Staff wellbeing and COVID-19 testing
Staff wellbeing and COVID-19 testing
Maintaining the health and wellbeing of pharmacy team members is a high priority for pharmacy contractors and the NHS during the COVID-19 pandemic.
This page contains information on NHS support tools to assist with staff health and wellbeing, and information on how pharmacy team members can access testing for COVID-19.
Testing for COVID-19
Note: Details of the NHS community pharmacy COVID-19 lateral flow device distribution service (or ‘Pharmacy Collect’) for the public is covered on this webpage.
Frontline workers, including community pharmacy staff in England, can access free testing for COVID-19. Lateral flow testing is available for all asymptomatic patient-facing NHS staff and PCR testing is available for any person with symptoms, or for staff who have tested positive with a lateral flow antigen test via the national testing service.
Lateral flow testing (for asymptomatic pharmacy staff)
Following the Government announcement on 9th November 2020 that lateral flow testing would be made available to all asymptomatic patient-facing NHS staff, NHS England and NHS Improvement (NHSE&I) published a letter to all primary care contractors on 16th December 2020, announcing how they could order lateral flow tests.
The supply of these tests would allow all patient-facing staff to be able to test, twice-weekly, using self-administered nasal swabbing and report their results through an online platform. Any positive lateral flow antigen tests would need to be followed up by a confirmatory PCR test.
The aim is to improve virus detection in primary care thereby helping to protect staff, reduce transmission and improve the resilience of services.
Ordering further supplies of test kits
On 29th June 2021, NHSE&I announced new arrangements for the distribution of COVID-19 Lateral Flow Test for use by pharmacy team members.
Previously, pharmacy contractors ordered stock of the test kits from the Primary Care Support England portal, but from 5th July 2021, staff should order test kits, when they are required, from https://www.gov.uk/order-coronavirus-rapid-lateral-flow-tests.
When ordering their tests online, staff should select yes to the question ‘Do you work for the NHS in England and take part in their staff testing programme?’. Staff should then input the postcode of their workplace to ensure the tests are registered as belonging to a healthcare worker.
Reporting of all test results via GOV.UK remains imperative – whether negative, void or positive. This is a statutory notifiable disease reporting requirement.
Updated FAQs have been published by NHSE&I, including the following:
Can I get more tests from another route that is more convenient for me (eg a local community pharmacy, or as a parent of a school age child)?
If you are able to order tests through the route described above, then you should do so, as this assures your organisation that its staff are compliant with testing requirements. If you do access LFDs through a different route, please ensure that your organisation is aware that you are participating fully in a twice a week LFD testing regime.
Staff engagement & training
- Contractors should read through the standard operating procedures (SOPs) on lateral flow antigen testing in primary care and frequently asked questions (FAQs).
- An NHS staff instruction leaflet and a Health Education England instruction video to support both staff training on self-administration of their test and interpretation of results is available. Contractors are advised to provide their employees access to these alongside any applicable information having familiarised themselves with both the leaflet and SOP.
- Patient-facing primary care staff are asked to test themselves twice weekly and report their results to Public Health England (PHE) within 24 hours, via the NHS Digital online platform. Please be aware that it is a statutory requirement to report all results, including negative, positive or invalid.
- Anyone who tests positive with a lateral flow antigen test will be required to follow Government guidelines, self-isolate with their household and get a confirmatory PCR test.
Accessing a PCR COVID-19 test (for pharmacy staff)
Pharmacy staff who think they or one of their household are eligible for a PCR test can apply for one via:
Testing for COVID-19 in pharmacies or selling test kits
Note: Details of the NHS community pharmacy COVID-19 lateral flow device distribution service (or ‘Pharmacy Collect’) for the public is covered on this webpage.
Rapid antibody tests
Some manufacturers are selling products containing COVID-19 testing kits that allow a swab or other type of sample to be taken at home or in the pharmacy setting, followed by a very rapid result within about 10 minutes.
Antibody testing programme
NHS England and NHS Improvement (NHSE&I) has also rolled out a COVID-19 antibody testing programme. Antibody testing is open to NHS staff, including community pharmacy teams, with each NHS region managing its own arrangements.
