Course Updates
Training Handbook Set A Module 1 General Update
Pharmacy First launched across England on the 31st of January. Speak to your supervisor about how this applies to your pharmacy and how pharmacists carry out face-to-face consultations with patients and supply treatment, including some prescription-only medicines, for certain conditions: impetigo, sore throat, earache, sinusitis, shingles, infected insect bites and uncomplicated UTIs in women. As you go through the training handbooks, think about when Pharmacy First might be appropriate and discuss with your supervisor.
NHS Pharmacy Contraception Service
Customers will be able to obtain regular supplies of their oral contraception, as well as help with starting contraception for the first time, or after they have had a break from contraception. The NHS Pharmacy Contraception Service is free of charge.
Individuals do not need to be registered with a GP to access this service. Pharmacies will only inform the GP practice that individuals have accessed the service, with their consent.
To be eligible to access this service a person must be an individual seeking to be initiated on an oral contraception (OC), or seeking to obtain a further supply of their ongoing OC:
- Combined Oral Contraceptive (COC) – from menarche up to and including 49 years of age; or
- Progestogen Only Pill (POP) – from menarche up to and including 54years of age.
Ask your pharmacist if your pharmacy is offering this service and discuss how they would like you to handle such queries
The NHS Community Pharmacy Blood Pressure Check Service
The NHS Community Pharmacy Blood Pressure Check Service supports risk identification and prevention of cardiovascular disease (CVD).
This service will:
- identify people over the age of 40 who have previously not been diagnosed with hypertension (high blood pressure), and to refer those with suspected hypertension for appropriate management.
- promote healthy behaviours to service users.
- undertake ad hoc clinic and ambulatory blood pressure measurements at the request of general practice.
What the service will provide
A community pharmacist will opportunistically measure the blood pressure of consenting adults who come into the pharmacy, by offering anyone a free blood pressure check who:
is over the age of 40;
- has not previously been identified as having hypertension or a related condition; and
- has not had their blood pressure measured by a health professional within the previous six months.
At the end of a consultation, where readings indicate:
- normal blood pressure, the pharmacist will promote healthy behaviours.
- high blood pressure, the pharmacist will offer Ambulatory Blood Pressure Monitoring (ABPM) from the pharmacy and will also promote healthy behaviours.
- very high blood pressure, the pharmacist will urgently refer the patient to see their GP within 24 hours and the pharmacist will inform the patient’s GP practice by NHS mail or via another locally agreed platform.
- low blood pressure, the pharmacist will provide appropriate advice and may also refer the patient to their GP if there are any concerns.
All blood pressure readings are sent to the general practice from the community pharmacy so records can be updated and appropriate action taken.
Ask your pharmacist if your pharmacy is offering this service and discuss how they would like you to handle such queries.
Training Handbook Set A Module 2
Pharmacy Technicians
From 26th June 2024, registered pharmacy technicians in England are able to supply and administer medicines under patient group directions (PGDs),following amendments made to the Human Medicines Regulations 2012.
Training Handbook Set B Module 2
Naproxen is a Non-Steroidal Anti Inflammatory (NSAID) medicine that can be used to treat painful periods and menstrual cramps only in women aged 15 to 50.
Training Handbook Set B Module 3
Codeine linctus used in the treatment of dry cough in adults and should not be used in children aged 12 years to 18 years of age with breathing difficulties. Codeine is an opioid medicine and is addictive. Evidence is limited that codeine linctus is effective in the treatment of short-term cough but may be effective in the treatment of long-term cough (lasting over 8 weeks). Codeine linctus will now only be available on prescription following assessment with a healthcare professional.
Training Handbook Set C Module 1
Fexofenadine – an antihistamine medicine that helps with the symptoms of allergies.
It’s used to treat:
- hay fever
- conjunctivitis (red, itchy eye)
- eczema
- hives (urticaria)
- reactions to insect bites and stings
- some food allergies
Fexofenadine is known as a non-drowsy antihistamine. It’s less likely to make you feel sleepy than some other antihistamines and can be recommended to adults and children aged 12 and over.
Training Handbook Set D Module 1
If menstrual bleeding is prolonged or heavy, a woman is said to be suffering from menorrhagia. In some women this condition can be so severe that it disrupts their day-today life.
There is often no known cause; however, conditions such as polyps, pelvic inflammatory disease or endometriosis can be causative factors – these conditions are usually also associated with irregular periods.
