In a letter sent to community pharmacy contractors from Chief Pharmaceutical Officer for England Dr Keith Ridge OBE and Jill Loader Deputy Director of Pharmacy Commissioning NHS England and NHS Improvement have outlined the arrangements that community pharmacy teams and dispensing doctors in England have to follow to deliver medicines to shielded patients.
The service is made up of two elements; an Essential Service and an Advanced Service.
Dr Keith Ridge and Jill Loader commented in the letter:
“This letter announces that, while patients meeting the COVID-19 shielding criteria need to stay at home and away from community pharmacy and dispensing doctor premises, they must be offered a home delivery option for their prescription items unless a family member, friend, relative or volunteer can collect the medicine for them.”
The primary care bulletin delivered to community pharmacy subscribers at 17.30 on Good Friday highlighted the fact that a recent change in legislation made this change possible.
“The National Health Service (Amendments Relating to the Provision of Primary Care Services During a pandemic etc.) Regulations 2020 came into effect on 27 March 2020 and provide for such an announcement.
“Medicines delivery services will be commissioned from both pharmacies and dispensing doctors across England from 9 April 2020 until 1 July 2020 in the first instance but may be extended as necessary as part of the COVID-19 response.
The communication has outlined that this ‘essential’ element is ‘mandatory’ and therefore community pharmacy contractors must offer this service to all shielded patients.
“The above regulations introduce an essential service that places a responsibility on pharmacy contractors to make sure that a home delivery option is available to people at high risk of complications from COVID-19 who are advised to isolate at home for 12 weeks and meet the ‘shielding’ criteria.
“This option has to be offered if their prescription items cannot be collected and delivered by a family member, friend, carer or volunteer. These patients are flagged as being in this group on the web version of their Summary Care Record.”
A monthly payment will be made for the period this service is commissioned. Ridge and Loader have said that this payment is aimed at recognising the administration required in assessing eligibility of patients, supporting the alternative of using volunteers to deliver prescription items and associated processing and advice.
0 – 100 items £0
101 – 2,500 items £34
2,501 – 5,000 items £396
5,001 – 12,500 items £500
12,501 – 19,167 items £542
19,168+ items £563
The essential service does not apply to distance selling pharmacies because they already are contractually obliged to deliver medicines.
An advanced service has also been commissioned to pay a ‘per delivery fee’ where the patient cannot make their own arrangements for the prescription items to be collected and no suitable volunteer can be found, and the pharmacy, therefore, themselves delivers medicines to the patient.
Payment will be £5 per delivery plus an allowance for VAT.
If a pharmacy does not wish to take part in the advanced service, as part of their essential services they may work with another pharmacy to deliver medicines on their behalf, or they must find another pharmacy who will dispense and deliver the medicine.
Community pharmacy teams have been encouraged to use volunteers to deliver these medicines.
Keith Ridge and Jill Loader said in the letter:
“We encourage all parts of the NHS to use these volunteers to maximum effect.”
“The service is restricted to those patients who are covered by the shielding policy and will apply across the whole of England. Pharmacy contractors should be aware that GPs have the ability to remove or add patients to the list of those deemed most vulnerable as their clinical condition changes. Appropriate checks should be made to ensure that the patient remains eligible for this service. The pharmacist can check this on the summary care record.
“Patients who meet the eligible patient criteria should be encouraged in the first instance to arrange for their medicines to be collected from the pharmacy and then delivered by family, friends or a carer.
“Where a volunteer is to be used, the pharmacist must be satisfied that the volunteer is an appropriate person to deliver medicines to the patient. Volunteers should not deliver Schedule 2 and 3 Controlled Drugs and pharmacists should use their professional judgement to determine whether it is appropriate for a volunteer to deliver Schedule 4 or 5 Controlled drugs.
“Where there is no volunteer available who can deliver the medicine(s) to the patient in the timescale that they are required, the pharmacy contractor must ensure that eligible patients get their prescription delivered. This can be done in one of the following ways:
- Deliver the medicine themselves as part of the Advanced Service.
- Arrange for another pharmacy to deliver it on their behalf as part of the Advanced Service.
- Arrange for the prescription to be dispensed and delivered by another pharmacy under the terms of the Advanced.
The advanced service began on April 8th 2020 and will run in the first instance until July 1st 2020.