Further details on how community pharmacies are now expected to ensure that very vulnerable patients can continue to receive their medicines safely during the COVID-19 pandemic, including changes to the pharmacy Terms of Service and a new Advanced service, have been published by NHS England and NHS Improvement (NHSE&I) this evening (10th April 2020).

The Terms of Service for all pharmacy contractors, bar distance selling pharmacies (DSPs), have been amended to require contractors to help shielded patients (a specific group of extremely vulnerable patients who are self-isolating at home, currently for 12 weeks) to receive their prescriptions.

In addition to these changes to the Terms of Service, an Advanced service, which contractors can provide if they wish to, is being commissioned by NHSE&I; this funds any deliveries that contractors have to make to shielded patients.

Terms of Service Changes

For the shielded patients, where they cannot identify a family member, friend or carer to collect their prescriptions from the pharmacy, the pharmacy must:

1. provide advice to the patient on how to identify a local volunteer to collect the prescription from the pharmacy on their behalf and then deliver it. This could be locally organised volunteer arrangements (e.g. organised by a local council) or volunteers from the NHS Volunteer Responders programme; or
2. where no volunteer is available, deliver the medicine as part of the Advanced service; or
3. where no volunteer is available, arrange for another pharmacy to deliver it on their behalf. The other pharmacy will be able to claim payment for the delivery under the Advanced service; or
4. where no volunteer is available, arrange for the prescription to be dispensed and delivered by another pharmacy (by referring the patient to another pharmacy, including a distance selling pharmacy).

If a patient does not identify themselves as being shielded, but the prescription items make the pharmacy team think they are within that group of extremely vulnerable patients (e.g. the prescription is for an immunosuppressant drug) they should ask the patient if they have been asked to self-isolate for 12 weeks, via a letter from the NHS, their general practice or hospital consultant.

Advanced service

This service will provide funding for each delivery of a prescription that a contractor makes under options b or c above.

The service specification includes details on the eligible patient group and sets out the requirements the contractor must comply with, including record-keeping.

The service formally commenced on Thursday 9th April 2020 and contractors can claim payments for deliveries to eligible patients from that date.

Funding

Pharmacies (excluding DSPs) will be paid a monthly allowance to recognise the work involved in supporting the group of shielded patients to obtain their medicines safely in accordance with the Terms of Service.

The monthly payment is aligned to the banding used for the Transition Payment, with a pharmacy dispensing the average number of prescriptions each month receiving £500 per month.

In addition to this, for the Advanced service, contractors (excluding DSPs) will be able to claim a payment of £5 per delivery, plus an allowance for VAT.

Both payments are from additional funding being made available to respond to the pandemic, i.e. they are not part of the community pharmacy global sum.

Read more on the new Terms of Service requirements and Advanced service

Commenting on the publication of the service requirements, Simon Dukes, PSNC CEO, said:

“These new arrangements, supported by the Prime Minister several weeks ago, will help to ensure that the most vulnerable patients in England can continue to receive the medicines they need, safely. We are pleased that the logistics involved for pharmacies in this have been recognised and that this service is supported by extra funding for the sector.

PSNC still has some concerns around the use of non-DBS checked volunteers which we cover in our guidance to contractors.

Pharmacies are of course allowed to continue with any existing delivery services they may have in place, including charging for patients outside of the shielded group, but our advice is that these should be prioritised to those who need them most during this pandemic.”