The post-December 31 Brexit landscape presents a number of challenges for Britain's community pharmacy network, executive director at Day Lewis Pharmacy executive director Jay Patel has said. 

Speaking at the Association of Independent Multiple Pharmacies' virtual conference yesterday (Thursday December 10), Mr Patel set out five key areas of focus pharmacists should consider as we go into 2021:

• Continuity of medicines supply: Despite the UK's resilient supply chain, there are likely to be some problems owing to the new customs and border changes. "We are told that medicines have been given a priority for transportation into the UK, and we hope that happens," he said. 
• Purchase prices: "We are expecting an increase in pricing, unfortunately," Mr Patel said. "The key driver will be uncertainty with the deal resulting in the pound being depressed, making imports more expensive. Without a Brexit announcement if the pound continues to slide, that could cause a further import in import prices. We saw that in 2016. The additional costs of transportation are also going to be passed on; we need to make sure that those costs are captured appropriately, and are attributed to Brexit and not the sector, and they follow their way through to reimbursement."
• Arrangements for licensing and the regulation of medicines: "The MHRA have said that FMD will cease to apply in the UK (except for Northern Ireland). They are considering setting up a UK version of FMD; the opportunity for us here would be to reshape the FMD process to the nuances of UK dispensing processes," he said. "We are told that parallel imports will continue to be accepted, which is good, however with the currency against us there could be less of a driver to use them."
• Patient and prescriber demand in respect of medicine shortages: "We have had the introduction of serious shortage protocols (SSPs); in advance of Brexit we need to familiarise ourselves with that process flows and the endorsement instructions in order to get paid. I'm confident our pharmacists do what they can to ensure patients get the right medicines, but it needs to be translated into how we get paid. We're looking at writing SOPs to support our pharmacists in following the process," he said. "With regards to period of treatment, we've seen a rise in 84-day prescribing during Covid; it almost crippled the supply chain when it happened in March. Approaches to correct this include electronic repeat dispensing (eRD), and Brexit is a key driver to encourage GPs to go back to 28-day instalments to ensure everybody gets their medicines."
• People: "EU citizens need to be living in the UK by the 31st of December in order to apply for the EU Resettlement Scheme, and the deadline to apply for the Scheme has been extended to the end of June 2021. You'll need to be aware of the new points-based immigration system. It's likely only pharmacists will be eligible; we as employers will need to be approved as a sponsor." Mr Patel suggested an extension of the scheme to pharmacy technicians ought to be looked at, as they would be in increasingly short supply.