Healthwatch Oldham 100: Your Pharmacy and Repeat Prescriptions Findings and Response from GMLPC

Our latest survey held in October/November 2019 asked people about their experiences of using their local pharmacy and the repeat prescriptions service. Healthwatch Oldham has produced an infographic which provides a snapshot of what people like about their pharmacy and things that could be improved.

The information we collect is anonymous, so people can be completely open and honest, and can opt-out at any time.

56 people completed the survey and it showed that...

Healthwatch Oldham would like to thank the Greater Manchester Pharmaceutical Committee for taking the time to look at the issues raised by local people about their local pharmacy and ordering repeat prescriptions. They have provided us with the following information which might explain some of these findings.

You may be aware of recent media reports about medicines supply issues. Let us explain some of the issues and the impact they are having.
 
1. Medicines supply: the current situation for pharmacies and patients

• Community pharmacy teams are increasingly reporting that they are struggling to source certain medicines. In some cases availability is an issue; in others, medicines are available but only at significantly inflated prices.
• Pharmacy teams are having to spend a lot of time sourcing medicines, sometimes having to contact up to seven or eight wholesalers to find a medicine. This can lead to delays for patients needing the affected medicines.
• Community pharmacists use a range of measures to ensure patients can access medicines in short supply, including:
  • “Staged” dispensing – this is where pharmacies only give patients some of their medicines and ask them to come back to collect the rest of the prescription later.
  • Liaising with GPs to find alternative medicines that may be suitable for patients.
  • Making many phone calls to different suppliers to try to find the medicines that their patients need.
  • Seeing if stock may be available in other local pharmacies.

2. Medicines supply and pricing

• Supply issues are not a new phenomenon, but there has been a recent surge in the number of generics affected.
• Medicines shortages can be caused by a range of factors, including manufacturing problems. Generics prices in England are also incredibly low compared to most parts of the world, which may make the market less attractive. Uncertainty around Brexit and contingency planning may be another factor currently exacerbating the issues.
• Pharmacies work hard to purchase medicines cost effectively, but shortages often lead to price increases. Where a shortage leads to a significant price increase, the Department of Health and Social Care (DHSC) can grant a ‘price concessions’ recognising this. Price concessions are examined monthly, and in November and December last year we saw an increase in the number of concessions being granted, indicating an increase in supply problems.
• In November 2018, DHSC granted 69 price concessions, and in December this figure rose to 85. You can read more about the concessions system at: https://psnc.org.uk/wp-content/uploads/2018/12/PSNC-Briefing-067.18-How-the-price-concession-system-operates-1.pdf
• Medicine supply is a national issue, but there can be regional variation and supply and pricing issues can affect individual pharmacies much more than others. This adds to the ongoing financial pressures on pharmacies.

3. Contingency planning and improvements

• Pharmaceutical Services Negotiating Committee (PSNC), the national community pharmacy negotiating body, has asked the Government to help protect pharmacies from the impact of any supply issues, both financially and in terms of the additional workload.
• We would also like to see improvements to the price concessions system so that pharmacies can have clarity about medicines prices and availability, earlier in the month.
• DHSC are working on contingency plans to ensure continuity of the supply of medicines after the UK’s exit from the EU with the support of stakeholders.

The new 5 year Community Pharmacy Contractual Framework which was agreed by the DSHC and NHS England and NHS Improvement has recognised the reimbursement model and stock and supply issues need to be addressed. These need to be addressed nationally.
 
We hope this helps to shed light on why these issues are occurring. We can assure you that we are raising these issues to the our national PSNC funding and supply team to minimise impact on patients, support pharmacies and ensure continued access.