Medicines and Prescriptions

NHS Community Pharmacist Consultation Service IT licence – extension to 30 September 2021 25/1/2021

Additional funding has been agreed so that all regions can arrange an additional six months for the community pharmacy CPCS IT licence for the period 1 April 2021 – 30 September 2021, on behalf of contractors.

Since March 2020, Pharmacy Integration Fund resource has been provided to regions to fund the community pharmacy CPCS IT licence to allow contractors to offer the service without additional IT costs being incurred.

This funding was due to end on the 31 March 2021, after which point contractors would be required to purchase their own IT from the range of system suppliers in the market offering CPCS functionality. This change is part of a package of interventions that NHSE&I has made to support contractors during the pandemic. Further information will follow locally from NHSE&I regional teams.

New standards for initial education and training of pharmacists introduced 25/1/2021

The General Pharmaceutical Council has published new standards for the initial education and training of pharmacists, which have been welcomed in a joint letter from the Chief Pharmaceutical Officers of Great Britain.

The implementation of these new standards will transform the education and training of future pharmacists, so they are able to play a much greater role in providing clinical care to patients from much earlier on in their careers and they will be independent prescribers from their first day on the register.

The changes will help meet the increasing demand for high quality professional pharmacist skills from patients and the NHS. To ensure the whole profession is able to meet this demand, it is also important that all the current professional workforce has the opportunity to develop existing skills and experience as required, so that they too can practice at this enhanced clinical level. 

Flu vaccinations in community pharmacy 25/1/2021

Thank you for the work you continue to do in community pharmacies in vaccinating patients for flu. The Department of Health and Social Care (DHSC) has confirmed that community pharmacies can now offer private patients and those covered by occupational health schemes a vaccine that has been centrally supplied, alongside NHS eligible cohorts. This is reflected in updated DHSC stock guidance for pharmacies.

Please retain some vaccines specifically for NHS eligible cohorts, as some may come forward later in the season, such as newly pregnant women or others who have not received their vaccine yet.

Community pharmacy urged to continue flu vaccination programme 21/1/2021

With community pharmacy vaccinating more people than ever before against the flu, contractors are urged to continue their efforts by encouraging as many as possible to get the flu jab to protect vulnerable people against co-infection of flu and COVID-19 and to reduce vaccine wastage.

Tips to help encourage uptake include:

• proactively targeting people coming into the pharmacy to encourage them to get the flu jab if they haven’t already had it;
• targeting people who collect prescriptions or call the pharmacy for advice, to ask if they have had the jab; and
• briefing team members about what the flu vaccine involves and why it is important, ensuring they are confident about booking appointments.

COVID-19 testing kits available from community pharmacy pilot sites in Bradford 14/1/2021

NHS Test and Trace, working with NHSEI and the LPC, is making Polymerase Chain Reaction (PCR) swab tests available at selected community pharmacies in Bradford through a four-week pilot which started on 4 January. The pilot aims to improve ease and access to COVID-19 testing by making test kits available at community pharmacies for eligible symptomatic individuals. It is also testing the operational feasibility of providing this service nationally. The test must be collected from the pharmacy by a representative without symptoms on behalf of a symptomatic patient. The test will be self-administered and then posted off via Royal Mail priority postbox. Click here to see pharmacies taking part.

Pharmaceutical Services Negotiating Committee (PSNC) statement 14/1/2021

The PSNC have released a statement about on how the Department of Health and Social Care, NHS England and NHS Improvement and the community pharmacy bodies have agreed to work together on plans to ensure that community pharmacies are used to maximum effect in the COVID-19 vaccination programme.  

Medicines delivery service commissioned for Clinically Extremely Vulnerable patients  11/1/2021

Following the Government’s announcement of the national lockdown and advice for all Clinically Extremely Vulnerable (CEV) patients to recommence shielding, the Community Pharmacy Home Delivery Service and the Dispensing Doctor Home Delivery Service has been commissioned from 5 January 2021 to 21 February 2021 (inclusive) for all CEV patients living in England.

This announcement supersedes the announcements made in December for this service provision to Tier 4 areas.

Pharmacies and dispensing doctors across England will be required to ensure those on the Shielded Patient List across the country can receive their prescription medicines and appliances at home. These contractors will receive the essential/mandatory service payments and can claim a fee for making a delivery to eligible patients during this period as set out in the service specification.

New pilot launched to identify people with undiagnosed high blood pressure  11/1/2021

Community pharmacies in Chesterfield, Dudley and West Birmingham are piloting a new service to identify people with undiagnosed hypertension (high blood pressure) to help prevent cardiovascular disease (CVD) as part of the NHS Long Term Plan.

Anyone visiting a pharmacy who appears to be over 40, will be offered a free, on the spot blood pressure check. Those with suspected hypertension will be offered ambulatory monitoring or referred to their GP where appropriate, for ongoing care to manage their blood pressure.

Further pilot sites are expected to start in early 2021.The pilot will be evaluated to inform potential inclusion in the Community Pharmacy Contractual Framework.

New pilot launched to support hospital patients to continue to stop smoking after discharge 7/1/2021

A new pilot in the Oldham area is testing the referral of patients to community pharmacy, to continue the stop smoking journey they started in hospital, as part of the NHS Long Term Plan commitments.

People can choose the community pharmacy they wish to be referred to on discharge from hospital. After referral, the pharmacist or trained pharmacy team member will arrange an initial consultation to discuss their quit progress and review the nicotine replacement therapy (NRT) or medication prescribed by the hospital team and make any necessary adjustments.

Further pilot sites are expected to start in early 2021.The pilot will be evaluated to inform potential inclusion of a smoking cessation service in the Community Pharmacy Contractual Framework in the near future.

Support for Community Pharmacy sites on Pinnacle, Outcomes4Health point of care system webinar - Thursday 7 January 2021, 7-8pm 

A webinar has been arranged for community pharmacy sites going live in January to demonstrate to their nominated administrators the Pinnacle, Outcomes4Health point of care system. The focus of the webinar will be to learn how to navigate the landing page to set up users and identify an individual to be vaccinated. This session will demonstrate data capture in sites and to demonstrate administrator functionality. 

A MS Teams Live link to join is available via FutureNHS. You do not need to pre-register.

Deployment of COVID-19 Vaccine Oxford/AstraZeneca for pharmacy teams 7/1/2021

This letter sent on 31 December 2020 from Keith Ridge, Chief Pharmaceutical Officer for England, outlines the implications for governance, handling and preparation of the vaccines for pharmacy teams.    

C1023 -  Medicines Delivery Service - Nationwide Commissioning Announcement 7/1/2021

Please see the attached (2) C1023 – Medicines Delivery Service – Nationwide Commissioning Announcement.

Local Enhanced Service for Community Pharmacy Vaccination  4/1/2021

NHS England & Improvement has had a great response from community pharmacy teams to deliver the vaccination and look forward to seeing the first pharmacy local vaccination services. We wrote to those pharmacy contractors who applied as part of the designation process on 18 December, published the Local Enhanced Service for Community Pharmacy and have now written to the designated sites rolling out the vaccine. To support community pharmacy on the vaccine rollout, we held a webinar on 23 December 2020. The slides and recording can be viewed on FutureNHS

Self Care Week 16 – 22 November 16/11/2020

Self-care week is an opportunity to promote self care messages and help people to ‘live self care for life’. NHSE are encouraging community pharmacies across the country to support their communities to take care of their health and wellbeing through self care.

The self-care forum has provided resources for download which include posters, fact sheets, leaflets and a ‘last minute activity guide for pharmacists’.

Medicines Management  16/11/2020

The COVID related information sources document can be accessed on the BEST website https://best.barnsleyccg.nhs.uk/COVID19-medicines-and-prescribing-information.htm 

Self Care Week 16 – 22 November  12/11/2020

COVID-19 vaccination in community pharmacy 12/11/2020

Importance of flu vaccinations for people with a learning disability   12/11/2020

Community pharmacy teams are being asked to ensure people with a learning disability (and autistic people in an at-risk group) receive their flu vaccinations as a priority cohort alongside people over 65 and pregnant women. Particular attention is being paid this year to making sure that everyone with a learning disability who requests their free flu vaccination within a community pharmacy setting receives one. New easy read resources have been produced to help with communications.

The National Health Service (Charges and Pharmaceutical and Local Pharmaceutical Services) (Amendment) Regulations 2020 - changes to the terms of service for pharmacy contractors 12/11/2020

A number of changes to the terms of service for pharmacy contractors came into effect on 9 November 2020.  These include requirements regarding accessing the Summary Care Record, updating NHS website and Directory of Services profiles, accessing NHSmail and facilitating remote access to services. Contractors must register their premises specific NHSmail account with the Medicines and Healthcare products Regulatory Agency (MHRA) to receive Central Alerting System (CAS) notifications.  

NHSE have managed a bulk upload of premises specific NHSmail accounts to the MHRA CAS system and will be following up outstanding pharmacies who will have a requirement to register manually. They will be producing further guidance on these changes. 

Medicines Management  12/11/2020

The COVID related information sources document can be accessed on the BEST website https://best.barnsleyccg.nhs.uk/COVID19-medicines-and-prescribing-information.htm 

Home delivery of medicines service commissioned  9/11/2020

During the national restrictions people who are clinically extremely vulnerable are advised by the Government not to go to a community pharmacy. Therefore a letter has been sent to community pharmacy providers to confirm that the Community Pharmacy Home Delivery Service and the Dispensing Doctor Home Delivery Service will be commissioned in accordance with the Home delivery of medicines and appliances during the COVID-19 outbreak: service specifications and guidance for all patients on the Shielded Patient List in England from 5 November 2020 until 3 December 2020. This means that all pharmacies and dispensing doctors in England will again be required to ensure patients on the Shielded Patient List receive their medicines at home. 

Prescribing and dispensing medications during restrictions  9/11/2020

Some patients may be anxious about access to their medications and appliances during the lockdown, however we kindly ask all prescribers and those dispensing medicines and appliances to be mindful of the need not to over-prescribe (through extending the normal length of prescriptions to patients) or to pull forward scripts, as this can create issues with supplies further down the line. Please reinforce this message with patients if necessary and reassure them that they will still be able to access their medicines and appliances during the lockdown. 

Medicines Management   9/11/2020

The COVID related information sources document can be accessed on the BEST website https://best.barnsleyccg.nhs.uk/COVID19-medicines-and-prescribing-information.htm 

DHSC guidance for community pharmacies on accessing DHSC centrally supplied flu vaccines 5/11/2020

Medicines Management   5/11/2020

The COVID related information sources document can be accessed on the BEST website https://best.barnsleyccg.nhs.uk/COVID19-medicines-and-prescribing-information.htm 

DHSC guidance for community pharmacies on accessing DHSC centrally supplied flu vaccines  2/11/2020

Please see DHSC guidance attached (attachment 6)  for community pharmacy in England on accessing DHSC centrally supplied flu vaccines.

NHS Test and Trace advice  2/9/2020

We understand that some pharmacies are being impacted by the need for staff to self-isolate. If pharmacy staff have been in contact with a COVID-19 positive case outside of work they must follow the self-isolation guidance. 

It is important to maintain a COVID-19 secure environment throughout the working day by following IPC guidance, including maintaining social distancing, working behind screens, regular handwashing and wearing appropriate PPE. Thought should also be given to staff rest breaks and minimising the possibility of transmission at this time.

If a member of the pharmacy team tests positive and there is a risk to the provision of pharmaceutical services then advice regarding the individual circumstances should be sought from the local Health Protection Team (specific individual circumstances will be considered and advice may therefore appear to differ). You should also contact your NHS England and NHS Improvement Regional Office regarding possible disruption to provision of pharmaceutical services.

If a member of staff receives a negative test they do not need to self-isolate as long as:

• everyone they live with who has symptoms tests negative
• everyone in their support bubble who has symptoms tests negative
• they were not told to self-isolate for 14 days by NHS Test and Trace or the NHS COVID-19 App – if they were, see what to do if you've been told you've been in contact with someone who has coronavirus
• they feel well – if they feel unwell, they should stay at home until they are feeling better. 

Please also find attached (attachment 1a and 1b) local COVID-19 Outbreak Management Plan for Primary Care, Community Pharmacy and Optometry practices and also a Public Health England flow chart regarding what to do if you have a case of COVID-19 in your setting.

Supply issue with Haloperidol 5mg/5mL oral solution, Nalcrom 100mg capsules, H2-antagonists and Zonisamide 2/11/2020

lease find attached a Medicines Supply Notifications (attachments 4a-4d) for Haloperidol 5mg/5mL oral solution sugar free, Nalcrom® (sodium cromoglicate) 100mg capsules, H2-antagonists (cimetidine, famotidine and nizatidine) and Zonisamide capsules: 

Medicine	Out of stock until	Alternatives
Haloperidol 5mg/5mL oral solution sugar free	March 2021	Alternative preparations and unlicensed specials remain available.
Nalcrom® (sodium cromoglicate) 100mg capsules	Late November 2020	Unlicensed imports have been sourced.
H2-antagonists (cimetidine, famotidine and nizatidine)	Please see MSN for further information	Cimetidine oral solution remains available. Famotidine 20mg and 40mg tablets are available in limited supplies. Unlicensed preparations of Cimetidine tablets, Famotidine tablets and Nizatidine 150mg capsules have been sourced.
Zonisamide 25mg, 50mg and 100mg capsules	Please see MSN for further information	Alternative manufacturer’s Zonisamide capsules remain available.

There have also been changes to the resupply dates of the medicines listed below. These communications were previously circulated via the NHSE&I commissioning routes. 

Original MSN reference	Date of original MSN/SDA	Supply issue	Resupply date originally communicated	Updated resupply date as of w/c 26th October 2020
MSN/2020/031	10/06/2020	Prednisolone 5mg suppositories	End July 2020	Delayed until January 2021

Please note that supply issues that have been categorised as tier 1 or 2, DHSC and the MSRG have requested that the NHSE&I commissioning routes are used to reach community pharmacy, GP practices and health and justice teams.  More serious supply issues are communicated via the Central Alerting System for action.

If you have any queries please contact: DHSCmedicinesupplyteam@dhsc.gov.uk

Childhood Influenza Enhanced Service 2020/21 – Update 2/11/2020

The updated flu letter issued on 5 August indicated that an inactivated vaccine may also be offered to those children whose parents refuse the live attenuated influenza vaccine (LAIV) due to the porcine gelatine content. 

