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Media And Political Bulletin – 16 April 2019

Media and Political Bulletin

16 April 2019

Media Summary

New rules have come into force to protect people who buy medication from online pharmacies. This comes after a BBC investigation uncovered poor care by some providers. A spokesman for the General Pharmaceutical Council, Mark Voce, spoke on this morning’s Today Programme. Clips of his interview can be accessed here and here.

Clampdown planned for British online pharmacies

BBC News, Dr Faye Kirkland, 16 April 2019

BBC News reports that new rules to keep people safe when buying medications from online pharmacies have been described as a “big step forward” by Britain’s pharmacy regulator.

It comes after patients and relatives raised concerns, as well as an investigation by BBC Panorama.

Duncan Rudkin, the General Pharmaceutical Council’s Chief Executive, told the BBC that he hoped the new rules would “make an important difference to improving standards of safety and care for patients”.

The way some online pharmacy websites operate will change, and more checks will be done on medications.

Pharmacy regulator sets safety rules for online drugs purchases

The Guardian, Ben Quinn, 16 April 2019

The Guardian reports that new rules to protect people from the dangers of buying inappropriate drugs from online pharmacies and to regulate access to addictive medications have been put in place by the pharmacy regulator.

The move comes as the use of online pharmacies has increased rapidly in recent years, while concerns have also been voiced about websites using doctors from companies based outside England.

Duncan Rudkin, the Chief Executive of the GPC, said: “People can be put at serious risk if they are able to obtain medicines that are not appropriate for them. We are now putting in place this updated guidance with further safeguards to protect people.”

Lancashire MP takes on pharmacy minister role

Dispensing Doctors’ Association, Ailsa Colquhoun, 15 April 2019

Dispensing Doctors’ Association reports that South Ribble MP Seema Kennedy has been appointed pharmacy minister, replacing Steve Brine who resigned the ministerial post over Brexit policy.

Kennedy, who has campaigned in the past for ‘Remain’, is a newcomer to health, but she has championed the needs of older people and the importance of inclusivity.

Prior to joining the health team, Kennedy was parliamentary private secretary to Prime Minister Theresa May with George Hollingbery. Kennedy qualified as a property lawyer before entering politics.

Health Minister Responds To Call For Information About Drug Shortages

Epilepsy Society, Nicola Swanborough, 15 April 2019

Epilepsy Society reports that Health minister Stephen Hammond MP has sent a statement to Epilepsy Society in response to their call for more information about medicines shortages.

Stephen Hammond wrote:

“In the past weeks, there has been speculation in the media about potential shortages of treatments for epilepsy and suggestions that these were linked to our exit from the EU. I want to put on the record that recent supply issues related to epilepsy medicines are in no way linked to our exit from the EU. Medicine supply problems can occur for a wide variety of reasons, and the Department of Health and Social Care has well-established routine procedures to deal with shortages, from whatever cause.”

His full response can be found here. This was in reply to an email sent by Clare Pelham, Chief Executive at Epilepsy Society, to Health Secretary Matt Hancock.

 

 

Parliamentary Coverage

House of Commons Questions – 15 April 2019

Tom Brake (Carshalton and Wallington): To ask the Secretary of State for Health and Social Care, whether there are breast cancer medicines that are not expected to have a six-week supply stockpiled by 12 April 2018.

Stephen Hammond: Leaving the European Union with a deal remains the Government’s top priority. However, as a responsible Government we must plan for every possible outcome including ‘no deal’.

The Government has been working closely with industry to ensure the supply of medicines, including medical radioisotopes, can continue uninterrupted in the event of a ‘no deal’ EU exit.

The Department is unable to discuss specific companies and medicines because, to reassure participating companies, we have committed to treating all information received confidentially, securely and to use it only for the purposes of the Department’s programme. However, we continue to work with all suppliers to ensure their plans remain on track.

We are confident that, if everyone does what they need to do, the supply of medicines and medical products will be uninterrupted.

 

Mr Clive Betts (Sheffield South East): To ask the Secretary of State for Health and Social Care, what steps is the Government taking to ensure timely access to maintenance medication for people with cancer.

Seema Kennedy: The Department fully understands that maintaining access to cancer medication is vitally important to many people in this country.

There is already a team within the Department that deals with medicine supply issues arising both in the community and hospitals. We have well established procedures to deal with medicine shortages, from whatever cause, and work closely with the Medicines and Healthcare products Regulatory Agency, the pharmaceutical industry, NHS England and others operating in the supply chain to help prevent shortages and to ensure that the risks to patients are minimised when they do arise.