WHAT CAN BE USED TO TREAT HEAVY MENSTRUAL BLEEDING? Tranexamic acid is a drug known as an anti-fibrinolytic – this is available OTC and is used to control bleeding.
WHO IS IT SUITABLE FOR? Tranexamic acid is suitable for women who:
- Are between 18 and 45 years of age
- Have had a heavy menstrual flow over several cycles
- Have a regular cycle of 21 to 35 days (that does not vary by more than three days each month).
Women should be referred to the pharmacist if they:
- Are under 18 or over 45 years old
- Are pregnant
- Have irregular periods
- Have a kidney disease
- Have abnormal periods or spotting between periods
- Have bleeding after sexual intercourse
- Are taking any other medication (including the contraceptive pill and warfarin)
- Have a history of thrombosis (blood clots) or a family member who has suffered from
Activity: Have a look in your pharmacy and find an example of the brand containing tranexamic acid and look at the instructions.
Training Handbook Set E Module 1 Page 20-21
The Misuse of Drugs regulations were updated on the 31st of December to enable the prescribing of specified controlled drugs by certain non-medical prescribers, including podiatrists, paramedics, physiotherapists, radiographers, chiropodists and podiatrists. Speak with your supervisor about how and where you can check the non-medical prescriber’s qualification and what medication they are allowed to prescribe.
Training Handbook Set B Module 3 page 50
All products containing the cough suppressant pholcodine have been withdrawn due to concerns of its potential to cause a severe allergic reaction in some people having general anaesthesia for surgery.
Please check packaging and patient information leaflets to see if pholcodine is an active ingredient. Advise customers that coughs usually clear up in 3-4 weeks and offer another cough mixture.
Training Handbook Set C Module 1 Page 2,3:
Promethazine hydrochloride is a sedating antihistamine commonly used in hayfever and other allergies. It is available as tablets and as an elixir and is not for use in children under the age of 2 years. Use of Phenergan Elixir is recommended for children aged 2 – 5 years. Exercise caution when supplying the elixir due to common misuse, speak to your pharmacist if you are concerned.
Training Handbook Set D Module 1 Page 9
Gina (estradiol 10mcg tablets) is indicated for the treatment of vaginal atrophy (VA) due to oestrogen deficiency in postmenopausal women aged 50 and above who have not had a period for at least one year.
Gina is the only product available without a prescription that effectively treats the cause of postmenopausal vaginal dryness. It acts to relieve symptoms of VA including: vaginal dryness, itching, burning, soreness and discomfort during sex.
Training Handbook Set D Module 2 Page 17
Eroxon Stimgel is a GSL product which is clinically proven to provide an erection within 10 minutes. Eroxon contains no active ingredient and instead works by controlled evaporation which stimulates nerve endings on the glans penis, leading to increased blood flow and stronger erections. It is reported to have a rare incidence of adverse events and has no known drug interactions.
Training Handbook Set D Module 2 Page 17
Tadalafil has been reclassified as a P medicine and belongs to a class of medicines called phosphodiesterase type 5 (PDE5) inhibitors.
As a PDE5 inhibitor, tadalafil is considered as a first-line treatment for ED by the National Institute for Health and Care Excellence (NICE). It should be taken as needed at least 30 minutes before sexual activity and no more than one tablet should be taken per day. It is reported to stay effective for up to 36hrs. The product should not be sold to men with or at risk of severe cardiovascular disorders, severe kidney or liver failure, or men taking a medication that has the potential to interact with tadalafil.
Training Handbook Set D Module 3 Page 22-24
Nicorette Quickmist mouth spray is a way to help customers stop vaping nicotine. This NRT product can help to break the nicotine withdrawal cycle by allowing them to gradually reduce their daily intake of nicotine until they can stop completely.
Training handbook Set A
Module 1, Page 10:
Medical Devices are products or devices that are designed for medical use such as blood glucose monitors or certain moisturisers. They will have a CE mark on them.
Module 3, Page 32:
Revised text: An accuracy checking technician works as part of the pharmacy team and can be involved in any of the activities that contribute towards providing services to patients. They have a more specific and specialised role in completing a final accuracy check on dispensed medicines prior to supply to patients. They work alongside and under supervision from a pharmacist, and often support and supervise other members of the pharmacy team themselves. The responsibility for the clinical check of a prescription remains with the pharmacist.
Training handbook Set B
Module 1, Pages 2, 4, 7 & 14:
Naproxen is currently not available.