It is, however, important to note that the NHS Test and Trace guidance for healthcare workers states that a positive antibody test result does not exempt someone from the requirement to self-isolate for 10 days if they are a contact of a confirmed case. Antibody testing can only inform about previous exposure and it is currently unknown whether this leads to protection against future COVID-19 infections.
NHS Test and Trace
The Government announced that the NHS Test and Trace programme would commence at 9am on 28th March 2020. The announcement was followed by the publication of information on how the programme will operate.
Anyone who tests positive for coronavirus will be contacted by NHS Test and Trace and will need to share information about their recent interactions. Contact tracers will ask those who have been in close contact with someone who tests positive for COVID-19 to isolate for 10 days, even if they have no symptoms. However, from 16th August 2021, those who have received both COVID-19 vaccinations will be able to end their isolation sooner – see details below.
Staff self isolation from 16th August 2021
From 16th August 2021, the Government changed the requirements to self-isolate following close contact with a positive COVID-19 case.
Fully vaccinated healthcare staff – include those working in community pharmacy – are no longer be expected to isolate and will be expected to return to work. However, NHS England and NHS Improvement (NHSE&I) wrote to NHS providers asking them to ensure that the following safeguards are put in place for them to safely do so:
- the contact should obtain a negative PCR test prior to returning to their workplace (staff should not attend work while awaiting the PCR test result);
- the staff member has had two doses of an approved vaccine, and is at least two weeks (14 days) post double vaccination at the point of exposure;
- provision of subsequent, daily negative LFD antigen tests for a minimum of 10 days before commencing a shift (with test results reported to Test and Trace via the web portal and to their duty manager or an identified senior staff member). Any contact who has a positive LFD test should self-isolate and arrange a PCR test;
- the staff member/student is and remains asymptomatic; and
- continued use of infection prevention and control (IPC) measures, in line with the current UK IPC guidance.
Any staff member who has not had both doses of the vaccine, or who is living directly (i.e. in the same household) as a positive contact, should continue to isolate in line with Government guidance – see section on application to community pharmacy below.
Application to community pharmacy 2020
NHSE&I indicated that, if a member of the pharmacy team tests positive and there is a risk to the provision of pharmaceutical services, then advice regarding the individual circumstances should be sought from the local Health Protection Team (specific individual circumstances will be considered and advice may therefore appear to differ). Contractors are also recommended to contact their regional NHSE&I team regarding the possible disruption.
NHSE&I has also clarified that, if a member of staff receives a negative test, they do not need to self-isolate as long as:
- everyone they live with who has symptoms tests negative;
- everyone in their support bubble who has symptoms tests negative;
- they were not told to self-isolate for 10 days by NHS Test and Trace or the NHS COVID-19 App; and
- they feel well.
PSNC guidance on NHS Test and Trace recommends that contractors should, in particular:
- Ensure the PHE Local Health Protection Team consider community pharmacy contact tracing cases. If the local team don’t make the initial contact with the pharmacy, contractors should escalate cases to the team, or call the team direct. This may not be necessary if a contractor is satisfied with the decision without full assessment.
- Ask pharmacy staff to provide the contact details of the pharmacy.
- Continue to take all appropriate steps to make the pharmacy COVID-secure, so far as practicable, including social distancing, the proper use (donning and doffing) of appropriate PPE, but recognise that if one staff member tests positive, sometimes other staff may still be close contacts and asked to self-isolate depending on the PHE Local Health Protection Team assessment.
Impact of NHS Test and Trace decisions on pharmacies
In early October 2020, PSNC, the Association of Independent Multiples (AIM), the Company Chemists’ Association (CCA), and the National Pharmacy Association (NPA) wrote a letter to raise concerns about the impact of Test and Trace on the sector with the Pharmacy Minister. Whilst we had hoped for sector specific advice on this issue, this has not been forthcoming. PSNC has therefore decided it would be pragmatic to release the Government’s response to our letter and recommends that pharmacy contractors and their teams follow the official documents for the healthcare sector referred to within it.
