Vaccinations for community pharmacy staff – bookings are now available through the national booking system for any pharmacy staff that haven’t yet been vaccinated

To book, please visit the NHS website

DHSC publishes plan to increase COVID-19 vaccination uptake
The Department of Health and Social Care (DHSC) has published a plan to ensure as many people as possible get vaccinated against COVID-19.

For more information on this plan, please visit the PSNC website

The NHS England and NHS Improvement (NHSE&I)  has been confirmed that the Pandemic Delivery Service will be commissioned from 19 February 2021 to 31 March 2021 (inclusive) for all clinically extremely vulnerable (CEV) patients living in England.

This news follows the Department of Health and Social Care (DHSC) announcement that up to 1.7m more individuals have been identified as CEV and would be added to the Shielded Patient List and that the Government’s shielding advice and support was being extended nationally until 31 March 2021.

For more information, please visit the PSNC website.

Herts Valleys CCG partnered up with Herts County Council to deliver a session on how to tackle COVID 19 vaccine hesitancy to primary care pharmacists, community pharmacists, and primary care nurses.

The online session was held on 11 February and was delivered by Jim McManus, Director of Public Health for Hertfordshire and Vice President of the Association of Directors of Public Health.

Please see the attached slide pack for more information on this session: Vaccine Hesitancy Seminar 

A video recording of the session can also be found here: Vaccine Hesitancy Seminar- Vimeo

Important Contact Details

Key Local Commissioner Emails

• NHS England:  england.pharmacyeast@nhs.net
• Drug and Alcohol Services:  Herts@cgl.org.uk
• Stop Smoking Service:  HealthImprovementService@hertfordshire.gov.uk
• Sexual Health Service: PublicHealth@hertfordshire.gov.uk
• Directory of Services NHS 111:  herts.dos@nhs.net
• East and North Herts CCG:  enhertsccg.covid-19@nhs.net
• Herts Valleys CCG:  hvccg.pmot1@nhs.net

Information for COVID-19 SOP

• Regional/local health protection teams

Find your local health protection team at www.gov.uk/health-protection-team

• NHS Regional Pharmacist: William Rial   William.rial@nhs.net
• NHS Local Pharmacy Network (LPN) chair: Jane Newman  england.eastpharmacylpns@nhs.net
• Local NHS lead for commissioning: Andrea Patman  apatman@nhs.net
• Local NHS Incident Room: england.eastofengland-COVID19@nhs.net
• Local Infection Prevention and Control Team: Frances Bolger, Head of Infection Control and Prevention frances.bolger@nhs.net.

On 15 January 2021, Primary Care East of England published guidance for pharmacies relating to Covid-19  fatalities for primary care workers. For further information and contact details please consult the attached documentation.

All information required can be found on the PSNC Covid-19 Hub

A wealth of useful and practical information is available from the following key organisations on their websites:

• Pharmaceutical Services Negotiating Committee (NB there are a number of useful FAQs here)
• General Pharmaceutical Council
• Royal Pharmaceutical Society
• National Pharmacy Association

The GPhC has published and will continue to publish new standards in their knowledge hub that helpfully clarifies some of the key areas for COVID-19 that may be causing you queries such as working with other pharmacies and volunteer groups. The standards will continue to be updated with new areas as and when they arise. This can be found on the knowledge hub of the GPhC website.

For current testing, wellbeing and Test and Trace resources, please visit the Covid-19 information site on the PSNC website

NHS England and NHS Improvement (NHSE&I)  issued an updated Standard Operating Procedure (SOP) for community pharmacies in relation to the COVID-19 pandemic.

A key amendment enables regional NHSE&I teams to notify pharmacies that they may work behind closed doors without the need for contractors to apply for such closed-door working. This change has been made to help healthcare bodies to tailor their response to the pandemic dependent on the local or regional situation. NHSE&I will consult with LPCs.

Full information on key changes to the SOP are highlighted clearly in yellow on the updated, published SOP and further information is available on the PSNC website.

