National Pharmacy Association (NPA) - News updates

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Patient safety considerations for OTC medicines

Benadryl Challenge on TikTok: The United States Food and Drug Administration (FDA) has issued an alert warning parents/guardians about a new challenge on social media. The ‘Benadryl challenge’ on TikTok encourages social media users to take excessive doses of Benadryl to bring about diphenhydramine hallucinations. This can cause severe side effects and parents/ guardians are advised to be vigilant and notify the school if their child engages in this challenge. In the US, the active ingredient in Benadryl is diphenhydramine, which is different to the UK products which contain cetirizine, or acrivastine, or acrivastine with pseudoephedrine. However, as diphenhydramine is available as an over-the-counter (OTC) medicine in the UK, potential misuse as popularised on social media is a possible patient safety risk. Pharmacy teams should be aware of the potential for misuse associated with products containing diphenhydramine, or Benadryl, as the public may be unaware of the differences in active ingredients, and be vigilant to repeated requests for these products, or requests for large quantities, and monitor sales on a regular basis. If pharmacy teams are receiving increased requests for OTC diphenhydramine or Benadryl products, and are concerned about the potential misuse of them, please inform the NPA Pharmacy Services team via email pharmacyservices@npa.co.uk;…

Free COVID-19 PPE for the frontline – Register with the PPE Portal

COVID-19 is classed as the PPE that providers are using over and above business as usual (BAU) use, due to COVID-19 infection control guidance, rather than what would have been used pre-pandemic. While such PPE requirements will vary according to settings, contexts and individual circumstances, the PPE Portal’s order limits can serve as an indicative approximation of such requirements (especially where providers may be in doubt). Eligible primary care providers in England (including community pharmacists, optometrists, dentists, orthodontists and GPs) should now order PPE through the portal, free of charge, to meet the increased need that has arisen as a result of the COVID-19 pandemic. The DHSC has partnered with the NHS and the e-commerce industry to develop this service in order to ensure that those on the frontline have what they need. The overriding priority is to protect people and our wider communities, thereby reducing infections and saving lives. We must make sure everyone has the PPE they need so please do play your part in this collective effort. Register and access the portal using your CQC/MHRA/NHSE/NHS BSA registered email. The latest guidance on what PPE items you can order (including order limits) is also available. Call the customer service team on 0800 876 6802 if you have any questions about using the PPE portal (including registration and queries or if you think you should have been invited but have not been).…

NPA supportive of temporary authorisation of the supply of unlicensed products in interest of public health

The NPA, which responded to the consultation, said it is supportive of the proposal by the Joint Committee on Vaccination and Immunisation (JCVI) on advising the government to use a tested but unlicensed vaccine against Covid-19 in the interest of public health. Helga Mangion, Policy Manager at the NPA said: “We are pleased with the reassurance from DHSE and MHRA of their commitment to robust scrutiny, objectivity and safety. “In our submission we reiterated the need for their objectives to be reviewed on a regular basis in line with new research and pandemic progression. “We foresee community pharmacies will also have a crucial role to play in ensuring as many people as possible get protected by any future coronavirus vaccine. “Provided the appropriate safety, quality and efficacy measures have been put in place, the NPA is supportive of the deployment of effective and legal mechanisms for bringing this pandemic under control.” The consultation which ran from 28 August to 18 September concluded that there will be three key changes to the proposals set out in the original consultation document, including; robust scrutiny of the impact of regulation 174A (which is the new power to impose conditions and dealing with their consequences); promoting objectivity by changing the ‘objective bystander’ test that relates to loss of immunity from civil liability; and creating an additional level of reassurance in relation to the expanded workforce.…

Pharmacies should be permitted to conduct COVID antibody tests, says NPA

The NHS itself is now offering antibody tests to a limited population (in England this is people working in adult social care), with the patient taking a finger prick blood sample themselves at home. Community pharmacies should be allowed to offer tests as long as they comply with the relevant devices regulations as set out by Medicines and Healthcare products Regulatory Authority (MHRA), says the NPA. NPA board member, Olivier Picard, said: “We now have a situation where members of the public can take a sample themselves in their own home and find out whether they have Covid-19 antibodies, but a qualified pharmacist cannot administer a test within a registered pharmacy. This inconsistency makes no sense and its time Public Health England updated its guidance to catch up with the facts on the ground. “Many people want to have Covid-19 antibody tests, in order to understand what has – and has not – happened in their body. In particular, people who have experienced ill health in recent months can use an antibody test to determine whether the symptoms they experienced might be due to the effects of Covid-19. A negative result could in turn lead them to ask themselves whether there is an underlying health problem unrelated to coronavirus, and seek professional help if necessary.…

