HEALTH AND SAFETY PROVISION AND PPE
and a safe, clean, and well-maintained space, while also protecting the privacy, dignity, and confidentiality, of the service’s recipients.
Specific principles of safe design Medicines supply activities taking place in the dispensary and the counter area are guided by specific principles of safe design.5
This is to create a dispensing environment that prevents errors, for example the wrong medication being dispensed, or a medicine being labelled for the wrong patient. There is also guidance on physical design that protects patient privacy, for example
soundproofing in the consultation room, or the creation of booths at the medicines counter, to prevent prescriptions being seen, or private conversations being overheard.
Provided they meet the GPhC standards and take account of other relevant guidance, pharmacy owners can determine the aesthetics and design of their pharmacy space.6
So, for example,
some invest in multiple or spacious consultation rooms, create an additional space to witness consumption of controlled medicines on site, install a dispensing robot, create transparent/ open-plan dispensaries, redesign their counter space, expand the pharmacy waiting area, or improve the layout of the floorspace. Among the many benefits of good design are enhanced workflow and efficiency within the pharmacy, improved patient privacy, maximised commercial appeal, customer flow, and resulting sales, and, for example, greater brand identity. The staff room and area behind the dispensary are also an important part of most pharmacies, as is a space for drivers to collect medicine deliveries.
Patient-facing activities at the counter
Community pharmacists have been dubbed the ‘scientist in the high street’ in the light of their expertise and accessibility to the public. Usually found in the consultation room or in the dispensary area, community pharmacists work alongside a team of staff that includes technicians and counter assistants, with the latter operating the counter or sales areas. Thus a patient wanting health advice ‘on spec’ can generally either speak with a counter assistant to resolve their issue, or gain access to the pharmacist with relative ease, and generally without an appointment. In fact, numerous campaigns over the past decades have attempted to drive more people into pharmacies and away from GP practice. For example, the latest public health campaign for pharmacy (running from 20 January – 22 March this year), which began before the coronavirus pandemic, aimed to encourage the public
46 Health Estate Journal July 2020
A screen placed on the counter, and an additional Perspex door limiting entry to the dispensary, to create social distance between pharmacy staff and service-users.
to ‘take the drama out of minor illnesses’, and use their local pharmacy ‘as the first place to go to for clinical advice on minor health concerns such as coughs, colds, tummy troubles, and aches and pains’.
Patients in close proximity to each other
There are a number of other activities that bring pharmacists and their teams directly into contact with patients and members of the public. For example, products purchased from the shop floor or the pharmacy shelves are collected at the counter, and paid for at the tills operated by pharmacy staff. In addition, the basic steps involved in medicines supply, which start with receiving and validating the prescription, and end with issuing the medicine(s) to the patient, usually with instructions and advice, all normally also take place at a space within the medicines counter. Patients too often find themselves in close proximity to each other, as they queue to access the counter, wait for their medication, or browse the pharmacy shelves.
The impact of COVID-19 on pharmacy activities It is against this background that, following the coronavirus pandemic, pharmacy owners find themselves having to implement social distancing measures within their community pharmacies.7 So, while in the normal scheme of things, such establishments have welcomed people into their stores, interacted with them across the pharmacy counter, and, where necessary, arranged one-to-one consultations with them a short distance across a table or desk, the arrival of the coronavirus has toppled these norms, forcing pharmacies to impose various strict measures to reduce the onward transmission of the virus.
The coronavirus causes a respiratory disease (known as COVID-19), and spreads from person to person, mainly through physical interaction. The UK Government first issued guidance to define what is generally meant by social distancing in March 2020.8
For
community pharmacy spaces, the Standard Operating Procedures (SOP) document published by NHS England and NHS Improvement9
makes several
recommendations, including, for example, where to display patient information posters, how to limit entry to the shop to maintain a distance of two metres between service-users, and how to prepare an area for isolating anyone too unwell to safely return home. To protect pharmacy staff from airborne virus particles transmitted by their service- users, pharmacy owners have also been installing full screens within their settings. At the time of writing, in the middle of April 2020, there are ample guidance and good-practice examples provided by various pharmacy bodies, including the GPhC and the Royal Pharmaceutical Society (RPS), on how to modify pharmacy spaces to create social distancing.10,11
‘‘
Many owners have also used
Pharmacies were given a ‘one-off’ £300
payment to support the installation of physical barriers such as screens and retractable tape barriers, or other adjustments to help enforce social distancing
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