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HDA Media And Political Bulletin – 18 January 2016

Pharmacists in surgeries no ‘substitute’ for pharmacy ‘first contact’ role

Pharmacy Biz, Neil Trainis, 15 January 2016

A report by published by the UCL School of Pharmacy welcomes a three-year pilot scheme to place 400 pharmacists in 700 surgeries in a bid to reduce prescription errors and improve medicines’ use. However, it warns that it should beware of threatening the community pharmacy network and its patient-facing role.

 

Labour MP vows to draw attention to pharmacy funding cuts

Chemist and Druggist, Annabelle Collins, 14 January 2016

Kate Hoey, Labour MP for Vauxhall, vowed to mobilise political support to fight the announced pharmacy funding cuts. Ms Hoey stated that members of the health community should “speak out” to raise awareness amongst the general public.

 

PSNC demands clarity on NHS England’s long-term plans

PSNC, 15 January 2016

PSNC stated that it would not engage in negotiations with NHS England, until further detail of its longer term plans and the analysis underpinning them are made available. Sue Sharpe stated that she feared larger funding cuts and further efficiencies were planned for 2017/18.

 

Drug shortages in U.S. emergency rooms on the rise

Reuters, Madeline Kennedy, 15 January 2016

A recent study documented that medicine shortages in the United States had risen by 400% since 2008. The reason for half of the incidents was not found, while the rest is mostly blamed on systemic causes which underline the problem of a too low drug supply.

Parliamentary Coverage

House of Commons Question:  Prescription Drugs , 15 January 2016

 

Ms Margaret Ritchie, MP: What assessment he has made of the effectiveness of the processes undertaken by the NICE for approving and commissioning new medicines for cancers and ultra rare diseases; and if he will make a statement.

 

Department of Health

George Freeman, MP:

No such assessment has been made.

The National Institute for Health and Care Excellence (NICE) is the independent body that makes recommendations to the National Health Service on the use of selected drugs and treatments through its technology appraisal and highly specialised technologies programmes. NICE does not commission new medicines and treatments.

NICE is responsible for its own processes and methodology, which it periodically reviews in consultation with stakeholders. Further information on NICE’s processes is available at: http://www.nice.org.uk/article/pmg19/chapter/Foreword

The Accelerated Access Review, chaired by Sir Hugh Taylor, is looking at speeding up access to innovative medicines and technologies for patients. NICE has been working closely with the review as it develops its recommendations which are due to be published in Spring 2016.

 

Full Coverage

Pharmacists in surgeries no ‘substitute’ for pharmacy ‘first contact’ role

Pharmacy Biz, Neil Trainis, 15 January 2016

 

A report by UCL School of Pharmacy has warned that NHS England’s vision of putting pharmacists to work in GP surgeries is no “substitute” for their role as “first contact healthcare providers.”

NHS England’s decision to part-fund a three-year pilot scheme which will place over 400 pharmacists in 700 surgeries was, UCL said, “a valuable first step” in reducing prescription errors and improving patients’ use of medicines.

It did, however, caution that the initiative should not be seen as a replacement for pharmacy’s patient-facing role nor should it endanger the community pharmacy network.

That echoed concerns voiced by Ian Strachan, chairman of the National Pharmacy Association, who told Pharmacy Business last year that “to lose sight of the value of the current infrastructure, the system in which we work now and the huge potential that has within the existing frameworks of care, would be catastrophically short-sighted.”

The UCL report said: “There is a large body of evidence indicating that community pharmacy can play an extended part in delivering accessible health care, alongside roles like reducing prescription errors and facilitating better medicines use.

“Increasing the number of clinical pharmacists working in GP practices is a valuable step. But it cannot substitute for a clear vision for the future of community pharmacies as ‘first contact’ health care providers.”

The report added: “Without well planned, pro-active, interventions pharmacy skills will be under-used and the established community pharmacy network lost. Yet if each community pharmacy in England were able to take on just 10 per cent of the average general practice’s existing workload over the next five years, this will release approaching 5,000 GPs and similar volumes of practice staff for additional service provision.”

The report also called for an extension to pharmacist prescribing and an improved joined-up health records system instead of medicines home delivery services and hub and spoke dispensing.

“Some planners may wish to see savings made via concentrating dispensing in warehouse-like facilities and increasing the use of medicines home delivery services,” it said.

“Yet at a system-wide level a potentially more desirable way forward could be to extend pharmacist prescribing and improve shared health record systems. This would combine convenient local medicines supply with more accessible forms of ‘pharmacist first’ care in areas ranging from managing blood pressure to providing better chronic obstructive pulmonary disease (COPD) and type 2 diabetes prevention and care.”

 

PSNC demands clarity on NHS England’s long-term plans

PSNC, 15 January 2016

 

PSNC has today said that it is unable to commence negotiations on community pharmacy in 2016/17 until NHS England shares further detail of its longer term plans and the analysis underpinning them.

