August 2015 CPN

CPN

Community Pharmacy News – August 2015

Flu vaccination service and settlement special • ‘A big win’ – flu vaccination Advanced Service announced • £2.8bn and CPCF changes explained • FAQs and flu preparation advice 5 point forward plan | Latest resources round up | Drug Tariff Watch

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Settlement 2015/16: Flu Vaccination Service launched As part of the 2015/16 funding settlement announced last month (see page 4) NHS England has agreed community pharmacies can offer flu vaccinations to eligible NHS patients aged 18 and over. Here we cover some common queries.

Wales The new Advanced Service only applies to England; Community Pharmacy Wales undertakes separate negotiations on Advanced Services which are provided in Wales.

Local services In many areas local services have been commissioned by NHS England teams in previous years. The national flu vaccination Advanced Service will replace these services.

Claiming payment

Fees and costs

It is not yet possible to say whether data collection and payment claims will be undertaken electronically or via paper, but these details will be shared with contractors as soon as they are available.

Contractors will receive £7.64 per administered dose of vaccine plus reimbursement of the vaccine costs (including VAT). An additional fee of £1.50 will also be paid per vaccination in recognition of costs relating to the provision of the service (e.g. training, revalidation and disposal of clinical waste).

Legal basis Flu vaccinations will be administered under the authority of a Patient Group Direction (PGD) and the associated regulatory requirements mean that they will have to be administered by a pharmacist (or nurse or other class of person named in Schedule 16 of the Human Medicines Regulations 2012).

Administration of a parenteral POM cannot be delegated to another person after the supply has been made under a PGD by a pharmacist.

The key details

Implementation costs Set up costs that contractors incur will not be separately funded, but they have been considered in the setting of the fees for provision of the service.

Funding

Training Many pharmacists will already have received the training they need to offer vaccinations for local services, but for those who do need training there are a range of organisations offering training and pharmacists will be free to choose the training they wish to undertake to acquire the required skills. It is anticipated that the Declaration of Competence approach will be used to assure pharmacy contractors that pharmacists have the necessary knowledge and skills to provide the service, but this and the associated details will be confirmed as soon as possible.

2 Community Pharmacy News – August 2015

Data reporting

Procurement

Details of pharmacy reporting requirements are still being finalised with NHS England, but reporting to the patient’s GP practice will be a requirement.

PSNC is seeking to minimise burden on contractors within the data capture requirements.

The NHS has set out a list of possible vaccinations in the annual flu letter and it will be up to contractors to source these from their suppliers; there will be no central procurement of vaccinations for pharmacies.

The national service will be funded from NHS vaccination budgets and therefore is in addition to and outside of the total agreed community pharmacy funding for 2015/16. The total delivered will be dependent on uptake of the service, but no cap has been set for this.

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What next?

Further work is being undertaken by PSNC, NHS Employers and NHS England in order to prepare for implementation of the service.

Contractors will be updated on this as soon as more information is available.

As is the case for any community pharmacy service, contractors will be required to offer it in accordance with a service specification.

PSNC, NHS Employers and NHS England are currently finalising the service specification.

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dispensing and supply

How many pharmacies currently provide flu vaccinations?

To assess the prevalence of these services PSNC conducted a survey of LPCs early in 2015 and found that:

Almost 90%

of LPCs had a local pharmacy flu vaccination service commissioned during the 2014/15 season

In the meantime contractors are advised to stay up to date by signing up for PSNC's email newsletters at psnc.org.uk/email.

More than 5,000 pharmacy contractors signed up to the services

21 out of 25

local NHS England Area Teams commissioned pharmacy flu vaccination services

84%

of those pharmacies signed up were active vaccination providers

Contractors could also consider matters such as training and whether they or their team You may also like to read more details about the will need any; stock requirements and procurement; what they might need to do to start offering the service in September; how they will promote the service; and whether they service at psnc.org.uk/flu. This page includes links to FAQs and a range of other resources will need to update any SOPs.

FAQs and Practical Points Q. Who is eligible to receive the service?

