HDA UK Media and Political Bulletin – 15 March 2021

Media Summary

UK vaccine rollout scaled up amid supply concerns
Financial Times, Sebastian Payne, Sarah Neville & John Burn-Murdoch, 15 March

The Financial Times reports that the UK will scale up its Coronavirus vaccination programme this week despite continued concerns inside Government about supply issues. Ministers are preparing for a significant increase in vaccination rates over the next three weeks, before a drop-off in April.
On Sunday the Government reported that it had administered 512,108 first dose vaccinations on Saturday – the highest daily tally since February 12. Vaccines Minister Nadhim Zahawi said “March will be a very big month for us” and predicted jabs would be delivered at “twice the rate over the next 10 weeks as we have done over the past 10 or 11 weeks.”

However, individuals with knowledge of the programme said that the UK was still encountering “major production challenges” with vaccines from AstraZeneca and Moderna, with only Pfizer on track to meet its schedule after upgrading its main production facility in Belgium. Because of these issues, vaccination levels are expected to dip again in April. Second doses are also expected to become a priority next month, as the NHS is operating on a basis of delivering second jabs 11 weeks after the first.

Amazon’s next high street target: your local chemist
The Times, Sabah Meddings, 14 March

The Times reports that Amazon has signalled plans to break into the pharmacy industry in the UK, having registered the trademark “Amazon Pharmacy” with the Intellectual Property Office.

In America, Amazon’s existing online pharmacy delivery service offers prescription medicines at a discount. Amazon is a direct challenger to the main US players — Walgreens, the owner of Boots, and CVS Health. It offers discounts of up to 80 per cent on generic drugs and 40 per cent on branded medicines. When it announced plans to venture further into pharmacy in November, Walgreens’ shares fell by more than 11 per cent.

It is not known how the model would work in the UK, where the price of prescriptions is regulated. This means Amazon would not be able to compete on price – its advantage would be convenience and speed. Online pharmacy services are already growing in the UK. Pharmacy2U, which uses a subscription model, has about 550,000 customers and posted sales of £78.3 million in the year to the end of last March.

Leyla Hannbeck, Chief Executive of the Association of Independent Multiple Pharmacies, said that online dispensaries could not offer the service that community chemists provided. “When someone is diagnosed with a long-term condition such as asthma or diabetes, and is put on new medicines for the first time, the pharmacist can talk to the patient and ensure they are taking them correctly,” she said.

 

Parliamentary Coverage

There was no parliamentary coverage today.

Full Coverage

UK vaccine rollout scaled up amid supply concerns
Financial Times, Sebastian Payne, Sarah Neville & John Burn-Murdoch, 15 March

This article is subject to copyright terms and conditions. You can access the article here.

Amazon’s next high street target: your local chemist
The Times, Sabah Meddings, 14 March

Amazon has signalled plans to break into the pharmacy industry in the UK, having disrupted the $300 billion (£215 billion) prescription drugs market in America.

The tech giant has registered the trademark “Amazon Pharmacy” with the Intellectual Property Office.

In America, Amazon’s online delivery service offers prescription medicines at a discount. It is not known how the model would work in the UK, where the price of prescriptions is regulated.

The prospect of Amazon moving into the sector met with dismay from high street chemists this weekend. In America, Amazon is a direct challenger to the main players — Walgreens, the owner of Boots, and CVS Health. It offers discounts of up to 80 per cent on generic drugs and 40 per cent on branded medicines. When it announced plans to venture further into pharmacy in November, Walgreens’ shares fell by more than 11 per cent.

Leyla Hannbeck, Chief Executive of the Association of Independent Multiple Pharmacies, said that online dispensaries could not offer the service that community chemists provided. “When someone is diagnosed with a long-term condition such as asthma or diabetes, and is put on new medicines for the first time, the pharmacist can talk to the patient and ensure they are taking them correctly,” she said.

Online pharmacy services are already growing in the UK. Pharmacy2U, which uses a subscription model, has about 550,000 customers and posted sales of £78.3 million in the year to the end of last March.

Amazon has soared during the pandemic. It reported sales of $125.7 billion for the last three months of 2020, an increase of 44 per cent.

Unlike in America, UK drug prices are regulated, which means Amazon would not be able to compete on price. Its advantage would be convenience and speed. Amazon Prime members in America receive unlimited two-day delivery on pharmacy orders.

Amazon declined to comment.

Media and Political Bulletin

16 April 2020

Media Summary

Local pharmacies face cash crisis

BBC News, Simon Read, 16 April 2020

Working life for pharmacists has change considerably since the lockdown, BBC News heard from Dai Williams, who runs two pharmacies in Rhondda in South Wales.

He highlights that thousands of independent community pharmacies across the country are facing a cash crunch, because the wholesale price of medicine has shot up, cutting margins and putting financial pressures on. Meanwhile, longer hours and twice as many deliveries have meant higher staff costs. For him, the biggest issue has been a sharp rise in demand for prescriptions.

And he says the net result could be closures, leaving communities around the country with no local chemists.

Coronavirus: Three quarters of public favour working with EU to get vital protective equipment

Independent, Lizzy Buchan, 16 April 2020

More than three quarters of the public think the UK should participate in EU schemes to secure vital protective equipment, as it emerged ministers passed on three opportunities to take part.

A new poll by Focaldata for Best for Britain found 77% of people favoured staying in the European Medicines Agency (EMA) and other EU agreements to help battle the coronavirus outbreak.

It comes amid reports the UK missed out on three chances to participate in EU schemes to bulk buy PPE, which is subject to huge demand from NHS and care staff battling the virus.

Therese Coffey, the work and pensions secretary, insisted that the government had “sufficient stocks” despite warnings by medics and care workers of a shortage of equipment.

Ways to safeguard UK drug supplies during COVID-19 and beyond

The Pharmaceutical Journal, Andrew Hill, 15 April 2020

Even before the COVID-19 pandemic, pharmacy was no stranger to medicines shortages. However, medicine supply chains in several countries are now being stretched to breaking point.

In the UK, the COVID-19 pandemic is stretching the NHS, including its supplies of essential drugs, to the limits.

Andrew Hill, honorary senior visiting research fellow at the University of Liverpool’s Department of Translational Medicine and adviser to World Health Organization says we may need new systems in place to ensure patients never miss out on medicines they need.

According to Hill, the UK supply chain is weak — and he argues that we need three new systems in place to protect our access to medicines, both during the pandemic and in the future, explored in this opinion piece.

 

 

Parliamentary Coverage

There was no parliamentary coverage today.

 

Full Coverage

Local pharmacies face cash crisis

BBC News, Simon Read, 16 April 2020

“The last month has been the hardest of my 35 years in pharmacy,” said Dai Williams.

He runs two pharmacies in Rhondda in South Wales and while demand has increased massively since the lockdown, that’s not been good for business.

