Pharmacy Consulting Supporting Primary Healthcare Tue, 13 Mar 2018 10:57:39 +0000 en-GB hourly 1 A Pioneer for female pharmacists Fri, 09 Mar 2018 11:14:03 +0000 Elsie Hooper (1879-1969), a pioneer for female pharmacists in the early 1900’s is being celebrated on International Women’s Day 2018.

On 17th June 1911, a small group of female pharmacists joined the Women’s Coronation Procession – alongside these pharmacists where a 40,000-strong march from Westminster to the Albert Hall in support of votes for women. Alongside those marching was Elsie Hooper. Elsie was born in 1879 and joined the Pharmaceutical Society in 1902 and shortly after became the first secretary of the National Association of Women Pharmacists. Elsie was one of the first ever females to receive two prestigious research awards – The Redwood Research Scholarship and the Pharmaceutical Society’s Burroughs Scholarship.

Further on into her career Elsie went on to own/manage two London pharmacies in Belsize Park and Hampstead. She was well known for her encouragement of female apprentices.

As well as a vast knowledge in Pharmaceuticals, Elsie also had a successful career in publishing and academia. She worked on the first British Pharmaceutical Codex, published in 1907. She also taught at the Gordon Hall School of Pharmacy in North London between 1920 and 1942, in which later she became the school’s proprietor.


– Jackie Peck

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Counterfeit Diet Pills – What Is the True Cost? Fri, 23 Feb 2018 13:26:11 +0000 Almost everybody wishes to lose weight at some time or another, whether it be for the holidays or a special occasion, but what is the best and easiest way to do it?

A quick internet search shows a variety of methods from joining a slimming club, dieting or going to the gym.  All of these methods take time and dedication in order to achieve the desired results, and here lies the rub.

In a world of fast foods, fast cars and, on the whole, a faster way of living why shouldn’t we have fast weight loss too? Internet sites promise, in some cases, that you can lose on average 21lbs per month using diet pills – but which ones to use – there are so many it doesn’t matter right?  After all they have been tested and are safe to use – wrong!

As highlighted in a recent episode of BBC’s Casualty, a lady in a care home was freely dispensing diet pills to her friends as part of a beauty regime. She was under the impression that they were from a ‘good’ company and ‘guaranteed’ to be safe.  It became apparent that the pills contained Sibutramine, which was suspended from the UK market in 2010, amid fears it increases the risk of heart attacks and strokes and was, as it turns out, a counterfeit medicine.

If you think this can only happen in TV land to unsuspecting little old ladies then think again!  Even musical icons can allegedly become a casualty of the counterfeit pill problem sweeping the global market.

The autopsy report, for a particular musical icon, allegedly concluded that he died from a lethal dose of a powerful opioid called fentanyl which is a drug that can be up to 100 times more powerful than morphine.  From investigations carried out it is believed that the pop icon didn’t know what he was taking as the container was marked with a label that’s found on a generic painkiller that contains acetaminophen and hydrocodone — the ingredients of many commonly prescribed painkillers, including Vicodin.

Counterfeiters rely on the fact that people want a cheap easy fix and don’t want to involve their GP for fear of embarrassment. They set up a fake website offering us this magic elixir at heavily discounted prices.

In order to stay safe and ensure that the medicine we wish to purchase is genuine it is imperative that we follow a few simple steps:

  • Check that the online pharmacy is genuine. Does it display this logo link?  The EU common logo must be displayed on every web page that offers to sell human medicines to the public.

  • Check the ingredients of products that claim to be ‘herbal’ or ‘all-natural’ they can actually contain chemical ingredients. Many contain Sibutramine – a medicine which was withdrawn from sale due to serious side effects including strokes and heart attacks, as mentioned above.
  • Are the prices ‘’too good to be true’’? If so – they probably are.


If, after doing these checks, you should come across what you suspect to be a ‘fake’ website – report it  via the MHRA website Medicines and Healthcare products Regulatory Agency.  The MHRA, the UK licencing body for medicines and medical devices, are currently running a fake meds campaign to combat the illegal trade in fake medicines.

Think! Is saving money by buying counterfeit diet pills, as dramatized in the programme Casualty, worth the cost of losing a life?

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MHRA GDP/GMP Symposium Overview Thu, 22 Feb 2018 13:33:21 +0000 The recent GDP/GMP symposiums both concentrated on  quality risk management, as compared to a previous emphasis on risk assessment.

MHRA inspectors appear increasingly unhappy that pharmaceutical companies appear to be throwing together risk assessments, without adequate consideration, and merely as a tick box exercise to satisfy the requirements of their QMS.