From mid-November, practices are able to offer the alternative vaccine as part of the current childhood influenza vaccination programme enhanced service 2020/21 for those 2 and 3 year olds who are not at risk, whose parents request the alternative vaccine. Practices will be able to claim an item of service fee for administering the alternative vaccine 

Medicines Management   2/11/2020

The COVID related information sources document can be accessed on the BEST website https://best.barnsleyccg.nhs.uk/COVID19-medicines-and-prescribing-information.htm 

Free CPD-accredited virtual diabetes event  29/10/2020

The NHS Diabetes Programme is working in partnership with Diabetes Professional Care (DPC) Virtual 2020, a free to access online event, to delve into the unforeseen 2020 diabetes care landscape from 11-13 November 2020.  Bringing the entire MDT community together to share experiences and learnings from the last 12 months, hear from 80+ speakers at 105+ CPD-accredited sessions about everything from the latest NHS England and NHS Improvement updates to practical training for supporting people living with diabetes and related conditions.

Ask Your Pharmacist Week resources  29/10/2020

Community pharmacy teams are invited to prepare for Ask Your Pharmacist Week which takes place on 2-9 November 2020. Organised by the National Pharmacy Association and supported by NHS England and NHS Improvement, the theme this year is ‘Your local pharmacy in the NHS family’. The aim is to build public understanding of the role of community pharmacy within the NHS consistent with the NHS Long Term Plan commitment to make greater use of community pharmacists’ skills and opportunities to engage patients. Access free campaign materials.

Changes to regulations  29/10/2020

Amendments to NHS regulations were laid by the Department of Health and Social Care on 20 October 2020 to introduce changes to the Terms of Service for community pharmacy contractors. These are due to come into force on Monday 9 November 2020. The changes include additions related to the COVID-19 pandemic, including a Pandemic Treatment Protocol, remote access to services and flexible provision for flu and coronavirus vaccination or immunisation services. A range of new items already agreed as part of the five-year Community Pharmacy Contractual Framework are also covered, including: the introduction of the Discharge Medicines Service, as a new essential service from 1 January 2021; and a requirement for all pharmacies to meet the Healthy Living Pharmacy Level 1 measures.

Community pharmacy webinar – Thursday 12 November, 6pm-7pm  29/10/2020

Community pharmacy teams across England are being invited to register to join the next national webinar with Dr Keith Ridge, Chief Pharmaceutical Officer, Director of Primary Care Ed Waller, and senior leads from the NHS England and NHS Improvement flu team and from NHS Test and Trace. Please register online and we will share the MS Teams details with you.

Updated Standard Operating Procedure   29/10/2020

As you will be aware, over recent weeks there has been a sustained increase in community transmission of COVID-19 in England, although there remains significant variation across localities. An updated version of the Standard Operating Procedure (SOP) for community pharmacy has been published and includes the latest guidance on infection prevention and control, PPE and NHS Test and Trace to support management of the second wave.

Medicines Management  29/10/2020

The COVID related information sources document can be accessed on the BEST website https://best.barnsleyccg.nhs.uk/COVID19-medicines-and-prescribing-information.htm

Supply issue with Salazopyrin En-tab 500mg tablets, Fluoxetine 30mg capsules and Konakion MM Paediatric 2mg/0.2ml ampoules  26/10/2020

Please find attached a Medicines Supply Notification for Salazopyrin En-tab 500mg tablets, Fluoxetine 30mg capsules and Phytomenadione (Konakion MM Paediatric) 2mg/2ml ampoule 

Medicine	Out of stock until	Alternatives
Salazopyrin En-tab 500mg tablets   Fluoxetine 30mg capsules   Phytomenadione (Konakion MM Paediatric) 2mg/0.2ml ampoules	Early December 2020 Mid December 2020 Early December 2020	Generic preparation remain available Alternative strengths remain available Unlicensed preparations available

There have also been changes to the resupply dates of the medicines listed below. These communications were previously circulated via the NHSE&I commissioning routes. 

Original MSN reference	Date of original MSN/SDA	Supply issue	Resupply date originally communicated	Updated resupply date  as of w/c 21st October 2020
MSN/2020/039	08/07/2020	Pregaday Tablets	October 2020	Late November 2020

If you have any queries please contact: DHSCmedicinesupplyteam@dhsc.gov.uk

Flu vaccine in people aged 65 years and over  26/10/2020

The aTIV flu vaccine should be offered to people aged 65 years and over as this is the preferred vaccine in this age group.   If a pharmacy or GP practice has run out of aTIV the patient can be advised to access aTIV from another provider whilst supplies remain in the area (as they currently do).   Guidance has been issued which advises how GP practices can order/pre-order additional vaccines from central DHSC stock where there is a genuine shortfall.   Community pharmacy guidance is due to be issued.  If no aTIV is available locally and it is unlikely that further supplies will be available, the general use of QIVc in this group of patients would then be appropriate.  

Medicines Management  26/10/2020

The COVID related information sources document can be accessed on the BEST website https://best.barnsleyccg.nhs.uk/COVID19-medicines-and-prescribing-information.htm

Changes to the Human Medicines Regulations 22/10/2020  

The Government response on changes to the Human Medicines Regulations to support the roll out of COVID-19 and flu vaccines has been published.  Amendments are likely to be made to the Human Medicines Regulations, which: 

• strengthen existing regulations allowing for the temporary licensing of medicines and vaccines on an exceptional basis, pending grant of a full licence;
• extends immunity from civil liability to companies producing the vaccine;
• allows a wider range of trained personnel to administer these vaccines; enables promotion of COVID-19 vaccine and treatments as part of national campaigns and provides some short-term exemptions to the need for a wholesaler dealers license to transfer vaccines under NHS or armed services authorised arrangements. 

Help with primary care network Directed Enhanced Service medicine reviews: polypharmacy comparators 22/10/2020

The NHS BSA Polypharmacy Prescribing Comparators can help primary care networks (PCNs) with the Structured Medication and Medicines Optimisation Service Specification.

Developed by a group of GPs and pharmacists in Wessex, working with Wessex AHSN and NHS BSA analysts, the award-winning comparators help practices and PCNs prioritise which of their patients may be at greatest risk of harm from problematic polypharmacy.

The comparators show practices and PCNs how many patients they have on eight or more, 10 or more, 15 or more, and 20 or more, medicines. They also identify patients taking a combination of medicines known to increase risk of harm. Find out much more and watch a short video.

Notice from the Department of Health and Social Care: Ordering additional adult flu vaccine stock 22/10/2020

Please see DHSC guidance attached (attachment 6)  for community pharmacy in England on accessing DHSC centrally supplied flu vaccines.

Medicines Management   22/10/2020

The COVID related information sources document can be accessed on the BEST website https://best.barnsleyccg.nhs.uk/COVID19-medicines-and-prescribing-information.htm 

Latest updates on flu vaccination for pharmacy teams   19/10/2020

Thank you to community pharmacy teams for the excellent work so far in administering over 1.2 million flu vaccines to priority cohorts this autumn.

The Department of Health and Social Care has secured a significant amount of additional flu vaccine stock for release across general practice, community pharmacy and NHS trusts.  A pre-set proportion of this additional stock will be made available to community pharmacy shortly, and the arrangements for how to order against it will be confirmed.

The Public Health England resources to support the mandated flu vaccination campaign are being delivered this week. The resources are in a clearly marked envelope and include a selection of posters to enable teams to target their flu vaccination service according to local circumstances and availability of vaccine. If contractors have not received their pack by 16 October 2020 please email partnerships@phe.gov.uk.

 An additional fund of money has been made available to pharmacies to use alternative premises in order to offer flu vaccinations more flexibly off site during the COVID-19 pandemic. The eligibility to claim against these monies for pharmacy is set out in the Drug Tariff, with regional teams now ready to start pre-approving these requests for monies to be claimed via the NHS BSA MYS online portal. 

Medicines Management  19/10/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Service enables pharmacies to make market entry applications digitally 15/10/2020

Primary Care Support England (PCSE) successfully launched a digital service for pharmacies to make market entry applications online earlier this year, hosted on its platform PCSE Online. It enables users to apply to open a new pharmacy, add or remove directors from their corporate structure and change ownership.

The service is available to those wishing to make an application and modernises a paper-based service, which used over 30 separate forms. It’s a one-stop online tool giving users a streamlined, faster and more efficient application process, and enables users to track the progress of their applications in real time.

The application process is simple - users register by emailing pcse.marketentry@nhs.net and the PCSE team will  contact them to guide them through setting up their profile and start making their application. Further information on the market entry process can be found on the PCSE website.

Update on bipolar drug Priadel  12/10/2020

The Competition and Markets Authority has announced an investigation into whether Essential Pharma ‘abused a dominant market position’ in relation to its supply of lithium-based treatments for bipolar disorder. Following the opening of the investigation Essential Pharma have said they will continue to supply the drug Priadel, removing the previous immediate threat to patients. The investigation comes after public criticism of the company by NHS England Chief Executive Sir Simon Stevens. Further guidance on Priadel following the previous CAS alert is expected from DHSC shortly.

Medicines Management 8/10/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

RPS and RCGP joint statement on delivery of flu vaccination programme  5/10/2020

The RCGP and the RPS has issued a joined statement emphasising how important professional collaboration locally between GPs and community pharmacy is to deliver the flu vaccination programme in the most effective way for patients. 

Environments where the vaccine is delivered must be safe and include adequate access to PPE. All eligible, trained professionals should be utilised to administer the vaccine and good processes for sharing information and routes of communication between GPs and community pharmacy should be established, to encourage uptake.

Action on Inclusive Pharmacy Professional Practice 5/10/2020

A joint national Statement of Principles on inclusive pharmacy professional practice for pharmacists and pharmacy technicians in England was published on 25 September 2020. Sixteen national organisations and over 40 individuals who attended the first National Roundtable on Inclusive Pharmacy Professional Practice, signed the statement in August 2020.

Roundtable members and national pharmacy organisations are now collaboratively developing key priorities for action on which they will work together, reporting back to a second roundtable. The statement and more information can be accessed via this blog published by Keith Ridge.

Help to increase electronic Repeat Dispensing    5/10/2020

NHS England and NHS Improvement have previously reminded GPs to consider transferring patients to electronic Repeat Dispensing (eRD) wherever possible. We know that many practices have increased their utilisation of eRD with average weekly usage increasing by 400k items since the start of the pandemic, but there are further opportunities.

GP Practices can request the latest list of their registered patients that the NHS Business Services Authority has identified as potentially being suitable for eRD, based on recent medication history by emailing nhsbsa.epssupport@nhs.net. Further background and support for transferring patients to eRD can be found in our letter of 4 June 2020

Medicines Management 5/10/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

New statement of principles on inclusive pharmacy published by pharmacy bodies  1/10/2020

The Chief Pharmaceutical Officer, the Royal Pharmaceutical Society and the Association of Pharmacy Technicians UK have published a joint national Statement of Principles on inclusive pharmacy professional practice for pharmacists and pharmacy technicians in England.

It can be found on the Royal Pharmaceutical Society and Association of Pharmacy Technicians in the UK websites. You can also read a blog by Dr Keith Ridge, Chief Pharmaceutical Officer

Alignment of business continuity plans to support local community pharmacies  1/10/2020

It is recognised that the temporary closure of an individual pharmacy and/or general practice can impact on the other pharmacies and general practices within a primary care network (PCN). Community pharmacy and their pharmacy PCN leads have been proactively incentivised via the Pharmacy Quality Scheme to have business continuity plans in place in anticipation of any temporary closures. We’re asking GP practices and PCNs to support their local community pharmacies by aligning business continuity plans in the event of a closure. Further details of this criterion can be found in section 7.2 here.

Patient Registration to Online Services – Vouching  1/10/2020

The CCG has received intelligence that in some cases patients are still being asked to physically attend the practice to present identification for registration to online services.

You may recall as part of the Medicines Ordering Safety and Waste programme of work it was confirmed by NHS England there were three types of vouching patients for registration to online service, also patients can also set themselves up for online services via the NHS app - this method DOES NOT require the patient to call the practice to set up online access.

The 3 types of vouching are:

Vouching by Information Held (Preferred option) aim to reduce footfall in GP practices during the pandemic.

Asking the patient a few predefined questions which could be a mixture of demographics and medical information, and when this matches the ID can be verified. This can be carried out over the telephone and with consent from the patient can have their online details either emailed or posted to them.

Examples of question:

Practice approved medical record vouching questions;

• patient name, DOB and address

and successful response to one or two of the following medical record questions

• confirm one of their repeat prescription medication
• last time they visited the practice for an appointment
• last time they ordered their medication
• confirm a recorded problem they may have on their record.

Self -Vouching when a member of staff knows the person presenting is the patient taking into consideration;

• the period of time an individual has been known to the person designated for vouching
• the frequency of attendance
• the period of registration
• this could also be a clinician during their appointment.

Provision of ID this requires patient to physically attend the practice which during the current climate could be a barrier to patients registering to order their medication online – also practices are trying to reduce footfall.

Identity verification follows legal, professional and ethical standards. The name of the person verifying an applicant’s identity, the method used and date should be recorded in the patient’s records

NHS app (Preferred option) This method can be used by patients who have a smart device such as a smart phone, ipad or tablet. Patients can download the app on apple and android devices. A copy of the patient ID such as driving licence or passport is imported via photo and then their identify verified using image scanning. Patients then link in to their GP service and use their nominated pharmacy.  

Ordering App’s

Once patients have being set up for online services the CCG would  strongly advise practices to signpost patients to the NHS app* to order their medications as this is integrated with all GP practice systems. Any requests for repeat medications will land directly into the practices workflow – and will not generate an email request . There are prescription ordering app’s that are available to patients that are not integrated and will generate email/fax requests for patients repeat medication. We have been made aware of instances where requests are being sent to unmanned generic email inboxes. Patients can still nominate the pharmacy of their choice when using the NHS app to order their medication.

The Medicines Management Team has developed a ‘setting up your NHS login guide’  to enable patients to set up an NHS login (attachment 3)

If you have any questions or concerns regarding this article please contact janine.lee@nhs.net

Medicines Management 28/9/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Extension of fluoxetine 40mg capsules Serious Shortage Protocol  28/9/2020

The Serious Shortage Protocol (SSP) for fluoxetine 40mg capsules is being extended to Friday 2 October because of ongoing supply issues.

If you have any questions regarding the SSP please contact the NHS Prescription Service:

Email: nhsbsa.prescriptionservices@nhsbsa.nhs.uk

Telephone: 0300 330 1349

Textphone: 18001 0300 330 1349

To access the latest information about SSPs (including supporting guidance), please visit the following link – https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/serious-shortage-protocols-ssps.