That’s because the wholesale price of medicine has shot up, cutting margins and putting financial pressures on.

Meanwhile, longer hours and twice as many deliveries have meant higher staff costs.

Thousands of independent community pharmacies across the country are facing a cash crunch.

The net result could be closures, leaving communities around the country with no local chemists.

Sharp rise in prescriptions

Working life for pharmacists has change considerably since the lockdown, said Dai Williams.

“Many of my colleagues have had to shut for a couple of hours during the day just to cope with the extra demands,” he reported.

The biggest issue has been a sharp rise in demand for prescriptions.

Making up the medicine is already time-consuming, but currently takes longer because staff are wearing protective equipment.

Social-distancing has also had an effect.

“I have a member of staff going round to doctors surgeries to pick up repeat prescriptions, return to the pharmacy to dispense them, and then deliver them to vulnerable members of the community,” said Mr Williams.

The number of deliveries has doubled since the lockdown from 40 to 80 a day.

“We have to cope with the extra work and stress, it’s simply what we have to do,” he said. “But it’s been tough,” he admitted.

Counting the cost

Pharmacies aren’t cashing in from the extra business as many supply prescriptions at a loss.

That’s because the NHS drugs tariff, which pharmacies receive for selling generic prescription drugs, is often lower than the prices suppliers demand.

That raises the prospect of heavy losses, especially for the majority of community pharmacies that make around 95% of their income from the NHS.

“Suppliers have increased prices since the lockdown,” said Mark Burdon, who operates five independent pharmacies in Tyne and Wear.

“The price of paracetamol wholesale climbed from around 50p to £2,” he said.

The ramp in the price of hydroxychloroquine – the malaria drug mentioned by Donald Trump as a possible Covid-19 cure – was even more dramatic.

“It used to cost us £2. Now it costs up to £32.49,” Mr Burdon said.

Paid in arrears

The surge in demand and higher prices has left Mr Burdon’s practices facing a drugs bill more than 50% higher in March than the previous month, which creates its own problems.

“We are effectively paid a couple of months in arrears by the NHS, and we have to pay suppliers before we get the money back,” he explained.

“Pharmacies are geared up for that but not these sudden extra charges, which could cause huge cashflow problems for some.”

Mr Burdon is one of the regional representatives of the Pharmaceutical Services Negotiating Committee.

He reckons the government should earmark emergency cash to help pharmacies stay afloat.

“The case has been proven for investment in the community pharmacy service as the front door to the NHS, supporting self-care and keeping people away from their GP or the hospital,” Mr Burdon said.

Behaviour problems

Meanwhile workers at pharmacies have reported a rise in aggressive behaviour from frustrated customers, with some reportedly even being forced to hire security guards.

Problems became so severe in one area that they launch a local campaign urging patients to respect pharmacy staff.

“We were getting calls that staff were getting abuse from a small number of patients, such as banging on windows and shouting, with one member of staff even reporting being spat at,” said Kath Gulson, chief officer of Community Pharmacy Lancashire.

“Problems began with the surge in prescriptions at a time when we faced reduced staff because some were forced to self-isolate.”

With pharmacies shutting at times to catch up with prescriptions, plus restrictions placed on the amount of over-the-counter drugs that could be bought, some customers got very angry, she said.

They launched the “Care for your pharmacy so your pharmacy can care for you” campaign.

“We’re just asking customers to understand the different way we have to operate now and support us so we can support the people that need us.”

Coronavirus: Three quarters of public favour working with EU to get vital protective equipment

Independent, Lizzy Buchan, 16 April 2020

More than three quarters of the public think the UK should participate in EU schemes to secure vital protective equipment, as it emerged ministers passed on three opportunities to take part.

A new poll by Focaldata for Best for Britain found 77 per cent of people favoured staying in the European Medicines Agency (EMA) and other EU agreements to help battle the coronavirus outbreak.

Brexit divisions were put aside in the face of the crisis, with 57 per cent of Leave supporters favouring working with Brussels to help the UK buy and develop medicines, vaccines, tests and protective equipment.

The move also attracted cross-party support, with six out of ten (62 per cent) Conservative voters backed working with the EU, as well as 37 per cent of Brexit Party supporters.

Nearly nine out 10 (88 per cent) of Labour voters agreed, rising to 95 per cent among Liberal Democrats.

It comes amid reports the UK missed out on three chances to participate in EU schemes to bulk buy personal protective equipment (PPE), which is subject to huge demand from NHS and care staff battling the virus.

Downing Street previously claimed it had failed to join the scheme due to a missed email, but it has now emerged that British officials in Brussels took part in four meetings in March during which bulk-buying was discussed, according to EU minutes reported by The Guardian.

Three rounds of procurement have since taken place, with European medics preparing to receive the first batch of €1.5bn (£1.3bn) of PPE within days. The European Commission says it is receiving more kit than it ordered.

Therese Coffey, the work and pensions secretary, insisted that the government had “sufficient stocks” despite warnings by medics and care workers of a shortage of equipment such as gloves, masks and gowns.

“The government has made an assessment that by joining the schemes, it wasn’t going to make any particular difference to the procurement of PPE,” Ms Coffey told LBC earlier this week.

“That’s still our basis of whether or not we attended a meeting in February or whether we attended the meeting in March. That’s still the outcome.” ​

But Naomi Smith, chief executive of Best for Britain, said: “We cannot go on like this. The medical professionals who are risking their lives to save others deserve much better.

“The government must take every opportunity it can to source important medical supplies and urgently seek participation of collaborative EU efforts if they can deliver the PPE we need.”

Layla Moran, Lib Dem MP and leadership candidate, told The Independent: “At a time when NHS staff are facing shortages of life-saving equipment, it is simply unforgivable that opportunities to take part in these EU schemes were missed.

“Serious questions will have to be answered in due course about whether this occurred as a result of ideology or incompetence.

“For now the focus must be on ensuring the NHS does not miss out again in future. Ministers must therefore urgently clarify whether the UK will participate in future EU schemes to secure the equipment our health service needs.”

Meanwhile, British and EU negotiators have agreed to stage further talks on a post-Brexit trade deal as the government insists on pressing ahead with its Brexit timetable.

David Frost, the UK’s chief negotiator, and his EU counterpart Michel Barnier met by videolink on Wednesday, where they agreed to continue trade talks remotely, with regular virtual meetings scheduled over the next three months.

In a joint statement, both teams said “real, tangible progress” was needed by June on hammering out the major trade agreement needed to prevent a no-deal crash out at the end of the year.

A crunch meeting will be held in June to “take stock of the progress made” as any extension to the transition period must be made by July.

Boris Johnson has repeatedly refused to countenance a delay – despite the pressures of the coronavirus outbreak, which has decimated the negotiating teams. Mr Barnier contracted coronavirus and has now recovered, while Mr Frost was forced to self-isolate after displaying Covid-19 symptoms.

