Archives: Contractor Email

Dear Contractor

The Department of Health and Social Care (DHSC) has issued a further five Serious Shortage Protocols (SSPs) (SSP043 – SSP047) in response to current concerns across the UK regarding the availability of antibiotic preparations required for the treatment of Group A Streptococcus infection. These SSPs, which are detailed in the attached letter from DHNI, came into operation in all parts of the UK on 19 December 2022 and have an expiry date of 31 January 2023.

SUMMARY

  • SSPs, made under the Human Medicines Regulations 2012, are an additional tool to manage and mitigate medicines shortages.
  • SSPs enable community pharmacists to supply specified medicines in accordance with a protocol rather than a prescription, without needing to seek authorisation from the prescriber – saving time for patients, pharmacists and prescribers.
  • DHSC has developed a further five SSPs in response to current concerns across the UK regarding the availability of antibiotic preparations required for the treatment of Group A Streptococcus infection.
  • These SSPs will allow community pharmacists to consider different oral antibiotic preparations to enable the continued supply of antibiotics to patients and mitigate the ongoing supply disruptions affecting phenoxymethylpenicillin.
  • For each SSP, DHSC has included specific patient counselling points which must be considered when deciding whether supply in accordance with an SSP is suitable for a patient.
  • Before supplying an alternative antibiotic, the pharmacist must firstly consider if a suitable supply can be made by using an alternative formulation of phenoxymethylpenicillin in accordance with the relevant SSP (SSP040 – SSP042).  Where that is not possible, only specified antibiotics can be substituted for prescriptions for duration of no longer than 10 days, in order of preference depending on availability and the dosing needs for the patient (see specific SSP for details).
  • Full details on these SSPs are available on the dedicated page on the Business Services Organisation website HERE.

ACTION

Contractors are asked to:

  • Note the issue of five SSPs (SSP043 – SSP047) in response to current concerns across the UK regarding the availability of antibiotic preparations (in addition to the three SSPs (SSP040 – SSP042) issued on 15 December 2022).
  • Review the attached letter from DHNI detailing these five SSPs, ensure that they are familiar with the detail contained within each SSP, and to ensure that their dispensary teams are aware of these new protocols.
  • Note that the ‘Addendum – Supporting information on notifying other healthcare professionals’ does not apply in Northern Ireland.  Pharmacists in Northern Ireland should refer to the existing SSP operational guidance on the BSO website HERE.
  • Note also the specific guidance on professional judgement and patient/carer consent detailed in the letter and in the operational guidance.

Contractors should contact their local SPPG office in the first instance should further information be required.  CPNI colleagues are also available for assistance.

Kind regards

SENT ON BEHALF OF
GERARD GREENE
Chief Executive

This update contains important information for community pharmacy teams, including details of the ongoing response to the COVID-19 pandemic.

BSO ALERTS 

CPNI ALERTS 

DOH(NI) ALERTS 

Pharmacy team(s) can keep updated via CPNI’s Contractor Calendar or Contractor Emails.

Or report medicine shortages, pricing and staffing issues via the CPNI’s Medicine Shortage Reporter or Situation Reporter.

Please bring this to the attention of your pharmacy team(s).

Kind regards

SENT ON BEHALF OF 
DR. GARETH C. GILVARY
Governance & Support Pharmacist
Dear Contractor,
CPNI attendees met with Mr Peter May, Permanent Secretary, DoH(NI) along with other SPPG and DoH(NI) officials on Wednesday 14 December 2022.

At the meeting Mr May, in listening to representations made by CPNI, gave a commitment that correspondence would be issued to CPNI no later than Monday 19 December 2022 containing a proposal, including financial aspects, for CPNI to consider in relation to current service and funding issues.
 
CPNI therefore expects to receive a proposal within the next working day or so. A meeting of CPNI Directors will be called on Monday as soon as is practicable after any proposal is received, with the decision of CPNI being conveyed to Contractors shortly thereafter.
 
For those Contractors who have been notified to provide Rota services over the Christmas and New Year holiday period your position of not being able to confirm rota service provision to SPPG is still applicable. I would ask that you share with CPNI offices info@communitypharmacyni.co.uk the details of the rota service that SPPG have asked you to provide.
 
Please do not hesitate to contact CPNI offices if you require any additional information.

Kind regards

SENT ON BEHALF OF 
GERARD GREENE
Chief Executive

Dear Contractor

The Department of Health and Social Care (DHSC) has issued three Serious Shortage Protocols (SSPs) in response to current concerns across the UK regarding the availability of antibiotic preparations required for the treatment of Group A Streptococcus infection. These SSPs, which are detailed in the attached letter from DHNI, came into operation in all parts of the UK on 15 December 2022 and have an expiry date of 31 January 2023.

