HDA UK Media And Political Bulletin – 16 June 2017

Brexit Alliance forms to protect UK patients, healthcare

Pharma Times, Selina McKee, 15 June 2017

 

NHS, medical research, industry, patients and public health organisations, including the ABPI, BioIndustry Association and the Faculty of Public Health have come together to form a new alliance that aims to protect the UK’s interests in these areas as it negotiates to separate itself from the European Union. The Brexit Health Alliance will be co-chaired by Sir Hugh Taylor, the former permanent secretary of the Department of Health, and Niall Dickson, the chief executive of the NHS Confederation. The Alliance’s position is that it is in both Europe and the UK’s interests to maintain co-operation in research and in handling public health issues, and it also wants the government to secure a commitment to medical research, the provision of alternative funding, and the right for UK citizens to receive healthcare in EU countries.

 

The launch of the Brexit Health Alliance was also reported by P3 Pharmacy.

 

Hunt: We haven’t exploited pharmacists’ skills enough

Chemist & Druggist, Annabelle Collins, 15 June 2017

 

C&D reports that Secretary of State for Health, Jeremy Hunt, stated during a speech given at the NHS Confederation’s Annual Conference the UK Government had not “exploited the tremendous skills pharmacists have” nearly as “effectively as it might”. He further recognised it had been “a difficult period” for the sector as it has been asked along with “every other part” of the NHS to make efficiency savings.

 

Jeremy Hunt’s speech proposing a “bigger role” for pharmacy was also reported by P3 Pharmacy.

 

Gov’t names two new health ministers

Pharma Times, Selina McKee, 15 June 2017

 

The new junior health ministers who are to replace David Mowat and Nicola Blackwood after they lost their seats in the UK general election last week were announced by the UK Government. Winchester and Chandler’s Ford MP Steve Brine and Thurrock MP Jackie Doyle-Price will join Jeremy Hunt at the Department of Health.

 

See PSNC’s response to the new appointments’ announcement here.

 

Major new NHS devolution deal revealed

Health Service Journal, Dave West, 15 June 2017

 

HSJ reports on the announcement of a new NHS Devolution deal in Surrey, the second after Great Manchester. Details are yet to be finalised, such as governance and local government involvement, but the detail will be similar to the Great Manchester one. While there are some “devolution” arrangements in Greater London, these do not involve as significant delegation of powers or budgets as with this deal.

 

June 2017 Price Concessions/NCSO

PSNC, 14 June 2017

 

The Department of Health has granted the following price concessions for June 2017:

 

Drug Pack size Price concession
Betahistine 16mg tablets 84 £11.95
Betahistine 8mg tablets 84 £6.33
Buspirone 10mg tablets 30 £9.57
Buspirone 5mg tablets 30 £9.57
Dapsone 50mg tablets 28 £45.20
Diamorphine 30mg powder for solution for injection ampoules 5 £16.52
Ethosuximide 250mg/5ml oral solution 200ml £173.00
Exemestane 25mg tablets 30 £12.00
Leflunomide 10mg tablets 30 £8.35
Leflunomide 20mg tablets 30 £8.16
Mefenamic acid 500mg tablets 28 £55.00
Nitrofurantoin 100mg tablets 28 £14.50
Nitrofurantoin 50mg tablets 28 £20.50
Olanzapine 10mg tablets 28 £69.82
Olanzapine 15mg tablets 28 £88.95
Olanzapine 2.5mg tablets 28 £16.95
Olanzapine 20mg tablets 28 £127.12
Olanzapine 5mg tablets 28 £33.00
Olanzapine 7.5mg tablets 28 £52.44
Oxazepam 10mg tablets 28 £18.95
Oxazepam 15mg tablets 28 £6.50
Pramipexole 88mcg tablets 30 £12.00
Ropinirole 5mg tablets 84 £165.00
Sodium cromoglicate 2% eye drops 13.5ml £6.99
Spironolactone 50mg tablets 28 £5.20
Sumatriptan 10omg tablets 6 £32.00
Sumatriptan 50mg tablets 6 £31.85
Tranexamic acid 500mg tablets 60 £11.45
Valsartan 160mg capsules 28 £17.10
Valsartan 40mg capsules 28 £8.80
Valsartan 80mg capsules 28 £11.43
Zolmitriptan 2.5mg orodispersible tablets sugar free 6 £17.90
Zolmitriptan 2.5mg tablets 6 £18.00

 

The price concession only applies to the month that it is granted.

