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CPCF Roadshow: 6 days to go

Following the announcement of a five-year deal on the Community Pharmacy Contractual Framework (CPCF), PSNC is holding a series of Sunday roadshow events for community pharmacists across England. The Roadshow begins in just under a week’s time, with events being held in Darlington and Doncaster on Sunday 25th August, so there is not long left...

3 hours ago

New pharmacy system receives EPS accreditation

NHS Digital has confirmed that a new Patient Medication Record (PMR) system called Titan has been granted Electronic Prescription Service (EPS) accreditation. The system supplier, Invatechhealth, has set out details about the system on their website. Their contact details and a link to their website is listed alongside other supplier details here. PSNC recommends that...

4 hours ago

CPCS: Check that your shared NHSmail account is in the pharmacy directory

Community pharmacies will be required to have a shared NHSmail account to deliver the Community Pharmacist Consultation Service (CPCS), but only accounts listed accurately in the NHSmail pharmacy directory will be recognised as meeting this requirement. Whilst most pharmacies will have their NHSmail set up correctly, contractors are advised to make sure that their pharmacy's...

8 hours ago

Dispensing

This page contains resources to support pharmacies in delivering Essential Service 1 – Dispensing Medicines.


7 Day Prescription Guide

MDS / MCA / Compliance Aid Guide

Area Prescribing Committee (APC)

Branded Generics

Local CCG Policies

Dressings on FP10

Medicines Information Websites

Medicines Shortages

Pharmaceutical Stationery Orders

Use of Emergency Salbutamol Inhalers in Schools

 

  

7-Day Prescription Guide

The 7-Day Prescription Guide is to assist you in deciding which of your patients may require 7-day prescriptions and will help you in your discussions with GPs.

 


MDS / MCA / Compliance Aid Guidance

Following increased queries regarding MDS requests we have produced a MDS contractor guide which can be found below.  This guide summarises the key points regarding MDS and addresses the common queries that we receive relating to MDS. 

MDS Contractor Guide

MDS Notification Form

If you are unsure about what you should be taking in to account when deciding whether to supply medicines to a patient in MDS then the recently published briefing from PSNC will be very helpful. It gives you and overview of the background to where community pharmacy currently finds itself with regards to this issues and some practical points for you to consider. Please see PSNC website for more information on the Equality Act 2010: https://psnc.org.uk/contract-it/pharmacy-regulation/dda/.

The PSNC website also contains some excellent FAQs which many pharmacy teams will find it useful to read. 

Improving patient outcomes through MCA: Guidance from the Royal Pharmaceutical Society (RPS MCA 2013).  

 

 

Medicines Compliance Aid Database launched by UKMi

UK Medicines Information (UKMi) has launched a Medicines Compliance Aid database, which makes recommendations on the suitability of transferring solid dose formulations from the manufacturers’ original packaging into multi-compartment compliance aids (MCAs).

The database, which is open access, makes recommendations based on physico-chemical stability and characteristics of the medicine and formulation, information received from manufacturers, and data (where available) on the storage in MCAs.

The database can be searched by the brand or generic name of the medicine, although most entries will be based on the brand leader.  Once searched, the product is given a traffic light colour-coded UKMi recommendation as to whether it is suitable or not to be placed in a MCA.

UKMi recommend using the database alongside the Royal Pharmaceutical Society’s Guidance Improving patient outcomes through the better use of multi-compartment compliance aids.

 

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Medicines Shortages

PSNC have produced a patient factsheet that can be used to highlight explain the issue to patients affected by a shortagehttps://psnc.org.uk/wp-content/uploads/2019/01/PSNC-Patient-Leaflet.pdf.
 
A briefing for prescribers / CCGs (produced in Feb 2019) is available below.
 
Medicines Shortages Briefing for Prescribers  
 
 
The RPS have also produced a medicine shortages poster helps that helps patients understand more about medicine shortages.  The poster can be downloaded from here: https://www.rpharms.com/publications/pharmacy-alerts/details/Medicine-shortages-poster-helps-spread-the-word.
 
 

Stock Shortages: Communication with Prescribers 

Stock shortages continue to be a significant problem and effective communication with prescribers is essential to reduce delays obtaining alternatives for patients.  Proactive, well-planned communication also helps to reduce the workload of pharmacy and surgery teams and to maintain positive relationships.  Information about effective communication along with forms to be used to suggest suitable alternatives for surgeries and for dealing with more general problems can be found below.

Stock Shortages: SBAR Guide - July 2019

 
 

Reporting Shortages

Reporting shortages to PSNC is essential to help PSNC in their concession conversations with the Dept. Health and Social Care.  Please report any supply issues by using the online reporting form. Alternatively, you can report any concerns about drug availability at Drug Tariff-listed prices by contacting PSNC via telephone on 0203 1220 810 or by emailing info@psnc.org.uk. You can email in copies of wholesaler invoices as evidence to medicines.shortages@psnc.org.uk or fax 0207 278 1127.
 