All businesses and NHS providers, including community pharmacy contractors, need to have an ability to cope with emergency situations, so that wherever possible, they can continue to provide services to patients and the public therefore ensure you update your Business Continuity Plan 

GPHC has confirmed where no locum cover can be secured at the pharmacy, and recognising the potential effects of the current pandemic, it would be in the patient’s best interest for medicines already dispensed to be supplied from the pharmacy. They have also relaxed the inspection process. Please see full details on the GPHC website.

For further details around the use of PPE please visit the PSNC website.

In the first instance patients should be encouraged to identify a family neighbour or relative to pick up their medicines on their behalf where possible. Where this isn’t possible we have therefore agreed with the organisations below that we will promote the relevant organisation’s contact details to community pharmacies that can be provided to the patient as follows.

How to access support:

• Hertfordshire County Council accessible to all patients across Hertfordshire

If you are an individual requiring support in collecting a prescription, please contact Herts Help on 0300 123 4044 or go to Herts Help Website.

• Communities 1st accessible to all patients across St Albans and Hertsmere

020 8386 4006      memberservices@communities1st.org.uk

• Welwyn/Hatfield CVS accessible to all patients across Welwyn and Hatfield

whcvscars@yahoo.co.uk

• London Colney Good Neighbour Scheme accessible to all patients in London Colney

01727 261104      events@londoncolney-pc.gov.uk

• Watford & Three Rivers Trust (W3RT) accessible to all patients in Watford and Three Rivers

01923 216955      communitycars@w3rt.org

• North Herts and Stevenage CVS accessible to all patients in North Herts and Stevenage

01462 689402      communitytrs@nhcvs.org.uk

•  Community Action Dacorum accessible to all patients in Dacorum

01442 212888      ctadmin@communityactiondacorum.org.uk

•  Harpenden Cares accessible to all patients in Harpenden

01582 460457

•  Support For All (Wheathampstead) accessible to all patients in Wheathampstead

01582 380910      info@wheathampstead-pc.gov.uk

•  Colney Heath Community Support Group accessible to all patients in Colney Heath

07803 313525

•  Redbourn Care Group accessible to all patients in Redbourn

01582 794550      info@redbourncaregroup.co.uk

If you are approached by volunteer organisations please do put them in touch with the LPC and we will add them to the list above.

As there are several updates from the accountable officer and other regulatory bodies in regard to CDs, we have listed the most important.

• Reporting Incidents and Concerns

The accountable officer requires only incidents or concerns that you consider are ‘extremely serious’ or have had a ‘catastrophic’ outcome to be reported. Reports must be made as soon as practicable and via www.cdreporting.co.uk. For the avoidance of doubt, they consider serious patient harm or death and any theft or significant loss especially where misappropriation by a Healthcare Professional would meet the above definition. Suspected misappropriation by HCPs at this time is of particular concern to us as colleagues across the system are under intense personal pressure. We receive regular reports of HCPs accessing CDs at work to cope, self-medicate or self-harm. Please do ensure that your governance ensures that the health and wellbeing of your colleagues is protected.

• Authorised persons to witness the destruction of obsolete Schedule 2 controlled drugs

In primary care we are currently not able to arrange for an authorised person to attend any premises. If you are unable to store expired stock safely please report this as an incident on www.cdreporting.co.uk

• The CGL website is regularly updated and is very comprehensive with lots of useful links.

CGL is going to honour all payments for instalment dispensing even though supplies are now going out in 14-day instalments. Click here for further information.

• Information for community pharmacies to support Health and Justice (HJ) services and released detainees for COVID-19

This guidance   is to provide you with information about supporting people that have been released from prison to access medicines.

The LPC is in discussions about reimbursement for instalment dispensing.

• Message from Police to Pharmacies regarding transportation, delivery and storage of controlled drugs. Click here for further information.

National pharmacy bodies have today published guidance on dealing with unwanted medicines that have been returned to community pharmacies.

PSNC has worked with the National Pharmacy Association, the Royal Pharmaceutical Society and the Community Pharmacy Patient Safety Group to produce the joint guidance for community pharmacies in England.

The contractual requirement for community pharmacies to accept unwanted/out-of-date/waste medicines for disposal from the public remains an important service during the COVID-19 pandemic, but it does bring potential risks for pharmacy teams.

This guidance has been compiled to help contractors determine how best to safely handle returned unwanted medicines at this time. It contains a list of considerations and a suggested procedure, as well as checklists to work through.

