Media and Political Bulletin - 30 November 2018

                                            

 

 

Media and Political Bulletin

30 November 2018

 

Media Summary

Six key questions Brexit poses for the NHS

BBC, Nick Triggle. 29 November 2018

This BBC report on ‘six key questions Brexit poses for the NHS’ includes a quotation from Martin Sawer, Executive Director of the HDA, who last month told the Health Select Committee that he was ‘very concerned’ about the prospect of a no deal, saying that it could have ‘catastrophic’ consequences for the supply of drugs.

The article states that Martin Sawer ‘even suggested the public may have to stockpile drugs themselves.’

Trade bodies meet DHSC officials ahead of parliament vote on Brexit

Pharmacy Business, Kiran Paul, 29 November 2018

Pharmacy Business reports that various trade bodies in the pharmacy sector have met with officials from the Department of Health and Social Care ahead of the parliament vote on the withdrawal agreement on the UK’s exit from the EU.

The Association of Independent Multiple Pharmacues, Company Chemists’ Association and National Pharmacy Association jointly sought updates from the DHSC on the plans to ensure the continuity of supply medicines to patients.

The meeting focused on ‘strengthening the lines of communication between government and the pharmacy front line and opportunities to introduce flexibilities into working practices.’

DH and PSNC discuss pharmacies sourcing alternatives if no-deal Brexit

Chemist and Druggist, James Waldron, 29 November 2018

Chemist and Druggist reports that the PSNC is in talks with the DH about granting pharmacies the power to ‘exercise discretion’ about whether to dispense equivalent medicines in the event of no-deal Brexit shortages.

It reports that the PSNC has been holding an ‘ongoing dialogue’ with the Department of Health and Social Care since the summer about ‘secondary measures’ which may be required to maintain the supply of medicines, ‘particularly in the event of no deal.’

One of these measures would be ‘giving pharmacies the ability to exercise appropriate professional discretion to ensure the continuity of an alternative equivalent medicine to patients in accordance with patient need’, PSNC said.

DHSC lifts validation protocol for 150mcg AAIs

DDA, Ailsa Colquhoun, 30 November 2018

The DDA reports that the Department of Health and Social Care has stated that stock levels are now at a level where the validation protocol is no longer required.

Dispensers are now permitted to dispense the total number of adrenaline 150microgram auto-injectors prescribed to each patient. However, whilst stock filters through the supply chain, some wholesalers may still apply a restriction to ordering levels.

Parliamentary Coverage

House of Commons, Tabled and Written Questions, 29 November 2018

Ben Bradshaw, MP: To ask the Secretary of State for Health and Social Care, how much funding for contingency planning for the UK leaving the EU without a deal will be made available to the Medicines and Healthcare products Regulatory Agency for the development of new processes or systems including software.

Full Coverage

Six key questions Brexit poses for the NHS

BBC, Nick Triggle. 29 November 2018

Whether it is a no-deal Brexit or the agreement brokered by the prime minister, leaving the European Union promises to have a profound impact on patients and the wider NHS.

From the staff who work on the wards and in the GP surgeries to the supply of vital medicines, there are implications.

Here is a look at six key questions.

Will we run out of medicines?

The UK imports 37 million packs of medicine each month from the EU - although it exports even more.

The port of Dover is the key supply route in and the transition arrangements mean it will remain unaffected.

The key challenge will be if there is a no-deal Brexit, because there is concern of potential huge delays at the port.

The government has asked firms to stockpile a six-week supply of drugs to mitigate any problems if there is no deal.

However, that is logistically difficult for medicines that need refrigerating, like insulin and vaccines, or those with a short shelf life, such as some cancer drugs.

Supplies of radioactive materials for scans could also be hit.

Contingency plans have been put in place to fly in vital treatments, the government has said.

But even the stockpiling of normal medicines is proving problematic, according to industry.

Small firms in particular have reported problems stockpiling drugs because they do not have the cash flows to fund reserves of supplies.

Last month, Martin Sawer, of the Healthcare Distributors Association, told the Health Select Committee that he was "very concerned" about the prospect of a no deal, saying it could have "catastrophic" consequences for the supply of drugs.

He even suggested the public may have to stockpile drugs themselves.

The government has always insisted this is not needed - and could in fact make the situation worse.

Only this week, Health Secretary Matt Hancock was telling MPs that while a no-deal scenario would be "difficult", he was "confident that if everyone does everything they need to do, then we will have an unhindered supply of medicines".

Will we have enough staff?

The health and social care sectors are huge employers with one-and-a-half million and two million staff respectively. About 5% of the registered workforce in each area are from Europe.

The Brexit agreement means all those currently working will have the opportunity to obtain "settled status" to allow them to stay.

It is not clear what a no-deal Brexit would mean.

