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 (including face masks)
As of 24th September 2020, it became compulsory for retail staff – including those working in community pharmacies – to wear a face covering in areas that are open to the public and where they come, or are likely to come, within close contact of a member of the public.
However, the latest guidance for health and care settings from Public Health England (PHE) and the other UK public health bodies, is as follows:
This supersedes the previous guidance issued on 18th June 2020 and separate advice on the use of PPE when administering vaccines, issued by PHE and NHS England and NHS Improvement (NHSE&I).
The infection prevention and control (IPC) principles in the guidance apply to all health and care settings, including community pharmacies.
The guidance says patients’ treatment, care and support is to be managed in three COVID-19 pathways:
High risk: There is no change in recommendations for IPC or for the use of PPE by staff when managing patients who have, or are likely to have, COVID-19.
Medium risk: This includes patients who have no symptoms of COVID-19 but do not have a COVID-19 SARS- CoV-2 PCR test result. Most patients visiting pharmacies will fall within this pathway.
Low risk: Patients with no symptoms and a negative COVID-19 SARS- CoV-2 PCR test who have self-isolated prior to admission to hospital.
The use of face masks (for staff) or face coverings is recommended (where face coverings are not legally required) in addition to social distancing and hand hygiene for staff, patients and visitors in both clinical and non-clinical areas to further reduce the risk of transmission.
Physical distancing of 2 metres is considered standard practice in all health and care settings.
Separate from the PHE guidance, on 24th September 2020, it became compulsory for community pharmacy staff to wear a face covering in areas that are open to the public and where they come, or are likely to come, within close contact of a member of the public.
The following use of PPE is recommended in community pharmacies, dependent on the individual circumstances:
|Pharmacy staff interactions with patients||Staff are working in an area with possible or confirmed cases and are unable to maintain 2 metres social distance from the patients.||Sessional use of a Type IIR face mask (Fluid Resistant Surgical Mask). One session could be a half day period of time, with a new mask being used after a break from work.|
|Pharmacy staff interactions with patients||Staff are providing direct care to a patient, where there is a possibility of the patient being infected with COVID-19 and there is (anticipated) exposure to blood/body fluids or non-intact skin.||Disposable plastic apron (single use), Type IIR mask (single use or sessional) and gloves (single use) should be worn.|
|Pharmacy staff interactions with patients||Staff are providing direct care to a patient, where there is a possibility of the patient being infected with COVID-19 but there is NO (anticipated) exposure to blood/body fluids or non-intact skin, e.g. administering vaccines.||
Sessional use of a Type IIR face mask (Fluid Resistant Surgical Mask). One session could be a half day period of time, with a new mask being used after a break from work.
Apply hand-hygiene measures between patients.
|Staff working in the pharmacy, e.g. in the dispensary, with other colleagues||The pharmacy is not COVID-19 secure, because staff cannot maintain a social distance from one another at all times.||
A Type I or Type II face mask should be worn to prevent the spread of infection from the wearer.
If Type IIR face masks are more readily available, and there are no supply issues for their use as PPE, then these can be used as an alternative to Type I or Type II masks.
The use of face masks and other PPE does not remove the need for other measures to help to protect staff, patients and the public and contractors should ensure that all appropriate and relevant steps continue to be taken to make the pharmacy COVID-19 secure.
The Government’s PPE portal can be used by community pharmacies to obtain all the COVID-19 personal protective equipment (PPE) they need; the supplies will be provided free of charge and the service will operate until 31st March 2022.
The Department of Health and Social Care (DHSC) has partnered with eBay, Clipper Logistics and Royal Mail to develop this service.
How can I access the portal?
Community pharmacies should have received an email invitation to register to access the service, which will have been sent to their NHSmail shared mailbox. If you cannot find the email, you can still create an account by visiting the portal and using your NHSmail shared mailbox email address to register.
