A switch by Royal Mail from using Inverness Airport to Glasgow Airport for mail plane deliveries to the Western Isles, has created a “significant challenge” for NHS Western Isles (NHSWI) in ensuring the continued timely delivery of short-life chemotherapy medicines for use in the islands.
In June, Royal Mail is set to change the processing of mail bound for the islands from its Inverness mail centre to its counterpart in Glasgow, as part of its plan, the company has confirmed, to reduce UK wide reliance on air transportation for letters and parcels and with a move for “more mail to be delivered via road and rail.”
This week, NHSWI confirmed that it has a senior staff team working to find a “safe and robust solution,” to the problem, which concerns intravenous, or ‘parenteral’, chemotherapies.
In a statement, NHSWI said that all chemotherapy requires consultant prescription via the ‘Chemocare’ system, which supports the governance, safety and legal requirements linked to chemotherapy, and confirmed that it mainly functions as part of an NHS Highland chemotherapy network.
A spokesperson for NHSWI said: “NHS Western Isles strives to obtain chemotherapy medicines from the Pharma pharmaceutical group, as these preparations will tend to have a longer shelf life.
“Unfortunately certain chemotherapy medicines have a short shelf life, including under 24 hours from when the medicine is prepared.
“NHS Highland prepares our chemotherapy products, as it does for Caithness and the Belford hospitals and Raigmore itself.
“Currently these medicines are delivered by the mail plane from Inverness, supporting the delivery of chemotherapy on a Tuesday at Western Isles Hospital.
“With the mail plane moving to Glasgow, this presents a significant challenge to NHS Western Isles in the timely delivery of chemotherapy medicines.
“Due to the issues surrounding Chemocare,” NHSWI’s spokesperson added, “the fact that all aseptic pharmacy services in Scotland are working at capacity the option of medicines being prepared elsewhere is not possible.”
Options currently being considered by NHSWI to address the problem include using commercial flights and the ferry, their spokesperson has confirmed, but, warned, these options will require, “scrutiny of safety and cold chain compliance,” and will be need to comply with legal requirements for transporting cytotoxic drugs.
The Health Board has also warned that the proposed change in the delivery time will also require a review of its working practices, including staff rotas.
NHSWI has other chemotherapy/cancer service arrangements with the Beatson Oncology Centre in Glasgow for certain cancers and patients, but has also warned that additional challenges exist “in terms of a national shortage of Consultant Oncologists and the associated recruitment challenges that that presents for our partners in the larger mainland Boards.”
In a statement, Royal Mail said that the change in delivery routes follows commitments set out in the ‘Business Recovery, Transformation and Growth’ agreement it signed with trade unions last summer, and said:
“The change will ensure that we maintain or, in cases, improve connectivity and service provision to the islands. The ongoing, timely nature of deliveries, are being treated with the utmost importance.”
Cllr Uisdean Robertson, Chair of Comhairle nan Eilean Siar’s Transport and Infrastructure Committee, said:
“Changes to service such as this should not be taken without early consultation with key local stakeholders. Comhairle nan Eilean Siar is aware of the impact this decision will have on NHS Western Isles and has raised the issue with Transport Scotland Aviation and the Cabinet Secretary for Transport.”
A Scottish Government spokesperson confirmed that the government are aware of the issue and were in contact with the NHSWI to discuss possible ways forward, adding the Chief Pharmaceutical Officer had been in touch with the Chief Pharmacist on the Western Isles and they were, “actively exploring alternative options for accessing these medicines.”
The Scottish Government also stated: “Royal Mail is a private company, with no requirement to consult with the Scottish Government on changes to its delivery routes.”
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