Eligible adult patients are people aged 18 years and over, at the time of vaccination, defined in the annual flu letter. They include: • people aged 65 years and over; • pregnant women; • carers; • people aged 18-65 years with one or more of the following medical conditions: º chronic respiratory disease; º chronic heart disease; º chronic kidney disease; º chronic liver disease; º chronic neurological disease or learning disability; º diabetes; º splenic dysfunction; or º a weakened immune system due to disease or treatment.

Note that care workers who are paid to provide care to people (for example in their own homes or in care homes) are not eligible for vaccination under the service, however they are likely to be eligible for flu vaccination as a result of their job. In this case the provision of flu vaccination would be a private occupational health responsibility which should be funded by the person’s employer.

Q. Will we need to have a needle stick injury procedure?

Pharmacy contractors should have a needle stick injury procedure in place and all staff involved in the provision of the service should be aware of the contents of the procedure.

Template needle stick injury procedures will be available from a

number of organisations, including the National Pharmacy Association (NPA).

Q. Will pharmacies have to pay for disposal of clinical waste associated with the service?

Yes. The funding agreed for the service recognises the cost of a clinical waste disposal service which contractors will need to put in place.

Q. When will the service commence?

PSNC, NHS Employers and NHS England anticipate that the exact date of commencement will be at the start of September, but implementation of the service requires regulatory changes and the timing of such changes can be impacted on by external events outside the control of any of the organisations. Further details on the start date will be provided as they become available.

Q. When will the service specification be published?

The service specification is also being finalised and will be published once it has successfully passed through NHS England’s internal governance procedures.

Do you have more questions about the flu service?

A range of FAQs, guidance documents and resources such as patient communication materials have been published on the PSNC website to help support contractors as they prepare to deliver the service. Check psnc.org.uk/flu regularly to ensure you don't miss the latest resources and information.

Turn over to find out more about the 2015/16 funding settlement psnc.org.uk 3

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The healThcare landscape

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Settlement 2015/16: Funding set at £2.8bn with changes to CPCF This year’s community pharmacy funding settlement brings a number of changes for contractors to be aware of as well as commitment from the NHS to collaborate on service development and EPS cost analysis.

PSNC has reached agreement with the NHS on a community pharmacy funding settlement worth £2.8 billion for the 2015/16 financial year.

The agreement sees the introduction of a new Advanced Service – a flu vaccination service (see page 2) – along with some changes to the Community Pharmacy Contractual Framework (CPCF).

In addition to this new service PSNC and the NHS have agreed to establish a joint working group to review the costs of the Electronic Prescription Service (EPS) to inform future negotiations. This will be extremely important for the sector as EPS rolls out, and PSNC’s priority will of course be to ensure that costs for contractors are fully captured and then recognised in later negotiations.

PSNC and NHS Employers have also agreed to work together to produce business cases for other community pharmacy services for consideration in the 2016/17 negotiations. These are an essential first step towards agreeing new services.

And PSNC will work with the NHS to take forward an agreement in principle on the publication of pharmacy earnings from the NHS, in line with the requirements on other health professions and service providers. This means that PSNC has agreed that in principle pharmacies will need to comply with a requirement to publish their earnings, and that we will work with the NHS to set out how this should happen.

PSNC had hoped that it would also be able to reach agreement with the NHS on a national minor ailments advice service as part of the 2015/16 settlement and in lengthy discussions with the NHS we had developed a detailed proposal for this. NHS England subsequently decided not to pursue this. This has been very disappointing and PSNC believes it will have a negative impact on both the NHS and patients, who are missing out on a valuable professional service that could both improve care and reduce pressures on GP practices and the wider health service.

The Settlement At A Glance Funding

Total funding: £2.8 billion the agreed funding Fees and allowances: As last year, £2bn of s. ance to be delivered through fees and allow n to be delivered Purchase margins: The additional £800 millio ins. marg ase purch d through agree changes so far. As Drug Tariff Changes: There have been no outcomes of the the on nd depe always any adjustments will full and fair re ensu to work will PSNC and Margins Survey Contractors will s. delivery of the agreed funding to contractor s and/or Practice price M ory Categ be informed of any changes to e.

