Allied Health Professionals: Prescribing Responsibilities

Lord Grade of Yarmouth Excerpts

Tuesday 6th February 2024 Lords Chamber

[Lord Markham (Con)]

Yes, because the noble Lord is correct: it should not take so long. We all agree with the approach. So noble Lords understand, there is a two-step process. First, the body to which we are trying to extend this needs to be agreed by a review of the Commission on Human Medicines; then, the Advisory Council on the Misuse of Drugs need to take a look at it. We are all aware of the dangers of anti-microbial resistance, which is why we need to be careful about things such as antibiotic prescribing. But in general, we want to do this as fast as possible.

[Lord Grade of Yarmouth (Non-Afl)]

My Lords, I am sure that most people will welcome the extension of prescribing facilities to pharmacies. Does the Minister understand that the rate of closure of independent pharmacies in the UK—these vital community facilities —is absolutely accelerating? Will he undertake to look at the rate of closure and understand why these small, independent businesses, which are the pillars of communities, are closing at such a rate? They are just financially unsustainable.

[Lord Markham (Con)]

I agree with my noble friend that not only are they the pillar of communities, but they are the front line in a lot of health services. This is about trying to put more business and activity their way to increase their viability, both in terms of paying for treatments such as these and increasing footfall generally. I completely agree with my noble friend that we want as many of these small businesses thriving in their own right, but also as a vital part of the health ecosystem.

NHS Winter Pressures

Lord Grade of Yarmouth Excerpts

Tuesday 10th January 2023 Lords Chamber

[Lord Markham (Con)]

I absolutely think these measures will improve the situation; I would not be putting them forward if I did not believe that. At the same time, just as we put out plans in October and are amending them now, I will continue to amend our plans. I think that is a flexible, responsible approach: you have a plan, you adapt that plan, you invest and you continue to improve. That is what we will continue to see and do; we will see those improvements go through this year and into the next.

[Lord Grade of Yarmouth (Non-Afl)]

My Lords, my noble friend the Minister mentioned pharmacies in his response, which clearly demonstrated a complete lack of understanding of the crisis that is going on in the independent pharmacy sector. They are closing at an alarming rate, yet they are the front line of the NHS, with record numbers of people coming to see them for free medical advice because they cannot get in to see their GP. There is a very serious crisis in the independent pharmacy sector, which is vital for healthcare. I have had many meetings, I have had letters, and I have got a campaign going in the media. It is clear from the responses that the department does not have a clue about the extent of the crisis and the closure of these independent pharmacies. Something needs to be done before they all close.

[Lord Markham (Con)]

I wholeheartedly agree with my noble friend that the pharmacies are the front line. We realise that they have been underutilised in the past. Actually, the plan of using them more for patients will put more funding their way, which I hope will support them, just as allocating Covid vaccinations to many pharmacies provided support. I hope my noble friend will see that this plan should add to the viability of a number of pharmacies by putting more business their way. They are a crucial part of the front line.

Pharmacy (Responsible Pharmacists, Superintendent Pharmacists etc.) Order 2022

Lord Grade of Yarmouth Excerpts

Tuesday 28th June 2022 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

My Lords, I congratulate my noble friend on bringing forward the order before us today. I am interested to understand the background to why we are moving from ministerial discretion to regulated control. I think my noble friend will assure the House this afternoon that the concerns raised by the Secondary Legislation Scrutiny Committee have been addressed and that any changes will be brought forward by statutory instrument, in which case the committee and the House will have the opportunity to look at them.

I join the noble Lord, Lord Hunt, and my noble friend, in paying tribute to community pharmacies for the work that they have done throughout the years, and particularly during the Covid pandemic.

What will the position of dispensing doctors be, who fulfil a role where community pharmacies do not reach? Quite a large network of rural areas is served by dispensing doctors. As the daughter and the sister of dispensing doctors, and as someone doing outside work with dispensing doctors, I think it is appropriate that we look at how they are potentially being asked, for example, to deliver a booster jab this autumn at the same time as the flu jab. That will pose enormous logistical challenges for community pharmacies, dispensing doctors and others. How do my noble friend and his department expect to address those challenges so that the rollout will go as smoothly in the autumn—particularly if it is combined with a flu jab—as it did in the previous three or four rounds?

[Lord Grade of Yarmouth (Con)]

My Lords, the health or otherwise of independent community pharmacies can be judged by the rate of closures, which has been increasing over the last few years for a number of reasons, not least the overall deal with the NHS. That deal requires, for example, an individually owned community pharmacy to be deemed to have received the same discount on the purchase of drugs that Boots and the other big chains get on volume discounts. There is a serious crisis in this sector. Can my noble friend the Minister give us some idea of the rate of closure? If he does not have the statistics today, perhaps he could place them in the Library. Closure is an upward trend.

[The Deputy Speaker (Lord Brougham and Vaux) (Con)]

The noble Baroness, Lady Brinton, will be taking part remotely and I call her now.

Future of Health and Care

Lord Grade of Yarmouth Excerpts

Tuesday 23rd February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord is entirely right that the regulation of both clinical care and social care is critical and key not only to good performance by both sectors but to the way in which they work together. That is why we will look at the CQC and its role in social care regulation. We will seek to enhance the way in which the CQC can look deeply into social care to set higher standards and to ensure that, when it comes to integrated care, social care is stepping up to the challenge as best it can.

