Updated: 30/06/2023

As you are aware, the way that pharmacy services are managed across the East of England region has changed. A letter has been sent to all contractors notifying you of these changes. For queries from 1 April 2023 onwards, please email hweicbhv.pharmacy@nhs.net. There will be no change to payment mechanisms.

April 2023 Newsletter update

Reminder to notify changes of ownership to ICB

A “change of ownership” for the purposes of the National Health Service (Pharmaceutical and Local Pharmaceutical Services Regulations 2013 (the Regulations) covers the situation where the legal identity of the pharmacy contractor has changed.   The proposed incoming pharmacy contractor must make an application pursuant to Regulation 26 of the Regulations before the change of ownership takes place.

 Reminder to contractors of the need to notify the ICB of any change of ownership

 A change of ownership must be notified to the ICB via the PCSE website. There are several different ways that a pharmacy (or DAC) can have a change of ownership:

  • Sole Trader to Sole Trader
  • Sole Trader to Body Corporate
  • Sole Trader to Partnership
  • Body Corporate to Sole Trader
  • Body Corporate to Body Corporate
  • Body Corporate to Partnership
  • Partnership to Sole Trader
  • Partnership to Body Corporate
  • Partnership to Partnership

 Fitness information must also be supplied when applying for inclusion in a pharmaceutical list for the first time.

 Reminder to contractors of the need to notify the ICB of any changes in Director and/or Superintendent Pharmacist within 30 days of their appointment

 A change in director or superintendent pharmacist for a corporate body must be notified to the ICB via PCSE website –  Market Entry – Primary Care Support England.

In line with the NHS (Pharmaceutical and Local Pharmaceutical Services)  Regulations 2013, where a pharmacy body corporate (or appliance contractor body corporate)  appoints a new director or superintendent, it must notify NHS England within 30 days, together with fitness information about the directors and superintendent pharmacist.

Schedule 4,  paragraph 32(4)  (Pharmacy body corporate)

If P is a body corporate and appoints a superintendent or director who was not listed on P’s application for inclusion on a pharmaceutical list, P must, within 30 days of the person’s appointment, supply to the NHSCB the information mentioned in paragraph 3 and 4 of Schedule 2 about that person.

Schedule 5 paragraph 22(4)  (Appliance contractor body corporate)

If C is a body corporate and appoints a director who was not listed on C’s application for inclusion on a pharmaceutical list, C must, within 30 days of the person’s appointment, supply to the NHSCB the information mentioned in paragraphs 3 and 4 of Schedule 2 about that person.

A Change of Ownership or Change in Director and/or Superintendent Pharmacist application will need to be submitted to Primary Care Support England (PCSE) via the PCSE Online service by using the following link:  Market Entry – Primary Care Support England

In order to access the form you will need to first register for the online Market Entry service, then log in to start your application.

If it is found that the ICB have not been informed of any of the above changes this may result in a Breach Notice being issued.   

Reminder to contractors of the need to notify ICB if you intend to permanently close the pharmacy premises

Community pharmacy contractors who no longer wish to provide NHS services from their NHS pharmacy premises must provide the ICB with adequate notice.

Contractors must give at least 3 months’ notice to the ICB in advance of the date on which they intend to cease providing pharmaceutical services.

The exception is for contractors with a 100 hours condition in which case 6 months’ notice is required.

The notification can be found here:  https://www.england.nhs.uk/publication/pharmacy-manual-chapter-38-annex/

Contractors should forward their completed notification (Annex 1 – Closure of premises notification) to the ICB using the following email address:  hweicbhv.pharmacy@nhs.net

Changes must also be notified to GPhC.

Hertfordshire & West Essex Area Prescribing Committee (HWE APC) – summary of recommendations

Please view link to newsletters for December 2022 and February 2023 HWE APC.

The top line headings of the recommendations likely to have most impact on primary care are listed below. Refer to the newsletters for further details.

