Tuesday 11 May 2021

Dear Colleagues,

Please find below correspondence which issued at 16:50 yesterday (10th May 2021) from HSCB Pharmacy & Medicines Management team.

HSCB CORRESPONDENCE: URGENT – CPVS – Updated PHA patient resource on COVID-19 AstraZeneca vaccine and extremely rare blood clots

In light of the recent updated JCVI guidance on use of the Astra Zeneca COVID-19 vaccine, PHA have updated their patient information resources. The updated factsheet entitled  COVID-19 AstraZeneca vaccine and extremely rare blood clots  can be found  at COVID-19 AstraZeneca vaccine and extremely rare blood clots | HSC Public Health Agency (hscni.net)

This updated factsheet should now replace the  PHE patient resource that was recommended as an interim measure for community pharmacies providing clinics over the last number of days. Printed copies of the fact sheet will be issued to community pharmacists as soon as possible.

Information for healthcare professionals in light of the JCVI guidance will also be shortly available via the PHA website. Further information will be provided in due course.

Kind regards

SENT ON BEHALF OF
Gerard Greene
Chief Executive

CPNI ALERTS 
Contractors will have received correspondence from CPNI this week in relation to:

CPNI CU#210507A: COVID-CPVS Updated JCVI Guidance on AstraZeneca Vaccine 07 May 2021
CPNI CU#210507B: COVID-CPVS Weekly Roundup 07 May 2021

Contractors are reminded that a number of surveys are open at present:

The Repeat Prescribing Survey For Community Pharmacies is now open and is to be completed by 14th May
The Living Well vaccination campaign Survey is now open and the closing date has been extended to 16th May
Thank you to the 250+ contractors who have already completed the Home Delivery Survey.  Those who have yet to complete it are asked to give their responses by 21st May

BSO ALERTS
 
General BSO Information and Circulars are available here.

Medicines Optimisation Regional Efficiency (MORE) Programme Letter 7th May 2021
HSC Policy Statement on Implementation of MORE  7th May 2021
Living Well 2021-22 Schedule Letter  7th May 2021
MPS 2779 – Melatonin 2mg, 3mg and 5mg capsules (Colonis Pharma Ltd)  
6th May 2021

Weekly Drug Alerts are available here.
MPS 2778 – Medicines Defect Information – Syonell 250mg gr tabs  4th May 2021

Weekly Shortage Information is available here.
Estradot 75mcg/24 hour patches  (MPS 2777) 29th April 2021
Elleste Solo MX40 and Elleste Solo MX80 Patches (MPS 2776) 29th April 2021

Serious Shortage Protocols are available here.
SSP – Fluoxetine 40mg Capsules expiry date of 17 May 2021

DOH(NI) ALERTS 

Recent correspondence is available here.

Use of the AstraZeneca Vaccine : Advice on Updated JCVI Statement 7th May 2021
MHRA and JCVI Announcement – AZ Vaccine Updated Contraindications 29 April 2021

HSCB ALERTS 

Recent correspondence is available here.

REMINDER – Lateral Flow Tests for Primary Care Staff – Registration  28th April 2021

The April edition of the NI Formulary Medicines Management Newsletter is available here.

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

Pharmacy team(s) can keep updated via CPNI’s
Contractor Calendar
Contractor Emails
Or report medicine shortages or pricing issues via the CPNI’s
Medicine Shortage Reporter

Many thanks

Ennis

SENT ON BEHALF OF 
Ennis Shields
Governance & Support Pharmacist
Dear Colleague
Please find below correspondence  issued today from the HSCB on the Community Pharmacy Vaccination Service:

The latest Community Pharmacy COVID-19 vaccination figures can be viewed at the COVIDcare dashboard NI Covid-19 Vaccinations Dashboard | COVID-19 (Coronavirus) Northern Ireland (hscni.net). To date community pharmacies have vaccinated over 38,000 patients – thank you to everyone involved!

KEY POINTS

 Use of Astra Zeneca COVID-19 vaccine– Advice on updated JCVI guidance – Please refer to Department of Health Correspondence (7t May 2021) https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-hss-md-35-2021.pdf

Eligible patients – reminder that only patients from eligible cohorts should be vaccinated. Reserve lists must only include patients eligible for vaccination through this service.

Vaccine stock – supply still remains limited. Your pharmacy will receive an email notification advising of when you can place an order for stock. Please do not place an order until you receive a notification email as your order will not be processed.

