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HARMACY leicestershire & rutland Your Local Pharmaceutical Committee Chief Officer Statement Dear Contractors. I hope all is well. The LPC have been working recently to update the strategy, vision and values to define the future direction of the LPC to ensure we add value and provide support to our local Pharmacy network and LPC members. ADVANCING COMMUNITY PHARMACY THROUGH INNOVATION, REPRESENTATION AND LEADERSHIP Engage, empower and inspire patients, contractors and commissioners and integrate Community Pharmacy into the wider healthcare Team We are in the process of updating the website and adding up to date information to ensure that you have access to information you require when needed. You will also be receiving more communications and updates on varying topics as we have engaged key stakeholders in the local NHS ensuring we receive and cascade key information. We are working with local providers to provide you with new opportunities and represent the profession to ensure community Pharmacy will be integrated, recognised and supported going forward. We look forward to meeting and working closely with you over the coming months ensuring that our community pharmacist and teams are “ fit for purpose” providing support and resources to ensure that we are closely aligned to the NHS strategy needs of your local patients. This ensures that our collective vision to provide quality care to our patients and your local community remains true to our core purpose of delivering quality care and support improvement of outcomes as one united pharmacy profession.The unity of our profession and the contribution of each and every contractor remains a vital ingredient to ensure we continue to integrate the profession in the local NHS ensuring we are recognised and supported for the work we do and realise the potential that we have to deliver. I would request you all to support the Profession and each other at a time that we truly have a great opportunity to finally realise our potential and provide the services that we are capable of providing. This is primarily dependent on each and every one of you to deliver services and provide excellent care to patients so that you currently have to enable us to provide you with more opportunities that will both provide professional satisfaction and financial benefit. The financial pressures of the NHS and limited resource/ capacity of Urgent Care, Secondary Care and GP’s has resulted in an opportunity to potentially provide further services through community pharmacy e.g. minor ailments, emergency repeat medication services to reduce the burden on OOH and emergency care services. NMS and MUR delivery is key to demonstrating our capability to the local NHS. At present, we have an average of 200 MUR’s delivered by our contractors which is depriving contractors of £1,271,200 in an NHS that is currently in great financial difficulty. We are fortunate to have this opportunity and it is vital that we upskill our skills and competency to deliver NMS and MUR’s of high quality whilst building excellent relationships with your GP’s. The NHS are looking at our performance and delivery of these services so I hope you will be supportive to enable the LPC to provide you with opportunities going forward. Best Wishes Luvjit Leicestershire and Rutland LPC will innovate, inspire and support Community Pharmacy teams. As the representative body of Community Pharmacy, we reinforce the importance and value provided by our profession. We represent contractors in local and national consultations to NHS England, Health and Wellbeing Boards and PSNC; We support, provide resources and guidance to our pharmacy contractors; support local enhanced and commissioned services promoting our local pharmacies enabling us to deliver quality healthcare and improved outcomes to our patients SUMMER 2015 NEWSLETTER WELCOME TO YOUR FIRST NEW EDITION OF OUR LPC

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HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

Chief Officer Statement

Dear Contractors. I hope all is well. The LPC have been working recently to update the strategy, vision and values to define the future direction of the LPC to ensure we add value and provide support to our local Pharmacy network and LPC members.

ADVANCING COMMUNITY PHARMACY THROUGH INNOVATION, REPRESENTATION AND LEADERSHIP

Engage, empower and inspire patients, contractors and commissioners and integrate Community Pharmacy into the wider healthcare Team

We are in the process of updating the website and adding up to date information to ensure that you have access to information you require when needed. You will also be receiving more communications and updates on varying topics as we have engaged key stakeholders in the local NHS ensuring we receive and cascade key information. We are working with local providers to provide you with new opportunities and represent the profession to ensure community Pharmacy will be integrated, recognised and supported going forward.

We look forward to meeting and working closely with you over the coming months ensuring that our community pharmacist and teams are “ fit for purpose” providing support and resources to ensure that we are closely aligned to the NHS strategy needs of your local patients.

