National News

PSNC webinar: Making sense of the 2018/19 funding settlement

PSNC News - 22 October 2018 - 3:21pm

Following the announcement of community pharmacy funding for 2018/19, PSNC will be holding a webinar to discuss the settlement on Tuesday 30th October at 7.00pm.

On the night Simon Dukes, PSNC Chief Executive, and Mike Dent, PSNC Director of Pharmacy Funding, will be available to answer your questions about the settlement and what it means for your pharmacy and for the sector more broadly.

The webinar will outline the 2018/19 community pharmacy funding settlement and the background to its agreement, as well as explaining the changes to the Single Activity Fee and Category M prices. It will describe the differences that community pharmacy contractors will see in their payments from the NHS and explain to listeners where to find resources to help estimate the potential changes to your income.

Lasting about an hour and a half, the webinar will give you plenty of opportunity to ask the presenters questions live and we’ll also be tweeting on the night so follow #pharmacyfunding to keep up with all that is going on.

This webinar is being organised at short notice* because PSNC is keen to share as much information about the funding settlement as we can and to answer any questions from contractors.

*Please note that our FMD webinar will now be held on Wednesday 7th November at 7pm. If you have signed up for this webinar you will be automatically notified of the change.

Register for our Funding 2018/19 webinar

Unable to attend the webinar?

It is still worth registering for the event so that you will be sent a link to the recorded version of the webinar as soon as it is available.

Categories: National News

Community pharmacy funding announcement: funding of £2.592bn agreed for 2018/19

PSNC News - 22 October 2018 - 12:00pm

Announcement summary

Contractor information

Community pharmacy funding levels will be maintained for 2018/19, with total funding set to £2.592bn. This will be split, as previously, to deliver £1.792 billion in fees and allowances and £800 million in medicine margin.

In order to deliver the £1.792 billion in fees and allowances, the Single Activity Fee will be set to £1.26 from the November Drug Tariff, but this will remain under review throughout the rest of the year.

Alongside this, Category M prices will reduce by £10m per month from November for the next five months (until March 2019). This is to repay excess margin earned by pharmacies in previous years, in particular 2015/16 for which the results of the margin survey show that there was a significant over-delivery of margin.

The price reductions follow the pause in margin recovery which PSNC agreed over the summer to help ease cash flow for contractors, and they reintroduce the recovery at a lower monthly rate (£10m monthly reductions, rather than £15m monthly) than it had been previously.

After rigorous analysis of funding and margin delivery rates and a very difficult debate at the October PSNC meeting, PSNC unanimously agreed to accept the funding offer from DHSC on the grounds that:

  • Community pharmacy is in the very early stages of rebuilding a constructive working relationship with HM Government, its only payer, and needs to demonstrate its desire to move away from the adversarial relationship that has halted progress for the past two years.
  • Previous plans revealed through the Judicial Review process had been to reduce community pharmacy funding by £33m this year.
  • In the context of widespread austerity and immense financial pressures on the health service, and pending substantial discussions on the long term future of community pharmacy, maintaining funding levels was felt to be the priority and the best likely offer.
  • The agreed levels of margin recovery have been set to repay a conservative estimate of excess margin and has been spread over the longest period possible to avoid greater shocks to the market.

In accepting the offer, PSNC expressed to HM Government its deep concerns about the financial pressures facing community pharmacy contractors and the fact that they would increasingly be unable to reinvest, given pressures from rising staff costs and business rates.

PSNC stressed the need for its goodwill in accepting this funding offer to be recognised in future negotiations, and also called for progress to be made in amending the current margin delivery system to smooth adjustments, and to remove the inequity in delivery caused by the proliferation of branded generics, as recognised by DHSC.

PSNC has expressed its desire to begin negotiations on community pharmacy funding for 2019/20 and beyond as soon as possible, and our intention remains to work towards a multi-year settlement that will give more certainty for contractors about future funding. This will necessarily involve substantive discussions with HM Government about its ambitions for community pharmacy in the long term and PSNC is keen to explore ideas about the development of pharmacies’ role in line with the emerging NHS long term plan which we have sought to influence working together with the other pharmacy organisations.

PSNC Chief Executive Simon Dukes said:

“We know that many community pharmacy contractors will be disappointed to hear that there is no more money available for pharmacies this year, and accepting this funding offer was a difficult decision for PSNC to make. But we were very mindful of the proposals we had seen previously to reduce funding by £33m this year, and in that context, along with the backdrop of uncertainty in the wider economic climate, we knew that pharmacy was not going to get a better offer from HM Government.

