Contractors are reminded that 30th June 2010 is the deadline for requests for CIP re-pricing checks for the period up to 31 March 2009.

Contractors who think that their payments up until 31 March 2009 have been significantly affected by the introduction of CIP processing only have until 30 June 2010 to ask in writing for a check of a month or months’ prescriptions. After this time no further checking of prescriptions pre 31 March 2009 will be undertaken.

Information on how to make a request for a recheck of prescriptions dispensed within the period up until 31 March 2009 is available on the NHS Prescription Services website

NHS Prescription Services have not yet confirmed time scales for carrying out these checks. Results are not expected to be available before the June cut-off date for requests.

This week is Cancer Prevention Week, 10^th to 14^th May 2010.

Cancer Prevention Week aims to promote healthy lifestyle choices that can prevent up to a third of all cancers, including healthy eating, physical activity and maintaining a healthy weight.  Raising awareness events across the UK.

Click for more information  http://www.wcrf-uk.org

Have you completed your Information Governance submission?

If not, the deadline for doing so is 31st March 2010 and the LPC would encourage all pharmacy contractors to complete it before this date.

If you require further information or assistance, please contact your local PCT IG representative or the LPC Office.

NHS East of England has now provided new guidance on the prescribing and use of unlicensed pharmaceutical specials.  The document is available to view and download using the link below:

The eastern region Strategic Health Authority (SHA) has awarded a grant to the School of Pharmacy at the University of East Anglia to provide and evaluate a Postgraduate Diploma in General Pharmacy Practice for 36 pharmacists across the eastern region.  The SHA grant covers the cost of workplace tutor training and community pharmacist course fees.

The programme is due to start in June 2010 and will run for three years. If you work as a pharmacist in community pharmacy in the east of England for a multiple, independent or as a locum, you can apply for one of the funded places on this programme.

Click here for more information http://www.essexlpc.org.uk/uploads/Community%20Diploma%20Pilot%20Flyer%20_V4.pdf

The University of Hertfordshire School of Pharmacy is hosting a course on Wednesday 17^th and 23^rd February or Sunday 13^th March for any pharmacist wishing to become a preregistration tutor.  For further information about the course or to book a place please contact Dr Russell Foulsham on r.m.foulsham@herts.ac.uk .

Following the success of the Essex LPC Conference on Sunday 27th September, the link below provides access to the event including the keynote speeches.

http://onstage.podia.net/conference09

In a unique event on the 30th November, PSNC brought together spokespeople from all three major parties to debate pharmacy issues.

Click link below for further information http://www.psnc.org.uk/pages/pharmacy_question_time_2009.html 

The NHS may be at risk of failing to prevent harm to patients from medicines unless it improves sharing of vital information when people move between services, says the Care Quality Commission (CQC). 

Click here to read more http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=35474&FAArea1=customWidgets.content_view_1&usecashe=false

The Department of Health Pandemic website is now operational and is reached by using the following link:

https://cps.pandemicflu.direct.gov.uk

To access this site, you will require a User ID and Password which will only be available from the PCTs.  Contractors acting as Distribution Centres will need to obtain these as soon as possible as you will need to enter the Patient Identification Number into the system prior to making supply.

It is not only the country that will go to vote during 2010. A  far more important election surely will be the election of the new committee for Essex LPC. The LPC will welcome interest from any contractors wishing to stand and represent their fellow pharmacists on all issues relating to pharmacy at a local level.

·            Developing a knowledge of the local health economy

·            Be aware of what is likely to happen locally

·            Have a greater understanding of national issues

·            Influence direction of travel for pharmacy

·            Work with fellow contractors

·            Develop skills in working as part of a committee which is most helpful for personal development for those that are ambitious.

The Chemist & Druggist Magazine reports:-

“Significant” potential barriers to pharmacy’s role in a national vascular screening programme must be removed by the Department of Health (DH), MPs have said. But pharmacists must also rise to the challenge of delivering the service, the all-party pharmacy group (APPG) warned.

It was announced today via the BBC that leaflets about the swine flu outbreak and how to prevent its spread are to be delivered to every UK household. Delivery of the government leaflets should start within days. There is no information as yet on the DH website.

The World Health Organization (WHO) raised its pandemic alert status to level four on Monday (see www.psnc.org.uk) after concluding there had been sustained transmission between humans.

Official UK guidance is that anyone with flu-like symptoms who might have been in contact with the virus - such as those travelling in affected areas of Mexico - should seek medical advice - but patients are being asked to minimise the risk of spreading the disease by not going to GP surgeries. Instead, they should stay at home and call their healthcare provider or NHS Direct.

The general public are being referred to NHS Direct either by phone or online. NHS Direct has stopped call centre staff from booking new periods of time off until further notice, as it anticipates more calls and its website has been much busier than usual. The national pandemic flu helpline set out in the government plans is not expected to be operational before the autumn, but there is now an online NHS Direct  ‘Flu symptom checker’ available through the NHS Direct and DH homepages. The NHS Choices website also has a comprehensive Q&A section on swine influenza.

The Department of Health is also urgently looking at increasing stockpiles of masks, most likely for issue to health professionals as scientific evidence does not support healthy people wearing masks while going about normal life.

This is re-iterated in the NHS Choices Q&A pages: The widespread wearing of masks by the general public during an outbreak is unlikely to be effective in preventing people from becoming infected with the virus.  However, masks may have some use for those already infected with the virus in preventing them spreading it further. Healthcare workers and emergency service staff will be advised on the situations in which it may be appropriate for them to wear masks.

The health Secretary has said a stockpile of anti-viral drugs will be used to treat patients showing symptoms, should the virus start spreading in the UK.

There are still only two confirmed cases in the UK. The Health Protection Agency said it was not releasing details about any suspected cases in England until swine flu is confirmed. Eight suspected cases are under investigation in Wales - all linked to travel in Mexico - while none have yet been reported in Northern Ireland. Scotland is awaiting the results of tests on 23 people displaying swine flu symptoms. Fourteen have been screened after returning from Mexico or the US, while nine had been in contact with the British couple confirmed as having swine flu. The results of swine flu tests on 23 people in Scotland are expected later. A Falkirk couple, who recently returned from Mexico, are the UK's first cases.

The virus is thought to have killed nearly 160 people in Mexico. The number of swine flu cases globally is rising, and the first death outside Mexico, that of a child in the US, has juts been confirmed.

The prime minister has said Britain is "among the best prepared countries in the world" to deal with the outbreak”.

"We have been preparing for this kind of scenario for many years," he said, insisting that Britain was now taking "all the urgent action that is necessary".

Useful websites

http://www.hpa.org.uk

http://www.dh.gov.uk

http://www.nhsdirect.nhs.uk

http://www.nhs.uk

http://news.bbc.co.uk/

The Essex LPC wishes to launch its Kitemarking service.  Further details of the article can be accessed by clicking the link below:

 

• is it relevant now,
• is there a demand,
• evidence base,
• stakeholder involvement (especially GP approval and support),
• will the service grow or become redundant?

• Access
• Demonstrable need for service
• Premises, competency, training, skill mix

For the full article, please click this link:   http://www.essexlpc.org.uk/index.asp?type=newsletter&id=167

• The establishment of a new office to be the centre of Essex LPC’s operations. This office will be located in the heart of Essex.
• The appointment of a new Chief Executive, Office Manager and support staff. The Committee plan to appoint a Chief Executive to work alongside John during the first quarter of 2009, taking over the full executive responsibility with effect from 1^st April 2009. Committee plans involve identifying and equipping the office in early 2009 and thereafter appointing a new office manager.
• The new office environment will provide the opportunity for the committee team, including the Chairman, MUR Development Manager, the Enhanced Services Kitemarking lead, the Finance manager and the Business Development Unit manager to work collaboratively. The new environment will also provide facilities for sub committee working.