Further details regarding How the price concession system operates can be found in this PSNC briefing: https://psnc.org.uk/dispensing-supply/psnc-briefings-dispensing-and-supply/psnc-briefing-067-18-psnc-briefing-067-18-how-the-price-concession-system-operates/.
 
 

Major Suppliers Online Stock Availability Information 

Due to the ongoing problem of stock shortages, it is increasingly necessary to spend time checking for out of stock information with wholesalers.  The major three wholesalers, AAH, Alliance and Phoenix, all have current stock information on their websites.  These can be accessed instantly and are continuously kept up to date.  They are linked to individual pharmacies’ account numbers so can also be used for ordering and in some cases can track those lines with on-going problems. 

These can be set up in a couple of minutes with a desktop icon on all your terminals for one click access.  The document below has comprehensive instructions to help you set these up.

Major Suppliers Online Stock Availability Information - July 2019

 

Primary Care Supply Update

The Department of Health and Social Care (DHSC) produce a Primary Care Supply Update which is uploaded to the SPS website. It provides an update on medicines with known supply actions, relevant information and advice from the Department of Health and Social Care (DHSC) Medicine Supply team. Any individual with an NHSmail account can register with SPS to gain access to the document. Therefore, as pharmacists can access it directly using their NHSmail account, they can be directed to this site for information.  
 
 

  

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Local CCG Policies

 

Dressings on FP10

We have become aware that some CCGs are implementing a change to the way that dressings are supplied by setting up schemes that allow direct supply of dressings to nursing teams.  These schemes circumvent the usual FP10 route.  This will obviously have an impact on community pharmacy by reducing the number of dressing items prescribed via FP10 route, essentially leaving non-GSL, expensive, infrequently used, part pack dressings on FP10.

Community Pharmacy West Yorkshire does not support the proposed changes but know that it is important that our contractors are informed enabling contractors to make adjustments to stocks held. 

Contractors are reminded that the NHS Pharmaceutical Regulations state that "P must, with reasonable promptness, provide the drugs so ordered, and such of the appliances so ordered as P supplies in the normal course of business". 

These CCG schemes will reduce the number of dressing items prescribed via FP10 route, mainly leaving non-GSL, expensive, infrequently used, part pack dressings on FP10. A community pharmacy contractor has no obligation to supply dressings if it is not part of normal business and is quite within the regulations to refuse to dispense a prescription for dressings where they determine this is the case

 

 

Bradford City CCG, Bradford District CCG and Airedale, Wharfedale & Craven (AWC) CCG

The CCGs do not have a dedicated page to prescribing / medicines management.

 

Calderdale

Link to Calderdale CCG Prescribing page: https://www.calderdaleccg.nhs.uk/prescribing/.

Calderdale CCG commissioning policies and guidelines are available in the key documents page of the CCG website:  https://www.calderdaleccg.nhs.uk/key-documents/.  NB Scroll down to the Clinical Commission Policies & Prescribing Guidelines heading, to find the links to Medicines Management & Prescribing Guidelines including Blood Glucose in Adults with Diabetes – Self-Monitoring Guidelines and Hayfever management in Primary Care.

 

Greater Huddersfield

Link to Greater Huddersfield Medicines Management page: https://www.greaterhuddersfieldccg.nhs.uk/key-publications/medicines-management/.  This page includes links to CCG drug policies.

Greater Huddersfield CCG have recently reviewed and updated their prescription lengths policy.  The policy is available below.

Prescription Lengths Policy - September 2018

The key principles for 7-day prescriptions within this policy is in-line with the Community Pharmacy West Yorkshire 7-day prescription guide and the MDS (monitored dosage system) guidance which can be found at the top of this page.  The policy is helpfully clear that it is the decision of the pharmacy whether MDS is an appropriate adjustment for a patient.  The policy includes a pro-forma for a pharmacy to use to request 7-day prescriptions.

We understand that this has led to some GP practices to review their provision of 7-day prescriptions.  The CCGs policy is clear that 7-day prescriptions are appropriate for some patients using MDS for example those requiring weekly supply, where less stable medication is prescribed and preventing waste where regular changes to medication are made.

 

North Kirklees

Link to North Kirklees Medicines Management page: https://www.northkirkleesccg.nhs.uk/medicines-management/.  This page includes links to CCG drug policies. 

North Kirklees CCG has commissioned PriDerm to provide community dermatology services.  Community pharmacies may be asked to dispense prescriptions for Isotretinoin and the Pharmacist's Guide to Dispensing Isotretinoin provides information on dispensing Isotretinoin in accordance with the Pregnancy Prevention Programme (PPP).

North Kirklees CCG have recently reviewed and updated their prescription lengths policy.  The policy is available below.