Since starting at PSNC in May, I have been struck by how hard community pharmacies are working on behalf of the NHS and patients, and we will continue to work with the other pharmacy organisations to ensure that HM Government sees the value that pharmacies are delivering. We must not underestimate the scale of the challenges ahead and we must make our case using evidence, through strategic influencing and by demonstrating that we are a sector innovating and embracing change and new technologies to deliver the outcomes that HM Government wants. If we can do all of this, then I do believe we will be able to create positive opportunities for community pharmacies.

Being able to reach a negotiated settlement for 2018/19 moves us forward in this process and away from the adversarial position that has halted progress over the past two years. We hope that HM Government will see this agreement as a signal of our willingness to work with them in the future, and we have stressed our desire to start negotiations on 2019/20 with them as early as possible.”

PSNC Funding Webinar

PSNC is keen to share as much information about the funding settlement as we can, and to give community pharmacy contractors the opportunity to ask questions about it, we will be holding a funding webinar on Tuesday 30th October at 7pm*.

The webinar will be presented by Mike Dent, PSNC Director of Pharmacy Funding, and Simon Dukes, PSNC Chief Executive. Click here for further details and sign up information.

*Please note that this webinar will now replace the FMD webinar previously scheduled for this time. The FMD webinar will now be held on Wednesday 7th November at 7pm. If you have signed up for this webinar you will be automatically notified of the change, or you can sign up here.

Further Information and FAQs

To help community pharmacy contractors and others to understand the impact that this funding settlement will have on their businesses and the background to its agreement we have produced a number of briefings and resources:

PSNC Briefing 055/18: How the 2018/19 funding settlement will affect your payments – information for contractors

PSNC Briefing 056/18: Background information on community pharmacy funding and the 2018/19 funding settlement

PSNC Briefing 057/18: Funding 2018/19 – Frequently Asked Questions

PSNC Committee Member Statements

PSNC Vice Chair and Regional Representative Bharat Patel said:

“PSNC agreed to this funding settlement in the one part with a heavy heart, because all our businesses are struggling at the moment, but in the other part with optimism, as although we are in the very early stages of rebuilding our relationship with HM Government, we hope we are starting to move towards more constructive dialogue about the future of pharmacy services.

I know that the contractors and LPCs who I represent will, rightly, ask me why we have not got any more money, particularly when community pharmacy collectively has made strong arguments and put forward a number of evidenced proposals for service development over the past two years. But the financial constraints on health and all public services are very severe indeed, and we are only just emerging from a period in which constructive dialogue about the future of community pharmacy had just not been possible.

Looking to the future, HM Government, as our payer, must have the final say in what it wants us to deliver, and our best strategy for success will be to work with Government, not to try to change what we cannot change, but to find ways to meet their objectives that are as beneficial for community pharmacies and their patients as possible. This is exactly what PSNC intends to do.”

PSNC Funding and Contract Subcommittee Chair Peter Cattee said: 

“PSNC’s Funding and Contract Subcommittee considered the available analysis on margins and funding delivery rates very carefully ahead of the wider PSNC discussion on the funding offer. We know the impact that flat funding has on businesses, and we are particularly concerned that the reductions to Category M prices will once again hit cash flow hard, so only very reluctantly accepted that part of the funding package.

We felt that spreading the margin recovery over five months would minimise the impact on cash flow as much as possible, and we were also only prepared to agree to the recovery of £50m of historical excess margin, pending agreement on the final results of the latest margin surveys.

I believe the retained margin system no longer works in the way that we want it to, and this is something PSNC is exploring in great detail as part of work to explore alternative funding models. Solutions are difficult, but although any new models will bring change and challenge for contractors, they should also bring opportunities for those willing to embrace new ways of working and delivering services.”

Categories: National News

Funding 2018/19 – Frequently Asked Questions (October 2018)

PSNC News - 22 October 2018 - 11:58am

To accompany the funding announcement for 2018/19, PSNC has set out responses to a number of questions to help to answer any queries that community pharmacy contractors may have.

PSNC Briefing 057/18: Funding 2018/19 – Frequently Asked Questions

If you have any queries on this PSNC Briefing or you require more information, please contact info@psnc.org.uk.

To browse other PSNC Briefings on PSNC’s Work, click here.

View Article…

Categories: National News

Background information on community pharmacy funding and the 2018/19 funding settlement (October 2018)

PSNC News - 22 October 2018 - 11:57am

This briefing sets out the community pharmacy funding settlement for 2018/19 and gives background information on what the announcement means and how community pharmacy funding works. This may be of particular use to journalists and others wanting to know more about how community pharmacy funding works.