Focaldata polled 2093 UK adults online between 7-9 April. Data are weighted.

Ways to safeguard UK drug supplies during COVID-19 and beyond

The Pharmaceutical Journal, Andrew Hill, 15 April 2020

The COVID-19 pandemic is stretching the NHS, including its supplies of essential drugs, to the limits. We may need new systems in place to ensure patients never miss out on medicines they need.

Even before the COVID-19 pandemic, pharmacy was no stranger to medicines shortages. However, medicine supply chains in several countries are now being stretched to breaking point.

In the United States, supplies of essential medicines for patients with coronavirus are running low. Medicines used for sedation and pain management are in high demand; for example, orders for fentanyl, midazolam and propofol have increased by 100%, 70% and 60%, respectively. Demand for albuterol, a common asthma inhaler medicine, has also risen significantly. And, in New York City, pharmacies have reported shortages of basic medicines such as paracetamol and azithromycin.

In Paris, the daily use of some medicines has increased by up to 2,000%. According a colleague — an intensive care clinician based in France — there is a long list of medicines in severe shortage, including anaesthetics, muscle relaxants, antibiotics and neuroleptics. In hospital geriatric and palliative care departments, midazolam and morphine, diazepam, and clonazepam are in short supply.

Meanwhile, at the time of writing, a group representing nine major hospitals in Europe — including King’s College Hospital in London — have warned of shortages of important intensive care medicines, such as muscle relaxants, sedatives and pain-killers within two weeks by mid-April 2020 if new measures are not taken.

Supply chain disruption

It should be possible to meet these demands if supply chains are stable. However, the COVID-19 pandemic has disrupted supplies of several essential drug ingredients and manufactured drugs from China and India, respectively. And, around 80−90% of the UK’s supply of generic medicines — of which India and China are major producers — is imported from other countries.

Raw materials for many essential medicines — known as ‘active pharmaceutical ingredients’ (APIs) — are manufactured in factories in China. These APIs are then exported to countries such as India, where they are formulated into tablets or injectable drugs for worldwide export and sale. Indian companies procure 70% of their raw materials from China, where manufacturing is cheap. Data suggest that the NHS relies on India for 25% of its medicines.

However, in February and March 2020, the spread of COVID-19 forced some Chinese factories to cease production. The workforce were in quarantine and transport between factories was not possible, so supply of raw materials for medicines was severely disrupted.

Since supply had been disrupted, production in and export from India, and other countries, has dwindled. In response, it was reported on 3 March 2020 that India would provide its own people with essential medicines first. At the time of writing, only excess supplies were being exported to other countries, which would have a detrimental impact on medicine supplies for the NHS in the UK. The ban was reported to have been partially lifted on 7 April 2020, but it is not yet clear when production of the raw materials in China and formulation of the end-product drugs in India will fully resume.

Shortages on this scale

The scale of the disruption to supply chains from the COVID-19 pandemic is unprecedented, with a wide range of medicines affected. It is not the first time there have been global medicine shortages, but previous shortages have been on a smaller scale.

For example, factories near Beijing closed for three weeks in 2008 to minimise air pollution during the Olympic Games, but closing API factories led to global shortages.

Then, in 2018, Hurricane Maria struck Puerto Rico and damaged a factory that manufactured the anticoagulant heparin, which disrupted supplies of the medicine.

Most recently, in 2019, China’s swine flu epidemic saw the deaths of millions of pigs, which led to further shortages of heparin, after shortages of heparin’s active ingredient — which is derived from pig intestines — disrupted production.

The supply chain can also be affected if factories fail regulatory inspections to assure the quality of drug production; for example, reports of contaminated batches of the blood pressure medicine valsartain caused disruption in 2018.

UK medicine stocks

Thanks to planning for a no-deal Brexit, the NHS should have supplies of essential medicines available to ensure that shortages do not occur. And, to protect the NHS’s current supplies, the parallel export of 80 medicines from the UK — including insulin, paracetamol and morphine used to treat patients in intensive care units — was banned on 20 March 2020. A further 52 medicines — including several respiratory medicines, antibiotics, analgesics and insulin products — were banned from export on 1 April 2020.

However, even before the onset of the COVID-19 pandemic, there were reports of shortages of dozens of life-saving medicines in the NHS. In November 2019, a leaked document listed 17 new medicine shortages. The supplies of diamorphine, for example, were “insufficient stock to cover the full forecasted demand in both primary and secondary care”. As of April 2020, diamorphine remains in short supply.

Treatments for COVID-19

The demand for any new treatment for, or vaccination against, COVID-19 is, of course, extremely high. Hydroxychloroquine, which is usually used to treat people with rheumatoid arthritis or systemic lupus erythematosus, in combination with the antibiotic azithromycin, has been thrust into the spotlight as a potential treatment.

However, evaluations of this combination’s efficacy are inconclusive and the European Medicines Agency advises hydroxychloroquine should be used only in clinical trials of patients with COVID-19, or for emergency use, rather than general use. In addition, regular users of the hydroxychloroquine around the world are now facing restricted supplies.

Other medicines are also being evaluated for their use in treating COVID-19, such as the antivirals remdesivir and favipiravir, as well as treatments to improve lung function, such as pirfenidone or tocilizumab. The first clinical trial results for these medicines are expected in May 2020, well ahead of the first preventative vaccines, which are expected in mid-2021.

Many of these medicines are small molecules with very low production costs. If these or similar medicines are effective in treating COVID-19, and if their APIs are manufactured in other countries, there could be international competition for limited supplies. The unproven medicine hydroxychloroquine has already been subject to this competition.

Will supplies be adequate to treat all people with COVID-19 in the UK? Worldwide demand could easily outstrip supply.

How the UK’s supply chain must change

Medicine supply chains are only as strong as their weakest links. If new COVID-19 treatments do emerge, the UK cannot afford to be at the end of long and unreliable supply chains.

Currently, the UK supply chain is weak — we need three new systems in place to protect our access to medicines, both during the pandemic and in the future.

1 Apply stress tests to our supply chains

Following the financial crisis of 2008, stress tests were applied to the banking system. Medicines supply could be tested in a similar way.

If similar tests were applied to the NHS medicine supply chain, they would answer important questions. Questions such as: how many medicines are originally manufactured in China and formulated in India? How would the NHS cope if Chinese supplies continued to be disrupted? For each essential medicine, are there alternative suppliers in other countries? Is there another medicine patients could take, if the preferred is no longer available? What happens if manufacturing in other countries is also affected?

In January 2020, the US Food and Drug Administration started checking the source of APIs for a wide range of essential medicines, soon after the threat of COVID-19 became apparent. The UK should be following similar procedures.

1 Diversify the sources of our medicines

The NHS should also be using at least three different companies in at least two different countries to source its essential medicines. These companies should also use different sources for their APIs.

