NHS Test and Trace: December 2020 update
NHS Test and Trace: December 2020 update
December 4, 2020
PSNC has today issued an update on the application of the NHS Test and Trace service to community pharmacies.
In early October, PSNC, the Association of Independent Multiples (AIM), the Company Chemists’ Association (CCA), and the National Pharmacy Association (NPA) wrote a letter to raise concerns about the impact of Test and Trace on the sector with the Pharmacy Minister.
Whilst we had hoped for sector specific advice on this issue, this has not been forthcoming. PSNC has therefore decided it would be pragmatic to release the Government’s response to our letter and recommends that pharmacy contractors and their teams follow the official documents for the healthcare sector referred to within it.
Letter from the Minister
Jo Churchill MP, Parliamentary Under Secretary of State for Prevention, Public Health and Primary Care, responded to the community pharmacy sector’s letter on 19th November. A copy of her letter can be viewed here.
The Minister confirms that:
- Government understands the impact that Test and Trace is having on community pharmacy;
- Pharmacy staff are eligible for priority coronavirus testing;
- If a member of staff tests positive outside of work, they must follow the self-isolation guidance;
- Maintaining a COVID-19 secure environment in the pharmacy is important;
- Clinical duties: If pharmacy staff follow the Infection Prevention and Control (IPC) guidance and specifically the new recommendations for primary and community health care providers (including maintaining social distancing, working behind screens, regular handwashing and wearing appropriate PPE and if a contact occurs in the course of clinical duties), they would not be considered to be exposed to infection and would not be asked to self-isolate; and
- Non-clinical duties in the pharmacy, e.g. the dispensary: Guidance on the management of staff and healthcare settings indicates that the effectiveness of the use of face masks, face coverings, or other PPE for prevention of transmission or acquisition of coronavirus infection cannot be guaranteed in settings other than the provision of direct care with patients or residents. Therefore, the use of PPE in other settings (such as a staff room or canteen) will not necessarily exclude an individual from being considered a close contact. In addition, if health and social care staff have been in contact with a COVID-19 case and are not following appropriate IPC, including wearing correct PPE, they will be considered as a contact for the purposes of contact tracing and isolation.
The letter also reiterates advice in NHS England and NHS Improvement’s (NHSE&I) COVID-19 SOP for community pharmacy. Advice can also be found in PSNC Briefing 022/20: NHS Test and Trace – Key points for contractors as Q&As.
In mid-November during an NHSE&I webinar, Public Health England (PHE) made clear that in cases where continuity of service may be interrupted, the Local Health Protection Team should be involved directly and asked to assess whether there are contacts that mean staff members should self-isolate. This is also the advice in the NHSE&I COVID-19 SOP for community pharmacy.
PHE also indicated that it:
- Recognises the vital role played by community pharmacy and that continuity of service is important;
- Must balance the risks of transmission between requests for self-isolation and allowing an essential service to continue; and
- Contact in clinical settings where pharmacy staff are following NHSE&I advice on wearing of PPE will mean there is no close contact and staff will not be asked to self-isolate if in contact with a person who is coronavirus positive;
Note: Generally, this is Type IIR face masks (NHSE&I guidance) but on occasions gloves and an apron, for example with closer contact with patient too unwell to be sent home (the NHSE&I SOP).
- Where significant contact occurs in non-clinical settings (for example with staff in the dispensary) but there has been significant mitigating steps taken to reduce transmission of coronavirus, a local assessment should be carried out to consider if the risks are great enough to mean self-isolation. There was an indication that PHE would have a fair and equitable approach and work with contractors to arrive at the appropriate answer.
Local Health Protection standard letters
Some Local Health Protection Teams have been issuing standard letters to contractors where a staff member has tested positive for coronavirus, inviting the contractor to make the assessment of any close contacts between that staff member and others. Contractors can then consider the steps they have taken to implement COVID-19 secure practices when considering whether other staff members should self-isolate for the relevant period, following the advice in the standard letter. Additional advice may need to be sought from the Local Health Protection Team.