On 23rd January we will be having our first and new format member event of 2020 in Marriott Hotel Leicester. We are looking to welcome our members and partners to what we believe will be a productive, engaging and informative day. Diane circulated information about the event earlier this week and further information, including the agenda will be shared over the coming weeks. Please ensure you put this date in your diary.
Our Superintendent Forum in 2020 will take place on 9th March.
Pharmaceutical Services Negotiating Committee (PSNC) update
Last week the AIM Chair Peter Cattee and I had a meeting with PSNC Chair Sue Killin and CEO Simon Dukes to discuss priorities and 2020 plans. At the meeting Sue and Simon indicated that the Community Pharmacy Contractual Frame Work (CPCF) implantation is PSNC’s current priority. This includes the National review of PSNC and Local Pharmaceutical Committee (LPC) structure and support for Community Pharmacy Contractors. An independent Chair, David Wright from East Anglia University, been appointed to conduct the review with help from a Steering Group. AIM PSNC representatives, Has Modi, Jay Patel and Peter Cattee and I will be consulted by the Chair of the Steering Group as part of this process, and as an organisation that has LPC representatives across the country we have also been allocated a representative on the Steering Group. The process will be running until March 2020. This is an important piece of work and as an organisation we will ensure that we do our best to secure the best outcome for AIM Members and the sector.
I have also included below the notes of the latest PSNC Committee meeting which was held on the 27th and 28th November: https://psnc.org.uk/wp-content/uploads/2019/12/PSNC-MeetingNovember-2019-Summary-Report-for-Contractors-and-LPCs.pdf
Pharmacy Integration Advisory Group (PIAG)
This group has been set up by the NHSE to look at how to support community pharmacy deliver for the rest of the NHS, in line with the NHS 10-year plan. There are number of areas of focus, including piloting some services on community pharmacy over the coming months with the view to evaluate and see if the services can be commissioned Nationally, and look at education and training needs. I will keep members up to date regarding developments.
I highlighted in the previous member newsletter that issues highlighted to us by members around branded generics are on the priority list for AIM to look into. We are planning to form a roundtable meeting where we will bring together a number of stakeholders, experts and prescribers (GPs) to discuss this topic and capture relevant data in order to put robust evidence in front of relevant authorities. We believe that working in partnership with a range of stakeholders will ensure we capture relevant data. AIM will also be writing a blog in C7D about this topic. Members will be updated on the progress.
The Community Pharmacy Contractual Frame Work for 2019/20 to 2023/24 outlined that the Government is pursuing legislative changes around Hub and Spoke and is seeking to enable greater use of automation. The Department of Health and Social Care (DHSC) can make simple changes to legislation to allow inter-company hub and spoke. DHSC will be discussing with PSNC which models will allow the whole sector to benefit. A consultation will begin early 2020 and AIM will be responding.
To ensure that our members are supported, we have set up a group of experts to look at all elements of Hub and Spoke, including workforce, costs, feasibility, various options and the ‘how’. The first meeting of the group is in December. Members will be kept updated on progress and have the opportunity to feed into the group. If you have any thoughts please do not hesitate to get in touch with me.
HMRC employment (for tax) status and IR35
In the 2018 autumn budget, the Chancellor announced reforms to the IR35 regulations to increase compliance and to bring the private sector into alignment with the public sector. Therefore, from April 2020, medium and large businesses (companies employing more than 50 people) will become responsible for assigning the tax status of locums contracted through their own limited company, to reflect the correct employment status position. To evaluate the impact of this on community pharmacy, a cross sector working group was set up, AIM had representation on this group. Concerns included the impact of this on the workforce and on determining locum tax status.
The group sent a letter to senior colleagues at HMRC in September 2019 offering the opportunity to re-engage. The group asked HMRC to respond within six weeks and, as this hasn’t yet happened, we are no further forward. We engaged with DHSC informally at a catch up in October to highlight our concerns about the impact this may have on workforce and the difficulty it may place contractors under in fulfilling the NHS Terms of Service. Unfortunately at the time DHSC were under pressure with Brexit and are now in purdah. Our aim has been to get greater clarity from HMRC and push for them to produce appropriate guidance. Members will be kept informed of any progress.
Most recent guidance from HMRC on IR35: https://www.gov.uk/government/publications/hmrcissue-briefing-reform-of-off-payroll-working-rules/hmrc-issue-briefing-reform-of-off-payrollworking-rules
The Urgent Care Delivery and Implementation Group (UCDIG), where AIM is a member of regularly meets to discuss how the service is progressing and where improvements are required – an operational document outlining issues that need clarification is being drafted and will be circulated to all contractors soon.
