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  • Community pharmacies forced to 'limit' services to comply with safe staffing guidance, pharmacy owners say

    Pharmacy owners have told the General Pharmaceutical Council (GPhC) that they have been forced to limit services including evening and weekend opening hours in an effort to operate safely.

    In response to safe staffing guidance published by the GPhC in June 2018, some pharmacies have also had to cut back on “added-value services” in order “to ensure they were operating safely at all times”, according to GPhC council papers released ahead of a meeting on 6 December 2018.

    In September 2018, the GPhC wrote to organisations representing pharmacy owners, including the Company Chemists’ Association (CCA), the National Pharmacy Association (NPA), the Association of Independent Multiple Pharmacies, Community Pharmacy Scotland and Community Pharmacy Wales, to ask what progress had been made on implementing the new guidance.

    The organisations responded by saying that some pharmacies had now taken action such as assigning “dedicated staff members to monitor staffing levels”, while others “[employed] more staff where required to obtain the right skill mix”.

    However, the council papers added: “They have also highlighted some of the difficult decisions taken by pharmacies to ensure they were operating safely at all times, including limiting added-value services such as free home deliveries and compliance aids; putting planned investment in service developments on hold; and limiting evening and weekend opening.”

    The responses from community pharmacies also noted workforce challenges that affected their staffing levels, such as funding cuts, the impact of Brexit on the recruitment of pharmacy staff from the EU, and a “declining pipeline in newly qualified pharmacists”.

    The GPhC reiterated in the council papers that the adequacy of staffing appeared in the top five standards not met throughout 2018.

    However, it added that although the overall number of pharmacies failing to meet the standard — 28–29 pharmacies each quarter — remains low, “it represents an increase on the numbers identified in 2016 and 2017, which ranged from 11–20 each quarter”.

    Malcolm Harrison, chief executive of the CCA, told The Pharmaceutical Journal: “CCA member companies take their responsibility for ensuring safe and effective pharmacy teams very seriously. They have approached the implementation of the new guidance in a range of ways to date.”

    However, he added: “Our members also recognise that, while meeting the GPhC’s standards, a range of external factors are having an impact on workforce supply within community pharmacy across the UK.”

    He added that staffing challenges arising from funding cuts, fewer newly qualified pharmacists and a “rapid segmentation of the pharmacy sector arising from new roles for pharmacists” are “sector-wide”.

    “To seek to avoid or overcome some of these external challenges, our members are already looking to develop solutions around flexible working patterns or to encourage more portfolio careers enabling and encouraging staff retention,” he added.

    Helga Mangion, policy manager at the NPA, said: “Funding pressures mean many pharmacies have had to take difficult decisions about staffing. However pharmacy teams continue to provide excellent patient-centred care and patient safety will always be their first priority.”

    The GPhC added in the council papers that it “will consider a possible thematic inspection of staffing levels as part of our planning for 2019/2020, subject to approval by Council [members]”.

     

     

  • PSNC says pharmacists should be able to substitute drugs to ease Brexit supply pressures

    Pharmacy negotiators have suggested that community pharmacists should be able to automatically substitute an alternative medicine if they cannot dispense the prescribed item, as a way to help deal with any possible drugs shortages post Brexit.

    The move to introduce routine therapeutic substitution was proposed in October 2018 by Sibby Buckle, vice chair of the Royal Pharmaceutical Society (RPS) English pharmacy board and chair of the RPS Pharmacy Digital Forum.

    Then, in November 2018, the Pharmaceutical Services Negotiating Committee (PSNC) suggested a number of ‘secondary measures’ to manage the risk to the medicines supply chain after Brexit. These include introducing routine therapeutic substitution, which means a community pharmacist would no longer have to go back to the GP or other prescriber for approval to switch to an alternative product; and more responsive drug tariff pricing, to ensure that pharmacy contractors are properly reimbursed for any additional incurred costs.

    The PSNC expressed concerns that current government plans for wholesalers and drug manufacturers to stockpile supplies for six weeks prior to Brexit are not enough to guarantee that patients will be able to get essential drugs after 29 March 2019 — especially in the event of a ‘no deal’.

    Buckle told The Pharmaceutical Journal: “The present system is time-consuming, inconvenient and unnecessary.

    She added that the necessary changes to the law could be made “very quickly” if there was political will.

    The Company Chemists’ Association (CCA), which represents high street pharmacy chains, has also accepted that Brexit may trigger the need to review the law around the substitution of medicines.

    Malcolm Harrison, chief executive of the CCA, said in a statement: “We recognise that in the light of potential shortages of medicines, provision is needed in the planning to allow pharmacists to take all reasonable steps to supply patients with medicines they need. This may include a review of current legislation to ensure any proposed actions — which could include the substitution of medicines — are made on a solid legal basis.”

    Meanwhile, the General Pharmaceutical Council (GPhC) argued that pharmacists need not dispense prescriptions issued in another European country in the event of a ‘no-deal’ Brexit.