[Lord Grade of Yarmouth (Con) [V]]

My Lords, the front line of social and community care—indeed the whole of the NHS—begins with local pharmacies, which, as the Government well know, are in dire financial straits, closing down at a rate of four or five every week. I ask my noble friend the Minister: is it the Government’s policy to wait until these vital community services have all gone bankrupt before they act?

[Lord Bethell (Con)]

My Lords, I start by paying an enormous tribute to the 11,251 community pharmacies for the work they do day in, day out, and in particular their contribution to the vaccine rollout. I remind my noble friend that £370 million has been made available by the Government in increased advance payments to support community pharmacies with cash-flow pressures caused by the pandemic. The community pharmacy contractual framework—the five-year deal—commits £2.5 billion annually to the sector. Non-monetary support has also been provided in recent months, such as the removal of some administrative tasks, flexibility in opening hours, support through the pharmacy quality scheme, and the delayed introduction of new services. I am afraid I do not quite recognise the figures my noble friend cited on the closure of pharmacies, but if he would like to write to me, I would be very glad to look into them more closely.

Pharmacies

Lord Grade of Yarmouth Excerpts

Monday 20th July 2020 Lords Chamber

Asked by

[Lord Grade of Yarmouth]

To ask Her Majesty’s Government what steps they are taking to ensure that independent pharmacies are able to continue to support the communities in which they are based.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]]

My Lords, I pay tribute to the immense contribution being made by community pharmacies in the epidemic. We are hugely grateful for the unequivocal commitment that the sector has shown and we want to make sure that the sector is treated correctly. We have made available £370 million in advance payments to aid cash flow, providing funding for the medicine delivery service for shielded patients and increased drug reimbursement prices. We are talking to the sector about additional funding for Covid-19 costs.

[Lord Grade of Yarmouth (Con) [V]]

I am grateful to my noble friend the Minister for that response but, as I am sure the whole House will agree, independent pharmacies in so many small towns such as Yarmouth and places such as the Isle of Wight are now the heroic first line of defence for GPs and the NHS. The most vulnerable in these communities depend on them for medical advice and deliveries of vital prescriptions, which they offer for free. In my view, it is totally unrealistic for the department to point to some recent funding help as if that has solved the problem. It is nowhere near enough to keep the pharmacies in business, let alone to allow the pharmacists to have a day off or even earn a living. It just demonstrates that the department fails to understand why independent pharmacists are still in such grave peril. May I please urge my noble friend to meet a delegation of these front-line heroes, to hear directly why their businesses continue to hang by a thread? When they fold, they will not be replaced.

[Lord Bethell [V]]

My Lords, I agree with every word of the tribute of the noble Lord, Lord Grade, to the role of community pharmacies, particularly during the epidemic. They have played an absolutely pivotal role in communities, with advice, medicines and support, and I pay tribute to their hard work and commitment. I would be very pleased to meet a delegation to discuss the challenges that they face.

Health: Sepsis

Lord Grade of Yarmouth Excerpts

Wednesday 22nd January 2020 Lords Chamber

Asked by

[Lord Grade of Yarmouth]

To ask Her Majesty’s Government, further to the University of Washington’s Global Burden of Disease Report, published on 16 January, what steps they are taking to address incidents of sepsis in the United Kingdom which is ranked 132 out of 195 countries for deaths caused by sepsis.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, over recent years the NHS has become much better at spotting and treating sepsis quickly. This means that more people are being identified as at risk of sepsis and mortality rates are falling. While we welcome this report’s attempt to advance knowledge of worldwide deaths from infection and sepsis, we are confident in our own data, which puts UK deaths from sepsis as significantly lower than reported in the study.

[Lord Grade of Yarmouth (Con)]

I thank my noble friend for that Answer. The House will not need reminding that some 50,000 people a year die in this country from sepsis, far too many of them unnecessarily. I declare my interest as an unpaid adviser to the UK Sepsis Trust, which has done remarkable work to improve awareness. Members of the trust, including clinicians and so on, have had many meetings at different levels within the department, begging for a registry of all sepsis cases in the UK. We have had a very sympathetic hearing but it is a bit like dealing with the laundry— nothing ever comes back. Can the Government make a commitment to introduce a registry which will help greatly to improve the targeting of the right antibiotics for the right cases?

[Baroness Blackwood of North Oxford]

I thank my noble friend for this Question and I pay tribute to his work on it, and the work of the UK Sepsis Trust. I am aware of the calls for a national sepsis registry for patients. It is important that we understand the data; we are confident that it provides an accurate indication. We think that UK data is as good as it can be at the moment but that there is a clear need for better data on sepsis. The problem with the registry as proposed is that it would use retrospective data collection. We want to go beyond this with the UK’s five-year national action plan for AMR, which includes a commitment to develop the real-time patient-level data of individual patients for infection, treatment and resistance history. Work is already under way by NHS England and NHS Improvement. I hope that is the kind of answer my noble friend was looking for.