Please note negotiations are still ongoing regarding a number of products.

Contractors will be alerted to any updates through our website and via our e-news email.  If you wish to subscribe to our email list, you can receive an email as soon as any announcements are made. Please note that PSNC cannot provide details of generic products that are suspected of being affected by generic supply problems unless and until the Department of Health grants a concession. No additional endorsements are required for price concessions.

If you have problems obtaining a Part VIII product or problems obtaining the product at the set Drug Tariff price, please report the issue to PSNC using the online feedback form on the PSNC Website.

If you have been able to source the product, please provide full details of the supplier and price paid. PSNC will investigate the extent of the problem and if appropriate discuss the issue with the Department of Health.

Any further concessions will be posted here on the website.

 

Parliamentary Coverage

 

There is no Parliamentary coverage today.

 

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Brexit Alliance forms to protect UK patients, healthcare

Pharma Times, Selina McKee, 15 June 2017

 

NHS, medical research, industry, patients and public health organisations have come together to form a new alliance* that aims to protect the UK’s interests in these areas as it negotiates to separate itself from the European Union.

 

The Brexit Health Alliance – which will be co-chaired by Sir Hugh Taylor, the former permanent secretary of the Department of Health, and Niall Dickson, the chief executive of the NHS Confederation – seeks to ensure that issues such as healthcare research, access to technologies and treatment of patients are given prominence and attention throughout the process.

 

The Alliance’s position is that it is in both Europe and the UK’s interests to maintain co-operation in research and in handling public health issues, and it also wants the government to secure a commitment to medical research, the provision of alternative funding, and the right for UK citizens to receive healthcare in EU countries.

 

These issues, says Dickson, “will have a profound impact on the future health and wellbeing of patients both here and in Europe”.

 

“Our aim will be to ensure a strong focus on health as Brexit approaches, and that we offer views from across the health sector to negotiators to ensure that patient care and the population’s health and wellbeing will be protected as we leave the EU,” added Sir Hugh.

 

Negotiations of the UK’s departure from the EU are due to start next week, but there remains much confusion over the UK’s position in the wake of the general election last week, in which the Conservatives failed to secure a majority government.

 

There remain significant and wide-ranging concerns over Brexit’s potential impact on the UK’s health and life sciences sectors.

 

Aside from the direct hit to NHS staff, as recently highlighted by a 96 percent drop in EU nursing applicants and estimates that more than 2,000 GPs could be lost if EU workers’ rights in the UK aren’t protected, the country stands to lose the European Medicines Agency, which some fear could result in delays to drug approvals and launches.

 

*Founding members of the Alliance are: the NHS Confederation; Welsh NHS Confederation; Northern Ireland Confederation; Association of UK University Hospitals; Academy of Medical Royal Colleges; NHS Providers; National Voices; Association of the British Pharmaceutical Industry; Association of British Healthcare Industries; The Richmond Group of Charities; BioIndustry Association; Faculty of Public Health; Association of Medical Research Charities; and Scottish NHS Chief Executive Group.

 

Gov’t names two new health ministers

Pharma Times, Selina McKee, 15 June 2017

 

The government has now named the two new junior health ministers who are to replace David Mowat and Nicola Blackwood after they lost their seats in the general election.

 

Winchester and Chandler’s Ford MP Steve Brine and Jackie Doyle-Price, MP for Thurrock, will join Jeremy Hunt at the Department of Health.

 

“I am very pleased to have been appointed as minister for public health. It is a wide ranging portfolio and I look forward to being able to make a real difference,” Doyle-Price said on social media, while Brine commented: “Very pleased the Prime Minister has asked me to join the Department of Health. They don’t waste any time here … much to do”.