The document discusses a number of changes and levers which the Department believes are needed in both the medium and longer-term to transform delivery and to align pharmaceutical services within the wider reform programme.

An overarching impact assessment including the Equality Impact Assessment and eight partial impact assessments have been published with the consultation document.

The consultation closes on November 20 2008. Click here to view the consultation document.

PSNC will be considering the consultation document and will respond in due course.

Increasing numbers of Scots are turning to pharmacies for health advice according to a survey published today by the Royal Pharmaceutical Society of Great Britain. The survey, carried out by YouGov, shows that four out of five Scots (81%) would consult their pharmacist for certain types of advice.

The survey was conducted to find out why people consult their pharmacist and if they are aware of the range of services available. The figures show an increase in the number of people approaching pharmacists compared with a similar survey in 2002 which found 72% of Scots were comfortable seeking health advice from a pharmacist.

"The results clearly reflect the changing role of community pharmacy in Scotland," explains Sandra Melville, Chairman of the Society’s Scottish Pharmacy Board. "People are recognising that pharmacists can provide a whole range of health services, information and advice."

Minor ailments topped the list of reasons people consulted pharmacists with 76% of Scots taking a trip to their local pharmacy for advice on things like hay fever, coughs and colds. While 24% would go to their pharmacist for advice on giving up smoking, 18% for a weight or diet issue and 17% for advice on contraception.

Later this year will see the start of the Scottish Government’s roll out of sexual health services, offering free Chlamydia testing and treatment and free emergency contraception across all community pharmacies in Scotland. Smoking cessation services will also be rolled out as part of the expansion of pharmacy services.

"Pharmacies have undergone a major change over the last few years", added Lyndon Braddick, the Society’s Director for Scotland. "Just over three quarters of all community pharmacies now have private consulting rooms, making it easier for people to feel comfortable talking about more personal issues. We hope to see this trend continue with the wider roll out of sexual health and smoking services. Pharmacy has a real role to play in making healthcare more accessible in the community and ease the pressure on the NHS."

The survey did show differing results between men and women, with 86% of women saying they would seek advice compared to 75% of men. The Society is encouraging men to follow the example of women and make a trip to their local pharmacy, not just for medicines but for lifestyle advice. Today, 95% of Scots live within a 20 minute walk, bus or car journey from their local pharmacy. With most open longer at more convenient hours it’s never been easier to get advice.

Essex LPC has been asked to  make a number of presentations locally.  Recently our CEO John Stanley  presented to South Essex LMC, and to South East Essex PCT Board. Other presentations are planned. If your organisation wishes to learn more about the White Paper please contact our office.  The presentation can be viewed and downloaded here ( in pdf format divided into 3 sections:-

http://www.essexlpc.org.uk/index.asp?type=newsletter&id=138

 Webcast on the Pharmacy White Paper

The Improvement Foundation recently hosted a webcast on the pharmacy White Paper. The webcast was initiated by Essex LPC. It included two presentations from  Ash Pandya, Head of Essex LPC's Community Pharmacy Business Development Unit and Bill Sandhu, Head of Medicines Management and Locality Prescribing at South West Essex PCT. The presentation explained the work that was being undertaken to move forward the White Paper proposals in Essex.

The presentations were followed by a discussion on the White Paper with contributions from Alastair Buxton, Head of NHS Services, PSNC and Anurita Rohilla, Head of Medicines Management for the Epping Forest locality of West Essex Primary Care Trust.

The presentations and the webcast recording can be accessed by clicking here

 White Paper marks new era for community pharmacy, news article here:-

http://www.essexlpc.org.uk/index.asp?type=article&id=195

Courtesy C&D.  Minimising the pain of clawback

PSNC's chief executive Sue Sharpe explains the reasons behind the recent category M clawbacks and how these can be minimised in future

Times are tough for contractors but the single greatest issue at present is the downturn in funding. Since January, when the changes to prices and fees from October fully fed through into payments, all contractors have seen significant reductions in NHS payments. 

January and February incomes were very low; the March/April payment should give some relief, reflecting the increase in practice payment from January 2008. But every contractor, independent and multiple, is feeling the pain. 

This is the consequence of the systems for evaluating available purchase profit income, and the action taken in the light of those systems.  

The contract funding, and the formula for annual adjustments delivered growth of c4.5 per cent per annum in total funding in 2006 and 2007. This is good and contrasts with far lower rates for nurses and other public sector workers. In the first year of the new contract, total funding was £1.766 billion. This year it was £1.935bn. 

There is a misapprehension that, because the £500m purchase profit income allowed under the contract has not increased, this means that total funding is being depressed. It is not. But the addition to total funding from the formula is provided by adjustment to fees and allowances, not by increased allowed purchase profits. 

Part of the agreement for our funding was that we would work jointly with the DH to identify purchase profits available to pharmacies, to enable reimbursement prices to be set at levels that delivered the target level of purchase profit each year - of £500m. The availability of that profit is measured by reference to prices paid by independent pharmacies only to ensure that independents are able to earn the target funding. 

Last year, 2006-07, we collected invoices from a sample of pharmacies and analysed prices paid for a representative sample of generic and branded medicines. We engaged consultants to check its statistical validity and accuracy. The results were not available until August last year and the levels of profits disclosed were well in excess of predictions and substantially more than double the £500m allowed.

 The profit monitoring system is still new and we could not cut corners, particularly when faced with such a heavy impact. So we agreed provisional reductions in October, whilst our examination and analysis continued.

Category M prices were reduced, to give lower levels of purchase profit for the remaining six months of the year. The NHS also needed to recover the excess profits deemed to have been earned in the first half of the year, and this is what leads to the recent low income levels.  

Pharmacies are not at present getting paid at the levels agreed in the contract because they are repaying excess profits the inquiry shows were earned from April to September 2007. 

The delay that we have seen is a real flaw in the mechanisms that we need to address. Contractors could not be expected to recognise that they were earning more profit than was provided for from April to September so their funding would be severely reduced for the rest of the year. 

The scale of the excess, and therefore the recovery, is hitting hard. Once we completed negotiations, we were able to secure an increase of 9.3p in practice payments from January 2008.

For the next financial year we are committed to making adjustments in July 2008. The impact would have been less acute had we been able to adjust prices in July last year.

 Our information indicates that levels of purchase profit have reduced since October, and the results of the current invoice inquiry will reflect that. We are confident we will be able to prevent another recurrence of the massive imbalance we have seen this year, and the financial position will improve.

Courtesy Chemist & Druggist:-

Health secretary Alan Johnson has offered a sneak preview of the contents of the imminent white paper on pharmacy and the impact it is likely to add to the drive to provide better access to services in the community.

 Mr Johnson told the NHS Confederation’s PCT Network last week that the white paper would “explore how we can expand the role of the local pharmacy – making it a healthy living centre, with readily available expertise on treating minor ailments, screening, routine testing, advice on taking medicine and support for patients with long-term conditions such as asthma”.

Georgina Craig, head of communications for the Company Chemists’ Association, said the speech was “a good omen”.