Even though your NHSmail shared mailbox has recently been updated to have the new shorter primary email address, pharmacy data was uploaded to the portal some weeks ago, before this change was made to NHSmail by NHS Digital. Contractors registering for the portal access must therefore use the longer original shared mailbox email address (in the format nhspharmacy.location.pharmacynameODScode@nhs.net). Emails sent to a pharmacy’s original longer NHSmail shared mailbox address will still be delivered to the mailbox.
What can be ordered?
Pharmacies can use the portal to meet the extra need for PPE that has arisen as a direct result of the COVID-19 pandemic. You should not use the portal to order PPE for non-COVID-19 requirements; this should be ordered through your normal supply channels.
Pharmacies can order:
- Type IIR masks;
- Gloves; and
- Hand sanitiser.
The current weekly order limits for pharmacies are listed on the GOV.UK website; the more staff a pharmacy has, the larger the quantity of PPE that can be ordered each week.
N.B. the GOV.UK website information on order limits refers to ‘registered staff’; this is the number of staff providing pharmacy services at the pharmacy, which is recorded on the portal when an account for the pharmacy is initially set up – it is not referring to staff registered with the General Pharmaceutical Council.
DHSC are keeping order limits under review to make sure they reflect the latest public health guidance, COVID-19 demand modelling and analysis.
Delivery times and cost
PPE ordered from the portal is free of charge and orders will be delivered by Royal Mail within 4 days. Some orders will require more than one box and may be received as multiple deliveries.
All PPE offered on the portal meets UK Government quality standards.
You can find more information on PPE standards at Public Health England’s COVID-19 PPE hub and NHS guidance on supply and use of Personal Protective Equipment (PPE) and other supplies.
Question or queries
Call the customer service team on 0800 876 6802 if you have any questions about using the PPE portal.
The team is available from 7am to 7pm, 7 days a week, to help resolve your queries.
Funding for previously purchased PPE
Please see the section below on reimbursement.
PPE reimbursement: how contractors can make a claim
PSNC and the Department of Health and Social Care (DHSC) agreed a mechanism by which pharmacy contractors could claim reimbursement for their expenditure on PPE during the COVID-19 pandemic in 2020. This is part of a wider scheme covering reimbursement of PPE for primary healthcare as a whole.
PPE purchased by contractors for use in the delivery of NHS pharmaceutical services, as a result of the COVID-19 infection control guidance, between 27th February 2020 and 31st December 2020 was covered by the reimbursement mechanism, providing the PPE would be used by the end of March 2021. Any PPE purchased directly by contractors from 1st January 2021 would not be reimbursable via the agreed mechanism.
Contractors can continue to order free of charge PPE for use in their pharmacy via the DHSC’s PPE portal.
How the reimbursement mechanism worked
Claims had to be made via the NHSBSA’s Manage Your Service (MYS) platform between 1st January and 12th February 2021. A central claims process option was also available for multiple pharmacies (with six or more pharmacies).
The original summary information released when the process was initially agreed is as follows:
Each pharmacy will be able to make two types of claims, where necessary.
1) Standard claims – this claim is for a set payment to cover the estimated standard PPE use of pharmacies from 27th February 2020 to 31st October 2020.
Contractors will be able to claim the amount set out in the table below, based on their average (mode) monthly prescription volume over the period of the claim. This is the most frequent band that pharmacies have found themselves in over the eight months from March – October 2020, with the higher band taken if there is more than one most frequent band. Pharmacy contractors will also have to state whether they were either open up to (and including) sixty hours per week on average, or more than sixty hours.
|Band||Range of number of items dispensed per month||Standard claim, <=60 opening hours||Standard claim, >60 opening hours|
|1||0 – 100||£830||£1,650|
|2||101 – 2,500||£830||£1,650|
|3||2,501 – 5,000||£1,030||£1,850|
|4||5,001 – 12,500||£1,640||£2,460|
|5||12,501 – 19,167||£2,490||£3,310|
The claim amounts in the table above have been calculated based on estimated usage and costs of standard PPE (aprons, gloves, Type IIR masks (sessional use and some additional masks for provision of clinical services) and hand sanitiser) by pharmacies dispensing different volumes of prescriptions up to 31st October 2020. These bands have been created to recognise pharmacies may not have kept detailed records on PPE spend during the pandemic period due to the unusual operating environment, and where the standard claim is made in isolation, no further evidence of spend will be required.