If we are aware of issues with cancer medications we work with national clinical experts to advise on management plans and ensure that appropriate information is provided to the National Health Service and specialist patient groups.

 

Full Coverage

New rules have come into force to protect people who buy medication from online pharmacies. This comes after a BBC investigation uncovered poor care by some providers. A spokesman for the General Pharmaceutical Council, Mark Voce, spoke on this morning’s Today Programme. Clips of his interview can be accessed here and here.

Clampdown planned for British online pharmacies

BBC News, Dr Faye Kirkland, 16 April 2019

New rules to keep people safe when buying medications from online pharmacies have been described as a “big step forward” by Britain’s pharmacy regulator.

It comes after patients and relatives raised concerns, as well as an investigation by BBC Panorama.

The General Pharmaceutical Council has issued guidance for providers.

It will help regulate access to addictive medication, such as strong painkillers.

Duncan Rudkin, the General Pharmaceutical Council’s Chief Executive, told the BBC that he hoped the new rules would “make an important difference to improving standards of safety and care for patients”.

The way some online pharmacy websites operate will change, and more checks will be done on medications.

Extra safety measures include:

  • Sites cannot be set up in a way that allows patients to choose a prescription-only medication before an online consultation with a healthcare professional
  • More safeguards will be introduced for certain medications, including antibiotics and medicines that need ongoing monitoring or management
  • For medications that are liable to abuse, overuse or misuse, or when there is a risk of addiction, the prescriber needs to contact the GP in advance of issuing the prescription (and they have confirmed it is appropriate for the patient and the appropriate monitoring is in place)
  • Online pharmacy websites should be clear about the identity and/or location of the pharmacies issuing prescriptions

Mr Rudkin said the Panorama programme “was really helpful in shining a light on a really important area of public safety”.

It revealed how easy it was for patients to buy drugs online that their own GPs would be highly unlikely to prescribe.

  • Buying medications online ‘can put health at risk’

Patients contacted Panorama after the programme.

Debbie Headspeath, 41, died in 2017 in Ipswich. Her brother, Kevin Duggan told the BBC that after her death, they found on bank statements that she had bought codeine from 18 online UK pharmacies.

Debbie had started a new job with war veterans and, despite waking up with stomach pains, she did not want to miss work.

“She put her jacket and bag on and then collapsed by the front door. She wasn’t found until several hours later when her partner came home from work and it was too late and she had gone. She died.”

Debbie had been prescribed the opiate-based painkiller dihydrocodeine by her family doctor in 2008 after developing back pain.

After several years, it was recognised she was addicted. The family doctor tried to wean her off, but she was able to secretly buy medication, prescribed by doctors and dispensed by UK pharmacies, without her GP being informed by the companies.

Kevin said: “There’s no justification for what they do, which is exploiting people with an addiction. I would like to invite the companies to try and justify their actions to my mum.

“To look my mum in the eyes and explain why they allowed this to happen.”

The inquest, which will decide the cause of death, is next month, but her brother told the BBC he felt the codeine had contributed to her death.

Son born addicted

Another relative of a patient contacted the BBC. His wife had developed back pain after the birth of their first child in 2014.

In 2016, he realised she was addicted to dihydrocodeine – the same drug prescribed to Debbie – and asked her GP to help her get off them.

In 2017, she found out she was pregnant again.

“I think when she fell pregnant she was taking 20 pills a day secretly.

“Then I think she realised, and then the midwife weaned her down to eight to 10 pills a day. And as a consequence of that, you know, my son was born addicted to opiates.

“To see your child in such distress, to see jerky movements; the shaking. It’s something that I wouldn’t want anybody to ever go through.”

His wife managed to come off the codeine, but she has recently relapsed. He says that, so far, the medications have cost them nearly £25,000.

Mr Rudkin told the BBC: “I really want to acknowledge the pain that some families have experienced that’s been associated in some cases with online pharmacies.

“It’s really important that the stories help to change regulations. We’ve taken steps to address the risk.”

Pharmacy regulator sets safety rules for online drugs purchases

The Guardian, Ben Quinn, 16 April 2019

New rules to protect people from the dangers of buying inappropriate drugs from online pharmacies and to regulate access to addictive medications have been put in place by the pharmacy regulator.

