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Media And Political Bulletin – 01 May 2020

Media and Political Bulletin

01 May 2020

HDA Statement regarding the availability of Public Health England-supplied PPE for community pharmacy

The Healthcare Distribution Association would like the community pharmacy sector to be aware that the stocks of Public Health England (PHE) PPE masks recently supplied by the Association’s member wholesalers to pharmacies, for staff use only, have now almost completely run out.  HDA member companies are awaiting a new sale event to be announced by Public Health England.

In the meantime, the Department of Health & Social Care has told HDA:

“We have extended our PPE supply route to Local Resilience Forums (LRFs) to help distribute stock to organisations outside of the NHS supply chain who have the highest need clinically and other services that would have a high priority need for PPE including Pharmacists.

Over 7 million more items of PPE have been delivered over the last week to the LRFs identified as being in the highest need of resupply. We will continue to make drops of PPE for distribution by the LRFs to meet some priority need until the new e-commerce solution is operational.

We will continue to make releases to wholesalers when stocks permit.

If providers are unable to access PPE through these routes and have an urgent need, they should contact the National Supply Disruption Response (NSDR) helpline to request emergency support. The 24/7 freephone number is 0800 915 9964.”

This statement about PHE-supplied PPE masks excludes the fact that individual HDA wholesalers may be able to obtain some supplies of appropriately certified PPE masks from their own sources.

Media Summary

 

EXCLUSIVE: Facing the pandemic challenge together

Pharmacy Business, Jeremy Main, 01 May 2020

The HDA’s Chair, Jeremy Main, wrote an opinion piece in Pharmacy Business highlighting the vital role of certain sectors that have for years been under appreciated, and are now suddenly being called upon more than ever.

Jeremy Main notably puts a spotlight on the pharmacy sector, who he believes has long been a pillar of local communities yet often not given enough recognition and been desperately under- funded.

He explores the challenges faced up and down the medicines supply chain in these unprecedented times, and applauds the efforts of everybody involved in the supply of medicines, urging one and all to work together.

Wholesalers ‘almost completely out’ of government-supplied PPE, trade body warns

The Pharmaceutical Journal, Carolyn Wickware, 01 May 2020

The Pharmaceutical Journal reports that the HDA has said it is currently waiting for an announcement of further supplies from Public Health England, with pharmacies instead advised to contact their local resilience forum (LRF) for the recommended fluid-resistant (Type IIR) surgical masks.

The statement comes after a survey by the Royal Pharmaceutical Society revealed that one in three pharmacists have been unable to access continuous supplies of PPE.

Martin Sawer, executive director of the HDA, said the amount of PPE available to wholesalers from sources outside of PHE was “not huge volumes at all and it varies a lot by wholesaler”. When asked whether sourcing PPE in this way would meet demand, Sawer said: “The HDA does not believe so currently, but the situation is very fluid as production sites globally open up again.” However, he added: “I do believe that PHE and the DHSC, and others, are prioritising PPE procurement for the UK.”

Pharmacists can supply some CDs with no script if asked by DH

Chemist+Druggist, Valeria Fiore, 30 April 2020

Chemist+Druggist reports that the government passed legislation on April 29 permitting pharmacists in England, Wales and Scotland to supply medicines in schedule 2, 3 and part 1 of schedule 4, without a prescription “in a pandemic situation”.

The legislation states that the health secretary may activate the legislation by making “an announcement permitting pharmacists without prescribing rights” to issue the medicines patients need in cases where the patient has been prescribed the medication before.

The legislation will allow pharmacists to supply medicines in schedule 2 to part 1 of schedule 4 under a serious shortage protocol.

Parliamentary Coverage

 

VAT zero rating for personal protective equipment

HM Revenue & Customs, 30 April 2020

This is a new temporary zero rate that will apply to supplies of PPE as defined by Public Health England’s coronavirus (COVID-19) PPE guidance on 24 April 2020.

The policy objective of this relief is to relieve the burden of VAT on the price of purchasing PPE used for protection from coronavirus by front line workers. This will particularly aid sectors that cannot recover VAT on such goods due to their VAT exempt status, such as care homes, but will benefit all consumers.

The temporary relief is being introduced as an urgent response to the coronavirus emergency. The measure will take effect from 1 May to 31 July 2020.

Full Coverage

EXCLUSIVE: Facing the pandemic challenge together

Pharmacy Business, Jeremy Main, 01 May 2020

As the Covid-19 pandemic has swept across the world the vital role of certain sectors that have for years been under appreciated are now suddenly being called upon more than ever.

One great example of this is pharmacy.

Having long been a pillar of local communities, pharmacies and pharmacists sit at the heart of a well-functioning healthcare system. Yet, they are often taken for granted, especially by those in government – not given enough recognition and desperately under- funded. Suddenly pharmacy and medicines supply are in the spotlight.

