Supply of medicines
Supply of medicines
There are growing concerns about how the COVID-19 pandemic might affect the supply of medicines.
The Department of Health and Social Care (DHSC) has well-established procedures to deal with medicine shortages and is working closely with industry, the NHS and others in the supply chain to ensure patients can access the medicines they need and to reduce the likelihood of future shortages.
Medicine suppliers have been asked to assess the impact that COVID-19 could have on the supply chain. In particular, DHSC has asked suppliers who still retain some of their EU exit stockpiles to hold onto these.
PSNC’s Dispensing and Supply Team has been monitoring the generic medicines affected by recent price hikes and is making applications to DHSC for price concessions in the usual way. We have also made clear the need for protection for pharmacies against these sudden price rises.
Pharmacy teams should continue to report supply issues to PSNC via the usual reporting forms.
DHSC and the Medicines and Healthcare products Regulatory Agency (MHRA) has added over 80 medicines to the list of medicines which must not be parallel exported from the UK. The parallel export ban will help ensure there is an uninterrupted supply of medicines for NHS hospitals treating COVID-19 patients.
Period of treatment of prescriptions
Some LPCs have flagged local moves by general practices to extend the period of treatment. Following discussions with PSNC about this, NHSE&I and DHSC have issued guidance to practices that this should not happen. The below guidance is contained in Dr Nikki Kanani’s letter to general practices:
|Prescriptions: Practices should not change their repeat prescription durations or support patients trying to stockpile: these actions may put a strain on the supply chain and exacerbate any potential shortages. Practices should consider putting all suitable patients on electronic repeat dispensing as soon as possible. The whole repeatable prescription can be valid for a year but each repeat should be for no longer than the patient has now. For example, if the patient has prescriptions for a month’s supply now then the repeat dispensing should be set up as 13 x 28 days’ supply.|
The guidance has been repeated several times via different NHSE&I communications routes and the British Medical Association’s GP Committee.
If contractors see that this guidance is not being followed, please immediately raise this with your LPC for further escalation. Pharmacies have also been asked not to support any patients trying to stockpile.
PSNC is continuing to discuss with DHSC how the impact of any extension to the period of treatment could be mitigated.
Using eRD to manage supply
Primary care is being asked to increase the use of electronic Repeat Dispensing (eRD) to better manage the situation with the NHS Business Services Authority (NHSBSA) helping GP practices to identify patients who may be appropriate for transfer to eRD. NHS Digital is also working to expand EPS to additional settings including GP hubs, paramedic prescribing and additional urgent care sites. Contractors are therefore encouraged to ensure that all staff requiring access to the national spine services, including EPS, the Patient Demographic Service (PDS) and the Summary Care Record (SCR), have active smartcards.
Wholesalers and deliveries
The Healthcare Distribution Association (HDA) has updated PSNC on the work its members are doing to ensure the ongoing resilience of the supply chain. HDA wholesalers will be as flexible as possible regarding credit caps for pharmacy purchases at this time to continue to secure all necessary supplies.
Wholesalers are, however, vulnerable to staff absences as all businesses are at the moment. There was particular confusion following the Prime Minister’s address to the nation asking people to stay at home, so clarification that all those working in the medicines supply chain are key workers was helpful.
HDA has asked that community pharmacy teams support the increase in demand on the supply chain by ensuring delivery tote boxes are returned to suppliers of medicinal products as quickly as possible. Tote boxes are essential to safe medicines supply as they help suppliers to protect and track medicines. HDA is therefore asking pharmacy teams to return any totes to their supplier’s delivery driver when they are making a delivery.
Urgent medicine supplies
The COVID-19 pandemic is increasing the number of requests patients are making to pharmacies for emergency supplies of medicines. Where appropriate, these requests may be dealt with via a patient funded emergency supply, a referral to their general practice or the Community Pharmacist Consultation Service (CPCS).
Pharmacists who receive requests from a patient for an emergency supply or CPCS referrals for urgent supplies should use their professional judgement to determine whether an emergency supply is appropriate and legal to make.
Hand sanitisers, soaps, formula milk and over the counter medicines
The Chief Pharmaceutical Officer has requested that pharmacies restrict quantities of soap, hand sanitiser, formula milk and OTC medicines sold to each person, so that there is enough for everyone. Stockpiling causes problems with the supply chain and can lead to unnecessary shortages. Pharmacies should therefore put in place mechanisms to ensure they can supply a sensible quantity of all of these products to as many people as possible.
Treatment of COVID-19
Clinical trials are ongoing and being developed to assess the benefits of a number of different medicines in treating COVID-19. Suppliers of medicines being tested have been asked to monitor requests and restrict orders in line with historic ordering requirements.
The Medicines and Healthcare products Regulatory Agency (MHRA) have issued a press release highlighting that chloroquine and hydroxychloroquine are not licensed to treat COVID-19 related symptoms or prevent infection. Pharmacists and GPs are asked to restrict prescriptions and supply to only those with current clinical need for licensed indications or as part of a clinical trial.