Payments in due cours

Services

nced Service New Services: National flu vaccination Adva introduced (see page 2). with funding to come NMS and MURs: These remain unchanged . £2bn d from the agree

CPCF Changes

s will need to National Audit: As in 2014/15, pharmacy team is yet to be which of topic the , participate in a national audit agreed. ing prescription Exemptions checks advice: Any patients claim nce of evide any nting charge exemption without prese s checks and ption exem the t abou med infor be entitlement must may be This . takes action on inappropriate claims that the NHS by med infor be also could undertaken verbally, but patients de provi will PSNC . form en writt in n giving them informatio template leaflets for this in due course. it means? We have a Got questions about the settlement and what ns worked and what tiatio nego the how in expla to series of briefings efings k/bri the settlement will mean. Visit psnc.org.u

PSNC website For up to date information and news on community pharmacy issues, visit the PSNC website at psnc.org.uk PSNC Community Pharmacy News is published by: The Pharmaceutical Services Negotiating Committee, Times House, 5 Bravingtons Walk, London N1 9AW Community Pharmacy News is edited by: Melinda Mabbutt who can be contacted at the above address or by email at: mmabbutt@psnc.org.uk PSNC Office: 0844 381 4180 or 0203 122 0810 4 Community Pharmacy News – August 2015

© PSNC

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PSNC reaction to the settlement

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PSNC Committee Member Comments

“The pressures on the NHS are showing no signs of easing and the health service remains a difficult environment both to work and negotiate in.

Negotiations are not straightforward with testing efficiencies demanded of all healthcare providers, and it was essential to protect funding levels for community pharmacies.

Community pharmacy provision of NHS flu vaccinations makes absolute sense for patients and for commissioners, and the commissioning of the service shows that our messages about the impact pharmacy can have are starting to get through. It is also a testament to all the work that LPCs and pharmacy teams have been doing to offer local services already.

Over the coming months we will be working hard with NHS Employers and NHS England to ensure that pharmacy teams, patients and the rest of the health service are ready for the new service.

PSNC is also pleased to have reached agreement to work with NHS England and other stakeholders to assess the costs of the Electronic Prescription Service (EPS). We know this has been a big concern to contractors as GP practices have adopted EPS, and we have been able to provide some analysis of increased costs to the NHS to persuade them that the current systems increase and do not reduce dispensing time. The joint work programme will build on this.

We are now preparing for the next round of negotiations to agree services that are manageable, fairly funded and offer good value for the NHS. Using community pharmacists and their teams to reduce unnecessary demands on general practice and other NHS services is essential if the NHS is to make best use of very scarce resources, and we know pharmacies can do a lot. We still suffer from pockets of ignorance and prejudice, even today, and progress is slower than we would like. But we are moving forward.”

Sue Sharpe, PSNC Chief Executive

“Offering a range of services helps us to build on the value we are already delivering, enables us to diversify our income streams, and means we can take greater control over the future of our businesses. Flu is a great example of this – we know patients want to receive vaccinations from us and we are not reliant on anyone else to ensure that that happens. We must make the most of it.”

Gary Warner, Chair of PSNC’s Service Development Subcommittee, a PSNC Negotiating Team member, and an independent community pharmacy contractor “This settlement will be a relief to independent contractors, particularly in a world in which the NHS is demanding efficiencies of all providers.

The pharmacy flu vaccination service is also very positive news. The focus for pharmacy businesses will now be on getting ready for the service. Independent community pharmacy is good at all of this, and many of us will have been preparing for local services already, so I know that we will meet the challenge.”

Bharat Patel, a PSNC Negotiating Team member and an independent community pharmacy contractor

PSNC News roundup In the past month PSNC has made a number of announcements which are summarised here. You can find out more at psnc.org.uk

677 people watched the recording of our popular endorsing and submission best practice workshop in July. Catch up now at psnc.org.uk/webinar PSNC Chair Sir Michael Pitt, who has extensive experience in local government, the civil service and the private sector, has been appointed as non-executive Chairman of PSNC. He will take up his post on 1st September 2015, replacing Sir Peter Dixon who All details correct at time of printing.