What the coronavirus crisis has brought into sharp focus is how almost overnight the sustainability and resilience of pharmacy can be questioned and thrown into doubt. In the blink of an eye, not only is the financial security of community pharmacy being severely tested, but also the health and safety, of pharmacy staff.

It has, therefore, been imperative that community pharmacy’s partners rise to the challenge of providing support to a vital front-line cog in the anti-COVID machine.

Understandably, many patients are un- aware of how many partners sit behind and support pharmacy. From the manufacturers of active pharmaceutical ingredients (API) in India and China, to the air freight providers who are flying in finished medicines, the medicines supply chain is a long one. At a time like this, with both massive global and local disruption, it is even longer and more complex.

But, of course, ultimately all that matters to patients is whether the pharmacist is able to hand over their medicines when they need them. A task that became harder as the demand for medicines in primary care dramatically increases and as GPs change their prescribing habits in response to coronavirus. Given the nature of the medicines supply chain, such an increase in demand has a significant effect, dramatically impacting each complex moving component further up the chain.

The challenges

Take the healthcare distributors that the HDA represents. In many ways, they face a similar challenge to the supermarkets. We have all seen the images of empty shelves with no pasta and bread, eggs or toilet rolls as customers panic buy.

The supermarkets argue that the required food is in the country, they just can’t get it to their shops quick enough. Although patients can’t panic-buy prescription medicines the increase in prescription days written has meant massively increased volumes of medicines have had to arrive at pharmacies at the same time.

Broadly, in the initial few weeks of the surge in demand at community pharmacy, we have not seen a significant spike in the number of additional shortages that could be attributed to the Covid-related increase in the number of scripts. This, of course, has been a team effort. Pharmacists ordering accurately and on time; the pre-wholesalers moving vast quantities of medicines; and the pharmaceutical manufacturers reacting to changing market dynamics.

The level of detail that has been addressed to ensure continuity of medicines supply has been simply astounding. It is a reminder how complex and interdependent the supply chain is. Every stage must be functioning efficiently for patients to receive their medicines. And when every stage is being severely challenged as a result of Covid-19 then the potential for a breakdown is critically high.

The HDA is aligning with pharmacy bodies to identify and mitigate potential risk factors and working around the clock with the government departments to have them formally addressed by official guidance or by the short-term easing of certain less critical regulations.

Shared experiences

Like pharmacy, wholesalers have been facing many new challenges in the day to day operation of their businesses. Due to very strong personal commitment, staff absences have thankfully been lower than many have expected, but nonetheless normal ways of working have had to be flexed or re-designed. Many staff members have been redeployed to add extra capacity in service centres and extra hours and shifts are being worked across our members’ businesses.

For example, one member has moved from a 5.5-day week with 16-hour days to a 24×7 operation to serve customers in London and the South East. Wholesalers are dealing with an unprecedented volume of orders, high call volumes and emergency orders.

Alongside pharmacists and following sustained lobbying we were grateful that the government has classified pharmaceutical wholesalers as key workers, allowing our sector’s staff members to continue to send their children to school. Additionally, we now also have access to the government’s Covid-19 testing regime.

This will mean more team members can be on the warehouse floor to get pharmacy orders packed and out for delivery. Another issue is security. As with many pharmacies our members have also reported increased examples of criminal behaviour – some very serious – targeting medicines distribution. Incidents so far remain low, but extra measures have had to be implemented.

Working together

Our members have over 12,000 warehouse staff and delivery drivers, who alongside the hundreds of staff members in customer support, purchasing, finance, security, IT have been working day and night to support pharmacies in meeting the huge surge in demand for medicines. In many ways, medicines distribution is the hidden player in the supply chain.

Patients interact with their GPs and pharmacists and appreciate that their medicines have been manufactured somewhere in the world. But the 24/7, just in time delivery service provided by HDA members often goes unseen.

Across all our member companies there are numerous examples of teams working selflessly and tirelessly to ensure medicines are delivered safely and on time. It has been a time of unprecedented challenge – and as with other supply chains, of course, not everything has been perfect – but by and large the efforts of our members along with manufacturers and pharmacists have underpinned the overall successful operation of ensuring patients receive their medicines.

In an unprecedented time like this we are all in it together and need to continue working together in the coming weeks and months. Let’s applaud the efforts of everybody involved in the supply of medicines, recognise the challenges we all have and work constructively to solve them.

Wholesalers ‘almost completely out’ of government-supplied PPE, trade body warns

The Pharmaceutical Journal, Carolyn Wickware, 01 May 2020

Wholesalers have “almost completely run out” of the personal protective equipment (PPE) supplied by Public Health England (PHE) for distribution to community pharmacies during the COVID-19 pandemic, the wholesaler trade body has warned.

In a statement published on 29 April 2020, the Healthcare Distribution Association (HDA) said it was waiting for an announcement of further supplies from PHE, with pharmacies instead advised to contact their local resilience forum (LRF) for the recommended fluid-resistant (Type IIR) surgical masks.