PSNC Briefing 056/18: Background information on community pharmacy funding and the 2018/19 funding settlement

If you have any queries on this PSNC Briefing or you require more information, please contact Mike Dent, Director of Pharmacy Funding.

To browse other PSNC Briefings on Funding and Statistics, click here.

View Article…

Categories: National News

How the 2018-19 funding settlement will affect your payments – information for contractors (October 2018)

PSNC News - 22 October 2018 - 11:57am

In this briefing, PSNC’s Funding Team explains the 2018/19 community pharmacy funding settlement and how it will affect your pharmacy business. The Briefing highlights the changes that have taken place, shows you how you can estimate the impact on your pharmacy, explains where you can find the relevant payment information in your FP34 Schedule of Payments, and should help you to understand the timing of your payments.

PSNC Briefing 055/18: How the 2018/19 funding settlement will affect your payments – information for contractors

The following appendix to this briefing summarises how and when the funding changes will have an impact on your cashflow.

Appendix 1: Summary of funding changes and pharmacy cashflow impact diagram

If you have any queries on this PSNC Briefing or you require more information, please contact Jack Cresswell, Funding Strategy Manger.

To browse other PSNC Briefings on Funding and Statistics, click here.

View Article…

Categories: National News

Self Care Week 2018

PSNC News - 22 October 2018 - 9:35am

Self Care Week, which is an annual national awareness week that focuses on providing support for self care across communities, families and generations, will be running again this year on 12-18th November 2018.

The campaign aims to provide people-facing organisations such as community pharmacies with a focus to hold a targeted campaign to support people to take care of their health and wellbeing and improve their understanding of doing so.

Choosing Self Care for Life is the strap line for this year’s campaign and organisations are being encouraged to use Self Care Week as a hook to help people choose self care for a healthier, happier life.

A £500 prize is available for the winner of the best Self Care Week initiative. See the criteria for details.

Useful resources

Healthy Living Pharmacies

Healthy Living Pharmacy teams may wish to host a health awareness event/campaign on self care, therefore the resources and training available from the Self Care Forum may benefit those wishing to engage with members of the public on this subject. More information on hosting a health awareness event/campaigns can be found on the PSNC health promotion ideas page.

Categories: National News

Patient leaflet: When patients are asked to return to the pharmacy for aTIV

PSNC News - 17 October 2018 - 4:44pm

PSNC has produced a new leaflet for pharmacy teams to give to patients when they are advising patients aged 65 years or over on the need to come back to the pharmacy at a later date for a flu vaccination if the pharmacy has temporarily run out of stock of the recommended vaccine (Fluad, the adjuvanted trivalent inactivated vaccine (aTIV)) for their age group.

Patient leaflet: Coming back to the pharmacy for your flu jab – important information for patients aged 65 years and over (Word)

Patient leaflet: Coming back to the pharmacy for your flu jab – important information for patients aged 65 years and over (PDF)

The leaflet covers key messages which are important for patients to be aware of, for example, why they are not able to have their flu vaccination immediately and why it is important to return to the pharmacy to have a flu vaccination.

The patient leaflet has been reviewed by the aTIV working group, which comprises representatives from Public Health England, NHS England, Department of Health and Social Care, PSNC and the GP Committee of the British Medical Association.

Contractors are also reminded that PSNC Briefing 050/18: Flu Vaccination Service 2018/19: Adjuvanted trivalent inactivated influenza vaccine provides a summary of relevant information on aTIV for contractors.

Categories: National News

Quality Payments webinar now available on-demand

PSNC News - 17 October 2018 - 12:26pm

More than 450 people tuned in to PSNC’s recent Quality Payments webinar and community pharmacy contractors can now access an online recording.

During the webinar Rosie Taylor, Head of Service Development at PSNC, and Zainab Al-Kharsan, our Service Development Pharmacist, guided contractors through the updated gateway and quality criteria. As well as describing the new elements of the scheme, the presenters also outlined the guidance and resources developed by PSNC plus where to find further information and support. The second half of the webinar was allocated to answering viewers’ questions.

With the next review point just four months away (February 2019), watching this webinar can provide a useful Quality Payments update for those contractors planning to take part.

Click here to view an on-demand version of the webinar.*

You can also click here to view the slide pack used in the webinar.

*Please note, to watch the recording, you will need to register (or input the email address you registered with previously).

