COVID-19 updates: 5 April 2020 – 30 April 2020
All the most important developments in the COVID-19 pandemic for pharmacists and their teams, as they happen.
This article contains historic information taken from The Pharmaceutical Journal live blog, which provides updates on the ongoing COVID-19 pandemic.
For the latest information on how the UK pharmacy sector is responding to the COVID-19 pandemic, visit: https://bit.ly/PJCOVIDLive
Thursday 30 April
- Some 100,000 people will be randomly selected to receive self-testing kits to look for COVID-19 antigens, under the first phase of the government’s mass testing programme. The programme falls under ‘pillar 4’ of the government’s COVID-19 testing strategy - to conduct UK-wide surveillance testing – and will be rolled out in two phases.
- The second phase will see a number of different antibody tests assessed for their accuracy and ease of use at home. These will first be carried out on volunteers from Imperial Healthcare NHS Trust who are known to have had the virus to establish their accuracy. Three hundred volunteers will also be given a test to self-administer at home. If successful, the tests will then be sent to a further 10,000 people to assess ease of use and then to 5,000 key workers, where its accuracy will be tested again by comparing the outcome with the results of blood samples tested in a laboratory. If antibody self-testing works, they will be rolled out to 100,000 people later this year. Health minister Lord Bethell said the testing programme will “track the rate of the infection” and “inform the future action we take to manage the spread of the virus”.
- Preliminary findings from a randomised controlled trial of the antiviral, remdesivir, in patients hospitalised with COVID-19 has found that the median time to recovery was 31% faster with remdesivir than placebo. The yet-to-be-published US study, which was sponsored by the National Institute of Allergy and Infectious Diseases, involved nearly 1,100 patients hospitalised with COVID-19 with lung involvement, including those requiring supplemental oxygen or mechanical ventilation. It found that the median time to recovery for those taking the antiviral was 11 days, compared with 15 days for those taking placebo. In addition, the mortality rate was 8.0% with remdesivir and 11.6% with placebo ((p=0.059), although this was found to be not significant. Commenting on the preliminary data, Jonathan Stoye, group leader of the Retrovirus-Host Interactions Laboratory at The Francis Crick Institute described the results as “highly promising” but warned that it was too soon to call remdesivir “a magic bullet” and that further trials were warranted.
- Community pharmacists in England will be included in the government’s death-in-service life assurance scheme, health secretary Matt Hancock has said. Hancock tweeted the update on 30 April 2020 following the announcement of the scheme, three days previously, which committed to paying £60,000 to families of “eligible workers who die from coronavirus in the course of their frontline essential work”. The Department of Health and Social Care had said the scheme would not automatically include community pharmacists.
- Responding to the announcement, RPS President Sandra Gidley said: “We very much hope this offer extends to pharmacy teams, as well as all pharmacists who support the public on the frontline. We will be seeking clarification about this with government officials, along with other detail about how the scheme will work in practice. As the professional body, the RPS wants to be involved in any further conversation taking place on this. We will be it raising with the Pharmacy Minister Jo Churchill at our regular weekly meeting with her.”
- Welsh health minister Vaughan Gething told the Welsh Assembly on 29 April 2020 that community pharmacists would be covered by an equivalent scheme. On 29 April the Scottish government announced a scheme which will pay a lump sum of twice annual earnings and continued survivor entitlements in the event of a death in service. The Scottish government is, the announcement said, “in discussion with social care and community pharmacy colleagues to consider what appropriate provision might be made available for those staff groups”, with more details to be published on 1 May 2020.
Wednesday 29 April
- Pharmacy teams in Wales will benefit from the government’s COVID-19 life assurance scheme, the Welsh health minister has confirmed. The scheme, which was announced by the UK government on 27 April 2020, committed to paying £60,000 to families of “eligible workers who die from coronavirus in the course of their frontline essential work”. The Department of Health and Social Care said the scheme would not automatically include community pharmacists. However, in a statement to the National Assembly on 29 April 2020, Vaughan Gething said: “I know that our front-line workers are going above and beyond to care for vulnerable patients every day, and this scheme gives equal recognition to staff across health, social care and community pharmacy.”
- Keith Ridge, chief pharmaceutical officer for England, said in a tweet that he had raised the issue of including community pharmacists in the scheme “at the highest level”.
I’ve raised this at the highest level— Keith Ridge (@keithridge1) April 29, 2020
- Local pharmaceutical committees (LPCs) are in talks with the National Pharmacy Association (NPA) about using a GPS tracking software to trace volunteers delivering medicines to patients who are shielding, the NPA has said. The Pro Delivery Manager (PDM) software, which is being used in every pharmacy in Wales to provide an audit trail for deliveries made by volunteers, tracks the location and timing of medicine deliveries.
- Mark Lyonette, chief executive of the NPA, told The Pharmaceutical Journal that as England is a much larger country, it would “probably be much harder” to use the software across the country. However, he said the NPA is “talking to a number of LPCs about whether this might be something they might want to do in a regional area, rather than across the whole country and there seems to be some really good interest in it”. He said the software, which is part-owned by the NPA, “gives that bit of assurance that the medicine left the pharmacy and got to the right place”.
- Pharmacists from overseas whose visas are due to expire before 1 October 2020 will receive an automatic one-year extension, the government has announced. In a statement published on 29 April 2020, home secretary Priti Patel said the extensions, which have been granted to a range of frontline heath workers, would include those working in the NHS and the independent sector, and also includes family members. The extensions will be free, and will also include exemption from the Immigration Health Surcharge. Matt Hancock, secretary of state for health and social care, said that “around 3,000 vital health and care workers and their families will benefit from the extension, and we are hugely grateful to them for protecting the vulnerable and saving lives”. The announcement follows previous confirmation, on 31 March 2020, that one-year visa extensions would be given to doctors, nurses and paramedics.
- Community pharmacies in Scotland have been asked to open over the two forthcoming May bank holidays. Funding for the extra days has been set at £1,200 for a full day’s opening and £700 for a half day. In a statement published on 28 April 2020, Jeane Freeman, Scottish Cabinet Secretary for Health and Sport, acknowledged that health and social care teams were “already working incredibly hard to look after people during this pandemic”, and offered her thanks “for their ongoing commitment and dedication during this unprecedented time”.
- In Wales, there is no nationwide requirement for community pharmacies to open over the May bank holidays, which this year fall on 8 and 25 May, but opening is being agreed at a local level. A spokesperson for Community Pharmacy Wales told The Pharmaceutical Journal that local Health Boards had reviewed their rota provision for the bank holidays to support extra demand during the pandemic and had extended it where needed.
- A collaborative clinical trial platform has been launched to accelerate the development of new drugs for patients hospitalised with COVID-19. The Accelerating COVID-19 Research & Development (ACCORD) clinical trial platform will rapidly test potential drugs through early stage clinical trials and feed them into the UK’s large-scale COVID-19 studies such as the Randomised Evaluation of COVID Therapy (RECOVERY) trial. The aim is to reduce the time taken to set up clinical studies for new therapies from months to weeks.