No part of this publication may be reproduced without the written permission of the PSNC. Produced for the PSNC by Communications International Group. ©. PSNC. Colour repro and printing by Truprint Media, Margate.

The publishers accept no responsibility for any statement made in signed contributions or in those reproduced from any other source.

completes four years as Chairman on 31st August.

Sir Michael has had roles including Chief Executive of Cheshire and Kent County Councils, and Chair of a Strategic Health Authority. Currently, he is also Chair of the Legal Services Board which oversees legal regulators in England and Wales.

Honorary doctorate awarded PSNC Chief Executive Sue Sharpe has been awarded an Honorary Doctorate of Science by the University of Sunderland in recognition of her contribution to the development of community pharmacy services and to patient welfare. Sue told graduates at the event: “You are graduating at a time that is the most professionally exciting for at least the last 65 years.

The NHS is now fully committed to using the skills the pharmacist has and that will provide new and unprecedented opportunities for rewarding careers.”

Distributed for PSNC by:

Communications International Group Linen Hall, 162-168 Regent Street, London W1B 5TB Tel: 020 7434 1530 Fax: 020 7437 0915

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PSNC launches pharmacy action plan Five-point transformation plan sets out PSNC’s community pharmacy service development priorities for 2016/17 to inform negotiating mandate with the NHS. PSNC has published a five-point plan setting out the steps we believe the NHS should take to transform the delivery of primary care by harnessing the potential of community pharmacy.

The plan sets out five key services that we believe the NHS could and should commission quickly via the Community Pharmacy Contractual Framework (CPCF). These services would help provide better care for patients as well as reducing pressure on GPs and urgent care services.

The plan follows the recent funding settlement, which included agreement on a national flu vaccination service, discussions about a possible minor ailments advice service and a commitment to work together on business cases for future services.

The commitment to the community pharmacy flu vaccination service shows that the NHS is starting to see the value pharmacy offers; but progress is too slow and we believe they must speed up.

The popularity of existing community pharmacy services shows how open the public are to receiving a range of services and advice from pharmacies. GPs continue to warn that their workload is unsustainable and we know that for many conditions community pharmacy teams can offer a safe, effective and more easily accessible alternative to a GP consultation. We also know that pharmacy is ready, willing and able to deliver many more services provided we are fairly remunerated for doing so. The ideas within the plan set out how the NHS can take advantage of this.

Some of the themes in the plan will be familiar to those in pharmacy - they build on PSNC’s vision and the evidence that has accumulated since its publication in 2013. Many of the services have been tested locally so we know that they will improve care for patients as well as reducing pressure on GPs and other providers; it is time to scale these local successes up and offer the services nationally.

This plan builds on our previous work but will provide a new focus, and it also sets out clearly the services we would like to discuss with the NHS. We will be discussing the plan with NHS England, politicians and others and we hope that the services set out within it will be included within the negotiating mandate for 2016/17.

You can read the plan opposite and find out more at psnc.org.uk/5pointplan

£264m

57million

could be saved annually by early diagnosis of COPD patients

GP consultations per year costing £2bn are for patients with symptoms that pharmacists could treat

84% 96% of the population can reach a pharmacy within 20 minutes by walking or using public transport 6 Community Pharmacy News – August 2015

of adults visit a pharmacy every year

Hospital admissions reduced by

50%

due to a pharmacy inhaler technique scheme

A sustainable NHS – the pharmacy five point forward plan The Secretary of State for Health and the head of the NHS want radical changes in the delivery of care, needed to ensure a sustainable NHS that can cope with increases in demand and financial constraints.

Community pharmacy can offer this transformational change, improving convenience for patients, creating capacity in general practice and other services and releasing substantial savings for the NHS. With commitment and energy from the government and the NHS we can make a big impact within just two years.

Community pharmacy is ready to help but can’t do it alone: as pharmacists, citizens and taxpayers we are calling on the Department of Health and NHS England to work with us to make it happen. Here is our five point action plan.

Give patients easier access to urgent medication Patients who have run out of regular medicines often use expensive out of hours services.

1

I Commission an urgent supply service so community pharmacists can supply routine NHS prescription medication at weekends and out of hours if patients run out.