The supply of flu vaccines for the NHS flu service 2020/21

The significant increase in demand for flu vaccinations seen in community pharmacies during the first month of the NHS flu vaccination service 2020/21 has led to many pharmacies running out of stock of the vaccines earlier in the season. Further supplies of the vaccines are due to be delivered to service providers, including community pharmacies, in phases, as agreed many months before the start of the COVID-19 pandemic. UPDATED information 20/10/2020: As part of the Government’s response to the coronavirus pandemic, the Department of Health and Social Care (DHSC) has secured additional supplies of vaccines for the UK from four manufactures that extended their production beyond the original final cycle. Due to these ‘extra’ production cycles, the extra vaccines will be available to pharmacy contractors throughout November and December. The arrangements for community pharmacies to obtain this stock are currently underway and will be confirmed as soon as possible to help them manage the flu vaccination demand from patients. The DHSC and Public Health England (PHE) have issued a leaflet to reassure patients eligible for a NHS flu vaccine that, overall, there is a sufficient supply of flu vaccines and to explain the phased delivery of these vaccines, before and during the flu season, which usually starts in December.…

Ban on the supply of single-use plastic straws and plastic stemmed cotton buds (England)

The Environmental Protection Regulations (Plastic Straws, Cotton Buds and Stirrers) (England) Regulations 2020 came into force on 1 October 2020. It bans the supply of plastic straws and plastic stemmed cotton buds to customers in England, after a transitional period unless exemptions apply. The ban applies to all businesses supplying these products, including manufacturers and retailers, such as community pharmacies, and has been introduced as a measure to reduce single-use plastic waste in order to protect the environment and marine wildlife.   What does this mean for community pharmacies? After 1 October 2020, the following exemptions apply for community pharmacies to allow supply of single-use plastic straws and plastic stemmed cotton buds. The exemptions that apply to community pharmacies are: Registered pharmacies exemption Community pharmacies (including distance selling pharmacies) can supply these at the premises or online, as long as the below criteria are met: Must not be advertised on the pharmacy premises; however, if a pharmacy has an online presence the product can be displayed on the website Must not be visually placed or freely accessible to customers Must not be offered or provided unless requested by a customer Medical devices and purposes exemption Community pharmacies can these if it is being used by a health professional, or under the direction of a health professional, for medical purposes, or if they are defined as a relevant device A health professional includes a registered pharmacist or registered   pharmacy technician A relevant device, is defined in Regulation 3 of The Environmental Protection Regulations (Plastic Straws, Cotton Buds and Stirrers) (England) Regulations 2020, and Regulation 2 of The Medical Devices Regulations 2002 Exemptions for forensic or scientific purposes Community pharmacies can supply these to a forensic service provider, or for scientific purposes (diagnostic, educational or research purposes) Transitional period for businesses, including community pharmacies Until 1 April 2021: Single-use plastic straws and plastic stemmed cotton buds can be supplied/sold to customers if they were purchased by the community pharmacy before 1 October 2020, therefore, the exemptions do not apply Until 3 July 2021: Single-use plastic straws attached to drinks packaging can be supplied/sold, therefore, the exemptions do not apply   Please note the following: The ban on the supply of single-use plastic straws and plastic stemmed cotton buds applies to end-users, pharmacies can continue to supply businesses requesting these products Single-use straws and plastic stemmed cotton buds made from other material or reusable alternatives can still be sold – some paper straws use adhesives containing plastic within the inner lining which are considered an acceptable alternative to plastic drinking straws Community pharmacies may receive inspections from their local authority and fines may be imposed if found in breach of the regulations.   FAQS Can I supply nutritional drinks which come with an attached straw, for example, Ensure plus liquid? Yes, nutritional drinks which come with an attached single-use plastic straw can still be supplied to customers, if they are supplied as products with a medical purpose, and under the direction of a registered pharmacist or registered pharmacy technician..…

Sanofi drug alert: Epilim gastro-resistant tablets 500mg

On 13/10/2020, a Class 2 medicines recall drug alert (EL (20)A/48) for certain batches of Epilim gastro-resistant tablets 500mg manufactured by Sanofi may have been received by some pharmacies. We subsequently contacted the Medicines & Healthcare products Regulatory Agency (MHRA) who advised us that the alert had not yet been finalised, and therefore, not issued on the MHRA or the Central Alerting System (CAS) websites. The MHRA had flagged to Sanofi to investigate. Subsequently, the finalised alert has been issued on 14/10/2020 and can be found here: https://www.gov.uk/drug-device-alerts/class-2-medicines-recall-sanofi-epilim-500mg-gastro-resistant-tablets-el-20-a-48 The alert advises healthcare professionals to stop supplying and quarantine the affected batches of Epilim gastro-resistant tablets 500mg PL 04425/0303, and return them to your supplier using your approved process:   PL 04425/0303 Batch number Expiry Date Pack Size First Distributed R0601 08/2022 30 06 November 2019 R0602 08/2022 30 05 November 2019 R0603 08/2022 30 06 November 2019   Please contact the Pharmacy Services team for further advice and support: Telephone: 01727891800 (Mon-Fri 9am to 6pm, Sat 9am to 1pm) Email: pharmacyservices@npa.co.uk…