Some of the feedback we have received so far:

“Was very useful and clarified a lot of items in a broad sense.” – Pharmacy Manager

“This webinar was very informative. It gave me a good picture of the requirements, changes, resources available, etc. I would definitely recommend this format as it is very convenient-no travelling involved, can be done at home.” – Pharmacist

“Very well presented. Information provided and resources available should make the task less daunting.” – Locum Pharmacist

Categories: National News

Adrenaline 150 microgram auto-injectors supply: Urgent actions required by pharmacy teams

PSNC News - 16 October 2018 - 11:32pm

Further to previous announcements about the availability of EpiPen and EpiPen Junior, the Department of Health and Social Care (DHSC) and NHS England have asked all community pharmacies to implement additional validation processes from tomorrow (Wednesday 17th October).

Steps for pharmacies to take

1. Read the new protocol from DHSC, noting in particular:

  • The flow chart of questions to ask patients to ascertain those who are in most need of supply;
  • The extension to the usability of some batches of Jext 150 and 300, previously advised of 300 EpiPen expiry extension; and
  • The guidance that all expired pens with precipitate or discoloured should be discarded. This can be checked by viewing the contents of the glass cartridge.

2. Read the FAQs prepared by DHSC

3. Implement the protocol with immediate effect (i.e. from 17th October)

This has been put in place following critical supply issues to ensure that the limited stock of adrenaline 150 microgram auto-injectors that will become available this week reaches those most in need.

DHSC has stated: “We have now reached a critical supply issue and need to implement controls on the supply of 150 microgram adrenaline auto-injectors. Children weighing 25kg or less with the greatest short term need must have access to these first, ensuring that every patient has at least one in date 150 microgram adrenaline auto-injector. This can only be achieved by restricting issue of new devices until further notice.”

Pharmacy contractors and their teams are asked to read the below protocol and Q&As and to implement this new verification procedure with immediate effect on Wednesday 17th October.

Read the Epipen 150 microgram validation protocol

Read the Q&As for pharmacies and dispensing practices

As the documents set out, community pharmacies are being asked to play a role in prioritising the limited stock now available by asking all patients who present with prescriptions (both NHS and private) for  adrenaline 150 microgram auto-injectors some brief validation questions to check whether they are most in need of a supply. A flowchart outlining the questions to be asked is included in the Protocol.

The Dispenser Validation Protocol

DHSC is advising that all patients need to have access to a minimum of two adrenaline 150 microgram auto-injectors, but that it is sufficient if just one of these is in-date (in this context meaning at least one month left before expiry) provided the patient also carries an expired device as back-up which is not discoloured and contains no precipitate.

Note: DHSC is now advising that expired auto-injectors should not be used if they contain a precipitate or are discoloured. This can be checked by viewing the contents of the glass cartridge in the auto-injector through the viewing window.

The dispenser validation protocol should allow pharmacies to deduce whether a prescription should be fulfilled, partially fulfilled, or supply should be delayed. The process applies to EpiPen Junior 150 microgram, Jext 150 microgram and Emerade 150 microgram adrenaline auto-injectors. The dispenser validation process does not apply to 300 microgram or 500 microgram strengths of adrenaline auto-injectors.

Ordering and Dispensing Auto-Injectors

Where patients meet the criteria and are eligible to receive supplies, pharmacies will then need to order the product from wholesalers who will carry out an additional prescription validation step.

Wholesalers have been asked to put in place measures to control the distribution of the limited available stock and will ask pharmacies to verify their order requests, perhaps by faxing or sending an image of the prescription with all the patient details obscured or by providing a unique prescription identifier number.

Where pharmacies only partially fulfil a prescription, patients will need to be advised to return to their prescriber for another one when they no longer have two devices or supply issues ease; an ‘owing’ should not be issued for the remaining auto-injectors. The prescription should be endorsed with the quantity supplied and submitted as part of the end of month submission process. Pharmacies unable to obtain any stock of adrenaline auto-injectors due to restrictions arising from existing wholesaler distribution arrangements should signpost patients to another pharmacy.

Where a patient is prescribed a different brand to what they have previously received, pharmacies will need to ensure that patients, parents and carers know how to use the auto-injector being supplied.

Pharmacy teams can use the patient letter shared on October 15th to help explain the situation to patients.

Further Recommendations and Information

DHSC have said that it is only through strict adherence to the protocol questions and criteria that stock will be able to reach patients who have a priority need.

