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Deliveries at 3am: one way for pharmacies to maintain supplies during the Olympic Games

Some community pharmacies in and around London will be affected by the Olympics. Debbie Andalo looks at how they will maintain “business as usual” during this period

By Debbie Andalo

Some community pharmacies in and around London will be affected by the Olympics. Debbie Andalo looks at how they will maintain “business as usual” during this period

Half of the 1,500 community pharmacies expected to be directly affected by the London 2012 Olympics will have normal twice-a-day deliveries from wholesalers during the games — provided nothing unexpected happens.
The pledge from the British Association of Pharmaceutical Wholesalers (BAPW) may seem ambitious but it reflects the confident mood across community pharmacy in the capital that drug deliveries will get through.
Wholesalers have, since early this year, been visiting each of the 1,500 sites to work out an Olympics strategy. Each pharmacy has been colour coded: red for those whose deliveries are under threat, amber for those whose schedule is being cut to a single daily delivery, and green for those whose deliveries will stay the same during the games. At the beginning of July, around 750 pharmacies were on green alert, 700 pharmacies were in the amber category, leaving 42 on red alert.

Martin Sawyer, executive director of the BAPW said: “The effect on pharmacies will be created by the venues themselves but it is also about the transport and traffic routes during the games, such as the VIP lanes, no parking and other traffic restrictions, such as no turning right.
With help from NHS London, there has been pressure put on some London authorities to relax their normal parking restrictions because it is such a unique occasion and we want to move as many reds as possible into the amber category.” 

Geoff Mellor, technical director at the BAPW, said discussions were still ongoing with the 42 “red” pharmacies to make alternative arrangements for their deliveries such as leaving stock at a hospital pharmacy to be collected by the pharmacy. “Not all the pharmacies affected are around Stratford. They are quite scattered. There are issues around the O2 arena in North Greenwich, Horse Guards Parade and Earls Court. We also have the VIP route which runs from Mayfair to the Olympic Park and that is a particular issue,” he said.

Contingency plan

The BAPW has drawn up its Olympics contingency plan following discussions with the London Organising Committee of the Olympic and Paralympic Games (LOCOG), Transport for London, the Department of Health and NHS organisations, including NHS London and Pharmacy London. Pharmacy organisations such as the National Pharmacy Association and the Pharmaceutical Services Negotiating Committee have also been involved. The span of organisations reflects the complexity and scale of the operation to guarantee deliveries, with plans being tweaked all the time.

Three weeks before the start of the games, which kick off on 27 July, the BAWP announced that daily conference calls would be held with the five wholesalers affected by the games – Alliance Healthcare, AAH, Phoenix Medical, Mawdsleys and Sangers (Maidstone)  – in order to deal with any unexpected problems which might arise. A helpline telephone number (available nearer the games) for pharmacies is also planned and a “joint communication” with other pharmacy organisations to explain to community pharmacists exactly what is happening about deliveries during the games is also being drawn up. Mr Sawyer said: “I think because we flagged up the issue of deliveries early it has meant that we have been able to work out what the challenges are and what we need to do. We have given ourselves enough time.”  

RPS advice

The advises that those pharmacies that are, or could be, affected by the games should consider alternative delivery arrangements (eg, deliveries at other branches and buddying arrangements with other pharmacies). They should liaise with their local pharmaceutical committee and primary care trust, especially where specific issues have been identified without any obvious solutions. If they do have to receive deliveries out of hours, Transport for London has issued specific guidance at . Pharmacies are also advised to the out-of-hours deliveries lead at their local authority.

Although it may be tempting for pharmacies to bulk order to ensure they have sufficient stock to cover demand over games time, there is the potential that, if many pharmacies take this approach, this could put considerable demand on the medicines supply chain.

Impact of quotas on certain lines, in conjunction with decreased frequency of deliveries, could increase difficulties in obtaining certain items. Pharmacies should be aware of the document “Best practice for ensuring the efficient supply and distribution of medicines to patients”, available at .

Delays to postal deliveries are likely, including Royal Mail and other providers, so it is worth considering the potential impact where postal services are used, including when submitting end-of-month prescription bundles to the NHS Business Services Authority.

 

Quotas will not be lifted

The Association of the British Pharmaceutical Industry (ABPI) has been kept up to date about the red, amber and green status of pharmacies and has passed the information on to drug manufacturers. It is recommending that any pharmacy which has a stock problem during the games should the manufacturer as soon as possible. But the ABPI confirmed that it has no plans to lift stock quotas during the games to help prevent supply problems arising, even though the issue of quotas was highlighted as a potential problem by the BAPW.