Medicines Management 24/9/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Flu vaccination funding for Community Pharmacy  21/9/2020

NHS England and NHS Improvement, the Department of Health and Social Care and the Pharmaceutical Services Negotiating Committee have agreed the funding for the Community Pharmacy Seasonal Influenza Vaccination Advanced Service in 2020/2021.

The fee per vaccination remains at £9.58, and for this year only:

• £0.50 per vaccination will be paid from CPCF funds
• up to £1m of medicines margin can be retained for vaccinations administered above the number of a normal year. This is in addition to the allowed £800m medicines margin under the Community Pharmacy Contractual Framework.

NHS England and NHS Improvement is also making additional funding available which will need to be pre-authorised by NHS England and NHS Improvement regional teams to support venue hire and cold storage costs for contractors who are planning off-site vaccinations. Further details are available on the NHS Business Services Authority website as part of the Drug Tariff.

Planning ahead for winter in Community Pharmacy  21/9/2020

As we plan ahead for winter, community pharmacy must remain vigilant and safe regarding COVID-19 and maintain its focus on infection control and prevention. In order to be prepared, we encourage all pharmacies to sign up for the national PPE portal, if not done so already, as an important emergency supply route. Pharmacies will need to do this via their original invitation email.

This winter pharmacies will need to take part in two health campaigns – the public facing campaign to encourage people to get vaccinated against flu begins in early October.

The national flu campaign resources will be delivered to all pharmacies in early October. Please register here to download any additional resources.

Up coming Webinars   21/9/2020

Wednesday 23 - Friday 25 September.           Clinical Pharmacy Congress 2020.

Thursday 24 September, 12:30pm - 1:30pm. Delivering the early diagnosis of cancer PCN specification: getting started and learning from others.

Wednesday 30 September, 12pm - 1:30pm.   Musculoskeletal (MSK) First Contact Physiotherapists: webinar and Q&A session. 

Wednesday 30 September, 4pm - 5pm.          Digital Primary Care - Flu Campaign 2020.

Wednesday 30 September, 10am - 12pm.      New PCN health and wellbeing coaches webinar.

Thursday 1 October, 11am - 12pm.                NHS Volunteer Responder programme - webinar.

Thursday 8 October, 12pm - 1:30pm.             New PCN care coordinators webinar.

Network Contract DES - Structured medication reviews and medicines optimisation: guidance 17 September 2020  21/9/2020

The 2020/21 Network Contract DES Specification includes requirements relating to delivery of a structured medication review (SMR) and medicines optimisation service by primary care networks (PCNs). The document (attachment 5) sets out implementation guidance for PCNs, including the principles of undertaking a SMR.

Medicines Management 17/9/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Update on Pharmoutcomes data transfer and Revised Flu DES 17/9/2020

Pharmacy Flu data transfer arrangements:

Please find attached (1) a letter explaining the arrangements that are in place this year across Yorkshire and Humber for the transfer of patient data between community pharmacies and GP practices in respect of flu immunisations. 

Seasonal influenza DES specification – updated

The Influenza and Pneumococcal Immunisation Directed Enhanced Service specification has been amended and republished to provide for additional new cohorts of patients to be vaccinated in general practice.

The new cohorts include household contacts of those on the NHS Shielded Patient List or of immunocompromised individuals, and health and social care workers employed through Direct Payment (personal budgets) and/or Personal Health Budgets, such as Personal Assistants, to deliver domiciliary care to patients and service users. It also covers a potential cohort of 50-64 year olds later in the flu season, depending on vaccine availability.

In addition, the specification requires that practices must include within at least one written communication to eligible patients offering vaccination, a request that the patient advises the practice of their ethnicity status if they have not previously provided this information to the practice and requires the practice to record this in the patient record.

 If you have any queries, please contact your local Screening and Immunisation Co-ordinator in the first instance.

NICE quality standards for community pharmacy 14/9/2020

New National Institute for Health and Care Excellence quality standards for community pharmacies were issued on 28 August 2020, setting out how they can support the health of the local population, what high quality care looks like and priority areas for the improvement of services. These include:

• offering advice and education to people with a long-term health condition or those looking for support to improve their health and wellbeing
• raising awareness of the health and wellbeing expertise and services available from community pharmacy teams
• developing and using local referral pathways and information-sharing practices
• using their skills and knowledge to support people from underserved groups.

Quality standards are intended to help providers to improve the quality of care they provide to patients and are more important than even during the COVID-19 pandemic, especially for those risk factors that make patients more vulnerable to COVID-19.

The standards are also important, as achieving Healthy Living Pharmacy Level 1 status will become an essential service requirement for all community pharmacies later this financial year.

Medicines Management For Information

Community pharmacy staff flu vaccination 14/9/2020

To help protect community pharmacy teams from seasonal flu and ongoing Covid-19 risks, NHS England and NHS Improvement is asking employers to ensure that all their staff, including locums, are vaccinated as soon as possible. The national flu immunisation programme letter of 5 August 2020 outlined how people eligible for free flu vaccination will be offered this through local NHS arrangements.

Community pharmacy employers are asked to encourage and enable staff who are eligible for a free flu jab to take this up, and to make sure all other members of their teams are also vaccinated. This will meet their responsibility to protect their staff and patients and support the resilience of the health and care system. It is particularly important to ensure that staff in vulnerable groups, such as Black and Ethnic Minority employees, are adequately protected this winter.

Medicines Management 14/9/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Anticoagulation Reconciliation 10/9/2020

You will recall that the CCG paid an upfront payment to practices in April 2020, this was for the 2020-21 PDA and this included a payment for the routine monitoring of Anticoagulation for the period April – July 2020.

The Anticoagulation Monitoring payment was based on a 4 month average of practices’ invoices submitted for 2019/20.   In order that a reconciliation can been carried out please can you fill in your patient numbers in the table below if you have not already done so:

Practice Name INR APRIL – JULY 2020
MONTH	Patient Numbers	Invoice Amount
APRIL
MAY
JUNE
JULY
Total	£0.00

When the information has been analysed you will be contacted by Rachel Barraclough to let you know if your practice has been over or under paid and the next steps that you will need to take.

Online workshops on remote monitoring 7/9/2020

During the COVID-19 outbreak, some NHS organisations used technology to support people with COVID-19 at home. Join this webinar series to hear from the clinicians involved about how this worked, what they did and what the benefits were.

• Tuesday 8 September, 10am - 11am. Tech-enabled Virtual Ward Model - the West Herts experience
• Tuesday 22 September, 10am - 11am. The primary care hot hub - the West London experience

Please contact InnovationCollaborative@future.nhs.uk for more information.

NHS Volunteer Responder programme updates 7/9/2020

Webinars are being held to provide regular updates on the NHS Volunteer Responder programme for referrers and colleagues working across health and care. They will provide an overview of the programme, including facts, figures and the most recent updates on programme adaptations in response to policy changes and the needs of vulnerable people.

• Thursday 17 September, 11am - 12pm
• Thursday 1 October, 11am - 12pm

National COVID-19 Clinical Assessment Service electronic prescriptions  7/9/2020

From 1 September 2020, the COVID-19 Clinical Assessment Service (CCAS), hosted by the South Central Ambulance Service, added the functionality for GPs within the service to prescribe, using the electronic prescription service (EPS).   This is intended to improve the patient journey and allow the CCAS GPs to complete an episode of care. The scope of prescribing will be for acute prescriptions only and may include controlled drug medicines where clinically appropriate.

EPS prescriptions coming from the CCAS are not restricted to patients in the South East Region as the service manages patient enquiries from across England. Pharmacists and dispensers will be able to use the contact details on the EPS token to telephone the service to contact the prescriber in the event of a query.

Hepatitis C service specification published  7/9/2020

The community pharmacy Hepatitis C Antibody Testing advanced service went live on 1 September 2020. Through this service, people who inject drugs and who are not currently accessing community drug and alcohol treatment services can be tested for the hepatitis C virus at a participating community pharmacy.

Any community pharmacy that meets the prerequisites for service provision detailed in the service specification can register to provide this service via the NHSBSA Manage Your Service platform. Full details of the service can be found in the service specification, which is available from the NHS England and NHS Improvement website.

New development opportunity for community pharmacists  7/9/2020

New continuing professional development (CPD) opportunities for pharmacists are available, coordinated by Health Education England (HEE), and funded by the Pharmacy Integration Programme, to help improve the care of patients presenting with minor illness through the NHS Community Pharmacist Consultation Service.

A programme of interactive online workshops and learning is being delivered to support community pharmacists in effective patient-facing consultations and clinical assessments for a range of common minor illnesses. The CPD is being delivered in partnership with the Royal Pharmaceutical Society, Royal College of General Practitioners and the Centre for Pharmacy Postgraduate Education. It will be facilitated by approved medics including GPs and advanced practitioner trainers.

Government consultation on expanded role in vaccinations for pharmacy professionals   7/9/2020

The government has published a proposal to expand the scope of Patient Group Directions (PGD) to allow pharmacists to administer unlicensed vaccines, including any COVID-19 vaccine. The consultation on changes to the human medicine regulations, which was published on 28 August 2020, also includes a proposal that pharmacy technicians could become eligible to safely administer a COVID-19 or influenza vaccine. The consultation closes on 18 September 2020.

Flu service specification published  7/9/2020

The Community Pharmacy Seasonal Influenza Vaccination Advanced Service and supporting Patient Group Direction (PGD) have been published on our website. The service became ‘live’ on 1 September and is available until 31 March 2021. Some amendments to the service have been introduced to support greater vaccination rates and to reduce the overall burden to contractors delivering the service during the pandemic. You should ensure you are familiar with the content of these documents and the PGD is appropriately signed before providing any NHS flu vaccinations.

Roll out of Electronic Prescription Service (EPS) Phase 4 from 7 September  7/9/2020

To help you prepare for winter, we are accelerating deployment of EPS Phase 4 which allows EPS to be used for patients without a pharmacy nomination. All GP practices using EPS with TPP SystmOne and EMIS Web will have Phase 4 enabled between Monday 7 and Friday 11 September 2020. Your system supplier will inform you of your specific switch-on date. For most practices, the move requires minimal action, but teams should consult the support materials and readiness checklist.

Phase 4 significantly reduces the need to hand sign prescriptions and deal with lost prescriptions. GP practices and pharmacies will also be able to track the status of more prescriptions using the EPS Prescription Tracker. Using EPS with a nomination is still the preferred and most efficient option, especially during the coronavirus (COVID-19) pandemic, so please continue to encourage your patients to nominate. EPS Phase 4 is not currently available in the Vision or Microtest systems.

Medicines Management 1/9/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Medicines Management 27/8/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Barnsley Pharmacy Opening Times – Bank Holiday Monday 31 August 2020  27/8/2020

Asda Pharmacy	Asda Superstore                 Old Mill Lane	Barnsley	S71 1LN	01226 704810	09:00-18:00
Boots	34-40 Cheapside	Barnsley	S70 1RR	01226 282616	10:00-16:00
Boots	Unit 2Cortonwood Retail Park	Brampton	S73 0TB	01226 341957	10:00-16:00
Morrison's Pharmacy	Cortonwood  Retail Park	Brampton	S73 0TB	01226 754763	10:00-16:00
Tesco Pharmacy	Wombwell Lane	Barnsley	S70 3NS	0345 6779035	09:00-18:00

Medicines Management 27/8/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Pharmacy Quality Scheme Part 2 for 2020/21 – initial update 27/8/2020

The Pharmacy Quality Scheme (PQS) Part 2 has been agreed and the final, detailed requirements will be published in the Drug Tariff in September. In the meantime, community pharmacies are being asked to look at the initial information shared on the Pharmaceutical Services Negotiating Committee’s website. It has been agreed that completion of the Part 1 scheme will be a Gateway requirement for the Part 2 scheme.

We would like to emphasise the PCN domain where community pharmacy and GP practices will need to collaborate to maximise flu vaccine uptake. In addition, community pharmacy is being asked to coordinate with their PCNs regarding business continuity during the pandemic.

Pharmacy contractors are asked to ensure that all outstanding staff risk assessments are undertaken and mitigating actions put in place as soon as possible.

Registration for the Interim Foundation Pharmacist Programme is now live  24/8/2020

Registration is open for the Interim Foundation Pharmacist Programme (IFPP) and the course begins from September 2020. Provisionally registered pharmacists should sign up to the Health Education England (HEE) dedicated IFPP web page. This includes a flowchart outlining the eligibility criteria and process, and the registration form. HEE is updating its FAQs regularly.

The Centre for Postgraduate Pharmacy Education will deliver the IFPP for provisionally registered pharmacists who work in community pharmacy. Find out more on the CPPE website. The new RPS E-portfolio for provisional registrants is also live, and funded for the 12-month duration of the programme.

To request the weekly email updates or submit your questions, please contact fpp@hee.nhs.uk. 

Barnsley Pharmacy Opening Times – Bank Holiday Monday 31 August 2020 24/8/2020

Asda Pharmacy	Asda Superstore                 Old Mill Lane	Barnsley	S71 1LN	01226 704810	09:00-18:00
Boots	34-40 Cheapside	Barnsley	S70 1RR	01226 282616	10:00-16:00
Boots	Unit 2Cortonwood Retail Park	Brampton	S73 0TB	01226 341957	10:00-16:00
Morrison's Pharmacy	Cortonwood  Retail Park	Brampton	S73 0TB	01226 754763	10:00-16:00
Tesco Pharmacy	Wombwell Lane	Barnsley	S70 3NS	0345 6779035	09:00-18:00

Medicines Management 24/8/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

SystmOne Template Monitoring of “High Risk” Patients being prescribed Direct Oral Anticoagulants Published 20/8/2020

To support practices in the Monitoring of “High Risk” Patients being prescribed Direct Oral Anticoagulants (please refer to letter dated 8 July 2020), the SystmOne template has now been published.  Some practices may find this helpful in prompting the clinician to review key patient factors.

It is entitled “Barnsley: DOAC Monitoring (v1.0)” and can be found by either searching for the name in the “Search Features” box in the bottom left of S1, pressing F12 when in a patient’s record to search and launch it this way, or practices can add this to their clinical trees (instructions are attached - 4).

If anyone has any problems accessing or using this template, please log a call via the IT Self Service portal.

Medicines Management 20/8/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Online workshops on remote monitoring  17/8/2020

During the COVID-19 outbreak, some NHS organisations used technology to support people with COVID-19 at home. If you would like to know more, and are keen to establish a similar service locally, join this webinar series to hear from the clinicians involved about how this worked, what they did and what the benefits were.

