HEALTH AND SAFETY PROVISION AND PPE
Shielding from COVID-19 in community pharmacies
As the coronavirus spreads, so our understanding grows that those providing health services must be protected from contracting the virus at their places of work – a pharmacy being no exception. However, argues Professor Parastou Donyai, director of Pharmacy Practice at the University of Reading, some community pharmacists feel they have been left to fend for themselves when it comes to COVID-19 shielding arrangements. She examines the case, and some of the official guidance that those running such establishments in the UK have been given to date to help minimise infection risk to themselves and their staff.
Community pharmacies are an integral part of the health landscape, but have a funding arrangement that is complex, and is perhaps most easily comparable with some general practices that are also funded through independent contracts for providing NHS services. Yet unlike the GP contract, which acknowledges the need for a ‘fit-for-purpose future estate’,1
capital
funding has not been a feature of the community pharmacy contract to date. For GPs, NHS England’s Estates and Technology Transformation Fund (ETTF), a multi-million pound investment in facilities and technology across England, has been available between 2015/16 and
2019/20, paying for a range of upgrades to selected practices, including new consulting and treatment rooms, reception and waiting areas, facilities for treating minor injuries, and extensions built to house more staff and even new health centres.2
In contrast, community pharmacies are excluded from the Department of Health and Social Care’s (DHSC’s) capital budget,3
so any spending on pharmacy premises has to be funded privately, either from the business itself, or through loans. This creates an apparent disparity in the way that investment in community pharmacy premises is regarded by
government, compared with GP practices. Yet community pharmacies are providing an increasing number of NHS services, including professional and clinical services, as well as traditional medicine supplies, and there is certainly an acknowledgement of their overall contribution to health service provision. For example, the current five-year contractual agreement between DHSC, NHS bodies, and the pharmacy negotiating body, describes ‘a vision for how community pharmacy will support the delivery of the NHS Long Term Plan’.4
Community pharmacy estate needs The activities within a community pharmacy fall generally within three areas – consultation, dispensary, and retail. A private consulting space within community pharmacies allows a range of clinical services to be delivered, which include, for example, medicine reviews, or ‘flu vaccinations. The counter space and the dispensing area are used for medicines supply activities. Almost all community pharmacies in the UK are also commercial sites, with the shop floor used to display purchasable health, care, and beauty products, and with some specific medicines displayed just behind the pharmacy counter to restrict their sale by law.
An example of a screen placed on the counter, by the till area within a community pharmacy, to create social distance between pharmacy staff and service-users.
Other than the need to adhere to premises standards issued by the pharmacy regulator, the General Pharmaceutical Council (GPhC), and to take account of professional guidance on creating a space for safe practices, community pharmacy owners have a good degree of freedom to design their pharmacy’s layout. To adhere with the GPhC standards for registered premises, pharmacy owners must create and maintain an environment for the safe and effective practice of pharmacy, with a physical environment appropriate for the provision of healthcare, secure and safeguarded from unauthorised access,
July 2020 Health Estate Journal 45
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