NHS Test and Trace: Update for community pharmacy
NHS Test and Trace: Update for community pharmacy
June 3, 2020
This guidance has ow been updated – see PSNC Briefing 022/20: NHS Test and Trace – Key points for contractors as Q&As for the latest information.
Since then, we know that a number of pharmacy teams across England have already been asked to self-isolate in accordance with the service. This has emphasised the need for contractors to consider the implications of the Test and Trace Service and the mitigations in the pharmacy which may avoid the need for whole pharmacy teams to self-isolate if one member tests positive for COVID-19.
Further information on the NHS Test and Trace Service for pharmacies, including some initial advice on patient and staff contacts, is set out below.
Guidance for pharmacies
PSNC is continuing to urgently seek guidance from the Department of Health and Social Care (DHSC) on whether the Government advice on the management of staff and exposed patients or residents in health and social care settings applies to community pharmacy and on whether pharmacy team members asked to self-isolate for 14 days with no symptoms will be eligible for a coronavirus test – so that if they test negative, they could return to work earlier.
Alongside seeking these clarifications, PSNC will also be having urgent discussions with DHSC about financial support for pharmacies that have to close temporarily if the whole pharmacy team has had to self-isolate.
PSNC Director of Operations Gordon Hockey said:
“The potential implications of the NHS Test and Trace Service for pharmacies are significant, and we are working with DHSC and NHS officials pressing for urgent clarity on these matters. As soon as we have answers we will share them with LPCs and contractors.”
Information for pharmacies on the NHS Test and Trace Service
The NHS Test and Trace Service is about breaking transmission chains, so the virus has less chance to spread as Government eases the lockdown restrictions. Key information on the Service applied to community pharmacy and relevant mitigations in the pharmacy include:
1. Close contacts
Anybody who tests positive for COVID-19 will be contacted by NHS Test and Trace and will need to share information about their recent contacts. The new HM Government guidance means those who have been in recent close contact with someone who tests positive must isolate for 14 days, even if they have no symptoms.
A close contact broadly means spending 15 minutes or more within 2 metres of an infected person, or a very close specified personal interaction for a shorter period of time e.g. skin to skin physical contact or travel in the same small vehicle, and applies to those who spend significant time with an infected person within the same household (see below FAQs for a fuller explanation).
2. A flow diagram setting out the procedure for those with symptoms or identified as close contacts:
3. When patient contacts in a community pharmacy are not close contacts
A pharmacy team member’s contacts with patients will not be close contacts if the appropriate mitigation has been used, for example, 2m social distancing, an appropriate Perspex screen or the safe use of appropriate PPE (see the PSNC information on the use of PPE in community pharmacies).
4. Contact tracers are likely to scrutinise staff contacts in a community pharmacy
A pharmacy team member’s contacts with other staff members are likely to be scrutinised by contact tracers to determine if they are close contacts. Relevant mitigations which may avoid the need for the whole pharmacy team to self-isolate if one member tests positive for COVID-19 are likely to include:
- any social distancing of 2m that has been possible;
- any safe and appropriate use of PPE;
- any working practices that reduce the transmission of coronavirus, for example, the use of separate staff teams in the pharmacy where contact between the two teams is minimised;
- lunch and break arrangements for staff; and
- any other appropriate arrangement that avoid close contacts.
Only those pharmacy team members who have had recent close contact with another staff member who then tests positive for COVID-19 will be asked to self-isolate.
5. Further mitigation of the risks for staff
Pharmacies have already been taking steps to reduce – mitigate – the risks of patient to staff and staff to staff transmission of coronavirus and should review the measures taken so far. Additional measures may be necessary to manage the risks and minimise close contacts between staff and between staff and patients.
Risks should be considered on a pharmacy basis and an individual staff member basis, particularly when considering those most at risk including BAME pharmacy staff. NHS guidance on supporting our BAME NHS people and communities during and beyond COVID-19 provides a helpful starting point and there is ongoing work on this issue by the Royal Pharmaceutical Society (RPS):
6. The NHS coronavirus app is awaited
The NHS coronavirus app is currently being trialled on the Isle of Wight. When this is rolled out across England the app will supplement the other forms of contact tracing now in place.
7. Community pharmacies that have to close
A community pharmacy that has to close should follow its business continuity plan and may also find helpful advice in the PSNC’s Resilience Guidance – Part 3: Emergency Closure developed with NHS England and NHS Improvement (NHSE&I)
DHSC Q&A on the NHS Test and Trace Service
DHSC has issued a separate Question and Answer document for external stakeholders for staff and employers. Key FAQs for employers include:
What is a “contact”?
- A ‘contact’ is a person who has been close to someone who has tested positive for coronavirus (COVID-19) anytime from 2 days before the person was symptomatic up to 7 days from onset of symptoms. For example, a contact can be:
- sexual partners or people who spend significant time in the same household as a person who has tested positive for coronavirus (COVID-19);
- a person who has had face-to-face contact (within 1 metre), with someone who has tested positive for coronavirus (COVID-19), including: being coughed on, having a face-to-face conversation, or having skin-to-skin physical contact, or any contact within 1 metre for 1 minute or longer without face-to-face contact;
- a person who has been between 1 and 2 metres from someone who has tested positive for coronavirus (COVID-19) for more than 15 minutes; or
- a person who has travelled in a small vehicle or on a plane near someone who has tested positive for coronavirus (COVID-19).
My staff are exposed to people every day, are they more likely to be told to self isolate?
- It is important for employers to play their part by making workplaces as safe as possible and by following the 5 steps to working safely.
If a staff member is notified, do they have to report to us?
- If an employee is notified to self-isolate for 14 days because they have come into close contact with someone who has tested positive for coronavirus, and are unable to work as a result, they should notify you that they are unable to work within the deadline you have set in you sickness absence policies (or normally within 7 days if you have not set one).
Will my whole workforce be told to self-isolate if someone tests positive?
- Only those who have had close recent contact with someone who then tests positive for COVID-19 will be asked to self-isolate.
What’s the minimum and maximum time an employee can be told to self-isolate for?
- As now, those who test positive for coronavirus will be asked to isolate for 7 days from the onset of symptoms and only stop isolating from day 8 once they have been fever free for 48 hours without medication.
- Those who have had close recent contact with someone who went on to test positive for coronavirus will be asked to self-isolate for the period ending 14 days after they came into contact with the person who has tested positive.