• Tuesday 8 September, 10am - 11am - Tech-enabled Virtual Ward Model - the West Herts experience, led by Dr Matthew Knight
• Tuesday 22 September, 10am - 11am - The primary care hot hub - the West London experience, led by Dr Tony Willis and Dr Kuldhir Johal

The online workshops will use Microsoft Teams and will be recorded. To talk about the workshops please contact us via email at InnovationCollaborative@future.nhs.uk

NHS Volunteer Responder programme updates  17/8/2020

Fortnightly webinars are being held to provide regular updates on the NHS Volunteer Responder programme. The webinars are for referrers and colleagues working across health and care including: primary care; social care; local authorities; government departments; voluntary sector organisations; STPs and ICSs; and NHS England and Improvement regional teams.

These webinars will provide an overview of the programme, including facts, figures and the most recent updates on programme adaptations in response to policy changes and the needs of vulnerable people.

• Thursday 20 August, 11am - 12pm - Join Microsoft Teams Meeting
• Thursday 3 September, 11am - 12pm - Join Microsoft Teams Meeting
• Thursday 17 September, 11am - 12pm - Join Microsoft Teams Meeting
• Thursday 1 October, 11am - 12pm - Join Microsoft Teams Meeting

Dates for your diary – up coming webinars  17/8/2020

Wednesday 19 August, 5 - 6pm - Digital Primary Care Online presence - accessibility compliance webinar. Public sector organisations have a legal duty to make sure websites and apps meet accessibility requirements. CCGs and GP practices are invited to attend and learn more about meeting the standards before the deadline of 23 September 2020.

The We Are The NHS: People Plan for 2020/21 has outlined some new developments for the pharmacy profession  17/8/2020

As part of the future mental health workforce, NHS England and NHS Improvement will be funding the employment by mental health trusts of 50 new specialist mental health pharmacists to work as part of multi-disciplinary teams in new models of community-based mental health care for adults and older adults, including supporting PCN clinical pharmacy teams.

To support this, Health Education England will be exploring a new training strategy to support these pharmacists to be responsible for medicines optimisation for people with severe mental health problems – particularly those with complex co-morbidities and physical health needs. 

Medicines Management 17/8/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

National Patient Safety Alert - Steroid Emergency Card to support early recognition and treatment of adrenal crisis in adults  17/8/2020

A National Patient Safety Alert has been issued asking providers to ensure all eligible patients with adrenal insufficiency are issued with a Steroid Emergency Card; and that processes are put in place to check if a patient has a Steroid Emergency Card ahead of any emergency treatment, elective surgery, or other invasive procedures

Updated Community Pharmacy SOP 13/8/2020

Please see attached the updated Community Pharmacy SOP (4), it can also be accessed here. Any changes since version 2 are highlighted in yellow. The sections which have been updated are:

• 3.1 Use of PPE
• 3.3 Face coverings
• 2 Shielded patients at highest risk of severe illness from COVID-19

Medicines Management 13/8/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

EMIS Web practices: new electronic notifications for the urgent supply of medicines 13/8/2020

EMIS Web practices will soon be able to receive electronic notifications from pharmacies about the urgent supply of medicines made as part of the NHS Community Pharmacist Consultation Service (CPCS). This will inform you that a patient registered with your practice has received an urgent supply of medicine from a community pharmacy.

EMIS Web practices will have the new functionality enabled this month. EMIS will inform you of your specific switch on date.

The notifications arrive as a workflow task within the EMIS Web system, prompting you to add the information to a patient’s record.

Please note, if you use a third-party product such as Docman for your patient document management you will need to configure your Document Management task settings in Workflow Manager.

You should still continue, however, to check for notifications received via NHSmail, fax or post.

System guidance is available from EMIS. Information is also available on the NHS Digital website

Medicines Management 6/8/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Interim Foundation Pharmacist Programme 3/8/2020

Health Education England and NHS England and Improvement have written to employers about the new Interim Foundation Pharmacist Programme to help provisionally registered pharmacists transition to full General Pharmaceutical Council (GPhC) registration and beyond.

This new programme forms the first phase of pharmacist education and reform and is designed to build support around the current cohort of pre-registration pharmacists who will become provisionally registered pharmacists in August 2020.

The COVID-19 pandemic has affected the training of the current cohort of pre-registration pharmacists, who have not had the full experience necessary for registration. The GPhC has decided to provisionally register this cohort, with the final assessment likely to take place later this year, with full registration to follow for those successful in the exam.

Medicines Management 3/8/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Patient Group Directions – Written instruction for the administration of seasonal flu vaccination 2020/21 for employees and peers 3/8/2020

Specialist Pharmacy Services were made aware of issues being encountered on the use of Patient Group Directions (PGDs) within healthcare organisations and occupational health services with regards to offering employees and peer to peer seasonal flu vaccinations.

Specialist Pharmacy Service in conjunction with Care Quality Commission, Medicines and Healthcare products Regulation Authority, Royal College of Nursing, Public Health England, British Medical Association Occupational Health Committee and representatives from the NHS and independent sectors have developed   written instructions for the administration of seasonal influenza vaccination for 2020/21.

The written instruction template and a factsheet will support the use of the written instruction and includes additional advice specific to GP practices in the use of PGDs and the administration of seasonal flu vaccinations.

Access to repeat prescriptions 3/8/2020

During the COVID-19 pandemic many practices have adopted new ways of working and have encouraged patients to request repeat prescriptions online, where appropriate. Online ordering of repeat prescriptions has many benefits for practices and patients, but it isn’t suitable for everyone. Following some recent enquiries, we wanted to clarify that practices must still have systems in place to enable patients to request repeat prescriptions by telephone or in person

Medicines Management 30/7/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Written instruction for the administration of seasonal flu vaccination 2020/21 27/7/2020

Specialist Pharmacy Services were made aware of issues being encountered on the use of Patient Group Directions (PGDs) within healthcare organisations and occupational health services with regards to offering employees and peer to peer seasonal flu vaccinations. 

Specialist Pharmacy Service in conjunction with Care Quality Commission, Medicines and Healthcare products Regulation Authority, Royal College of Nursing, Public Health England, British Medical Association Occupational Health Committee and representatives from the NHS and independent sectors have developed written instructions for the administration of seasonal influenza vaccination for 2020/21.

The written instruction template and a factsheet will support the use of the written instruction and includes additional advice specific to GP practices in the use of PGDs and the administration of seasonal flu vaccinations.

Medicines Management 23/7/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Medicines Management 22/7/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Electronic notifications for urgent supply rolling out to more community pharmacies 20/7/2020

Most community pharmacies in England will be able to send electronic notifications for urgent supplies of medicines provided as part of the CPCS by the end of this month (July 2020). 

The new functionality, which is already in use at pharmacies using Sonar Informatics, will be enabled for pharmacies using Pinnacle’s PharmOutcomes system over the next three weeks. This means that GP practices that can receive the electronic workflow notifications (all TPP SystmOne practices and some EMIS Web practices in pilot) will start to see an increase in numbers. 

More information is available on the NHS Digital website. 

Medicines Management 20/7/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Medicines Management Newletter – July 2020 20/7/2020

Please see attached the July Medicines Management Newsletter for information.

Employing a provisionally-registered pharmacist guidance  15/7/2020

The General Pharmaceutical Council (GPhC) has written to pharmacy owners and superintendents to share guidance about employing provisionally-registered pharmacists.

The COVID-19 pandemic has affected the ability of trainees completing the pharmacist pre-registration scheme in 2020 to finish their training as planned, and to sit the registration assessment as originally scheduled. 

Pending successful completion of the rescheduled assessment, the GPhC governing council has agreed a policy for registering pharmacists on a provisional basis.

The policy sets out that current pre-registration trainees who meet the criteria for provisional registration are able to be provisionally-registered as a pharmacist, with certain restrictions, from 1 August 2020. 

The guidance sets out what employers and superintendents must do, if they plan to employ a pharmacist who is provisionally registered.

Pharmacy Quality Scheme – Essential Criteria Checklist 15/7/2020

We have worked with the Department of Health and Social Care and Pharmacy Services Negotiation Committee to develop a new Pharmacy Quality Scheme (PQS) for 2020/21 which will be in two parts. Part 1 recognises the work many pharmacy contractors have already completed as a result of COVID-19 to ensure a safer environment for all staff and people who visit the pharmacy.

It is an Essential Criteria Checklist which includes a list of actions that must all be completed by any contractor wishing to claim a payment of £1,630 for PQS 2020/21 Part 1. Claims  can be made via the NHS Business Services Authority (NHS BSA) Manage Your Service website and contractors are encouraged to complete this as soon as possible. Full details of the checklist can be found in the Drug Tariff determination on the NHS BSA website.

Completing Part 1 before 29 January 2021 is a prerequisite for claiming Part 2 of the PQS which will be announced in September 2020.

Webinar recording – risk assessment in community pharmacy    15/7/2020

We wrote to community pharmacies on 24 June 2020 to ask them to carry out a risk assessment of their pharmacy staff who are at potentially greater risk of COVID-19 within a four week period. On 8 July 2020 we held a webinar, involving speakers from the National Pharmacy Association and Royal Pharmaceutical Society, to help and support community pharmacy employers and managers to carry out these risk assessments within the agreed timescale.

This risk assessment work is an important part of a wider programme that the NHS is leading nationally to address the impact of COVID-19 on the BAME workforce. This includes work to improve protection, support and representation for the BAME pharmacy workforce across all sectors including community pharmacy teams.

The webinar recording and slides have been published on the FutureNHS website. The NHS Business Services Authority has sent every pharmacy a briefing and link to a risk assessment SNAP Survey to complete. There will be two windows for collection of information, by 17 July 2020 and by 31 July 2020 – please complete the declaration in both windows.

Urgent supply electronic notifications (North East and Yorkshire)15/7/2020

NHS Digital recently started rolling out electronic notifications for urgent supplies of medicine (as part of CPCS) issued by pharmacies that use Sonar Informatics to TPP SystmOne GP practices.  The notifications arrive as a workflow task and include ‘structured’ information which means details can be added directly to a patient’s GP record, without having to transcribe the information manually.

Following a successful pilot in London, the new functionality was rolled out to GP practices using SystmOne in the London, East of England and South East regions on Monday 29 June.

Medicines Management 15/7/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

COVID-19 support developments 13/7/2020

Work is ongoing to support community pharmacies with the impact of COVID-19:

• Negotiations between the Department of Health and Social Care, the Pharmaceutical Services Negotiating Committee (PSNC) and ourselves on specific additional community pharmacy costs associated with the COVID-19 pandemic began on 8 July 2020.
• The supply of personal protective equipment (PPE) has strengthened but any pharmacies experiencing problems obtaining PPE are asked to report issues to their local NHS England and NHS Improvement pharmacy contract team so issues can be followed up and resolved.
• Pharmacies are also asked to report any details of issues they encounter with local outbreaks of COVID-19 to their local pharmacy contract team to help the NHS understand the problem and provide appropriate support.
• The latest Public Health England COVID-19 ‘Stay Alert to Stay Safe’ public-facing campaign resources are available on the Campaign Resource Centre – please create a log-in to access these free materials.

New risk assessment survey for community pharmacies 13/7/2020

NHSE recently sent a letter to all NHS providers reminding us as employers, we each have a legal duty to protect the health, safety and welfare of our own staff. Completing risk assessments is a vital component of this.  Thank you to the many of you who have completed risk assessments and continue to provide support for your at-risk staff during this challenging period.

NHSE will be seeking to understand the progress made in completion of risk assessments across the NHS, to help us to understand where assistance is needed locally, and help us to develop our wider support offer to systems. We are asking consistent questions across all NHS organisations, including Community Pharmacies and Dispensing Appliance Contractors.

The NHS Business Services Authority sent out a briefing on Thursday 9 July, with a link to the SNAP survey for all pharmacy contractors to complete. The same survey will be repeated and there will be two windows for collection of information, by Friday 17 July and by Friday 31 July – please complete the declaration in both windows even if 100% of assessments have already been completed. Data will be collated immediately after close and shared with regional teams and commissioners to allow follow up where needed.

Resources to support community pharmacy owners and managers to complete the risk assessments are available here:

• Royal Pharmaceutical Society website
• National Pharmacy Association website

Medicines Management 13/7/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

DRAFT Anticaog for SPAF Barnsley guidelines – June 2020 13/7/2020

Please find attached letter and draft guidance appendix* regarding prioritisation of patients on high risk medicines who require review.​

*The guidance has now been approved by the APC and is available at the following link:

https://best.barnsleyccg.nhs.uk/clinical-support/medicines/prescribing-guidelines/Anticoagulation%20for%20SPAF%20Barnsley%20Guidelines.pdf

Education and training for NHS staff in community health services, supporting the response to COVID-19 10/7/2020

As part of the NHS response to COVID-19, NHSE have brought together free, accessible education and training resources in a single place to support healthcare staff across community health service settings. These resources will ensure staff feel comfortable and confident in their roles during the pandemic and provide guidance in tandem with further support, including face-to-face training. Topics include PPE, infection control and other role-specific guidance

https://www.england.nhs.uk/coronavirus/publication/education-and-training-for-nhs-staff-in-community-health-services-supporting-the-response-to-covid-19/

Pre Registration Trainee Pharmacy Technician Programme 2020  10/7/2020

Health Education England has agreed to national funding to increase pre-registration trainee pharmacy technician numbers for this financial year. This is a great opportunity to be proactive in the training and development of the pharmacy technician workforce in general practice and to ensure that there are sufficient numbers to fill the positions that PCNs will demand through the ARRS.

The funding available is £16.5k for year one and £15.5k for year two. 

HEE are looking for collaborative partnership bids, for example between a GP/PCN and Community Pharmacy, with a host employer and named clinical supervisor for the 2 year programme.  The trainee would rotate between the partnership organisations. The trainee will undertake a level 3 apprenticeship with additional support from the training hub and HEE. The timescale is tight as the cohort will ideally begin in September.

Please find attached the HEE information letter and guidance for prospective employers and sample training plan with further details of the scheme. 

They are looking for Expressions of Interest at this stage. If you would like to register, please email louise.berwick2@nhs.net or melanie.robinson7@nhs.net. They will then set up a webinar with HEE colleagues to give you the opportunity to ask any questions and discuss next steps. 

