NENC Messages
New Contact for NENC ICB
nencicb-tv.pharmacyandoptometry@nhs.net
24th Nov 2020
Temporary Opening Hours
Dear Pharmacy Colleague,
We would like to thank you for all your work over the past months and for your continued work to ensure that patients have access to local services.
This email is to provide further detail on the section in the latest Pharmacy SOP regarding the operating Model (detailed in Section 5.1, pages 6 – 8 in the attached SOP document).
We continue to monitor the local situation across North East and North Cumbria to ensure national guidance is followed. We recognise the challenges you continue to face and are seeking to take a pragmatic approach to managing any changes to opening hours. Please ensure that you communicate with us any concerns regarding opening hours as early as possible, so that we can support you deliver services to local people.
Should you have a requirement due to concerns over safety or efficacy of service delivery, at times of extreme pressure, require to implement the SOP allowance to work behind closed doors or to apply to amend your opening hours or temporarily close, the following processes should be undertaken:
WORKING BEHIND CLOSED DOORS FOR ONE DAY
If you think you need to temporarily work behind closed doors for one day only – NO prior consent is needed from the North East and North Cumbria NHS England & Improvement Team.
However, the following points should be followed-
- This decision sits with the Responsible Pharmacist, and should be documented and recorded on the Responsible Pharmacists Log.
- The Responsible Pharmacist should contact NHS England by emailing the Pharmacyandoptometry@nhs.net generic inbox to inform us that this action has been taken with a brief description of the reasoning and circumstances .This is in order for NHS England to record these amendments to contractual arrangements and monitor provision of services across our areas.
- Your Superintendent Pharmacist / Area Manager etc should be informed of this decision to allow them to support you to resolve the concerns
- You MUST maintain access for patients as detailed in the SOP and ensure there is information available to patients as to how to do this
- The allowance is only for a maximum of up to two and a half hours per day and must follow the guidance below
- This is to allow the pharmacy to continue to provide services behind closed doors and not to facilitate a cessation of all services during that period
WORKING BEHIND CLOSED DOORS FOR MORE THAN ONE DAY – (word document attached)
If the Responsible Pharmacist determines that the working behind closed doors may be required to be enacted for a period of more than one day – prior consent from North East and North Cumbria NHS England & Improvement Team needs to be obtained in advance.
The following points should be followed-
- This decision is a Professional Decision taken by the Responsible Pharmacist and should be recorded as a professional decision with the reasons behind this outcome recorded
- The Responsible Pharmacist should APPLY to NHS England for consent to take this action using a Temporary Opening Hours Application Form (as attached) detailing that you need to enact the “Working Behind Closed Doors” policy. This should be emailed to the generic inbox to clarify why this action is required. Please mark your email with the title “URGENT – Working behind closed doors policy application” Pharmacyandoptometry@nhs.net
- Your Superintendent Pharmacist / Area Manager etc should be contacted and informed of this decision to allow them to support you to resolve the concerns
- You MUST maintain access for patients as detailed in the SOP
- The allowance is ONLY for a maximum of up to two and a half hours per day and must be utilised within the guidance below
- This is to allow the pharmacy to continue to provide services behind closed doors and not to facilitate a cessation of all services during that period
- NHS England will determine the date period within which these actions can be taken after which the pharmacy must revert to normalised working patterns and hours or submit a further application.
Where a pharmacy needs to work behind doors closed to the public it can do so for up to 2.5 hours a day before 10 am, between midday and 2pm or after 4pm.
100-hour pharmacies needing to work behind closed doors due to extreme pressure, can do so before 10am, between midday and 2pm or after 6pm.
TEMPORARY SUSPENSION OF SERVICE (UNEXPECTED CLOSURE)
If you have a Temporary Suspension of Service for circumstances outside of your control – e.g. Responsible Pharmacist calls in sick or Locum Pharmacist is delayed, etc please continue to inform NHS England via an planned temporary suspension of services form or sending the necessary details via email to ENGLAND.Pharmacyandoptometry@nhs.net
APPLICATION TO TEMPORARILY AMEND OPENING HOURS OR CLOSE A BRANCH TEMPORARILY-(Sch 4 Paragraph 27) – (word document attached)
If you need to apply for a Temporary Amendment to Contractual Opening Hours or Temporary Closure
- Please complete a Temporary Opening Hours Application Form (as attached) and apply to NHS England fully detailing the circumstances via email to Pharmacyandoptometry@nhs.net within 24 hours
- NHS England will consider the application and inform you of their decision.
- If the application is refused the pharmacy must revert to full contractual hours immediately.
