Friday Letter 19/04/2019

Friday 19th April 2019

April 2019 price concessions

A list of price concessions have been granted by the Department of Health and Social care for April 2019.

Please see the latest list on the PSNC website.


Changes to coding of NHS England locally authorised payments

There will be changes to the way Enhanced Services payments will be appear on your Schedule of Payments (FP34).

The changes will be applied to April 2019 Enhanced Services claim submissions. Please see more information below

Click here to view


Fraudulent Prescriptions of Genotropin

At the beginning of April, the LPC had received communication that a number of pharmacies were receiving fraudulent prescriptions for Genotropin 12mg.

Following this, we are again this week receiving more reports from across North East London.

If you identify a fraudulent prescription, please inform us at the LPC and make a report with your local NHS team (London region details below).


Pharmacy take on the network contract directed enhanced service 2019/20 — NHS Networks

At the end of January 2019, NHS England published a five-year framework for GP services. One of the major changes in the contract is the introduction of the network contract as a directed enhanced service (DES).

The aim is for general practice to take a leading role in every primary care network when it goes live on 1 July 2019. The briefing highlights aspects of relevance to local pharmaceutical committees and community pharmacy contractors.


Safeguarding – protecting the anonymity of the pharmacist who reports concern

Following reports of pharmacists reporting safeguarding concerns and having their names disclosed to the person implicated in the abuse or neglect claim, the PSNC have reviewed the issue and suggested the following:

1) Pharmacists have a professional requirement to take action to safeguard children and adults at risk.

GPhC Standards for pharmacy professionals requires pharmacists and technicians “…to take action to safeguard people, particularly children and vulnerable adults and this standard explicitly needs” “…to be met at all times, not only during working hours…”.

2. Contractors must provide pharmaceutical services that comply with professional standards.

Under the Terms of Service, contractors “…must provide pharmaceutical services and exercise any professional judgement in connection with the provision of such services in conformity with the standards generally accepted in the pharmaceutical profession.” (see Schedule 4, Paragraph 29 to The National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013).

3. When reporting a safeguarding concern, a pharmacist should ask that his or her name is not disclosed if this could compromise his or her safety or wellbeing.

Authorities do not have to protect the anonymity of a person who reports a safeguarding concern, but may choose to do so, to the extent that they can. In practice, whether a pharmacist’s identity will be disclosed is largely determined by local policies/procedures and whether there are any particular concerns about the safety of the person making the report. Even if a pharmacist’s name is not disclosed initially, it may be if there is more formal enforcement action, such as a court case.

4. Government guidance: Information sharing Advice for practitioners providing safeguarding services to children, young people, parents and carers , provides helpful guidance including key principles applying to disclosures and when and how to share information.

5. For those who may be more likely to have to raise safeguarding concerns, it may be helpful to try to engage with their Local Authority safeguarding teams, to build up relationships and develop a shared understanding of the challenges each group faces.

It is unacceptable for any pharmacy staff to be threatened or intimidated. Should you or a member of your team experience this treatment, please contact and report the incident to the police.


URGENT Levomepromazine 25mg/ml injection supply issue – information for Primary Care

Please be reminded of the recent supply issue, take the appropriate action if you have not done so already done so and share with your relevant networks.

URGENT Levomepromazine 25mg/ml injection supply issue – information for Primary Care

Overview of Supply

  • Sanofi informed NHS England and DHSC on 5th April 2019 that they are going out of stock this week of levomepromazine 25mg/ml injection and new stock is expected to be available from the end of April.
  • The supply issue is due to a quality deviation experienced at their Italian factory and is not linked to EU exit.
  • The only other UK supplier, Wockhardt, have informed us that due to the unexpected increase in demand, they will also go out of stock of levomepromazine injection and their next delivery has been delayed with further stock expected at the end of April.
  • Wockhardt have confirmed the remaining levomepromazine 25mg/mL injection stock which is held at Alliance will be ring-fenced for primary care use only. Stock at Alliance is limited and will not last until the end of April.
  • Existing stocks are likely to be exhausted by end of this week and no new supplies are expected until end of April.
  • GPs, palliative care networks and community pharmacies should consider the following advice and work together during this period to ensure patients can be managed appropriately.