Benefits: Ensures patients have uninterrupted and convenient access to medicines. Contributes to 7-day NHS working and saves around £45 per patient.

Offer people advice at their own convenience, using pharmacy as a first port of call Patients often consult GPs when they can obtain advice and help quickly and conveniently from a pharmacy.

2

I Use community pharmacists to advise people with symptoms, offering treatment or referral as needed.

Benefits: Reduces demand for GP appointments, creating capacity within practices and a net saving of £25 per patient per GP consultation, and offering speedier support for patients.

Care for frail and older people Many house-bound patients and people discharged from hospital receive no help with their medicines which can lead to health complications and readmission.

3

I Community pharmacists can provide support to frail and older people and their carers at their homes if necessary.

This ensures they are using medicines properly and safely, particularly after hospital discharge.

Benefits: Helps patients as they move between hospital and their home.. Reduces avoidable health complications and the costs of caring for those, saving around £2,000 per hospital admission. Medicines advice can improve health outcomes and prevent readmission to hospital.

Support people to manage their long-term conditions more effectively People with long-term medical conditions need support to use their medicines properly to avoid poor outcomes, hospital admission and sometimes even fatal complications. But GP management of some patients is unnecessary.

4

I Community pharmacists should support and monitor people with simple hypertension and asthma to help them to manage their own health.

Benefits: Offers convenient care, support and advice that can lead to significant improvements in disease control and quality of life. Reduces workload for GP practices releasing capacity for them to carry out other roles.

Help identify people with undiagnosed respiratory disease Nearly 3 million people in the UK are thought to have undiagnosed Chronic Obstructive Pulmonary Disease (COPD).

The failure to diagnose and treat the condition at an early stage can lead to a worsening of the disease which requires additional expensive care or hospital treatment.

5

I Community pharmacists should provide risk assessments for people potentially at risk of having or developing COPD, followed by advice and stop smoking support or referral.

Benefits: Early diagnosis and intervention contributes to public health efforts, and subsequent support offered by pharmacists improves outcomes from medication, reducing expensive treatment of exacerbations and improving patient’s quality of life.

Find out more about the plan and the evidence for the services within it at psnc.org.uk/5pointplan

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Pharmacy notice board In this section of Community Pharmacy News we have highlighted some key notices for you and your team to be aware of in the coming weeks and months.

Funding settlement and flu service to do list:

Read PSNC Briefings on the settlement and new service – visit psnc.org.uk/briefings Review working practices to ensure that you and your teams can build the new service into your routine work as well as continuing to offer the New Medicine Service, MURs, and any local services.

Sign up to PSNC’s Newsletters to ensure you don’t miss out as more information on the flu service and CPCF changes becomes available. Sign up at psnc.org.uk/email

Yellow Card app

There's now an app for both patients and healthcare professionals to report problems with medicines.

You can download the Yellow Card app from the App Store at: ow.ly/PKzB7 or Google Play at: ow.ly/PKzB8.

ation Are you taking on a pre-registr trainee this year?

Grant’ is payable to The ‘Pre-Registration Training ors to support the ract cont y mac community phar training of a pre-registration pharmacy student. £18,440 The grant is currently set at the by d orise auth is per year and team nd Engla NHS l loca or’s ract cont ority accordingly. who instructs the Pricing Auth form which PSNC has developed a template to use to apply wish may ors ract pharmacy cont rereg for the grant at: psnc.org.uk/p

Cancer support resources Public Health England campaign Public Health England (PHE) has launched a national campaign to raise awareness of the increased risk of breast cancer in older women and the range of breast cancer symptoms. A briefing has been created for pharmacy teams which gives advice on how to approach the topic with patients and gives details of where to order free materials for the campaign.

Download the briefing at: dld.bz/dNHhU Pharmacy newsletter Cancer Research UK has launched a newsletter to help support pharmacy teams. The first issue advises on how to start conversations about cancer. Read it now at: tinyurl.com/pharmacycancernews

Addition of Tramadol MR capsules to Part VIIIA

The Preface of the August 2015 Drug Tariff annotates the addition to Part VIIIA of Tramadol modified-release (MR) capsules with effect from September 2015.