Waste Report – reminder that the waste report and DNA figures must
 be completed for “Week 6 – 3th May to 9th May
” using the online form, even if it is a nil report.
This is a mandatory requirement and those who have not submitted a report will be contacted.
The report can be accessed at Waste Report.
Entries should only be submitted from midday Friday 7th May and must
 be submitted by Monday 10th May at 4pm
.
THIS MUST BE COMPLETED BY ALL CONTRACTORS. IF YOU ARE YET TO PLACE AN ORDER OR USE ANY STOCK PLEASE SUBMIT A NIL REPORT.
If you are able to get a 9th dose from a vial but do not use it, this is not classed as waste and should not be included in your report.

Breast-feeding mothers – There is no known risk associated with any current COVID-19 vaccines whilst breastfeeding. The JCVI advises that breastfeeding women may be offered any suitable COVID-19 vaccine. Please refer to COVID-19 vaccination – A guide for women who are pregnant or breastfeeding | HSC Public Health Agency (hscni.net) for support information when discussing vaccination with patients.

Monitoring fridge temperatures – HSCB has been informed of another cold-chain breach in a community pharmacy that has resulted in the wastage of a significant number of Astra Zeneca COVID-19 vaccines. Please take this opportunity to review your cold chain procedures to ensure there are adequate measures in place to prevent a similar incident occurring.  Ensure that vaccine fridge temperature is observed and that vaccines are stored between the recommended temperatures of 2-8°C. The Trust Medicines Information Team recommend twice daily monitoring as a minimum requirement, as most errors occur when the fridge temperature is not checked at the start and end of the working day.

Manufacturer’s Patient Information Leaflet – there have been amendments to the manufacturer’s PIL. Until printed versions become available, pharmacies should avail of the online version at Regulation 174 Information for UK recipients for COVID-19 Vaccine AstraZeneca

VMSIf a patient doesn’t match on VMS do not proceed to vaccinate. This applies even if you know the patient and they have an H&C number. Their details must match on VMS to proceed. You will not be paid if you proceed to vaccinate. The patient will not have a vaccination record to share with their GP.
If a patient’s VMS status indicates that they have already been vaccinated at another centre, but the patient informs you that they have not been vaccinated – do not vaccinate the patient.
If you are having problems accessing VMS, please contact your local HSCB office. 

COVID-19 vaccination programme social media resources can be found at – http://pha.site/cparesources You can either download directly from the page or share from the PHA social media feed.

New material:
Graphic – Vaccine questions and answers – links to updated Q&A
Graphic – What to expect – links to updated leaflet
Video – Did you get your COVID-19 vaccine? – vimeo.com/540693980
BAME Video – Bulgarian – Todor Petrov, Consultant in Dermatology speaks in Bulgarian about the importance of the COVID-19 vaccine  
BAME video – Arabic – Aziz Laamrani, support worker STEP NI, speaks about the importance of the COVID-19 vaccine 
BAME video – Tetum – Arsenia Guterres, Support worker, speaks about the importance of the COVID-19 vaccine

Queries: From day to day, information on the service has been changing very rapidly. Therefore it is really important that you read all the update letters as soon as possible. They have all been date marked to make it easier to identify the recent  updates. Before contacting your local HSCB office, please refer to:http://www.hscbusiness.hscni.net/services/3250.htm for all the latest information

Service FAQs at Service FAQs  ** These are not for public viewing and are password protected** Password: CPVS001!

Support on VMS – please refer to the FAQs available at VMS FAQs

Please do not contact individual HSCB staff directly.  Please contact your local HSCB office who will triage your query and send to the appropriate contact.

Kind regards

Gerard Greene

SENT ON BEHALF OF 
GERARD GREENE
Chief Executive

Dear Colleagues,
 
Please find attached for your attention, correspondence from Northern Ireland’s Chief Medical Officer and Chief Pharmaceutical Officer.  

The JCVI have today issued updated guidance on the use of the AstraZeneca Covid-19 Vaccine.

The updated JCVI advice states:

JCVI advises that, in addition to those aged under 30, unvaccinated adults aged 30 – 39 years who are not in a clinical priority group at higher risk of severe COVID-19 disease, should be preferentially offered an alternative to the AstraZeneca COVID-19 vaccine, where possible and only where no substantial delay or barrier in access to vaccination would arise.

Importantly, this updated advice does not mean that JCVI advises against using the AstraZeneca vaccine in the 30 to 39 year cohort, only that an alternative is preferable when this would result in no substantial delay or barrier in access to vaccination would arise.