The BAPW is concerned that some care homes or nursing homes, for example, may stock up on medicines before the games in order to make sure they have enough supplies during the event. But ABPI chief executive Stephen Whitehead said: “The situation will not change during the Olympics. Removing quotas at this time is not the answer. Lifting restrictions on excessive orders from medicine traders who are exporting for profit would lead to shortages of some medicines and it would put patients at risk.”

NHS London is also being kept up to speed with the colour status of community pharmacies and has been working with the BAPW, Transport for London and primary care trust clusters, as well as local pharmaceutical committees (LPCs) to ensure that drug deliveries get through. A spokesman said: “With good planning, we believe that this should be sufficient to ensure that their patients are able to receive their medicines in a timely manner. Boots UK Ltd, which is the multiple with by far the most pharmacies likely to be impacted on by the games, has developed its business contingency plans to ensure deliveries of medicines to its stores.”  NHS London said a small handful of pharmacies — less than a dozen — are likely to have their deliveries rescheduled for a time between midnight and 6am.  

He said: “PCT clusters, together with LPCs, are working with these individual pharmacies to ensure that they can receive these deliveries in a safe manner and be able to provide services throughout the period,” he said. NHS London has also asked all pharmacies to complete a self-assurance check list, which forces them to review their own contingency plans, including how they expect to deal with any disruptions in supplies, he added.

Impact

London 2012 impacts mainly on pharmacies in the six London Olympics boroughs: Barking and Dagenham, Greenwich, Hackney (which, geographically, includes a third of the Olympics site), Newham, Tower Hamlets and Waltham Forest.

Brij Vyas is projects lead for North East London LPC and has been its Olympics co-ordinator. The LPC is responsible for pharmacy contractors in Barking and Dagenham, Newham, Tower Hamlets and Waltham Forest.
Like others, he is confident that deliveries will get though but the issue for pharmacists is their timing. He said: “The question remains what time the deliveries will arrive. That is the difficulty which some colleagues who are on the Olympics route are talking about. There is talk that they may be coming between midnight and 6am. But they are being supported by the PCT and the wholesalers.”

Pharmacists are also worried about supplies of Controlled Drugs during the games, he said. “The wholesale companies are liaising with pharmacies about this and have sent out letters to pharmacists about what’s happening. It is potentially quite critical if you consider methadone, for example. If there isn’t much room in the CD cabinet you can’t keep more supplies. Companies are making contingency plans with pharmacies such as using couriers should the need arise. I think pharmacists generally are aware of what steps they should take as far as deliveries are concerned but I think each day will be different because it will depend on which Olympic event is taking place.”  

City and Hackney LPC said that its discussions with the PCT cluster and the BAPW have been constructive. Only two pharmacy contractors in Hackney have been given red status and they have been able to rearrange deliveries to an alternative branch or neighbouring pharmacy. Its chief executive officer Martin Crisp said: “It’s been a bit of a movable feast. One of the most useful things for us is that NHS London has produced a self-assurance checklist to make sure that contractors have everything covered in terms of medicines supply as well as making sure that staff can get in during the games.”  

He said the LPC has done a lot of work with the PCT cluster in drawing up contingency plans: “We have looked at how the hospitals can support us and how we can support them during the Olympics. I think that there is some good work being done. It’s not just necessarily about stocking up; it’s more about thinking the issue through. If patients are going to [stock] up, for example, then there is an opportunity to talk to GPs beforehand to think it through with them.” He said his advice to contractors is to the PCT if they have a serious supply issue during the games. “But if they are after advice or support do get in touch with the LPC,” he said.

A chance to prove our worth

Across the river in South London pharmacy contractors in Greenwich said the games give the profession the chance to prove its worth. Raj Matharu, chief officer of Bexley, Bromley and Greenwich LPC, said: “The message we have been given is that Olympics routes are sacred — even though we have made representation to the London Mayor and LOCOG. In the interest of national security, nothing is going to be changed. I think it will represent an opportunity for pharmacists to show that we can provide a service for patients in the most extreme of circumstances.”

Like others, the LPC is confident that supplies will get through but some will be made through the night. He said: “Some pharmacists are making themselves available for night time deliveries but I would be very reluctant myself to have my staff out at night, especially where CDs are concerned.” Mr Matharu believes that it is going to be up to pharmacies to make sure that they get the deliveries they need. He said: “I think that the supplies will get through but the contractors are going to have to pull out all the stops, be really flexible and be prepared to go that extra mile. The onus is being put on us.”

It is a view which reflects the mood and commitment of colleagues across London as well as that of wholesalers. Mr Sawyer from the BAPW added: “We all know that this is a one off. The last thing that anybody wants is to find somebody having trouble getting their medicines.”

Citation: Electronicjuice URI: 11104027

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