• Tramadol 100mg MR capsules (60) • Tramadol 150mg MR capsules (60) • Tramadol 200mg MR capsules (60) • Tramadol 50mg MR capsules (60) Therefore all prescriptions submitted with the September bundle will be reimbursed according to the Drug Tariff listed price.

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The healThcare landscape

Drug Tariff Watch Below is a quick summary of some the changes due to take place from 1st September 2015.

Part VIIIA Additions Category C Additions: SC Special Container • Sodium dihydrogen phosphate anhydrous 340mg/Sodium bicarbonate 250mg suppositories (10) – Lecicarbon C • Sodium dihydrogen phosphate anhydrous 680mg/Sodium bicarbonate 500mg suppositories (10) – Lecicarbon A • Tramadol 100mg modified-release capsules (60) • Tramadol 150mg modified-release capsules (60) • Tramadol 200mg modified-release capsules (60) • Tramadol 50mg modified-release capsules (60) • Varenicline 1mg tablets and Varenicline 500microgram tablets SC (25) - Champix • White soft paraffin 95% / Liquid paraffin 5% ointment SC (50g) - Diprobase • White soft paraffin 95% / Liquid paraffin 5% ointment SC (500g) - Diprobase Part VIIIA Amendments SC Special Container • Alendronic acid 70mg/100ml oral solution unit dose sugar free (4) is changing to Category A • Alum powder (500g) is changing to Category C J M Loveridge Ltd

• Brinzolamide 10mg/ml eye drops SC (5ml) is changing to Category A • Chlorphenamine 2mg/5ml oral solution (150ml) is changing to Category C Piriton Syrup • Paracetamol 500mg/5ml oral suspension sugar free (150ml) is changing to Category A • Prochlorperazine 3mg buccal tablets (50) is changing to Category A Part IX Deletions It is important to take careful note of removals from Part IX because if you dispense a deleted product, prescriptions will be returned as disallowed and therefore payment will not be made for dispensing the item.

• Nélaton Catheter (‘ordinary’ cylindrical Catheter) Single use – Cure (Male) (HM8-HM16) 8-16ch (Female) (HF8-HF16) 8-16ch • Biosensor Strips – Advantage Plus

Need to know if an item can be dispensed on an FP10? Check on our database at: psnc.org.uk/FP10database

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JULY 2015 CPN – Correction for Changes to Part VIIIB of the Drug Tariff on pg. 11 PSNC has been alerted to a publishing error in our article titled ‘Drug Tariff July 2015 changes: products moving to Part VIIIA’. There is no equivalent licensed product to the listings for Amlodipine oral solution and suspension removed from Part VIIIB in July 2015.

Instead, there is now a licensed ‘alternative’ listed in Part VIIIA; this is Amlodipine 10mg/5ml oral solution sugar free.

Products which continue to be prescribed as per the old Part VIIIB listings, and supplied as unlicensed specials, will need to be appropriately endorsed to ensure correct payment.

Can it be dispensed on an FP10?

When pharmacy teams receive NHS prescriptions they must check whether the items prescribed are allowed on the NHS before dispensing. If they are not allowed, the pharmacy may not be paid for them.

Pharmacy teams may wish to check PSNC’s ‘Dispensing on an FP10 database’ (available at: psnc.org.uk/FP10database) for more information on whether an item can be dispensed on an FP10, and we have listed some products below that we have recently received queries about.

Product

Is the item listed in the Drug Tariff?

Does it have a ‘CE’ mark?

Is it in the blacklist?

Can it be dispensed on an FP10?

Additional information

Bioteque America (R&J medical ltd) ring pessary with support size 4

Yes

Yes

n/a

Yes

This item is a medical device (CE marked) and appears in Part IX of the Drug Tariff.

Gauze swab type 13 light 12ply non-sterile 10cm x 10cm

No

Yes

n/a

No

This item is a medical device (CE marked) and is not listed in Part IX of the Drug Tariff.

Anti-Embolism Stockings

No

Yes

n/a

No

This item is a medical device (CE marked) and is not listed in Part IX of the Drug Tariff.

