A-E

We know most people are respectful and appreciative of their local pharmacy and the staff who work there. However, stress like the cost of living crisis or pressures like rushing to get to the pharmacy before it closes, national stock shortages etc. can influence how a patient acts toward pharmacy staff. Communicating with people exhibiting unacceptable behaviour can be very challenging.

Two poster documents have been developed by the NPA Marketing team to support Pharmacy branches. Both carry the NHS logo. Here they are for you to download, print and display ZERO Tolerance Poster A4  ZERO Tolerance poster A5.

The antibiotic formularies across Surrey and Sussex can be found on the following links:

• For Surrey Heartlands Pharmacies, information here.
• For Frimley Pharmacies, information here.
• For Sussex Pharmacies, information here.

A joint LPC/LMC statement on the use of MCA’s is available as available here.

Requests for Multi-compartment dosage aids (MCA’s/dosette/nomad/blister packs)

• The prescriber is responsible for determining the number of days supply on a prescription. For patients requiring frequent medication changes, the prescriber may decide to prescribe in 7 day quantities, to minimise the amounts of waste that would occur on medication changes. This would be a clinical decision of the prescriber. If 28 day prescriptions have been issued the pharmacy is not obliged to amend what has already been dispensed when a change occurs. A whole new set of prescriptions should be issued with a supply of a new compliance aid (discarding the previous one and its contents) following the pharmacy Standard Operating Procedure. Once medicines have been dispensed by a pharmacist, whether into a MCA or in manufacturer’s cartons, then no further changes to what has been dispensed should be made by a pharmacist. The NHS terms of service for pharmacies does not require pharmacists to modify previously provided MCA’s.
• The community pharmacist is the individual who makes the decision on the reasonable adjustment under the Equality Act to enable a patient to take their medication correctly. This could include large print labels, easy to open tops, tick charts, MCA’s etc. The pharmacist would assess the patient and decide what adjustment would be suitable. The provision of MCA’s is not an essential service under the pharmacy contract and there is no renumerated service in Surrey or Sussex for the provision of a MCA.

In a statement published on the 22^nd June 2022, the Royal Pharmaceutical Society (RPS) said that while MCAs are “often viewed as a solution” to people experiencing obstacles when taking their medicines, “the limited evidence base suggests a lack of patient benefit outcomes and sometimes they can cause harm”. The RPS pointed to other solutions to help with medicine use. 

We have put together this short document on common issues that are raised during a CPAF visit. Please use this document to support your pharmacy in complying with the terms of the Community Pharmacy Contractual Framework (CPCF).

The Community Pharmacy Patient Safety Group provides a forum for community pharmacy organisations, competitors in a commercial sense, to openly share and learn from each other when things go wrong, as well as from other sectors and industries.

The Patient Safety Group is made up of the 16 largest community pharmacy organisations, as well as the Independent Pharmacies Association (IPA), National Pharmacy Association (NPA) and Numark to represent independent and small multiple pharmacies. Meetings are attended by the organisations Medication Safety Officer (MSO). Most of these MSOs are the Superintendent Pharmacist, or a senior member of their team.

The CD Accountable Officer for the South-East NHSE Region is Julie McCann. The CD AO office can be contacted on: england.southeastcdao@nhs.net

For any of the following:

• Report an incident
• Report a concern
• Complete a controlled drug declaration
• Apply to be a temporary authorised witness to witness the destruction of controlled drugs
• Record controlled drugs that have been destroyed

The link to the site is https://www.cdreporting.co.uk/nhs/account/signing

Pharmacy owners who want to change their core contractual hours (core opening hours) must apply to the ICB. There are 2 application routes.

Existing application route

The existing application route is defined in para 24(1) of Schedule 4 of the PLPS regulations, which applies to applications to reduce the total number of core opening hours, or to rearrange the existing number. This route is a 2-part regulatory test, which is:

▪ First, whether the proposed changes to core opening hours maintain as necessary the existing level of service provision and, if not,

▪ Second, whether they will maintain a sustainable level of adequate provision in circumstances where this is unnecessary or unrealistically achievable.