 

Doyle-Price has been an assistant government whip since May 2015, while Brine also took on the same role in July 2015.

 

The government also confirmed that Ludlow MP Philip Dunne will retain his position as a minister of state for health and Lord O’Shaughnessy stays as junior health minister.

 

Major new NHS devolution deal revealed

Health Service Journal, Dave West, 15 June 2017

 

A health and social care devolution style deal is being put in place in Surrey, it has been announced – the second after Greater Manchester.

 

The arrangement will be similar to the one in Greater Manchester but not exactly the same.

 

Transformation funding for the Surrey Heartlands area – covering Surrey Downs, North West Surrey, and Guildford and Waverley clinical commissioning groups – will be confirmed for the coming years.

 

Extended delegated commissioning arrangements are also due to be put in place for the patch, however it is understood these are not yet finalised. The detail – for example of governance and local government involvement – are not yet clear.

 

It is the first area to receive a similar deal to Greater Manchester. There are some “devolution” arrangements in Greater London but these do not involve significant delegation of powers or budgets.

 

NHS England said: “This agreement will bring together the NHS locally with Surrey county council to integrate health and social care services and give local leaders and clinicians more control over services and funding.”

 

Matthew Tait – the former NHS England director who was recently appointed as joint chief officer for the CCGs – is expected to be confirmed as the accountable individual for the system; in a role akin to Jon Rouse’s in Manchester.

 

The patch includes the constituency of health secretary Jeremy Hunt.

 

Surrey was the subject of a row earlier this year over an apparent deal with the government to receive additional funding in return for dropping a referendum on raising council tax. At the time, the government cited the “devolution deals” it was working on.

 

It is part of announcements by NHS England today focusing on integration and developing health systems. NHS England chief executive Simon Stevens was expected to name the first confirmed “accountable care systems” today at Confed 2017. These are also due to receive delegated transformation funding and powers.

 

NHS England medical director Sir Bruce Keogh is expected to say later today: “We need to heal fractures between services and tear down those administrative, financial, philosophical and practical barriers to the kinds of services our patients want us to deliver.”

 

The national commissioning body is also announcing that it struck a deal with drugs company Roche to make the cancer drug Kadcyla available for routine use on the NHS, having previously rejected it on the grounds of affordability.

New minister joins Department of Health

Health Service Journal, Joe Gammie, 21 December 2016

 

Lord O’Shaughnessy has been appointed Parliamentary Under-Secretary of State to the Department of Health, as well as Government Whip. He replaces Lord Prior who has become Parliamentary Under-Secretary of State at the Department for Business, Energy and Industrial Strategy. John O’Shaughnessy is a former Downing Street aid and was director of policy for David Cameron from May 2010 to October 2011.

 

The C+D Debate: Is the NPA/PV split ‘a backwards step’?

Chemist and Druggist, Thomas Cox, 20 December 2016

 

Leaders in the sector comment on the recent National Pharmacy Associations (NPA)’s decision to split from Pharmacy Voice. The NPA argued the move will make the structure of community pharmacy easier to understand but the decision was not unanimously welcomed by the sector. Ash Soni, former RPS chair said “it seems an odd move”, while RPS English Pharmacy Board chair Sandra Gidley explained that it provided an opportunity for the society “to offer more leadership”.

 

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New minister joins Department of Health

Health Service Journal, Joe Gammie, 21 December 2016

 

A former Downing Street aide and policy director to David Cameron has been appointed as a minister at the Department of Health.

 

Number 10 said today that Lord O’Shaughnessy had been made parliamentary undersecretary of state to the DH as well as a government whip.

 

He is a former Downing Street aide, and was director of policy for Mr Cameron from May 2010 to October 2011.

 

He will replace Lord Prior, who has overseen drugs spending, life sciences, NHS commercial issues, and blood and transplant since July after Theresa May reappointed Jeremy Hunt as health secretary.

 

Lord Prior was originally made a parliamentary undersecretary of state in 2015 after the general election.