This ensures that our collective vision to provide quality care to our patients and your local community remains true to our core purpose of delivering

quality care and support improvement of outcomes as one united pharmacy profession. The unity of our profession and the contribution of each and every contractor remains a vital ingredient to ensure we continue to integrate the profession in the local NHS ensuring we are recognised and supported for the work we do and realise the potential that we have to deliver.

I would request you all to support the Profession and each other at a time that we truly have a great opportunity to finally realise our potential and provide the services that we are capable of providing. This is primarily dependent on each and every one of you to deliver services and provide excellent care to patients so that you currently have to enable us to provide you with more opportunities that will both provide professional satisfaction and financial benefit.

The financial pressures of the NHS and limited resource/ capacity of Urgent Care, Secondary Care and GP’s has resulted in an opportunity

to potentially provide further services through community pharmacy e.g. minor ailments, emergency repeat medication services to reduce the burden on OOH and emergency care services.

NMS and MUR delivery is key to demonstrating our capability to the local NHS. At present, we have an average of 200 MUR’s delivered by our contractors which is depriving contractors of £1,271,200 in an NHS that is currently in great financial difficulty. We are fortunate to have this opportunity and it is vital that we upskill our skills and competency to deliver NMS and MUR’s of high quality whilst building excellent relationships with your GP’s. The NHS are looking at our performance and delivery of these services so I hope you will be supportive to enable the LPC to provide you with opportunities going forward.

Best WishesLuvjit

Leicestershire and Rutland LPC will innovate, inspire and support Community Pharmacy teams. As the representative body of Community Pharmacy, we reinforce the importance and value provided by our profession. We represent contractors in local and national consultations to NHS England, Health and Wellbeing Boards and PSNC; We support, provide resources and guidance to our pharmacy contractors; support local enhanced and commissioned services promoting our local pharmacies enabling us to deliver quality healthcare and improved outcomes to our patients

SUMMER 2015

NEWSLETTER

WELCOMETO YOURFIRSTNEW EDITION

OF OUR LPC

One year on from the National Review of Asthma Deaths (NRAD), Asthma UK has discovered over 22,000 people with asthma in the UK have been prescribed medicines in an unsafe and potentially life-threatening manner and 90,000 people in England have uncontrolled asthma which is not being monitored by healthcare professionals.

However, community pharmacy teams can make a real difference in this area. PSNC’s report on community pharmacy and asthma, published this time last year in response to the NRAD, pulls together evidence from a number of local pilots and services to show the impact that community pharmacy teams can make in this area. For example, by helping people to understand and use their inhalers

People with asthma need much better support, says new study

‘‘ ‘‘correctly, we know that pharmacies can help people to better manage their conditions, reducing hospital admissions and even deaths caused by asthma.

The report, along with useful resources for pharmacy teams, can be found on our devoted webpage: psnc.org.uk/asthma

Have you joined the Asthma UK healthcare professionals’ community? You can sign up to the Asthma UK healthcare professionals’ community free of charge to receive a resource pack and regular updates on their work. Visit the Asthma UK website to sign up: www.asthma.org.uk/Sites/healthcare-professionals

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

You will be receiving a free range of information and resources to support you in the delivery of EHC and Chlamydia Screening Public Health community based service from Public Health.

This information will also be available on the Leicestershire and Rutland LPC website at; http://psnc.org.uk/leicestershire-and-rutland-lpc/public-health-llr-ehc-and-chlamydia-campaign/

The new EHC posters and window stickers have been produced in consultation with local young people and replace the old 'pink' laminated posters so please remove these and use the new images. If you have any queries about any of this information please contact the PH team on [email protected]

Public health information Campaign – EHC and Chlamydia – Leicestershire and Rutland LPC

Pharmacists who will be providing the EHC under a community based services contract for Leicestershire and Rutland MUST also have attended a local EHC workshop. Booking is via the CPPE website at: www.cppe.ac.uk

The required online modules (EHC and contraception, safeguarding children and vulnerable adults can be accessed at www.cppe.ac.uk

The next workshop date is outlined below; Please contact Sejal.Gohil.cppe.ac.uk

If there are no workshops available on the website please contact Sejal Gohil ([email protected] )to be placed on a waiting list as more training dates will be coming up very soon.