MHRA Inspectors want to see the rationale behind the risk assessment process i.e. how the ratings for low, medium and high risk are arrived at and how this risk is then continually monitored.  It is not sufficient to say that the risk is at an acceptable level and then leave it as is. MHRA inspectors want to see that risks are constantly being identified, reviewed and re-evaluated to ensure that procedures employed to reduce/remove the risk are still effective or could be improved upon.

Other topics that the MHRA symposiums focused on were:

  • Transportation: the emphasis being on failure to assess lost/stolen products within the QMS which in turn indicates ineffective Quality Risk Management. A major concern of the MHRA is that lost/stolen products are being under-reported.
  • Validation of data loggers used for transport route risk assessment. MHRA the inspectors want to see that the data loggers used for this purpose have calibration certificates and that they have been stress tested. Such requirements will have implications for the use of disposable loggers which are for single use and therefore become unusable once the stress testing has been conducted.
  • Cold chain – in particular freezer validation and the conditioning of cold packs. Terry Madigan’s MHRA inspector’s blog ( was cited as guidance.
  • Due Diligence – on diverted products. Warning signs to look for:
    • false document.
    • last minute changes to consignee details
    • requests to deliver to a residential address (this should be avoided if at all possible)
    • personal credit card or cash payments.

Be Aware! The diversion of products can be achieved by stealth.  Customers may obtain a subtle surplus of pharmaceutical product, over a period of time, and after gaining the trust of the supplier, which can then be diverted to the illegal supply chain.

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Pharma companies and post-Brexit Fri, 16 Feb 2018 17:17:26 +0000 MPs were told in December that UK patient involvement in clinical trials will diminish post-Brexit making manufactures less likely to invest here.

They were also told that unlocking the potential of patient data held by the NHS may be enough to persuade the pharmaceutical industry to continue to look to the UK for involvement in developing new drugs and mitigate any disadvantages from leaving the EU.

Faculty of Pharmaceutical Medicine have also warned MPs that leaving the EU would damage research.

The UK may run the risk of becoming less attractive to drug companies looking to test their drugs and invest.

How to make most use of the NHS to create more clinical research?

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Is your RP always in the loop? Mon, 12 Feb 2018 14:41:55 +0000 Do you keep your RP informed? Is your RP aware of the little problems you’ve encountered along the way? And the seemingly harmless solutions you’ve applied.  Has he or she been made aware of the time you organised that half-hour non-qualified transportation? Or when a shipment was delayed at Customs? Or the Uncontrolled copies of SOP’s flying around the building? The answer is hopefully yes. And hopefully the issue has been brought up more than a day before an Inspection  -and certainly before it comes out in the Inspection itself because, no matter however much of a  thrill-seeker the RP may be, surprises like those are not really appreciated.

Problems happen all the time in any operational business, dilemmas and irregularities can often seem the norm. Your Responsible Person is there to help, advise and guide where possible, and document the anomalies when necessary.

Keep the RP in the loop.


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European Medicines Agency (EMA) to move from London to Amsterdam. Fri, 02 Feb 2018 14:37:13 +0000 Following a bun fight between 19 EU countries and a failure to agree on the new location of the EMA within the group of EU foreign ministers the decision was made by tossing a coin, at least it wasn’t ‘Rock, Paper, Scissors’! Amsterdam won through meaning that following Brexit the 900 staff currently operating from London will be moved to Amsterdam, though around 200 have already indicated they do not want to move.
The EMA is already talking about the likelihood of significant disruption caused by the move, made worse by the fact that the site in Amsterdam will not be ready until after March 2019, which will mean two moves in short succession (a fact that the Italians who were the others on the shortlist are not at all happy about). With the likely depletion of experienced essential staff as well as other Brexit issue the picture for those dealing with the EMA is not looking good.

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Do you have the correct licences for supply of Controlled Drugs? Tue, 23 Jan 2018 13:22:44 +0000 Are you a Wholesaler exporting Controlled Drugs or are planning to expand your product range to include Controlled Drugs? Do you hold a valid United Kingdom Controlled Drug Licence from the Home Office – if not you should and your WDA (H) may need to be varied to allow you to supply Narcotics. Where are you exporting to – do you know the requirements for the Controlled Drugs of the relevant National Competent Authority as it varies on a country by country basis.  For example in Ukraine it is necessary for the Controlled Drugs to be accompanied by State Police Escort and in Nigeria it is necessary that they are accompanied by a Superintended Pharmacist. For more details please contact Pharmacy Consulting Limited who can provide a Controlled Drugs Workshop and guide you through the process as relevant to your business.

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The Death of the Local Community Pharmacy Fri, 19 Jan 2018 12:43:14 +0000 It is with sadness that I reflect on the news of 2017 and the start of 2018.

