HEALTH AND SAFETY PROVISION AND PPE
their own ingenuity, implementing a range of measures, and sharing these practices with online pharmacy communities.7
For
example, pharmacies have used physical objects such as stock cages to create social distance, redirected patients through their aisles using signage, added tape to the ground to indicate standing areas, created standalone areas for prescription drop-offs, and installed Perspex screens to the counter areas, as well as – where possible – adding hatches and openings through which prescriptions and medicines can be exchanged.
A range of behavioural changes This is in addition to a range of behavioural changes, such as altering opening times and implementing temporary closures to ease overcrowding, purchasing personal protective equipment to reduce the risk of transmission, promoting remote consultations, the issuing of online prescriptions, the use of contactless payment to reduce physical contact, booking prescription pick-up appointments to prevent queuing, and arranging more deliveries for patients staying at home, or delivering to the pharmacy car park to help social distancing.
The argument might be made then that this financial support reflects the government’s recognition of community pharmacy in ‘the fight against COVID-19’. After all, against a backdrop of zero investment in community pharmacy infrastructure, this payment could be viewed as a change of stance toward pharmacy spaces, at long last. This view might be premature, however. For example, there is some indication that the cost of installing Perspex screens in themselves far exceeds the £300 reimbursement fee.
Pharmacies fending for themselves? To help with the financial implications of introducing these new measures, at the end of March 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.12
Very little PPE provision
A far greater concern is that pharmacies have been given very little personal protective equipment (PPE). Instead, at the time of writing, the government advice to pharmacies was that PPE in a pharmacy setting is not needed if social distancing of two metres is maintained – and that if it cannot be maintained, fluid- resistant surgical masks (FRSM) should be used on a ‘sessional’ basis (as opposed to single use) for contact with possible or confirmed cases of COVID-19.13
This advice differs from that issued to other
primary care practitioners, including general practices, where disposable gloves, aprons, and single use of FRSM and eye/face protection are recommended in numerous contexts.14 The disparity leaves pharmacists and their teams feeling vulnerable and nervous, especially as they struggle to source PPE privately, and it brings the need for the physical barriers into even sharper focus. Have pharmacies been left to fend for themselves when it comes to COVID-19 shielding arrangements? There is certainly evidence that community pharmacy is being recognised for its contribution to tackling the current pandemic. Whether investing £300 in pharmacy premises is adequate to shield pharmacy staff from the virus is a more difficult question to answer – but this small investment could provide some hope that the topic of funding for community pharmacy premises might just be something that continues to be considered long after the pandemic has ended.
References 1 BMA. GP Contract Agreement England 2020/21 [
www.tinyurl.com/ybtwz4cm].
2 NHS England. Estates and Technology Transformation Fund [
www.tinyurl.com/ ybqusff3].
3 Gershlick B, Kraindler J, Idriss O, Charlesworth A. Health and social care funding priorities for the next government. The Health Foundation, 23 November 2019 [
www.tinyurl.com/yd3j48po].
4 Department of Health and Social Care. Community Pharmacy Contractual Framework five-year deal: year 2 (2020 to 2021). Updated: 23 February 2020 [
www.tinyurl.com/ydgfl8l2].
5 Adcock H. Design for a safer dispensing process. Pharm J 2007; 279 (7481): 644–5 [
www.tinyurl.com/y9pc4gff].
6 Colquhoun A. Design features to consider before refitting your pharmacy. Pharm J 2015; 294 (7853) online [
www.tinyurl.com/ybm3vjuc].
7 Stewart K, Barai R, Praities N, Dowdall M. How to keep your community pharmacy running during the COVID-19 pandemic. Pharm J; 22 April 2020 [
www.tinyurl.com/ya55akfv].
8 Public Health England, 2020. Guidance on social distancing for everyone in the UK (Updated 30 March 2020; Withdrawn on 1 May 2020) [
www.tinyurl.com/s65duqz].
9 NHS England and NHS Improvement. Novel Coronavirus (COVID19) standard operating procedure: Community pharmacy, 22 March 2020 [
www.tinyurl.com/ydcptb33].
10 Royal Pharmaceutical Society. Coronavirus – Information for pharmacists and teams, 2020 [
www.tinyurl.com/ybgtx2kz].
11 General Pharmaceutical Council. Covid-19: Social Distancing. Protecting
Parastou Donyai
Parastou Donyai is Professor of Social and Cognitive Pharmacy at the University of Reading. Her research explores the psychology and language of decisions about medication usage and non-usage. She studied pharmacy at King’s College London, graduating in 1993, and after her pre-registration training in hospital, returned to KCL to complete a PhD in 1998. After working as a pharmacist in a variety of settings (hospital, primary care, and private sector), she returned to academia in 2003. Inspired by her experience as a pharmacist, she turned her focus to studying people within the healthcare setting: trainees, health professionals, and recipients of health services. She completed a postgraduate diploma in psychological research methods in 2007, and went on to obtain a second full degree in psychology in 2014.
She has an interest in psychiatric therapeutics, and is an associate member of the College of Mental Health Pharmacy. She is also a member of the British Psychological Society and the Royal Pharmaceutical Society, and a registrant with the General Pharmaceutical Council.
July 2020 Health Estate Journal 47
yourself and your teams, 30 March 2020 [
www.tinyurl.com/yc6jxl33].
12 NHS England and NHS Improvement. Preparedness letter for community pharmacy, 31 March 2020 [
www.tinyurl.com/ydcmvfy2].
13 NHS England and NHS Improvement. Preparedness letter for community pharmacy, 14 April 2020 [
www.tinyurl.com/y7tc3h8k].
14 Public Health England. Guidance: COVID- 19 personal protective equipment (PPE), 3 May 2020 [
www.tinyurl.com/to3l2ey].
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