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
Frontline workers, including community pharmacy staff in England, can access free testing for COVID-19. Lateral flow testing is being made available to all asymptomatic patient-facing NHS staff and PCR testing is available for staff with symptoms, or for staff who have tested positive with a lateral flow antigen test via the Department of Health and Social Care’s (DHSC) national testing service.
PCR testing will allow those currently unable to return to work because they or a member of their family or household have symptoms of coronavirus to know whether they do have the virus.
Lateral flow testing (for asymptomatic pharmacy staff)
Following the Government announcement on 9th November 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 late on 16th December 2020, announcing how they can order lateral flow tests.
The supply of these tests will 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 will 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 test kits
- Primary Care Support England (PCSE) will this week start to invite contractors, via emails to their shared NHSmail accounts, to order lateral flow testing devices.
- Contractors are advised not to place orders until they have received their invitation.
- Invitations will be staggered across NHSE&I regions to ensure a smooth ordering process.
- Following receipt of an invitation, contractors should log on to the PCSE online portal and complete their orders. Contractors had until 30th December 2020 to place their orders.
- Contractors who have not been able to place an order before the deadline will still be able to go onto the portal and order tests. However, deliveries of orders placed after the deadline may take place at a later date.
- Contractors will be able to order one box for every patient-facing employee who is providing NHS services, including any temporary staff (e.g. locums).
- Test kits are expected to be delivered from early January 2021.
- Contractors should provide one box to each member of patient-facing staff as soon as possible after delivery. Each box will contain 25 lateral flow tests, enough for 12 weeks.
- Contractors can check their order was placed correctly by going to the Orders Placed page on PCSE Online. If a contractor encounters a blank page after placing their order, please re-check the Orders Placed page to make sure multiple orders are not placed by mistake.
Delivery of test kits
- The delivery window for test kits will be from week commencing 4th January 2021 and deliveries will continue throughout January 2021.
- Please disregard the expected day of delivery quoted on the order confirmation as the deliveries will be on bespoke routes, and as such outside of the usual cycle.
- PCSE cannot provide an actual delivery date due to the need to provide bespoke delivery routes and the volume of orders that are being processed.
Staff engagement & training
- Contractors should read through the standard operating procedures (SOPs) on lateral flow antigen testing in primary care and the available 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.
Contractors should already have access to the PCSE online portal, which is normally used to order supplies such as EPS dispensing tokens, FP57s etc. However, if any contractor does not have access, they should contact PCSE at www.pcse.england.nhs.uk/contact-us.
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:
Accessing priority C-19 testing
Community pharmacists and their staff are classed as essential workers who are prioritised for testing and employers can refer essential workers for testing if they are self-isolating because either they or members of their household have coronavirus symptoms.
They can do this by uploading the names and contact details of self-isolating essential workers to the secure employer referral portal. Referred essential workers will then receive a text message with a unique invitation code to book a test for themselves (if symptomatic) or their symptomatic household members at a testing site.
To get a login to the employer referral portal, pharmacy contractors should email email@example.com with the following information:
- organisation name
- nature of the organisation’s business
- names (where possible) and email addresses of the 2 users who will load essential worker contact details
Once employer details have been verified, two login credentials will be provided for the employer referral portal.
Testing for COVID-19 in pharmacies or selling test kits
COVID-19 Test Kit Distribution Service pilot
The Pharmaceutical Services (Advanced and Enhanced Services and Emergency Declaration) (England) (Amendment) (No. 3) Directions 2020 introduced the necessary legal framework for a Coronavirus Testing Service, under the ‘Enhanced Service’ part of the NHS pharmacy contract.
NHSE&I, DHSC and Community Pharmacy West Yorkshire (CPWY) are currently working together on piloting the distribution of COVID-19 test kits through community pharmacies in the Bradford area. The NHS Community Pharmacy COVID-19 Test Kit Distribution Service pilot aims to improve local access to testing by making test kits readily available at community pharmacies across an identified area. The opt-in service is making COVID-19 swab testing available for collection by non-symptomatic people from outside the household on behalf of those patients that are experiencing symptoms and self-isolating.
Information on any further rollout will be released once the pilot has been completed.
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.
These tests are different from the postal kits that are being used as part of the national testing programme, whereby the swab is taken by you at home and then returned by post or courier.
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.
Application to community pharmacy
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.
The recently updated COVID-19 SOP for community pharmacy has further information on the subject.
PSNC guidance for contractors
PSNC has updated its guidance on NHS Test and Trace based on recent discussions between NHSE&I and PHE. These discussions have indicated 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.
View the updated guidance in full: PSNC Briefing 022/20: NHS Test and Trace – Key points for contractors as Q&As
Impact of NHS Test and Trace decisions on pharmacies
As PSNC continues to monitor the issues some community pharmacies are experiencing with NHS Test and Trace, we are particularly interested in the impact that incorrect handling of cases by contact tracers is having on pharmacies.
Contractors are asked to complete our survey on the impact of NHS Test and Trace decisions to help inform our work in this area and any media reports.
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.
Letter from the Minister
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.
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.
The letter also reiterates advice in NHS England and NHS Improvement’s (NHSE&I) COVID-19 SOP for community pharmacy. Advice can also be found in PSNC Briefing 022/20: NHS Test and Trace – Key points for contractors as Q&As.
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. This is also the advice in the NHSE&I COVID-19 SOP for community pharmacy.
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 long-awaited NHS COVID-19 app launched on 24th September 2020. It is being heavily promoted to members of the public, as the Government sees this as a vital part of the NHS Test and Trace service in England.
The Government is encouraging 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 will 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.
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 initial offer involves free access to a number of wellbeing apps (Unmind, Headspace, Sleepio and Daylight) from now until the end of December 2020 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.
Looking after you too: coaching support for primary care staff
As part of work to ensure all staff delivering frontline primary care services feel supported to maintain their psychological wellbeing during the COVID-19 pandemic, the NHS has launched the #LookingAfterYouToo initiative. This is a free resource – available to all clinical and non-clinical staff working in primary care – offering individual coaching sessions with a highly skilled and experienced coach.
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.