The move comes as the use of online pharmacies has increased rapidly in recent years, while concerns have also been voiced about websites using doctors from companies based outside England.

The new safeguards announced on Tuesday by the General Pharmaceutical Council (GPC) include:

  • obliging pharmacy websites not to allow a patient to choose a prescription-only medicine and its quantity before an appropriate consultation has taken place.
  • ensuring pharmacy staff can identify requests for medicines that are inappropriate, including identifying multiple orders to the same address.
  • putting in place robust processes to carry out identity checks on people obtaining medicines.

Further safeguards will also have to be in place before supplying a range of categories of medicines, including antibiotics, non-surgical cosmetic medicinal products such as Botox, and medicines deemed liable to abuse, overuse or misuse, or where there is a risk of addiction.

Duncan Rudkin, the Chief Executive of the GPC, said: “People can be put at serious risk if they are able to obtain medicines that are not appropriate for them.

“We are now putting in place this updated guidance with further safeguards to protect people.”

The GPC cited online research it had commissioned from YouGov, which found that 25% of people say they are likely to use online pharmacies in the future, but 50% of those unlikely to do so have concerns about the safety of online pharmacies.

Rudkin added: “I would strongly urge patients and the public wanting to obtain medicines online to only use online pharmacies registered with us, to protect their health. These pharmacies have to meet our standards and follow this guidance, so they provide safe and effective services, and we will be inspecting pharmacies to make sure this is the case.”

Against the backdrop of Brexit, the Department of Health and Social Care and NHS England have recently been criticised for giving little practical advice to patients in England about what they can do if they are left unable to get hold of their normal drugs.

Lancashire MP takes on pharmacy minister role

Dispensing Doctors’ Association, Ailsa Colquhoun, 15 April 2019

South Ribble MP Seema Kennedy has been appointed pharmacy minister, replacing Steve Brine who resigned the ministerial post over Brexit policy.

Kennedy, who has campaigned in the past for ‘Remain’, is a newcomer to health, but she has championed the needs of older people and the importance of inclusivity. She is a signatory to the Keep Me Posted campaign, which calls for the continuation of non-digital options in the provision of utilities, financial and other services, she has also campaigned to make local roads safer, and to improve support for older people.

During her time in the Commons, Ms Kennedy has served as Vice Chair of the All-Party Parliamentary Group for Apprenticeship.

Prior to joining the health team, Kennedy was parliamentary private secretary to Prime Minister Theresa May with George Hollingbery. Kennedy qualified as a property lawyer before entering politics.

Health Minister Responds To Call For Information About Drug Shortages

Epilepsy Society, Nicola Swanborough, 15 April 2019

Health minister Stephen Hammond MP has sent the following statement to Epilepsy Society in response to our call for more information about medicines shortages. Mr Hammond is replying on behalf of Health Secretary Matt Hancock.

Stephen Hammond writes:

“In the past weeks, there has been speculation in the media about potential shortages of treatments for epilepsy and suggestions that these were linked to our exit from the EU. I know from numerous correspondence and posts on social media that this has caused worry for many with epilepsy and their families.

“I want to put on the record that recent supply issues related to epilepsy medicines are in no way linked to our exit from the EU. Medicine supply problems can occur for a wide variety of reasons, and the Department of Health and Social Care has well-established routine procedures to deal with shortages, from whatever cause. We work closely with manufacturers, the NHS and patient groups so you can continue to access the right medicines. In fact, we have been working closely with the supplier of the medicines referenced in this piece, together with the Epilepsy Society and wider NHS to manage any issues.

“My priority is to ensure you receive helpful, accurate information about this issue and the extensive work that has been ongoing to manage it. I also want to assure you that we continue to work to ensure that there will be no impact on medical supplies caused by our exit from the EU.

Trading arrangements

“To be clear, if we leave under the conditions of the Prime Minister’s Withdrawal Agreement there will be no changes to our current trading arrangements with the EU during the implementation period, during which we will negotiate our future trading partnership with the EU. Therefore, while there may still be routine medicines shortages that we will manage through our strong standard procedures, the supply of medical products, including epilepsy drugs, will continue on the same basis as it does now during that period.

“I made a written ministerial statement in February about my Department’s plans for the continuity of medicines and medical products in the event we exit the EU without a deal. As part of our contingency plans, we have looked at over 300 different epilepsy medicines provided by nearly 50 different companies. Many companies are holding stocks far beyond the six weeks’ additional buffer we requested.