- The government has said that six drugs will initially enter the programme, including bemcentinib, an AXL kinase inhibitor, MEDI3506, an interleukin-33 monoclonal antibody, and acalabrutinib, a Bruton’s tyrosine kinase inhibitor. The National Institute for Health Research confirmed that phase II studies of bemcentinib would be beginning across the UK “within the next few days” and that the other two compounds were awaiting final regulatory approval but would be entering phase II trials “soon after this is received”. Further potential treatments will be introduced into ACCORD as the programme rolls out over the next few weeks.
Tuesday 28 April
- Recommendations on re-using prescribed medicines in care homes and hospices in England have been altered to help ease pressure on the medicines supply chain during the COVID-19 pandemic. The Department of Health and Social Care (DHSC) has produced a standard operating procedure (SOP) that will allow care homes and hospices to reuse medicines as long as they carry out a risk assessment on each medicine using three key indicators: that no other stocks of the medicine are available in an appropriate timeframe and there is an immediate patient need; no suitable alternatives for an individual patient are available; and the benefits of using a medicine that is no longer needed by the person for whom it was originally prescribed or bought outweigh any risks for an individual patient receiving that unused medicine.
- The SOP says that medicines must also be checked by a registered healthcare professional to ensure that they are suitable for re-use. This includes checking if the medicine has been opened, whether it is in date and if it has been stored in accordance with good practice guidance. The SOP applies to all medicines, including liquid medicines, injections (analgesics, insulin), creams and inhalers, that are in sealed or in blister packs.
- A trial to assess the use of drones to transport medical supplies to the Isle of Wight could start as soon as next week, the government has said. The scheme, which has been brought forward from 2021 as part of the COVID-19 response, will use a Windracer ULTRA unmanned aerial vehicle designed and built by a team from the University of Southampton to transport medical supplies to St Mary’s Hospital, on the Isle of Wight, from mainland hospitals. “The concept of using drones to deliver medical supplies has been proven in countries such as Rwanda where they are helping to save lives by reaching isolated communities quickly and cheaply,” said Tom Cherrett, professor of logistics and transport management at the University of Southampton. “The Windracers ULTRA platform could provide an additional service to the NHS on the Isle of Wight should they need it as part of their Covid-19 response.” The trial is currently awaiting approval from the Civil Aviation Authority.
- Emergency legislation allowing pharmacists to supply some controlled drugs without a prescription will be introduced “as soon as possible”, Home Secretary Priti Patel has said. The proposed measure was one of three set by the Home Office to help secure access to controlled drugs during the COVID-19 pandemic. In a letter to the Advisory Council on the Misuse of Drugs (ACMD) sent on 22 April 2020, Patel said that the measures would be used in “limited circumstances following an announcement by the Secretary of State”. The ACMD supported the measure, but recommended that pharmacists be issued with national-level guidance on its implementation. In her response, Patel said that guidance would be developed and issued by the devolved nations, but that it should be aligned across the UK and developed in consultation with relevant professional bodies and royal colleges.
- “These measures will not come into use with immediate effect,” Patel added, saying that the government, together with the NHS service and devolved administrations, “will carefully consider when to ‘switch on’ these measures”.
Monday 27 April
- GPhC has released an update for preregistration trainees. It says that the regulator is working “as quickly as possible” to confirm details of provisional registration for those in preregistration training that are “practicable, fair, and provide the necessary safeguards and reassurance to patients and the public”.
- It says that the GPhC is looking at options for holding the preregistration examination, including online sittings: “We are investigating learning and experience from other healthcare training schemes and university assessments which have been recently adapted as part of this work.”
- It adds that time spent provisionally registered would count towards the two years of practice needed to become an independent prescriber and “towards any Foundation training that provisionally-registered pharmacists may undertake”.
- Pharmacies have been sent a set of fresh posters and social media graphics that can be used to remind patients how they should use their community pharmacy during the COVID-19 pandemic. The messages tell the public that they should not enter a pharmacy if they, or someone they live with, has COVID-19 symptoms; that they should not order extra medicines; and that pharmacies may have to operate differently during the current pandemic. Each of the graphics is optimised for use on Facebook or Twitter, and they follow reports from the General Pharmaceutical Council that it has received an increase in complaints about pharmacies from members of he public who may not appreciate the pressure that community pharmacy is currently facing.
Source: HM Government
- The use of convalescent plasma transfusions has been added to the ongoing Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) trial - an international effort focusing on critically ill COVID-19 patients. Convalescent plasma was used as an effective treatment during the SARS outbreak in 2002 and there is some limited evidence of benefit for patients with COVID-19.
- In parallel with the trial, the programme for collecting plasma in England is being increased. NHS Blood and Transplant will contact people who have recovered from confirmed COVID-19 infection to invite them to donate plasma. In a press release the Department of Health and Social Care said that the collection of plasma would be ramped up over April and May 2020 to deliver up to 10,000 units of plasma to the NHS every week, enough to treat 5,000 COVID-19 patients per week. “Convalescent plasma has been used as an effective treatment for emerging infections in the past, and this step forward underpins our science-backed approach to fighting this virus,” said deputy chief medical officer, Jonathan Van Tam.
- All prescription charges should be scrapped during the COVID-19 pandemic, the Pharmaceutical Services Negotiating Committee , the British Medical Association, and the Dispensing Doctors’ Association, have jointly told the health and social care secretary. In a letter to Matt Hancock, the three organisations said the need for many patients to sign their prescription and pay for it puts both patient and dispenser at risk through “unnecessary contact”. The bodies say the requirement to sign prescriptions by patients who pay for them should be removed permanently, and their letter adds: “Our recommendation, to allow for a smoother and safer prescription procedure for all, is the introduction of a temporary removal of the prescription charge altogether.”
- Community pharmacies will be required to open during the first of this year’s May bank holidays, NHS England has confirmed. All pharmacies will be expected to open between 2pm and 5pm on Friday 8 May 2020 unless an exception has been agreed with regional NHS teams. In an update the Pharmaceutical Services Negotiating Committee (PSNC) said: “As before, PSNC will be pressing for funding to cover the additional costs that opening for additional hours – at short notice and on a bank holiday – will bring for contractors who are already struggling to make ends meet through this public health crisis.”
Friday 24 April
- Paracetamol has, in some cases, been sold at more than double its usual price in recent weeks, according to the Competition and Markets Authority (CMA). A report published by the CMA’s COVID-19 Taskforce on 24 April 2020 said that of complaints received about paracetamol price hikes, the median price increase was 233%. The report also said that between 20 March and 19 April 2020, complaints about medicines pricing formed between 4% and 8% of the total number of complaints received by the CMA about price increases overall each day. But on 9 April, this rose to around 20% — reflecting, the report said, a spike in complaints about paracetamol and ibuprofen pricing. On 23 March 2020, The Pharmaceutical Journal reported vast paracetamol price hikes on some online bidding platforms.
