Archives: Contractor Email

Dear Colleague

Reducing the risk for COVID-19 transmission for community pharmacy staff and visitors 

With the outbreak of the COVID-19 pandemic, community pharmacies are under increased pressure. 

To help support community pharmacy teams in their roles and manage patients’ expectations in the coming weeks, please see some guidance you may want to implement and share with pharmacy visitors, particularly on social media. 

Communicate key message 

  1. All pharmacies should display posters at entry points asking patients who are symptomatic not to enter the community pharmacy premises. 
  2. Other COVID-related posters from PHA should be displayed throughout the pharmacy 

*Please ensure all PHA COVID-19 posters are up to date – the latest versions can be found here* 

Social Distancing Measures 

Options which may be considered: 

  1. A suggested two-metre demarcation area between the dispensary and the public; 
  2. Restricting access to the pharmacy – either by limiting the number of patients allowed to be present in your pharmacy at one time or by creating a physical barrier; 
  3. Changes to pharmacy processes to ensure patients are not waiting in the pharmacy for a prolonged period, for example by asking patients to call back for prescriptions and/or allowing a reasonable turnaround time for prescriptions to be ready; 
  4. Pharmacy-specific public messaging to provide reassurance and ask for patience and understanding. 

Robust Health and Wellbeing Measures for Pharmacy Staff 

Options which may be considered: 

  1. Ensuring staff practice good hand hygiene: washing hands regularly as advised or using alcohol-based sanitisers, if available; 
  2. Checking staff temperatures regularly; 
  3. Reducing manual handling of prescription orders by providing a box for patients to deposit their prescription forms in; 
  4. Encouraging contactless payments; 
  5. Ensuring the pharmacy is cleaned regularly with appropriate products; 
  6. Ensuring PHA advice is followed should a patient present in the pharmacy with COVID-related symptoms; 
  7. Ensuring Personal Protective Equipment is used as advised. 

Key messages to share  

You may wish to share some of the key messages with pharmacy visitors or on social media. An example is given below. 

As Coronavirus (COVID-19) is quickly becoming part of our everyday lives, we have a responsibility to our local community, our hard-working pharmacy staff and their families to try and limit the spread of the virus. With this mind we are considering the introduction of some of the following measures: 

  • If you are unwell (especially with cough or a fever) we would ask that you do not come to the pharmacy. Please contact your GP or call 111. Your GP will be able to

arrange a prescription if necessary. 

  • In order to allow staff to appropriately disinfect all pharmacy surfaces, we may/will (delete as appropriate) be closing between 1PM to 2PM to facilitate this. 
  • We are introducing social distancing and are limiting the number of people inside the pharmacy to (insert number- depending on each pharmacy’s discretion) at a time.  
  • Once inside the pharmacy, customers are asked to stand at least 1m apart while waiting (if possible). 
  • If collecting prescriptions, please telephone in advance to ensure that we have received the prescription, following which we will prepare and have it ready for collection. 

Alternative option: 

  • If collecting prescriptions, please leave your telephone number with pharmacy staff and we will ring you when your prescription is ready. 

This is a worrying time for everyone – (insert pharmacy staff names) are committed to delivering the same high standards. 
These measures are being put in place to protect everyone in our community, particularly the most vulnerable. 
Please take care yourself, family, friends and neighbours, be kind to each other and practice good hygiene by regularly washing your hands.  

Thanks for your patience and co-operation during this time. 

CPNI will continue to advise and support you over the weeks and months ahead. 

Yours sincerely

SENT FOR AND BEHALF OF GERARD GREENE | Chief Executive

Dear Colleague,

The following concessionary prices have been granted for March 2020:

Drug Pack Size Concessionary Price
Amiodarone 200mg tablets 28 £2.35
Diclofenac sodium 100mg modified-release tablets 28 £11.33
Frovatriptan 2.5mg tablets 6 £10.31
Hydroxyzine 10mg tablets 84 £2.09
Imipramine 25mg tablets 28 £3.79
Irbesartan 150mg tablets 28 £5.36
Irbesartan 300mg tablets 28 £4.70
Irbesartan 300mg / Hydrochlorothiazide 12.5mg tablets 28 £4.74
Lamotrigine 100mg dispersible tablets sugar free 56 £7.49
Lymecycline 408mg capsules 28 £6.45
Memantine 10mg tablets 28 £3.44
Memantine 20mg tablets 28 £8.88
Mirtazapine 15mg tablets 28 £2.29
Mirtazapine 30mg tablets 28 £1.89
Mirtazapine 45mg tablets 28 £2.74
Nefopam 30mg tablets 90 £10.10
Nitrofurantoin 50mg tablets 28 £12.45
Oxytetracycline 250mg tablets 28 £4.79
Quinine sulfate 300mg tablets 28 £6.67
Rivastigmine 3mg capsules 28 £3.97
Sulpiride 200mg tablets 30 £6.68
Tamoxifen 20mg tablets 30 £5.46
Trihexyphenidyl 2mg tablets 84 £9.42
Venlafaxine 37.5mg tablets 56 £6.50

This is the first update of concessionary prices for March 2020.

Concessionary prices will be paid against the usual code, no additional endorsements are needed.

Concessionary prices may be granted up until the end of the month so CPNI will notify you of any further concessionary prices as and when they are agreed.

Please continue to notify CPNI of any pricing issues you are experiencing.

Concessionary prices are also published on the CPNI website www.communitypharmacyni.co.uk

Kind regards,

Katherine

SENT FOR AND BEHALF OF KATHERINE KIDD | Head of Pharmacy Development

Dear Colleague

PPE kits will be arriving in your pharmacies this week.

At this point, PPE only needs to be used if:

  • you are entering a room in an emergency where an infected/possibly infected patient is isolated and
  • when decontaminating a room where such a patient has been present (in this case the PPE is to protect the worker from the cleaning products being used).

PPE that has been used should be disposed of as clinical waste.

Strictly enforced arrangements for further replenishment will be in place and will be communicated to you shortly by the Department of Health (NI).

The guidance on PPE use will be kept under review as the pandemic progresses.

Kind Regards,

SENT FOR AND BEHALF OF GERARD GREENE | Chief Executive

Dear colleague

CPNI is acutely aware of the huge surge in community pharmacy activity as a result of COVID-19, patient demand and  changes to GP arrangements that were introduced last week and we know that community pharmacy teams are being stretched way beyond the normal levels of service provision.

Cathy Harrison attended the CPNI Board meeting on Thursday past (12 March) and there has been extensive and on-going activity with DoH(NI) and HSCB pharmacy leads since then to fast-track contingency measures for Community Pharmacy teams. CPNI Directors also met yesterday (15 March) and will meet again today to prioritise the urgent support that you and your staff need.

The following areas are being actively worked on and I would ask you to check your emails regularly for further advice/information/support.

  • Dispensing pressures – increased volume, increased quantities of medicines prescribed, medicines supplies and shortages, managing prescription work-flow, medicine price increases and funding/cash-flow pressures.
  • Specific service issues – including MDS, supervision of methadone/buprenorphine substitute prescribing patients, SOPs.
  • Staff issues – increased workload on staff, COVID-19 risk factors facing pharmacy staff, staff safe-guarding mechanisms, imminent staff absenteeism due to isolation etc, back-fill options and the contingencies to maintain services and keep pharmacies open.
  • Patient issues – managing patient flows in pharmacies, social distancing measures, prioritising at-risk patients, delivery of medicines to patients.
  • Premises issues – demarcation zones and/or restricted access zones within pharmacies for social distancing, security of premises and staff.
  • Business Continuity measures.

These are only some of the areas under active development within CPNI.  We are aiming to issue more specific interim CPNI guidance imminently and in a phased through-out the coming weeks and months.  As the COVID-19 situation develops, other aspects will come into play and we will address these with the relevant lead organisations and keep you informed.

I can assure you that the Community Pharmacy financial implications resulting from COVID-19 have been raised at the highest level within the DoH(NI) and HSCB and progressive steps are being taken within the Health Service to enable Community Pharmacy to operate in a financially stable manner throughout this very difficult period. Further information will be shared with Contractors when it becomes available in due course.

CPNI Office and Directors are available should you require any further information or assistance at this time.