No-deal exit scenario

“I am acutely aware that issues with supply could have a severe impact on someone’s health. This is why building up buffer stocks and stockpiling is only one part of the multi-layered approach we have put in place to minimise the risk of any disruption to the supply of medicines and medical products in a no-deal exit scenario. Other critical measures include:

  • securing, via the Department for Transport, additional freight capacity (away from the short straits crossings to Dover and Folkestone) for goods to continue to come into the UK in the event of a no-deal EU exit;
  • buying extra warehouse space for additional stock;
  • supporting companies in booking space on aircraft for products with short shelf-lives or specific storage conditions;
  • making changes to, or clarifications of, certain regulatory requirements so that companies can continue to sell their products in the UK even if we don’t have a deal;
  • strengthening the processes and resources used to deal with shortages if they do occur.

“This multi-layered approach is essential: A combination of all these measures will be required to help ensure the continuation of medical supplies. I am confident that if everyone does what they need to do, the supply of medicines should be uninterrupted in the event we leave the EU without a deal.

Serious Shortage Protocol

“I am also aware of speculation in the media about the impact of the introduction of a Serious Shortage Protocol on patients with epilepsy. A protocol is an additional tool to manage supply issues when all other measures have been exhausted or are deemed ineffective and would only be issued if clinicians think it is appropriate. This is a business as usual policy, and is not linked to our exit from the EU. Let me be clear – a protocol will never be used to substitute a treatment for epilepsy. In the event of a supply issue, a patient with epilepsy would always be referred back to their prescriber for any decision about their treatment before an alternative is given.

“We have committed to treating all information relating to no deal plans confidentially, securely and for use only as part of the Department’s programme, to ensure that participating companies are open and honest with us and therefore we are unable to publicly discuss plans around specific medicines or companies. However, many companies have decided to share their contingency plans with the Epilepsy Society directly and you can access this information online.

No deal Brexit contingency plans

“We aim to be as transparent as we can about our preparations for EU exit, whatever the outcome, and we will continue to keep the public and our stakeholders regularly up to date.

“Epilepsy medications are vital to many people in this country and I want to reassure anyone reading this: Whatever the Brexit outcome, it is our priority to make sure the supply of medicines can continue uninterrupted. I will continue to work tirelessly to ensure this is the case.”

Email from Clare Pelham

Mr Hammond’s response was in reply to the email below from Clare Pelham, Chief Executive at Epilepsy Society to Health Secretary Matt Hancock:

Dear Matt Hancock,

I am writing following the Newsnight programme last night to ask for your help.

As you will understand, we are receiving a large number of calls to our Helpline and other enquiries from people with epilepsy reporting current shortages in the supply of their epilepsy medication and/or concerned about possible future shortages, especially in the context of Brexit.

It is important that people with epilepsy are confident that they have an accurate understanding of the position to prevent unnecessary anxiety. We understand that some of the reporting last night on Newsnight was based on a leaked document, and may perhaps not be the latest, or most authoritative, statement of the current position.

We would be grateful therefore if you could give us a statement today that we can share with callers to our Helpline and on Social Media that sets out clearly the current position, including naming epilepsy drugs, if any, that are likely to be unavailable in the coming month.

As you will know, the Epilepsy Society is engaging constructively with the Medicines Supply Team on how best to address the underlying issues and communicate effectively with people with epilepsy. And we are happy to do anything further that would be helpful.

Best wishes

Clare

Clare Pelham Chief Executive Epilepsy Society

Clare Pelham gives her response to Health Minister Stephen Hammond

Clare Pelham today issued the following response to Stephen Hammond’s reply: “This is incredibly important information and I hope that it will be reassuring for people with epilepsy that there is much work being done behind the scenes to ensure that everyone gets their medication when they need it.

“We know that the current shortages are not caused by Brexit but are part of an underlying trend of epilepsy medicine supply shortages.

“We have suggested to Matt Hancock that he commissions a Review of the reasons for the faulty drug supply chain.

“This is a long-standing problem of at least 10 years; and yet shortages ought to be avoidable.

“We are delighted to have the support of the National Pharmacy Association for this request; and we hope to be able to work with the Government to realise our shared ambition of a lasting solution to this problem.”

More information

Professor Ley Sander, Medical Director at Epilepsy Society advises on ways to manage the current shortages of epilepsy medications

Media And Political Bulletin – 16 April 2019

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