At the moment, the NHS will typically have at least two different companies to supply commonly used medicines, but these companies might both be relying on the same company in China for their raw materials. This mechanism would protect us from future disruption of the supply chain. Online import−export databases can be used to track the source of raw materials of many medicines, and to ensure that raw materials for all essential medicines are sourced from at least two independent suppliers.

1 Produce medicines and diagnostics in the UK

We must consider manufacturing more medicines and diagnostic tests in the UK, instead of relying mainly on imports. In times of shortage, other countries — such as India — hold on to supplies and reduce exports to treat their own people. We could do the same.

The UK is home to large pharmaceutical companies with world-class expertise in drug development. We have the technical ability to set up the mass production of essential medicines in the UK or other countries, if the supply chains fail in China, India or elsewhere. Additionally, the UK could start production of medicines and vaccines against COVID-19 as soon as the first clinical trials show benefits.

Manufacturing drugs and diagnostic tests in the UK will be significantly more expensive than in China and India: in fact, all the new systems proposed would incur cost and inconvenience. But this is the price we must pay to ensure rapid access to the treatments we need.

Media and Political Bulletin

02 March 2020

Media Summary

FDA reports first coronavirus-related drug shortage

CNBC, Berkeley Lovelace Jr., 28 February 2020

CNBC reports that the FDA has said the pharmaceutical industry has reported the first shortage of a drug due to the COVID-19 outbreak. The FDA, which declined to identify the drug, said the shortage is related to a manufacturing site impacted by the outbreak in China.

“It is important to note that there are other alternatives that can be used by patients. We are working with the manufacturer as well as other manufacturers to mitigate the shortage,” the agency said in its notice.

The FDA also said it has been in touch with more than 180 manufacturers of human drugs since 24 January, asking them to evaluate their entire supply chain and other components manufactured in China.

10 things you should know about the English pharmacy contract update

C+D, Valeria Fiore, 28 February 2020

While the overall funding for community pharmacy is fixed at £2.592bn per year until 2024, the number of services offered by the sector will grow in 2020-21.

An update on the English community pharmacy contractual framework (CPCF) for 2019-20 to 2023-24, shared with contractors last week (February 23), offers more detail about some of the services first announced in the contract last year.

C+D gives their pick of the 10 key updates contractors need to get ready for.

 

Parliamentary Coverage

Medicines and Medical Devices Bill: overarching documents

Department of Health and Social Care, 28 February 2020

Further documents relating to the Medicines and Medical Devices Bill 2020 have been published:

  • The impact assessment evaluates the measures in the Medicines and Medical Devices Bill and gives an overarching assessment of the impact they will have.
  • The illustrative statutory instruments accompany the Delegated Powers Memorandum. These are illustrative examples of how the powers in the bill may be used, and are not final drafts for consultation.
  • The 10 factsheets provide additional information on key areas of the Medicines and Medical Devices Bill.

 

Full Coverage

FDA reports first coronavirus-related drug shortage

CNBC, Berkeley Lovelace Jr., 28 February 2020

The Food and Drug Administration said the pharmaceutical industry reported the first shortage of a drug due to the COVID-19 outbreak that has spread to 44 countries in a matter of weeks.

The FDA, which declined to identify the drug, said the shortage is related to a manufacturing site impacted by the outbreak in China.

“The shortage is due to an issue with manufacturing of an active pharmaceutical ingredient used in the drug,” the agency said in its notice dated Thursday. “It is important to note that there are other alternatives that can be used by patients. We are working with the manufacturer as well as other manufacturers to mitigate the shortage.”

The agency has been warning consumers that the impact to the medical supply chain would likely impact their own lives, including potential disruptions to prescription drugs or shortages of critical medical products in the United States. China, where the outbreak began in late December, is a large supplier of active pharmaceutical ingredients used to make several medicines.

China this week began reopening operations for a number of businesses, but travel restrictions that are still in place are likely to slow down production.

The FDA also said it has been in touch with more than 180 manufacturers of human drugs since Jan. 24. The agency is asking them to evaluate their entire supply chain and other components manufactured in China.

“Also, as part of our efforts, the FDA has identified about 20 other drugs, which solely source their active pharmaceutical ingredients or finished drug products from China,” the agency said.

10 things you should know about the English pharmacy contract update

C+D, Valeria Fiore, 28 February 2020

While the overall funding for community pharmacy is fixed at £2.592bn per year until 2024, the number of services offered by the sector will grow in 2020-21.

An update on the English community pharmacy contractual framework (CPCF) for 2019-20 to 2023-24, shared with contractors last week (February 23), offers more detail about some of the services first announced in the contract last year.

Changes include the introduction of the NHS Discharge Medicines Service, which community pharmacies will be expected to provide a new essential service from July. As part of this, hospitals will be able to digitally refer patients to their pharmacy for guidance on newly prescribed medicines or updated prescriptions.

Pharmacies will continue to deliver the Community Pharmacist Consultation Service (CPCS), which will be expanded to include referrals from NHS 111 online in June, and from GP practices later this year.

The Pharmaceutical Services Negotiating Committee (PSNC) is still finalising the details of each service, in collaboration with NHS England and the Department of Health and Social Care (DH) and working towards an agreement on the payment contractors will receive in 2020-21.

Here is our pick of the 10 key updates contractors need to get ready for:

  • Hepatitis C testing service: This service will be nationally commissioned from April, and will ask pharmacies to refer patients found to have positive antibodies to a local treatment service. Although all pharmacies can offer this service, it will “generally only be of interest to those pharmacies offering a locally commissioned needle and syringe programme”, PSNC said in a Frequently Asked Questions document, published last week (February 23). Reimbursement fees and service specifications are still being defined.
  • CPCS referrals from NHS 111 online: From June, pharmacies could receive referrals for urgent medicines supply from NHS 111 online.
  • NHS Discharge Medicines Services: This new essential service is expected to be introduced from July. It will allow pharmacists to use their skills as medicines experts to offer guidance on newly prescribed medicines to patients recently discharged from hospital. Under the service, PSNC expects pharmacies to receive a fee for each referral they complete, but the amount is still being decided.
  • CPCS referrals from GP practices: This extension of the CPCS could be introduced as early as October, subject to the success of current pilots, and will see GP practices refer patients to pharmacies when appropriate.
  • Clinical pilots: A number of clinical services will be piloted over the coming financial year. These include a blood pressure testing service; a smoking cessation referral service; and a point of care testing for Streptococcus A in community pharmacy.
  • NHS travel vaccinations service: Subject to negotiations with NHS England and the DH, pharmacies could soon be offering four NHS travel vaccines: against polio, typhoid, hepatitis A and cholera. PSNC believes these vaccines, already provided by some GP practices, could be introduced by March 2021.
  • Transitional payments: These will increase from April and will be linked to each pharmacy’s dispensing volume. However, payments will reduce over the course of this financial year, as new services are introduced and funding is transferred to them. PSNC was unable to share details on the revised payment bands for 2020-21 at this stage, as these are currently being finalised with the DH.
  • Establishment payments: Contractors can expect to receive reduced establishment payments. These will be phased out by the end of 2020-21, as announced as part of the CPCF last year.
  • Reduced Medicines Use Reviews (MUR) budget: In 2020-21, NHS England will commission a maximum of 100 MURs per pharmacy and from July, when the new NHS Discharge Medicines Services is introduced, “70% of MURs will be targeted solely at high risk medicines”, the commissioning bodies, the DH and PSNC said in a letter to contractors. MURs will be decommissioned by April 2021.
  • Pharmacy Quality Scheme (PQS): Funding for this has been maintained at £75m but payments will be made to pharmacies depending on their 2019 prescription volume – a new aspect of the scheme. More details on this will be announced in “due course”, according to a PSNC briefing published last week (February 23).

