Community pharmacy contractors should consider their business continuity arrangements in light of the COVID-19 pandemic.
Below is advice and information for contractors to support them in responding to the pandemic. These documents have been drafted to help pharmacies assess their business mix and decide how they can improve their dispensary efficiency, whilst still supporting their most vulnerable patients, in the event of multiple members of staff being off work to COVID-19.
The Government has announced that schools in England will be closed for all but a limited number of children. Schools have been asked to continue to provide care for children who are vulnerable and children whose parents are critical to the COVID-19 response and cannot safely be cared for at home.
The definition of key workers has been deliberately drafted broadly, so that all the people involved in the medicines and pharmacy supply chains who are critical to the supply of medicines, and the delivery of pharmacy services, to patients and the public – including pharmacists and pharmacy staff – are included.
Template letter that pharmacy contractors can issue to their staff (Microsoft Word)
Legitimate movement letter
The Royal Pharmaceutical Society (RPS) has produced a letter that pharmacy staff can use to help verify their right to legitimate movement as a key healthcare worker with law enforcement teams.
Government's safety net indemnity
The Department of Health and Social Care (DHSC) has confirmed that community pharmacy is covered by the Government’s safety net indemnity provisions in the Coronavirus Act 2020. DHSC has confirmed that the Secretary of State for Health and Social Care has made arrangements with NHS Resolution for the safety net indemnity to apply to community pharmacy, confirming that:
….where COVID related activity on behalf of the NHS is not covered [by existing indemnity arrangements], lawyers have confirmed that the provisions of the Coronavirus Act 2020 (CVA) cover community pharmacy teams.
The Coronavirus Act does give the Secretary of State powers to provide or arrange for the provision of the indemnity described in the Act, but the question is whether those powers have been exercised – whether the Secretary of State has in fact provided or arranged for the provision of that safety net indemnity (see this PSNC article for the background). DHSC has confirmed that it has been arranged and the relevant FAQs on NHS Resolution’s website have now been updated to confirm this.
PSNC wanted to clarify the position to avoid confusion, particularly around the application of the Government’s safety net indemnity to volunteers delivering medicines to shielded, vulnerable and other patients. If volunteers are not covered by a pharmacy’s indemnity insurance arrangements, they should be covered by the Government’s safety net indemnity.
The answer to question 11 in the FAQs on NHS Resolution’s website, which asks about the indemnity arrangements for community pharmacists, now states:
“…we do not want any indemnity concerns to be a barrier or delay to the response to the coronavirus outbreak. The powers taken in the Coronavirus Act 2020 allow the Secretary of State to provide indemnity for clinical negligence liabilities arising from NHS activities carried out for the purposes of dealing with, or in consequence of, the coronavirus outbreak, where there is no existing indemnity arrangement in place. Under these powers we have made provision for organisations or individuals undertaking NHS activities to respond to the coronavirus to be covered for clinical negligence in these circumstances. This includes those working in community pharmacy delivering pharmaceutical services for the NHS.”
Details of the claim procedure for community pharmacy are expected to be announced in due course.
NHS IT developments
The following changes have been made to the NHS IT systems used in community pharmacy to support the ongoing COVID-19 pandemic. (Note, information on EPS and eRD use during the pandemic can be found on our Supply of medicines page.)
Summary Care Record (SCR)
Shielded Patient Flag: NHS Digital has added a ‘Shielded Patient Flag’ (also known as a Vulnerability flag) to the SCR of patients who are on the shielded patient list. This flag displays an alert when viewing the SCR of such a patient. The alert is available when using NHS Digital’s SCRa web portal (available from within the Spine portal) and via SCR 1-click solutions.
Additional Information included by default: For the duration of the pandemic, Additional Information has also been added to most SCRs, without the need for patients to ask their GP practices to activate this. SCR with Additional Information includes: details of the management of long-term conditions; medications; immunisations; care plan information; and significant medical history, past and present.
New COVID-19 codes added to SCR Additional Information: New COVID-19 SNOMED CT codes have been added to SCR Additional Information to capture suspected or confirmed COVID-19 status from GP systems. GPs have been instructed to record whether a patient is assumed to have had COVID-19, whether a patient has been tested, and whether the patient is at risk of medical complications should they contract the virus. If GP practices use these codes on their clinical systems, this will also be visible within SCR Additional Information.
Extending access for locums: To support community pharmacy teams to work efficiently and flexibly in response to COVID-19, access to the NHS Summary Care Record (SCR) is being automatically granted to all those with the pharmacist 5F multi-site code on their Smartcard, by the addition of a new role – National Locum Pharmacist + SCR – COVID-19. The new code will automatically expire after one year.
Multi-site code added to cards of pharmacy professionals: NHS Digital is adding the multi-site FFFFF Smartcard code to Smartcards with the pharmacist or technician role, for the duration of the pandemic. A temporary Smartcard position has been created to provide greater flexibility for pharmacists and technicians during the ongoing pandemic. This will help pharmacy staff if they unexpectedly find themselves working at their non-usual pharmacy – e.g. because of staff shortages.
Can you help? Case studies requested
SCR and Smartcard changes are scheduled to last during the pandemic (including SCR with Additional Information as the default SCR). PSNC is requesting pharmacy teams email firstname.lastname@example.org with experiences about why the changes are necessary even were it not for the pandemic. Please share experiences and case studies about how wider SCR access supports your ability to care for your patients.
Shared-Care (supervised consumption)
Shared-Care service provision for people being treated for substance use during the COVID-19 pandemic (updated 25th March 2020)
For more information, see our instalment dispensing page.
Multi-compartment Compliance Aids (MCA) provision
Template letter to share with patients (Microsoft Word)
Template letter to send to care homes (Microsoft Word)
Please also see our Supply of medicines during the pandemic page for guidance on medicines re-use in care homes and hospices.
For more general information on making business continuity arrangements, see our emergency and business continuity planning page.
For additional EPS/IT contingency resources see our EPS/IT contingency arrangements hub.