The government has also indicated it will create a skilled migrants system similar to the one that operates for workers from the rest of the world. That system - known as tier two visas - allows doctors and senior nurses to be recruited from overseas.

But unions have pointed out that some lower-paid nurses and non-clinical staff such as health care assistants, porters and care workers will not be covered by such a system, because the cut-off is that the worker must be earning at least £30,000 a year.

Nicola Sturgeon urges answers on how much Brexit will cost the NHS

NHS managers warn about impact of no deal

The NHS, taxes and that 'Brexit dividend'

There are other related factors too.

The message Brexit sends to people from Europe and the weaker value of the pound, which means any money sent back to their homeland is worth less, could put off people from working in the UK.

That is a point made last month by the Cavendish Coalition, a group of 36 health and care charities.

It predicted Brexit could worsen the staffing shortages currently being seen in the health service.

The government is more confident, arguing staff from Europe will stay and that it has a plan to "grow its own", with increasing numbers of doctors and nurses in training.

What about our health insurance cards?

About 27 million people in the UK have European Health Insurance Cards.

They entitle the holder to state-provided medical treatment across the EU and also in Iceland, Liechtenstein, Norway or Switzerland.

The cards cover pre-existing medical conditions as well as emergency care.

This will continue during the transition period, but, like much else, what happens afterwards has yet to be resolved.

And if there is a no deal, the cover EHIC provides will cease to exist in theory.

Attempts could be made to put reciprocal agreements in place - and given the amount of tourism into the UK from Europe it would clearly be in everyone's interest to ensure individuals are entitled to health care.

Then there are the one million UK citizens who live abroad in the EU.

They are currently eligible for the same health care as citizens of the EU country in which they live and they can use EHIC when they travel.

The EU and UK have agreed that these people would retain their rights, but once again a no-deal Brexit could scupper that.

Could medical research lose out?

The UK is considered a world leader in medical research, having produced around 25 of the top 100 prescription treatments.

The country currently benefits from access to research funding from the EU via programmes such as Horizon 2020 and the Innovative Medicines Initiative.

These will continue during the transition phase, but beyond that it seems likely the UK will be treated as a third-party collaborator, meaning it will be less likely to lead programmes and will have little role in the design of them.

Collaboration on rare diseases could also be put at risk. As the number of patients with rare conditions in each country is low, it is only possible to recruit enough patients for clinical trials by carrying out those trials across countries, according to the Brexit Health Alliance.

Restrictions to the free movement of researchers and academics could also have an impact. Around three-quarters of UK researchers have worked abroad and currently nearly a fifth of science, technology, engineering and mathematics academics at UK institutions are from the EU.

The government believes a "mutually beneficial outcome" is perfectly possible to deal with all these problems, given the UK is such a key player in medical and scientific research.

The government is also increasing its spending on research and development.

Medical research concern over Brexit

What is the impact of EU migration on NHS demand?

Clearly, the NHS is struggling to cope with the number of patients it is seeing.

The three key waiting time targets for cancer, A&E and hospital operations are being missed in every part of the UK.

The public does believe migrants are a factor in this - or at least the wider demand on services.

In 2017 an Ipsos opinion poll found 58% of people in the UK agreed with the view that immigration placed pressure on public services.

The government's Migration Advisory Committee looked at this in the autumn.

Its report found migrants were net contributors to the health service - in that they gave more than they took.

That is because of the significant numbers working in the health service and the fact they were less likely to use it.

The committee said this was because they tended to be young and healthy.

The only exception was in maternity care, the committee said.

The proportion of births to mothers from the EU has trebled in the past 15 years to one in 10.

What about the £350m Brexit dividend?

It was one of the most controversial claims of the referendum campaign.

Vote Leave said the money saved in payments to the EU would mean an extra £350m a week could be spent on the NHS.

The prime minister has claimed this has come true. Over the summer she announced the NHS budget would increase by £20bn by 2023.

On top of that, about £4bn will be given to the rest of the UK.

That amounts to more than the promised £350m a week.

Theresa May has said it will be partly paid for by a Brexit "dividend".

Although, as the UK is committed to paying into the EU budget until the end of the transition period and will also have to pay the £39bn divorce bill, it arguably leaves little to cover the cost of the rise.

The Treasury has said a combination of economic growth and perhaps even tax rises may be needed.

Another way to look at it is to ask whether the NHS would have got such a rise if Brexit was not on the cards?

Many think so. After all, it was long overdue.

Since 2010 the NHS has been receiving between 1% to 2% extra each year - half the average rises it previously enjoyed.

Trade bodies meet DHSC officials ahead of parliament vote on Brexit

Pharmacy Business, Kiran Paul, 29 November 2018

Various trade bodies in the pharmacy sector has met the Department of Health and Social Care (DHSC) officials ahead of the parliament vote on the withdrawal agreement on the UK’s exit from the EU.