In addition to the validation processes, there have been some changes to the recommendations around use of the various auto-injectors in addition to the changes announced previously. Pharmacy teams should note:

  • During the period of reduced supply, the cut-off for switching from 150 microgram to 300 microgram dosage for all devices is now 25kg. This change will result in off-label use of Jext 150 microgram and Emerade 150 microgram;
  •  The extension to the usability of some lots of Jext 150 microgram and 300 microgram, and the previously advised Epipen 300 microgram expiry extension; and
  • The guidance that all expired auto-injectors with precipitate or discoloured should be discarded.

Pharmacies with existing wholesaler orders for adrenaline 150 micgrogram auto-injectors placed prior to Wednesday October 17th will need to complete the new validation processes to ensure stock is ordered for those patients most in need. We expect wholesalers to contact you regarding this, but you may wish to raise this with them directly also.

As a reminder of the current distribution arrangements:

Emerade is available via AAH and Phoenix

Epipen is available via Alliance Healthcare

Jext is available via Alliance Healthcare

 

For further information see our dedicated adrenaline resource page

 

Categories: National News

Patient questionnaire requirement of the Flu Vaccination Service

PSNC News - 16 October 2018 - 9:00am

Community pharmacy contractors are reminded that a requirement of the Flu Vaccination Service is to ask all patients who have a flu vaccination to complete the patient questionnaire.

An IT platform is available to enable patient questionnaires from the Flu Vaccination Service to be completed electronically either by the patient themselves or with help from the pharmacy team.

The IT platform allows patient questionnaire details to be recorded in several ways including:

  • completing the questionnaire online – a tablet device could be used in the pharmacy (if available) and the patient could input their responses;
  • using a QR code to access the questionnaire if the patient has a smart phone with a QR code reader App installed on it;
  • providing the patient with a compliments slip detailing the website address and QR code for them to complete the questionnaire online at a convenient time; and
  • a downloadable copy of the patient questionnaire which the patient can complete in the pharmacy.

Where patient questionnaires are completed on paper, contractors should utilise the functionality available on the IT platform to submit the patients’ responses online so that these responses can be collated and analysed along with those submitted electronically by patients.

Contractors can also view, for their own pharmacy, a high-level summary of patient responses on the IT platform. Contractors are encouraged to monitor this throughout the flu season to see how patients are responding to questions about the service being provided. It may also be beneficial to view this after the service has finished on 31st March 2019, so contractors have a high-level summary, for their pharmacy, of patient responses for the Flu Vaccination Service 2018/19.

guidance document on how to use to complete the process is available on the IT platform.

Categories: National News

PGD addendum published for the Flu Vaccination Service 2018/19

PSNC News - 15 October 2018 - 4:30pm

Public Health England (PHE) has published an addendum to the community pharmacy Flu Vaccination Service 2018/19 Patient Group Direction (PGD).

This addendum provides the legal basis for two activities to take place:

  1. For pharmacists to administer the recommended vaccine to patients who have inadvertently received the non-recommended vaccine for their age group during the 2018/19 Flu Vaccination Service, for example, patients aged 65 years or over who have received a quadrivalent vaccine (QIV) instead of the recommended adjuvanted trivalent inactivated vaccine (aTIV); and
  2. For pharmacists to re-vaccinate patients who have received an incomplete dose of vaccine, for example, if some of the vaccine was spilled in the process of administering the vaccine.

It is important to note, that NHS England has advised that the addendum is not advocating active recall of patients who have been given the non-recommended vaccine, but where a patient presents requesting re-vaccination with the recommended vaccine, and they have been advised of the risks and benefits of doing so, the addendum will allow for this to take place.

FAQs

Do I need to sign the addendum?
No. Pharmacists are not required to sign the addendum, but it is important that they are aware of it so, if either of the above circumstances occur, pharmacists are aware that the PGD allows them to re-vaccinate a patient.

Do I need to print a copy of the addendum and attach it to the PGD?
Contractors/pharmacists are strongly encouraged to print a copy of the addendum and attach it to the PGD in the pharmacy to ensure that new pharmacists signing up to the service are made aware of the addendum.