Actions for Community Pharmacy:

1. First doses for unvaccinated adults who are aged 30 to 39 years and are not in a clinical priority group at higher risk of COVID-19 disease:

Community pharmacies may offer the AstraZeneca vaccine to individuals in this cohort who have made a fully informed choice to receive the vaccine. Individuals should be informed that it is preferred that an alternative vaccine is used in this cohort and that they can access an alternative vaccine from the HSC Trust vaccination centres, subject to appointment availability.
Individuals may still choose to receive the AstraZeneca vaccine having received clear information on the benefits and risks of vaccination and consenting accordingly, for instance where someone has an appointment booked for vaccination in the coming days and may prefer not to reschedule to receive an alternative vaccine through the HSC Trust vaccination centres.
Individuals should receive clear information on the extremely rare thrombosis/thrombocytopenia adverse events, how to monitor for symptoms that might be related to the adverse event, and what action should be taken by individuals and health professionals in the event of such symptoms arising.

2. First doses for unvaccinated adults who are aged 30 to 39 years and are in a clinical priority group at higher risk of COVID-19 disease:

The advice from JCVI remains that the benefits of prompt vaccination with the AstraZeneca vaccine continue to outweigh the risk of adverse effects in unvaccinated adults who have underlying health conditions which put them at higher risk of severe COVID-19 disease. No further action is required for this cohort.

3. Second doses:

All those who have received a first dose of the AstraZeneca COVID-19 vaccine should continue to be offered a second dose of AstraZeneca COVID-19 vaccine, irrespective of age. The second dose will be important for longer lasting protection against COVID-19.

4. First doses for unvaccinated adults who are aged 40 years or over:

Community pharmacies should continue to offer the AstraZeneca vaccine to unvaccinated individuals aged 40 years and over, unless otherwise contraindicated.

Advice for Vaccine Clinics in the coming days:

CPNI appreciate that this information may have an impact on vaccine clinics underway and those which are planned.  If contractors have concerns in relation to non-attendance and potential waste implications please feel free to contact the office and speak to a member of the team.

In ensuring that patients are fully informed of these changes, contractors can provide them with a copy of the Public Health England patient leaflet which has been updated.  An updated version for Northern Ireland is expected to follow shortly.
Kinds regards

Ennis

 
SENT ON BEHALF OF
Ennis Shields
Governance & Support Pharmacist

Dear Colleague

Please find below correspondence from HSCB Pharmacy & Medicines Management team.

The latest Community Pharmacy COVID-19 vaccination figures can be viewed at the COVIDcare dashboard. To date community pharmacies have vaccinated over 32,000 patients – thank you to everyone involved!