- On 20 March, the CMA said in an open letter that it would tackle the “minority of bad apples” in the pharmacy and food and drinks sectors who were charging “unjustifiably high prices”. In its latest report it said it will continue to monitor prices, both from retail businesses and companies further up the supply chain.
- The inclusion of extra information on patients’ summary care records (SCR) has been temporarily changed from opt-in to opt-out during the COVID-19 pandemic. Details classified as Additional Information including patients’ significant medical history, immunisations, and reasons for medication, will now appear on their SCR unless patients have previously asked for this information not to be included. NHS Digital said that at the end of the pandemic emergency period the SCR will return to needing prior explicit consent for the Additional Information to appear. Patients who have previously opted out can contact their GP practice if they would now like their Additional Information included on their SCR.
- The pharmacy regulator has written to seven pharmacies warning them about selling illegal COVID-19 home-testing kits. The General Pharmaceutical Council (GPhC) told the pharmacies that no kits have yet been given the Europe-wide CE approval mark, and that the Medicines and Health products Regulation Authority has said it is illegal to sell home-testing kits that do not carry the mark. The pharmacies were asked to remove these kits from sale. GPhC chief executive, Duncan Rudkin, told pharmacists during an NHS England and Improvement webinar on 22 April 2020, that this was one of a number of “novel complaints” that the regulator had been dealing with since the beginning of the pandemic.
Thursday 23 April
- Good news for those working in critical care:
Working in an NHS critical care team? You need access to Critical Illness, essential medicines information to support complex decision making - now available at no charge. Register as an NHS user for instant access #COVID19— Pharmaceutical Press (@PharmPress) April 23, 2020
- Hospital pharmacists have been asked to monitor stock levels of anticoagulants in preparation for an increased demand from COVID-19 patients as haemofiltration sets and fluids face supply shortages. A supply disruption alert, sent by the Department of Health and Social Care (DHSC) to NHS trusts on 22 April 2020, said three manufactures of the sets and fluids, which cover 70% of the NHS market, have reported “limited supplies”. “The current supply issues are due to the recent increase in demand during the Covid-19 pandemic,” the alert said, adding that nearly 30% of patients who require advanced respiratory support also require renal replacement therapy. These patients “appear to have a hyper coagulopathy”, which the DHSC said causes clotting around the filters inside haemofiltration sets. Where filters would usually last 72 hours, the alert says the filters in these cases are becoming clotted “after several hours of use”. Clinicians have therefore been advised to use systemic anticoagulation to allow the sets to be used for between 24 and 48 hours, with pharmacists tasked with ensuring stock levels “are monitored and adequate for the anticipated increased requirement”.
- Patients can now nominate pharmacies to receive electronic prescriptions on a one-off basis, the Pharmaceutical Services Negotiating Committee (PSNC) has said. The feature will allow patients to collect a prescription, issued through the Electronic Prescription Service (EPS), from another pharmacy if their usual pharmacy is temporarily closed due to COVID-19, after GP IT system supplier TPP SystmOne introduced the feature. The new feature comes as approximately a quarter of GP practices can now send electronic prescriptions to pharmacies that have not been nominated by patients. The PSNC said in an update on its website that GP IT system EMIS has increased the pace of its roll out of phase 4 of the EPS, while TPP SystmOne is continuing its national roll out with “many more sites due to go live in the coming weeks and months”. Microtest and Vision were also said to be piloting phase 4 with some of their GP practices.
- Everybody should take a daily supplement of vitamin D because the indoor lifestyle created by the Covid-19 lockdown may be depriving people of the vitamin needed for the absorption of calcium to maintain healthy bones and teeth, according tonew advice from Public Health England. The recommendation on the online NHS vitamin advice page says children from the age of one and adults should take 10 micrograms a day. Babies up to the age of a year should take between 8.5 to 10 micrograms a day. Until now the advice was that daily vitamin D supplements should only be considered between October and March to take into account fewer hours of sunshine.
- Good to see pharmacy staff at the NHS Nightingale Hospital in London taking it all in their stride.
- Visas for preregistration pharmacists working in the UK should be automatically extended for one year, the Royal Pharmaceutical Society (RPS) and British Pharmaceutical Students’ Association (BPSA) have said. Sandra Gidley and Regan McCahill, presidents of the RPS and BPSA respectively, wrote to home secretary Priti Patel on 23 April 2020 explaining that prereg pharmacists are working across the health service to support patient care during the COVID-19 pandemic. “With the registration assessment being postponed and the logistics of provisional registration still being determined by the regulatory body, there is an urgent need for clarity for both sponsors and visa holders”, the letter said. The request follows a recent Home Office announcement that doctors, nurses and paramedics will automatically have their tier 2 and tier 4 visas extended for one year, at no cost. Prereg pharmacists should be offered similar, the RPS and BPSA said, to “maintain the national pharmacy workforce and to support other healthcare professions during this time of great need”.
- Community pharmacies are to be asked to open over the forthcoming May bank holidays, in a similar way to the unscheduled Easter opening, Ed Waller, director for primary care strategy at NHS England, has said. Speaking at a NHS England and Improvement webinar on 21 April 2020, Waller said prescribing levels on the two Easter bank holidays were higher than normal meaning that a wider community pharmacy service would be required on the bank holidays that fall on 8 May and 25 May 2020. Waller said NHS England would need “more than the usual number of pharmacies to be open over the bank holidays, something akin to Easter”. He also said NHS England was aiming to give pharmacies more notice of opening requirements for the bank holidays.
- Up to 300,000 people are to be asked to take part in a government-run study that will aim to track the spread of COVID-19 and assess levels of immunity through antibody testing. The pilot stage of the study, will see 25,000 people self-administering nose and throat swabs to see if they have COVID-19. They will then be asked to take further tests every week for the first five weeks and then every month for a year. The study will be expanded to include 300,000 people over the next 12 months, and it will also see adults from around 1,000 households providing blood samples monthly over a year to assess what proportion of the population has developed antibodies to COVID-19.Sarah Walker, a principal investigator at the University of Oxford Nuffield Department of Medicine, which will help run the study, said it would “transform our understanding of the infection”.
Wednesday 22 April
- Boots has added 400 vehicles and 500 drivers to its medicine delivery service, as it responds to a significant increase demand for home deliveries during the COVID-19 pandemic. The company also rolled out a prescription delivery service to a further 40 stores. In a statement published on 22 April 2020, Boots said that one month ago it was delivering around 90,000 prescriptions per week, but that this had jumped to around 150,000 prescriptions in the last seven days.
- Boots added that many of their new drivers had lost their previous jobs, or were unable to work as usual, due to the pandemic. The company also said that energy firm EDF had donated vehicles and drivers to support their delivery service. Nathan Clements, human resources director for Boots UK and the Republic of Ireland, said he would “like to thank all our colleagues, particularly those who have recently joined us - not only as drivers, but also in our warehouses and pharmacies, and our partners, who are stepping forward onto the front line to help care for patients across the UK”.