Media and Political Bulletin

11 May 2018

Media Summary

Greater pharmacist involvement can improve medicines supply chain, report says

The Pharmaceutical Journal, Graham Clews, 9 May 2018

 

The Pharmaceutical Journal reports that pharmacists should be more involved in all stages of medicines’ supply to improve drugs’ availability and quality, according to a newly published report by the International Pharmaceutical Federation (FIP).

The report ‘Pharmacists in the supply chain: the role of the medicines expert in ensuring quality and availability’, published on 8 May 2018, concluded that investment in training and education are needed to strengthen pharmacists’ roles in supply chains. And it sets out the skills that pharmacists need to have in these areas.

“Pharmacists engaged, or interested in being engaged, in the supply chain may need special courses, which are not always provided by the basic curriculum,” said Ulf Janzon, co-chair of FIP’s working group on pharmacists in the supply chain.

 

Parliamentary Coverage

 

There is no parliamentary coverage today.

 

Full Coverage

Greater pharmacist involvement can improve medicines supply chain, report says

The Pharmaceutical Journal, Graham Clews, 9 May 2018

 

The International Pharmaceutical Federation has concluded that investment in training and education are needed if pharmacists are to strengthen their roles within the medicines supply chain.

Pharmacists should be more involved in all stages of medicines’ supply to improve drugs’ availability and quality, the International Pharmaceutical Federation (FIP) has said.

The report ‘Pharmacists in the supply chain: the role of the medicines expert in ensuring quality and availability’, published on 8 May 2018, concluded that investment in training and education are needed to strengthen pharmacists’ roles in supply chains. And it sets out the skills that pharmacists need to have in these areas.

“Pharmacists engaged, or interested in being engaged, in the supply chain may need special courses, which are not always provided by the basic curriculum,” said Ulf Janzon, co-chair of FIP’s working group on pharmacists in the supply chain.

“For example, these pharmacists often assume leadership roles, and so courses in leadership and management should be provided in addition to courses in logistics.”

The report looks at pharmacists’ roles in the drugs supply chain in high-, middle-, and low-income countries. And it finds that in some low-income countries, particularly in rural and remote areas, a shortage of pharmacists means that other healthcare personnel have taken on roles in pharmaceutical storage and distribution at the point of dealing with individual patients.

The report’s chapter on the UK says pharmacy education and training is “at a crossroads”, and that “the roles of the pharmacist within primary care in the UK are changing rapidly”.

It adds that “both the primary and secondary care sectors have been profoundly affected by regular medicines shortages within the medicines supply chain, negatively affecting patient care”.

Queen’s Speech 2017: ABPI analysis

ABPI, 21 June 2017

 

With the UK Government having announced that there will be no Queen’s Speech in 2018, this Queen’s Speech sets out the Government’s legislative agenda for the next two years. The main focus of the Queen’s Speech was on setting out the Bills that will be required by Brexit. Notably, a number of Conservative manifesto pledges were not included in the Speech including proposals on fox hunting, grammar schools and changes to the winter fuel allowance and pensions. Of relevance to the pharmaceutical pharmacy, the Patient Protection Bill aims to create an independent Health Service Safety Investigation Body to oversee the investigation of mistakes and ‘never events’ in the NHS. It is unclear how this may impact on medicines safety and regulation.

 

BREAKING: New pharmacy minister announced

Chemist & Druggist, Annabelle Collins, 22 June 2017

 

Steve Brine MP will replace David Mowat as Pharmacy Minister, the Department of Health has confirmed yesterday afternoon. He will replace David Mowat MP, who has remained as Pharmacy Minister since losing his seat in the general election earlier this month. In May 2015, Mr. Brine was appointed as parliamentary private secretary to Health Secretary Jeremy Hunt. He also served as an assistant government whip from July 17, 2016 until last week (June 14).

 

New paper shares insights for safer medicines delivery

P3 Pharmacy, 21 June 2017

 

With many pharmacies reporting an increase for medication delivery services, especially for older or more vulnerable patients, the community pharmacy Patient Safety Group has developed a detailed discussion paper looking at how delivering medicines to people’s homes can be made as safe as possible.

 

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Queen’s Speech 2017: ABPI analysis

ABPI, 21 June 2017

 

The 2017 Queen’s Speech took place today [21 June] at the State Opening of Parliament. With the Government having announced that there will be no Queen’s Speech in 2018, this Queen’s Speech sets out the Government’s legislative agenda for the next two years.

 

​The main focus of the Queen’s Speech was on setting out the Bills that will be required by Brexit. Notably, a number of Conservative manifesto pledges were not included in the Speech including proposals on fox hunting, grammar schools and changes to the winter fuel allowance and pensions.

 

Here is a brief summary of the key Bills of relevance to the pharmaceutical industry:​

 

Repeal Bill          

 

This will repeal the 1972 European Communities Act and convert all EU law into UK law. This will ensure there is no regulatory ‘cliff edge’ when Britain leaves the EU. Controversially, this Bill will create ‘Henry VIII’ powers which allow Parliament temporary powers to amend EU law without a vote.

 

Customs Bill

 

Regardless of the agreement that the UK comes to with the EU over any transitional arrangements ahead of Britain leaving the customs union, this Bill will ‘ensure the UK has a standalone UK customs regime on exit.’

 

Trade Bill

 

This Bill ‘will put in place the essential and necessary legislative framework to allow the U.K. to operate its own independent trade policy upon exit from the European Union.’

 

Immigration Bill

 

This will allow for controls on the number of people coming to the UK from Europe. If this Bill were not introduced then the free movement of people would become part of UK law under the Repeal Bill. The Bill does not indicate how liberal any future immigration policy might be, but suggests that it will still allow the UK to attract ‘the brightest and the best’.

 

Data Protection Bill

 

This primarily impacts on social media platforms and security services. It also updates the powers and sanctions available to the information commissioner. It is unclear whether this will have any impact on health data.