CPPE Workshop - EHC for Pharmacists and pre-reg trainees.

When: Wed, 16 September, 19:30 – 21:30

Where :Premier Inn Leicester Fosse Park Hotel, Braunstone Lane East, Leicester LE3 2FW, United Kingdom (map)

Description :Helen Marie Root register at ; https://www.cppe.ac.uk/

The FAQ document contains important information relating to contacts for ordering material, training and payment queries.HARMACY

l e i c e s t e r s h i r e & r u t l a n dYour Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

Please note: You are required to undertake face to face training every 3 years.

One of the most serious threats facing public health today is antibiotic resistance. Huge advances have been made in the treating and prevention of illnesses but today the pipeline of new antibiotics has slowed down.

European Antibiotics Awareness Day (18th November) aims to encourage the responsible use of antibiotics.

Antibiotics Expert Mark Gilchrist said: “The number of new antibiotics is at an all-time low; at the same time infections due to antibiotic-resistant bacteria are rising. Pharmacists are working with other health disciplines to combat the global threat of antibiotic resistance and preserve existing stocks of them by ensuring their appropriate use as well as increasing the public’s ‘understanding.Pharmacists know that antibiotics don't work for common viral illnesses such as colds and coughs, and they won't make you feel better any sooner. As winter approaches pharmacists are perfectly placed to advise on common ailments

Antibiotic Resistance

you or family members may need help with. Make the pharmacist your first point of call if you have a cough or a cold to make sure you treat yourself better without antibiotics”.

Pharmacists can help prevent antimicrobial resistance in multiple ways. The guidelines ongood pharmacy practice, prepared jointly by the International Pharmaceutical Federation (FIP) and WHO state: “The mission of pharmacy practice is to contribute to health improvement and to help patients with health problems to make the best use of their medicines”

This includes:• Providing proper counselling when dispensing antibiotics to the patient and his/her family• Encouraging patients to take the full prescribed antibiotic regimen• Working with prescribers to order sufficient doses to complete or continue a course of therapy

• Recommending therapies other than antibiotics for minor diseases• Providing updated information on antibiotics to prescribers• Monitoring the supply of antibiotics and their use by patients.

Counselling Patients on changes in brands.

Patients are increasingly raising queries on dispensed medicines when brands are changed outside of pharmacists. Pharmacists can support patients an reassure them at the point of collection to ensure we can continue to provide support for medicines optimisation and adherence particularly the frail and elderly who can feel anxiety and doubt when they don’t “ recognise” the boxes they receive. We play a vital to provide expertise and reassurance that the medicines are correctly dispensed and that they will continue to receive the full therapeutic benefit.

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

In collaboration with NHSE, Leicester City CCG and the Arial Fibrillation Association, the LPC has agreed for “Heart Rhythm Week” to be one of Leicester City’s Public Health Campaigns for the year. Please Continue to display your posters and hand out leaflets after the campaign finishes and send your audit to Leicestershire and Rutland LPC, 54 Brandon Street, LE4 6AW.

Heart Rhythm Week provides a platform for individuals, groups, organisations and healthcare professionals to come together to raise awareness of Atrial Fibrillation and heart rhythm disorders. Together, we can work to secure early diagnosis and improve outcomes for the many millions of people across the globe affected by arrhythmias.

Heart Rhythm Week Public Health Campaign For Leicester City

There are three simple themes:

1. Detect AF with a simple pulse check

2. Protect from AF-related stroke with anticoagulation, not aspirin.

3. Correct if treatment is not effective, review and refer for specialist support

Did you know?