Please note: If the prescription is one of the following, pharmacy staff will need to check the relevant sections of the Drug Tariff/PSNC website: • FP10CN or FP10PN (community nurse prescriber) – Part XVIIB. • FP10D (dental prescriber) – Part XVIIA. • FP10MDA (instalment dispensing) – psnc.org.uk/mda

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The healThcare landscape

PSNC regularly receives questions from LPCs and pharmacy contractors about what is going on in the wider health and care landscape beyond community pharmacy. In this round-up we cover the latest news from the past month Hunt sets out 25 year vision for the NHS Health Secretary Jeremy Hunt has outlined his future plans for a patient-led, transparent and safer NHS in a speech given last month. The full speech is available to view on the GOV.UK (dld.bz/dNudq) website.

Create urgent care networks, urges NHS England NHS England’s Role and Establishment of Urgent and Emergency Care Networks (dld.bz/dNucZ) urges the creation of networks to monitor standards of care and designate urgent care facilities. The networks will bring together system resilience groups (SRGs) and other stakeholders to address challenges that are difficult to tackle in isolation.

Eight new vanguard sites announced NHS England has revealed eight new vanguard sites that will transform urgent and emergency care for more than nine million people.

eight new vanguard sites will transform urgent and emergency care for more than nine million people

At these sites urgent care will be delivered not just in hospitals but also by GPs, pharmacists, community teams, ambulance services, NHS 111, social care and others.

New Commissioning for Value resources Additional resources added to the Commissioning for Value (dld.bz/dNudd) webpage include pathway data for maternity and early years, substance misuse, and mental health at local authority level.

88% of responses to GP practice friends and family tests are positive Record 1m responses for GP friends and family tests More than 1m responses to GP practice friends and family tests (FFTs) have been collected since December 2014, when the scheme was rolled out to primary care.

Official data has shown that practices have continued to receive a high rate of positive responses with 88% of the 1,019,161 responses received to date having been positive.

Contract awarded to replace NHS mail Consultancy film Accenture has been awarded a £60m contract to deliver a replacement for the NHS’s secure email system. The “NHSmail2” project will include upgrades designed to make it easier for the system’s 650,000 users to interact with colleagues using other secure email services. It will also include expanded video and audio capabilities.

Many under-16s have tried e-cigarettes Health and Social Care Information Centre (HSCIC) has discovered that more than a fifth (22%) of 11 to 15 year olds have used e-cigarettes on at least one occasion in their report, Smoking, Drinking and drug use among young people in England (dld.bz/dNudw). The report also found that: • boys (23%) were more likely to have ever used e-cigarettes than girls (20%); and • nine in ten (89%) regular cigarette smokers had used e-cigarettes, compared to one in ten (11%) who had never smoked.

more than a fifth (22%) of 11 to 15 year olds have used e-cigarettes on at least one occasion

Urgent action pledged on over-medication of people with learning disabilities NHS England has promised rapid and sustained action to tackle the over-prescribing of psychotropic drugs to people with learning disabilities after three separate reports highlighted the need for change.

Research carried out by the Care Quality Commission, Public Health England (PHE) and NHS Improving Quality has found: • there is a much higher rate of prescribing of medicines associated with mental illness amongst people with learning disabilities than the general population; • medicines are often used for long periods without adequate review; and • there is poor communication with parents and carers, and between different healthcare providers.

In the report authored by PHE it is estimated that up to 35,000 adults with learning disabilities are being prescribed 10 Community Pharmacy News – August 2015

antipsychotics, antidepressants or both without appropriate clinical justification.

NHS England has written a letter (dld.bz/dNud2) urging the review of prescriptions, and promised to spearhead a call to action to tackle these problems, similar to that which reduced inappropriate use of antipsychotics for dementia patients.

This has involved bringing together representatives of both professional and patient groups for an urgent summit on 17th July, at which an action plan and a delivery board was established to drive the necessary changes.

NHS England are also considering issuing a patient safety alert to ensure that frontline clinicians and other health professionals are aware of the concerns, and have published information on their website (dld.bz/dNud3) for concerned patients and family members.