The NHSBSA will be emailing contractors around 8th January 2021 to confirm which band they are in, in case of doubt.
Please note that any pharmacies that were open for less than 90% of the time from 27th February 2020 to 31st October 2020, or that changed ownership during that period, will not be able to make a standard claim. These pharmacies will instead need to claim their actual PPE costs via the Exceptional claim process below.
2) Exceptional claims – this type of claim can be used to cover any PPE purchased:
- between 27th February 2020 and 31st October 2020 in excess of the standard claim value and to be used up until 31st March 2021; and/or
- between 1st November 2020 and 31st December 2020* and to be used up until 31st March 2021.
* From 21st September 2020, pharmacies could obtain all their COVID-19 PPE free of charge from the DHSC portal.
When making an Exceptional claim, contractors will be required to confirm that they have documentation to evidence the value of their combined standard and exceptional claims and can make this documentation available on request.
Between 27th February 2020 and 30th June 2020, any PPE (including visors) used as a substitute for unavailable standard items can be covered as part of an exceptional claim. Where PPE is claimed up to 30th June 2020 outside of the now standard list (aprons, gloves, Type IIR masks and hand sanitiser) the contractor will need to be able to evidence the need for that PPE, if requested to do so. This evidence may take the form of a staff risk assessment or similar.
Additionally, Exceptional claims should be made where the pharmacy was open for less than 90% of the time from 27th February 2020 to 31st October 2020 or where they changed ownership during that period, as the standard claim amount option will not be available to them.
Multiples may make a single central claim if they wish, however, this must be supported by appropriate evidence. A template spreadsheet will be published by NHSBSA to allow contractors to do this, splitting spend between the various categories. The link for this template will be included within the NHSBSA email confirming pharmacy’s standard claim team around the 8th of January 2020.
Pharmacy contractors can find FAQs around the claim process for PPE here.
Face coverings - use by patients and customers
From 24th July 2020, people in shops, including community pharmacies, are required by law to wear a face covering (subject to some exemptions).
Key aspects of the new Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020 include:
- It is not compulsory for a member of staff in a shop to wear face coverings (but see also the above guidance on use of PPE in pharmacies);
- Certain people are exempt from the requirements, for example, children under the age of 11;
- There are reasonable excuses for not wearing a face covering, which include a person who cannot put on, wear or remove a face covering because of any physical or mental illness or impairment, or because of a disability within the meaning of the Equality Act 2010, or those who cannot put on, wear or remove a face covering without severe distress;
- If asked by a pharmacy staff member, a person in the pharmacy may remove their face covering in order to assist in the provision of healthcare or healthcare advice;
- A face covering can be removed to take medication, e.g. to consume methadone in a pharmacy; and
- Where a relevant person, such as a police constable or police community support officer, considers that a person who should wear a face covering is not wearing one, he or she may direct that person not to enter the relevant place, or direct that person to wear a face covering, or direct that person to leave the premises.
The liability for wearing a face covering is with the individual, not the retailer. Contractors may want to use the posters and social media statics which are available in PHE’s Campaign Resource Centre to help remind patients of the requirement.
Contractors’ terms of service provide that a pharmacy may refuse to provide medicines and appliances on prescription if a person commits or threatens to commit a criminal offence. The police have formal enforcement powers and can issue fines for people refusing to comply with the face covering legislation, and the Government has indicated that retailers could refuse entry to people refusing to wear a face covering.
