Providers of community nursing services must have ‘contingency plans’ in place to allow for the recent closure of several Lloyds pharmacies amid concerns about the impact on medicines supply and prescribing in the community, a leading charity has warned.
The Queen’s Nursing Institute told Nursing in Practice that providers should take action to ensure there is ‘no interruption or delay in care’ for those using their services.
LloydsPharmacy, a national pharmacy chain, has recently announced the closures of all 237 of its pharmacies inside Sainsbury’s stores, and is ‘selectively selling some branches’ of its high street stores.
And one NHS trust has reported that these closures have also impacted the supply of medicines to its community nursing teams and other community services, community hospitals, clinics, and a prison.
Susan Watkins, chief pharmacist at Shropshire Community Health NHS Trust, told our sister title The Pharmacist that when a LloydsPharmacy branch closed earlier this year, its co-located hub also stopped supplying the trusts’ community teams with medicines.
Shropshire Community Health NHS Trust had contracted a LloydsPharmacy hub to dispense named patient medicines for its community hospital and prison, as well as supply medicines to teams such as district nurses, dental, podiatry, minor injury units and other clinics.
This hub shared a premises with a LloydsPharmacy community pharmacy, and when that community pharmacy was sold, the hub also ceased its operations.
And while another community pharmacy contractor took over the community pharmacy premises, there was some uncertainty over who would fulfil the contract with the NHS trust, which required licensing for wholesale dealing and controlled drugs.
The new NHS trust supplier also needed to be able to fulfil the needs of different community teams – such as the medicines that district nurses, GPs making home visits and clinics, needed to have on hand.
Although the trust contract was eventually fulfilled by another supplier, Fairview Health, Ms Watkins said that it was challenging to ensure continuity of medicines supply amid the uncertainty and sudden nature of the closure.
‘It was a challenging time, with all eyes on me to make it happen and ensure continuity of supply of medications for the entire trust,’ said Ms Watkins, adding that she had only received 12 weeks verbal notice of the closure via a video call, and did not receive anything in writing.
While Ms Watkins said that she has ‘nothing but praise’ for the staff working in the hub and that ‘the service we had from Lloyds over the years was amazing’, she described the uncertainty around the closures as ‘a difficult situation’.
A spokesperson for the Queen’s Nursing Institute, a charity which supports and promotes the community nursing sector, commented that ‘the closure of so many branches of a big retail company like Lloyds pharmacy risks having an impact on the prescribing and ready supply of medicines in the community’.
They added: ‘Community service providers likely to be affected should have contingency plans in place to take account of this, to ensure there is no interruption or delay in care for people who need their services.
‘Many people depend on the pharmacy nearest to where they live, and the potential closure of so many of them could make access to medicines more difficult.’
Riaz Esmail, the chief pharmacist of the new supplier, Fairview Health, warned that the pressures facing medicines suppliers such as rising costs, drugs shortages and workforce gaps were ‘universal’.
‘An organisation like ours, which is agile, was able to come in and provide those services in a very, very short time,’ he told The Pharmacist.
‘But I think there could be a number of other instances like this happen, which were not planned.
‘The response has to be that we need to make sure that it’s more robust in the future, so that these kinds of things don’t happen again.’
He added: ‘We need to be looking at why this these supply issues arise, and trying to find a universal solution, so that these instances are better managed across the board.’
‘We don’t want them to have an impact on patient care, and we’re very, very close to that now,’ he warned.