A&E is in crisis and there are no free appointments in GP practices, and yet Pharmacies are closing as they are not viable. What is the cheapest health care intervention?  The empathetic pharmacy assistant who will ask you well-rehearsed questions to establish if you have the common cold or the Aussie Flu? The know if you have a raging temperature and feel like death that you need to be in bed with an antipyretic and plenty of fluids. If you have a secondary bacterial infection and are coughing up coloured sputum or are short of breath is it that you best speak to their pharmacist prescriber or your GP if he has an appointment?

The assistant can advise you to get a flu jab next year and that the pharmacy can do it for you now if you cannot get an appointment at the GP. The pharmacist will spend valuable time with the customer assessing them while the technician prepares the prescriptions for them to check after their consultation. So why do we want to disrupt this system, bring it to its knees resulting in Independents and Multiples alike announcing closures of non-viable pharmacies. Does the government realise that when we have more expensive service providers that are at crisis point, medical students being brought into hospitals to help, that the very small amount of funding required to keep pharmacies viable and open is a no brainer? Instead of reducing funding it should be increased.  With ever increasing patients being diagnosed with dementia, mental health issues and chronic diseases the local networks and support and the watchful waiting of the local healthcare provider is invaluable. It cannot be replaced by a “Dispensing HUB” or a “Courier driver “who will be different every time and will not know that Tom and Rose are not very mobile and slightly deaf, so may take 15 minutes to get to the door to collect their medication. What does the future hold for our elderly without their local support network. Where is our regulator or our negotiating body? Who is fighting for the pharmacies? Have the pharmacists and pharmacy owners lost their voice? I hear no protesting, I hear nobody putting up a fight? I see a profession that is giving up! Your patients need you, do not give up, it is time to come out fighting.

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I have overheard two worrying conversations involving relatively recently qualified pharmacists. Mon, 08 Jan 2018 12:37:56 +0000 Scenario 1

Patient asks for advice about travelling with medication to a north African resort for three weeks and wanted to know how they should best store their medication. Given that they had been told that their accommodation included a fridge the patient asked whether it would be best to keep the product in there. The pharmacist asked what the product was and then went away to check the pack/PIL for storage information. When they returned it had been identified that the storage recommendations for the product stated ‘store below 25⁰C’. Having heard this, the patient said ‘oh that’s all right then I will keep it in the fridge’, to which the pharmacist brusquely replied, ‘no you can’t do that, it will damage the medication’. Looking a little confused the patient queried why to which the pharmacist said that because it didn’t say ‘store in the fridge’ it would be inappropriate to do so and that the patient would just have to find somewhere cool to store it instead.

Scenario 2

Doctor phones for advice about the differences between two different brands of what appear to be the same product (an injectable cosmetic product). The product the doctor is used to using comes in two variants basically two different volumes and asks if the alternative product is directly equivalent. The Pharmacist finds examples of the alternative product and then the conversation goes along the following lines…”oh okay, yes there are two versions of the other product but it is not clear what the volume of each is, all I can see on the box is a code saying 0.9cc and 1.8cc, not sure what that means…..” Surprisingly the doctor did not hang up at that point! Even worse, the pharmacist continued “I am not sure whether the 0.9 or 1.8 pack is bigger, I send you both for you to have a look at”.

Now I am not saying that age or experience was definitely a contributor here but these do seem to be examples of an increasing tendency for supposed expert to give answers to questions without any proper thought or heaven forbid admit that they don’t have all the answers. From experience, pharmaceutical or medical questions, whatever the context, very rarely have completely black and white answers. Surely as professionals it is our responsibility to use our broader scientific knowledge and experience. Again experience shows that it is much better to say that you will look into a problem and get back to the enquirer. To paraphrase an old saying, it is better to keep quiet and someone think you a fool, than to open your mouth and prove it.

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Pregabalin and Gabapentin set to reclassify to controlled drugs (CD) Fri, 22 Dec 2017 10:56:59 +0000 With official figures showing pregabalin related deaths to 111 and gabapentin related deaths to 59, the Home Office launched on 13th November three options for the reclassification of these two drugs.

The options for its reclassification includes schedule 3, this would mean fulfilling the requirement for them to be stored in a safe locked storage.

The fear within community pharmacy is further costs – to have a large enough suitable locked storage cabinet that is ideally bolted against a wall. If your current CD cabinet has enough space, then you’re fine, but the likelihood is that you require the space and room.

On the other hand, wholesalers would require a CD Home Office licence to ensure they can continue their business. However, not knowing what category these two drugs would go under makes it difficult to apply for the current licence, so you must wait. We play the waiting game.

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