Jo Churchill MP, Parliamentary Under Secretary of State for Prevention, Public Health and Primary Care, responded to the community pharmacy sector’s letter on 19th November. A copy of her letter can be viewed here. In summary, the Minister confirms that:
- Government understands the impact that Test and Trace is having on community pharmacy;
- Pharmacy staff are eligible for priority coronavirus testing;
- If a member of staff tests positive outside of work, they must follow the self-isolation guidance;
- Maintaining a COVID-19 secure environment in the pharmacy is important;
- Clinical duties: If pharmacy staff follow the Infection Prevention and Control (IPC) guidance and specifically the new recommendations for primary and community health care providers (including maintaining social distancing, working behind screens, regular handwashing and wearing appropriate PPE and if a contact occurs in the course of clinical duties), they would not be considered to be exposed to infection and would not be asked to self-isolate; and
- Non-clinical duties in the pharmacy, e.g. the dispensary: Guidance on the management of staff and healthcare settings indicates that the effectiveness of the use of face masks, face coverings, or other PPE for prevention of transmission or acquisition of coronavirus infection cannot be guaranteed in settings other than the provision of direct care with patients or residents. Therefore, the use of PPE in other settings (such as a staff room or canteen) will not necessarily exclude an individual from being considered a close contact. In addition, if health and social care staff have been in contact with a COVID-19 case and are not following appropriate IPC, including wearing correct PPE, they will be considered as a contact for the purposes of contact tracing and isolation.
In mid-November during an NHSE&I webinar, Public Health England (PHE) made clear that in cases where continuity of service may be interrupted, the Local Health Protection Team should be involved directly and asked to assess whether there are contacts that mean staff members should self-isolate. PHE also indicated that it:
- Recognises the vital role played by community pharmacy and that continuity of service is important;
- Must balance the risks of transmission between requests for self-isolation and allowing an essential service to continue; and
- Contact in clinical settings where pharmacy staff are following NHSE&I advice on wearing of PPE will mean there is no close contact and staff will not be asked to self-isolate if in contact with a person who is coronavirus positive;
Note: Generally, this is Type IIR face masks (NHSE&I guidance) but on occasions gloves and an apron, for example with closer contact with patient too unwell to be sent home (the NHSE&I SOP).
- Where significant contact occurs in non-clinical settings (for example with staff in the dispensary) but there has been significant mitigating steps taken to reduce transmission of coronavirus, a local assessment should be carried out to consider if the risks are great enough to mean self-isolation. There was an indication that PHE would have a fair and equitable approach and work with contractors to arrive at the appropriate answer.
Local Health Protection standard letters
Some Local Health Protection Teams have been issuing standard letters to contractors where a staff member has tested positive for coronavirus, inviting the contractor to make the assessment of any close contacts between that staff member and others. Contractors can then consider the steps they have taken to implement COVID-19 secure practices when considering whether other staff members should self-isolate for the relevant period, following the advice in the standard letter. Additional advice may need to be sought from the Local Health Protection Team.
The NHS COVID-19 app
The NHS COVID-19 app launched on 24th September 2020. The Government encouraged businesses and organisations, such as hospitality services, to display official NHS QR code posters at their venue entrances to help support contact tracing.
NHS COVID-19 app users can then be able to scan (check-in) as they enter a venue. This means that if people visit the venue and later test positive for coronavirus, other app users who were there at the same time may be sent an alert, if local public health teams think this is necessary.
Community pharmacies are not required to display NHS QR code posters but may do so, according to Government advice.
Government advice on which venues should display the official QR poster states that for community pharmacy:
‘Customers generally move around the space rather than congregate, and are expected, by law, to wear face coverings. QR codes are therefore not required but can be used if a community pharmacy wishes to offer this option.’
If community pharmacies provide flu vaccinations at other premises, for example, a community centre, an NHS QR code poster may need to be displayed and a log of those attending may need to be kept.
Healthcare workers should pause the NHS COVID-19 app when at work: For those who have downloaded and are using the NHS COVID-19 app, NHS England and NHS Improvement (NHSE&I) advises healthcare workers to pause the app while working in a healthcare building, such as a hospital or GP surgery. This includes an NHS community pharmacy. The app should also be paused if working behind a fixed Perspex (or equivalent) screen, which is big enough to provide adequate protection. Further advice for healthcare workers can be found on the NHS website.