 

Lord Prior, who is a former chair of the Care Quality and Commission and Norfolk and Norwich University Hospitals Foundation Trust, has become parliamentary undersecretary of state at the Department for Business, Energy and Industrial Strategy.

 

Writing on hsj.co.uk in September, Lord Prior said a system dedicated to continuous improvement and learning towards patient wellbeing and safety was key to a sustainable NHS.

 

He stressed the NHS should not be “immune” from fundamental change, and while the connection between health and social care and achieving parity between physical and mental health, had been recognised, more needed to be done.

 

Lord Prior said last year the creation of NHS Improvement was a “fundamental change” from Monitor’s role as a financial regulator.

 

He also spoke about the “hugely limited” role of the market in healthcare in his previous role as CQC chair.

 

In addition, Lord Prior has said new models of care can be achieved without structural “reorganisation”.

 

The C+D Debate: Is the NPA/PV split ‘a backwards step’?

Chemist and Druggist, Thomas Cox, 20 December 2016

 

What will the split between the two community pharmacy bodies mean for the sector?

 

The National Pharmacy Association (NPA) announced last week (December 13) that it will discontinue its alliance and pull its funding for Pharmacy Voice from 2017, signalling the end of the pharmacy bodies’ three-year agreement.

 

The NPA argued the move will make the structure of community pharmacy easier to understand. But the decision has split the sector – with one community pharmacy boss calling the move a “retrograde step”.

 

C+D looked into both sides of the debate, and asks: Is the split between the two a backwards step for community pharmacy?

 

We’d like to get your views – so make sure you vote in the C+D poll.

 

The split ‘weakens the sector’

 

Tricia Kennerley, Walgreen Boots Alliance

 

Tricia Kennerley, the vice president and director of international public affairs at Walgreens Boots Alliance – the parent company of Boots – criticised the timing of the NPA’s split from Pharmacy Voice, and argued it would weaken the sector at a time when pharmacists needed to be “unified”.

 

Kennerley told C+D the split was “very disappointing”. “At a time when the sector is facing difficult times, it’s really important that we are unified in our representation to the government and NHS England to build a stronger role for pharmacy that can help alleviate some of the burdens facing the NHS.”

 

“We should be working together to achieve this. Fragmenting the sector back into different representative organisations will not help the situation.”

 

Ash Soni, former RPS chair

 

Former Royal Pharmaceutical Society (RPS) president Ash Soni said the split is a strange step. “It seems an odd move,” he told C+D. “The NPA was a key driver in developing Pharmacy Voice as the voice of community pharmacy owners”, he said.

 

Currently, Pharmacy Voice represents the NPA as well as the Association of Independent Multiple Pharmacies (AIMp) and the Company Chemists’ Association (CCA), in a three-year agreement that will end next year.

 

The move allows for a positive future

 

Salim Jetha, Avicenna chief executive

 

On the other side of the debate, the CEO of independent pharmacy group Avicenna, Salim Jetha, said the split could be a significant move forward for the sector.

 

“The split will free the NPA to carry out its mandate to concentrate on the independent sector”, he said. “Perhaps Pharmaceutical Services Negotiating Committee (PSNC) should review its operational methods and absorb some of the positive aspects of Pharmacy Voice,” he added.

 

Although PSNC is not one of the three founding members of Pharmacy Voice, it has worked with them on initiatives such as the Community Pharmacy Forward View.

 

Sandra Gidley, RPS England chair

 

The RPS English Pharmacy Board chair Sandra Gidley said the move would offer the society an opportunity to “provide leadership”, she told C+D.

 

“We will continue to work closely with Pharmacy Voice, the NPA, the PSNC and all other bodies in pharmacy to make sure there is a joined up voice for community pharmacy.

 

“The RPS remains focused on providing leadership for the whole profession, across Great Britain, advocating for improved patient care through better use of pharmacists.”