Medicines Supply Notifications for Pregaday tablets and Intal inhalers 10/7/2020

The table below provides a summary of the attached MSNs:

Medicine	Out of stock until	Alternatives (NB FP10 prescriptions must indicate that a special is required/prescribed by the GP if relevant)
MSN/2020/039 Ferrous Fumarate 322mg/Folic Acid 350microgram (Pregaday) tablets	October 2020	UKMi have provided clinical advice on switching to alternative iron and folic acid containing products
MSN/2020/040 Sodium cromoglycate 5mg (Intal) inhaler	Mid-November 2020	Unlicensed imports have been sourced

Please be aware this communication is also being circulated separately to all Community Pharmacies in England

If you have any queries please contact: DHSCmedicinesupplyteam@dhsc.gov.uk 

Medicines Management 10/7/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Registration renewal requirements for pharmacy professionals 6/7/2020

The General Pharmaceutical Council has announced that pharmacy professionals with a registration renewal deadline between 1 September and 31 December 2020 will not be required to submit revalidation records when renewing their registration, in recognition of the challenges resulting from the COVID-19 pandemic.

This relaxation already applied to professionals with a renewal deadline between 20 March and 31 August 2020. Instead, pharmacy professionals should submit a reflective account when renewing their registrations. For more information please see the GPhC website

Temporary closures and changes to opening hours 6/7/2020

On 30 June 2020 the Department of Health and Social Care announced the extension of emergency provisions until 1 September 2020. This enables pharmacies to apply to NHS England & NHS Improvement to temporarily close or change their opening hours. In the application a contractor must state their reasons for the change; and give at least 24 hours’ notice of the temporary change or closure. Contractors are reminded of the need to update their DoS profile and NHS website entry in the event of a temporary closure or change to opening hours.

The emergency provisions also enable the home delivery of medicines and appliances service during the COVID-19 outbreak until 31 July 2020, as noted in Tuesday’s bulletin (more information can be found here). 

New Medicines Service 6/7/2020

From 1 July 2020, contractors providing the NMS are no longer required to possess an MUR certificate. This is linked to plans to complete the phasing out of MURs by 30 April 2021. 

Medicines Use Reviews 6/7/2020

Planned changes to the MUR target groups have been delayed until 31 December 2020. 70% of MURs undertaken must be for patients taking high-risk medicines or those that have recently been discharged from hospital. Previously the target group for patients recently discharged from hospital was expected to end at midnight on 30 June 2020.

Reminder: Infant pneumococcal conjugate vaccine (PCV13) schedule 3/7/2020

Public Health England has published guidance for healthcare practitioners on changes to the infant pneumococcal conjugate vaccine (PCV13) schedule. Included in this guidance is what to do if infants are given the incorrect schedule for their date of birth – for infants born on/after 1 January 2020 who are inadvertently given a dose of PCV13 before 12 weeks of age, they should be offered a second dose of PCV13 from 12 weeks of age allowing a minimum interval of 4 weeks between PCV13 doses.

All children will require a 12 month booster dose of PCV.

Clinical guidance for healthcare professionals on maintaining immunisation programmes during COVID-19 3/7/2020

NHS England and NHS Improvement, together with Public Health England, has published clinical guidance for healthcare professionals on maintaining our NHS immunisation programmes during COVID-19.

It underlines that the routine immunisation programme must be maintained, and gives advice on how to approach some of the specific challenges practices may face in doing this. It also includes a series of FAQs that can be used in communication with the public. The production of the guidance has been supported by the Royal College of General Practitioners (RCGP) and the Royal College of Paediatrics and Child Health (RCPCH).

Central Alerting System: Class 2 Drug Alert, Action Within 48 Hours, Patient Level Recall 3/7/2020

BCM Specials Limited has informed us that a number of foreign body particulates including glass and rubber have been found in one of the containers of the Active Pharmaceutical Ingredient (API) used in the manufacture of Mepacrine Hydrochloride 100mg tablets. No foreign body particulates were identified during the manufacturing process, routine associated batch analysis or investigative analysis performed to date, however, because of the use of API from the affected container in the manufacture of batch 85641 the decision to recall all available stock from this batch has been made as a precautionary measure.

Advice for healthcare professionals:

• Contact patients who have been supplied Mepacrine Hydrochloride 100mg Tablets from the affected batch 85641 and ask them to stop using tablets from this batch as soon as possible and return any unused medicine to their pharmacy. 

• Stop supplying the above products immediately and remove from the shelves within your store. Quarantine all remaining stock and return it to your supplier using your supplier’s approved process.

Full details of the drug alert are included in the attached PDF file. This information is also published on the MHRA website https://www.gov.uk/drug-device-alerts

Home delivery of medicines and appliances 1/7/2020

COVID-19 waste management guidance SOP version 2.1 (updated document) 1/7/2020 

MaPPs2: Medicines – Medication Adherence tools 1/7/2020

Clinical Pharmacist's Support to Practices 29/6/2020

Since the start of the pandemic clinical pharmacists (and the Medicines Management team) have continued to support practices via remote working. Feedback is that this approach is working well and it’s been decided this should be maintained for the foreseeable future, which is in line with the government’s guidance on home working wherever this is possible. ​ This will additionally support practices in reducing numbers of staff and potential COVID contacts within practices.

This has been a huge achievement that the CCG quickly provided IT kit to all of the clinical pharmacists to enable remote access and has committed to continue to support these staff to work remotely.

We are aware that some of the clinical pharmacists prior to the pandemic were undertaking face to face reviews with patients and most of this work has continued remotely, however we are aware that there are certain activities that have ceased due to the need for face to face contact e.g. acute same day clinics. 

At this stage of the pandemic we are still advising clinical pharmacists ( and the Medicines Management team staff) to wherever possible work remotely and will only review this in exceptional circumstances and following a risk assessment carried out by the CCG.  If practices have any queries or requests in relation to this position could you please contact janine.lee@nhs.net. 

We shall of course continue to review this position as government guidance is updated.

Medicines Management 29/6/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Medicines Management 26/6/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

NHS Community Pharmacist Consultation Service helps 332,000 patients in first seven months 22/6/2020

More than 180,000 consultations have taken place between patients and community pharmacists under the NHS Community Pharmacist Consultation Service (CPCS) since the NHS stepped up its response to COVID-19 at the end of January, bringing the total number of CPCS consultations since the service was introduced in October 2019 to over 332,000. The service, available at 94 per cent of community pharmacies in England via referral from NHS 111, enables patients to quickly access expert advice from a community pharmacist for a range of minor illnesses, or to get an urgent supply of a previously prescribed medicine.

NHS England’s Chief Pharmaceutical Officer Keith Ridge said “Pharmacies across England have put their all into supporting their communities during COVID-19 and made a real difference to so many patients and their families. Now, more than ever, access to same day advice and care via the CPCS is even more valued - as demonstrated by these high usage numbers. The achievement of 332,000 referrals since the service started is phenomenal and demonstrates once and for all how much trust the public places in NHS 111 and their local pharmacist. Thank you to everyone who has worked so hard to make this a success.”

Please also see articles above including Psychological First Aid Training, NHS Practitioner Health, Mobile and Broadband enhancements, NHS Complaints process and coaching support for all non-clinical and clinical primary care staff, Plasma Appeal, Scams, Book of Remembrance.

Expansions to smartcard functionality and SCR information 19/6/2020

As highlighted in the 2 June bulletin, additional information has been added to the Summary Care Record (SCR), including the shielded patient flag, and suspected or confirmed cases of COVID-19. These changes apply except where patients have previously informed the NHS that they did not want an SCR or additional information to be shared.

All community pharmacists and pharmacy technicians, including locums, can also use their smartcard to view the SCR, shielded patient flag, personal demographic service and access the Electronic Prescription Service (EPS) from any pharmacy in England. This additional functionality has been made available for 12 months initially to support workforce flexibility during the COVID-19 pandemic. 

Medicines Management 19/6/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Minimising the spread of infection 15/6/2020

Earlier this week NHS England and NHS Improvement sent a letter to organisations across the NHS, including community pharmacies, GP practices and PCNs and dental and optometry providers, to ask them to take actions to minimise the spread of infections in the NHS while maintaining patient access to services.

The key actions for community pharmacies are:

1. To prepare for potential staff absence, providers should review their existing business continuity plans and take actions as required. This includes ensuring that arrangements are in place to maintain patient access to services.
2. Providers should inform their commissioner as soon as they consider that delivery of the full contracted service may be compromised by staff absence due to Test and Trace. The commissioner will work with the contractor to put business continuity arrangements in place and to maintain access to services for patients.

Ongoing and consistent implementation of national infection prevention and control guidance, including in staff areas, will be paramount in reducing healthcare associated infections. This includes all staff adhering to social distancing (2 metres) wherever possible.

Electronic Repeat Dispensing 15/6/2020

Community pharmacies are likely to be experiencing an increase in electronic repeat dispensing (eRD), and patients whose prescriptions are moving to eRD may need advice and support on how to use the service as they adjust to the new arrangements. GP practices have been advised by NHS England and NHS Improvement to discuss the changes with local community pharmacies.   

On 4 June, NHS England and NHS Improvement wrote to community pharmacists and GPs to say the requirement for patients to consent to receiving their regular medication via eRD had been temporarily suspended until 30 June 2020. Any patient who is already receiving or who has agreed to receive electronic prescriptions may now begin to receive the regular medication in this way, subject to the practice confirming that the service is both clinically and practically appropriate for the patient. Practices may also seek consent and pharmacy nomination from patients who are suitable but currently receiving paper prescriptions.

Medicines Management 15/6/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Updated Advice for Health and Justice Healthcare Teams on Medicines 15/6/2020

Please see attached updated advice for health and justice healthcare teams on medicines and pharmacy services continuity. 

This is also updated on the website: https://www.england.nhs.uk/coronavirus/publication/advice-for-health-and-justice-healthcare-teams-on-medicines-and-pharmacy-services-continuity/

Patient Access: Online ordering of prescription 12/6/2020

 The Medicines Management Team have received a number of calls from patients who have had difficulties using Patient Access to order their repeat prescriptions online. The majority of the issues are with the Patient Access website/account and therefore we are unable to help using the practice systems. Patients should be provided with the following advice:

On the http://www.patientaccess.com, website, click on technical support in the bottom right corner. Patient should select "Ask" and then will then be able to submit their details to start a chat with one of the patient access support team members.​

The GP practice (or MMT) cannot reset a user’s password within the practice system, the user would need to reset this themselves using the Patient Access Website. Here's a couple of links that the practice might find helpful to share with patients: 

https://support.patientaccess.com/signing-in/trouble-signing-in
https://support.patientaccess.com/signing-in/contact-support

Medicines Management 12/6/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Medicines Management – June Newsletter 12/6/2020

The Medicines Management June Newsletter is attached.

Specialist Pharmacy Service’s monthly webinars 10/6/2020

The Specialist Pharmacy Service’s (SPS) Medicines Use and Safety Team host regular webinars at 1pm for an hour. 

Pre-registration for each event is required. Future webinars include:       

• Wednesday 17 June - Resources to support pharmacy teams working in care homes
• Thursday 25 June - Remote Consultations in Care Homes

SPS also run a Care Home Resource Hub to support pharmacy teams working into care homes in response to increased pressure from the COVID-19 pandemic.

Medicines Management 10/6/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Nosocomial infections 10/6/2020

Please see attached nosocomial infections system letter. This letter helps to clarify the steps which organisations should be taking to minimise nosocomial infections, protect staff and ensure the timely reporting and management of outbreaks and staff absence in the NHS.

Medicines Management 8/6/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Medicines Management 5/6/2020

Please note the information sources document and other local Covid-19 medicines and prescribing guidelines can be accessed on the BEST website at the following link.

Working in care homes during Covid19: new training resource 3/6/2020

The Royal Pharmaceutical Society (RPS) has today published a training resource to support pharmacists and pharmacy technicians newly deployed to care home settings during the COVID-19 pandemic to deliver safe and effective patient care with confidence. This practical guide has been developed to enable pharmacy professionals provide a baseline level of patient care covering four key areas of practice: clinical reviews, medicines supply, structured medication reviews, and medicines information.

The COVID-19 care homes training resource provides step-by-step instructions for upskilling. It includes a self-assessment knowledge and capability guide, targeted learning using a range of resources and worked case studies which show how to apply your knowledge in practice. It also provides tools for reflection, peer support and feedback.

Access to RPS COVID-19 learning resources is free during the pandemic for the entire pharmacy profession, through registering on www.rpharms.com or using RPS membership details.

Summary Care Record (SCR) additional information and COVID-19 codes 3/6/2020

Under new COVID-19 policy arrangements, over 21 million patient SCRs have so far been enriched to include additional information. This does not include patients who have previously informed the NHS that they do not want an SCR or additional information to be shared.  There will also be a temporary change to include COVID-19 specific codes on SCRs. Users of the SCR application and SCR 1-click will be made aware of specific, suspected and confirmed COVID-19 information by a message box displayed within the SCR. 

Flexible access to essential digital tools for community pharmacy teams 3/6/2020

Community pharmacists and pharmacy technicians will be able to access the core national digital tools including the Shielded Patient Flag (SPF), Summary Care Record (SCR), the Electronic Prescription Service (EPS) and the Patient Demographic Service (PDS) from any community pharmacy in England by Friday 5 June 2020.

Temporary smartcard positions have been created by NHS Digital that will provide additional flexibility to approximately 19,000 pharmacists and over 3,500 pharmacy technicians for an initial 12 months during the COVID-19 pandemic. The new position has already been granted to existing locum pharmacists and pharmacy technicians to ensure consistent access to SCR from wherever they are working. This work is being done centrally, with no action required by individuals.

COVID-19 - Uplift to pharmacy contractors’ payment on 1 June 2020 3/6/2020

To mitigate cash flow issues due to COVID-19, in April and May pharmacy contractors received an uplift to their advance payment totalling £300 million. On 28 May a further uplift to their advance payment totalling £50 million was announced. This will be made on 1 June 2020. Further information is available on the NHS Business Services Authority website. 

Medicines Management 3/6/2020

The COVID related information sources document can be accessed here.

Extension of Serious Shortage Protocol for fluoxetine 10mg tablets to 11 September 2020 3/6/2020

Due to  ongoing supply issues, the Serious Shortage Protocol for fluoxetine 10mg tablets which was introduced on 12 March 2020, is being extended to Friday 11 September 2020.

(This SSP was previously due to end on 12 June 2020)

If you have any questions regarding the SSPs please contact the NHS Prescription Service:

Email: nhsbsa.prescriptionservices@nhsbsa.nhs.uk

Telephone: 0300 330 1349

Textphone: 18001 0300 330 1349

To access the latest information about SSPs (including supporting guidance), please visit the following link – https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/serious-shortage-protocols-ssps.