She said: “Government is clearly linking pharmacy with the access agenda, which is key.”

Concerns about 100-hour pharmacies went all the way to Parliament this week, backed by an MP who told C+D the exemption rules were "totally wrong". 

Simon Burns MP asked the government to justify the 100-hour exemption, which he said could put many small family-run pharmacies out of business. 

The MP was spurred on by his constituent Maurice Waldman, whose pharmacy in Chelmer Village, near Chelmsford, is threatened by a possible 100-hour opening. Mr Burns demanded the government urgently review the regulations.

 The Galbraith review oncontrol of entry exemptions is now complete, a government spokesperson said. But the review will not be released until the pharmacy white paper is also ready. Mr Burns responded:

"There is no point in having a review, sitting on it for months and then deciding what to do, when in that time lots of small pharmacies could have gone out of business."

 Waldmans Pharmacy could lose half its prescription business to the 100-hour opening planned by a nearby Asda, Mr Waldman warned. He said: "It's good that there is more choice available, but if I can't compete then what choice will there be?" 

John Stanley, LPC secretary for the Essex region, said several 100-hour applications had been filed in the area, and he said the government review was "long overdue". 

Pharmacy industry experts, including the NPA and the Independent Pharmacy Federation, have expressed fears over the 100-hour exemptions, which force PCTs to approve applications from contractors willing to open for 100 hours per week.

• Access to a health care professional. One of the unique selling points for pharmacy is having access to a qualified healthcare professional without an appointment,
• Access to POM medicines Access to POM and P medicines may become limited. This will be very important if the absence of the responsible pharmacists results in no pharmacist being present on the premises at the time.
• Access to GSL medicines. Do you agree that the legislation should stop people now being sent down the road to a newsagent to purchase GSL medicines when the responsible pharmacist is off duty (say during the pharmacist’s lunch hour), when there are qualified medicine counter assistants present is this wrong? If so, then it is important to state that when the responsible pharmacist is absent, the sale of GSL medicines should take place providing appropriately trained staff are present.

• What would the impact be on commissioning of Enhanced Services? Again, where there is a threat there may be an opportunity. 
• If the responsible pharmacist was absent for significant periods during the day what would be the impact be on say supervised consumption of methadone, EHC and other enhanced services?
• If you were allowed to be absent from the pharmacy could you, as a consequence, offer domiciliary visiting, adherence clinics or perhaps run an anti-coagulation clinic?

• Exceptions might include pharmacies, which are set up temporarily, for example at sporting and entertainment events or due to exceptional circumstances, say a flood or a fire?

• The identity of the responsible pharmacist for all times that the pharmacy is open,
• The changes made to SOPs
• Services, advanced and enhanced, offered on the day
• The identify of pharmacy support staff

• Will SOPS need to be altered, say if a member of staff is absent? The responsible pharmacist will be expected to review the situation daily to assess whether the SOPs remain appropriate for the day. If for example a qualified support staff member is absent the SOP may need revision.
• Do you think that the areas to be covered by written pharmacy procedures should be specified in the regulations? If so, which of these areas would you want specified?
• What happens if a pharmacy is under the control of a locum pharmacist for one or more days each week?
• What is the impact on the employment status of locum pharmacists if they do not use their own SOPS?

• Do you think that roles and responsibilities for the responsible pharmacist need specific additional competencies?
• Should a responsible pharmacist have additional qualifications?
• Should a responsible pharmacist have a minimum period of experience before being eligible to be a responsible pharmacist and if so what should this be?
• Do you think, that a pharmacist once qualified, and irrespective of the sector in which they have previously worked, is still a pharmacist and should not need additional qualifications or experience to work in another sector.
• Recent experience in a community pharmacy for say, a year might be appropriate.
• Does the undergraduate course and the pre-registration training prepare pharmacists to undertake these new roles?
• Should this consultation be considered alongside the Educational Consultation being conducted by the RPSGB?
• What consideration should be taken of the impact of changes in the legislation upon the pharmacy workforce?
• Who should provide training if required and where will the resources come from?
• Once a pharmacist meets the criteria for a responsible pharmacist what does he or she have to do to maintain this? Is it transferable from one pharmacy to another?

Essex LPC continues in its aim to inform Pharmacist Contractors of opportunities in our locality.

The LPC still maintains a high profile within all five PCTs in Essex and representatives of the LPC have been present at many of the PCT Board & Professional Executive meetings as possible. We also have been present at the Strategic Health Authority meetings. There has also been an attempt to engage at various levels within the many Practice Based Groups in Essex.

Our aim as always is not only to attend these meetings but also to attempt to influence the agenda items where possible when pharmacy input is possible.

Essex LPC representatives also meet regularly with the neighbouring LPCs within the East of England and have many successes including joint presentation of motions for debate at the PSNC conference in March. The East of England LPCs represent over 1000 pharmacies.

On a locality level all LPC members regularly meet with the pharmacists in their areas and hold local meetings as well as informing all pharmacy teams of new services and developments. There has also been an attempt by some members to personally visit pharmacies in their area.

By use of our Public Relations Team at Mosaic Publicity we have had a programme of press releases, which have aimed at raising public awareness of advanced and enhanced services available at pharmacies in Essex.

For the future we aim to consolidate work started by the committee and will encourage all pharmacists to get the maximum from the pharmacy contract and provide the customers and patients visiting our pharmacies the best possible pharmaceutical service.

The enclosed reports from the work stream leads and LPC members and officials show the scope of our current working programme.

The full Annual Report and the Business Development Annual Report can be downloaded from:-

http://www.essexlpc.org.uk/index.asp?type=newsletter&id=134

Introduction

Essex Local Pharmaceutical Committee is the body that represents 300 pharmacy contractors providing service for patients based across the five Essex PCT’s:-

North East Essex, Mid Essex, West Essex, South East Essex and South West Essex.

Essex LPC welcomes the opportunity to participate in this consultation.  Details of the proposals have been circulated to all committee members.  Committee members have taken the opportunity to discuss proposals with pharmacy contractors in each of their localities across Essex.  The committee has devoted dedicated time to discuss the possible implications of the proposals.  Naturally the committee have considered the impact of the proposals on the provision of community pharmacy services.  In Essex the local pharmaceutical committee is keen to continue with the positive working relationship it has established with the five PCT’s on the face of it the devolvement of the global sum to PCTs could support local service developments.

However the committee is particularly concerned in respect of the timing of the proposals as follows:-

Timing Strategic Concerns

Pharmacy contractors are concerned about the uncertainty created by the delay in the publication of the Galbraith report.  Contractors obviously are unaware of the content of the white paper on pharmacy, which is scheduled to be published in the Autumn.  Implementation of practice based commissioning is at an early stage, and certainly currently lacks any consistency.  All of the above strategic developments should be allowed to mature first and then influence this change.

Timing Concerns – Implementation Capacity

PCT’s are only just beginning to recover from the reorganisation associated with the introduction of the “patient led NHS”.  For many localities capacity for PCT engagement is extremely limited.  PCT’s are quick to inform the LPC of the pressures that they are currently under.  The committee is aware of the reduction in skills and capacity.  With the introduction of the new pharmacy contract in 2005, and the modification of the associated regulations PCT’s some localities are already struggling with implementation.  By way of example one of the PCT’s in Essex has informed the LPC that they do not have the capacity to undertake the monitoring of community pharmacies associated with the community pharmacy assurance framework.  Other PCT’s are having difficulty interpreting the new regulations, particularly in respect of exempt pharmacy applications.  In discussions we PCT’s the committee has learnt that there is no enthusiasm for this change to take place in the near future.