- There is “insufficient data” to recommend the use of any drug for pre- or post-exposure prophylaxis against COVID-19, outside of clinical trials, the National Institutes of Health (NIH), the United States’ medical research agency, has said in its first treatment guidelines. The guidelines, drawn up by the NIH’s COVID-19 Treatment Guidelines Panel, do not recommend any specific antiviral or immunomodulatory treatments, as “no drug has been proven to be safe and effective”, they say. It advises against the use of the malaria drug, hydroxychloroquine plus the antibiotic, azithromycin outside of clinical trials because of the toxicity risk, and against the use of the antivirals, lopinavir/ritonavir or other HIV protease inhibitors because of negative clinical trial results and “unfavourable pharmacodynamics”. The panel also recommends against interferons and Janus kinase inhibitors. In addition, it recommends against use of systemic corticosteroids for mechanically ventilated adults with COVID-19 who don’t have acute respiratory distress syndrome (ARDS) but highlighted a preference for low-dose corticosteroids over no corticosteroids in patients with refractory shock.
- Human trials of a COVID-19 vaccine developed by teams at the University of Oxford will start on the 23 April 2020, less than four months since development started, the health and social care secretary, Matt Hancock, has announced. Speaking at a government press briefing on 21 April 2020, Hancock added that the government would invest in manufacturing capability so that if the vaccine is shown to be safe and effective, it can be made available “as soon as humanly possible”. The vaccine, ChAdOx1 nCoV-19, is made from a weakened version of a common cold virus (adenovirus) from chimpanzees that has been genetically changed so that it is impossible for it to grow in humans. This is combined with genes that make proteins from the COVID-19 virus (SARS-CoV-2), called spike glycoprotein, which play an essential role in the infection pathway of the SARS-CoV-2 virus. The trial will take place across multiple locations in the UK and involve up to 510 healthy volunteers aged between 18 and 55.
Tuesday 21 April
- Pharmacy technicians may be asked to prepare injectable medicines for intensive care patients with COVID-19 outside of pharmacy aseptic units. The NHS Specialist Pharmacy Service (SPS) said in a statement that the pandemic had “generated an unprecedented demand for injectable medicines in ICU”, which are usually prepared and administered by nursing staff. But insufficient nursing capacity has meant that “chief pharmacists may need to consider other options such as deploying pharmacy staff to prepare medicines in clinical areas”. As there is “no regulatory framework that applies to this situation”, NHS SPS recommends gaining approval from hospital trust medical and nursing directors as well as the trust board before taking this approach to managing demand.
- The Association of Pharmacy Technicians UK said in guidance published on 17 April 2020 that pharmacy technicians should “discuss and agree the scope of practice and accountability with their chief pharmacist or designated deputy” before taking on the role. It added that the medicines should be prepared in “designated areas away from the immediate clinical areas”, with technicians who have previous experience preparing injectable medicines.
- A group of voluntary emergency 4X4 drivers are helping rural pharmacies in the East Midlands get medicines to vulnerable patients. Simon Dale, founder and chair of Leicestershire and Rutland 4x4 Response group said their normal role is to help emergency services and local authorities in times of extreme weather. But the registered charity was contacted by Boots in March 2020 and it is now delivering around 90 prescriptions a day for a number of local pharmacies including Lloyds and Masons Chemists. “I’ve never known the pharmacies be so busy. These are big rural areas for a pharmacy to cover,” he said. Dale, who would usually be working as a long distance lorry driver but is currently furloughed, said his group had leafleted other rural pharmacies in the area in case they need their services.
Source: Courtesy of Simon Dale
- The pharmacy regulator has reported an increase of more than 100 fitness to practise complaints in March 2020 compared with the usual level of complaints during the same month in previous years. General Pharmaceutical Council (GPhC) board papers, due to be discussed at a council meeting held online on 23 April 2020, said there had been a “significant rise in the number of concerns being received”. The papers said that many of the complaints “related to concerns about pricing and profiteering”, although it was thought unlikely that the rise in complaints would result in an equivalent increase in the number of fitness to practise cases. The GPhC added that it was focusing its FtP resources “where they were most needed”, while minimising the burden on pharmacies. The first principal FtP hearing by videoconference was expected to take place next week.
Monday 20 April
- NHS England has created a pharmacy-led clinical assessment service (CAS) to take on routine queries from NHS 111 online. The CAS, which launched on 16 April 2020, will use pharmacists who have been re-deployed from other parts of the NHS and those who have voluntarily returned to work to take on the routine queries, in order to “free up other clinical disciplines to focus on COVID-19 related demand”. The announcement, made in an NHS England bulletin sent to pharmacists on 17 April 2020, added that pharmacists working in the CAS will handle patients with symptoms similar to those seen under the Community Pharmacist Consultation Service. Patients using NHS 111 online will also be able to select “speak to a pharmacist today” instead of booking a call back from an urgent primary care service.
- The Scottish government should support the use of volunteers to help deliver opioid substitution therapy (OST) and injecting equipment provision (IEP) to people who use drugs during the COVID-19 pandemic the Scottish Drug Deaths Taskforce has said. Catriona Matheson, chair of the taskforce, told The Pharmaceutical Journal that under the proposal, one of a number made by the taskforce, volunteers could work in pairs, with a local recovery community support group member — vetted by Disclosure Scotland’s “Protecting Vulnerable Groups” (PVG) scheme — teamed up with another person to make the deliveries. In England, the pandemic delivery service does not allow for volunteers to deliver Schedule 2 and 3 controlled drugs, which includes the OST drugs methadone and buprenorphine. A spokesperson from Community Pharmacy Wales (CPW) said that community pharmacy was “following the comprehensive guidance issued by the Welsh Government in March” for substance misuse and homelessness services. They added that CPW was aware of discussions about using “appropriately trained third sector ‘volunteers’ (e.g. from substance misuse projects, such as Kaleidoscope, to support patients), but there remains a lack of clarity on where these discussions have reached”.
- Twenty-one new COVID-19 studies have been given funding from the National Institute for Health Research (NIHR) and UK Research and Innovation. The projects, which will run over a maximum 18-month period, include the Platform Randomised trial of INterventions against COVID-19 In older peoPLE (PRINCIPLE) study, one of the three national priority clinical trials. The PRINCIPLE study is the first clinical trial of potential COVID-19 treatments to take place in GP practices and it will initially evaluate the malaria drug, hydroxychloroquine, but the antibiotic, azithromycin, is to be included. The other studies, which are receiving £14.1 in funding, will focus on vaccine development, developing an antibody test for COVID-19, population surveillance and transmission and spread of COVID-19. Jonathan Sheffield, the NIHR’s COVID-19 research operations director, said the studies represented some of “the best and brightest scientific research into COVID-19 being done anywhere in the world”.
- Access for pharmacy staff to nationally-organised COVID-19 testing has been improved, but staff will need a car to get the test. The Care Quality Commission has created an online portal that will allow health and care workers, including pharmacy staff, to book a test if they or their families have symptoms of COVID-19. The NHS Business Services Authority sent a link to pharmacy contractors on 18 April 2020 that can be used to invite staff to take a test. Staff who think they need a test should contact their employers for details. The Pharmaceutical Services Negotiating Committee warned that staff can only be tested if they have access to email, a phone and a car.
