As you will be aware, our member companies operate over 50 pharmaceutical distribution warehouses across the four countries of the United Kingdom, and as you have kindly acknowledged, their efficiency and business resilience has held up incredibly well in the face of the COVID-19 pandemic outbreak.  HDA and its members really did appreciate the UK Government’s decision to classify employees in our sector as Key Workers.  This allowed our members’ businesses to operate with much improved levels of staffing and certainty than might otherwise have been the case.  The priority given to Key Workers, both regarding access to schools and the testing regime, was really helpful in allowing management to plan staff rosters and guarantee medicines supplies continued.  To have this certainty now begin to be thrown into doubt, seemingly due to the lack of a testing prioritisation process, is difficult to understand.  We had assumed that all the planning for coping with a potential second wave of COVID would include the type of challenges that we are now experiencing.

HDA is now collecting weekly member company data to quantify the impact on the sector.  So far, the Association has received reports of testing delays for employees at medicines warehouses in Stoke, Chessington, Cardiff, Southampton, Hinckley, Warrington, Gateshead, Norwich and Belfast.  To add insult to injury, some staff in Belfast have been offered testing slots in Scotland for example, and others tests several hours away from their localities.  HDA companies report that these delays in getting colleagues back to work – some waiting at home just for a test for nearly a week – is beginning to have an effect on business operations.

We believe that it must be in the interests of our members’ businesses, patients and the NHS, if we can jointly acknowledge and solve these issues before the situation gets out of hand.  HDA would support testing prioritisation, alongside the clear and public communication of guidance, and would be keen to work with you and your Department to achieve this. I look forward to hearing from you shortly.

Yours sincerely,
Martin Sawer

Dear HDA members,

Please see below letter from Lord Bethell, Minister of Innovation at DHSC, thanking all staff in the healthcare distribution sector for their hard work during the COVID-19 pandemic.

17 June 2020

Dear Martin,

Thank you to all staff in the healthcare distribution sector

I personally want to thank all staff in the healthcare distribution sector for their hard work during the COVID-19 pandemic.

As the father of four young children, I lean on the pharmaceutical wholesale industry to provide solutions for the sniffles, cuts and scrapes of a busy home life, and I am grateful that the supplies of key family medicines and supplies has never wavered.

These are unprecedented times and I have been very impressed by the response from healthcare distributors and their staff during this very busy and challenging period for all of us. It was because of your efforts that hospitals have been able to continue to treat patients with severe Covid-19 symptoms and community pharmacies have been able to continue to supply patients with their medication in primary care.

Healthcare distribution staff have a vital role in our joint response to the COVID-19 pandemic and I can assure you that all Health Ministers are incredibly grateful for the work that you are doing.

Finally, I also want to thank the Healthcare Distribution Association for representing the sector and working with the Government and the NHS on the challenges of the COVID-19 pandemic.

Thank you again for all your work and support.

From the Lord Bethell

Parliamentary Under Secretary of State for Innovation (Lords)