Guidance on dealing with patient-returned / unwanted medicines

Checklists on dealing with patient-returned / unwanted medicines

NHS Digital are adding the multi-site FFFFF Smartcard code to Smartcards with the pharmacist or technician role, for the duration of the pandemic. The initiative has been supported by PSNC and NHS England and NHS Improvement. The bulk activity performed by NHS Digital is scheduled to take place across this week and to be finished by the end of the week.

A temporary Smartcard position has been created to provide greater flexibility for pharmacists and technicians during the ongoing pandemic. This will help pharmacy staff if they unexpectedly find themselves working at their non-usual pharmacy – e.g. because of staff shortages.

Whilst the LPC position is that ideally EPS should be available for dispensing of FP10s this is not currently possible for all providers as outlined below. It is essential that community pharmacies ensure locum pharmacists or a member of the community pharmacy team is able to access the shared generic nhs.net pharmacy email address when the pharmacy is open.

Community Trusts

The Community Trusts that support patients locally do not currently have access to the EPS system and are setting up contingencies to support virtual clinics. The LPC has therefore agreed that in these cases that as the risk of posted prescriptions not arriving in time for a patient is a genuine concern, we have recommended that the prescription is scanned and emailed via nhs.net which will be auditable and traceable. This should then be followed by the original prescription being posted to the community pharmacy. We have been assured that the number of prescriptions should not be too onerous but wanted to make you aware that you might receive some prescriptions via this route at the current time until a better process can be identified.

Hertfordshire Partnership University NHS Foundation Trust (HPFT)

Medicines prescribed in HPFT community outpatient appointments are usually done so through issuing FP10 prescriptions which are dispensed by community pharmacies. To support (a) the government’s social distancing and isolation measures, (b) avoid any unnecessary clinic appointments and (c) support any staffing shortages the following actions have been recommended to be taken by HPFT prescribers:

•  FP10 prescriptions (including prescriptions for Controlled Drugs) can be posted via the royal mail tracked service to the service users preferred pharmacy. The pharmacy must be told in advance that they should expect these FP10s in the post and an NHS.net email address requested. Prior to posting the FP10 prescriptions they should be scanned and emailed to the chemist and the envelope labelled “FAO Responsible Pharmacist”. The service user should be informed once the FP10 prescriptions have been posted.
• Prescription quantities must not be changed from normal practice as increasing quantities will put the medicines supply chain at risk.
• In order to provide an increased supply of medication several FP10s can be written at the same time to cover the next couple of months but each prescription must be clearly post-dated for example one dated for now, another dated for the next month and thereafter. However this must only be done if the patient is stabilised on their medication and the prescriber does not anticipate any dose changes.
• If the patient is stable on their medication and the medication being prescribed is within the HPFT formulary then GPs should be encouraged to take over prescribing responsibilities as per normal practice.

Dentistry

Remote prescribing may be undertaken for some dentistry patients where necessary. Dentists have been advised to follow the below steps for remote prescribing:

STEP ONE:

• Complete prescription and sign.
• Scan copy and email securely to pharmacy email address.
• Contact pharmacy via phone or by other appropriate means to advise them you will be emailing scanned prescription.
• Attach copy to patient’s clinical records.

STEP TWO

• Send original signed copy to pharmacy postal address within 72 hours.
• Log all sent prescriptions, confirming receipt with pharmacy.

We would also like to remind all pharmacists that you can dispense private prescriptions from a private dentist as an Emergency Supply at the request of a prescriber. This can be in the form of a secure email followed up with the paper prescription sent in the post as per the process for NHS prescriptions.

We have been working with local CCGs to get the following messages out:

1. GP Practices should be encouraging patients to order repeat prescriptions online or through their normal channels. Patients should not be directed to the community pharmacy who would normally drop their prescriptions to the GP practice in person as according to CCG guidelines.
2. GP practices should not extend prescription duration at the current time which could potentially affect the supply chain detrimentally. This was included in Nikki Kanani’s letter to general practices nationally. Pharmacies are also reminded they should also not be advocating this approach for any of their patients.
3. GP practices and pharmacies are asked to consider the opportunity for electronic repeat dispensing which will also decrease requests from patients.