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WHO ARE WE
OUR GOAL IS
We publish monthly newsletters covering all relevant aspects of pharmacy to ensure our members and partners are kept abreast with the latest news from across the profession. The newsletters also include advice on pharmacy practice and policy.
I hope you are keeping well.
Please find below the May newsletter. I am sad to say that unfortunately, due to the situation with COVID-19 we need to cancel our July event; however, we are hopeful that normality will return soon and that we can welcome you to our AGM and annual dinner event on 10th November in London which we are hoping to make a memorable event. If the current situation with COVID-19 continues we will do our best to hold a digital conference for our members.
You may have heard it being mentioned frequently at the most recent NHS England webinars that issues such as prescription directions, challenges around written consent etc, are being brought to the attention of decision-makers and this is in big part thanks to AIM representation highlighting these issues promptly on behalf of our members (further information provided in this newsletter). Please keep letting us know of the concerns you have or the issues you are facing. We are here to represent and support you.
I wanted to also take this opportunity to highlight that as members of AIM you have access to many of AIM’s partners and suppliers, who provide various services and products, often at a special rate for AIM members. We are currently in the process of launching a page on our website where our partners and suppliers are listed and members can see what services, support and offers are available to them. We will share this with members as soon as it is ready.
What is covered in this newsletter:
1. PSNC update 2. NHS England care home operational framework 3. Pre-reg training update 4. Representation matters 5. Pharmacy practice matters
1. PSNC Update The PSNC have asked for funding to address the margin issue, COVID-19 costs, cashflow issue and advance payments. Earlier this week we heard the announcement that the Department of Health and Social Care (DHSC) will increase medicine reimbursement prices by £15 million in June. This amount is to address the run rate in Cat M and to ensure that funding does not fall further behind as prices rise. The DHSC are currently in touch with the Treasury regarding the other funding asks, including funding for COVID-19 costs.
AIM has provided very robust evidence of COVID-19 costs for contractors and this was very much appreciated by the PSNC when calculating the costs for their negotiations with the DHSC. We have made strong representation on PSNC to try and seek the best outcome for our members. Our representatives on PSNC are Has Modi, Jay Patel and Peter Cattee. If you have any matters related to funding that you would like AIM to take forward on your behalf, please do not hesitate to contact me and our representatives on PSNC.
2. Operational Framework for Cross-system Pharmacy and Medicines Support for Care Homes NHS England have been working on an operational framework for the delivery of clinical pharmacy and medicine optimisation services to care homes. This is with the view to direct local health systems to co-ordinate pharmacy teams to provide support to care home residents and staff. It describes the medicines and pharmacy contribution to the work and sets out how teams should collaborate across the NHS system.
It also provides practical advice, resources and a model of service to help local systems reduce the risk of harm during the COVID-19 period by ensuring that consistent medicines and pharmacy services meet the needs of care home residents and staff. It includes an implementation plan to activate the model of service at local level. The work is being led and co-ordinated in each area by a clinical lead appointed by each CCG and has the backing of the regional and national NHS England and NHS Improvement pharmacy and primary care teams.
I have attached the published document. Below is a summary of the key points involving community pharmacy:
- NHSE acknowledge that pharmacists can play a significant role to support care homes in terms of clinical support, medicines supply, general advice and delivering structured medication reviews (SMRs). - They are trying to bring workforce from GPs, PCNs, CCG, and community pharmacy together and they are encouraging pharmacy teams to be part of the multi-disciplinary team as “every one has a role to play”. - Capability is assessed based on a self-assessment tool and also signposts various training/learning resources. - There are currently no mention of national versus local delivering and fee for delivering. - It is not clear if this is an optional service. - AIM would like this to be an optional service for contractors that is fully funded, included cost to cover backfill. - There is potential that LPCs can manage this and support contractors locally.
AIM will follow this closely and ensure we put forward the best solution for our members. We will continue insisting on access to PPE for pharmacy teams should they be involved in working with care homes.
We will continue insisting on access to PPE for pharmacy teams should they be involved in working with care homes. Please get in touch if you have any views about this.
