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The impact of COVID-19 on Northern Ireland’s community pharmacy profession was clearly outlined this morning when Gerard Greene, Chief Executive of Community Pharmacy Northern Ireland and Peter Rice, Chair of UCA-NI Ltd, appeared before the Assembly Health Committee.

Gerard Greene provided the committee with an overview of the frontline role that the profession is playing in the pandemic, highlighting the fact that there has been a huge surge in the number of visits to pharmacy premises across the province – a rise of thousands of patients per day.

The main issues discussed included:

Funding

All community pharmacists have had to spend money at a time when they were already struggling with their cashflows.

Pharmacies have had to commit to significant additional resources, such as adaptations, overtime and extra staffing and are literally hoping for funds to follow.

Despite the fact the profession has experienced a legacy of underinvestment, Gerard Greene said, pharmacy teams across the province are stepping up to the challenge, but cannot continue without government or health service support.

There has also been a huge hike in the number of prescriptions – and in the number of items on them – and pharmacists have had to place orders with wholesalers on an unprecedented scale. In many cases, wholesalers are telling the pharmacy contractors that they have had reached their credit limit and are demanding payment; adding to the problems being tackled.

The pharmacy bodies also outlined their concerns over potential delays at BSO, asking if they would be able to deal with this extra and unexpected surge in the number of prescriptions being processed, as any delay in payment for dispensing will add to cashflow problems as well.

Gerard Greene also informed the committee about global supply issues on particular products, primarily paracetamol. Last week, he said, a packet of paracetamol cost 79p, this week it’s almost £2. He also pointed out that some prescription item prices are also rocketing above drug tariff rates.

Peter Rice advised that global issues are arising on availability of ingredients and on packaging; the increased demand, he said, causes price increases, and he told the committee that the public needed to pace both its medicines usage and its requests for medicines.

Peter also pointed out that retail income has nosedived and that pharmacists are losing the fee element for services that have been suspended, such as Pharmacy First.

Repeat prescribing

When pressed as to the reasons for the huge hike in prescriptions, the committee was told that, while pharmacists are working with their local GP surgeries, the hike means that management of weekly prescriptions needs to transfer to community pharmacists.

Many patients, who may previously have ‘under ordered’ items, or not used inhalers they were prescribed, are now flocking to the GP for prescriptions. In addition, many patients are ordering long before their repeat prescription is due and, in many cases, it has fallen to the community pharmacist to realise this.

(PiF has already spoken to some pharmacists, who have said that many patients have been stockpiling medicines.)

Colm Gildernew asked the pharmacy reps how long it would take for community pharmacy to take control of repeat prescribing.

Peter Rice said that the profession was very well placed to manage repeat prescribing and that this move would quell panic and free up phone lines at GP surgeries.

Pharmacists, he said, know their patients and have the relevant skillset. Since the prescriptions are in another facility, they can’t be accessed. Giving community pharmacy permission to do repeat prescribing would, he said, also free up time in GP surgeries.

Gerard Greene said that they were working with the Department of Health and the Health and Social Care Board on a number of solutions, including the implementation of a repeat dispensing process.

Testing

At present, pharmacists are not eligible for rapid testing as they are not on the priority list for healthcare workers.

Both Gerard Greene and Peter Rice pointed out that staff testing is essential, since staff need to have negative results to return to work.

Pharmacies in Italy, Gerard Greene said, are the only accessible healthcare provider left, so it’s vital to protect and resource this service over the next 10-16 weeks and beyond.

He concluded by paying tribute to all pharmacy teams – who, he said, have been working early, all day and into the night including at weekends and bank holidays to deal with extra work.

‘The profession,’ he said, ‘is currently on its knees at a time when it really is needed to step up.’

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