Local Support and Interpretation of Guidance Covid-19 – as of 20 March 2020


Practical Advice on how to deal with the current crisis

We are very aware that the information coming out of national organisations is constantly changing and front-line staff will struggle to know how to apply it.

The sections below will help you to find the key guidance and interpret it for your business. This section will be constantly updated as new guidance is issued.

Protecting the Pharmacy Team

Pharmacy Entry Point Signs

Please make sure you have the PHE Covornavirus poster displayed at all entry points to your pharmacy.

In the warmer months you may want to use an external display sign with the above poster in it and keep the door to your pharmacy open to allow fresh air to circulate. This will also help avoid the public making contact with the door handle on entry and exit.

Please refrain where possible from using vented heating and air-conditioning which could circulate the virus further within the building.

Hand washing

Follow NHS How to wash your hands guidelines, which should be carried out for 20 seconds.

Increase the frequency that all staff do so, for example you may wish to set a phone or computer alarm to remind you on an hourly basis.  As the pandemic continues you may find it hard to remember to do this vital step.

Consider placing hand sanitiser if available at entry points for customer use or before signing for their script.

Cleaning arrangements

Increase cleaning of touching points such as door handles, counter tops, and shelving – particularly at shoulder and head height where contact is made most and where sneezes or coughs may land.

Remove large quantities of stock items from shelving to allow for swift cleaning.

Maintain social distancing

2 metres between patients where practicable (consider ‘staff at risk’ for example those that may be asthmatic, or consider limiting the number of people entering at the premises at any one time). Consider using barriers or screens in front of the counter, if available or use tape to mark distances on the floor.

PPE

PPE should only be used if you have a suspected case in your isolation area or if you have had to come into close contact with that individual. It should also be worn during decontamination. Guidance on how to wear and remove PPE has been given. Please follow environmental cleaning guidance given and see section 4. Post-transfer actions in the Community Pharmacy SOP.

Vulnerable people – at risk staff

For a full list of people who are deemed to be at risk of getting severe symptoms from the Coronavirus please click here

It is your responsibility to assess the risk to your staff and take appropriate decisions to protect them (multiple pharmacies will be given HR support by their Head Office. If this means that staff have to self-isolate and you can no longer operate your pharmacy safely for your contracted hours, please follow the information below on reducing your hours or closing your pharmacy.

School places for children of key workers

The government has announced that all front-line healthcare staff who are unable to get their children looked after at home will have access to school places. Guidance states the following:

  1. If it is at all possible for children to be at home, then they should be.
  2. If a child needs specialist support, is vulnerable or has a parent who is a critical worker, then educational provision will be available for them.
  3. Parents should not rely for childcare upon those who are advised to be in the stringent social distancing category such as grandparents, friends, or family members with underlying conditions.
  4. Parents should also do everything they can to ensure children are not mixing socially in a way which can continue to spread the virus. They should observe the same social distancing principles as adults.
  5. Residential special schools, boarding schools and special settings continue to care for children wherever possible.

If your work is critical to the COVID-19 response, or you work in one of the critical sectors, and you cannot keep your child safe at home then your children will be prioritised for education provision. This includes pharmacy staff. Please click here for PSNC guidance on what to do in your pharmacy.

Reducing your hours or closing your pharmacy

It is increasingly likely that we may see unplanned or even planned closures of pharmacies for a range of periods in the coming days and weeks. Clearly this should and will be as a last resort.

We would remind you of the contractual requirement to notify NHSE&I of any closures or reduction in opening hours immediately. As well as this being a  contractual requirement, this is needed to facilitate the mapping of the impact of the COVID-19 situation and the wider coordination of support.

The relevant forms for notification can be found here: https://www.england.nhs.uk/commissioning/primary-care/pharmacy/app-forms/

This should be emailed to: england.pharmacyeast@nhs.net For planned closures, you should make every attempt to discuss the situation with NHSE&I in advance, emailing them at the above address and requesting a call. However, if you have made the necessary notification and you need to close the pharmacy to maintain staff or customer safety, this is a professional decision and the LPC will support you.

Your LPC has discussed the need for pragmatism from all parties in these discussions, fully understanding the unprecedented challenges our pharmacies are facing, and the magnificent job you are all doing.

Changes in professional guidance for registered staff

Professional Judgement
These are unprecedented times, and all Pharmacists will have to make many professional decisions about the most appropriate course of action to take in many scenarios. Your LPC is having continual discussions with all system partners to ensure they understand the pressures and difficulties you face, and that we expect and demand that you receive backing for your actions from commissioners.

Communication is key, so please ensure you keep local surgeries and NHS England informed of significant issues, including any suspension of normal services or regarding contractual matters via england.pharmacyeast@nhs.net

If you have a query in regards to Covid-19 please send an email to;  england.eastofengland-covid19@nhs.net

General Pharmaceutical Council

Please Read-Statement issued to registered staff about using professional judgement in staff and patients’ best interest. Including options such as access to a pharmacist by phone or video link for short durations to allow continuity where all other options have been exhausted. Main point- completed prescriptions could be given out to patients in the absence of the responsible pharmacist for short periods.

Funding and new services

As part of the national response to COVID-19, HM Government is seeking to commission two further services from the community pharmacy sector:

  • An NHS Urgent Medicines Supply Service: This would be a service for patients whose GP practice is closed, allowing them to continue receiving their medicines without a prescription. The service will be switched on locally as needed – this has already happened in some locations.
  • A Medicines Delivery Service: This would support vulnerable patients self-isolating at home. Details and funding are under negotiation.

Further information about the commissioning of these services is due shortly

Waveney Pharmacies
With provisions being made nationally and locally for the increase and spread of the Coronavirus we just wanted to highlight the locally commissioned Funded Emergency Supply Service. If for any reason there is a disruption to the services from the GP practice it is important for pharmacies in Waveney to remember to use this service to limit the disruption to patients in obtaining prescription medicines.

For full details on the Local Funded Emergency Supply Service click here.

Shortages reporting and re-imbursement

Reporting medicine shortages

PSNC is aware that there are an an increasing number of shortages in the system and that prices are fluctuating significantly from Drug Tariff listings. They are flagging these issues daily and are in urgent talks with DOHSC about how they can protect contractors from the affects of these changes and we hope to have more information soon.

In the meantime, please report shortages to PSNC via this link

Please also restrict quantities of hand soap, hand sanitisers and over the counter medicines such as paracetamol to prevent individuals stockpiling. These measures are also being implemented in supermarkets.

Prescribing intervals 

NHSE, LMCs, LPCs and CCGs are strongly supporting Primary Care guidance which states that prescribing intervals should not be increased during this crisis to protect the supply chain. GPs are being asked to put all eligible patients onto eRD Please let the LPC know of GPs are not sticking to this guidance using amit.patel22@nhs.net