Module 1, Page 12:
Felbinac based products are currently not available.
Module 1, Page 13:
Mucopolysaccharide Polysulfate (MSP) can be used for the relief of muscular pain and stiffness, sprains and strains for not more than seven days in adults and children over 12 years old.
Module 2, Page 23:
New product: Ipratropium and xylometazoline use for adults over 18 years
Module 2, Page 23:
New product: Saline nasal drops and sprays for use in nasal congestion.
Module 2, Page 24:
Tyrothricin is no longer used in OTC products for sore throats.
Module 2, Page 24:
New pharmacy service: Some pharmacies offer the sore throat test and treat service where a swab is taken to from the throat to determine whether the sore throat is caused by streptococcal infection. The pharmacist may be able to supply a course of antibiotics under a Patient Group Direction (PGD).
Module 2, page 28
All products containing the cough suppressant pholcodine have been withdrawn due to concerns of its potential to cause a severe allergic reaction in some people having general anaesthesia for surgery. Please check packaging and patient information leaflets to see if pholcodine is an active ingredient. Advise customers that coughs usually clear up in 3-4 weeks and offer another cough mixture.
Module 3, Pages 34 & 42:
Penciclovir cream is currently not available.
Module 3, Page 39:
New Product: Hexetidine is an antibacterial and antifungal agent that can be found in a mouthwash and used to help to relieve mouth ulcers.
Module 4, Pages 48 & 50:
Ranitidine and pantoprazole products are currently not available.
Module 4, Page 55:
Additional text: Stimulant laxatives should only be tried after lifestyle, dietary changes or other types of laxatives have not been effective
Training handbook Set C
Module 4, Page 37:
Trichloroacetic acid is no longer available.
Module 6, Pages 67 & 68:
Malathion based products are currently not available.
Training handbook Set D
Module 1, Page 9:
Tranexamic acid tablets are currently not available OTC, customers can be referred to their GP as appropriate.
Module 2, Page 14:
Hormonal contraception: New products – Two branded progesterone-only pills containing desogestrel are now available as pharmacy only medicines to women who are suitable. Ask your pharmacist for further information on these products.
Module 2, Page 16:
Revised text: Chlamydia Testing and Treating Service with azithromycin is no longer available OTC. Some pharmacies provide home testing kits to detect chlamydia or STIs.
Module 2, Page 17:
Tamsulosin used in the treatment of Benign Prostatic Hyperplasia is currently not available.
Module 3, Page 23:
NRT tablets are currently unavailable.
Module 3, Page 25:
E-Cigarettes and vaping devices containing nicotine are available and some customers may wish to use these as an alternative to smoking.
Training handbook Set E
Module 2, Page 24:
Items for treating STIs are only free if endorsed by the prescriber with FS (free supply of sexual health treatment). Without the FS endorsement, the prescribed treatment is a chargeable item.
Module 2, Page 34:
Pharmacies should stock ‘Emergency steroid cards.’ These are issued by the prescriber initially, but pharmacists should supply replacements when needed or where they feel there is a need.
Module 4, Page 71:
The endorsing process of electronic prescriptions differs to that of paper prescriptions. For electronic prescriptions, the PMR system is used to send necessary notifications. Dispense notification (DN) messages can be submitted once a prescription has been electronically dispensed. Claim notification (CN) messages are the final claim message that include endorsement particulars and information on the charge status of the prescription. The most up to date information regarding prescription endorsement can be found on the Pharmaceutical Services Negotiating Committee (PSNC) website.
Module 4, Page 75:
Some prescriptions need to be divided by the red separators provided by NHS Prescription Services.
Module 4, Page 75:
Prescriptions for free supply of sexual health treatment that have been endorsed by the prescriber with ‘FS’ and signed.
Set A, Module 4, Page 77:
Question 6 can be discarded.
Set A, Module 1, Page 15:
Question 3 can be discarded.
Set C, Module 3, Page 27:
Both B and C can be considered correct.
Set C, Module 5, Page 59:
Question 8 – No answer listed in Pharmacist Guide.
Set D, Module 2, Page 19:
Question 3 – Pharmacist Guide answer is incorrect.
Set E, Module 2, Page 33:
Quantity is incorrect – should be 4/52
Set E, Module 4, Page 79:
Question 1 can be discarded
Set E, Module 4, Page 79:
Question 6 can be discarded
Pharmacist’s Guide:
Incorrect amount of time for Set E assessment. Should be 45 mins.