Friday 17 April
- Community Pharmacists in Northern Ireland have lent their voices to a rendition of Bill Withers’s ‘Lean On Me’ in support of their local communities. Listen here.
- EMIS Health is offering free video consultation software to its 5,200 community pharmacy customers to “protect [pharmacy] staff and patients” during the COVID-19 pandemic. The company, which makes software for healthcare providers, said that its Patient Access for Professionals service would be offered free for 12 weeks, allowing pharmacists to provide secure video consultations to patients. Patients can access the video consultations using the free Patient Access app. Shanel Raichura, clinical director at EMIS Health, said the service will help pharmacists “protect themselves and their staff and to extend the services they offer, reducing demand on other parts of the NHS”.
- This comes as Boots has also announced they are planning to trial pharmacist video consultations, with digital service provider LIVI. In an announcement on 16 April 2020, Boots said the trial “has been brought forward to assist patients isolating due to the COVID-19 pandemic”. However, the company did not clarify when the trial was expected to start.
- The Metropolitan Police has advised pharmacists to remove identification lanyards when leaving their pharmacy as part of new security advice to follow during the COVID-19 pandemic. The advice also recommends pharmacists “consider what additional security measures could be introduced” to the pharmacy, including reinforcing doorframes and hinges. Pharmacists are also advised to have “a minimum of two members of staff at opening and closing times” to minimise risk. The document states that the Met is “committed to working with pharmacies to protect their business and prevent crime”, adding that if staff witness or become the victim of a crime, they should report it to “prevent further crime and keep people safe”. Robbie Turner, Royal Pharmaceutical Society director of pharmacy and member experience, said in a statement that the advice “highlights how safety of staff is paramount”. He added: “They’ve committed to working with us and across the profession to ensure pharmacy teams get the support they need.”
- The advice comes after a pharmacist in Kent told The Pharmaceutical Journal that he was left “in shock and shaken” after he was punched in the ear by a customer who became angry when he was told that his wife’s prescription was not yet ready.
- During the recent Easter bank holiday, pharmacies in Scotland processed approximately six times as many items as would normally be expected, Community Pharmacy Scotland (CPS) has said. In a video update, Harry McQuillan, chief executive of CPS, said the weekend had been “significantly busier” than a normal bank holiday, with around 300,000 items processed compared to the 50,000 that is typical for Easter. McQuillan also said that pharmacists gave out a lot of advice to people, both over the phone and in person, adding that “the NHS is certainly very grateful for you being there on Monday and Good Friday”. In Scotland pharmacies had been requested, rather than required, to remain open on Good Friday and Easter Monday. Funding for these days was set at £1,200 for a full day, and £700 for a half day.
Thursday 16 April
- The antibiotic, azithromycin, has replaced interferon beta, a protein that is produced by the body as a defensive response to viruses, in the UK-based Randomised evaluation of COVID-19 therapy (RECOVERY) trial. According to the trial protocol, azithromycin is preferred over other macrolides because data suggest it has stronger immunomodulatory effects.
- Patients in the azithromycin arm of the trial will be given 500mg doses by mouth (or nasogastric tube) or intravenously once daily for 10 days. The trial is now also open to patients with a suspected SARS-Co-2 infection, having previously only been open to those with a proven infection. Patients who lack capacity to give consent, because of a medical condition, can now also be recruited using a legal representative. Other changes to the RECOVERY trial protocol include an adjustment to the recommended corticosteroid for pregnant women to prednisolone 40 mg administered by mouth, instead of dexamethasone.
- Pharmacists have been given access to a free mental health support service in Wales, the Welsh Government has confirmed. The Health for Health Professionals Wales service, which was previously only open to doctors, has been expanded to offer support and advice to all front-line NHS Wales staff during the COVID-19 pandemic. The Welsh government is putting in an extra £1m to expand the service, which is offered by Cardiff University and offers a confidential helpline, face-to-face counselling and guided self-help tools and online resources. Announcing the news, Vaughan Gething, Welsh health and social services minister, said: “The health and wellbeing of our all our dedicated NHS Wales staff is paramount at all times but especially so during this acutely challenging time — so it’s vital we do all we can to care for them.”
- Pre-registration pharmacists should be provisionally registered “without delay” to support patients through the COVID-19 pandemic, the Royal Pharmaceutical Society (RPS) has said. In a statement published on its website, the RPS called on the General Pharmaceutical Council (GPhC) to carry out the provisional registrations, adding that doing so would ensure the careers of pre-registration pharmacists are not disadvantaged. The statement comes after the GPhC and the Pharmaceutical Society of Northern Ireland (PSNI) jointly said on 26 March 2020 that they were looking into the possibility of a form of provisional registration for current pre-registration trainees.
- Gail Fleming, director of education and professional development at the RPS, said that the time pre-registration pharmacists spend as provisionally registered should count towards their foundation training and the two years’ practice needed to become an independent prescriber. “These ‘provisional pharmacists’ can’t be left in limbo”, Fleming said. “Their role needs to be clearly defined and their registration needs to be fast-tracked so they can start picking up the reins of their career. Their contributions must then be acknowledged as part of their career development.”
- The NHS has not had to trigger its surge capacity plans to cope with peak numbers of COVID-19 patients, the chief executive of the organisation that represents NHS hospital trusts in England has said. Chris Hopson, chief executive of NHS Providers, said that while the number of COVID-19 patients admitted to hospital so far had been “about as expected”, the number of patients that need “high-end” mechanical ventilation is lower than originally estimated. In a statement, published on 15 April 2020, Hopson said that although the peak of demand may still be “a number of days away” he said the extra spare capacity that has been created, including the chain of Nightingale hospitals had been “hugely reassuring”. Hopson said that one of the most important factors now for hospitals was that they were provided with a “consistent supply” of personal protective equipment to protect staff working in the hospitals.
Wednesday 15 April
- Patients can take paracetamol or ibuprofen when self-medicating for symptoms of COVID-19, experts have concluded. The conclusion comes after the Commission of Human Medicines (CHM) and the National Institute for Health and Care Excellence (NICE) began reviewing evidence, on 17 March 2020, linking the use of non-steroidal anti-inflammatory drugs (NSAIDs) – including ibuprofen – to increased susceptibility of COVID-19 or the worsening of symptoms. The review, which concluded on 14 April 2020, found that evidence of a link was insufficient. CHM and NICE said in a joint letter that NSAIDs should be used at the “lowest effective dose for the shortest possible period” and that patients who have been prescribed NSAIDs as a treatment for a long-term condition, such as arthritis, should keep taking these medicines as normal. However, NICE said the review did not consider people who are taking NSAIDs long-term for existing chronic conditions.