KEY POINTS

  • Eligible patients – reminder that only patients from eligible cohorts should be vaccinated. 
    • Update 18: 30 to 34 years : From Friday 30 April 2021, Community pharmacy are allowed to vaccinate those who are aged over 30 years (born on or before 30 April 1991).
    • There has also been a change as of Friday 30 April 2021 to the age of HSCWs eligible for vaccination: health and social care workers (aged 30 or over at 30 April 2021).
    • Update 17: 35 to 39 years : From Monday 26 April 2021, Community Pharmacy are allowed to vaccinate those who are aged over 35 years old (born on or before 30 April 1986). 
    • PLEASE NOTE: Update 14 (8 April 2021) provided notification of the JCVI statement regarding 18-29 year olds and the Astra Zeneca COVID-19 vaccine. Due to recent cohort drops, all eligible cohorts for community pharmacy vaccination have now been released. Therefore reserve lists must not include those in any age cohorts outside of those in the eligible list in Appendix 1
  • Please note Business Support will NOT be available on Monday 3 May 2021.
  • Vaccine stock – Whilst we had anticipated that supplies would improve at the end of April, unfortunately supply still remains limited. Your pharmacy will receive an email notification advising of when you can place an order for stock. Please do not place an order until you receive a notification email as your order will not be processed.  
  • Waste Report – reminder that the waste report and DNA figures must be completed for “Week 5 – 26 April to 2 May” using the online form, even if it is a nil report. 
    • This is a mandatory requirement and those who have not submitted a report will be contacted. The report can be accessed HERE.
    • Entries should only be submitted from midday Friday 30 April and must be submitted by Tuesday 4 May at 4pm.
    • THIS MUST BE COMPLETED BY ALL CONTRACTORS. IF YOU ARE YET TO PLACE AN ORDER OR USE ANY STOCK PLEASE SUBMIT A NIL REPORT.
    • If you are able to get a 9th dose from a vial but do not use it, this is not classed as waste and should not be included in your report.
  • Updated contraindications – JCVI and MHRA have updated the Astrazeneca COVID-19 vaccine contraindications and the next steps. Please refer HERE for further information. 
    • Vaccination with the AstraZeneca COVID-19 vaccine is now contraindicated in individuals who have a history of a previous episode of heparin-induced thrombocytopenia and thrombosis (HITT or HIT type 2). These individuals may be offered vaccination with an alternative COVID-19 vaccine. 
    • You must provide each patient receiving the AstraZeneca COVID-19 vaccination with adequate information on blood clotting prior to vaccination. This can be found HERE.
  • Manufacturer’s Patient Information Leaflet –in light of JCVI statements, there has been amendments to the PIL. This may mean that some of the PILs in use within Pharmacy are not up to date. Updated printed copies of the PIL will be made available from next week – in the meantime pharmacies should avail of the online version.
  • Waste collections:
    • The pharmacy contractor is required to make arrangements for the removal and safe disposal of any clinical waste (in line with DoH Health Technical Memorandum 07-01: Safe management of healthcare waste) related to this service.
    • An additional sharps box (purple lidded 1 x 11L) and clinical waste bag has been provided to community pharmacies by the HSCB via Cannon Hygiene Services (Initial). These sharps boxes should be labelled/marked ‘COVID Vaccination Service’ for identification purposes. 
    • The CPVS service fee includes remuneration for management of clinical waste and any requirements for supply or disposal in addition to those provided centrally are to be met by the contracted pharmacy. Additional supplies and disposal of sharps boxes, clinical waste bags, etc. can be organised through any of the licensed clinical waste providers.
  • Reporting Side Effects – In addition to reporting significant side effects to the MHRA and the patient’s GP practice, PHA duty room should also be contacted for specific advice on how to manage any patient affected. Please contact PHA duty room on 0300 555 0119.
  • Professional education video – this has been developed by the Public Health Agency and Consultant Haematologists at the Belfast Trust for pharmacists. It provides background information and advice on the optimal management of patients who may present with symptoms suggestive of a thromboembolic event after receiving the AstraZeneca COVID-19 vaccination. This is a professional resource and not intended for public use.
  • It is available at HERE. (Password to open video is: InfoVaccines2021).
  • A series of Question and Answer Sessions are planned – if you have any questions please submit these to pha.immunisation@hscni.net.  Other professional resources can be found on the Public Health Agency website.
  • Personally Identifiable Information – We have been notified of some incidents where personally identifiable information has been shared by email with the VMS system supplier.  Please do not share this information by email. The supplier will contact you to get any information needed and provide guidance re format and amount that can be shared. 
  • VMS
    • If a patient doesn’t match on VMS do not proceed to vaccinate. This applies even if you know the patient and they have an H&C number. Their details must match on VMS to proceed. You will not be paid if you proceed to vaccinate. The patient will not have a vaccination record to share with their GP.
    • If a patient’s VMS status indicates that they have already been vaccinated at another centre, but the patient informs you that they have not been vaccinated – do not vaccinate the patient. 
    • If you are having problems accessing VMS, please contact your local HSCB office.
  • RNIB support – RNIB are now supporting CPVS by allowing those who are blind or partially sighted to contact their phoneline and ask for details on participating pharmacies. All public webpages have been updated with the relevant contact details. Phone operators have been briefed on the service and key reminders to be shared with patients, such as ID, ensuring to share any additional needs at the point of booking, etc
  • COVID-19 vaccination programme social media resources can be found at HERE. You can either download directly from the page or share from the PHA social media feed.
    • New material:
      • Graphic – Vaccine questions and answers – links to updated Q&A.
      • Graphic – What to expect – links to updated leaflet.
      • BAME Video – Bulgarian – Todor Petrov, Consultant in Dermatology speaks in Bulgarian about the importance of the COVID-19 vaccine.
      • BAME video – Arabic – Aziz Laamrani, support worker STEP NI, speaks about the importance of the COVID-19 vaccine.
      • BAME video – Tetum – Arsenia Guterres, Support worker, speaks about the importance of the COVID-19 vaccine
  • Queries: From day to day, information on the service has been changing very rapidly. Therefore it is really important that you read all the update letters as soon as possible. They have all been date marked to make it easier to identify the recent  updates. Before contacting your local HSCB office, please refer to:
    • HERE for all the latest information.
    • Service FAQs at HERE. These are not for public viewing and are password protected Password: CPVS001!
    • Support on VMS – please refer to the FAQs available at HERE.
  • Please do not contact individual HSCB staff directly unless told to do so. Please contact your local HSCB office who will triage your query and send to the appropriate contact.  

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 

  • Weekly Drug Alerts are available here.
  • Weekly Shortages Information is available here.
  • Serious Shortage Protocols are available here.

CPNI ALERTS 

DOH(NI) ALERTS 

HSCB ALERTS 

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

Pharmacy team(s) can keep updated via CPNI’s

Contractor Calendar

Contractor Emails

Or report medicine shortages or pricing issues via the CPNI’s

Medicine Shortage Reporter

Many thanks, stay safe – Gareth

SENT ON BEHALF OF 
DR. GARETH C. GILVARY
Governance & Support Pharmacist