Archives: Contractor Email

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

Dear Contractor,

A number of Contractors have received this letter from SPPG earlier this week directing that they provide Rota services over the Christmas and New Year holiday period.

CPNI has sought clarification on the appropriateness of SPPG directing pharmacies to do so and, today CPNI has sent this letter to Mr Joe Brogan.

Advice received by CPNI would indicate that SPPG have not followed due process in directing Contractors regarding Rota services at this time.

As you are aware CPNI will be meeting the Permanent Secretary DoH(NI) on Wednesday 14 November 2022 to discuss various pharmacy matters and CPNI will update you further then.

Please do not hesitate to contact CPNI offices, or your local Director if you require any further information.

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 

SPPG Correspondence to Rota Pharmacies 7 December 2022

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 understands local SPPG offices have written to pharmacies scheduled to provide Rota services over Christmas/New Year to direct that Rota be provided, with staff at local SPPG offices following the letter up with a phone-call to pharmacists in the pharmacy.

CPNI will be seeking further clarification in relation to the correspondence issued and we will update you accordingly. In the interim, you may want your pharmacists to re-direct any follow-up calls to the Contractor or the relevant person within your pharmacy practice.

CPNI Board meets later this week and a meeting with the Permanent Secretary DoH(NI) will take place on Wednesday 14th December.

The priority for CPNI remains the provision of safe services to patients and fair & reasonable remuneration for the services provided by Contractors and their teams. Accordingly, the meeting with the Permanent Secretary on 14th will be important in that context.

Operational and funding difficulties in community pharmacy continue to worsen and it is unusual for SPPG to take this assertive stance in relation to Rota rather than focussing on resolving the fundamental issues that are causing current problems.

We will update you further over the coming days.

Please do not hesitate to contact the CPNI office or any CPNI Director should you require further information.

Kind regards

SENT ON BEHALF OF 
GERARD GREENE
Chief Executive