Personal protective equipment, staff safety and security
Personal protective equipment, staff safety and security
This page provides information on the use of personal protective equipment (PPE) to protect workers during the COVID-19 pandemic. It also includes information on wider measures that can be used to protect staff and guidance on the personal safety of pharmacy staff.
If you are looking for information on testing for pharmacy staff or support tools to assist with staff health and wellbeing, please visit our Staff wellbeing and COVID-19 testing page.
Use of PPE in community pharmacies
Public Health England’s (PHE) updated guidance on the use of personal protective equipment (PPE), published on 2nd April 2020, recommends the use of fluid-resistant surgical masks (FRSM) in pharmacies when working in an area with possible or confirmed cases and where pharmacy teams are unable to maintain 2 metres social distance from patients.
The guidance for community pharmacy staff is summarised in Table 3 of the guidance – Recommended PPE for ambulance, paramedics, first responders and pharmacists.
The updated guidance reflects the fact that coronavirus is now widespread in the community, meaning clinicians are more likely to see patients with the virus, some of whom may have minimal or no symptoms. Despite advice to patients with COVID-19 symptoms that they should stay away from pharmacies, some people are not following that guidance and pharmacy team members are potentially being exposed to possible or confirmed cases.
The PHE guidance does not recommend use of FRSM where staff do not have contact with patients, e.g. staff working solely in the dispensary. However, we recognise that in most pharmacies, staff cannot confine their work to a single area of the premises, which is either patient-facing or with no direct dealings with patients. It is therefore likely that many pharmacy contractors and their teams will decide that staff working in multiple locations throughout the pharmacy premises may need to wear FRSM.
It is important to note that while pharmacy staff may now choose to wear FRSM in line with the revised guidance, it is imperative that social distancing and self-isolation (where appropriate) continue to be practised and hygiene measures, such as regular hand washing, continue to be followed.
Use of protective screens is also an important measure to consider, if these have not already been installed; a full height screen will provide protection to staff and in most circumstances this will remove the need for them to use FRSM.
Supplies of PPE to community pharmacies
Following discussion with PSNC, DHSC and NHSE&I worked with Public Health England (PHE) to send free of charge packs of PPE to pharmacies in mid-March; the packs contained 50 masks, 200 aprons and 100 pairs of gloves.
Following the publication of updated guidance on use of PPE, PSNC is pressing DHSC and NHSE&I to ensure that pharmacy teams have access to the PPE they need from the PHE stockpile. We will also work to ensure that where contractors have to purchase PPE, the costs incurred are captured, so these can be used in negotiations for additional funding related to the pandemic.
Additional quantities of FRSM, from the PHE stockpile, were delivered to AAH, Alliance Healthcare and Phoenix Healthcare on Thursday 9th April 2020. This stock was to be sold to pharmacy contractors for staff use (the stock must not be sold on to members of the public).
PPE obtained directly or indirectly (via wholesalers) from the national stockpile should only be used by pharmacy staff; it is not for resale to the public.
NHSE&I have published a new webpage on PPE supply, which included the following information on 16th April 2020:
Information for primary care, hospices, social care and home care providers
There are a range of options available to primary care, hospices and home care providers to get of PPE equipment.
A new online ordering site is being developed and will enable primary care, community care and social care providers to register their PPE requirements more easily. The site will be rolled out so that these providers can request critical PPE from a central inventory. Further details will be released on how to register directly to providers as part of a phased approach. Orders will be managed in line with the published guidance from Public Health England and shipped directly via Royal Mail.
Accessing urgent supplies
Any organisation running critically short of PPE, and has exhausted other supply routes, can phone the National Supply Distribution Response (NSDR) on 0800 915 9964 for an urgent delivery.
Expiry dates of PHE provided PPE
PHE have confirmed that the expiry date on some PPE has been extended after they and NHS Supply Chain worked with manufacturers and independent testing houses to formally test certain products using accelerated age testing, to see if it was possible to extend their life. The products that passed these tests were subject to relabelling with a new shelf-life as appropriate and can continue to be used. All products that are not up to standard within the PHE stockpile will be destroyed.
The NHS’s stockpiled PPE is checked as part of the stock management process operated through the NHS Supply Chain. This means rotating stock to make sure that items which have been there the longest are issued first.
Some products may appear to have out-of-date ‘use by/expiration’ dates or have relabelled ‘use by/expiration’ dates. Please be assured products being issued have passed stringent tests that demonstrate they are safe. The PPE is exposed to extreme conditions for prolonged periods, to see how the product deteriorates. All that are not up to standard are destroyed and not distributed to trusts.
We have been working with independent test facilities and the Health and Safety Executive (HSE) who, after being provided with scientific evidence, were content with our assessment that these are safe to use by NHS staff.
Source: Guidance on supply and use of Personal Protective Equipment (PPE) (20th March 2020, NHSE&I)
NHSE&I/PHE updates on PPE
Installing protective screens in pharmacies
Social distancing, alongside installation of bollards/tapes, physical barriers or screens is considered to be the most effective way of protecting pharmacy staff. PSNC recommends that contractors do install screens on medicines counters, wherever this is possible.
To support the installation of such barriers, NHSE&I is making a £300 payment to all pharmacies, except distance-selling pharmacies. The payment will be made automatically to all contractors (bar distance selling pharmacies and those that have agreed with NHSE&I to close for longer than 2 weeks) and it is expected to be paid by the NHSBSA in the payment which will be made on 1st May 2020.