What should I do if a patient returns to the pharmacy and says she was given a non-recommended vaccine for her age group, for example, the patient is  65 years old and received the QIV instead of the recommended aTIV?
Pharmacists should follow the process in PHE’s recently updated Inactivated influenza vaccine guidance for healthcare practitioners, which states:

  • Inform the patient of the error and its potential implications;
    • Advise the patient that although the QIV and aTIV will offer some protection to all age groups, individuals aged 65 years and over (particularly those more than 75 years of age) may not respond as well to the QIV as they would to the aTIV, and individuals aged under 65 years will not benefit from the opportunity to make protection against an additional flu strain if they have been given aTIV;
  • Following a discussion about the risks and benefits, advise the patient that they could, if they wish, be given a second dose of the vaccine they should have had;
    • The clear benefit is the additional protection that may be offered by the correct vaccine, but they should be alerted to the potential increased risk of a local or systemic reaction. Although there is no data available on the safety and effectiveness of administering a second flu vaccine shortly after the first in adults, this advice is based on general principles of vaccination, experience of flu revaccination following cold chain and administration incidents and information about the high dose flu vaccine used in the United States (which contains four times the amount of antigen that is in a single dose of QIV or aTIV);
  • If a decision is made to offer the vaccine the patient should have received, it is recommended that this is done as soon as possible after the first dose was given and ideally within a week. This will enable protection to be made as soon as possible. It can, however, still be given if more than a week has elapsed.

This advice also applies to those who have inadvertently been given non-adjuvanted trivalent influenza vaccine (TIV).

Categories: National News

Epipen Junior Shortage – Patient Letter

PSNC News - 15 October 2018 - 12:52pm

Following the ongoing supply issues with Epipen Junior 150mcg which are expected to last for several months, NHS England has today issued a letter (shared through GPs) to all patients and users of Epipen Junior with further advice.

To view the letter click here.

The letter can be used by pharmacies to support patients and make them aware of the latest advice which includes some of the following recommendations:

  • Children should avoid known allergens as much as possible.
  • In the event of a severe allergic or anaphylactic reaction, the child must be given their adrenaline straight away and 999 contacted as usual
  • Expiry dates on a pen refer to the end of the stated month for example ‘Expiry date: November 2018’ refers to 30th November 2018
  • An out-of-date pen can still be used – It might give a lower dose of adrenaline but it is not dangerous and is better than no immediate treatment
  • Alternative pens may be supplied for example Jext or Emerade and the instructions for use differ between different devices
  • A child weighing more than 25kg (4 stone) should be prescribed a 300mcg adrenaline pen, even though this may fall outside the product licence for Jext and Emerade
  • When ordering replacement pens, priority will be given to those with out-of-date pens so patients should not seek to replace their pen until it has reached its expiry
  • The letter includes links to training videos for each device

 

Categories: National News

Quality Payments – How to become a Dementia Friend

PSNC News - 15 October 2018 - 9:43am

This PSNC Briefing provides an overview of how to achieve the Dementia Friends quality criterion of the Quality Payments Scheme for the February 2019 review point.

PSNC Briefing 054/18: Quality Payments – How to become a Dementia Friend

If you have any queries on this PSNC Briefing or you require more information, please contact Zainab Al-Kharsan, Service Development Pharmacist.

To browse other PSNC briefings on services and commissioning click here.

View Article…

Categories: National News

Ask PSNC: Flu FAQs

PSNC News - 15 October 2018 - 9:05am

The team at PSNC has received a number of queries on the NHS Flu Vaccination Service 2018/19. Below are some of the questions asked in recent weeks.

Q. Can patients living in sheltered accommodation receive an off-site flu vaccination?
Yes, if the patient falls into one of the eligible groups as listed in Annex A of the service specification they can receive an off-site vaccination if they live in sheltered accommodation as this is their place of residence.

Q. We are a distance selling pharmacy without a consultation room; can I provide the Flu Vaccination Service to patients in their own homes?
No. Community pharmacy contractors must have a consultation room that meets the requirements outlined in the service specification, even if they intend to vaccinate off-site only.

Q. If a web-based platform such as Sonar or PharmOutcomes is available in my area for the Flu Vaccination Service, do I have to use it?
PSNC would strongly encourage the use of web-based platforms, such as Sonar or PharmOutcomes if they are available in your area as this means that the local NHS England team and/or the LPC will be able to access local data to monitor uptake of the service. It also means the GP notification form may be able to be sent electronically, taking away the need to print out a GP notification form and deliver or fax to the GP surgery.

Q. If a patient has already received a seasonal flu vaccine this year (e.g. in January 2018), do they still need a vaccine during this flu season (e.g. September 2018 – March 2019)?
Yes. If the patient received the vaccine produced for the 2017/18 season, then they will still need a dose of the vaccine produced for the 2018/19 season as the vaccine for 2018/19 contains different strains from the previous year.

In addition, the protection gained from flu vaccine is thought to last for one season only so those eligible to receive the vaccine are recommended to have it every year to ensure on-going protection.