Timing – Engagement with Pharmacy Contractors

The new pharmacy contract was designed to encourage greater engagement of pharmacy contractors in NHS services.  Essex LPC believes that a lesson to be learnt from the implementation of the new contract is that such engagement requires careful integration and planning.  By comparison the successful development of the community pharmacy contract in Scotland appears to have been coordinated, building upon capacity, skills and infrastructure.  The committee urge the department to give careful consideration to the views expressed by LPC’s and PCT’s as part of this consultation. 

In particular the experience of local contracting by way of the enhanced services component at the new pharmacy contract has been disappointing.  Pharmacies are keen to provide a wider range of services, however currently commissioning of enhanced services by PCT’s is fragmented.  It is essential that nationally agreed payments and services for essential services continue.

The committee believes that there is already evidence that PCT’s will have difficulty in managing treatment periods.  The committee is particularly concerned of the potential increase in wasted medication that could occur with the extension of prescribing periods.  By devolving the global sum PCT’s will be encouraged to influence prescribing periods, with access to practice payments, and access extended to prescription fee, container fee and additional allowances.

Contractors have expressed concerns that currently “post code prescribing” results in patients access to medication being dependent upon where they live.  Contractors are particularly concerned that patient pharmacy services continue to be agreed nationally.  “Post code pharmacy services” must be avoided.  Pharmacies need the assurance of national contract with predicable levels of funding.

Conclusion

The consultation includes seven distinct questions.  The committee believes that responding to these questions in isolation potentially limits the scope of input into the consultation.  The committee trusts that PSNC will provide valuable detailed technical responses associated with the questions. 

Essex LPC is particularly concerned that adequate safe guards are introduced. Such safe guards must ensure that local distortions of remuneration and reimbursement are avoided.  These safe guards need to be developed and agreed with PSNC prior to the implementation of the proposals.

John Stanley

Chief Executive

Essex LPC

11th October 2007

Introduction

Essex Local Pharmaceutical Committee is the body that represents 300 pharmacy contractors providing service for patients based across the five Essex PCT’s:-

North East Essex, Mid Essex, West Essex, South East Essex and South West Essex.

Essex LPC welcomes the opportunity to participate in this consultation.  Details of the proposals have been circulated to all committee members.  Committee members have taken the opportunity to discuss proposals with pharmacy contractors in each of their localities across Essex.  The committee has devoted dedicated time to discuss the possible implications of the proposals.  Naturally the committee have considered the impact of the proposals on the provision of community pharmacy services.  In Essex the local pharmaceutical committee is keen to continue with the positive working relationship it has established with the five PCT’s on the face of it the devolvement of the global sum to PCTs could support local service developments.

However the committee is particularly concerned in respect of the timing of the proposals as follows:-

Timing Strategic Concerns

Pharmacy contractors are concerned about the uncertainty created by the delay in the publication of the Galbraith report.  Contractors obviously are unaware of the content of the white paper on pharmacy, which is scheduled to be published in the Autumn.  Implementation of practice based commissioning is at an early stage, and certainly currently lacks any consistency.  All of the above strategic developments should be allowed to mature first and then influence this change.

Timing Concerns – Implementation Capacity

PCT’s are only just beginning to recover from the reorganisation associated with the introduction of the “patient led NHS”.  For many localities capacity for PCT engagement is extremely limited.  PCT’s are quick to inform the LPC of the pressures that they are currently under.  The committee is aware of the reduction in skills and capacity.  With the introduction of the new pharmacy contract in 2005, and the modification of the associated regulations PCT’s some localities are already struggling with implementation.  By way of example one of the PCT’s in Essex has informed the LPC that they do not have the capacity to undertake the monitoring of community pharmacies associated with the community pharmacy assurance framework.  Other PCT’s are having difficulty interpreting the new regulations, particularly in respect of exempt pharmacy applications.  In discussions we PCT’s the committee has learnt that there is no enthusiasm for this change to take place in the near future.

Timing – Engagement with Pharmacy Contractors

The new pharmacy contract was designed to encourage greater engagement of pharmacy contractors in NHS services.  Essex LPC believes that a lesson to be learnt from the implementation of the new contract is that such engagement requires careful integration and planning.  By comparison the successful development of the community pharmacy contract in Scotland appears to have been coordinated, building upon capacity, skills and infrastructure.  The committee urge the department to give careful consideration to the views expressed by LPC’s and PCT’s as part of this consultation. 

In particular the experience of local contracting by way of the enhanced services component at the new pharmacy contract has been disappointing.  Pharmacies are keen to provide a wider range of services, however currently commissioning of enhanced services by PCT’s is fragmented.  It is essential that nationally agreed payments and services for essential services continue.

The committee believes that there is already evidence that PCT’s will have difficulty in managing treatment periods.  The committee is particularly concerned of the potential increase in wasted medication that could occur with the extension of prescribing periods.  By devolving the global sum PCT’s will be encouraged to influence prescribing periods, with access to practice payments, and access extended to prescription fee, container fee and additional allowances.

Contractors have expressed concerns that currently “post code prescribing” results in patients access to medication being dependent upon where they live.  Contractors are particularly concerned that patient pharmacy services continue to be agreed nationally.  “Post code pharmacy services” must be avoided.  Pharmacies need the assurance of national contract with predicable levels of funding.

Conclusion

The consultation includes seven distinct questions.  The committee believes that responding to these questions in isolation potentially limits the scope of input into the consultation.  The committee trusts that PSNC will provide valuable detailed technical responses associated with the questions. 

Essex LPC is particularly concerned that adequate safe guards are introduced. Such safe guards must ensure that local distortions of remuneration and reimbursement are avoided.  These safe guards need to be developed and agreed with PSNC prior to the implementation of the proposals.

John Stanley

Chief Executive

Essex LPC

11th October 2007

Contractors, wholesalers and manufacturers have reacted angrily to the government’s raid on generic purchase profits, which representatives said could cost each pharmacy up to £40,000 a year.

The Pharmaceutical Services Negotiating Committee said contractors faced a £400m a year cut from current category M margins. This represented a lack of joined up thinking by government and sent mixed messages about what it wanted from pharmacy, industry leaders said.

Steve Dunn, group managing director of wholesaler AAH, said too little progress had been made in increasing service provision and that cuts in traditional funding meant pharmacists were left with the worst of both worlds.

Celesio, which owns AAH and Lloydspharmacy, said the tariff changes would lose it 30 million euros (about £20m) this quarter.

But Warwick Smith, director of the British Generic Manufacturers Association, said the £400m cut was in line with government’s agreed £500m limit on total purchase profit. “It’s just the system working as it was intended,” he said.           

However, stakeholders said “wild” fluctuations in retained profit made financial planning difficult for contractors.

Wholesaler Phoenix’s chief executive Paul Smith said: “To be able to plan for and make the necessary investment in pharmacy services to deliver the contract to best effect, we need a degree of certainty and stability that is currently missing.”