- If you are considering applying for, or have an approval to temporarily close a pharmacy, you should follow the PSNC guidance document https://psnc.org.uk/wp-content/uploads/2020/03/PSNC-Briefing-019.20-Emergency-closure-checklist-for-community-pharmacy.pdf
IN ANY OF THE CIRCUMSTANCES ABOVE – PLEASE ENSURE YOU AMEND YOUR DOS PROFILE VIA THE DOS UPDATER – see appendix A in attached Pharmacy SOP
If you are unsure as to any of the above please contact NHS England Pharmacyandoptometry ENGLAND.Pharmacyandoptometry@nhs.net
or your Local Pharmaceutical Committee (LPC) who will be able to provide advice.
Link to PSNC Guidance:
https://psnc.org.uk/our-news/temporary-closures-during-the-covid-19-outbreak/
Attached for your convenience is:
- Covid-19 Pharmacy SOP – Oct 2020C0796 COVID-19 Community Pharmacy SOP_Oct 2020
- Schedule 4 Paragraph 27 application form – pertaining to the SOP working behind closed doors and temporarily amending opening hours or to close pharmacy
temporary_opening_hours_application_form_oct_2020_v2 – (002)
Pharmacy and Optometry
NHS England and NHS Improvement – North East and Yorkshire
Waterfront 4, Goldcrest Way, Newburn, Newcastle-upon-Tyne. NE15 8NY
Prescription Nominations – a message from NHSE
The following guidance has been received from NHSE regarding patient nominations:
- Display the “Your Prescription – Your Choice” poster and refer to it in conversation with patients as appropriate.
- Encourage patients to contact NHS England Directly via the “Your prescription, your choice” route. [Display the Poster and offer the Report Form]
- If patients are not minded to contact NHS England Directly, or if the pharmacist prefers, ask the patient to complete the Report Form which the pharmacist may then submit on behalf of the patient to the local NHS England office.
- If the patient does not wish to fill out a form, seek the patients consent to share their name and address with NHS England, along with the details of when their nomination had changed without their permission or consent. This allows NHS England to at least verify the nomination and to add this to the concerns list.
- Remind patients that consent has three permanent elements:
- The patient MUST be informed clearly about the consent and implications
- The nomination consent MUST be voluntary and not induced in any way.
- The patient must have capacity [we have had a patient with severe dementia seemingly consent to a change of nomination over the phone].
Failure to ensure any one of these three elements = failure to obtain proper patient consent.
For NHS England to take action, we need the evidence. This evidence is strongest when provided directly by the patient. If anyone requires a printed copy of these documents then please contact us on info@communitypharmacycumbria.org.
Dear Colleague
Following on from Linda Bosher’s email of 5 April 2019 sharing EU Exit information, please now find attached, for your information, some Frequently asked questions on Data Protection in a no deal EU Exit.
Kind regards
Glyn Mrs Glyn Bosson
EU Exit Letter
15th April 2019
EU Exit Primary Care Guidance – Final Version for HoPC11.4.19
Contractor Update: Serious Shortage Protocols
June 28, 2019
On Monday (1 July 2019) legislation will come into force allowing the Department of Health and Social Care (DHSC) to issue Serious Shortage Protocols (SSPs).
SSPs are a potential way to help pharmacies manage any serious shortages of medicines that may occur, without needing to refer patients back to prescribers.
If an SSP is issued, community pharmacy contractors must, under their Terms of Service, consider the SSP, so it is important that contractors are aware of the legislation and the new requirements.
To help contractors to do this, PSNC has today issued a contractor briefing and flowchart diagram:
PSNC Flowchart: Serious Shortage Protocols (SSPs) – Dispensing and Claim Process Steps
This briefing explains the legislation and what pharmacies should do if an SSP is issued, including worked examples of the endorsing requirements.
PSNC will also be holding a webinar to help contractors to understand SSPs and what they mean for pharmacies on the evening of Thursday 18th July – sign up details will be available soon.
For more information, please see this PSNC news story.
Disposal of Unwanted Medicines
5th June 2019
Pharmacies are obliged to accept back unwanted medication from patients. On return of medication, the pharmacist must sort them in to solids, liquids and aerosols and the local NHS England team will arrange for a waste contractor to collect them.
Contractors requiring an interim collection of patient returns should contact the relevant NHS England mailbox given below : stating Fcode, pharmacy address and the number of bins that need collecting.