This application route considers the needs of people in the area, and the opening hours and provision of pharmacy services by the applicant’s pharmacy and other pharmacies in the area.

New application route

The new application route is defined in para 26(2ZB) of Schedule 4 of the PLPS regulations, which applies to applications to rearrange the existing number of core opening hours (the total number of weekly hours must remain the same). This route has a single regulatory test, which states that NHSE (in practice, the ICB) must:

‘… seek to ensure that the people who are accustomed to accessing pharmaceutical services at the pharmacy premises are likely to benefit from the changes because, overall, they would be more likely to access those services at those premises during the proposed core opening hours than during the existing core opening hours.’

This application route considers the needs of people who are accustomed to accessing pharmacy services at the applicant’s pharmacy, and the opening hours and provision of pharmacy services by the applicant’s pharmacy.

What to include with applications

With both the new and existing application routes, pharmacy owner applicants will need to:

▪ Specify which application route applies, otherwise, the application will be invalid.

▪ Provide the ICB with such information as may reasonably be requested (i.e., provide all relevant information when the application is made).

▪ Consider what evidence is relevant to their application, and depending on the application route, this could include, for example:

• Any changes to local GP practice hours and the opening hours of nearby pharmacies.
• Information about the demand for and use of the pharmacy’s services – patient surveys, levels of use – for prescriptions/requests for advice/OTC medicines sales/services e.g. Pharmacy First – for the relevant days/times. (e.g. the proposed core opening hours and the existing core opening hours and other relevant hours – if Saturday afternoon is quiet with few patients, as well as showing another time in the week better meets the needs of patients, you may need to show that some of the small number of patients in the afternoon could have come in the morning).
• The distance from the applicant’s pharmacy to nearby pharmacies, including any 100 (72) – hour pharmacies, or other pharmacies, their opening days and times, the services they offer, and how patients can travel to them.
• Evidence of the economic viability of the current opening hours, which can be considered alongside evidence of patient demand for the pharmacy’s services during these hours (the Pharmacy Manual will be amended to state this or something similar).
• Other evidence relevant to the regulatory test.

Note: for an application under the new application route to be granted, people accustomed to using the pharmacy must be likely to benefit from the changes because, overall, they are more likely to access pharmacy services at the premises during the proposed hours than during the existing hours. An application could be about moving a set number of core hours or a broader change to core opening hours.

CPE have provided an information page, which addresses some key information relating to the changes to opening hours applications as part of the CPCF settlement.

We have put together this short document on common issues that are raised during a CPAF visit. Please use this document to support your pharmacy in complying with the terms of the Community Pharmacy Contractual Framework (CPCF).

The Discharge Medicines Service (DMS) has complex reporting requirements that need to be completed at the end of each month. These requirements see contractors having to enter a lengthy data set for each DMS intervention completed into the Manage Your Service (MYS) portal. If your pharmacy uses PharmOutcomes, this guide from Pinnacle, will help you create a bespoke report to help with your data return. PharmOutcomes User Guide – DMS Reporting. The report effectively converts your DMS records to the format aligned with the requirements of the MYS portal. This will reduce workload for the pharmacy team members.

To view a Surrey DMS webinar click here

To view a Sussex DMS webinar click here

While pharmacy teams will be familiar with this service already, CPSS, along with our hospital colleagues put together a short ‘refresher video’ for the service.

Please feel free to watch the refresher video on the Discharge Medicine Service here.

Slides for the video can be found here.

All acute hospitals in Surrey and Sussex are live with DMS except for Surrey and Sussex Healthcare NHS Trust which is still awaiting a go live date.

From 31st July 2023, it is a Terms of Service requirement for each NHS community pharmacy owner to have a business continuity plan for a temporary suspension of service (closure) due to illness or other reason beyond their control, and to action this when necessary.

Community Pharmacy England has developed a business continuity plan template for use by contractors; this includes planning for business continuity during periods of disruption to IT services and notices for managing a temporary closure.

Business Continuity Planning – Community Pharmacy England (cpe.org.uk)