Empowering you to meet regulatory and best practice requirements

This month’s Patient Safety Champions’ letter continues the focus on maximising the value of the Monthly Patient Safety Review (PSR) for patient safety. Your Patient Safety Champion will be reflecting on the quality of the monthly SMART-ER actions that are set, and may share their reflections with you.

Also, in this month’s letter is a section on the upcoming Winter Flu Vaccination Service. If your pharmacy will be providing flu vaccinations, this highlights several key documents and processes that all members of the pharmacy team must be aware of.

COVID-19 Medicine Delivery Units (CMDUs) were established in England as part of pandemic-specific arrangements to provide access to community-based COVID-19 treatments. NHS England have confirmed that from the 27th June 2023, Integrated Care Boards (ICBs) have responsibility for ensuring routine access to COVID-19 treatment.  

ICBs are in the process of defining and implementing new routine local pathways for COVID-19 treatments, which may result in you receiving prescriptions for oral COVID-19 treatment. If a prescriber chooses to prescribe treatment (in line with NICE guidance), you may receive a prescription for oral antiviral treatment (nirmatrelvir plus ritonavir (Paxlovid^®) or molnupiravir (Lagevrio^®) – see below). These oral antivirals are currently available free of charge via Alliance Healthcare UK.

The current preferred antiviral medications to treat vulnerable patients with COVID-19 are:

• First-line: Nirmatrelvir plus ritonavir (Paxlovid^®) (an oral antiviral)
• Second line: Sotrovimab (nMAb) (which should only be used if Paxlovid^® is contraindicated or unsuitable) (an IV preparation, which is administered in a hospital setting only)
• Third line: Remdesivir (RNA polymerase inhibitor) (an IV preparation, which is administered in a hospital setting only)
• Fourth line: Molnupiravir (Lagevrio^®) (an oral antiviral)

Pharmacists should ensure they are familiar with the summary of product characteristics, including awareness of the risk of any interactions, for Paxlovid^® and Lagevrio^®. The Specialist Pharmacy Service has produced a resource to support the use of these medicines in practice, including links to specially-produced patient information for Paxlovid^®.

The following webpages are also useful resources for Healthcare professionals (HCPs):

• Information for patients on treatment and how to access it
• Information for HCPs

You may receive information regarding new locally commissioned services for the supply of oral COVID-19 treatments from your Local Pharmaceutical Committee (LPC) or directly from the Integrated Care System (ICS). If so, please contact your Healthcare Partnership Manager (HPM) for support.

Children aged 2 years and over are eligible for our Travel Vaccinations & Health Advice Service and Malaria Prevention Service. To enable the pharmacist to properly conduct the travel service consultation, it is important that the child attends the appointment so that an accurate weight of the child can be obtained. Pharmacists will be aware that the dose of antimalarial medication is based on weight and an inaccurate weight could lead to either sub-optimal malaria prophylaxis or overdose. The notes section within KnowMalaria should be used to document that the child was weighed in store.