 

Patient Protection Bill

 

This creates an independent Health Service Safety Investigation Body to oversee the investigation of mistakes and ‘never events’ in the NHS. It is unclear how this may impact on medicines safety and regulation.

 

The Queen’s Speech only ever gives an overview of the legislation that the Government intends to introduce over the course of a Parliament. As more detail emerges on what these Bills are likely to include and when they are likely to be introduced to Parliament, the ABPI will be working understand how they will impact on the pharmaceutical sector and how they can be influenced. ​​​

New paper shares insights for safer medicines delivery

P3 Pharmacy, 21 June 2017

 

With many pharmacies reporting an increase for medication delivery services, especially for older or more vulnerable patients, the community pharmacy Patient Safety Group has developed a detailed discussion paper looking at how delivering medicines to people’s homes can be made as safe as possible.

 

To inform the paper, two members of the Patient Safety Group shadowed their delivery drivers for a day to gain a better understanding of the potential risks that can arise to patients, their families and to delivery drivers themselves.

 

A new paper looks at home delivery

 

The insights gathered through this shadowing exercise have been used to create tools to help delivery drivers and pharmacy teams evaluate the safety of their medicines delivery services, improving this vital community pharmacy service.

 

The Patient Safety Group reports that many pharmacies are already embedding these insights in their daily practice by updating delivery processes and procedures. The Group encourages pharmacies who offer, or are planning to offer, medication delivery services to read through the insights and consider how their services compare with the Group’s findings.

 

José Moss, deputy superintendent at Boots UK, Patient Safety Group member and lead author of the discussion paper said: “Shadowing our delivery drivers was a thoroughly enlightening experience. We gained a true insight into the complex needs of some of our delivery patients and the unique challenges that our delivery drivers face in their day-to-day work.

 

“This paper comes at a time when many community pharmacy teams are building more robust policies and procedures into their pharmacy practice around safeguarding children and vulnerable adults, in line with the new quality criteria.

 

“We have found through our experiences that often the most vulnerable of our patients are those who are less mobile or who have substantially fewer social interactions due to being home-based. These are often the patients who receive their medications via a delivery service so we feel it is timely that we publish our insights into providing the safest possible service for these groups.”

Brexit casts shadow over sector’s future

P3 Pharmacy, 7 June 2017

 

P3 Pharmacy reports on a survey conducted by CIG Research that finds pharmacists are feeling “gloomy” about the sector’s future in post-Brexit Britain. Immediate fears include medicine shortages, rising drug prices and business costs. Looking at healthcare more widely, survey respondents anticipated reduced investment in UK pharma, an NHS staffing crisis, and a negative impact on regulation and standards as the UK falls outside the remit of the European Medicines Agency.

 

Jeremy Hunt remains health secretary in post-election reshuffle

Health Service Journal, Allison Coggan and Nick Carding, 11 June 2017

 

Jeremy Hunt has been confirmed as Health Secretary in Theresa May’s new cabinet, a post he has held since 2012. He will be joined by two new ministers at the Department of Health after previous incumbents Nicola Blackwood and David Mowat both lost their seats. It is not yet known who will replace Mr. Mowat or Mrs. Blackwood, or when appointments will be made.

 

BREAKING: Pharmacy minister David Mowat MP loses seat

Chemist & Druggist, Grace Lewis, 9 June 2017

 

Pharmacy minister David Mowat MP lost his seat in his constituency of Warrington South in last week’s vote. Despite no longer being an MP, Mr. Mowat will officially retain his pharmacy brief until a new minister is appointed, according to a PSNC statement. Mr. Mowat was first elected in 2010 and again in 2015, and gained the pharmacy minister role in July 2016 after Alistair Burt’s shock resignation. Reactions on Twitter were yet another indication of the continued debate around the controversial implementation of pharmacy funding cuts.

 

P3 Pharmacy also reported on David Mowat losing his parliamentary seat. Chemist & Druggist compiled winners and losers amongst “pharmacy’s parliamentary champions”. The ABPI’s full response to the confirmed result of the UK General Election 2017 is available here and its reaction to the formation of a minority government is available here.  

 

Sustainability and transformation plans: working together is not going to be easy

The Pharmaceutical Journal, Editorial, 9 June 2017

 

With nearly 55 million people living in England, the 44 STPs aim to improve collaboration across local health and care organisations to help boost the health of the nation. STPs are moving away from a competitive model, introduced in 1990 by the NHS and Community Care Act, and require NHS and local government leaders to collaborate to improve care based on local needs. The Pharmaceutical Journal comments: “To address the financial challenges of the NHS, it is only right that there should be more collaboration between organisations.”

 

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Brexit casts shadow over sector’s future

P3 Pharmacy, 7 June 2017

 

With less than a day to go to the general election, pharmacists are feeling pessimistic about the future of community pharmacy in post-Brexit Britain, envisaging working life as more complicated and even harder in financial terms.

 

Immediate fears include medicine shortages, and rising drug prices and business costs. The prospects for healthcare on a wider basis are equally bleak, with pharmacists anticipating reduced investment in UK pharma, an NHS staffing crisis, and a negative impact on regulation and standards as the UK falls outside the remit of the European Medicines Agency.

 

The gloomy outlook stems from a survey conducted by CIG Research, a division of Communications International Group, completed by 214 pharmacy staff – the vast majority identifying themselves as pharmacists, proprietors and managers – in May. The findings are perhaps to be expected given that over half the respondents stated that they voted to stay in the EU, though when asked how they would choose if the referendum were to be repeated, the Remain figure jumped to over 62 per cent.

 

Given that the Leave figure was more or less consistent at around 21 per cent, it suggests that those who were undecided last June feel much more strongly on the subject a year on.

 

One of the areas in which Brexit seems likely to have a significant impact on pharmacy concerns staffing. More than half of those polled said they employ non-UK nationals in their pharmacy, six in ten of whom are EU passport holders.

 

While the majority said they expected the employment of these individuals to not be affected by Brexit – or said they hadn’t given the matter any thought – a substantial minority believed work visas would become a requirement and a small number anticipated replacing non-UK EU workers with British passport holders. Of the 179 pharmacies involved in the survey who have non-UK staff, four in ten said that these individuals were worried about their future employment status.

 

Many survey participants said they had already noticed changes to their business that they attribute to Brexit. Chief among these is an increase in medicine purchase prices – this was felt more strongly by independents than multiples, which is unsurprising given the bargaining power of the big players – but also striking has been a rise in problems accessing EU products and services, and a downturn in sales.

 

All of these are predicted by respondents to become even more marked once the UK exits Europe, with an accompanying increase in paperwork and decline in quality control in relation to medicines.

 

The majority of respondents see Brexit as having a negative effect on nearly all aspects of their work, from declining consumer confidence, spending and profitability, to an escalation in the price of medicines, and staffing and running costs. Even medicines safety and innovation in pharmacy practice are viewed as being in peril, and there are real concerns about the UK becoming marginalised once it is outside the EU.