Category M Price Changes

Please find below a summary of changes that are being made to the October Drug Tariff. Work continues to validate the results of the invoice inquiries. The minister’s decision on Category M prices is reported below; the adjustments are provisional, and PSNC is extremely concerned about the results of the analysis. Our expert advisers are continuing their work on the results, which we will not accept until we have completed our investigations. The impact of the changes to reimbursement prices will cause a significant reduction of income levels from October and we recognise the need to ensure that this pattern does not recur. Changes to fees and allowances will be applied from October 2007, reflecting the application of the formula for future years agreed as part of the new community pharmacy contractual framework. This resulted in an increase to funding of 4.3%, bringing total funding for 2007-8 to £1.94bn. This includes extra funding to cover the costs of increasing regulatory burden. At a time when pay settlements in the NHS have been tightly capped this level of increase, adjusting for increased business costs, is good. All Global Sum payments including item fees and establishment payments will continue to be paid at the current rates. The minimum volume for eligibility for volume-linked payments rises by 3% from October onwards with a corresponding rise in the upper level for eligibility for the protected professional allowance; details are in the tables below. Payment for advanced services – Medicines Use Reviews and Prescription Interventions – rises from £25 to £27; the maximum number of reviews per pharmacy remains unchanged. Monitoring of purchase profit income provided to independent pharmacies is an essential component of the work to ensure delivery of the contract funding. This showed that purchase profits have greatly exceeded the target levels. PSNC is undertaking exhaustive analysis of all the results, and is still working with the Department on the figures, but Category M prices from October 2007 will reduce substantially, with the aim of removing £400m per annum from current margins. Category M prices are normally adjusted quarterly, and PSNC expects to have finished negotiations with the Department of Health well in advance of decisions on the January prices. The levels of excess purchase profit income mean that contractors will have received more income in the first half of the year than was allowed under the funding agreement, and in order to balance this overpayment, it has been necessary to reduce practice payments from 35.6p to 25.2p per item. So contractors will see a reduction in NHS income in future months. It is unacceptable that contractors should face these significant and unexpected fluctuations in income levels during the year, and it is a major priority for us to ensure that the Department of Health finds ways to address this for the future. Category M was introduced in April 2005 and is still a relatively new process for managing generic medicines prices. It has yet to deliver the stability and predictability contractors need. Summary of Payments from October 2007 The Establishment Payment thresholds and values will be: Number of items per month for 1 April 2007 to 30 September 2007 Number of items per month for 1 October 2007 to 31 March 2008 Establishment Payment for 1 April 2007 to 31 March 2008 2,060 - 2,319 2,120 - 2,389 £23,278 2,320 - 2, 574 2,390 - 2,649 £24,190 2,575+ 2,650+ £25,100 The Practice Payment thresholds and values will be: Number of items per month Practice Payment for 1 October 2007 to 30 September 2008 Contribution in Practice Payment for DDA for 1 October 2007 to 30 September 2008 Up to 1,099 £600 £600 1,100 -1,599 £2,550 £1,200 1,600 - 2,119 £3,600 £1,500 2,120+ 25.2p per item 6.6p per item The upper threshold for receiving the Protected Professional Allowance will also be 2120 items per month. Full details will be shown in the October 2007 Drug Tariff. Related Information Category M Prices (October - December 2007) October Paper Drug Tariff Delayed October Online Drug Tariff October 2007 CPN

The statistics for May and June are now available and it is encouraging to note the continuing trends of more MURs being completed by more pharmacies.

June was our best ever month with 2868 MURs being claimed by 149 pharmacies. This is the first time over 50% of pharmacies in Essex have claimed in one month..

Continuation of this growth will lead to at least a doubling of numbers of MURs completed by the year end.

I am encouraged by the number of contacts I have had regarding discussions on workshops and help with support for MURs for specific disease states and have currently got 5 appointments booked over the next month. Topics indicated are COPD, diabetes, dermatology, CHD, osteoporosis and asthma. Should any of these be areas you would be keen to pursue in your locality please contact me.

SW Essex are progressing their work on a bid for assessments as part of the PCT falls strategy. Arvinder can give an update at the LPC meeting.

Dialogue with the other PCTs has had to be postponed pending my return to work.

An article detailing the early successes of the LPC with regard to MURs appeared in the July edition of Pharmacy Management.

Graham Fletcher

MUR Development Officer

Essex LPC 

4 September 2007

Essex Community Pharmacy Practice Development Unit

Vacancy – Project Manager

Flexible Working Arrangements

The Practice Development Unit was developed in response to the Governments strategic pharmacy plan, which was published in September 2000.  Even then Essex LPC recognised the challenge of implementing the NHS plan.  Now in 2007 these challenges continue to be a significant priority.  The implementation of the new community pharmacy contractual framework in 2005 and the recent reorganisation of PCTs as part of “commissioning a patient led NHS” in 2006 has caused the unit to refocus its activities. The introduction of new service delivery initiatives (including medication use reviews and practice based commissioning) add to the long-term agenda for the Practice Development Unit.

Essex Local Pharmaceutical Committee supports project work undertaken by ECPPDU.  Working along side the LPC it has a key role in the initiation and development of new community pharmacy services.

· Do you share our passion to develop the services available from community pharmacies and their integration into the wider NHS?

· Does flexible (self managed) project working together with the Essex Local Pharmaceutical Committee appeal to you?

· Do you understand and admire the mechanisms, which support community pharmacy service delivery to the general public?

· Do you have excellent written and oral communication skills?

If the answer to the above questions is ‘yes’ we would like to hear from you.  We would like to know about your background, experience, your strengths your weaknesses and your aspirations.  In particular tell us about your passion for community pharmacy services delivery.  Pharmacy qualification not essential.

Please make contact by email to info@essexlpc.org.uk

All responses treated in confidence.  Don’t delay contact us today.

John Stanley

Chief Executive

Essex LPC

April 2007

The formal transfer of the supply of domiciliary oxygen begins on February 1st, 2006 when Allied Respiratory will start their contract. The LPC and the PCTs are grateful for your continued goodwill and service to patients beyond the original October date, but now seek your support during the transition phase to ensure that patients receive a seamless transfer of service and associated care.

<a href="http://www.surveymonkey.com/s.aspx?sm=g1H6kZa8upByUB8bZljSgg_3d_3d">Click Here to take survey</a>

http://www.surveymonkey.com/s.aspx?sm=g1H6kZa8upByUB8bZljSgg_3d_3d

The NPA has had several new resources and initiatives launched in the last couple of months and I thought it might be helpful to summarise the main ones (see below)

More details are available on the NPA website www.npa.co.uk .

NPA “Stop Smoking Toolkit” Launched

The NPA has published a Stop Smoking Toolkit. This is a practical guide for pharmacists, LPCs, PCTs and local authorities detailing how to implement and integrate a community pharmacy stop smoking service.

Stop Smoking Resource Pack launched by the NPA

The NPA has produced a Stop Smoking Resource Pack to meet the needs of its members in light of the bans throughout the UK this year. It has been distributed to its Northern Ireland and Wales members already before their bans and is scheduled to arrive with members in England by the beginning of June.

There are also resources in the campaign section of the website (members area) http://www.npa.co.uk/members/smokingcampaign.php

Ask Your Pharmacist – reloaded for 2007

NPA to make public facing campaign ‘a multimedia smorgasbord of activity’

The NPA’s Ask Your Pharmacist consumer campaign has been running with great success for many years. Indeed, our members report that their customers often tell them when they pop in for advice that unnamed sources have suggested they should “ask their pharmacist”.

With this core message in the sub conscious of the public, the NPA’s Ask Your Pharmacist campaign for 2007 will take an integrated, multi channel approach, with three core objectives:

• To build consumer awareness of the community pharmacist role;
• To introduce new services e.g. MURs, stop smoking services;
• To build relationships with local media to promote the part pharmacy plays in community health care.