- According to NICE, the review identified 156 references, 13 of which were assessed for relevance by reviewers. “However, none were suitable for inclusion,” it said. “This means that no evidence from published scientific studies was found to determine whether acute use of NSAIDs is related to increased risk of developing COVID-19 or increased risk of a more severe illness.” It added that the evidence suggested that, although NSAIDs reduce acute symptoms, such as fever, they may mask symptoms of worsening acute respiratory tract infection, with further evidence needed to confirm if this applies to COVID-19.
- Pharmacists should be central to future mass testing for, and vaccination against, COVID-19 the International Pharmaceutical Federation (FIP) has said. In a statement issued on 14 April 2020, the FIP said that once evidence-based, rapid point-of-care tests for the illness ere available in the community, the pharmacy network should be authorised and harnessed to administer these. Likewise, when COVID-19 vaccines are available, regulations should allow for pharmacists to vaccinate adults against the virus. “The valuable service that pharmacists and their teams provide to communities, and their important contribution to easing the huge strain being placed on health systems during the current coronavirus/COVID-19 pandemic is now clearer than ever”, said Dominique Jordan, president of the FIP.
- Pharmacy owners have been urged to ensure that there are at least two members of staff working in community pharmacies at all times. The advice comes from the Pharmaceutical Services Negotiating Committee (PSNC) in response to reports of pharmacists facing abusive behaviour — and sometimes even violence — from patients during the COVID-19 pandemic. The PSNC said it understood that staff sometimes have to leave unexpectedly but it urged contractors not to leave pharmacists working alone, even for a short period.
- The Pharmacists’ Defence Association (PDA) has called on the Company Chemists’ Association (CCA) to “ask its members to confirm that they will strictly enforce a policy and display notices confirming a zero tolerance approach” to abuse of staff. In a statement published on 10 April 2020, Mark Koziol, chair of the PDA, said: “Pharmacy staff are being abused and even attacked today and it needs to stop; we need immediate action from the CCA.” In response, a spokesperson for the CCA told The Pharmaceutical Journal that “We believe that pharmacy owners and the employers of pharmacists should have the freedom to choose how they will deliver a safe and secure working environment for their people”. The CCA was, they added, “working closely with our members, the police and other partners to ensure that pharmacies remain as safe an environment for the workforce as possible”.
Tuesday 14 April
- The Nightingale Hospital in Manchester has begun admitting COVID-19 patients. Here is a tweet from the pharmacy team there.
12 days ago @MFT_Pharmacy were asked to set up a pharmacy service at Nightingale NW. Today this incredible team, led by @RuthMurdoch1 delivered just that for our first patients. Thank you. All of you. pic.twitter.com/TOpMAlmocQ— @MFT_Chief_Pharmacist (@MFT_Chief_Pharm) April 13, 2020
- Final year pharmacy students can join their arranged preregistration workplace ahead of the scheduled start date to help deal with the COVID-19 pandemic, according to guidance from six professional bodies. The guidance, published jointly on 9 April 2020 by the Royal Pharmaceutical Society (RPS), the Pharmacy Schools Council, and others, says that this can be arranged by “mutual consent”. It also emphasises that any deployment of pharmacy students to help with the pandemic must be voluntary and that students should not feel coerced.
- “We’d like to say a very big thank you to the future members of our profession who are keen to help in these unprecedented times”, said Gail Fleming, RPS director for education and professional development, describing student volunteers as “pharmacy heroes”.
- COVID-19 patients with chronic obstructive pulmonary disorder (COPD) should continue taking their regular inhaled and oral medicines, including corticosteroids, in line with their self-management plan, according to rapid guidelines published by the National Institute for Health and Care Excellence (NICE). But the guideline states that if a COPD patient develops symptoms of COVID-19, they should not be started on a short course of oral corticosteroids and/or antibiotics.
- The pharmacy minister has said the rising number of incidents of abuse or violence in pharmacies is “unnacceptable”. It comes as the RPS has received confirmation that pharmacists and their teams are covered by the provisions of the Assaults on Emergency Workers Act 2018. This allows judges in England and Wales to apply more severe sentences to those found guilty of physical attacks.
This is absolutely unacceptable. The number of incidents has been rising and our community pharmacists are part of the frontline in our emergency response to Covid-19. Remember you are not their only customer, be patient they are all doing an amazing job #respectyourpharmacisthttps://t.co/yGZHM9feDi— Jo Churchill MP #StayHomeSaveLives (@Jochurchill4) April 12, 2020
- A particular combination of drugs, touted for potential prophylaxis or treatment for COVID-19, should not be used in treating people with a QT prolongation, warn US cardiac experts. The recommendations, published jointly by the American Heart Association, the American College of Cardiology and the Heart Rhythm Society on 9 April 2020. Complications that may arise from the combination include severe arrhythmia, polymorphic ventricular tachycardia and increased risk for sudden death, therefore the three organisations have recommended that anyone prescribing these drugs should take action to minimise the risk of arrhythmia, including monitoring the cardiac rhythm and QT intervals of patients, particularly in those with pre-existing cardiovascular disease.
- In the UK, prescribers have been told not to prescribe, or seek compassionate use, of any of the medicines currently being trialled for the treatment of COVID-19 — which includes hydroxychloroquine — outside of the ongoing randomised controlled trials. Click here to read more about potential treatments for COVID-19.
Thursday 9 April
- Boots is to temporarily close 60 pharmacies in quieter areas by 15 April 2020, so that staff can be either redeployed to busier pharmacies or stay at home. In a statement published on 8 April 2020, Boots said the closing stores were typically in city centre or shopping centre locations and are usually within a few minutes’ walk to the next closest Boots pharmacy. A spokesperson for Boots said that “we are committed to being there for the people that need us and we will not leave a community without a pharmacy”.
- A spokesperson for Lloyds Pharmacy told The Pharmaceutical Journal that at the moment, it had no plans to follow suit. “Most of our pharmacies are on local high streets with communities that depend on us, so wherever possible we will try and stay open. We will keep the situation under review”.
- Children’s rainbows are brightening up branches of Charles Michies pharmacy in Aberdeen and the north east of Scotland. The pharmacy put out an appeal on Facebook, asking local children to send their pictures to them to include in their public health information on TV screens.
- Sue Gordon, group manager at Charles Michies, said “We wanted to add something positive to the messages on the screens, as well as sharing a symbol of community spirit.” Gordon added: “We’ve had such a great response to it, with all sorts of drawings and photos being sent in from customers. I’d like to thank everyone for sharing them with us.”
Source: Charles Michies Pharmacy
- Guidance for pharmacy professionals on making ethical and professional decisions during the COVID-19 pandemic has been published by the Royal Pharmaceutical Society (RPS). Amongst other areas, it covers working outside of usual areas of specialism or competence; direct and indirect discrimination in decision making, and managing sparse resources.
- In a statement accompanying the launch of the guidance, the RPS said that pharmacy teams “should be reassured that should decisions be called into question at a later date, they will be judged according to the circumstances at the time of the decision, not with the benefit of hindsight”.