 

Jeremy Hunt remains health secretary in post-election reshuffle

Health Service Journal, Allison Coggan and Nick Carding, 11 June 2017

 

Jeremy Hunt will remain the health secretary as part of Theresa May’s new cabinet, it has been confirmed.

 

Mr Hunt arrived at Number Ten at 4.15pm, smiling at the assembled media and wearing his NHS pin on his lapel.

 

Shortly after 5pm, a statement from Downing Street confirmed Mr Hunt would remain in the post he has held since 2012.

 

It means Mr Hunt, who saw his majority cut from 28,500 in 2015 to 21,600 (a drop of 4.1 per cent) in Surrey South West seat, will reach five years as health secretary in September.

 

However he will be joined by two new ministers at the Department of Health after previous incumbents Nicola Blackwood and David Mowat both lost their seats.

 

Parliamentary undersecretary of state Mr Mowat lost his Warrington South seat to Labour’s Faisal Rashid, who won with a majority of 2,549. Mr Mowat came second, polling 27,445 votes.

 

Public health minister Ms Blackwood lost the Oxford West and Abingdon seat to Liberal Democrat Layla Moran by 816 votes.

 

It is not yet known who will replace Mr Mowat or Ms Blackwood, or when appointments will be made.

 

Prior to polling day there had been speculation that Mr Hunt might have been replaced by another former health minister, Ben Gummer, but Mr Gummer lost his Ipswich seat to Labour’s Sandy Martin in one of the shock results of the election.

 

The Conservatives won 318 seats overall, with Labour second after winning 261 seats.

 

Sustainability and transformation plans: working together is not going to be easy

The Pharmaceutical Journal, Editorial, 9 June 2017

 

It is vital that pharmacy engages with sustainability and transformation plans now to avoid being left behind.

 

The new sustainability and transformation plans (STPs) — five-year plans for the future of health and care services in local areas — are going to reshape local health and social care in England.

 

With nearly 55 million people living in England, the 44 STPs aim to improve collaboration across local health and care organisations to help boost the health of the nation. For instance, from our reading of the plans, STPs could help reduce the incidence of stroke by ensuring patients with atrial fibrillation are prescribed anticoagulants, help reconfigure specialist cardiac services, improve asthma outcomes and lead to better management of long-term conditions.

 

Different way of working

 

The NHS has operated in a competitive environment since 1990 when the NHS and Community Care Act introduced the concept of the internal market. Now, STPs require NHS and local government leaders to collaborate to improve care based on local needs. This will dramatically change everyone’s way of thinking and working.

 

Some leaders are working together and talking through challenging issues, for instance, asking how they are going to integrate services for older people. But it will not be enough for leaders to hold business meetings. Frequent contacts, developing trust and looking at longer term change are required. The nature of the dialogue should be examined because, if it is an environment where leaders of organisations compete for a transaction, then they will not share useful information with others.

 

To address the financial challenges of the NHS, it is only right that there should be more collaboration between organisations. With the rise in chronic conditions, which cannot be treated with a single fix, patients will need care from a range of bodies, including pharmacy, which is also on the frontline but often relegated to the margins of any large reshaping of the NHS landscape.

 

When leaders meet, they need to develop a shared purpose: a high-level vision where all people can live better and longer lives that can be cascaded back to their organisation to increase engagement among staff.

 

Collaboration

 

In health, with advances in technology, people are thinking through how they can shift resources to offer more care in the community to prevent hospital admissions. It will be a challenge for the different organisations to collaborate in STPs. Many of the bodies with a healthcare function are already engaged with each other in the STPs, but not so with other groups such as local authorities, which are important because they provide services, too, such as rehabilitation for stroke sufferers.

 

STPs’ relationship with local councils has been patchy. In some areas, STP leads have been keen to share their plans with local councils, but this is not always the case.

 

Getting a foot in the door

 

Pharmacy owners, pharmacists and locums need to read the plans in their area, make frequent contact with the people and organisations involved in the STPs to ensure that pharmacy and pharmacists are on the radar. They need to make sure that any long-term plans firmly include the benefits to patients of pharmacy involvement. Sometimes it is going to be difficult to enter dialogue with STPs and it will be hard to identify the right people to engage with.

 

STPs will have different priorities in different regions, so it cannot be expected that they will treat pharmacy services the same. Some may want minor ailment services, others may not be interested in smoking cessation services, for instance. But not being involved means citizens with health challenges over the next five years may not reap the benefits of pharmacy services.

Media Summary

EU drug regulators concerned about Brexit impact

Pharmaphorum, Richard Staines, 27 January 2017

The likely departure of the European Medicines Agency (EMA) from London is just one of the concerns provoked by Brexit. A number of key staff have already left the EMA in anticipation of the move. Hugo Hurts, executive director of the Netherlands Medicines Evaluation Board, told the Medicines for Europe conference in London: “Brexit is surely going to happen, and that is very serious. We need to be able to cope with the consequences”. The Medicines for Europe conference highlighted that post-Brexit changes could place strains on the regulatory system. Moves to streamline regulatory systems are likely to be sought to address this.

Revealed: What really happened to pharmacy’s Call to Action?

Chemist and Druggist, Lilian Anekwe, 27 January 2017

The NHS’s ‘Call to Action’ for community pharmacy brought promise to the sector, with its resolve to ‘secure community pharmacy services that deliver great outcomes cost effectively’. However, three years have passed and tangible manifestations of this Call to Action have not appeared. For example, surveys in 2013 showed that the tendency of pharmacies to be in clusters sparked concern at the time, and this concern prevails today. Tentative steps are being taken, but the Call to Action is yet to reap the results many hoped it would achieve.

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EU drug regulators concerned about Brexit impact

Pharmaphorum, Richard Staines, 27 January 2017

European drug regulators are concerned about the impact of Brexit, the likely move of the European Medicines Agency from London and the uncertain status of the UK regulator on the network’s capacity.

Hugo Hurts, executive director of the Netherlands regulator, the Medicines Evaluation Board, told a generics and biosimilars conference in London that the upheavals will place more strain on the regulatory system.

The EMA has already begun to feel the impact, with key staff already leaving ahead of Brexit. However there is also concern about the future role of the UK regulator, the Medicines and Healthcare products Regulatory Agency (MHRA).

The MHRA handles a substantial part of the EMA’s workload and in the event of a hard Brexit, could leave the system and become a standalone regulator.  This would leave a shortfall in expertise within the EMA system.

Hugo Hurts told the Medicines for Europe conference in London: “Brexit is surely going to happen, and that is very serious. We need to be able to cope with the consequences. If we are going to get Brexit the network is confronted with huge change, leaving the EMA and national competent authorities to fill the gaps. Part of the solution is that we have to be prepared to have more regulatory efficiency.”