Most medicines don’t suffer shortages, claims government

13 June 2016, Chemist and Druggist, Annabelle Collins

 

In response to Kevin Barron calling for a meeting with Alistair Burt to discuss stock shortages, the Department of Health (DH) has stressed that the “vast majority” of prescriptions are not subject to supply problems. A DH spokesperson added that it was working closely with members of the supply chain to mitigate the impact of shortages on patient care. It stated it would “respond fully to [the letter] in due course.”

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Service alert: Error with some EPS Release One (R1) prescriptions

2 March 2016, PSNC

The Health and Social Care Information Centre (HSCIC) have published a news item regarding an issue with the use of the Electronic Prescription Service (EPS):  One GP system supplier has been working with HSCIC to fix an error. The error meant that some GP practices were able to send Schedule 2/3 Controlled Drug prescriptions via Release 1 (barcoded). Usually such prescriptions should not be transmitted via Release 1.

If pharmacy teams come across affected prescriptions the solution is:

  • Dispense the prescription as if it had been a paper one – the paper element is the legal one and both words and figures appear on the physical prescription;
  • Don’t scan the barcode, but if you do this will not cause an issue.
  • HSCIC explain affected prescriptions should be some of those Release 1 controlled drug prescriptions dating between 26th February and 2nd March. The relevant GP system implemented a fix today.

This issue does not impact EPS Release 2 prescriptions.

Identifying other issues with the national EPS systems

PSNC recommends to be aware of possible future issues, pharmacy teams use the following three EPS tools:

  • Alerts: Staff can register to receive text or email alerts in the event that the national HSCIC systems that support EPS are experiencing issues at tinyurl.com/Spinealerts.
  • Checker: Visit the HSCIC service status checker webpage which provides information about the status of the national systems at tinyurl.com/EPSchecker.
  • Tracker: The EPS Prescription Tracker webpage provides information on the status of individual prescriptions at tinyurl.com/EPStracker.

 

DH rejects calls to vaccinate all under-11s against men B

3 March 2016, Chemist and Druggist, Beth Kennedy

The Department of Health has rejected a call to vaccinate more children against meningitis B stating that it wasn’t “cost-effective”. The government has however agreed to a debate in the House of Commons.

 

This news was also reported by Pharmacy Biz. In The Guardian, Polly Toynbee welcomes this decision. She argues that as health spending is rationed, it is important to have rules as to which treatments or vaccination programmes are good value for money.

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GOVERNMENT REFUSES TO MAKE MENINGITIS VACCINE AVAILABLE TO ALL CHILDREN

2 March 2016, Pharmacy Biz, Neil Trainis

 

The government has rejected calls for the meningitis B vaccine to be offered to all children under the age of 11 on cost grounds.

Pressure has been growing for Bexsero to be made available to children above the age of one. At the moment infants aged two months are eligible, with another dose at four months and a booster at 12 months.

The death of two-year-old Faye Burdett from meningitis intensified public support for the treatment to be made available to older children. A parlimentary petition pushing the case for expanding its availability has also gained over 800,000 signatures, ensuring a parliamentary debate.

The government, however, remains unmoved and said: “National immunisation programmes are introduced on the advice of the Joint Committee on Vaccination and Immunisation (JCVI), the independent expert body that advises the Government on all immunisation matters.

“JCVI reviewed all available evidence before it advised on eligibility for the Bexsero vaccine. It recommended that MenB immunisation should be routinely offered to the group of children at the highest risk – infants at two months of age with a further dose at four months and a booster at 12 months, provided that the vaccine could be procured at a cost-effective price.

“There is a duty on the Secretary of State for Health to ensure, so far as is reasonably practicable, that the recommendations of the JCVI, are implemented.”

 

On meningitis B vaccination, the government has got it right – for once

3 March 2016, The Guardian, Polly Toynbee

 

Rationing is a word politicians shy away from. Luckily for the rest of us, experts and patients are not so squeamish about choosing health priorities

Few things terrify parents more than the threat of meningitis. Any fever might turn out to be this most horrible and rapid of diseases, early signs of which are easily missed by medics (let alone by unqualified NHS 111toilet telephone operators).

