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Pressure of urgent supply pilot sign-up came at 'worst time'

Nick Hunter: Existing local urgent supply service attracts a lot of walk-ins

NHS England’s emergency supply pilot came at “the worst time of year” for pharmacists, Nottingham local pharmaceutical committee (LPC) has said.

Nottingham City clinical commissioning group (CCG) – which was chosen to participate in the first phase of the pilot scheme – has decided not to go live in December as planned, due to tight time frames and clashes with an existing urgent supply service, C+D has learned.

Nick Hunter, chief officer of Doncaster, Rotherham and Nottinghamshire LPCs – which covers Nottingham City CCG – told C+D that pharmacies had “something like 72 hours” at the beginning of December to decide whether they wanted to sign up to the scheme.

“Pharmacies are very, very busy in the run up to Christmas…and it takes time to get [the details] worked out,” Mr Hunter told C+D last Friday (January 6).

Existing services

“Around 80%” of pharmacies in the LPC’s area have already been providing an emergency supply service for “about two years”, Mr Hunter said. The existing service attracts “a lot” of walk-in patients and is “well known” by local healthcare providers, he added.

“We appreciate that there are other areas that don’t have anything and nationally [the pilot] is a step forward in the right direction, but it feels a bit like a backwards step for us.”

The new pilot scheme also clashes with an existing contract with healthcare provider Derbyshire Health United (DHU), which is commissioned by the NHS to run the county’s out-of-hours health services. This includes operating NHS 111 – through which patients requiring emergency medication will be referred to community pharmacies under the pilot scheme, Mr Hunter explained.

“DHU has this very sensible clause in its contract that there will be no changes to its service in December, because it can be the worst time of year to deal with any unintended consequences,” he said.

“There are various other emergency care contracts that link to NHS 111 provision, so [any service change] could potentially impact other out-of-hours services, A&E and the ambulance service,” Mr Hunter stressed.

While Mr Hunter is “cautiously optimistic” about the success of the pilot scheme, he is concerned that having the NHS 111 referral as the only point of entry to the service could mean “some [patients] could get lost” while trying to seek help.

What's happening across the country?

NHS England told C+D last week (January 3) that a “small number” of pharmacies started providing the pilot service last month in Brighton and Hove, Guildford and Waverley, and Peterborough and Cambridgeshire. But Fylde Coast and Nottingham are planning for “some pharmacies” to go live in January instead.

“Some” pharmacies in the West Midlands were able to sign up to the scheme “earlier than planned”, in time for the Christmas period, NHS England added.

Sally Greensmith, local professional pharmacy network chair for Surrey and Sussex praised the "collaborative working" between Guildford and Waverley CCG, NHS England, NHS 111, the LPC and community pharmacists, which enabled pharmacies in the area to "go live" with the pilot by the “planned” date of December 15.

Pharmacies in Brighton and Hove have also transitioned over from the locally commissioned service, she added.

“There are bound to be teething problems” with any new service pilot, Ms Greensmith admitted. But “these will be addressed before the full rollout of the service”, she said.

NHS England confirmed last month that it had added the urgent supply pilot to the gateway criteria to receive quality payments. However, pharmacists predicted a delay with the roll-out, because of problems accessing NHSmail – a prerequisite for providing the service and also to qualify for the quality payments funding.

The Pharmaceutical Services Negotiating Committee director of NHS services Alastair Buxton stressed it is “really important” that contractors request an email account before the end of the month, in order to meet the February 1 deadline to qualify for funding.

Are you planning to sign up for the urgent supply pilot?

Gerry Diamond, Primary care pharmacist

pharmacists are employed by OOH providers to do the same emergency suppky service and can see some conflict for example where the meds are not on the PMR or SCR, such as discharge item from hospital or an out patient clinic, specialist medication that a community pharmacy would be unable to supply as it has no record or evidence of it's supply

Nick Hunter, Community pharmacist

The pharmacies in Nottingham City should go live and will be using PharmOuctomes to report activity through to NHSE.

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