The statement comes after a survey by the Royal Pharmaceutical Society revealed that one in three pharmacists have been unable to access continuous supplies of PPE.

On 9 April 2020, three wholesalers — AAH Pharmaceuticals, Alliance Healthcare and Phoenix — received supplies of PPE from the government reserve.

However, AAH Pharmaceuticals, which said at that time it had received “limited stocks” of masks, told The Pharmaceutical Journal in a statement on 30 April 2020 that it has “run out of the [government] stock”.

“We are working with the HDA to understand when new stocks will be released, and how regularly thereafter, to ensure that all community pharmacies have access to the protective equipment that they need,” it said, adding that the company is sourcing masks through its own suppliers and expects these to be available “in the next couple of weeks”.

Alliance Healthcare said it also “does not have any of the PHE-supplied stock available” but added that it does have “limited stock available” from other sources, with further deliveries anticipated in May 2020.

The third wholesaler, Phoenix, would not comment on its current PPE supply.

The HDA’s statement said it wanted “the community pharmacy sector to be aware that the stocks of PHE PPE masks recently supplied by the association’s member wholesalers to pharmacies, for staff use only, have now almost completely run out”.

It added that the Department of Health and Social Care (DHSC) had advised the trade body that PPE supplies were directed to LRFs “to help distribute stock to organisations outside of the NHS supply chain who have the highest need clinically, and other services that would have a high priority need for PPE, including pharmacists”.

Martin Sawer, executive director of HDA, said the amount of PPE available to wholesalers from sources outside of PHE was “not huge volumes at all and it varies a lot by wholesaler”.

When asked whether sourcing PPE in this way would meet demand, Sawer said: “The HDA does not believe so currently, but the situation is very fluid as production sites globally open up again.”

However, he added: “I do believe that PHE and the DHSC, and others, are prioritising PPE procurement for the UK.”

In a statement on its website, the Pharmaceutical Services Negotiating Committee (PSNC) told community pharmacies that are running out of PPE to contact their LRF for more supplies.

Simon Dukes, chief executive of PSNC, said the HDA’s comments show “just how critical the national PPE situation is becoming”.

“It is putting the safety of community pharmacy staff at risk, which is quite simply unacceptable,” he said, adding that he would highlight to government “the absolute imperative that our staff are protected”.

Pharmacists can supply some CDs with no script if asked by DH

Chemist+Druggist, Valeria Fiore, 30 April 2020

New legislation will allow pharmacists to supply certain controlled drugs without a script to patients who have been prescribed them before when given the go ahead by government.

The government passed legislation yesterday (April 29) permitting pharmacists in England, Wales and Scotland to supply medicines in schedule 2, 3 and part 1 of schedule 4, without a prescription “in a pandemic situation”.

The legislation states that the health secretary may activate the legislation by making “an announcement permitting pharmacists without prescribing rights” to issue the medicines patients need in cases where the patient has been prescribed the medication before.

Before making an announcement that relates to Scotland or Wales, the health secretary “must consult” with the ministers in the respective countries, according to the legislation.

Pharmacists may also be allowed “to change the intervals in prescriptions for drugs specified in schedule 2 or 3” during the pandemic, following agreement with the prescriber or – if they are unavailable – a person chosen by the prescriber to “agree this type of change”.

The legislation will also allow pharmacists to supply medicines in schedule 2 to part 1 of schedule 4 under a serious shortage protocol. This applies when “to help manage a serious shortage” the pharmacists might need to “reduce the amount to be supplied” or offer a “different pharmaceutical form of the drug that was prescribed”. This may “not necessarily [be] in a pandemic situation”, the legislation said.

Limitations

The change in the law will apply only to “the area to which the announcement relates” and “during the period specified in the announcement”, according to the legislation – which was signed by home secretary Priti Patel. Earlier this month, Ms Patel consulted with the Advisory Council on the Misuse of Drugs and asked them to “advise on the potential harms or risks” of implementing the measures.

The period to which these measures apply “must initially not be for more than three months”. However, this could be extended for additional periods, “of not more than three months at a time”.

Commenting on the legislation, Royal Pharmaceutical Society President Sandra Gidley said the legislation will help patients “needing ongoing treatment for palliative care or substance misuse therapy” to continue to access their treatment “when the usual means of prescribing and accessing it are unavailable”.

“Now the legislation has been published, we will shortly provide professional guidance for pharmacists who may need to supply controlled drugs under the new measures,” she said.

Media And Political Bulletin – 01 May 2020

From Factory to Pharmacy

As part of our mission to build awareness, understanding and appreciation of the vital importance of the healthcare distribution sector, we developed an infographic explaining the availability of medicines. It identifies the factors that can impact drug supply, as well as the measures that HDA members undertake day in, day out to help mitigate the risks of patients not receiving their medicines.

See the Infographic

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