Medicines Management 1/6/2020

The COVID related information sources document can be accessed here.

Medicines Management in Care Homes - COVID-19 response to support care home residents - Selection & use of specific Snomed code by Clinical Pharmacists 1/6/2020

In Fridays bulletin we explained that the CCG’s clinical pharmacists will be supporting practices in the requirement to deliver structured medication reviews for care home residents, and we asked that any queries be directed to Erica Carmody. Unfortunately the email address that we provided was incorrect. We apologise for the inconvenience this has caused, but unfortunately any queries sent to that email address cannot be accessed.

The correct email address and the one queries should be directed to is: erica.carmody1@nhs.net

Switching warfarin patients to DOACs during the coronavirus pandemic – updated June 2020 1/6/2020

The local guidance (attached) has been updated in response to advice issued by NHS England and NHS Improvement at the end of last week.

Additional supplies of apixaban and rivaroxaban have been secured nationally in a ratio of 4:1.   Prescribers are therefore advised to consider apixaban or rivaroxaban in proportion to the 80:20 split secured  as the DOACs of choice when switching from warfarin, unless there is a specific clinical reason to do otherwise.  This advice regarding choice of DOAC only applies to patients who are switching from warfarin.  Patients who have already been switched from warfarin to an alternative DOAC should not be changed.

The updated guidance will be uploaded to the BEST website. 

Medicines Management in Care Homes - COVID-19 response to support care home residents - Selection & use of specific Snomed code by Clinical Pharmacists 29/5/2020

The CCG’s clinical pharmacists will be supporting practices in the requirement to deliver structured medication reviews for care home residents. To support this piece of work the CP’s will be utilising where required the Barnsley Care Home template (within practice systems) and this has been updated to include:

Snomed code : 1127441000000107 Medication Review done by clinical pharmacist

All reviews that are being carried for this specific covid-19 response by CP's will be read coded using this code. Searches have been carried out and we are confident this is not a code that is routinely being used in practice. By using this code we will be able to identify and report on the progress of reviews carried out using the code and dates of review.

We have also asked pharmacists to add a disclaimer within the patients notes  where it has only been possible to undertake a desk based review ( due to COVID limiting possible contact);  "this is a desk based review as part of the Covid-19 care home  response" . This would mean some longer-term medicines optimisation matters, which are   not considered an immediate risk or priority are not actioned but will be picked up in future SMR reviews.

Any queries should be directed to Erica.carmody@nhs.net

Suspension of the Pharmaceutical Needs Assessments 27/5/2020

The Pharmaceutical Needs Assessments was due to be renewed and published by Local Authority Health and Wellbeing Boards in April 2021.

Department of Health and Social Care announced on 22 May that due to current pressures across all sectors in response to the COIVD-19 pandemic, the requirement to publish renewed Pharmaceutical Need Assessments will be suspended until April 2022.

Local Authority Health and Wellbeing Boards will retain the ability to issue supplementary statements to respond to local changes and pharmaceutical needs during this time.

The NHS Pharmaceutical and Local Pharmaceutical Services Regulations 2013 will be updated in due course.

Community pharmacy webinar 27/5/2020

The recording of the community pharmacy webinar held on 20 May with Ed Waller and Keith Ridge is now available on the Future NHS platform.

Medicines Management 27/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Wellbeing and accessing support during the COVID-19 pandemic - a ‘where to start guide’ for pharmacy staff 22/5/2020

The current and future challenges around COVID-19 present us with significant personal and professional matters to cope with. Therefore, it is especially important for us to look after ourselves and each other. The NHS Specialist Pharmacy Service with London NW University Healthcare NHS Trust have developed "wellbeing and accessing support during the COVID-19 pandemic - a ‘where to start guide’ for pharmacy staff". This includes resources to encourage all staff to establish good habits with respect to their wellbeing from the outset and provides some immediate ‘go-to’ strategies and information to support ongoing wellbeing during the pandemic.

A reminder to keep your NHS 111 Directory of Services Profile and your NHS website profile up to date 22/5/2020

With more people using online services, it is important to keep your NHS website profile up to date. It is important that contractors update their DoS entry and that the pharmacy NHS website entry is correct for Monday 25 May. The step-by-step guide for updating your NHS Website profile is available. For temporary closures of more than 5 days please amend your opening times within the Dos Profile Updater, for temporary closures of less than 5 days please amend your RAG status to ‘RED’ using the DoS Capacity status tool which can be accessed from the login page on the DoS Profile Updater. 

Community Pharmacy Opening Hours – Spring Bank Holiday 22/5/2020

See attached opening hours for community pharmacies in Barnsley for the upcoming Spring Bank Holiday.

 

Medicines Management 22/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Medicines Management 20/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

VitA-POS® eye ointment name change to HYLO NIGHT® 20/5/2020

VitA-POS® night-time eye ointment has been renamed HYLO NIGHT®. The ingredients and composition remain exactly the same.

HYLO NIGHT® is listed on SystmOne but may be difficult to locate due to an initial upload issue. This will be rectified at the beginning of June with a new update. In the meantime, the manufacturer has provided the attached guide to support GP practices using SystmOne or alternatively contact a member of the Medicines Management Team for advice.   For EMIS users, HYLO NIGHT® will be released on to the system next week.

Until HYLO-NIGHT® is listed on the practice systems, prescribers can continue to prescribe VitA-POS® as this can be issued as HYLO NIGHT® by the pharmacy, where stocks of VitA-POS® have been exhausted.  VitA-POS® is included in the dry eye treatment guidelines and these will be updated in due course to reflect the name chang

Medicines Management 18/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Medicines Management 15/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Anticoagulation and Shared Care Invoices 13/5/2020

Practices are reminded not to submit any invoices for both Anticoagulation Monitoring and Shared Care Drugs Scheme for the period from 1 April to 31 July 2020.  

This is because the 20/21 PDA upfront payment that was paid to practices in April also included a 4 month average payment for Anticoagulation Monitoring and the Shared Care Drugs Scheme.

If your practice has submitted any invoices for the above mentioned schemes for this period Ruth Simms will contact you to request a Credit Note.

At the end of July a reminder will be sent to practices to request actual anticoagulation activity for April, May, June and July in order that a reconciliation can been done against what practices have been paid and actual activity achieved.  Practices will then be informed whether they have been over or underpaid and to request either a Credit Note for overpayment or an additional invoice be submitted to claim any underpayment.  

Should you have any queries please contact Ruth Simms; ruth.simms@nhs.net 

Management of patients prescribed testosterone during the pandemic 13/5/2020

Local guidance (attached) has been produced in consultation with the BHNFT endocrinologists to support with the management of patients prescribed testosterone replacement therapy.   The guidance is on BEST. 

Medicines Management  13/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Community Pharmacy 11/5/2020

Thank you to everyone who joined the NHSE Community Pharmacy webinar on Thursday.  You can watch the event again on Future NHS.

 Medicines Management  11/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

NHS Service Finder supports hospital pharmacy departments to discharge patients during the COVID-19 crisis 7/5/2020

Hospital pharmacists will be able to use NHS Service Finder to instantly access up-to-date information on community pharmacies, including NHS email addresses. Electronic notes can now be sent on discharge to the relevant community pharmacy using secure NHS email. The development comes in the wake of the COVID-19 crisis, to support the safe and timely discharge of patients and enable effective communication between hospital and community pharmacists. NHS Service Finder gives access to accurate, real-time information to help signpost patients to available services to best meet their needs. It can be used by healthcare professionals to access the NHS 111 Directory of Services and NHS.UK service information on any device.

NHS Community Pharmacist Consultation Service 7/5/2020

During the pandemic the NHS Community Pharmacist Consultation Service (CPCS) has continued to be delivered within community pharmacy. We recognise this has been a valuable service for patients providing access to remote consultation for acute minor illness and urgent medicines supply. It is vitally important, that even during these busy periods, incoming CPCS referrals are checked for regularly throughout the day and at least an hour before closing. Some referrals may be made to the pharmacy overnight and so it is also good practice to check for these at the start of the working day. We are aware some pharmacies have been sending referrals back to NHS111 at the end of the working day stating that they had been unable to make contact with patients. If no contact can be made then the referral can be closed on the CPCS IT system as set out in the NHS CPCS Toolkit and not sent back to NHS111. 

Urgent - Medicine Supply Notification on Ranitidine - all formulations 7/5/2020

On behalf of DHSC please see the below information.

• A tier 2 medicines supply notification for ranitidine (all formulations) - attached

Please be aware this communication is also being circulated separately to all Community Pharmacies in England

Please note that supply issues that have been categorised as tier 1 or 2, DHSC and the MSRG have requested that we use our commissioning routes to reach community pharmacy and GP practices. More serious supply issues are communicated via the Central Alerting System for action.

If you have any queries please contact: DHSCmedicinesupplyteam@dhsc.gov.uk

GP and community pharmacy services over the bank holiday weekend 7/5/2020

Please find attached images which outline the availability of GP and community pharmacy services over the bank holiday weekend. 

Medicines Management  7/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Payments for the home delivery of medicines and appliances service during the COVID-19 outbreak 6/5/2020

Community pharmacy contractors are now able to claim payment on the Manage Your Service (MYS) portal . Contractors must submit their claims for payment monthly via the MYS platform no later than the 5th of the following month.

Community pharmacy webinar - change of date 6/5/2020 

The next community pharmacy webinar will take place on Thursday 7 May from 7pm – 8pm instead of Wednesday 6 May. Dr Nikki Kanani will be joining Keith and Ed to talk about COVID 19 and impact on BAME communities.  Please click here to join. 

Medicines Management 6/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

New legislation relating to controlled drugs 5/5/2020

Three temporary emergency measures have been introduced by the UK Government into legislation [The Misuse of Drugs (Coronavirus) (Amendments Relating to the Supply of Controlled Drugs During a Pandemic etc.) Regulations 2020]. Please be aware that these new measures WILL NOT come into use now. These temporary measures would only potentially be used in limited circumstances in a particular area following an announcement by the Secretary of State if there were severe disruptions to the supply of repeat prescriptions of controlled drugs for patients. A further update is available on the GPhC website.

Community Pharmacy 5/5/2020

Pharmacies are being asked to consider providing a safe space for victims of domestic abuse, as part of the UK SAYS NO MORE campaign run by Hestia, a national charity. Pharmacies are asked to display posters and where appropriate make their consultation rooms available as safe spaces where victims of domestic abuse can contact specialist domestic abuse services for support and advice.

The initiative is being supported by the General Pharmaceutical Council and Royal Pharmaceutical Society. For more information about how pharmacies can become a Safe Space, visit https://uksaysnomore.org/safespaces/

Medicines Management  5/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Medicines Management 4/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

How to access Dental Treatment 1/5/2020 

General dental practices are expected to remain open to act as a primary contact point for all local patients to secure initial urgent dental care through the provision of remote telephone triage, self-care advice and treatment through prescription of pain killers and antibiotics to manage urgent dental care symptoms where appropriate.

They will also be able to refer those patients in need of urgent treatment to a designated treatment centre where they can be seen, but only where clinically this is absolutely necessary.

Outside of normal dental practice hours and at weekends, patients should contact NHS111 to access advice and support.

All dental practices are responsible for triaging patients who contact the practice seeking access to urgent dental care (UDC) regardless of whether they are considered ‘regular’ patients of the practice. This means patients that do not have a regular NHS dentist can still access urgent care.

Medicines Management 1/5/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Medicines Management  30/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted. 

Medicines Management 29/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Community Pharmacy Webinar  28/4/2020

The recording of the 22 April community pharmacy webinar with Ed Waller and Keith Ridge is now available on the Future NHS platform. It includes updates on Covid-19 testing by Dr Aidan Fowler, Deputy Chief Medical Officer at the Department of Health and Social Care and a regulatory update from Duncan Rudkin, Chief Executive of the General Pharmaceutical Council.

Accessing Medicines for detainees released during COVID-19  28/4/2020

This recently published guide is to support probation and youth offending teams and other teams supporting people released from custody on accessing medicinesand pharmacy services during the COVID-19 outbreak.

Medicines Management 28/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted. 

Patient facing information for pharmacies 27/4/2020

We have produced new public-facing digital posters for pharmacies to use on social media and in-pharmacy screens with the following messages:

• Don’t enter your local pharmacy if you or anyone you live with has coronavirus symptoms
• There’s no need to order extra medicines
• Pharmacies are having to make changes to allow them to stay open during the pandemic.

These can be downloaded here and will also be used on our social media and shared with stakeholders for use on their channels as well.

We have also updated the following nhs.uk pages to reflect feedback from community pharmacy in light of the coronavirus pandemic:

• How to order repeat prescriptions online
• What to expect from your pharmacy team
• How to get medical help from home

We will be launching a public facing PR campaign in early May.

Medicines Management  27/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Guidance on ethical professional decision making in the COVID-19 Pandemic  24/4/2020

The Royal Pharmaceutical Society have produced a new ethical decision making framework to support pharmacists and pharmacy teams faced with making difficult decisions linked to the exceptional impact of Covid19. The framework can be used to support colleagues involved in strategic planning, or to help people with their medicines and is for use by pharmacy professionals in all settings.

Extending access to Shielded Patient Flag and SCR for locum pharmacists 24/4/2020

To support community pharmacy teams to work efficiently and flexibly in response to Covid-19, we have been working with NHS Digital to extend access to the Summary Care Record (SCR). This will also provide access to the Shielded Patients Flag in SCR Application (SCRa).

The first phase of this work will grant SCR access to all locum pharmacists with the 5F locum code on their smartcards. A new smartcard role, National Locum Pharmacist + SCR – Covid 19, will start to be added to smartcards from this evening and will automatically expire after one year. This will be done centrally with no action required by individuals.

This role should be used when working flexibly at sites where you do not have a dedicated smartcard role specific to the site. 

A reminder to keep your NHS 111 Directory of Services Profile and your NHS website profile up to date 24/4/2020

With more people using online services, it is important to keep your NHS website profile up to date.  The step-by-step guide for updating your NHS Website profile is available here. For temporary closures of more than 5 days please amend your opening times within the Dos Profile Updater, for temporary closures of less than 5 days please amend your RAG status to ‘RED’ using the DoS Capacity status tool which can be accessed from the login page on DoS Profile Updater.

Medicines Management 24/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

EPS one-off nomination in TPP SystmOne 23/4/2020

One-off nomination functionality for EPS has been rolled out to all TPP SystmOne users. The new feature allows patients’ electronic prescriptions to be sent to an alternative pharmacy when their regular nomination is not appropriate, for example if it is closed or if specific items are required.