The messaging methods are also changing – ramping up the reach of the campaign by tailoring the media platforms to different audiences.

To engage with the youth market, the NPA has created its own MySpace site and will use this as a vehicle to take health messages to this market and offer up links back to the AYP website’s ‘find your nearest pharmacy’ at: http://www.npa.co.uk/ayp/index.php

The AYP advert will appear after an editorial piece to camera that will form part of the GMTV programme.  The Adverts and editorial will run twice a day every day during allergy week in May.

The Ask Your Pharmacist campaign will run in the health pages of the Daily Express and this will include a mixture of editorial and linked adverts for ten weeks over a six months period.

NPA Beer Mats hit the spot with students and landlords

Fifty thousand free beer mats and posters have been requested by student unions in England, Wales and Scotland as part of the second wave of the NPA’s Ask Your Pharmacist campaign. The materials highlight the stop smoking services available in local pharmacies.

Repeat dispensing – NPA publishes a complete guide to implementation

The NPA has developed a resource pack to help its members set up and run an efficient repeat dispensing service.

Substance misuse: NPA issues Standard Operating Procedure

The NPA has produced a Standard Operating Procedure (SOP) resource to help pharmacists in England and Wales ensure the safe and efficient provision of injecting equipment and paraphernalia to drug users.

New self-care SOP for England and Wales

The NPA, supported by an educational grant from GSK +plus, has produced a Standard Operating Procedure (SOP) resource to equip pharmacists in England and Wales in providing advice and support to people caring for themselves or their families.

Community Pharmacy Patient Questionnaire details finalised

The NPA is offering its members three options of support:
1. A resource pack to guide its members through the complex area of patient surveys. This is a practical guide showing how to design, implement, analyse and evaluate the results of the survey. Copies of this will be distributed to all members free of charge.

2. The STANDpoint system from Customer Research Technologies (CRT) conducts all the research electronically and provides speedy analysis of results. CRT simply delivers the device to the pharmacy and collects it two weeks later. Results are returned to contractors within the next 5 days.
3. Alternatively, the entire paper-based survey can be managed by CFEP-UK Surveys, who will provide a complete questionnaire pack and supporting materials to make the process hassle-free. Patients can return questionnaires to the pharmacy or post directly to CFEP-UK Surveys in the freepost envelopes provided. Track your survey online with a secure website log-in. You will receive a high quality report, with comparisons to national benchmarks, customized results poster and guidance on how to interpret your results. CFEP-UK Surveys is an established patient feedback company helping healthcare professionals and organisations make a difference to their patient-centred care.

PRESS RELEASE

 For immediate release

2 February 2007 For immediate release

Bharat Patel, our PSNC regional representative, would be happy to receive comments relating to this important topic.  Please forward all comments to info@essexlpc.org.uk

Representatives of Pharmaceutical Services Negotiating Committee met Anne Galbraith on 1 February to discuss PSNC’s initial response to the current Review. PSNC was represented by its Chairman, Barry Andrews; together with Chief Executive, Sue Sharpe; the Chairman of Funding and Contract Sub-committee, Steven Williams; and Chairman of Service Development Sub-committee, Ash Soni.  Barry Andrews opened the PSNC response to the Review by emphasising the strengths of the current contractual arrangements in supporting high levels of access for patients, that high level of access being dependent on sufficient business confidence to invest in

premises and training of staff.  It is PSNC’s position that all communities, whether they are affluent or in socially deprived areas, have core needs – the prompt supply of prescribed medicines with advice, support for self care and over the counter medicines, and support for healthy lifestyles.

PSNC stated that there is great potential to develop the pharmacy contract by introducing minor ailments services and public health services in sexual health and obesity management, among others. The use of pharmacies in influenza inoculation and the adoption of pharmacist prescribing would provide substantial improved access to services for patients.  Whilst the national components of the pharmacy contract had delivered real

improvements to patient services, PSNC expressed disappointment that development of local services had been severely hampered by both the financial pressures facing Primary Care Trusts and the re-organisation which took place in Autumn 2006.  A special meeting of PSNC will consider a number of questions posed by the Chairman of the Review, Anne Galbraith, and the Committee will put forward proposals that:

• Offers value for money for the NHS and PCTs;

• Reduces cost, complexity and administrative burdens on PCTs;

• Supports increased access where services, or choice of services, are inadequate;

• Develops the value of community pharmacy services for PCTs;

• Supports the government’s health priorities;

• Supports competition and choice in service quality; and

• Restores business confidence.

- ENDS –

If you have any queries regarding this report please contact Steve Lutener, email

steve.lutener@psnc.org.uk Telephone 01296 438421

Residents across Essex who regularly take medication are being offered a free ‘Medicines check-up’ at their local pharmacy.

The aim is to ensure patients are getting the most from their medicines, making sure that pills and potions do not clash and that they are not suffering from any side effects.

Chris Rose, of the Essex Local Pharmacy Committee and a Witham pharmacist, said: “The aim of the check-up is to ensure the medicines people take are right for them and are working effectively to manage their illness.

“This also includes finding out whether their dosage of medication should change but none of this would be done without their GP’s say so.”

Following the check-up – otherwise known as a Medicines Use Review – at the pharmacy, their doctors are informed of the pharmacists’ suggestions.

People who are most likely to benefit are those who:

• Are taking four or more prescribed medicines on a regular basis
  
  
• Are taking medicines for a long-term condition such as asthma, arthritis, diabetes, epilepsy or coronary heart disease, and
  
  
• People over the age of 75
  
  

People who are taking more than one medicine and have been collecting it from the same pharmacy for three months or more will need to approach that pharmacy and arrange a time to see the pharmacist.

During the review they will be asked what medicines they take, including non-prescription drugs such as vitamins, supplements, herbal remedies or homeopathic remedies – in tablet, cream, inhaler or liquid form – all of which will be entered on a form to give a complete picture.

“It’s a great opportunity to ensure they are getting the best from their medicines and to have any queries or concerns answered by a professional. The added bonus is they can also find out whether they need to make any lifestyle changes,” added Mr Rose.

Ask your local pharmacy if they are participating in the Medicine check-up.

In a novel approach to try to reduce the potential £5million waste of prescribed medicines, community pharmacies in North East Essex have been given the opportunity of engaging in a Local Enhanced Service called the Non-Dispensing Incentive Scheme.

Further information of the scheme background, together with useful resources including the SLA details, a template GP communication  and a Power Point presentation are available on our website.   Full details here…

Mid-Essex Hospitals currently provides prescribing and pharmaceutical advice to Mid-Essex PCT under SLA.  Following promotion of the previous postholder we now have a 6 month secondment opportunity for a pharmacist to fulfill the role of Prescribing Support and Medicines Management Pharmacist; job description attached (Band 8a).

The post is currently based in Mid-Essex PCT at Kestrel House and involves working closely with the Hospital Consultants and GPs as well as continuing to input to the provision of hospital pharmacy services.  This is a full time post, but long part-time would be considered.

This position is available immediately and offers an excellent opportunity for a pharmacist to gain some experience of PCT work.  You will have excellent clinical skills and you should also have some experience of primary care/community pharmacy, or if not, at least a good understanding of the issues facing primary care prescribing and interface issues.