Alternative agents

  • Haloperidol 5mg/1ml solution for injection ampoules (DrugsRUs)
  • Midazolam 10mg/2ml solution for injection ampoules (Hameln, Accord, Roche)
  • Cyclizine 50mg/ml solution for injection ampoules (Advanz)
  • Metoclopramide 10mg/2ml solution for injection ampoules (Hameln, Ennogen)

Management Plan – GPs, Palliative Care Networks and Community Pharmacies to review and action immediately

  1. During the period of shortage, new patients should only be started on levomepromazine if other treatment options have been exhausted. This is to try to avoid disrupting existing treatment regimens where possible whilst acknowledging that for some new patients levomepromazine may be the only option available.
  2. Community pharmacies who require stock for existing patients should order Wockhardt stock from Alliance.
  3. Community pharmacies having difficulty obtaining stock should contact their local secondary care trusts as they have been asked to support primary care and hospices where possible, to understand if they have stock that can be made available to allow the continuation of treatment in existing patients.
  4. Some specialist importers have identified stock they can bring into the UK. Lead times vary between 7-21 days. If community pharmacies are considering ordering unlicensed imports, the community pharmacist will need to inform the prescribing doctor the product being supplied to the patients is an unlicensed product. Please consider placing orders now for 1-2 weeks of stock based on forecasted demand. We are currently aware that Clinigen, Waymade, Alium and Mawdsleys have sourced unlicensed supplies from abroad.
  5. Community pharmacies unable to obtain levomepromazine injection should liaise with the prescriber to discuss using an alternative product as outlined in the memoabove.


Upcoming LPC events

Please find below dates of important meetings that will require your attendance, we urge at least one pharmacist per pharmacy to attend the meetings:

Date Event Venue Time
16/05/2019 Primary Care Network Developments Best Western Plus Epping Forest 7:00pm-9:45pm
22/05/2019 Community Pharmacy Working Together to Secure New Services Best Western Plus Epping Forest 7:00pm-9:45pm
13/06/2019 Diabetes week session Best Western Plus Epping Forest 7:00pm-9:45pm

Please register now for the May and June evening events using this link:

The LPC wants to help you seize the opportunities and minimise the stress that these big changes will bring.


Building Alliances and Conversations for Integrated Child Health.

Great Ormand Street Hospital are organising a multi-sector event to look at how they can improve integration of care for their paediatric patients with complex needs. This will be in central London on the 9th May, 12-5pm. For further details and to book please click on this link:

If you have any queries, please contact:


Registration for the Primary Care Respiratory Academy (PCRA) 2019 Community Pharmacy Meeting in North East London on 11th June is now open!

PCRA is an educational programme run in collaboration with the Primary Care Respiratory Society, providing expert-guided learning and peer-to-peer exchange through live events and digital resources. The Community Pharmacy Platform is brand new for 2019, and is tailored specifically to your needs as community pharmacists.

The agenda has been developed alongside community pharmacy respiratory experts, providing an event full of insightful and interactive workshops. The free evening meeting in North East London is on 11th June 2019. Click here to register.


Pharmacy Business Awards- Extension to 22nd April 2019

The Pharmacy Business awards entries will remain open until 22nd April 2019.

If you are interested in putting a submission is for consideration for one of the following awards, please do so urgently to avoid missing the extended deadline.

Pharmacy Business of the Year Award Enterprise Award
Pharmacy Team Award Innovation Award
Pre-Reg Trainee of the Year Award Natural Healthcare Pharmacy Award
Health & Beauty Pharmacy Award Pharmacy Assistant Award
Community Award Public Health Pharmacist of the Year Award
Local Health Initiative of the Year Award Johnson & Johnson Perfect Pharmacy Store


Pharmacists in GP event – 30th April

There are still some places on the Healthy London Partnership Pharmacist in GP event at the end of the month.

This event is aimed at those involved in the Clinical Pharmacist programme, those who want to continue to employ pharmacists in general practice or emerging PCNs.

To book your place, please visit

For further questions, please contact or Funmi Worrell on


Free training and support to help build greater confidence in pharmacy

From, new online training courses that fit around the busy scheduled of pharmacists and pharmacy technicians.

Sign up for this free, interactive learning at and see the following promotion video for more information.

RBforHealth Video


EU Exit Primary Care Guidance

Please be reminded of last weeks updated guidance on preparations in Primary Care for a no deal EU exit, published on Thursday 11th April.

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