Reporting COVID-19 exposure in the workplace
The General Pharmaceutical Council (GPhC) has issued a reminder that all pharmacy employers must make sure they comply with health and safety reporting requirements, particularly in the context of the current pandemic.
The Health and Safety Executive has published guidance on reporting cases of COVID-19 transmission that happened in the workplace under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013. This includes guidance for employers about using their judgement on whether or not a confirmed diagnosis is likely to have been caused by an occupational exposure and when to report.
Pharmacists and their teams have been spending all of their time through this pandemic serving their patients and their communities. Amidst the pace of the days it is often too easy to forget about your own wellbeing and that of your teams. Please take some time to take care of yourselves and your teams so you can continue to take care of your patients and your communities; we hope the tools below will help you to do so.
Note, LPCs can find further information on how to support their contractors on our Mental Health Support page (LPC Members only).
NHS England and NHS Improvement (NHSE&I) have organised a range of psychological support for all NHS staff, including those working in primary care, during the COVID-19 outbreak.
The offer involves free access to a number of wellbeing apps (Unmind, Headspace, Sleepio and Daylight) to support healthcare workers’ mental health and wellbeing. Information on how to access this support is available on the NHS Employers website; an NHSmail email account may be required to access some of the apps. There is also support on the NHS Our People website in the form of access to helplines and apps, as well as access to short 10-20 minute online guides to help develop new skills and help improve your experience at work. They have also introduced a confidential staff support line, operated by the Samaritans, which is free to access from 7.00 am – 11.00 pm, seven days a week.
Staff mental health and wellbeing hubs
Healthcare staff, including community pharmacy teams, now have rapid access to mental health services and support, courtesy of a series of new mental health and wellbeing hubs. Each of these 40 of these hubs offers free and confidential clinical assessments by trained mental health professionals plus access to talking therapies and other secondary care mental health services to those who need it. These hubs are going live across the country over the next few weeks, please check back on the NHSE&I website if a hub in your local area is not listed yet.
NHSE&I has also worked with NHS Practitioner Health to set up an enhanced mental health service to which wellbeing hubs can refer primary care health team members with more complex needs. This service offers access to prescribing clinicians, addiction services and interventions focused on trauma.
Confidential coaching support available to primary care individuals and leaders
NHSE&I are offering those who work in primary care settings, including community pharmacy, confidential coaching to build wellbeing, resilience and positive team cultures.
- #LookingAfterYouToo has seen over 7,000 individual coaching sessions booked. It has been incredibly well-received and highly rated by those using the service.
- #LookingAfterYourTeam launched in January 2021, and is available to those who lead, manage or organise a team or group in primary care. This offer is centred around compassionate and collaborative team leadership, helping leaders and managers to explore team topics and clarify their thinking.
A ‘where to start guide’ for pharmacy staff
The NHS Specialist Pharmacy Service with London North West University Healthcare NHS Trust have developed wellbeing and accessing support during the COVID-19 pandemic – a ‘where to start guide’ for pharmacy staff. This includes resources to encourage all staff to establish good habits with respect to their wellbeing from the outset and provides some immediate ‘go-to’ strategies and information to support ongoing wellbeing during the pandemic.
Pharmacist Support resources
Pharmacist Support is the profession’s independent charity for pharmacists and their families, former pharmacists, trainees and MPharm students.
The charity’s free and confidential support includes a suite of wellbeing resources – delivered through webinars and factsheets – aimed at helping individuals identify the signs and symptoms of stress and equipping them with tools and techniques to help deal with feelings of pressure.
Pharmacist Support has now launched a campaign to help pharmacists and pharmacy students to prioritise their wellbeing. It can be difficult for pharmacy staff to find time to prioritise their own needs so the ACTNow campaign aims to raise awareness of the importance of wellbeing.
The campaign encourages community pharmacy teams to:
Allow time for wellbeing
Consider needs of your colleagues
As part of the campaign, Pharmacist Support has developed a central resource hub, named the Wardley Wellbeing Hub, where you can take ACTion to manage those every day pressures and worries.
PSNC is supporting this campaign and encourages all pharmacy staff to take some time to take care of themselves if they can.