- Community pharmacies opening on Good Friday and Easter Monday will be funded at a rate of £250 per hour, the Pharmaceutical Services Negotiating Committee (PSNC) has said. Pharmacies in England were told they must open between 2pm and 5pm on the bank holidays, but that they would not be funded at a premium holiday rate. The PSNC had argued that payments should reflect the holiday opening hours and its chief executive, Simon Dukes, said: “The negotiations over Easter opening hours have concluded much later than we had hoped and we know that this has caused considerable logistical challenges for contractors. We are pleased to have reached agreement on a funding rate though and we look forward to resolving similar questions around the May bank holidays much earlier.” Deputy director of pharmacy commissioning at NHS England, Jill Loader, said the payment “does reflect some acknowledgement that it is a bank holiday”.
- Government proposals to allow pharmacists to supply some controlled drugs without a prescription during the pandemic have been backed by the Advisory Council on the Misuse of Drugs (ACMD). The proposed legislation would only apply if the patient had been receiving the controlled drugs as part of ongoing treatment. In a letter published on 7 April 2020, the ACMD said it was “generally supportive” of the proposal, but noted that pharmacists would “require additional support and guidance, as they will be working outside of the scope of their usual practice in exceptional circumstances”. A spokesperson for the Home Office told The Pharmaceutical Journal that “we are grateful to the ACMD for addressing these proposals urgently, and we will consider their response carefully”.
- Sandra Gidley, president of The Royal Pharmaceutical Society (RPS), said the Society supported the proposal to allow supply of some controlled drugs without a prescription, saying it would be used in “exceptional circumstances”. Gidley added that the RPS “will provide guidance to the profession to provide clarity and maintain high standards of supply, once the necessary legislation is passed”.
Wednesday 8 April
- The government has called on over 100 UK-based pharmaceutical and diagnostic companies to rapidly develop a reliable COVID-19 antibody test to help it achieve its goal of carrying out 100,000 tests a day by the end of April. This comes as the government admitted in a statement that the antibody tests it has validated so far, have not provided accurate results. A group of businesses including Abingdon Health, BBI Solutions, CIGA Healthcare and Oxford University have therefore collaborated to design and develop a new antibody test, the government said.
- Meanwhile, AstraZeneca and GlaxoSmithKline (GSK) are working with Cambridge University to set up a new testing laboratory, with the aim of processing 30,000 tests a day by the start of May to identify whether people currently have the virus. The government has previously promised that pharmacists would be among those prioritised for these tests. John Newton, the government’s adviser on testing, said: “We have already launched from scratch an entire new network of testing labs across the UK and, with the support of industry, we can go even further, both in support of our existing work and in developing new tests.”
- Pharmacists in Wales with symptoms of COVID-19 are now able to access testing through their Local Health Board (LHB). A network of COVID-19 testing sites have been set up across Wales, with pharmacists who require a test identified by their employer before being given a time by the LHB to attend for the test. Elen Jones, policy and practice lead for the Royal Pharmaceutical Society (RPS) in Wales, said that early feedback from RPS members had suggested that testing was being provided within 24 hours, with many accessing a test within just a few hours, subject to capacity, and results being provided in 1-3 days. However, Jones added that the RPS is “still concerned that testing for the wider pharmacy team is variable throughout Wales, as is testing for household contacts, meaning some pharmacy team members continue to isolate because a member of their household ‘might’ have it”.
- Pharmacies have been warned that prisoners released temporarily because of the COVID-19 pandemic may not have the drugs or prescriptions they would usually have to ensure they continue to receive the medication they were prescribed in prison. The Ministry of Justice announced on 4 April 2020 that some prisoners who are within two months of the end of their sentences will be temporarily released and in a letter to community pharmacies, sent on the same day, chief pharmaceutical officer for England, Keith Ridge, encouraged pharmacies to use current regulatory and “usual community pharmacy and COVID-19 mechanisms and services” to supply urgent medicines to released patients to avoid harm.
- The pharmacy regulator and the Royal Pharmaceutical Society (RPS) have jointly produced a letter for pharmacy staff “in support of the legitimate movement of pharmacy employees between their home and place of work”. The letter, addressed to “law enforcement teams”, and co-signed by General Pharmaceutical Society chief executive, Duncan Rudkin, and RPS chief executive Paul Bennett says: “Pharmacy staff are working extremely hard on the frontline to maintain the supply of medicines and healthcare advice to the public. It is essential that they are able to travel freely between their place of residence and place of work for this to continue.” The letter should be stamped by the pharmacist’s employer.
Source: Stefan Rousseau / PA Wire / PA Images
- The new NHS Nightingale Hospital, based at the ExCel Centre in London’s Docklands (pictured), has begun to admit its first patients for treatment of COVID-19. The hospital was built from scratch in less than two weeks and was officially opened by Prince Charles on 3 April 2020. The hospital has a capacity of 4,000 beds, which will solely be for treating COVID-19 patients, and it includes a fully operational pharmacy, which was also built and stocked in days. Alwen Williams, group chief executive of Barts Health NHS Trust, which is running the east London Nightingale hospital, tweeted a picture of the site’s pharmacy, writing “in awe of what has been achieved”.
In awe of what has been achieved @NightingaleLDN as I went home this eve. A hospital pharmacy nearly operational @Ral_sez@Jharchowal@BH_Pharmacy@NaheedPhul@RichardAGoodman@keithridge1@S_AshtonNHS@NHSEnglandLDN Thank you team for all your hard work 🙏 pic.twitter.com/blHuZ2OMGj— Alwen Williams (@A_WilliamsNHS) April 6, 2020
Tuesday 7 April
- Community pharmacy in Scotland is to receive an initial £5.3 million in funding to support them during the pandemic, Jeane Freeman, cabinet secretary for health and sport, has announced. At a government press conference held on 7 April 2020, Freeman said the funding had been agreed with Community Pharmacy Scotland to help address pharmacies “unparalleled levels of activity” and would cover equipment costs, adaptations to premises, additional staffing and locum fees. The money is in addition to the three-month advance payment to be paid at the end of April. Freeman also said she was pleased that the sector had “responded so positively to my request of them that they remain open on Good Friday and Easter Monday where it is possible for them to do so”. She said the Scottish government would “meet in full additional costs incurred by community pharmacies to support the NHS at this time”.
- Talks with NHS England and Improvement over community pharmacy’s use of the new volunteer-led medicines delivery service have “taken far longer” than anticipated, the Pharmaceutical Services Negotiating Committee (PSNC) has said. The ongoing negotiations centre around how pharmacies will be expected to make use of the 750,000 volunteers who have offered to provide services, including delivering medicines, to vulnerable patients. Simon Dukes, chief executive of the PSNC, had raised patient safety concerns about the scheme, and in a further statement he said that the negotiations are “an incredibly frustrating process that has taken far longer than we wanted it to – the lack of clarity is extremely unhelpful for contractors who we know are facing increasing demands for deliveries from patients”. The PSNC added that it has asked that pharmacies only be required to use DBS-checked volunteers to deliver medicines.