- 1 in 4 people over the age of 40 will develop AF - AF causes 1 in 5 strokes and increases the risk of dementia risk by 50% - A simple pulse check is the easiest way to detect AF

Permanent disability and other consequences of AF-related stroke place a heavy burden on carers, family members and health and social services costing the NHS £3 billion annually which can be prevented.

This is a 12 month collaborative working project with a potential for a commisoned service which will be rolled out across Leicestershire after a pilot.

Please continue to display your posters and ensure you return your completed audit sheet to Leicestershire and Rutland LPC Office, 54 Brandon Street, Leicester LE4 6AW.

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

The financial pressures of the NHS and limited resource/ capacity of Urgent Care, Secondary Care and GP’s has resulted in an opportunity to potentially provide further services through community pharmacy e.g. minor ailments, emergency repeat medication services to reduce the burden on OOH and emergency care services.

NMS and MUR delivery is key to demonstrating our capability to the local NHS. At present, we have an average of 200 MUR’s delivered by our contractors which is depriving contractors of £1,271,200 in an NHS that is currently in great financial difficulty. We are fortunate to have this opportunity and it is vital that we upskill our skills and competency to deliver NMS and MUR’s of high quality whilst building excellent

NMS AND TARGETED MUR DELIVERY

PHARMACY SPOTLIGHT

We are looking for examples of best practice and great work in our local community pharmacies to share in our newsletter . If you have any great news to share and can send a brief outline of your news via email to [email protected] We would love to hear from you and give our pharmacies to share best practice and great work across Leicestershire.

LEICESTERHIRE AND RUTLAND LPC OFFICE54 Brandon StreetLeicesterLE4 6AWEmail : [email protected]: http://psnc.org.uk/leicestershire-and-rutland-lpc/

You can view the full size image at http://psnc.org.uk/wp-content/uploads/2013/07/CPN-MUR-Poster-Target-Groups-Jun-2015.pdf

relationships with your GP’s. The NHS are looking at our performance and delivery of these services so I hope you will be supportive to enable the LPC to provide you with opportunities going forward.

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

HARMACYl e i c e s t e r s h i r e & r u t l a n d

Your Local Pharmaceutical Committee

Ramadan And The Role Of The PharmacistThe Muslim holy month of Ramadan, in which Muslims fast from just before sunrise to sunset each day, is upon us again. This year it began in mid-June. Special issues that may arise in a pharmacy during Ramadan include providing advice on appropriate diet and on medical compliance among the Muslim population. Pharmacists are ideally placed to offer advice on appropriate diet, lifestyle and supporting medicines optimisation.

Fasting during Ramadan is prescribed for every healthy, adult Muslim whereas the weak, the sick, children, travellers and menstruating women are among those exempt. Muslims observing the fast are required to abstain not only from eating food and drinking water but also from consuming oral medicines and injecting intravenous nutritional fluids. However, not all Muslims who are ill seek this exemption and insist on fasting in any case. Fasting by Muslims during illness can cause problems if not supervised by health professionals. However, health problems during Ramadan can develop in otherwise healthy individuals and such patients could benefit from receiving advice on their diet.

Diet/Lifestyle Advice

• Consume food from the major food groups: bread and cereal, milk and dairy products, fish, meat and poultry, beans, vegetables and fruits. (Vegetarians and vegans should amend this list as appropriate.)· Intake of fruits after a meal is strongly suggested. Diet in Ramadan should not differ much from the normal diet and should be as simple as possible.• "Complex carbohydrates" or slow digesting foods should be consumed at sahur so that the food lasts longer (about eight hours) resulting in less hunger during the day. These complex carbohydrates are found in foods that contain grains and seeds like barley, wheat, oats, millet, semolina, beans, lentils, wholemeal flour and unpolished rice• Refined carbohydrates or fast-digesting foods last for only three to

four hours and may be better taken at iftar to restore blood glucose levels rapidly. Fast-burning foods include those that contain sugar and white flour. Dates are an excellent source of sugar, fibre, carbohydrates, potassium and magnesium and have been recommended since the days of the Prophet Mohammed as a good way of breaking the fast.