Kind Regards,

SENT FOR AND BEHALF OF GERARD GREENE | Chief Executive

Dear Colleague,

I recognise the huge impact that COVID-19 and recent changes implemented this week by GP’s across NI (in relation to 56/84+ day prescribing, surgeries being closed to patients and changes to prescription ordering & collection arrangements) are having on already over-stretched pharmacy teams.

There has been on-going and frequent meetings & discussions with HSCB, DoH(NI), BMA & RCGP colleagues in relation to these critical issues. You will have received correspondence from HSCB on these matters and while I acknowledge they do not address the immediacy of the mounting problems you and your teams are facing I want to assure you that we are continuing to advocate for changes to alleviate the severity of all the issues you face.

I am in regular contact with Joe Brogan in relation to these issues and I have attached copy correspondence that has been issued by HSCB to pharmacy teams today.

I spoke again with Joe Brogan this evening and he has asked that I share the email below with you.

Please do not hesitate to contact me should you require any additional information.

Yours sincerely,

Gerard

From: Joe Brogan
Sent: 13 March 2020 19:07

Dear Gerard

I would be grateful if you could consider sending the following out to pharmacy contractors;

Dear Colleague

We are now entering the next phase of our response to the Corona Virus. I appreciate over the past few days there have been significant challenges faced already and we will collectively work to address these.

I also know this is just the beginning of what will be a challenging time for us all. Community pharmacy is recognised as a key part of the health service response and I along with my colleagues in the Board and DoH will be doing our utmost to support community pharmacy services for our patients. We recognise the many challenges that are being faced and steps are being taken to address these.

In order to provide a structure to manage our collective response, we have agreed to convene a weekly Pharmacy COVID response group with CPNI to take forward and provide assurance in relation to service, finance and human resource issues. We will augment this with a daily conference call with CPNI to identify and address issues as they emerge.

I acknowledge and appreciate the critical work of maintaining safe dispensing of medicines that community pharmacy provides daily and we must focus on maintaining the delivery of this key objective over the coming weeks and months.

Best wishes

Joe

Joe Brogan, Head of Pharmacy and Medicines Management, HSCB

Gransha Park House, Clooney Road, Derry/Londonderry BT47 6FN

Tel: 028 95363375

Download

Dear Colleague,

COMMUNITY PHARMACY CONTINGENCY PLAN TO ENSURE THE SAFE SUPPLY OF MEDICINES TO PATIENTS

The developing COVID-19 pandemic will place additional pressures on all primary care HSC service providers, including GP practices and community pharmacies.

CPNI will continue to engage with key stakeholders to focus resources to ensure essential services are streamlined and can be sustained during this rapidly changing situation.

CPNI Board is aware of the changes introduced by GP practices, many of which are planning to close their receptions and potentially limiting appointments for patients. Many of the proposed changes, which vary across localities, will create undue pressure and potentially shift risk to community pharmacies.

Community pharmacies’ prime concerns are:

  • Safeguarding services to patients;
  • Protecting the health and wellbeing of the community pharmacy team;
  • Maintaining the integrity of the medicine supply chain.

For this reason, CPNI Board is recommending that all contractors and pharmacy teams adopt the following process in relation to the dispensing service until new protocols are put in place:

CPNI Board Recommended Interim Protocol for Prescription Supply, Collection and Delivery during the COVID-19 Response Period

  • 28 day dispensing of all prescriptions (regardless of prescription duration)
  • Collection of prescriptions from GP practices to be arranged according to community pharmacy capacity and workforce availability, this process must be streamlined and involve no additional workload for community pharmacy
  • Delivery of prescription medicines to patients may need to be limited depending on availability of community pharmacy workforce and capacity. If available, this should be offered on a risk stratified basis, with services prioritised to the most vulnerable people in our communities, including those self-isolating with no family support.

CPNI also has raised this matter with HSCB and joint correspondence from Asst Directors of Integrated Care, HSCB Joe Brogan & Margaret O’Brien is to be issued today to GP’s & Community Pharmacies.

Please do not hesitate to contact CPNI offices should you require any additional information.

Yours sincerely

SENT FOR AND BEHALF OF GERARD GREENE | Chief Executive