Pharmacies can be searched by postcode and opening hours. One-off nominations do not affect future prescriptions; these will continue to be sent to the patient’s regular nominated pharmacy. The one-off prescription will, however, be affected if the regular nomination is changed before it has been downloaded by the pharmacy.

EMIS is also developing this functionality for their EMIS Web system and will share further information on this in due course

Returning to pharmacy or volunteering 23/4/2020

Extra help for pharmacy would be invaluable right now, with pharmacy teams across the country under huge pressure because of COVID-19. The Royal Pharmaceutical Society are providing advice on roles or activities for volunteers or those who may wish to return temporarily to the register, based on their skills and experience

Medicines Management 23/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Pharmacy Clinical Assessment Service 22/4/2020

The Pharmacy Clinical Assessment Service (CAS) continues to build on the initial phase launched last Friday. The CAS is run by South Central Ambulance Service (SCAS) as part of the COVID-19 CAS response to support the NHS 111 and IUC response to the pandemic. Pharmacists from a range of backgrounds have volunteered to work remotely including staff from community pharmacy providers and returners to practice.

A number of NHS 111/IUC partners across the network have supported the set up and design of the CAS so that the operating model can be optimised and  build on the learning from the NHS England and Improvement Pharmacy Integration Fund IUC programme. Derby University has made available short introductory course modules and material taken from the IUC Pharmacist course commissioned jointly by NHSE&I and Health Education England. This will be available to pharmacists to underpin their practice and provide access to other IUC pharmacists to act as mentors and buddies as the Pharmacy CAS develops.

Metropolitan Police Guidance: Community Pharmacy Security  22/4/2020

The Metropolitan police has issued guidance specifically for community pharmacy premises offering advice on security of premises, and safety and well-being of staff and customers during the pandemic.

Movement of Pharmacy Employees Between their Residence and Place of Work  22/4/2020

The RPS and GPhC has produced a letter to support the legitimate movement of pharmacy employees  between their home and place of work. 

Medicines Management  22/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Local guidance (attached) has been produced to support with the management of patients on vitamin B12 (hydroxocobalamin) injections during Covid 19. The guidance has been endorsed by the haematologists at BHNFT. 

Medicines Management 21/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Pharmacy Clinical Assessment Service 20/4/2020

To support the NHS 111 and IUC response to the Coronavirus pandemic a Pharmacy Clinical Assessment Service (CAS) has been established aligned with the national COVID-19 CAS. The service went live at 16.00 on Thursday 16 April. It will run 08.00 – 20.00 for 7 days a week with a team of pharmacists.

The aim of the service is to:

• Increase clinical capacity within services sitting behind the NHS 111 Online access route in order to free up other clinical disciplines to focus on COVID-19 related demand;
• Re-deploy pharmacists employed in other roles (who have volunteered by agreement with their employer) and returning pharmacists (those who have left the NHS and have volunteered to return) to manage other routine case-mix calls that use the established skill set of pharmacists.

The case mix of calls for the Pharmacy CAS has been adapted from the existing NHS Community Pharmacist Consultation Service (NHS CPCS) symptom groups and those calls that would normally be handled by IUC CAS Pharmacists so that the Pharmacy CAS will be available to 111 providers at time of high demand.  111Online users will also be able to select “speak to a pharmacist today” as an alternative to booking a call back from an urgent primary care service. Patients with declared Coronavirus symptoms will be assessed by clinicians through the COVID-19 CAS who may then transfer patients direct to a pharmacist for specific medicines advice to support self-care.

As with NHS CPCS, the Directory of Services (DoS) will enable the appropriate clinical outcomes to be directed to the Pharmacy CAS. The service offer will be reviewed on an ongoing basis with a view to expanding its activity and scope in a phased approach to ensure safety.

The pharmacists all undergo the same training as the COVID-19 CAS clinicians with some additional training to support the pharmacy specific role using the learning from the current IUC pharmacist training programme

Easter opening of pharmacies – claims process  20/4/2020

The claims process for those pharmacies who were open on Good Friday and Easter Monday has now become live. From Friday 17 April until midnight on Tuesday 5 May, pharmacy contractors will be able to log on to the NHSBSA MYS portal to declare their opening hours and claim the appropriate payment. The payments will be made as part of April submissions, and paid to contractors on 1 June. These payments will not show on the standard payment schedule, but NHSBSA will write to all contractors who claim any hours on the two bank holidays to confirm the payment.

Medicines Management 20/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Upcoming Webinar 17/4/2020

Wednesday 22 April, 7-8pm: Community pharmacy webinar with Keith Ridge and Ed Waller

Medicines Management 17/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted, although please  note that there are no additions today.

Next community pharmacy webinar 16/4/2020

Details of the next webinar with Keith Ridge, Chief Pharmaceutical Officer and Ed Waller, Director for Primary Care Strategy and NHS Contracts will be held on 22 April at 7pm. Link to join can be found below: Wednesday 22 April, 7-8pm: community pharmacy webinar with Keith Ridge and Ed Waller.

Acute use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with or at risk of COVID-19 (RPS2001) 16/4/2020

In response to the public health emergency posed by COVID-19, we have established a rapid policy development process to aid clinicians in offering best care and advice to patients with or at risk of COVID-19. This document sets out the clinical policy for the acute use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with or at risk of COVID-19. The chronic use of NSAIDs is outside of the scope of this policy with a separate review to take place. NICE has also produced a rapid evidence summary.

Medicines Management 15/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

New campaign resources  15/4/2020

Materials for NHS healthcare settings were recently updated to include

• Updated ‘Do not enter’ posters for healthcare settings including GP and pharmacies (for those with symptoms of coronavirus)
• New Pharmacy opening times poster – for use when pharmacy may be closed to the public during normal opening hours

All downloadable here.

Preparedness letter for community pharmacy 15/4/2020

The latest regular update for community pharmacy was published yesterday and includes information on Personal Protective Equipment (PPE) following the updated guidance which was published by Public Health England (PHE) on 12 April 2020, the NHS Home Delivery service and the use of NHS Volunteers for collecting medicines, amongst other guidance.

Medicines Management 15/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Temporary closures and changes to pharmacy opening hours on your NHS website profile 14/4/2020

With more people using online services due to COVID-19, it is important to keep your NHS website profile up to date and to reflect any temporary closures or changes to your opening hours. Pharmacy profiles editors will receive guidance via email from the NHS website service desk explaining how to do this for both short-term (up to four days) and longer term (five days or more) changes. The step-by-step guide is also available.

Confirming pharmacist status 14/4/2020

The Pharmacists’ Defence Association has designed a personalised digital ID card to help pharmacists confirm their status. The card may be of particular use for locum pharmacists who may not be able to obtain an employer stamp or endorsement to use with other documentation. The card can be saved on smartphones or mobile devices or printed off.

NHS Home Delivery Service 14/4/2020

An NHS Home Delivery Service has been commissioned from both community pharmacies and dispensing doctors to ensure delivery of medicines to eligible patients who have been identified as ‘shielded’. More details are in our letter published today.

Patients who meet the ‘shielding’ criteria, are encouraged in the first instance to see if their medicines can be collected from the pharmacy or dispensing practice and delivered by family, friends, a carer or a volunteer.  Where this is not possible the patient’s pharmacy or dispensing doctor team will arrange delivery

Medicines Management 14/4/202

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Additionally please find attached version 2 of the Covid 19 Rheumatology Guidance referred to in this document.

Medicines Management 9/4/202

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

General Practice Communication Links with Pharmacies 8/4/2020

Practices are reminded to share their Safehaven emails with pharmacies and that communication links with pharmacies are maximised. 

Medicines Management 8/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted. Please also find attached SWYFT guidance on lithium and Covid-19 (as referred to in the information sources document).

Importance of Maximising Use of Electronic Repeat Dispensing (eRD) 8/4/2020

On 31 March 2020, NHS England and Improvement published a letter (attached) that detailed the importance of maximising use of electronic repeat dispensing (eRD) as part of the Covid-19 pandemic response. The letter includes an offer of practical assistance to practices including webinars and the provision of a dedicated email and phone support.

Electronic Prescription Service (EPS) 8/4/2020

As part of the Covid-19 Primary Care response to reduce footfall into general practice and support remote working NHS Digital have reviewed the Electronic Prescription Service (EPS) go-live process.  

The activities required for a general practice to go live with EPS for their non-dispensing patients have been updated. These are actioned locally, and all previous procedures and communications are now out of date. It is recommended that there is a four-week notice period before go-live. Practices can go live sooner than four weeks and this will be a local decision.   

Further information on EPS go lives can be found: https://digital.nhs.uk/services/electronic-prescription-service/switching-on-eps

If needed, remote support for go live is available from CCG/CSU colleagues as appropriate and/or Faheem Ismail of NHS Digital (faheemismail@nhs.net , 07917592318).

Supporting people to access medicines 7/4/2020

A letter has been published and sent to community pharmacies with information about supporting people to access medicines who have been released from prisons and other prescribed places of detention for adults and children.

Medicines Management 7/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Medicines Management 6/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Medicines Management 3/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care’. Latest items are highlighted.

Extending drug monitoring for shared care drugs 3/4/2020

The Rheumatology and Gastroenterology specialists at BHNFT have advised that the drug monitoring for DMARDs can be extended from 3 months to 6 months in the following circumstances:

• Patients prescribed DMARDs or biologics who have been on a stable dose for 6 months and have had no issues with monitoring EXCEPT patients prescribed tocilizumab (see below).

 Patients prescribed tocilizumab (red drug) as monotherapy will continue to be monitored by BHNFT. However, some patients prescribed tocilizumab will also be prescribed methotrexate, these patients need to continue being monitored every 3 months.

The rheumatology specialists are happy to monitor advice and guidance for any clinical question on existing or new patients.

Please find attached the ‘Specialist Drugs Service spreadsheet’ of monitoring requirements which has been updated to reflect these changes. Please refer to the highlighted rows for details of drugs where the monitoring has been extended.

We are waiting to hear from Dermatology regarding extending monitoring in their patients taking immunosuppressant drugs. We will provide an update as soon as we hear anything further.

Uplift to Pharmacy Contractors’ Payment 2/4/2020

Yesterday, the NHS Business Services Authority published information about an uplift to pharmacy contractor’s payment from today. To mitigate cash flow issues that contractors are facing due to COVID-19, an uplift of £300 million in total over the next two months will be made to contractors’ ‘advance payments’. This uplift is not additional funding over and above what was agreed for 2020/21 under the Community Pharmacy Contractual Framework 5-year deal. The uplift will be reconciled in 2020/21. Further discussions continue with Pharmaceutical Services Negotiating Committee (PSNC) on wider issues and further communications will follow. 

Pharmacy Letter 3 31.03.2020 (attached)

This is the third in a series of regular updates to community pharmacy regarding the emerging COVID-19 situation.

Advice for health and justice healthcare teams on medicines and pharmacy services continuity 2/4/2020

This guidance describes the changes that may be needed to provide continuity of medicines during an outbreak. Providers should already have plans for pandemic and seasonal flu outbreaks or major incidents that can be used and adapted for COVID-19 outbreaks.

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0090-guidance-for-medicines-and-pharmacy-service-continuity-in-HJ-services-270320.pdf

Easter opening for community pharmacy 2/4/2020

As you will all understand, a crucial phase of the pandemic will be ongoing over what is usually a long Easter weekend but for the NHS more widely will be an extremely busy time and pharmacies will need to be open on Good Friday and Easter Monday as part of the wider NHS response to the pandemic. Further information on the requirements will follow as soon as possible and discussions are ongoing with PSNC.

Medicines Management 2/4/2020

For Medicines Management information please see attached document ‘Medicines Management COVID related information sources for primary care’. Latest items are highlighted.

RCN - Prescribing safely under COVID-19 2/4/2020

This guidance has been developed to support nurses practicing within areas such as general practice, extended hours and out of hours who are being asked to treat patients via a telephone or video or through other remote consultation when they would normally see them face to face.

https://www.rcn.org.uk/clinical-topics/medicines-management/covid-19-remote-prescribing

Medicines Management 1/4/2020

For Medicines Management information please see attached document ‘COVID related information sources for primary care 1.4.2020’. Latest items are highlighted.

Community Pharmacy Opening Hours 1/4/2020

Please find attached a spreadsheet detailing changes to community pharmacy opening hours across SYB (a separate tab for each CCG area). Please note that this reflects the notifications we have received but comes with the caveat that there may be some changes that we have not yet been notified of.

Medicines Management 31/3/2020

For Medicines Management information please see attached document ‘Medicines Management COVID related information sources for primary care’. Latest items are highlighted.

Online Medicines guides  31/3/2020

Due to the increase of patients requiring being set up online to order their medicines, guides for both practices and patients have been developed (see attached documents) to support them to make use of the online services. Also in there is a process guide to help practices identify those patients who can set themselves up and those who practice would need to set up.

EMIS - Proxy Set Up

EMIS - Set Up

EMIS Patient Guide - Patient Access

EMIS Patient Guide - Proxy Patient Access

Process for online access d0.2

SystemOne - Set Up

TPP Patient Guide 1

Online Medicines guides 30/3/2020

Due to the increase of patients requiring being set up online to order their medicines, guides for both practices and patients have been developed (see attached documents) to support them to make use of the online services. Also in there is a process guide to help practices identify those patients who can set themselves up and those who practice would need to set up.

 

Repeat px 30/3/2020

To manage patients expectations can patients be reminded of the correct process for ordering their medicines which is as follows;

We advise that you start to plan for your next supply of repeat prescriptions medicines 7 days before your medicines are due to run out. The GP practice will need at least 48 hours to issue your prescription and up to another 48 hours will be needed by your chosen pharmacy to prepare and obtain your medication, this will also allow for weekends and bank holidays

We have received reports from community pharmacy of situations where patients are presenting at the pharmacy for their repeat prescription before the recommended processing time. Patients are informing the pharmacy they advised to collect early via the following sources;

• When I ordered it online, it said it will be ready in 2 days
• The ordering box at the surgery says to pick it up in two days
• The receptionist told me to come and collect it today when I requested it, so I have done
• The doctor told me to come and it will be ready for me

This is creating  additional pressures on community pharmacy and exposing pharmacy staff to unnecessary patient contact. Prescriptions are taking longer to process than normal and there are delays in the supply chain for common items - can practices please advise patients to contact their pharmacy prior to their visit to reduce unnecessary visits and travel.

