Flexible opening hours during the COVID-19 outbreak
Flexible opening hours during the COVID-19 outbreak
April 14, 2020
The workload and other pressures on community pharmacy have increased during the outbreak, and for remaining pharmacy staff to stay well and not be fatigued, contractors may need to consider steps to temporarily shorten the working day or have periods of time for staff to recover and catch up with any backlog of work. The same steps may be needed for a period of time, even if the pharmacy team is not reduced in numbers.
NHS England and NHS Improvement (NHSE&I) have already agreed that contractors may make use of opening hours flexibility, as set out in the Community Pharmacy SOP (see below). In addition, the Department of Health and Social Care (DHSC) has recently confirmed that contractors may use relevant provisions in the terms of service on temporary opening hours and closures during an emergency requiring flexible opening hours (primarily paragraph 27 of schedule 4 of the NHS Regulations), which permit contractors to give 24 hours’ notice to NHSE&I of additional or alternative flexible opening days and hours and, if NHSE&I agrees, or at least if it does not object, to provide those flexible opening hours.
Opening hours flexibility (closed-door working) already granted by NHSE&I
NHSE&I has already granted some flexibility in the hours that pharmacies need to open to the public, specifically:
- If under significant pressure, at the discretion of the responsible pharmacist, pharmacies may close their doors to the public for up to 2.5 hours a day, including lunch.
- All pharmacies will be expected, to be open to the public between 10am and 12 noon and 2pm and 4pm (on every day they have contracted opening hours) and any working behind closed doors should be outside of these hours.
- Similarly, 100 hours pharmacies should be open from 10am -12pm and 2pm-6pm (if these are contracted hours) and any working behind closed doors should be outside of these hours.
- A sign on the door must give information about how to contact the pharmacy if urgent help is needed (NHSE&I has provided a poster, available from the NHS resources folder in the PHE Campaign Resources Centre).
No notification to NHSE&I is required for opening hours flexibility (closed-door working), which is not a temporary closure, and contractors must update their NHS 111 Directory of Services (DoS) entry and NHS website profile as appropriate.
Opening hours flexibility initiated by contractors – now confirmed by DHSC
The flexible provision of pharmacy services may assist contractors as the outbreak continues, if opening hours at one or more pharmacies need to be adjusted to match the staff and resources available. This provision permits contractors to manage the pharmacies across their own network, if NHSE&I agrees with the contractor’s proposal.
Contractors must apply to NHSE&I for the temporary flexible provision of pharmacy services – for temporary changes to the days or times the pharmacy will be open, or a temporary closure of the pharmacy – and to do so, should give:
- 24-hours’ notice of the proposed change or closure to NHSE&I and;
- the reasons for the request.
NHSE&I will only agree with a contractor’s request if it consider the reasons are adequate.
Having given 24-hours’ notice, the contractor does not need NHSE&I’s permission in advance of the change, or closure, so, if NHSE&I does not object to the request, it can be implemented. If, subsequently, NHSE&I does not approve the request, the pharmacy must go back to its original opening hours.
If NHSE&I grant the request, the contractor may revert to the original hours by giving NHSE&I 24-hours’ notice.
What is NHSE&I likely to accept?
What flexible provision of pharmacy services – flexible opening hours – NHSE&I is likely to accept is apparent in its recent decisions around Easter bank holiday openings, for example:
- closure of a pharmacy in an area where there is minimal demand due to the Government’s social distancing policy (e.g. large shopping malls);
- pharmacies co-located with GP practice hot sites, dealing with COVID-19 patients, where patient access to the pharmacy is affected;
- closure of a pharmacy unable to open for reasons beyond the control of the contractor.
To ensure patient and public safety, as well as the safety and welfare of the pharmacy team(s), contractors may have to consider which days and times they can provide pharmacy services – can open one or more pharmacies – from which they provide NHS pharmacy services.
Primary Care Commissioning (PCC) has drafted a form to use for applications to NHSE&I, and contractors are encouraged to use this form and send it to their NHSE&I regional office. A link to the form will be provided as soon as it is available.
Note: If contractors need to close a pharmacy immediately, because they are prevented from providing pharmacy services due to staff illness or other reasonable cause, they may still do so (and without seeking NHSE&I consent) under other provisions in the regulations. Relevant advice is here.
Contractors are reminded that they must update their DoS and NHS website entries, as appropriate, to show any revised opening hours or closures.