For Morecambe Bay and South Cumbria contact: england.lancsat-pharmacy@nhs.net
For North Cumbria contact: ENGLAND.Pharmacyandoptometry@nhs.net
For further information on disposal of unwanted medicines click here for a link to the PSNC website
NHSmail: changes to password policy
May 28, 2019
NHS Digital are introducing an improved NHSmail password policy this month, which will include less frequent password changes.
NHSmail users’ passwords will become valid for 365 days instead of the current 90-day expiry. This change follows PSNC, on behalf of the Community Pharmacy IT Group (CP ITG), lobbying NHS Digital about its approach to frequent forced password changes for national systems including NHSmail. PSNC asked NHS Digital to consider applying the National Cyber Security Centre’s (NCSC) guidance that states:
“Regular password changing harms rather than improves security, so avoid placing this burden on users”.
NHSmail users will be notified they must change their password within 45 days of the new policy’s introduction. The new policy also adopts some of the NCSC’s other password guidelines; new NHSmail passwords must follow criteria including:
•a minimum length of 10 characters without requiring a mix of character types;
•not matching your previous four passwords;
•not detected as a common password, e.g. password1234; and
•not detected as a breached password (a password used for an account that has previously been compromised).
Top tip: NCSC recommend that a strong and memorable password is created by choosing three random words, e.g. ‘planeyellowbread’.
Commenting on the change in password policy, Alastair Buxton, Director of NHS Services at PSNC said:
“We have lobbied NHS Digital over the last two years to update their approach to passwords, in order to conform to UK Government guidance, so we are delighted that they are making this change to NHSmail. We hope they will likewise make this change as soon as possible to all other national NHS IT systems, such as EPS.”
PSNC, working with the CP ITG, maintains a list of commonly requested NHSmail features. If you have a suggestion then please email PSNC’s Community Pharmacy IT Lead.
Read more at: PSNC’s NHSmail webpage and at the NHSmail webpage about the change to password policy.
28th May 2019
Dear Colleague,
We would like to inform you about impending supply issues affecting supplies of Ethinylestradiol 30 microgram/Levonorgestrel 150microgram tablets and diamorphine 5mg injection.
Please see attached communications about these impending issues including a Microgynon ‘Dear Health Care Professional’ letter, which should be circulated to relevant networks in primary care.
These communications are being distributed to all GP practices and Community Pharmacies in England.
Regards
Pharmacy Team
Diamorphine primary care communication-May 2019
Microgynon_Ovranette Comms May 2019
Community Pharmacy Assurance Framework (CPAF) – arrangements for 2019/20
To ensure that patients and members of the public receive safe, effective and high quality pharmaceutical services, NHS England has processes in place to monitor compliance by pharmacy contractors, who are included in one of NHS England’s pharmaceutical lists, with the terms of service set out in the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 (the 2013 regulations).
One of these processes is the use of the Community Pharmacy Assurance Framework (CPAF) to be conducted in two parts.
Part One: All pharmacy contractors to be invited to complete a short screening questionnaire consisting of ten questions to assure themselves and NHS England that they are compliant with the terms of service.
Part Two: The data collected from this questionnaire along with other information held by NHS England to be used to shortlist pharmacies to be considered for a contract monitoring visit. Only these pharmacies are asked to complete a full CPAF questionnaire. A copy of the full CPAF can be viewed here.
This approach means that the majority of contractors do not need to complete the full CPAF questionnaire. However, both the Pharmaceutical Services Negotiating Committee (the PSNC) and NHS England recommend that all pharmacy contractors make use of the full CPAF questionnaire to assure themselves that they are compliant with the terms of service.
Pharmacies will be asked to complete the screening questionnaire during June 2019. Please note that the CPAF screening questionnaire was updated in 2018 following development work by the CPAF working group, a working group with membership from NHS England, NHS Business Services Authority (NHSBSA) and the PSNC. The CPAF screening questionnaire again includes the two questions focusing on safeguarding and pharmacy audits; which replaced the questions on ‘owings’ and prescribed medicines advice, which have been retired and no longer need to be answered.
The NHS Business Services Authority (BSA) will carry out the administration of both the screening questionnaire and the full CPAF at a national level on our behalf and this is facilitated through a secure on-line mechanism to allow pharmacy contractors to complete their returns. The screening questionnaire will be available to view in advance from 20 May 2019 and can be found here.
Contractors will have four weeks to complete the screening questionnaire which will be available from Monday 3 June 2019 with a closure date of Sunday 30 June 2019. The questionnaire should only take around 20 minutes to complete.
Contractors will receive information and instructions on how to access and complete the questionnaire from the BSA during week commencing 27th May 2019.
