As the NHS moves from a pandemic to an endemic response to COVID-19 infections, ICBs will be at the forefront of providing timely access to COVID-19 treatments to their local populations. Access to COVID-19 treatments will become part of routine services, with the preferred route of access through primary care and integrated urgent care.
ICBs are expected to support access to existing COVID-19 treatments, as well as new treatments as they become available.
It is vital that COVID-19 treatments are supplied, stored, prescribed, dispensed and taken correctly, and that systems are in place to ensure that the right patient receives the right dose of the right product at the right time.
Our pages will help you work to the principles below. Further information can be found on our article on Managing risk when supplying and administering COVID-19 treatments across the system.
To follow the principles for COVID-19 treatment deployment you should consider these implementation points.
Care pathways identified
It is expected that care pathways define the patient journey and describe roles and responsibilities. Eligible patients should have been pre-notified of their potential eligibility due to being extremely high risk. Eligible patient cohorts are listed here; prescribers are responsible for checking patient eligibility before prescribing.
Systems should use their normal pharmacy services for receiving a prescription for dispensing. Pharmacy services must be available every day including weekends and bank holidays. A legal mechanism for prescribing (via paper or using an existing electronic prescribing system) must be agreed with the Chief Pharmacist who is providing oversight to the system.
There is no need to confirm that the patient is COVID-positive or meet the criteria as part of the clinical check. It is the prescriber’s responsibility to confirm that the patient meets the criteria.
Pharmacies have developed mechanisms throughout the COVID-19 period to allow patients to collect their medicines. These must be described in SOPs and take into account the requirements for COVID-19 treatments to be started promptly. They must be available every day including weekends and bank holidays to ensure patients do not miss the treatment window specified. Options should include collection by a non-household member or by courier.
Pharmacies with established arrangements for the transport of medicines to patient homes should utilise those. Delivery services must be available every day including weekends and bank holidays to ensure patients do not miss the treatment window specified.
In the absence of a validated courier process, ICBs could be required to put in place systems for delivery that might include options for using a courier, delivery service, homecare provider or taxi.
Consideration should be given to appropriate security and reliability of the transport method used in addition to any packaging requirements for transport.
ICBs might need to consider additional processes with their logistics provider with regards to the safe and secure transfer of medicines directly to patients.
All incidents should be notified to the designated clinical lead and reported using local governance processes.
Report and suspected adverse reactions via the Coronavirus Yellow Card Reporting site.
Advice for systems
- Updated in line with commissioning framework to provide access to COVID-19 treatments in the community. Editorial changes throughout & links updated - NHSE commissioning framework and NICE TAG Sections on prescribers, patient registration, overlabelled packs and transfer for collection removed.
- Links updated - NHSE commissioning and clinical policy & NHSE SOP Section on electronic prescribing removed Minor editorial changes to section on overlabelled packs, Addition of wording regarding expiry date extension
- Summary text amended.
- Clinical advice on Molnupiravir moved individual article. Points about data and learning given headings and made clearer.
- Editorial changes. Checklist removed. Minor changes and additions to implementation advice, including change for overlabelled packs to remain on electronic stock holding systems.
- Section on breastfeeding added.
- Addition of information leaflet and PIL within dispensing section. Links added and amended.
- Links added and amended. Minor editorial amendments.
- Italicisation removed from text on pregnancy and heading added to improve readability. Link to SmPC added. Links checked and tidied. Some other minor editorial amendments.
- Reference to availability of guidance on use in people with swallowing difficulties added