However, contractors must think carefully about the appropriateness of resorting to enforcement options. If a person is not wearing a face covering, it may be difficult to determine if a relevant exemption applies, and in any event, the health needs of the patient or customer should also be considered; this is particularly relevant in healthcare settings, such as pharmacies.
Social Distancing and Infection Control risk management
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.
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.
Risk assessment template
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.
The Community Pharmacy Patient Safety Group has developed guidance on the safe use of consultation rooms during the pandemic, to help pharmacy teams consider how they can minimise risk when using them: Safe use of consultation rooms: COVID-19
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:
Ventilation of indoor spaces to help stop the spread of coronavirus
New guidance has been published by the Department of Health and Social Care (DHSC) on how ventilation in the workplace can help to stop the spread of coronavirus (COVID-19).
The guidance includes a short section on ‘workplace settings’ which explains the importance of identifying areas that are not well ventilated, gives examples of control measures for reducing the risk of airborne transmission and indicates that any actions to improve ventilation should not compromise other aspects of safety and security (for example, propping open fire doors should be avoided).
It indicates that employers should provide employees with clear guidance on ventilation, why it is important, and instruction on how to achieve and maintain good natural ventilation or to operate systems if there are user controls. There is also brief advice on mechanical ventilation systems.
The DHSC guidance follows an update this week to the Health and Safety Executive guidance for employers on Ventilation and air conditioning during the coronavirus (COVID-19) pandemic. This fuller guidance for employers adds the reminder that ventilation should be considered alongside other control measures needed to reduce risks of transmission as part of making your workplace COVID-secure, such as social distancing, keeping your workplace clean and frequent handwashing.
HSE spot checks and inspection of pharmacies
The Health and Safety Executive (HSE) undertakes spot checks and inspections of work environments, including community pharmacies, to ensure workplaces are COVID-secure – doing this by calling, visiting and inspecting relevant premises. HSE also assists local authorities, which also undertake inspections of retail premises, including community pharmacies.
HSE information states that officers visiting premises will carry identification from their business (HSE works with approved partners) and a letter of authorisation from HSE. Calls may currently come up as an unknown number. If you wish to verify that an officer who calls or visits your organisation is genuine – which pharmacy contractors are particularly encouraged to do if contact is made by telephone – please call 0300 790 6896.
For more information on HSE on spot checks and inspections, see Work Right – HSE campaigns
Individual staff risk assessments
Supporting staff from 1st April 2021 when shielding is paused
NHSE&I published a letter for primary care teams on supporting clinically extremely vulnerable (CEV) staff when shielding is paused from 1st April 2021. It advised that employers, should refresh risk assessments for all CEV staff to determine the appropriate work arrangements from 1st April, reflecting the current workplace context, as well as including next steps to support these staff members.
Individual risk assessments
NHSE&I requested all NHS providers, including pharmacy contractors, to 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 outlined the responsibilities of employers as well as the support available to help them, including an annex highlighting examples of good practice.
Support on undertaking staff risk assessments is available from the following organisations:
- NHS England and NHS Improvement (NHSE&I) – also see their webinar for community pharmacy
- NHS Employers
- Faculty of Occupational Medicine
- General Pharmaceutical Council (GPhC)
- National Pharmacy Association (NPA)
- Pharmacists’ Defence Association
- Royal Pharmaceutical Society (RPS)
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.
Security and personal safety
During the 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.
Resources on respecting pharmacy teams
As well as the above support, the following resources may be useful in managing public expectations during the pandemic. NHS England and NHS Improvement (NHSE&I) created some primary care assets to help explain to the public how accessing services may differ during the pandemic. The pharmacy resources urge the public to:
- treat pharmacy teams with respect and follow the guidance on social distancing and face coverings;
- not go to a pharmacy if they have coronavirus symptoms or are self-isolating;
- ask about moving their prescriptions to electronic repeat dispensing (eRD); and
- order repeat prescriptions online.
The social media images and suggested wording for posts can be downloaded as part of the NHS Primary Care Access Social Media Assets pack in the Campaign Resource Centre.