So far the numbers of referrals are as follows:
Total minor illness referrals: approximately 14,800
Total urgent supply referrals: approximately 22,400NHS England (NHSE) team are keen to highlight the following points to contractors:
- NHSE expects pharmacies to monitor the incoming messages from NHS 111 at several points during the day as this is essential to running the service and needs to be part of day to day operations. Their message is not wait for patient to walk in – check your CPCS IT system and NHS mail.
- Patients should not be asked to dial 111 back
- Pharmacy should provide this service during opening hours unless exceptional and rare circumstances that require the pharmacy to request a ‘temporary withdrawal’
- Pharmacists should, check the patient’s SCR unless good reason no to. Remember to seek patient consent first
- Locums will need to understand the service and be able to deliver this
If the service must be temporarily withdrawn by the pharmacy contractor due to exceptional, rare and unforeseen circumstances, they must ensure that:
A few other points:
- The pharmacy contractor must inform the NHS 111 provider and local IUC CAS of the temporary withdrawal by calling the NHS Directory of Services Provider and Commissioner Helpline (0300 0200 363) as soon as possible (and not wait for patient to come first) to stop referrals being made to the pharmacy.
- The local NHS England team must also be informed by the pharmacy contractor.
- The elements of their business continuity plan related to the service are activated
There have been some concerns about:
We have shared these issues with NHSE team. In late Spring 2020 there will be training sessions provided for pharmacists that will further enable them to deliver clinical consultations, assessments and communications. The training is funded by NHSE and will be delivered by an appointed provider following a national procurement exercise by Health Education England (HEE).Members are encouraged to report any issues or share any success stories regarding the CPCS with me to ensure we bring these up at the relevant forums with the view to seek best outcome for members.
Over-the-counter (OTC) Audit
Members may have seen recently in the pharmacy media that we have published an OTC audit together with the CCA. This audit will run until March 2020 and provides an opportunity to gather information about how often patients and the public receive advice from community pharmacies and are not advised to buy an OTC medicine to ensure best interest of the patient or customer and promote patient safety. The purpose of the audit is to investigate the reasons for the non-supply of OTC medicines that a patient has requested and pharmacists using their professional judgement not to provide a requested OTC product. The audit will also help us evaluate how often community pharmacy teams have concerns about the use or misuse of medicines and do their part in stopping unnecessary and incorrect usage of medicines.
Please find the audit and guidance document attached to this newsletter.
Pharmacy practice matters
Please find attached a letter from Chief Pharmaceutical Officer Keith Ridge to pharmacy contractors regarding seasonal influenza.
Delivery of medicines
There have been a number of incidents highlighted by superintendents in regards to delivering medicines to patients in taxis which I thought I would highlight in this newsletter. In some cases the taxi driver delivered the medicines to the wrong address and handed over the medication to a neighbour without double checking the address on the package with the patient who then opened the bag leading to breach in patient confidentiality. Other cases involved taxi drivers posting medication through the letter box at the wrong address because they were in a hurry leading to the patient being without important medicines. It is important for branches to note that the responsible pharmacist is accountable for ensuring they have exercised due diligence regarding patient safety and if taxis are used (if no other option and in urgent situations) then correct and thorough guidance is given to the taxi driver. It may be prudent to give the taxi driver a telephone/mobile number so they call you if there are any problems.
Following some fitness to practise cases this year regarding mismanagement of Controlled Drugs (CDs) in a community pharmacy setting, I would like to highlight the importance of safe storage, handling and recording of Controlled Drugs. Pharmacy teams are very busy particularly now during the Christmas period, however my advice would be to enter CDs in the record book and store appropriately as soon as these arrive in the pharmacy. It is also important that pharmacists have the relevant knowledge of different schedules of CDs and follow the relevant guidance, including when delivering CPCS.
The GPhC have carried out a survey of registered pharmacists and technicians asking questions about the day to day roles and responsibilities of pharmacy professionals. More than 6,000 pharmacy technicians and more than 12,000 pharmacists, which is over 23% of professionals on the register, responded to the survey. The regulator hopes the survey findings will provide useful insights into pharmacy professionals’ training, professional practice, future plans, job satisfaction and work-life balance. The results of the survey will be published as an infographic by the GPhC in the coming days. Unfortunately, as this is embargoed we cannot highlight these in this newsletter.
Members are encouraged to look out for this survey when published by the GPhC. The RPS have also conducted a survey of approximately 1,300 pharmacists across the profession in various settings, looking specifically on stress levels experienced by the profession. The results will be published next week.
Based on feedback from members, we have created a section on this newsletter to post questions that members would like to ask other members. This allows information-sharing amongst AIM members. Questions can be asked anonymously, and all responses received can be shared with the member who asked the question – if they are happy it can also be shared with everyone. We have received the following question and request for feedback from an AIM member. If you are able to assist, then please respond to Diane or me by 11 December.
Question: If any AIM member uses CascadeHR software, could they advise if they are happy to discuss please?
Finally, I would like to take this opportunity to wish you a Merry Christmas and very Happy New Year!