If you would like any further information please contact paula.wilkinson@midessexpct.nhs.uk

Further details - http://www.essexlpc.org.uk/index.asp?type=newsletter&id=106

 NPC Plus, in conjunction with Chemist and Druggist, is putting on a series of half-day therapeutic training events aimed specifically at community pharmacists. These workshops will follow the style of the well known and respected National Prescribing Centre (NPC) therapeutic training programme for NHS professionals, and will commission a number of the NPC's trainers to deliver them.

The content has been specifically modified to meet the needs of practising community pharmacists, by covering two key disease areas - namely cardiovascular risk and respiratory disease. Pharmacists who attend will gain a good understanding of the current clinical evidence / controversies in these areas and should be in an even better position to help patients with their medicines and improve their care, not least when undertaking MURs.

The following is the website link to the C&D website, where individuals can register for the workshops.  http://www.dotpharmacy.com/NPCworkshop.html

When and Where?

31st October  ( two separate sessions one morning, one afternoon )

Five Lakes Resort, Colchester Road,

Tolleshunt Knights, Maldon, Essex CM9 8HX

The East of England Strategic Health Authority (SHA) is beginning a review of acute services across its area.  The objective of the review will be to agree a new pattern of hospital services for the region that will meet the demands of 21st century healthcare and be financially sustainable

Dr Paul Watson, Director of Commissioning for the SHA, explained: “ Most UK hospitals follow the ‘district general hospital’, or DGH, model that was set out in the National Hospital Plan in 1962, more than 40 years ago.  This envisaged hospitals providing a full range of A&E, emergency medicine and surgery, elective care, maternity and outpatient services to population of between 250-300,000.  There are currently 19 such hospitals in our region.”

However, a number of major issues have caused commentators to question the sustainability of this DGH model.  These include clinical standards, medical staffing and financial sustainability. 

Dr Watson continued: “Healthcare is changing almost daily, and medicine today is very different from 40 years ago.  Modern clinical standards demand that some services need a much larger caseload than exist in most DGHs in order to guarantee the best possible clinical outcome.  An example of this is cancer surgery where some cancer services, including gynaecological, urological and upper gastrointestinal; require a catchment area of one million people to give the best achievable outcomes.  Other examples are vascular surgery and neonatal intensive care.  This means that these clinical services need to be centralised in a hospital which would serve the catchment area of several of the current DGHs.”

With regard to medical staffing, Dr Watson explained that emergency hospital care has traditionally been provided by doctors in training.  Restrictions in working hours have meant that more doctors are required to staff a 24/7 rota.  In 1990 a 24 hour rota could be staffed with three doctors, however, following full implementation of the European Working Directive (EWTD) in 2009 this could increase to nine or ten. At the same time the supply of doctors in training is reducing due to changes in the way they are taught.  This means more emergency care will need to be provided directly by consultant staff leading some medical professional bodies to call for a reduction in the number of hospitals providing emergency care.

While it has been suggested that some hospitals are too small to cover the costs required to provide comprehensive hospital services, the evidence is not conclusive.  However the financial problems in the region do tend to be centred in smaller hospitals.  The combination of patient choice, independent sector provision and the transfer of more services that were traditionally delivered in secondary care into the community means that the number of people using each hospital will also change.

Dr Watson concluded: “In view of these issues we have decided to undertake a major review of acute services across the region to agree a new pattern of hospital services for the region that will meet the demands of 21st century healthcare and be financially sustainable. 

The initial phase of the review is a technical analysis of how these issues are affecting hospitals in our region.  This will give us a view on whether current configuration is sustainable and, if not, the degree of change that will be required. 

“This will be completed over the next month and once this is done a structured process will be established, including discussion with our many stakeholders, to prepare detailed service proposals for consultation.  This next phase should be completed early in the New Year.”

The current reviews of acute services in the area,“Investing In Your Health” – the strategy for community and hospital services in Hertfordshire, and the review of services at the Hinchingbrooke Hospital, will continue and their results incorporated into the main review process.

The Judges' decision is final

The Prescribing Team maintains a detailed database of all NHS prescriptions dispensed in the community in Scotland. The information is supplied to ISD by Practitioner Services Division (PSD) who are responsible for the processing and pricing of all prescriptions dispensed in Scotland.  These data are augmented with information on prescriptions written in Scotland that were dispensed elsewhere in the United Kingdom. All these prescriptions are dispensed by community pharmacies, dispensing doctors and a small number of specialist appliance suppliers.

Information is available on Scottish Prescribing and Dispensing statistics to 31/3/2005:

http://www.isdscotland.org/isd/info3.jsp?pContentID=1041&p_applic=CCC&p_service=Content.show&

• Dispensers
  • Pharmacists
  • Essential Small Pharmacy Scheme-one dispensing practice is supported by the scheme
  • Dispensing Doctors

• Prescribing Statistics
  • Volume and Cost
  • Summary data for Scotland and by board
  • Top Ten drugs
  • Nurse Prescribing
  • Generic Prescribing
  • Prescription Charges
  • Dispensing Remuneration by month

• Medicines Information
• Prescription Cost Analysis
• Informed Comment (latest Antibacterial Prescribing)
• The Drug Tariff

  GPs write the vast majority of these prescriptions, with the remainder written mainly by nurses and dentists. They also include prescriptions written in hospitals that are dispensed in the community, but exclude drugs dispensed within hospitals themselves.

Pharmacists (sometimes called Chemists) are experts in medicines and how they work. They play a key role in providing quality healthcare to patients.

They dispense your prescriptions, provide a range of services related to specific health issues and can offer advice on healthy living and minor ailments.

Use this site to find where you local Pharmacy is located, when they are open and the services that they provide.

Click here:- http://www.nhs.uk/England/Pharmacies/Default.aspx

There are provisions within the Prescription Only Medicines (Human Use) Order 1997, as amended, for a pharmacist within a registered retail pharmacy premises to make supplies of prescription-only medicines without a legally valid prescription in an emergency. Requests for emergency supplies can be made by either a patient or a prescriber. Further information on the legislative conditions that apply to emergency supplies can be found on p13 of ‘Medicines, ethics and practice: a guide for pharmacists and pharmacy technicians’ (30th edition, July 2006).

When a request for an emergency supply is received, pharmacists should consider the individual circumstances of the request and use their professional judgement to determine which course of action they believe to be in the patient’s best interests. Pharmacists should not be pressured into making an emergency supply by their employers, colleagues or patients, but should act in accordance with their own assessment of the situation.

Consideration must be given to making an emergency supply whenever a patient has an urgent need for a medicine, and the medical consequences, if any, of not making the supply must be taken into account. Pharmacists must be satisfied that their decision will not lead to patient care being compromised and should be able to justify their reasons for making or refusing to make an emergency supply. Where an emergency supply is made, the appropriate records must be maintained (see MEP, p13).

An emergency supply is a private transaction for which pharmacists may charge. The amount charged is at the pharmacist’s discretion and company procedures may be in place for this.

Legislation does not prevent a pharmacist from making an emergency supply when a doctor’s surgery is open. As with any request for an emergency supply, pharmacists must consider the best interests of the patient. Where a pharmacist believes that it would be impracticable in the circumstances for a patient to obtain a prescription without undue delay they may decide that an emergency supply is necessary. Automatically referring patients who are away from home and have forgotten or run out of their medicines to the nearest local surgery to register as a temporary resident may not always be the most appropriate course of action. The Society would be concerned if pharmacists were not meeting genuine patient needs because of a lack of appreciation of the legal position.