3. Pre-reg Registration Review
The GPhC held an engagement event for stakeholders on 21st April where they outlined the emerging direction of travel of thought around provisional registration. This included two scenarios:
1. Cancelling the Registration Assessment and enabling all trainees to register automatically. 2. Creating no solutions for the short-medium-term and leaving trainees in limbo until the assessments next summer.
The GPhC views are as follows:
• Those entered on the register would practice as pharmacists with structured support to manage the transition from initial education and learning. • They would have access to a named clinical supervisor or preceptor to provide the appropriate support and structure during this limited period. • They would not be able to act as a Responsible Pharmacist. • They would accelerate work towards identifying an online solution.
AIM has been working with the cross-sector workforce development group (WDG) to respond to these proposals on behalf of our members. We are particularly concerned about the proposed limitations proposed by the GPhC around the Responsible Pharmacist (as above). The WDG has made a number of recommendations to GPhC on behalf of the sector, please see below:
• Action must be taken to minimise the negative impact of changes due to Covid-19, on this and future cohorts of trainees. • Appropriate funding should be made available to allow employers to provide the necessary support for provisional pharmacists during this ongoing period of uncertainty. • Provisionally registered pharmacists should be able to perform all duties of a newly qualified pharmacist, including acting as the Responsible Pharmacist. • Trainees should be signed off by their tutor at 52 weeks using a robust updated framework which prioritises patient safety. This should be a dual sign off process by both tutor and trainee. • To enable this to happen safely and effectively provisional pharmacists should receive structured support and have easy contract with a named pharmacist. • The retention of the pre-registration evidence portfolio would allow for the review and support of provisional registrants. • We recommend the GPhC considers all options, including moving all or some aspects of the registration assessment online. The movement of the calculation paper online, as soon as possible, would provide further assurances of the quality of trainees before they join the provisional register. • Efforts should be made to allow provisionally registered pharmacists to join the full register as soon as possible. The GPhC Council will be meeting on Thursday afternoon (21/05/2020) and the final decision will be communicated soon after. As soon as this is clarified, I am sure that PSNC will be reviewing all additional costs and be seeking funding to cover some or all of these. Members will be able to follow this on our twitter page and our website under ‘latest news’ tab once we hear back from the GPhC.
Campaign – I would like to take this opportunity to thank all our members who participated in this campaign. We captured hundreds and hundreds of pictures and these were highlighted on social media under the #pharmacyheroes. This got a lot of traction and was picked up by the Royal Family who tweeted the pictures and our campaign, to millions of their followers as part of their #ThankfulThursday message, this helps a lot with raising the profile of pharmacy.
We have made a video with your pictures. You can watch it here: https://drive.google.com/open?id=1Mqs1SqzHbbdtmJZY8KjX_7DsQF4dPJHK. Just a quick warning, in case you are wondering about the music, I am a big Eurovision fan, cannot help it, and this was the Swedish winner song in 2015 about heroes and I thought it suited our campaign well. I hope you like it. We have also had several coverages in the local media as part of the campaign featuring our members (example below). https://www.eastbourneherald.co.uk/news/people/hailsham-pharmacists-grateful-publics-support-during-crisis-2854669
PPE – We have persistently raised the issues around the lack of PPE. The DHSC held a meeting with stakeholders about this topic mainly covering safe system of work. I have attached the slides to this newsletter. We are repeatedly told that PPE is generally in short supply across all healthcare sectors and that pharmacy contractors should liaise directly with wholesalers regarding issues. We will continue highlighting the issues regarding PPE. If you have any questions or comments please let me know.
Pharmacy Post COVID-19 Period – This is a particularly important topic and hence why I have highlighted it in a different colour. The COVID-19 period has demonstrated that pharmacy is placed at the heart of the primary care and as a sector we need to ensure we have a vision and strategy on how we move forward following this period. AIM has actively been working on identifying how a new pharmacy model would look post COVID-19, to that effect we set up a Task and Finish Group some weeks ago that is currently looking into this. We believe that AIM members, as groups, are very well-placed to set examples for the rest of the sector. Members are highly encouraged to get in touch and provide your views on what has worked well during this period that we want to keep, what is it that we need to get rid of, and what are the potentials of introducing new things and doing things differently.
