Maintaining pharmacy services during the outbreak

Maintaining pharmacy services during the outbreak

April 17, 2020

During the outbreak, the Secretary of State for Health and Social Care has permitted the use of emergency regulations that allow contractors temporary flexible opening hours and temporary closures of pharmacies. A minimum of 24 hours’ notice is required, and NHSE&I must have agreed (or not objected) to the change or closure.

Contractors have their own responsibilities under the terms of service and manage their own pharmacy or network of pharmacies to maintain the provision of pharmacy services, including the dispensing of medicines, for the benefit of patients and the public. Information from Europe, where the COVID-19 outbreaks are ahead of the UK, suggests that community pharmacy is able to maintain core pharmacy services during an outbreak. Although more staff may continue to become ill or be absent from work for other reasons, those staff who have been self-isolating may return to work. However, there is no certainty that staff numbers will be maintained, even with more pharmacy team members coming into the workforce. There may be increasing difficulty maintaining service provision for contractors individually and for the network as a whole in certain areas.

If one or more contractor closes pharmacies temporarily in an area, there is the potential for patients and the public to lose reasonable access to a pharmacy. Therefore, it is suggested that contractors liaise with NHSE&I well in advance of seeking temporary flexible opening hours and temporary closures where reduced hours or closures could affect the overall provision of medicines and pharmacy services to patients and the public – i.e. that contractors give more than the 24 hours’ minimum notice where possible. This is to ensure that closures by a number of contractors do not result in all the pharmacies in one area closing at the same time. LPCs should also be able to assist in discussions with NHSE&I.

If services in an area cannot be maintained, NHSE&I could use its powers to intervene, including its new power to require a pharmacy to open in an emergency This is a realistic option if a contractor is intending to close a pharmacy where NHSE&I considers it essential for patients and the public, and is maintaining other pharmacies in the wider area. It is suggested that, where practical, contractors should liaise with NHSE&I to avoid any gap in the provision of services arising and for the need for NHSE&I to intervene (which in rural areas could include asking a dispensing doctor to dispense medicines for a normally ineligible patient).

Contractors may also need to discuss plans for closing with other contractors in a local area to ensure pharmacy services can continue to be provided within an area. Again, it is suggested LPCs are involved in any discussions. There are competition issues around such discussions, for all involved, but there are exemptions which can apply, and the Competition and Markets Authority has given assurances to business cooperation in response to COVID-19, stating:

The CMA understands that this may involve coordination between competing businesses. It wants to provide reassurance that, provided that any such coordination is undertaken solely to address concerns arising from the current crisis and does not go further or last longer than what is necessary, the CMA will not take action against it.

The CCA and NPA has also provided continuity of pharmacy services planning guidance, which contractors might find helpful.

PSNC and other community pharmacy stakeholders are continuing to have discussions on these issues with NHSE&I and DHSC, and we will provide an update as soon as we can.

Contractor action

If temporary flexible opening hours and temporary closures of pharmacies may affect pharmacy service provision in an area:

1. Discussions with other contractors with nearby pharmacies may be appropriate;

2. Discussions with NHSE&I should be well in advance of any formal application or notification;

3. Seek advice from your local LPC, who should be able to assist with this process.

For any queries, please contact Gordon Hockey, PSNC’s Director of Operations and Support.

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