If you require your patient  to access their medicines urgently please let the pharmacy know so they can plan ahead and prioritise the prescriptions in their workflow.

Medicine prescriptions 27/3/2020

We have had queries about medicine prescriptions issues related to GPs over-prescribing. A letter was issued by Keith Ridge on community pharmacy last week including the position below. 

The DHSC is working closely with industry, the NHS and others in the supply chain to ensure patients can access the medicines they need, and precautions are in place to reduce the likelihood of future shortages.

It is essential that GP practices do not issue prescriptions for a longer duration than usual, pharmacies do not order request larger quantities, and patients and the public do not order earlier or seek to stockpile medicines as this behaviour could put the supply chain at risk.

DHSC is monitoring the impact of coronavirus on UK medicines supply. Information on this activity can be found here.

Eclipse Live  - Weekly Extractions 26/3/2020

Eclipse Live is a tool which identifies patients at  risk of medicines related hospital admission. GP practice staff workload and patient social distancing with COVID-19 will increase the risk of patients missing out on necessary monitoring and this tool will become more useful than ever as a safety net in identifying and minimising these risks.

An important part of Eclipse Live working efficiently is that the algorithms are run on the latest data. The Eclipse Live Company (Prescribing Solutions) are offering practices the opportunity for weekly extractions to be set up as an automated data extract.  Keri Whitmore from Prescribing Solutions will be emailing practices who are currently completing manual extractions to sign them up to this service. The process takes 1-2 weeks so it is important that practices sign up as soon as possible to the process to allow this to be completed before we start running into CovID 19 peak pressures.

PSA testing in asymptomatic gents 25/3/2020

PSA screening for asymptomatic men should not currently be performed unless there are concerns regarding metastatic disease, and particularly not in men aged 70 and over

Changes to medication management service in response to covid-19 24/3/2020

In response to COVID-19 amendments need to be made to the Medication Management Service Guidance and Specification to eliminate the requirement for face-to-face patient medication reviews.

Additionally there are reports that some pharmacies are unable to provide Medication Management Service reviews due to the intense pressures they are facing in relation to workload pressures.

The CCG has made the pragmatic decision to temporarily suspend requirement to deliver the medication management reviews (MMR’s) as part of the medication management service specification. This is in situations where pharmacies are unable to practically undertake a face-to-face medication review prior to producing a care plan. In these instances the pharmacist should use their professional judgement and consider one of the following two options: -

Option 1:

• Provide the MMS review over the telephone and provide a care plan from information provided. Implementing any necessary adaptation e.g. Monitored Dosage System (MDS) provided.

Option 2:

• In instances where Option 1 isn’t possible i.e. due to significant capacity issues provide the domiciliary care provider with a MAR chart and medicines dispensed into original packs or an MDS (whichever is practical for the pharmacy). 

The key reason for these changes is to free up capacity for community pharmacy and community nursing staff, so that they can prioritise their workload in relation to Covid-19.

Any queries relating to these changes please contact the medicine management team on 01226 433798.

COVID-19 – Diabetes At-a-Glance Factsheet for Primary Care 24/3/2020

The Primary Care Diabetes Society have published an at-a-glance factsheet for primary care with some important and useful information for primary care HCPs – including the following advice about prescriptions:

Be very aware that people with diabetes, in addition to the expected respiratory symptoms of COVID-19, are also at increased risk of metabolic decompensation whilst trying to self-manage their  diabetes at home.

• Ensure patients have adequate supplies of medication
• Ensure patients have necessary supplies of monitoring equipment at this time. This is especially important for those who require ketone monitoring equipment.

MS Society - Coronavirus and MS treatments 24/3/202

ttps://www.mssociety.org.uk/about-ms/treatments-and-therapies/disease-modifying-therapies/covid-19-coronavirus-and-ms  

Epilepsy Society - Epilepsy and the coronavirus FAQ’s 24/3/2020

https://www.epilepsysociety.org.uk/epilepsy-and-coronavirus-covid-19-faqs#.Xnn2lW52vIV

Immunosuppressant treatments in neurology 24/3/2020

Advice from the Association of British Neurologists: https://cdn.ymaws.com/www.theabn.org/resource/collection/6750BAE6-4CBC-4DDB-A684-116E03BFE634/ABN_Guidance_on_DMTs_for_MS_and_COVID19_APPROVED_11_March.pdf

Immunosuppressant treatments in gastroenterology  24/4/2020

Advice from the British Society of Gastroenterology: https://www.bsg.org.uk/covid-19-advice/bsg-and-basl-covid-19-advice-for-healthcare-professionals-in-gastroenterology-and-hepatology/

Crohn’s and Colitis UK: https://www.crohnsandcolitis.org.uk/news/coronavirus-covid-19-advice

PrescQIPP 24/3/2020

PrescQIPP have produced a signposting document to provide links to the most frequently discussed media reports. PrescQIPP acknowledge that the picture is changing so frequently that they feel it is impossible to provide robust advice. The document is accessible at this link:https://www.prescqipp.info/news/covid-19-virus-and-medicines/ (registration is required to access). The page will be updated regularly by PrescQIPP.

Key points from the above link will be included in these daily bulletins.

UCLH MI Service 24/3/2020

University College London Hospital NHS Trust (UCLH) Medicines Information Service have produced a resource (attached) which includes links to guidance and position statements produced by different professional bodies / medical specialities.

MDS patients who can cope with original pack dispensing 23/3/2020

A GP practice has been approached by a community pharmacy asking them to provide a list of MDS patients who, in an extreme emergency, would be able to manage without the MDS for a short period of time (i.e. original containers) and who has assistance from a carer or relative.

The pharmacy is attempting to plan ahead as much as they can and is wanting to put in place a contingency plan for future potential issues. The dangers with this approach are that an individual’s circumstances are changing so quickly and one day may have the support of a family member but the next day they may be self-isolating.

Request for hospital only medication to be prescribed in general practice 23/3/2020

Requests are being made to general practice to prescribe hospital only drugs. These requests are being made by patients who are either self-isolating or who are in one of the at risk/vulnerable patient groups where social distancing is strongly advised. Hospital only drugs have a red traffic light status. These drugs are given this status for reasons such as low patient numbers requiring specialist therapy, so GPs do not become familiar with these medicines or medicines that require more extensive monitoring (either the disease state or the drug itself). Those patients self-isolating or in an at risk/vulnerable group would usually collect these medicines from the hospital direct. Since this is no longer possible, patients are asking their GP to prescribe.

Different ways to facilitate collection of these from the secondary care environment needs to be considered. Possibilities include the use of Homecare companies or the volunteer sector to collect medication and deliver to the patient.

Packing down paracetamol 23/3/2020

The Over the Counter (OTC) packs of paracetamol tablets are in very short supply. The Royal Pharmaceutical Society has produced guidance to allow community pharmacies to use a dispensing pack of paracetamol to produce smaller packs that can then be sold to the public. Guidance on this can be found at the following link: www.rpharms.com/coronavirus#paracetamol

FSRH CEU Clinical advice to support provision of effective contraception during the COVID-19 outbreak 23/3/2020

 https://www.fsrh.org/documents/fsrh-ceu-clinical-advice-to-support-provision-of-effective/fsrh-clinical-advice-to-support-provision-of-effective-contraception-covid.pdf

Rheumatology  patients on DMARDs- advice on stopping treatment 20/3/2020

• Advice from the British Society of Rheumatology https://www.rheumatology.org.uk/news-policy/details/Covid19-Coronavirus-update-members 

Patient information from support organisations which may be helpful advice for patients

• Diabetes UK https://www.diabetes.org.uk/about_us/news/coronavirus
• British Heart Foundation https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health

Patents with asthma and COPD- concerns about the use of steroids 20/3/2020

• Asthma UK advise continuing use https://www.asthma.org.uk/advice/triggers/coronavirus-covid-19/ 
• British Lung Foundation advice https://www.blf.org.uk/support-for-you/coronavirus 

Concerns about increased number of deaths in patients with hypertension and diabetes  20/5/2020

Patient information from support organisations which may be helpful advice for patients

• Diabetes UK https://www.diabetes.org.uk/about_us/news/coronavirus
• British Heart Foundation https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health

Ibuprofen and other NSAIDs (potential concern regarding the suppression of the inflammatory reaction as well as potential to increase ACE2) 20/3/2020

• MHRA alert advises that patients, with confirmed Covid-19 or believe they have Covid-19, use paracetamol in preference to NSAIDs. Those currently on NSAIDs for other medical reasons (e.g. arthritis) should not stop them. https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103001
• NHS.uk advice is to use paracetamol until we have more evidence https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/ 
• HSE Ireland have issued a statement which differs slightly from the NHS England advice.https://www.hse.ie/eng/services/news/media/pressrel/advice-about-anti-inflammatory-medication-and-covid-19.html 

Are patients at higher risk from Covid-19 infection if they take an ACEi or ARB? 20/3/2020

The risk of using ACEi or an ARB has been proposed as an hypothesis, however there is currently no evidence to suggest that this is true. Several organisations have released statements advising prescribers not to stop treatment as the harms from stopping are likely to be greater than the risks of continuing.

• The British Cardiovascular Society and the British Society for Heart Failure (16 March 2020) https://www.britishcardiovascularsociety.org/news/ACEi-or-ARB-and-COVID-19
• The European Cardiology Society (13 March 2020) https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang
• The European Society of Hypertension https://www.eshonline.org/spotlights/esh-stabtement-on-covid-19/
• The Renal Association https://renal.org/covid-19/renal-association-uk-position-statement-covid-19-ace-inhibitorangiotensin-receptor-blocker-use/

Patients taking these drugs and presenting unwell with suspected or known COVID-19 infection should be assessed on an individual basis and their medication managed according to established guidance:

• Heart Failure: Heart 2019;105:904-10.
• NICE guidance: Heart Failure: https://www.nice.org.uk/guidance/ng106 
• Hypertension: https://www.nice.org.uk/guidance/ng136/chapter/Recommendations#monitoring-treatment-and-blood-pressure-targets 

PrescQIPP 20/3/2020

PrescQIPP have produced a signposting document to provide links to the most frequently discussed media reports. PrescQIPP acknowledge that the picture is changing so frequently that they feel it is impossible to provide robust advice. The document is accessible at this link: https://www.prescqipp.info/news/covid-19-virus-and-medicines/ (registration is required to access). The page will be updated regularly by PrescQIPP.

Pharmacy Monitored Dosage System ( MDS ) Requests 19/3/2020

Carers, family and friends should be encouraged and requested to support patients with administering medication if its required.

We recommend that  there should be no new referrals to Community Pharmacy to supply dosette boxes or monitored dosage systems (MDS) at this time.  Whilst pharmacies and hospitals will make every effort to continue to supply existing patients with dossette boxes or MDS,  they may have to revert to original pack dispensing ( using medicines administration charts) to cope with the Pandemic workload. 

Pharmacy Delivery Services 19/3/2020

Pharmacy delivery services are only sufficient for patients who currently have their medications delivered. Deliveries are made at the discretion of the Pharmacy and some Pharmacies charge for this service.  There are currently no processes in place for pharmacies to deliver to infected or isolating households.  Practices should advise patients to make arrangements for someone to collect medicines from the Pharmacy on behalf of anyone who is ill or self-isolating 

Sharing of  "Safe Haven" mail address with Community Pharmacies 19/3/2020

If the GP Practice 'safe haven" email is set up such that the GP practice can receive and respond to prescription queries and requests in a timely manner then this could be shared with Community Pharmacies to reduce GP Practice footfall. However this should only be done where there is the Practice commitment to maintaining oversight of the queries and requests being received. 

All Pharmacies have a safe haven address, however this should NOT be used to urgently communicate with Community Pharmacies ; where a response is required in less than 24 hours. 

From 1st April 2020, faxes are no longer an acceptable way of communicating between NHS Providers . NHS mail is an accepted way of securely communicating Patient Identifiable Information.

Prescription Quantity & Duration 19/3/2020

Practices should follow guidance which has been sent out regarding issue of prescription quantity and duration. Stockpiling will exacerbate pressures on prescribed medicine stocks and may create shortages. The current advice is for patients to continue ordering prescriptions as usual , maintain current prescription length and in particular NOT increase quantities to 84 days . This includes prescriptions for dressings , appliances and nutrition products ( including baby milks). Patients should be asked to order only what is needed. 

There has been an increase in patient requests to obtain Paracetamol on prescription and this should only be prescribed in the usual quantity on the regular repeat prescription.

Repeat Prescription Ordering 19/3/2020

Practices should comply with guidance which was  sent out last Friday in respect  of "Repeat Prescription Ordering" ( see below) ; directing patients  first-line to online services where appropriate.  To support this NHS England have agreed that people no longer need to attend GP practices to present Physical ID in order to self-verify.

"In order to reduce patient footfall and exposure, this  is best done by patients ordering online if possible  - patients can be supported by a family member, friend or carer. 

Practices should provide patients with advice regarding arrangements for patients who usually drop their  prescription request off at the practice reception:

• Encourage  patients to set up online ordering , the Medicines Management Team would be happy to support patients setting up online ordering and are on hand to talk patients through the changes and what would work best for them. Medicines management team advice line: 01226 433771 (9am - 4pm, Monday to Friday)  OR Email: barnsleyccg.mosw@nhs.net

• Requests can alternatively be posted into the practice (not the pharmacy) using Royal mail services or the external practice mailbox, for any practices where this is not possible then a temporary mailbox/postbox at the entrance to the practice which can be safely and securely used to receive prescription requests could be set up.    

Practices and community pharmacies should agree suitable times and locations to collect prescriptions in the event that there is restricted access to the GP premises.

Referral of Patients to Community Pharmacy 19/3/2020

Community Pharmacies have a vital role in medicines supply and are a key part of the primary care response to this Pandemic. Appropriate use of their services and reducing unnecessary potential staff exposure to the virus is as important as for any other member of the primary health care team. The risk to their staff and work overload are compounded ;  Pharmacies are less resourced than GP practices regarding the PPE they have been provided with and also Pharmacies are dealing with increasing referrals from NHS 111 for the recently introduced Community Pharmacy Consultation Service (CPCS).

Practices are advised that before implementing any change in usual practice in referral of activity to Community Pharmacies , the practice should first have a conversation and agreement with the Pharmacies about the volume and type of referral to ensure that they can manage taking into consideration their current staff and workload. 

Practices are also asked to respect the importance of adhering to GDPR legislation when communicating and referring patients , particularly that patient identifiable information (PID) should be communicated securely and appropriately.