Dear Contractor,
Following on from Contractor Update, CPNI has had further engagement with SPPG officials specifically in relation to the adherence service. CPNI remain committed to finding a resolution, but that has not been found yet. CPNI have confirmed that contractor action will proceed on 1st December 2022 as previously outlined. The actions that will be taken forward by contractors are:
- Adherence
- Reaffirmation that contractors will not take on new adherence/compliance (Cohort 2) patients until such times that a commissioned service is agreed and implemented for all patients in Cohort 2.
- From 1 December 2022 contractors will only be able to provide adherence/compliance services to patients who are being discharged from hospital following completion and receipt of an ARF, irrespective of whether the patient previously had received compliance support from their community pharmacy and irrespective of the duration of hospital stay.
- Rota services will be withdrawn from 25 December 2022.
- Belfast on-call service will be withdrawn from 23 December 2022.
- Community pharmacy will no longer undertake blood pressure monitoring on behalf of any other healthcare provider as this is not a commissioned service.
- Community pharmacy will be unable to provide information to Trust staff relating to patient admission or discharge in the absence of a formal process. Community pharmacy teams usually receive an unplanned phone call on which they are expected to provide considerable confidential information at admission, or to facilitate the supply of prescription medicines to the patient at discharge, often before the prescription is issued to the pharmacy. This presents information governance, patient safety and professional risks.
- Contractors may wish to write to the Department of Health or SPPG expressing their concerns – some additional information is provided relating to this in Appendix 1.
- Contractors may wish to submit an application to reduce their contracted hours to help manage workforce challenges.
CPNI has also advised SPPG that the Pharmacy First for Urinary Tract Infections (UTI) Service cannot be rolled out at this time and that the addition of Winter Pressures to Pharmacy First over the coming months cannot proceed. Those pharmacies involved in the UTI pilot may continue.
In relation to Rota and Belfast on-call services pharmacies should notify SPPG that they are withdrawing from these services from the dates stated above in order to maintain the safety of patients and the health and well-being of pharmacy teams.
We have been advised that Trusts will not be in a position to issue an ARF for patients being discharged from hospital who have previously received adherence support from their community pharmacy. We have asked Trusts not to request non-commissioned adherence support from community pharmacy, for any patient, if an ARF cannot be provided.
CPNI wishes to find a resolution to the current challenges facing community pharmacy. The actions focus on non-commissioned services which community pharmacy cannot be expected to undertake on behalf of the Health Service for no funding. The position on Rota and Belfast On-call has been taken as community pharmacies are struggling to provide services for their contracted opening hours and to try providing out-of-hours cover would put further pressure on an already stretched workforce and potentially put patient safety and the health of pharmacy teams at risk.
Further action may be considered in due course.
CPNI recognises the difficult position that pharmacy staff can be put in by both patients and other healthcare providers. This action is not to target other parts of the Health Service or patients, but to express to the Department of Health that community pharmacy can no longer provide unfunded and non-commissioned services while trying to maintain the safe provision of commissioned services to patients. Community pharmacy teams should remain professional and respectful to those affected by any of the actions, but explain why it has had to be taken. CPNI has written to the Regulator and each of the Trusts to advise of the action being taken.
CPNI has provided some points which may help pharmacy staff when responding to queries from the public or other healthcare professionals. These points can be found in Appendix 2.
A further meeting has been scheduled with the Permanent Secretary for the week commencing 12 December 2022 after which service provision will be reviewed.
Please do not hesitate to contact the CPNI office or any CPNI Director should you require further information.
Kind regards
GERARD GREENE
Chief Executive