Once you have submitted the completed questionnaire you will have the facility to save, print or access your responses for further reference.
Further Extension on Article 50
16th April 2019
Dear colleagues,
You will have seen that the Government has now agreed with the EU a further extension of the Article 50 period to 31 October 2019.
Please therefore immediately make the necessary changes to stop your no deal provisions being enacted on Friday 12 April but keep them on hold.
Please disseminate this instruction today to all NHS organisations in your region.
We are currently working with the Department of Health and Social Care and partners to review the position and will provide you with additional information and guidance about the next steps and maintaining an EU Exit provision as soon as possible.
Thank you for your help,
Professor Keith Willett
EU Exit Strategic Commander
Medical Director for Acute Care & Emergency Preparedness
EU Exit Letter
15th April 2019
EU Exit Primary Care Guidance – Final Version for HoPC11.4.19
Clinical Governance deadlines – 31st March 2019. Action required.
27th February 2019
Community pharmacy contractors are reminded that three key actions relating to the clinical governance aspects of the terms of service must be completed by 31st March 2019. The three key actions are:
- NHS Data Security & Protection Toolkit – this has replaced the old Information Governance Toolkit and reflects the new GDPR requirements.
- Pharmacy’s clinical audit – each pharmacy needs to complete a clinical audit of its own choosing by 31st March. You can choose any topic for the audit but cannot use the NSAID audit linked to Quality Payments. (This is in addition to the national audit you did in late 2018 on seasonal flu vaccination advice for people with diabetes.)
- Community Pharmacy Patient Questionnaire (CPPQ) – you also need to complete your 2018/19 CPPQ patient survey by 31st March. Many of you will already have done this for Quality Payments.
For more information, please read the PSNC Briefing 004/19: Upcoming clinical governance deadlines – actions to be completed by 31 March 2019
To assist contractors PSNC and NHS Digital held an online workshop about the Data Security and Protection (IG) Toolkit on 30th January 2019, this webinar is available on demand to watch.
During the webinar, representatives from PSNC and NHS Digital discussed the questions in the Toolkit, talked viewers through the guidance materials available and answered questions on how to make the Information Governance (IG) declaration.
Click here to watch: https://tinyurl.com/yysuxlo
Medicines Supply Update (No Deal Brexit)
27th February 2019
NHS England has published updated information on planning for continuity of supply of medicines in the case of a ‘no deal’ EU Exit. This information also includes supporting Q&As which may be helpful in any discussion with patients about their medicines and medical products.
The nhs.uk website has also been updated with some patient facing information on medicines supply.
In addition, Stephen Hammond MP, Minister of State for Health, has also written to, the NHS, Adult Social Care, Royal Colleges and Charities to provide an update on work to ensure the continuity of supply of medicines and medical products in the event the UK leaves the EU with no deal. A copy of the letter is below;
Stephen Hammond DHSC EU Exit technical update
FOR INFORMATION – metoprolol 50mg and 100mg tablets
25th February 2019
Information for all community Pharmacies
Please see below information and link to a memo on the SPS website regarding metoprolol 50mg and 100mg tablets.
Metoprolol 50mg and 100mg tablets
- DHSC has been made aware of an ongoing supply issue with the following two products:
- Metoprolol 50mg tablets
- Metoprolol 100mg tablets.
- The issue has been caused because of some manufacturers discontinuing the products and others having supply difficulties.
- Milpharm/Aurobindo, are currently the sole supplier of both presentations to the UK market.
- Supplies of both presentations are currently available but may be limited, further stock is arriving over the coming weeks however supply is likely to be intermittent for a number of months.
- If patients are having difficulty obtaining metoprolol, they may need to be switched to an appropriate alternative treatment.
- Please see a memo which had been developed by UK Medicine Information with input from national experts at NHSE and NHSI, which advises on management options for patients affected by this supply issue, including the use of alternative beta blockers, dosing information for these alternative beta blockers and monitoring requirements.
- This is available on the SPS website at the following link: https://www.sps.nhs.uk/articles/shoratge-of-metoprolol-50mg-and-100mg-tablets/
- Suppliers of alternative beta blockers have been contacted to determine if they can meet any additional demand and currently, the manufacturer of carvedilol has indicated it would be unable to meet demand if patients were switched to this product. Manufacturers of bisoprolol, atenolol and propranolol have indicated they have capacity to support any additional demand on their products.
- DHSC are continuing to work with the manufacturers Milpharm/Aurobindo, to expedite future deliveries will continue to monitor the overall situation.
Thanks
Community Pharmacy team – CNE