  • Palliative care formulary for adults – Recommended for use
  • Sacubitril valsartan (Entresto®) for chronic heart failure with reduced ejection fraction – Prescribing support document AMBER INITIATION: RECOMMENDED FOR RESTRICTED USE – for initiation and stabilisation by specialists in community or secondary care and continuation in primary care
  • Woundcare formulary Update – Alprep® Pad addition Recommended for use
  • Hypromellose product choice update for Herts Recommended for use
  • Relugolix–estradiol–norethisterone acetate for treating moderate to severe symptoms of uterine fibroids – AMBER INITIATION: RECOMMENDED FOR RESTRICTED USE – for initiation and stabilisation by specialists in community or secondary care and continuation in primary care
  • Cenobamate RAG rating update – AMBER – in line with information from local tertiary epilepsy services.
  • HWE ICS guidelines for the management of infection in primary care Recommended for use
  • Management of men and women, aged 50 or over, with or at risk of osteoporosis – HWE prescribing guidelines Recommended for use
  • Triple inhalers in COPD – RAG rating change in West Essex to align with Herts – change from AMBER INITIATION to GREEN
  • Melatonin – insomnia in adult & paediatric patients with a learning disability – HWE prescribing support & lowest cost product options  AMBER INITIATION: RECOMMENDED FOR RESTRICTED USE – for initiation and stabilisation by specialists in community or secondary care and continuation in primary care

Actions for community pharmacists- Methotrexate 10mg tablets dispensing

Prescribing colleagues across the ICS have been reminded that ONLY methotrexate 2.5mg strength should be prescribed. Methotrexate 10mg tablets are non-formulary across the ICB and not recommended to be prescribed in either primary or secondary care.

Actions for community pharmacists:

  • If patients are prescribed 10mg tablets – confirm the strength, they usually take with the patient/their record and their GP surgery
  • Remind the patient of the once-weekly dosing and risks of toxicity and potentially fatal overdose if they take more than has been directed
  • Where applicable, write the day of the week for intake in full in the space provided on the outer package
  • Demonstrate the Patient Card included with the methotrexate packet and encourage patients to carry it with them to alert any healthcare professionals they consult who are not familiar with their methotrexate treatment about their dosing schedule
  • Remind patients that they should have blood tests at least every 3 months

Hertfordshire & West Essex Area ICB Prescription and Medicine Optimisation

01) Register to receive drug alerts 
Please ensure that your pharmacy has registered to receive drug alerts directly from https://www.gov.uk/drug-device-alerts/email-signup and has a process in place to action these alerts as necessary.

This is a CQC requirement. A generic inbox is preferred to ensure continuity. You can also choose to receive email alerts directly to your personal email.

02) NHS Community Pharmacy Blood Pressure check service – IT update for action 
NHS England has announced that community pharmacy contractors will need to use an NHS approved clinical IT system to make their clinical records and payment claims for the Hypertension case-finding advanced service from 1st September 2023. Once the clinical IT systems go live with new Application Programming Interface (API) to automate payment claims and reporting data to the NHSBSA, the use of an approved IT system will become mandatory and the existing manual MYS claim process for the service will be retired.

Please read attached briefing carefully to provide information about how this works.
Further communication will follow in the run up to the start date to remind contractors.

03) National shortage of GLP-1 receptor agonists (GLP-1 RAs) for Type 2 diabetes (T2DM) 
The Department of Health and Social Care (DHSC) has updated the shortage status of GLP-1 RAs to high impact. There are limited, intermittent supplies of all GLP-1 RAs (injectable and oral forms) and supply is not expected to return to normal until at least mid-2024.

A Medicine Supply Notification (MSN) containing actions for clinicians has been issued. Clinicians are reminded that GLP-1 RAs for use in the management of T2DM should not be prescribed off label for weight loss.

04) NHS funded Community Pharmacy training offers (no attachment)
The new NHS funded training for community pharmacists is now available to help expand your clinical skills and improve patient care. Courses include Clinical Examination Skills and Independent Prescribing. Please visit the Community Pharmacy Training Page for more information and to register.