Q. A patient has requested a flu vaccination, but they seem generally unwell; can they receive the vaccine?
Vaccination may be postponed in those who are acutely unwell until they have fully recovered. This is to avoid confusing the differential diagnosis of any acute illness by wrongly attributing any signs or symptoms to the adverse effects of the vaccine.

Further FAQs can be found at: psnc.org.uk/fluFAQs

Categories: National News

MPs publish report on generic medicine price increases

PSNC News - 12 October 2018 - 10:14am

The Public Accounts Committee (PAC) has today published a report of its investigation into price increases for generic medicines, calling on the Department of Health and Social Care (DHSC) to make plans to help address the impact of these price rises on the NHS by the end of the year.

The unexpected increase in prices of certain generic medicines last year was first investigated by the National Audit Office, and then by the PAC, which is a cross-party group of MPs who scrutinise the value for money of public spending. The Committee held an inquiry to which PSNC gave both written and oral evidence. PSNC highlighted the impact that the generic shortages and price rises were having on community pharmacies, as well as describing all the work that pharmacy teams had done to ensure that no patients were harmed.

The PAC’s report on its inquiry states that the NHS had to spend additional time, money and effort to source medicines affected by price rises in 2017, noting “the extra efforts that pharmacies had to make to get medicines that were in short supply”.

The report references the new powers available to DHSC to collect information about the generics market (introduced as part of the Health Service Products (Provision and Disclosure of Information) Regulations) and the MPs have asked the Department to set out what actions it will be able to take to address future price rises and what skills and capacity it needs to put in place to make use of the new powers.

The Department has also been asked to set out its plans for maintaining the supply of medicines both before and after Brexit, and the MPs recommended that DHSC and NHS England should establish clear and timely information flows about generics price or supply issues, including with local commissioners and clinicians.

PSNC has been in close contact with DHSC to monitor the generics pricing situation and to ensure that officials are aware of the impact on community pharmacies.

Since the beginning of 2018 we have been seeking a fairer concessions system that is more responsive to price rises to ensure that community pharmacy contractors do not carry unreasonable costs on behalf of the NHS.  PSNC continues to work with DHSC to try and reduce the burden that generic medicine shortages place on community pharmacies.

Read PSNC’s written submission to the Public Accounts Committee

Read the transcript of the evidence session on July 4th (or watch a video of the evidence session here)

The inquiry report by the PAC recommends that DHSC:

  • Share its plan for maintaining the supply of medicines pre- and post-Brexit;
  • Establish clear and timely information flows between itself, NHS England and local bodies to identify and inform about generic medicine supply and/or pricing issues;
  • Update its guidance to CCGs on contingency planning to mitigate the financial impact of unforeseen price increases;
  • Set out the full range of actions it can take to addresses rises in the price of generic medicines, and what skills and capacity it has put in place to use its new powers; and
  • Ensure that the first annual review of the Health Service Products (Provision and Disclosure of Information) Regulations includes an assessment of how well the provisions are working.

Read the PAC’s report on price increases for generic medicines in full.

Mark Burdon, an independent community pharmacy contractor and PSNC Regional Representative for the North East and Cumbria, said:

“PSNC was pleased to assist the PAC in this inquiry and it is good to see that MPs recognise the important role that community pharmacy teams play in ensuring that patients do get their medicines when they need them.

As we know and is made clear in the report, generic medicines shortages are a very complex global issue and with Brexit on the horizon that is likely to remain the case. We would now like to see the Department of Health and Social Care working with us to develop a fairer and more responsive concession system that ensures that hard working pharmacies do not face unfair risks, and that the impact of supply problems is not passed on to them or their patients.”

Categories: National News

MHRA Drug Safety Update – October 2018

PSNC News - 11 October 2018 - 3:39pm

Date issued: 11th October 2018

A new Medicines and Healthcare products Regulatory Agency (MHRA) Drug Safety Update (Vol 12 Issue 3, October 2018) has been published and includes articles on:

  • Rivaroxaban (Xarelto▼) after transcatheter aortic valve replacement: increase in all-cause mortality, thromboembolic and bleeding events in a clinical trial.
  • Ritonavir-containing products: reports of interaction with levothyroxine leading to reduced thyroxine levels.
  • Ponatinib (Iclusig▼): reports of posterior reversible encephalopathy syndrome.
  • Transdermal fentanyl patches: life threatening and fatal opioid toxicity from accidental exposure, particularly in children.

To see the latest MHRA Drug Safety Update in full, visit the GOV.uk website.

Categories: National News

Community pharmacy leadership training funded by PhIF

PSNC News - 11 October 2018 - 9:00am

Community pharmacists and pharmacy technicians are being encouraged to apply for free leadership training.