    In its response to the Medicines and Healthcare products Regulatory Agency (MHRA) consultation on Brexit contingency plans, the GPhC said it did not agree with the MHRA’s proposal “to enable continued recognition of prescriptions issued in an EU/EEA country”.

    Instead, the GPhC argued that recognising prescriptions from the EEA could put patient safety at risk as the practitioners writing the prescriptions may no longer be qualified to do so in the UK after a no-deal Brexit.

    Health and social care secretary Matt Hancock has told MPs that building refrigeration capacity to store stockpiles of medicines in the event of a ‘no-deal’ Brexit is expected to cost in the “low tens of millions” of pounds.

    Speaking at a House of Commons health and social care select committee hearing on Brexit on 23 October 2018, Hancock said the money would not come from extra NHS funding, but instead from Treasury Brexit contingency planning.

    Drug manufacturers and health industry leaders have also written to Hancock after warning that the government’s current medicines supply plans will not suffice in the event of a ‘no-deal’ Brexit.

    In an open letter to Hancock, dated 30 October 2018, representative bodies including the Association of the British Pharmaceutical Industry, the Brexit Health Alliance, (which includes the Academy of Medical Royal Colleges) and the NHS Confederation said the UK risks “widespread shortages” under the government’s current medicine supply plans.

  • NHS England looks to save £70m by curbing prescribing of eight more items in primary care

    NHS England has launched a public consultation on whether to limit the prescribing of eight items in an effort to save almost £70m per year.

    It has launched consultation on whether eight items should be included in clinical commissioning group guidance on “items that should not be routinely prescribed in primary care”.

    The guidance was first published in November 2017, listing 18 items that should no longer be prescribed in primary care as they were considered to be of low clinical value or were not cost effective, and NHS England said it would review the guidance annually.

    In the latest review, the committee identified eight further items for inclusion on the list, including silk clothes, amiodarone for abnormal heart rhythms, bath and shower emollient preparations, dronedarone for atrial fibrillation and minocycline for acne.

Helga Mangion, policy manager for the NPA

Community pharmacies forced to 'limit' services to comply with safe staffing guidance, pharmacy owners say

Pharmacy owners have told the General Pharmaceutical Council (GPhC) that they have been forced to limit services including evening and weekend opening hours in an effort to operate safely.

In response to safe staffing guidance published by the GPhC in June 2018, some pharmacies have also had to cut back on “added-value services” in order “to ensure they were operating safely at all times”, according to GPhC council papers released ahead of a meeting on 6 December 2018.

In September 2018, the GPhC wrote to organisations representing pharmacy owners, including the Company Chemists’ Association (CCA), the National Pharmacy Association (NPA), the Association of Independent Multiple Pharmacies, Community Pharmacy Scotland and Community Pharmacy Wales, to ask what progress had been made on implementing the new guidance.

The organisations responded by saying that some pharmacies had now taken action such as assigning “dedicated staff members to monitor staffing levels”, while others “[employed] more staff where required to obtain the right skill mix”.

However, the council papers added: “They have also highlighted some of the difficult decisions taken by pharmacies to ensure they were operating safely at all times, including limiting added-value services such as free home deliveries and compliance aids; putting planned investment in service developments on hold; and limiting evening and weekend opening.”

The responses from community pharmacies also noted workforce challenges that affected their staffing levels, such as funding cuts, the impact of Brexit on the recruitment of pharmacy staff from the EU, and a “declining pipeline in newly qualified pharmacists”.

The GPhC reiterated in the council papers that the adequacy of staffing appeared in the top five standards not met throughout 2018.

However, it added that although the overall number of pharmacies failing to meet the standard — 28–29 pharmacies each quarter — remains low, “it represents an increase on the numbers identified in 2016 and 2017, which ranged from 11–20 each quarter”.

Malcolm Harrison, chief executive of the CCA, told The Pharmaceutical Journal: “CCA member companies take their responsibility for ensuring safe and effective pharmacy teams very seriously. They have approached the implementation of the new guidance in a range of ways to date.”

However, he added: “Our members also recognise that, while meeting the GPhC’s standards, a range of external factors are having an impact on workforce supply within community pharmacy across the UK.”

He added that staffing challenges arising from funding cuts, fewer newly qualified pharmacists and a “rapid segmentation of the pharmacy sector arising from new roles for pharmacists” are “sector-wide”.

“To seek to avoid or overcome some of these external challenges, our members are already looking to develop solutions around flexible working patterns or to encourage more portfolio careers enabling and encouraging staff retention,” he added.

Helga Mangion, policy manager at the NPA, said: “Funding pressures mean many pharmacies have had to take difficult decisions about staffing. However pharmacy teams continue to provide excellent patient-centred care and patient safety will always be their first priority.”

The GPhC added in the council papers that it “will consider a possible thematic inspection of staffing levels as part of our planning for 2019/2020, subject to approval by Council [members]”.

 

 

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