Prescription Lengths Policy - September 2018

The key principles for 7-day prescriptions within this policy is in-line with the Community Pharmacy West Yorkshire 7-day prescription guide and the MDS (monitored dosage system) guidance which can be found at the top of this page.  The policy is helpfully clear that it is the decision of the pharmacy whether MDS is an appropriate adjustment for a patient.  The policy includes a pro-forma for a pharmacy to use to request 7-day prescriptions.

We understand that this has led to some GP practices to review their provision of 7-day prescriptions.  The CCGs policy is clear that 7-day prescriptions are appropriate for some patients using MDS for example those requiring weekly supply, where less stable medication is prescribed and preventing waste where regular changes to medication are made.

  

Leeds

Leeds CCG have informed us that they are introducing a change in dressings supply.  We understand that each pharmacy has been sent a letter by post regarding this change.  The letter and dressing list can be found below for your information.

Leeds CCG Dressings Letter

Leeds Dressing List

Also, see Community Pharmacy West Yorkshire stance on dressings supply here.

 

Improving communication about medicines between primary and secondary care

If you have a query regarding the medicines for a patient who has been under the care of Leeds Teaching Hospitals please email;  medicinesinformation@nhs.net or call 0113 206 4344 / Fax 0113 206 5210. 

If your patient has been or is in the care of Leeds & York Partnership FT please email: Pharmacyleedspft.lypft@nhs.net  or call 0113 855 6319 / Fax 0113 855 6322.

 

Wakefield

Link to Wakefield Medicines Optimisation page: https://www.wakefieldccg.nhs.uk/home/patient-in-wakefield/what-we-do/medicines-optimisation/.

Wakefield CCG have informed us that they are introducing a change in dressings supply from 21st May 2018.  We understand that each pharmacy has been sent a letter regarding this change but a copy of the letter and list of dressings affected can be accessed below: 

Wound Care Products Letter 

Wound Product Stock List

Also, see Community Pharmacy West Yorkshire stance on dressings supply here

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Branded Generics 

All medication should be prescribed generically unless there is a clinical benefit to patients.  Community Pharmacy West Yorkshire is aware some Medicines Management Teams / GP practices are switching to prescribing branded generics to achieve ‘cost savings’. 

To highlight the impact branded generic prescribing has for patients, the NHS and community pharmacy, Community Pharmacy West Yorkshire has produced a letter that contractors can choose to use with the local GP practice teams to explain the impact of ‘branded generics’.  The letter can be found below. We encourage contractors speak with the practice pharmacist/technician and their local GP practice teams to highlight the negative impact branded generic prescribing has for you as a contractor. 

Branded Generics Letter

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Area Prescribing Committee - APC


South West Yorkshire Area Prescribing Committee

The South West Yorkshire Area Prescribing Committee (SWYAPC) coordinates issues of prescribing across Bradford, Calderdale, Kirklees (Greater Huddersifled and North Kirklees) and Wakefield.

The SWYAPC website (www.swyapc.org) may be a useful resource for pharmacy teams, particularly if dispensing a drug not commonly seen in primary care.  The website also hosts local prescribing guidelines, such as the local antibiotic formulary, wound management formulary and details of RAG classification identifying drugs that should not be prescribed in primary care.  There are some great resources on the website, including respiratory resources (inhaler technique videos, inhaler leaflets for patients) and a wide array of antimicrobial resources. 

This includes developing prescribing guidelines for use across these areas and RAG (Red, Amber, Green) classification of drugs that may be used in primary and secondary care. 

RAG classification defines where the responsibility for prescribing between primary and secondary care lies and is intended to encourage appropriate shifts in prescribing between hospital clinicians and GPs. For example, drugs which have been classified as RED are hospital only and should not be prescribed in primary care. 


The Leeds Formulary

The development of the Leeds Formulary has been overseen by the Leeds Teaching Hospitals Drugs and Therapeutics Group and is supported by the Leeds Area Prescribing Committee.  The formulary aims to provide information on medicines supporting safe, evidence-based, cost-effective practice. The formulary is a dynamic document and is updated continually.  More information can be found here: http://www.leedsformulary.nhs.uk/

 

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Pharmaceutical Stationery Orders

EPS tokens and other NHS stationery can be ordered via the Primary Care Support England (PCSE) portal.  Click here for further details of how to register for the portal.

 

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Use of Emergency Salbutamol Inhalers in Schools

From 1st October 2014 the Human Medicines (Amendment) (No. 2) Regulations will allow schools to keep a salbutamol inhaler for use in emergencies. 
 
The Department of Health has written guidance for schools which will be of interest as schools are advised to discuss the use of inhalers and spacers with their community pharmacist. 
 
The guidance can be found here.
 
School Inhaler Request Form

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Medicines Information Websites

Below are a few websites commonly used in practice by medicines information services that are free to access and may be of use when dealing with enquiries within community pharmacy

Information on any aspect of drug therapy can be obtained from the Regional Medicines Information Centre in Newcastle 0191 2824631.  This and other useful medicines information numbers can be find in the front cover of the BNF.

 

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Last Updated: 24th April 2019