Fully funded through the Pharmacy integration Fund (PhIF), Health Education England (HEE) is offering a range of training courses to help community pharmacy professionals improve their clinical and leadership skills.With courses available across the country, this opportunity is open to all pharmacists and pharmacy technicians working in a community setting. HEE have produced two briefings which provide further information on the training available.

The briefings, which contain details of how to sign up, can be viewed via the links below:

PhIF training for community pharmacists

PhIF training for community pharmacy technicians

Categories: National News

Adrenaline for anaphylaxis kits – a reminder to health care professionals

PSNC News - 10 October 2018 - 2:59pm

Following the recent Department of Health and Social Care Supply Disruption Alert on EpiPen® and EpiPen Junior® adrenaline auto-injectors (AAIs) that advises conserving supplies for patients who truly need them, NHS Improvement has issued a reminder letter to community pharmacies and GP practices that healthcare professionals can use adrenaline ampoules to treat anaphylactic reactions.

The letter states that some healthcare professionals may be holding EpiPens® or other AAIs, in preference to adrenaline ampoules to treat anaphylaxis; however, this should not be necessary. All healthcare professionals providing services where anaphylaxis treatment may be required, including but not exclusive to the Flu Vaccination Service, should have the competency to draw up and administer adrenaline from ampoules with a normal syringe and needle.

NHS Improvement has therefore advised that when adrenaline needs to be replaced in anaphylaxis kits, that adrenaline ampoules are used (dosing charts, needles and syringes should also be included) rather than AAIs.  This will reduce the reliance on AAIs and therefore preserve essential EpiPen® stocks for patients, parents, carers, teachers, etc. who, as lay persons, cannot be expected to administer adrenaline via a needle and syringe.

Read the NHS Improvement Letter: Adrenaline for anaphylaxis kits – a reminder to health care professionals

Frequently asked questions:

Q. What would normally be contained in an anaphylaxis pack?
The Green Book states that an anaphylaxis pack normally contains two ampoules of adrenaline (epinephrine) 1:1000, four 23G needles and four graduated 1ml syringes, and Laerdal or equivalent masks suitable for children and adults. The mask for children would only be required if the pharmacy is providing a vaccination service to children; the Advanced Service does not include the vaccination of children.

Q. If a pharmacist administers adrenaline in an emergency to treat anaphylaxis, is a PGD required to authorise the administration?
No. Regulation 238 of the Human Medicines Regulations 2012 allows adrenaline to be administered by anyone for the purpose of saving life in an emergency.

Categories: National News

Book now for our FMD webinar

PSNC News - 9 October 2018 - 3:02pm

PSNC will be holding a webinar about the Falsified Medicines Directive (FMD) on Tuesday 30th October at 7.00pm.

On the night Alastair Buxton, PSNC’s Director of NHS Services, will explain how the introduction of FMD will affect the day-to-day working of community pharmacy teams and what they need to do to prepare.

Webinar Details When is it?
Tuesday 30th October at 7.00pm

Who should sign up?
This webinar is of vital importance to all contractors as this new legislation affects all pharmacies. Find out more about FMD at: psnc.org.uk/FMD

How do I register?
Please sign up here

As well as describing the new processes that FMD will introduce, Alastair will also outline the guidance and resources developed by the UK FMD Working Group for Community Pharmacy, plus where to find further information and support.

 During the 60-minute webinar there will also be an opportunity for viewers to ask questions.

With the implementation of FMD just four months away (February 2019), this webinar will provide contractors and their teams with key actions for them to undertake in advance of that date.

Register for our FMD webinar

 

Unable to attend the webinar?
It is still worth registering for the event so that you will be sent a link to the recorded version of the webinar as soon as it is available.

Categories: National News

Dispensing & Supply monthly update (September 2018)

PSNC News - 9 October 2018 - 11:35am

This briefing is part of a series issued regularly by PSNC to inform pharmacy contractors and pharmacy teams on monthly Drug Tariff changes, commonly asked questions and articles regarding dispensing and supply.

This briefing can also be found in the Dispensing & Supply section of September’s CPN.

PSNC Briefing 053/18: Dispensing & Supply monthly update (September 2018)

This month we also published Dispensing Factsheet: No Charge and Multi-Charge Items in CPN.

If you have any queries on this PSNC Briefing or you require more information, please contact the Dispensing & Supply Team.

To browse other PSNC briefings on dispensing and supply click here.

View Article…

Categories: National News
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