SUMMARY

  • SSPs made under the Human Medicines Regulations 2012 are an additional tool to manage and mitigate medicines shortages.
  • SSPs enable community pharmacists to supply specified medicines in accordance with a protocol rather than a prescription without needing to seek authorisation from the prescriber – saving time for patients, pharmacists and prescribers.
  • DHSC has developed SSPs for three phenoxymethylpenicillin products.
  • Full details on these SSPs are available on the dedicated page on the Business Services Organisation website HERE.

ACTION

Contractors are asked to:

  • Review the attached letter from DHNI detailing these SSPs and to ensure that their dispensary teams are aware of these new protocols.
  • Note that the ‘Addendum – Supporting information on notifying other healthcare professionals’ does not apply in Northern Ireland.  Pharmacists in Northern Ireland should refer to the existing SSP operational guidance on the BSO website HERE.
  • Note also the specific guidance on professional judgement and patient/carer consent detailed in the letter and in the operational guidance.

Contractors should contact their local SPPG office in the first instance should further information be required.  CPNI colleagues are also available for assistance.

Kind regards

SENT ON BEHALF OF
GERARD GREENE
Chief Executive
Dear Contractor
Northern Ireland’s Chief Medical Officer has issued correspondence advising on an updated drug safety alert regarding Valproate. The CMO’s letter is available 
here.

SUMMARY

The letter provides the following advice for healthcare professionals:

  • Continue to follow the existing strict precautions, including that valproate should not be prescribed to female children or women of childbearing potential unless other treatments are ineffective or not tolerated and that any use of valproate in women of childbearing potential who cannot be treated with other medicines is in accordance with the Pregnancy Prevention Programme
  • Following a new safety review conducted in light of concerns that the current regulatory requirements for safe use are not being consistently followed, the Commission on Human Medicines (CHM) has advised that there should be greater scrutiny of the way valproate is prescribed and that further risk minimisation measures are required – in particular that 2 specialists should independently consider and document that there is no other effective or tolerated treatment for patients aged under 55 years
  • Consider all other suitable therapeutic options before newly prescribing valproate in patients younger than 55 years

ACTION

Contractors are asked to:

  • Review the attached correspondence and ensure pharmacy teams are aware of the communication
  • Note that these new measures will be implemented over the coming months. In the meantime, GPs and pharmacists should continue to provide repeat prescriptions for valproate and dispensers should continue to ensure patients receive the patient card, a copy of the Patient Information Leaflet and packaging bearing pregnancy warnings
  • Note that patients currently taking valproate must be advised not to stop taking it unless they are advised by a specialist to do so

Further information on current safety measures for valproate due to risks with pregnancy exposure, safety review of data relating to valproate, CHM advice and recommended new measures, adherence to Pregnancy Prevention Programme requirements, and the use of valproate outside of the licenced indication, is available in the MHRA Drug Safety Update bulletin.

If you have any queries please do not hesitate to contact a member of the CPNI team.

Kind regards

SENT ON BEHALF OF
GERARD GREENE
Chief Executive
Dear Contractor
The Business Services Organisation have today issued a Medicines Supply Notification regarding antibiotics for the treatment of Group A Strep HERE.

SUMMARY

  • Supplies of antibiotics for the treatment of Group A Strep have seen a surge in demand and may be temporarily in limited supply at certain wholesalers and pharmacies.
  • Supplies are available with manufacturers, and deliveries into wholesalers and pharmacies are being expedited and are expected in the coming days.
  • Guidance has been issued on what antibiotics can be used if first line treatment is not available and can be found HERE.
    • This guidance has been developed to support management of GAS infections in England however the information on antibiotic selection remains applicable in Northern Ireland. Local guidance is in development.

ACTION

  • Contractors and their pharmacists are asked to review the attached correspondence and ensure pharmacy teams are aware of the communication.
  • The communication provides guidance on what action is required:
    • Where antibiotic therapy is required for the treatment of suspected Strep A infection
    • If the formulation of antibiotic prescribed is unavailable
    • If the antibiotic prescribed is unavailable and other formulations are unsuitable and
    • Use of solid oral dosage form antibiotics in children.
  • If you have any further queries, please contact the Business Services Organisation or the CPNI office.

Kind regards

SENT ON BEHALF OF
GERARD GREENE
Chief Executive