Responding to the letter published on 17th December 2015, in which NHS England announced a £170m funding cut and set out other plans for community pharmacy in 2016/17 and beyond, PSNC Chief Executive Sue Sharpe said she feared NHS England was aiming for a larger funding cut in 2017/18 alongside reductions in pharmacy numbers and a drive towards a commoditised supply service, bypassing access to the support and advice available at community pharmacies.

She said the Government was ‘ignoring entirely’ the evidence for the value of commissioning community pharmacy services, and that it appeared to have settled on a ‘course of action that will run counter to its stated ambition to develop a clinically focused pharmacy service’.

PSNC discussed the content of NHS England’s December 17th 2015 letter at its meeting this week (January 12th and 13th 2016). It had asked NHS England for information on its funding allocations for pharmacy for future years ahead of the meeting but this has not been forthcoming. Without this, and lacking further information on NHS England’s plans on pharmacy numbers and increasing the duration of prescriptions, the Committee felt it was being deprived of information essential for a proper consultation.

Read the full letter from Sue Sharpe below.

Community Pharmacy in 2016 2017 and beyond: Response from Sue Sharpe

PSNC will host a meeting of LPCs on 20th January 2016 to discuss its response to the Government plans and consultation and is also working collaboratively with the other national pharmacy organisations.

More information on the NHS England letter is available here.

 

Drug shortages in U.S. emergency rooms on the rise

Reuters, Madeline Kennedy, 15 January 2016

 

U.S. emergency rooms are increasingly running short on medications, including many that are needed for life-threatening conditions, a recent study documents.

Since 2008, the number of shortages has risen by more than 400 percent, researchers found. Half of all emergency room shortages were for life-saving drugs, and for one in 10 there were no available substitutes, they report in Academic Emergency Medicine.

Half of the individual shortage incidents had no explanation, the authors found. The rest had a variety of systemic causes that add up to a U.S. drug supply too low to meet public demand.

“Drug shortages are of particular concern in emergency care settings where providers must rapidly treat ill and injured patients,” said lead author Kristy Hawley of the George Washington University School of Medicine and Health Sciences in Washington, D.C. “For most medications, substitutes exist but may not be as effective and may have more side effects, or providers may not have as much experience with them,” she told Reuters Health by email.

The researchers looked at U.S. data on drug shortages between 2001 and 2014. The information came from hospital doctors’ reports, and it’s possible there were additional unreported shortages, the authors note.

The number of shortages declined steadily between 2001 and 2007 but began a sharp, continual rise in 2008.

Of the 1,798 shortages reported over the 13-year period, 610, or about one third, were for drugs used in emergency medicine. Over half of these were shortages of drugs used as lifesaving interventions or for high-risk conditions.

The average shortage duration for emergency drugs was nine months.

Drugs for treating infections were the most common ones to run low, with 148 shortages. Painkillers and drugs for treating overdoses and poisonings were also among the most common shortages.

Hawley noted that a particularly problematic shortage was for nalaxone, the only injectable treatment for opiate overdose.

In nearly half of shortage incidents, the manufacturer did not give a reason for the shortage when contacted. For shortages with a known reason, about a quarter were due to manufacturing problems or delays, around 15 percent were caused by market supply and demand issues and about 4 percent were from problems with raw materials.

“Just imagine that a critically ill patient comes to the ER and needs to have specific medication. When we do not have this medication, it can lead to delays in treatment, or it could lead to suboptimal treatment,” said Dr. Ali Pourmand, a professor of emergency medicine at George Washington University who was not involved in the new study.

Pourmand noted in an email that when doctors use substitute drugs they are less familiar with, there is a risk of medication error, and health care costs could increase as a result. Such errors could include issues with dosages or dangerous interactions between multiple drugs.

“Ultimately, a multifaceted approach involving regulators, manufacturers, providers, and other stakeholders will be required to address this growing public health problem,” Pourmand said.

In 2013, the U.S. Food and Drug Administration released a plan to combat drug shortages (see Reuters story of Oct. 31, 2013, here: reut.rs/1PelXlb). Last spring, the agency also released a mobile app for doctors and pharmacists to search for information about drug shortages.

Pourmand urges emergency departments to plan for shortages. “Current policy initiatives have had a limited effect on addressing drug shortages. Emergency Department providers must be aware of shortages and take an active role in mitigating their effects on patient care.”

“While local and regional systems can collaborate to prepare for shortages and put protocols in place to protect patients to the best of their ability, the root cause of drug shortages should be aggressively explored at the national level by policymakers, manufacturers, physician-led organizations, and patient advocacy groups,” Hawley said.

HDA Media And Political Bulletin – 18 January 2016

From Factory to Pharmacy

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