Local COVID alert levels and guidance for shielding and supporting clinically extremely vulnerable groups (England)

On 12 October 2020, the Prime Minister announced standardisation and simplification of local rules by introducing a three-tiered system of local COVID alert levels in England. Following this, guidance was published on 13 October 2020 by the Department of Health and Social Care (DHSC) and Public Health England (PHE) on shielding and supporting those who are identified as clinically extremely vulnerable from COVID-19. This update is split into two sections to give a brief overview of what is now applicable in England; however, how this affects community pharmacies is explained below. Please note the following in relation to community pharmacies: Community pharmacies are able to open regardless of the local COVID alert level and are required to ensure they are operating in a COVID-secure manner, see NPA resources below to help with this: NPA COVID-19 individual and workplace risk assessment packs: https://www.npa.co.uk/news-and-events/news-item/superintendent-update-launch-of-covid-19-individual-risk-assessment-pack-for-community-pharmacies-uk/ NPA and the Company Chemists’ Association business continuity of pharmacy services guidance: https://www.npa.co.uk/information-and-guidance/covid-19-business-continuity-guidance-continuity-pharmacy-services-plan/ NPA COVID-19 updates: https://www.npa.co.uk/coronavirus-updates/ Further considerations for community pharmacies include: The Community Pharmacy Home Delivery Service During the COVID-19 outbreak service (pandemic delivery service) commissioned by NHS England & NHS Improvement (NHSE&I) earlier on in the year for people who were shielding, has now been terminated, even in the areas of local outbreaks Community pharmacies should now follow their prescription collection/delivery processes as in pre-COVID-19 times for all patients – ensure all SOPs are updated to reflect this The DHSC/PHE guidance on shielding and supporting identified as clinically extremely vulnerable from COVID-19 details how to advise such customers/patients – details can be found in section 2 below The NHS Volunteer Responders Programme continues until at least the end of this year – if a volunteer is recruited by the pharmacy to carry out deliveries after 1 October 2020, they will be required to undergo GPhC approved training; however, if they were recruited before 1 October 2020, they are not required to undergo approved training as long as they have been trained by reading standing operating procedures or something equivalent Further reading on the above can be found at: NHSE&I updates and guidance: https://www.england.nhs.uk/coronavirus/publication/preparedness-letters-for-community-pharmacy/…

IMPORTANT UPDATE for pharmacies providing pharmacy services at a distance, including online pharmacies

A number of pharmacies have been approached by online prescribing services to dispense private prescriptions regularly. We have also been made aware of a number of issues recently with regards to the way pharmacy services are provided in some cases. Example of areas of concern include: How prescriptions originating from online prescribing companies are being processed and dispensed Prescribing and dispensing high-risk medicines, or those requiring ongoing monitoring Circumstances where the patient has refused consent for the prescriber or pharmacist, to contact their regular GP, or no consent has been obtained Dispensing and supplying medicines against private prescriptions issued by online prescribing services for patients under 18 years of age without appropriate safeguards We would like to highlight the following key points to members to ensure that services you provide at a distance are delivered a safe and complaint manner and are compliant with expected standards: Before engaging in provision of these services, pharmacy owners/superintendent pharmacists must have in place robust processes and safeguarding measures to ensure online pharmacy services can be provided safely and effectively, in-line with the current GPhC guidance: https://www.pharmacyregulation.org/registration/internet-pharmacy Certain treatment conditions prescribed on private prescriptions including, for example, gender dysphoria may require ongoing monitoring or management – in such cases, the pharmacist needs to ensure that the medicines are clinically appropriate by carrying out relevant checks, for example, hormone therapy used in treatment of gender dysphoria may involve licensed products being used off-label All members are strongly advised to ensure that they have read, understood and implemented the requirements of the GPhC guidance on delivering pharmacy services at a distance: https://www.pharmacyregulation.org/standards/guidance/buying-medicines-safely-online…

NPA/CCA Community Pharmacy school resource

The NPA/CCA Community Pharmacy – A career choice in Scotland resource includes a PowerPoint presentation, information handouts, activity sheet, and further information on how to become part of the community pharmacy team in Scotland. The pack describes the role of a community pharmacist, why it is valuable career choice and how to find out more about becoming a community pharmacist. In addition to pharmacists, the resource highlights other community pharmacy roles including Pharmacy technicians, pharmacy dispensers and healthcare assistants.  The pack, developed in consultation with school teachers, provides a number of ways to offer pharmacy information to school pupils at their subject choice stage and when considering careers either in class time or at career fairs. NPA members in Scotland can use the resource to provide support to schools directly by attending career events, or by signposting the resource to their local schools. These resources include: Community Pharmacy – A career choice in Scotland PowerPoint Community Pharmacy – A career choice in Scotland Handout Community Pharmacy – A career choice in Scotland Activity Sheet Community Pharmacy Team Member Information Pharmacist Information sheet Community Pharmacist information sheet Access NPA/CCA Community Pharmacy – A career choice in Scotland resources here…