The biggest petition signed in parliamentary history calls for vaccination of children up to the age of 11 against meningitis B. After the death in February of two-year-old Faye Burdett, the campaign really took off. But the department of health has ruled against mass vaccination, restricting this to infants of two to four months old. Why? Because, says the department, it would not be cost effective.

The organiser of the petition, Lee Booth, responded, saying: “It beggars belief, really, that the government are putting costs ahead of saving children’s lives.”

That’s a heartfelt cry, echoed by most citizens in such pleas for lifesaving treatments. At a time when the NHS has never been so brutally squeezed financially, its share of UK GDP spending falling lower year by year, his protest might sound reasonable.

But on the principle behind this one, the government is right for once. All health spending is rationed, and it always will be, regardless of who is paying, whether that’s private insurance companies or the state, through the taxpayer.

That means there have to be rules as to which treatments or vaccination programmes are good value for money, taking into account what else that money would buy and how many other lives could be saved or improved by it.

The health economist Prof Alan Maynard is one of the devisers of the QALY concept, or the quality-adjusted life year. This is the system used for measuring how much health gain is produced for each pound spent for any particular health intervention.

Currently, the rule of thumb is that a year of life of good quality is worth £30,000. That’s the scale the drug companies should work to when trying to sell a new drug to the NHS: if it costs more, or offers less, National Institute for Health and Care Excellence (Nice) should rule it out.

In 2014-15 there were 418 cases of meningitis B, 240 of them children; 25 people died. Maynard says meningitis B deaths are tragic, but for a vaccination programme “the benefits are positive but not great, while the costs are enormous. It’s a classic example of the opportunity costs, where you would deprive many other patients of things for which they would benefit.”

Labour set up Nice to benchmark drugs and treatments to provide a rational basis for rationing – one of it best acts. David Cameron, in opposition did what irresponsible oppositions often do, and supported a Daily Mail drive to provide the most expensive cancer drugs, which might prolong the very last stage of life for a few months longer.

By setting up a special cancer drugs fund he broke the principles of Nice, providing high-cost drugs regardless of their QALY benefits.

A recent report from the National Audit Office has just lambasted the fund’s operation. Not only did it bust its budget, letting drug companies rip, but there was no evaluation of how well those drugs did at extending life, or of the effects or value of them. As a result, the fund has been all but folded into Nice.

Rationing is a word politicians shy away from. It’s painful and distasteful to coldly calculate human life and suffering in hard cash. But someone has to, and committees comprised of experts, lay people and patient members are there to do it.

The joint committee on vaccines and immunisation has so far ruled that vaccinating all children against meningitis B is not value for money – and it takes a measure of fortitude for the politicians to bow to such expertise against a hailstorm of public opinion.

For some years, I was a lay member of the national screening committee, weighing up excruciating choices about which diseases it was worth screening for. There was great pressure for a universal prostate cancer programme, but at the time it failed to cross the threshold: the test provided many too many false negatives and false positives, and the treatment was uncertain. It would unearth many cases for treatment in people who would never have died of it. There was much protest from those who said it should be the men’s equivalent of the mass breast cancer screening programme.

But later the bowel cancer screening project did pass the test for efficacy, producing clear enough results and good enough life-saving treatment: good, value-for-money QALYs. Choosing health priorities means making cruel decisions; politicians are wise to leave it to experts and stay out of it.

As for saving lives, air pollution causes at least 40,000 deaths a year in the UK, according to new report from the Royal College of Physicians. Deaths aplenty could be avoided for relatively low cost in many fields – but nothing stirs up public indignation more than the NHS denying ultra-expensive treatments to save a few people.

Behind the scenes, cost is often a matter of drug companies scalping the NHS: Novartis was charging far too high a sum for the meningitis B vaccine. When it sold it on to GlaxoSmithKline (GSK), the price came down enough to make it worthwhile for the youngest babies. If GSK reduced the price further, that might yield enough QALYs to vaccinate all children. Money is at the wicked heart of many matters of life and death. Just ask the drug companies.

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.

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