His colleague, Stan van Belkum, in a talk on improving IT systems, said: “[Brexit] will only bring more pressure on us and we will have to work together to lower the administrative burden.”

Amsterdam is one of many European cities that has put itself forward as a potential home for the EMA in the increasingly likely event of a move out of London.

In order to streamline the system, Medicines for Europe, which represents the interests of generic and biosimilar drug manufacturers, has published its own action plan, containing a wish-list of ways to make the regulatory system more efficient.

Many of the issues facing these companies stems from bureaucracy and costs generated by national regulators, who in many cases are responsible for authorising generics individually through a decentralised regulatory process.

Generics firms at the conference were particularly concerned about the fees to the regulators to keep their drugs on the each national market.

But the fee structure varies greatly, and often they generate fees for small variations to the label of each drug. To counter this, Medicines for Europe is pushing for a flat fee structure, like the one implemented by the Austrian regulator, AGES, covering all costs of variations and related bureaucracy.

Christa Wirthumer-Hoche, head of AGES, said the flat fee structure has benefits for both pharma companies and regulators, allowing drugs companies to budget for the costs of keeping a medicine on the market, while regulators have a clear idea about their annual incomes.

Wirthumer-Hoche said: “It will be the basis for further discussion on simplifying the variation system.”

Caroline Kleinjan, chair of Medicines for Europe’s regulatory and scientific affairs committee, agreed: “We can realise fully the transparency we need at our end to keep marketing authorisations and our products alive, it will make things clear for the regulators too.”

Van Belkum’s “Rog”, a group of regulators and industry figures that aims to make drug regulation more industry-friendly, is arguing in favour of flat fees.

The group will present a business case for a flat fee structure to heads of European regulators this year, Van Belkum said.

Public spending hawk slams Hunt’s ‘clusters’ blunder

Chemist and Druggist, Thomas Cox, 26 January 2017

 

Meg Hillier, Labour and Co-operative MP, and chair of the Public Accounts Committee, criticised Hunt’s ‘simplistic comments’ about clustered pharmacies. This comment demonstrates the ongoing public debate on funding cuts. Chemist and Druggist have produced a short video explaining why the cuts remain a high priority item on the UK Government’s agenda and what the Public Accounts Committee is doing to tackle excessive drug pricing and oversubscribing in the NHS.

 

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Public spending hawk slams Hunt’s ‘clusters’ blunder

Chemist and Druggist, Thomas Cox, 26 January 2017

 

The chair of the government committee responsible for critiquing how the government spends public money has criticised Jeremy Hunt’s reference to “clustered” pharmacies.

 

Meg Hillier, Labour and Co-operative MP, and chair of the Public Accounts Committee, has criticised the health secretary for using “such simplistic comments” and “accusing pharmacies of clustering in certain areas”.

 

She visited superintendent pharmacist Raj Radia at his Spring Pharmacy in her constituency of Hackney South and Shoreditch, London earlier this month (January 13), where she spoke with C+D digital reporter Thomas Cox.

 

Watch the video to find out more on:

 

  • Why the funding cuts continue to be a hot topic for government
  • What the Public Accounts Committee is doing to tackle excessive drug pricing and oversubscribing in the NHS…
  • …and why pharmacists like Mr Radia have an important role in “making sure MPs are doing their job”

Media Summary

NHS England rejects all requests for cuts protection so far

Chemist and Druggist, Grace Lewis, 25 January 2017

NHS England has so far rejected every application from pharmacies requesting financial protection from funding cuts. The Pharmacy Access Scheme is designed to protect pharmacies which are situated a mile or more from another pharmacy from the “full effect” of the cuts – as long as they are not in the top 25% best-performing businesses according to dispensing volume. NHS England has apologised for the delay in responding to some pharmacies. 88 applications still need to be reviewed by the commissioner.

NHS Scotland and RPS Scotland publish best practice standards for managing medicine shortages

The Pharmaceutical Journal, 24 January 2017

NHS Scotland and the Royal Pharmaceutical Society (RPS) in Scotland have launched a best practice standards for the management of medicines shortages in secondary care. Providing guidance to NHS hospitals about the management of drug shortages at a local level, the standards aim to minimise risks to patients caused by treatment delays. Collaborative working across NHS Scotland is key, and multidisciplinary teams will be integral to supporting patient care under the strain of drug shortages.

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House of Commons, Oral Answers, Prime Minister’s Office, 25 January 2017

Dr Philippa Whitford (Central Ayrshire) (SNP): The European Medicines Agency provides a single drug licensing system for 500 million people and results in the UK having drugs licensed six to 12 months ahead of countries like Canada and Australia. Yesterday, the Health Secretary stated that the UK will not be in the EMA, so can the Prime Minister confirm this and explain how she will prevent delayed drug access for UK patients?

The Prime Minister: There are a number of organisations that we are part of as members of the European Union. As part of the work that we are doing to look at the United Kingdom’s future after we leave the European Union, we are looking at the arrangements we can put in place in relation to those issues. The pharmaceutical industry in this country is a very important part of our economy, and the ability of people to access these new ​drugs is also important. I assure the hon. Lady that we are looking seriously at this and will ensure that we have the arrangements that we need.

A full transcript can be found here.

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NHS Scotland and RPS Scotland publish best practice standards for managing medicine shortages

The Pharmaceutical Journal, 24 January 2017

NHS Scotland and the Royal Pharmaceutical Society (RPS) in Scotland have launched best practice standards for the management of medicines shortages in secondary care.

The jointly developed standards provide guidance to NHS hospitals around the management of drug shortages at a local level and aim to minimise risks to patients caused by treatment delays.

The guidance outlines four guiding principles, including collaborative working, to ensure that medicines in short supply are used for the patients with the greatest clinical need and that no action is taken that could exacerbate a shortage for the wider NHS. The document also lists 13 standards covering policy, risk assessment and internal processes. A key recommendation is ensuring that when a medicine is in short supply, only the volume of medicines required to meet normal demand should be ordered to avoid exacerbating the shortage. The standards also state that the director of pharmacy in each health board is responsible for ensuring that there are strategies, procedures and sufficient staff in place for effective management of medicines shortages.

Roisin Kavanagh, lead pharmacist University Hospital Crosshouse and co-chair of the working group that supported the development of the standards, comments: “A range of staff within health boards need to be involved in the management of shortages including pharmacy, medical and nursing staff; this guidance provides best practice advice on the management of shortages by multidisciplinary teams and promotes collaborative working across NHS Scotland to minimise the impact of shortages on patient care.”

John McAnaw, chair of the RPS Scottish Pharmacy Board, says: “The RPS in Scotland will continue to engage with medical and nursing professional bodies and organisations to ensure these best practice standards are shared across our professions and help underpin collaborative working at all levels.”

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.”

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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