• Avoid fried foods, spicy and sugary foods which cause indigestion, heartburn, and weight problems• Drinking of sufficient water and juices between iftar and sleep to avoid dehydration, and for detoxification of the digestive system, should be encouraged in fasting individuals. However, the intake of large amounts of caffeine-containing beverages should be avoided• Light exercise, such as stretching or walking is recommended. Overweight people should increase the amount of exercise and reduce the amount of food intake to help reduce weight.• Follow good time management procedures for Ibada (prayer and other religious activities), sleep, studies, work, and physical activities or exercise. A good balance in the amount of time attributed for each activity will lead to a healthier body and mind in Ramadan.

Advice for the sick who fast during Ramadan:Ramadan fasting is obligatory for the healthy adult but, when fasting might significantly affect the health of the fasting individual or when one is genuinely sick, Islam exempts him or her from fasting. "God intends every facility for you, he does not want to put you into difficulties" (Koran 2:185). From an Islamic point of view, this exemption represents more than a simple permission not to fast. The Prophet said: "God likes his permission to be fulfilled, as he likes his will to be executed." Another saying suggests that "a gift that God gives you, you have to accept". In the light of these sayings, many believe that any Muslim who is sick,

or whose sickness would adversely affect his well-being during the fasting period, should either not fast or at least break his fast accordingly. An additional argument often used is that if the fasting by a sick Muslim would jeopardise his health further, then this ultimately will neither benefit himself nor his role in society (Ummah) and he should be discouraged from observing the fast.It is also important to follow good time management procedures for Ibada (prayer and other religious activities), sleep, studies, work, and physical activities or exercise. A good balance in the amount of time attributed for each activity will lead to a healthier body and mind in Ramadan.

However, a significant number of patients, for whatever reasons, do decide to observe the fast. It is these patients who need to seek the opinion of health professionals on an individual basis.

• Those suffering from acute conditions may need advice about altering their dosing regimen. Drugs that are normally required to be taken frequently, such as antibiotics, can be problematic for fasting patients.• Increasing availability of alternative drugs with long half-lives as well as the increasing formulation of short-acting drugs as sustained release

preparations, have offered much needed assistance to fasting patients.• Alternative routes of drug administration can help fasting patients. Some patients suffering from mild forms of angina pectoris could benefit from taking glyceryl trinitrate as a patch rather than sublingual tablets. The drug would enter the blood stream through the skin, and not orally (which would break the fast). Again, this may only be possible in specific patients and needs to be discussed with the patient's doctor. Pharmacists should be willing to advise patients and practitioners on the availability of alternative dosage forms for medication during Ramadan.

Diabetics who are taking oral hypoglycaemic agents along with the dietary control should exercise extreme caution if they decide to fast. These patients should consult their medical doctor for dose adjustment. If they develop low blood sugar symptoms in the daytime, they should end the fast immediately." In addition, diabetic patients taking insulin should consult their doctor to see if their dose can be adjusted to allow fasting during Ramadan. In all cases of fasting with diabetes, blood sugar levels should be closely monitored, especially before and after meals.

In summary, Islam offers an exemption to the sick from observing their fast during the holy month of Ramadan. However, some patients may be able to fast if their health is not adversely affected during the period of fasting. In such cases, advice from pharmacists and doctors about changing prescriptions to equally effective drugs that have reduced dosing, such as sustained release formulations, may be beneficial to the fasting Muslim. In all cases of illness, it is recommended that Muslim patients, if they do fast, do so under medical supervision. Pharmacists, doctors and other health professionals are undoubtedly keen to help.

Extracted from Fasting During Ramadan : A Muslim pharmacists perspective by Saghir Akhtar PHd, MRPharmS The Pharmaceutical Journal Vol 267

No 7173 p691-692 10 November 2001

Source; http://www.pharmaceutical-journal.com/pj-online-fasting-during-ramadan-a-muslim-pharmacists-perspective/20005415.article