Association of Independent Multiple Pharmacies, Company Chemists’ Association and National Pharmacy Association jointly sought updates from the DHSC on the plans to ensure the continuity of supply of medicines to patients.

The meeting focused on “strengthening the lines of communication between government and the pharmacy front line and opportunities to introduce flexibilities into working practices,” the organisations said in a joint statement.

Pharmaceutical Services Negotiating Committee (PSNC) also met DHSC officials separately to discuss the so-called ‘secondary measures’, actions that may be required to help maintain the supply of medicines, besides the ongoing manufacturers’ stockpiling.

These measures include allowing pharmacies to exercise appropriate professional discretion to ensure the continuity of an alternative equivalent medicine, quick and clear reimbursement and stock availability information for community pharmacies, more responsive Drug Tariff pricing and reimbursement of any additional costs incurred and appropriate regulatory and practical support.

PSNC said it is also engaging with MPs about Brexit and has recently written to the All-Party Parliamentary Group on Access to Medicines and Medical Devices about the need to maintain the supply of medicines beyond March next year.

It will host a meeting tomorrow (30 November) of the Community Pharmacy Brexit Forum, bringing together industry associations to consider the latest developments and discuss them with the DHSC.

Prime Minister Theresa May’s Brexit deal will be put to vote on 11 December, but she faces an uphill struggle to overcome opposition from across the political spectrum.

DH and PSNC discuss pharmacies sourcing alternatives if no-deal Brexit

Chemist and Druggist, James Waldron, 29 November 2018

PSNC is in talks with the DH about granting pharmacies the power to “exercise discretion” about whether to dispense equivalent medicines in the event of no-deal Brexit shortages.

The Pharmaceutical Services Negotiating Committee (PSNC) has been holding an “ongoing dialogue” with the Department of Health and Social Care (DH) since the summer about “secondary measures” which may be required to maintain the supply of medicines, “particularly in the event of no deal”, it said in a statement yesterday (November 28).

One of these measures would be “giving pharmacies the ability to exercise appropriate professional discretion to ensure the continuity of an alternative equivalent medicine to patients in accordance with patient need”, PSNC said.

The negotiator has also been telling the DH about pharmacies’ need to access “quick and clear reimbursement and stock availability information”, it said.

Contractors need “more responsive drug tariff pricing and reimbursement of any additional costs incurred”, PSNC stressed, as well as “appropriate regulatory and practical support to ensure the continuity of medicines supplies to patients”.

Dukes: A deal is essential

PSNC chief executive Simon Dukes said: “From a medicine supply perspective, an agreed deal is essential if we are to reduce the negative impact of a chaotic exit from the European Union.

“PSNC will continue to work with officials at the DH to help minimise disruption from a no-deal Brexit.

“Quite rightly a lot of community pharmacists and local pharmaceutical committees are concerned about Brexit and the impact it will have on patients, communities and of course businesses,” Mr Dukes added. “I share your concerns.”

PSNC will host a Brexit Forum meeting for community pharmacy stakeholders to discuss the latest developments with the DH tomorrow (November 30).

Multiples discussed medicines supply with DH

The Company Chemists’ Association (CCA), which represents the UK’s largest multiples, has also met with the DH to discuss “plans for ensuring the continuity of supply of medicines to patients as the UK leaves the EU”, alongside the Association of Independent Multiple Pharmacies and the National Pharmacy Association, it said today.

“The meeting focused on strengthening the lines of communication between government and the pharmacy front line and opportunities to introduce flexibilities into working practices,” the CCA said.

“Given the potential for disruption, we are very pleased to be working with the DH,” it said, which it will continue to do before and after Britain is scheduled to leave the EU on March 29.

The House of Commons is scheduled to vote on December 11 on the terms of Theresa May’s deal for the UK’s withdrawal from the EU.

Last month, the Healthcare Distribution Association’s executive director Martin Sawer told MPs that pharmacists need emergency powers to substitute drugs on prescriptions in the event of a no-deal Brexit, in order to prevent shortages.

Royal Pharmaceutical Society president Ash Soni said at the time it would be “sensible” to allow pharmacists to switch medicines on prescriptions in the event of Brexit shortages.

DHSC lifts validation protocol for 150mcg AAIs

DDA, Ailsa Colquhoun, 30 November 2018

From Thursday 29th November, adrenaline 150microgram auto-injectors are no longer be subject to additional validation processes.

The Department of Health and Social Care (DHSC) has stated that stock levels are now at a level where the validation protocol is no longer required.*

Dispensers are now permitted to dispense the total number of adrenaline 150microgram auto-injectors prescribed to each patient. However, whilst stock filters through the supply chain, some wholesalers may still apply a restriction to ordering levels.

* EpiPen products were subject to prescription validation prior to the protocol introduced October and this will continue as before.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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