At the same time, we are also working with other parts of the sector to ensure alignment. A proposal will be submitted to NHS England and this work is being referred to as Restoration and Recovery. NHS England have also commissioned Ipsos Morri to conduct a survey with GPs and pharmacists on clinical innovations during the COVID-19 period that NHS England want to keep and further develop going forward.
Recognition for pharmacy – AIM has consistently been highlighting the challenges regarding the recognition for the services this sector provides. We have been writing to senior politicians and decision-makers and have been the organisation raising this issue with NHS England and Department of Health. Following our request and official letter to NHS England asking for community pharmacy to be looked at more favourably within the healthcare sector and overcoming prejudice, the Chief Pharmaceutical Officer and the DHSC, have agreed to set up a session with sector leaders to discuss and identify the issues and propose the next steps forward, including how pharmacy can better be integrated as part of the NHS family. Members will be kept informed.
Prescription Directions – Following issues raised by our members regarding prescription directions, particularly regarding Apps, AIM has raised this issue with both the GPhC and NHS England. NHS England told us that they were not aware of this and thanked us for bringing this to their attention and said they have dedicated a team to investigate. The GPhC said the same thing and they are working closely with NHS England on this. AIM has captured data on this topic and we are submitting this to both NHS England and the GPhC. We will keep members informed.
5. Pharmacy Practice
Flu Vaccination – NHS England and DHSC are currently looking at three elements regarding this year’s flu vaccination service:
1. Delivery of the programme bearing in mind social distancing challenges which they think may be an issue in pharmacies and patients popping in pharmacy randomly. 2. Extension of the cohort – the Secretary of the State and Public Health England (PHE) are looking at this currently. NHS England will be looking at implications on “what NHS England buys from pharmacy”. 3. Making sure that all healthcare workers including pharmacists and their teams are vaccinated.
In addition, we have been told that issues regarding stock availability and collaborative working with GPs are being looked into. As part of GP PQS (which currently is on hold), GPs need to demonstrate that they are overcoming barriers to collaborative working around flu. Considerations will also be given to jabbing outside of pharmacy.
We have highlighted the urgency of this topic as our members are looking to get ready for September when the season starts. I will keep members informed about this topic. If you have any queries regarding vaccination training provision or any general queries about the flu service please do not hesitate to let me know.
NMS – Many members have raised concerns and issues regarding seeking consent with regards to delivery of NMS and MUR service. AIM has raised this issue with PSNC, NHS England and the DHSC. They acknowledge that seeking written consent is currently a challenge and are looking into this with the view to advise contractors at the earliest opportunity. Any change unfortunately requires changes to the underpinning legislations and hence DHSC are keen to say that this is not straight forward.
Following feedback to NHS England, they have now changed the requirement for consent regarding electronic repeat dispensing (ERD) to an opt in and opt out model and we are hoping that the same can be repeated for some of the current pharmacy services.
CPPQ – The PSNC are discussing potential changes to the CPCF for the new normal phase, so they may seek to remove the CPPQ requirement for this year, but at present the requirement still applies.
Patient Safety – Please find below the latest data and trends regarding patient safety reports. Work and environmental factors were the biggest cause stated for the error followed up by LASA, educational factors and issues with equipment. Please note that AIM members can use the patient safety reporting elements of the ReportSmart platform free of charge and receive comprehensive relevant data directly to head office. The platform can be accessed via our website under patient safety: https://www.aimp.co.uk/home
AIM is represented on the patient safety group (PSG). For any further information please contact us and we will pass your queries to Claude Pereira who represents AIM as MSO on PSG.
We are aware these are not normal times and we are trying to do all we can to keep you informed, to support you and to represent your views. We know how valuable our events are to our members and partners and we are looking to see how we can operate these digitally should the current COVID-19 situation continue (second wave). As ever, if anyone has any suggestions how we can improve communication during these times please let me know.