PSNC had been pressing NHSE&I to recognise the costs of installing protective barriers for pharmacy staff in the additional funding we are seeking for contractors to help them cope with the COVID-19 pandemic. Some contractors are reporting high prices for protective screens, but many have been able to source these at reasonable prices and sometimes on a cost-only basis from suppliers looking to support the NHS through the pandemic.
Social Distancing and Infection Control Risk Review Template
All pharmacies have already put in place arrangements to support social distancing and to reduce the risk of spread of infections, but as the progress of the pandemic continues, it is clear that we will all need to maintain social distancing and COVID-19 related infection control processes for many months to come.
As the pandemic continues and we all get used to living and working in a “new normal” situation, people’s consciousness of the need to maintain social distances at all times may reduce and consequently new or additional measures at each pharmacy may need to be taken to ensure distancing is maintained on an ongoing basis.
PSNC has published a risk assessment template will help pharmacy teams to identify further potential changes which could be made to their pharmacy environment or procedures during the pandemic to increase the safety of staff and patients.
Individual staff risk assessments
NHS England and NHS Improvement (NHSE&I) are requesting that all NHS providers, including community pharmacy contractors, complete individual risk assessments for at least staff in at-risk groups (including Black, Asian and Minority Ethnic (BAME) staff) by 24th July 2020.
A letter from NHSE&I outlines the responsibilities of employers as well as the support available to help them. It refers to the following resources which may assist contractors:
- A risk reduction framework published by the Faculty of Occupational Medicine;
- Updated guidance from NHS Employers; and
- Practical tools and case studies on the NHSE&I website.
The letter also contains an annex highlighting examples of good practice.
Also, the Royal Pharmaceutical Society (RPS) and the UK Black Pharmacists Association (UKBPA) have published the results of a survey which found that more than two-thirds of BAME pharmacists and preregistration pharmacists have not yet had COVID-19 risk assessments.
PSNC is concerned about the higher COVID-19 risks identified for BAME individuals, particularly those who work in the healthcare sector, and we support the need for these risk assessments, particularly for those people who are in more vulnerable groups.
Facemasks and face coverings
Since the start of the outbreak, community pharmacy contractors have been taking steps to ensure their pharmacies are COVID-secure for patients, the public and staff, and have been adopting a variety of measures including, as appropriate, the use of facemasks.
There is clear advice for pharmacy staff to wear a Type IIR facemask for patient interactions – see here – but the advice for staff to staff interactions is less clear. The official Public Health England (PHE) advice is for pharmacy staff to follow advice for ‘shops and branches’ and other retail outlets. However, the use of facemasks in pharmacy is complicated by the way in which pharmacy staff routinely move from patient interactions (a patient facing role) on the medicines counter to non-patient interactions, working in the dispensary. In such cases it may be important for sessional use of Type IIR facemasks to be used by these staff.
Last week in a letter to primary care contractors, NHS England and NHS Improvement (NHSE&I) referenced new guidance for the hospital sector and indicated that new primary care guidance would be issued. Until such guidance is issued, community pharmacy contractors are asked to consider whether to follow the guidance issued to hospital staff in non-clinical situations, as well as the advice for visitors to wear face coverings, as follows:
|Staff interactions with patients||Working in an area with possible or confirmed case(s) and unable to maintain 2 metres social distance should wear a surgical facemask – fluid resistant (Type IIR) surgical facemask – for sessional use. One session could be a half day period of time on the medicines counter.||
Sessional use of facemasks (Type IIR) – personal protective equipment (PPE)
|Staff to staff working (e.g. staff working in the dispensary)||In all settings that are unable to be delivered as COVID-secure, all staff (both in clinical and non-clinical roles), when not otherwise required to use personal protective equipment (PPE), should wear a facemask; worn to prevent the spread of infection from the wearer*||
*The recommendation is for a Type I or Type II facemask worn to prevent the spread of infection from the wearer. If Type IIR facemasks are more readily available, and there are no local supply issues for their use as personal protective equipment, then these can be used as an alternative to Type I or Type II masks.
|Patient/public in the pharmacy||Patients and the public should be encouraged to wear a form of face covering, to prevent the spread of infection from the wearer.||
Visors also offer protection against COVID-19 infection or transmission.
The use of facemasks is part of an assessment by contractors to ensure pharmacies are COVID-secure for patients, the public and staff, which is important for their safety and as part of a contractor’s health and safety and Terms of Service responsibilities. Other measures include, as appropriate, but are not limited to, handwashing, physical screens, revised working practices, split teams, and any revised lunch and break arrangements; assessments for individual staff members are also important.
Guidance on handling medicines returned for disposal
The National Pharmacy Association, PSNC, Royal Pharmaceutical Society and the Community Pharmacy Patient Safety Group have jointly issued guidance for pharmacy teams on handling medicines returned for disposal during the pandemic:
Security and personal safety
During the current outbreak, there have been reports of security incidents at community pharmacies, including a very few where those attending a pharmacy have been abusive to staff. Therefore, while you may be tempted to try – for very short periods – to operate community pharmacies with a pharmacist alone due to staff having to leave unexpectedly, PSNC would urge you not to do so and to always ensure there is a minimum of two pharmacy staff the premises at all times.
Contractors are also reminded that as supermarkets and others increasingly prioritise NHS staff over other customers, NHS or other forms of identification can become targets for theft and should be kept safe and not on display.
PSNC and the other national pharmacy bodies have had discussions with senior police representatives regarding the safety of community pharmacy teams and premises during the pandemic. The National Police Chiefs’ Council has issued the following guidance for community pharmacy teams:
LPCs may also be able to raise any security concerns with local police forces and the Police and Crime Commissioner.