This update sets out a number of new measures (including the postponement of the Pharmacy Quality Scheme (PQS)) that have been agreed to support community pharmacies as they respond to the COVID-19 pandemic, as well as the new services that are under discussion and the support that PSNC is asking the Government for.

Measures to help community pharmacies

In light of the developing COVID-19 pandemic and the impact that this is already having on community pharmacies, PSNC has gained agreement from NHS England and NHS Improvement (NHSE&I) and the Department of Health and Social Care (DHSC) on a number of measures to help contractors.

A letter published by the Chief Pharmaceutical Officer confirms that we have agreed:

• Pharmacy Quality Scheme: the scheme will be postponed for three months and the period of delay will be kept under review. The released £18.75 million will be delivered to contractors for activity associated with the COVID-19 response.
• Hepatitis C testing service: the introduction of this Advanced Service will be delayed from April 2020 for at least three months.
• Pharmacy Integration Fund pilots: the three pilots announced last month (blood pressure testing; stop smoking support; and point of care testing) have been postponed until further notice.
• Community Pharmacist Consultation Service: existing pilots for GP referrals to the service will remain in place, but will not be extended at this time.
• Community pharmacy patient questionnaire (CPPQ) and pharmacy clinical audits: NHSE&I will not take action against contractors who have not completed these by 31st March 2020.
• Practice leaflets: NHSE&I will not take action against contractors who have not updated their practice leaflets during the period of the pandemic.
• Public health campaigns: for the time being, these will only be focused on the national COVID-19 response.
• Data Security and Protection Toolkit: the current submission deadline has been amended from 31st March 2020 to 30th September 2020.
• Data submission: NHSE&I will not require data returns regarding NMS and MURs or complaints during the period of the pandemic.

The requirement for contractors to complete the National Antimicrobial Stewardship Clinical Audit for 2019/20 had already been waived. NHSE&I regional teams have also been asked to review the need for any local pharmacy Enhanced services.

Community Pharmacist Consultation Service (CPCS)

Patients being referred to the CPCS with upper respiratory tract symptoms, which are not believed to be COVID-19 cases, are now being told to phone the pharmacy and to speak to the pharmacist. Unless there is a clinical need for the patient to be seen in the pharmacy, the pharmacist can provide a consultation by telephone, as is provided for in the service specification. If the consultation is conducted in this manner, the pharmacy is eligible to claim the fee for provision of the service.

New services under discussion

As part of the national response to COVID-19, HM Government is seeking to commission two further services from the community pharmacy sector:

• An NHS Urgent Medicines Supply Service: This would be a service for patients whose GP practice is closed, allowing them to continue receiving their medicines without a prescription. The service will be switched on locally as needed – this has already happened in some locations.
• A Medicines Delivery Service: This would support vulnerable patients self-isolating at home. Details and funding are under negotiation, but NHSE&I have confirmed that there will be additional funding for such a service.

All further details are the subject of urgent discussions with NHSE&I and DHSC. Full guidance on these two services will be made available to contractors as soon as possible.

PSNC asks for the sector

PSNC is increasingly concerned about the viability of community pharmacies in this difficult environment and we have relayed our concerns to HM Government, including underlining the absolute necessity of protecting the services that pharmacies are providing at the moment. This has included meetings with officials and ongoing dialogue with the Pharmacy Minister, Jo Churchill.

We have told HM Government that, in addition to measures set out above, the sector needs:

• A significant cash injection to ensure the resilience of the sector, supply chain and prevent closures;
• New monies to fund the additional services being agreed;
• Further reductions in services including pausing the New Medicine Service (NMS) and Medicines Use Reviews (MURs);
• Funding for pharmacies that have to temporarily close;
• Measures to support cashflow during the pandemic, e.g. due to increases in medicine prices; and
• Indemnity cover for re-deployed pharmacy staff.

Resilience: We are in discussions with NHSE&I about resilience of the network and the importance of the community pharmacy network remaining open; and with staff absence due to illness or for other reasonable cause, this may mean a flexible approach to opening hours and local arrangements between pharmacies to ensure continued supply of pharmacy services and essential medicines to patients and the public.

Practical issues: Discussions are also ongoing on a wide range of practical issues including adding locum codes to Smartcards; supplies of OTC medicines; COVID-19 testing for healthcare staff; supply of posters and other display materials for contractors; communications; protection for pharmacy staff; PNAs; opening hours; and periods of treatment.

Key workers: In regards to the announcement made by the Government yesterday on ‘key workers’ during the pandemic (whose children can still go to school), PSNC is pressing for confirmation that pharmacy staff are classed as key workers, and how pharmacy staff will be able to use public transport when there is a lockdown in London.

We are progressing urgent discussions on all of these and will update contractors as soon as we can.

PSNC Chief Executive Simon Dukes said:

“Everyone in community pharmacy is phenomenally busy at the moment responding to the rapidly developing COVID-19 situation and I know that the radio silence on national measures has been unhelpful, frustrating and worrying. I hope this short update and the news on what is being done to protect pharmacies provides some reassurance that we and other pharmacy bodies have been working flat-out behind the scenes to make your case at the highest levels and will continue to do so.

There is much more to do, and PSNC is in ongoing and urgent discussions with NHSE&I and DHSC on a significant number of issues related to the COVID-19 response, while LPCs are also busy managing local responses. Our discussions are wide-ranging and will be ongoing as this situation continues to evolve. We will continue to work to get answers and solutions for you and we will continue updating you as soon as we are able to.”

Further updates for contractors: PPE and Medicines Supply

By now, packs of Personal Protection Equipment (PPE) should have been delivered to community pharmacies by DPD. If a pharmacy hasn’t received their pack, they  should call the National Supply Disruption line on 0800 915 9964 or email supplydisruptionservice@nhsbsa.nhs.uk.

On medicines supply, DHSC has well-established procedures to deal with medicine shortages and is working closely with industry, the NHS and others in the supply chain to ensure patients can access the medicines they need and to reduce the likelihood of future shortages. Medicine suppliers have already been approached by Government to assess the impact that COVID-19 could have on the supply chain. In particular, DHSC has asked suppliers who still retain some of their EU exit stockpiles to hold onto these. We are talking to DHSC about this.

In his letter, the Chief Pharmaceutical Officer has requested that pharmacies restrict quantities of soap, hand sanitiser and OTC medicines so that there is enough for everyone. Stockpiling causes problems with the supply chain and can lead to unnecessary shortages. Pharmacies should therefore put in place mechanisms to ensure they can supply a sensible quantity of all of these products to as many as possible.

In further updates in the past few days:

• GPhC inspections: The General Pharmaceutical Council (GPhC) has written to all pharmacies to announce a change in their approach. Routine inspections of pharmacies have stopped, and inspectors will instead aim to support pharmacies in their pandemic response. View the announcement from GPhC. Yesterday they issued a joint statement with the PSNI which includes important guidance on pharmacy operations during an absence of the responsible pharmacist. View the joint statement.
• PHE posters: Following a change in the case definition, to remove the link to travel history or contact with confirmed cases, community pharmacies are now advised to display anew Public Health England (PHE) poster. The poster is available from the PHE campaign resources hub.
• Rapid tests for COVID-19: Some manufacturers are selling products for the diagnosis of COVID-19 infection in community settings, such as pharmacies. The current view by PHE is that use of these products is not advised. View the advice from PHE.
• RPS: The Royal Pharmaceutical Society (RPS) has launched a COVID-19 hub page.

Links to all key information on COVID-19 can be found on PSNC’s main COVID-19 page: psnc.org.uk/coronavirus