- Some European countries are experiencing shortages of medicines used to treat patients with COVID-19 and other EU member states have said they expect shortages “very soon”, the European Medicines Agency (EMA) has said. In a statement, published on 6 April 2020, the EMA said the shortages include medicines used in intensive care units including anaesthetics, antibiotics and muscle relaxants, as well as drugs that are being used off-label for COVID-19. EU authorities have now agreed measures to support the availability of medicines during the COVID-19 pandemic, including an industry single point of contact system under which pharmaceutical companies will report anticipated or current medicines shortages directly to the EMA.
- Legislation has been introduced in Wales to require businesses, including pharmacies, to take “reasonable measures” to keep a distance of 2 metres between people in the premises or waiting to come in. But a spokesperson for Community Pharmacy Wales (CPW) said the legal requirement to maintain a two metre distance between staff members would be particularly challenging in some community pharmacies.
- “Pharmacies obviously don’t want to put staff in danger, but they also need to keep functioning during this time. We are working with Welsh Government to better understand what ‘reasonable’ adjustments to working practices to accommodate the 2 metre rule actually mean,” they said. CPW is also advising community pharmacists to check with their insurers regarding the implications of legal compliance issues created by the regulations.
- All pharmacy schools should ensure that students’ performance in assessments taken during the COVID-19 pandemic does not negatively affect their degree classification, the British Pharmaceutical Students’ Association (BPSA) has said. In a statement, Regan McCahill, president of the BPSA, said that some pharmacy schools had announced that assessments completed during the current disruption could only be used to improve overall degree classification. If the results would lower a degree classification, then the assessment would be marked as a ‘pass’ — meaning the overall degree grade was unaffected. But other universities, McCahill said, had said their assessment policy did not cover students on courses regulated by outside bodies, such as the MPharm. “It is our understanding that applying such a policy is not a regulatory issue”, McCahill said, adding that the BPSA urged all schools to “relieve their students’ stress and anxieties” by putting this “safety net” in place.
- Medicines, Ethics and Practice (MEP), alongside 21 Royal Pharmaceutical Society (RPS) guides to various aspects of practice, have been made freely available as part of the Society’s response to the COVID-19 pandemic. Previously the material was only accessible to RPS members, but they have been made available to support pharmacists returning to patient-facing roles. The guides include Emergency Supply, Controlled Drugs, and Preparing for Day One in both community and hospital pharmacy.
- In a statement, the RPS said that the decision had been “inspired by the way pharmacists are supporting each other during this global emergency”, and that it had “heard your call to do everything we can to make sure every pharmacist who needs it has access to up to date guidance”.
- Patients who are considered ‘vulnerable’ to contracting COVID-19, and should be shielding, will now be flagged on the Summary Care Record (SCR). This means community pharmacists will receive an alert when accessing the record of an at-risk patient using the SCR application. In a statement on its website, the Pharmaceutical Services Negotiating Committee (PSNC) said the flag “will support pharmacy teams’ decision making about how to best support those people in the shielded group”. The PSNC added that the flag, which went live on 3 April 2020, is currently being piloted with community pharmacy before being rolled out to other parts of the health and care system. The Government has asked 1.5m patients across six categories to shield for at least 12 weeks.
Monday 6 April
- Fourteen fake or unlicensed medical products advertised to treat or prevent COVID-19 are under investigation by the Medicines and Healthcare products Regulatory Agency (MHRA). In a statement on its website, the MHRA said on 4 April 2020 that it was investigating fake self-testing kits, “miracle cures”, “antiviral misting sprays” and other products.
- “There is no medicine licensed specifically to treat or prevent COVID-19, therefore any claiming to do so are not authorised and have not undergone regulatory approvals required for sale on the UK market,” warned Lynda Scammell, MHRA enforcement official. “We cannot guarantee the safety or quality of the product and this poses a risk to your health.” The MHRA statement added that the National Fraud Intelligence Bureau has also received reports from people who have lost money when trying to buy personal protective equipment (PPE) or self-testing kits from fraudulent websites that do not exist.
- Pharmacists and pharmacy technicians requiring a Disclosure and Barring Service (DBS) check can now get approval within 24 hours under a temporary fast-track service launched on 30 March 2020. The DBS service will fast-track checks of the adults and children barred lists free-of-charge for healthcare workers recruited to help with the coronavirus pandemic. According to guidance published by the DBS a fast-track check will be provided for an application made “by a person who is registered, or who the Registrar is considering registering, as a pharmacist or a pharmacy technician”. The General Pharmaceutical Council announced on 27 March 2020 that 6,200 former pharmacy professionals have been registered to help with the pandemic, giving them the option of working of returning to work. The DBS guidance added that the Department of Health and Social Care has advised that if there is no match against the barred lists, the applicant can be recruited into a job before receiving the full DBS certificate.
- A “Care For Your Pharmacy” campaign has been launched by Community Pharmacy Lancashire (CPL), in response to increased reports of aggression towards pharmacy teams. The campaign, scheduled to run over three months, will be promoted through local media coverage and social media. As well as sending out a request for “patience and respect”, the campaign will share information about the protective measures that pharmacies have put in place during the pandemic, and about medicines supplies.
- Kath Gulson, chief executive of CPL, described the campaign as a “a public health message for our local people”. The theme of the campaign is, she said, to “care for our teams, care for your health, and care for one another. Sadly, some people have been a little impatient, so we’re just trying to get that message out: Care for your pharmacy, so that your pharmacy can care for you”.
Source: Nic Bunce / Shutterstock.com
- Community pharmacies in England will be required to open from 14:00 to 17:00 on Good Friday and Easter Monday, NHS England and Improvement (NHSE&I) has confirmed. But pharmacies can request an exemption to this requirement, particularly if there is likely to be minimal demand due to social distancing — for example, pharmacies based within shopping centres.
- NHSE&I said that contractors would be able to claim additional payment for these hours, but that the rates would be based on normal working days rather than bank holidays. Simon Dukes, chief executive of the Pharmaceutical Services Negotiating Committee (PSNC) said the negotiator was arguing for full bank holiday funding. “Any decision to treat the Bank Holidays as normal days fails to recognise the legal responsibilities that employers have to pay enhanced rates for work on these days, and we are trying to change their minds on this,” he said.
- A joint letter from the UK’s four chief medical officers and NHS England’s medical director has been sent to NHS trusts asking them to make “every effort” to enrol patients into national prioritised clinical trials on COVID-19.Almost 1,000 patients from 132 different hospitals have so far been recruited in 15 days to join the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial, being coordinated by researchers at Oxford University, and thousands more are expected to join, making it the largest randomised controlled trial of potential COVID-19 treatments in the world. The trial is testing several medicines including, lopinavir-ritonavir, an HIV treatment; dexamethasone, a steroid used in a range of conditions to reduce inflammation; and hydroxychloroquine, a treatment for malaria.
- The UK government is also funding two other major trials: the Platform Randomised Trial of INterventions against COVID-19 In older peoPLE (PRINCIPLE) which is looking at interventions against COVID-19 in older people in primary care, and the Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) which is an international effort focusing on critically ill COVID-19 patients.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20207947
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