Where a request for an emergency supply is made by a patient, there is a requirement for the pharmacist to interview the patient. This should usually be a face-to-face interview. However, if this is not possible pharmacists should explore alternative means of interviewing the patient, such as by telephone. Regardless of the method used to interview the patient, pharmacists should satisfy themselves that the request is genuine and should take all necessary steps to ensure that a supply is made where appropriate.

Pharmacists should be alert to the potential for abuse of the emergency supply provisions. Repeated requests for an emergency supply may indicate underlying problems that need to be addressed. However, when repeated requests for an emergency supply are made pharmacists should still use their professional judgement to decide on the most appropriate course of action at the time of the request.

There are no provisions for a pharmacist to make an emergency supply of a Schedule 2 or 3 Controlled Drug, except phenobarbitone for the treatment of epilepsy.

Where a pharmacist is not able to make an emergency supply, he or she should do everything possible to advise the patient on how to obtain essential medical care.

Introduction of the Urgent Supply of Repeat Medication scheme in Scotland complements these arrangements and permits community pharmacists in Scotland to maintain continuity of supply of repeat medication on the NHS when GP surgeries are closed. Established in December 2005, the facility allows community pharmacists in Scotland who have signed the relevant patient group direction to provide a full cycle of a patient’s repeat medication in prescribed circumstances. Full details of this scheme can be obtained from local NHS boards and the Scottish Executive Health DepartmentThere are provisions within the Prescription Only Medicines (Human Use) Order 1997, as amended, for a pharmacist within a registered retail pharmacy premises to make supplies of prescription-only medicines without a legally valid prescription in an emergency. Requests for emergency supplies can be made by either a patient or a prescriber. Further information on the legislative conditions that apply to emergency supplies can be found on p13 of ‘Medicines, ethics and practice: a guide for pharmacists and pharmacy technicians’ (30th edition, July 2006).

When a request for an emergency supply is received, pharmacists should consider the individual circumstances of the request and use their professional judgement to determine which course of action they believe to be in the patient’s best interests. Pharmacists should not be pressured into making an emergency supply by their employers, colleagues or patients, but should act in accordance with their own assessment of the situation.

Consideration must be given to making an emergency supply whenever a patient has an urgent need for a medicine, and the medical consequences, if any, of not making the supply must be taken into account. Pharmacists must be satisfied that their decision will not lead to patient care being compromised and should be able to justify their reasons for making or refusing to make an emergency supply. Where an emergency supply is made, the appropriate records must be maintained (see MEP, p13).

An emergency supply is a private transaction for which pharmacists may charge. The amount charged is at the pharmacist’s discretion and company procedures may be in place for this.

Legislation does not prevent a pharmacist from making an emergency supply when a doctor’s surgery is open. As with any request for an emergency supply, pharmacists must consider the best interests of the patient. Where a pharmacist believes that it would be impracticable in the circumstances for a patient to obtain a prescription without undue delay they may decide that an emergency supply is necessary. Automatically referring patients who are away from home and have forgotten or run out of their medicines to the nearest local surgery to register as a temporary resident may not always be the most appropriate course of action. The Society would be concerned if pharmacists were not meeting genuine patient needs because of a lack of appreciation of the legal position.

Where a request for an emergency supply is made by a patient, there is a requirement for the pharmacist to interview the patient. This should usually be a face-to-face interview. However, if this is not possible pharmacists should explore alternative means of interviewing the patient, such as by telephone. Regardless of the method used to interview the patient, pharmacists should satisfy themselves that the request is genuine and should take all necessary steps to ensure that a supply is made where appropriate.

Pharmacists should be alert to the potential for abuse of the emergency supply provisions. Repeated requests for an emergency supply may indicate underlying problems that need to be addressed. However, when repeated requests for an emergency supply are made pharmacists should still use their professional judgement to decide on the most appropriate course of action at the time of the request.

There are no provisions for a pharmacist to make an emergency supply of a Schedule 2 or 3 Controlled Drug, except phenobarbitone for the treatment of epilepsy.

Where a pharmacist is not able to make an emergency supply, he or she should do everything possible to advise the patient on how to obtain essential medical care.

Introduction of the Urgent Supply of Repeat Medication scheme in Scotland complements these arrangements and permits community pharmacists in Scotland to maintain continuity of supply of repeat medication on the NHS when GP surgeries are closed. Established in December 2005, the facility allows community pharmacists in Scotland who have signed the relevant patient group direction to provide a full cycle of a patient’s repeat medication in prescribed circumstances. Full details of this scheme can be obtained from local NHS boards and the Scottish Executive Health Department

The NHS has outlined the role pharmacists can play in practice based commissioning (PBC). The Primary Care Contracting (PCC) bulletin is for service commissioners, such as primary care organisations and GPs, but is also a useful resource for pharmacists looking to become involved in PBC. It stresses the importance of collaboration between all professional groups, and of pharmacists in both service commissioning and delivery.

Understanding of PBC both by and for pharmacy is described as "still evolving", but PCC provides a list of top tips. It adds that a range of services should be developed alongside, or integrated into, PBC. Prescribing – both supplementary and independent – has "enormous potential", as have self-care and medicines management

http://www.essexlpc.org.uk/index.asp?type=newsletter&id=84

Following the death of a young child who ingested his parents’ methadone mixture, pharmacists are reminded of the importance of ensuring that patients are counselled on the appropriate storage of all medicinal products supplied to them.

Patients should not only be advised on the appropriate storage conditions for the medicine but should also be reminded of the importance of storing medicines out of the reach of children.

Particular care must be exercised when medicines that are potentially dangerous even in small quantities, for example, Controlled Drugs, are being stored in a patient’s home.

GP system suppliers have been working to develop the systems needed to operate the Electronic Prescription Service.

Once a system has met the technical requirements of the Electronic Prescription Service, it is first implemented at a single initial implementer site (or a small number of sites) for further testing. Until a system has been successfully proven at an initial implementation site, authority for wider deployment of the system cannot be given.

The table below shows the compliance status of GP systems that are currently working with the programme. This information will be updated on a regular basis.

Where rollout authority has not yet been granted, GPs may wish to contact their system supplier to ascertain when this is likely to happen.

More info: http://www.connectingforhealth.nhs.uk/eps/supplierstatus/status_of_gp_systems

During the formal consultation process, from 14 December 2005 until 22 March 2006, the debate was divided mainly between the options of two or five PCTs.  There was relatively little support for the options of three and four PCTs.

In considering an analysis of the options and the feedback from consultation, the Essex Strategic Health Authority (SHA) Board decided, at its special meeting on 6 April this year, to recommend two PCTs to the Secretary of State.  It was a close decision with arguments for and against both the options for two or five PCTs; as Mike Brookes, SHA Chairman, said at the time:

“This was an extremely difficult decision, particularly in view of the fact that the arguments for two and five PCTs had moved a lot closer during the consultation as a result of what people had said to us.”

Commenting on today’s decision, Terry Hanafin, Chief Executive of Essex SHA said:

“The decision to have five PCTs offers a merger that will strengthen health planning and save management costs, with the least disruption, as a lot of the work of the current 13 organisations is already done across the five areas of Essex.  Now we have a final decision on the way forward we can get to work on the transition and reduce the level of uncertainty for staff and local people.

“While there were mixed views on the changes during the consultation, I am sure that everyone in the NHS, its partners and local people will be able to get behind this decision and make it work.”