As we are all acutely aware, the COVID-19 pandemic has changed the way we live, work, study and socialise. For many, the changes have increased social isolation and resulted in greater anxiety and stress levels. For some, this has led to or exacerbated ongoing neglect or domestic abuse. It has also restricted access to support services.

Safeguarding children and adults with care and support needs is a priority for all community pharmacy teams. The teams have already played a crucial role during the pandemic by establishing safe spaces in their consultation rooms for people experiencing domestic abuse.

As the second wave continues, pharmacy teams must remain vigilant to signs of abuse and neglect. They should remember that abuse can come in many forms. It can include physical, emotional, sexual or economic abuse as well as online grooming and coercive control. Anyone can be affected by abuse regardless of gender, age, ethnicity, socioeconomic status, sexuality or background.

Neglect

Vulnerable people may be more likely to experience neglect as the workload of healthcare and social care professionals increases during the pandemic. This neglect may be exacerbated if family and friends are unable to visit.

Worryingly, during the first wave of COVID-19 some areas of the UK reported a reduced number of safeguarding referrals. This may have happened due to less contact with healthcare professionals, an increase in staff workload, or a reduction in the number of visitors to care homes, who in normal situations may have raised concerns about the welfare of patients. 

Exploitation  

During periods of isolation, adults with care and support needs, particularly those living alone, may become more vulnerable to exploitation based on their age, disability, mental or physical impairment or illness. 

Domestic violence  

During the first wave, there were concerning reports of increased levels of domestic abuse, violence, and coercive control. These may have been the result of tensions caused by lockdown-induced factors such as social isolation, financial difficulties, working from home, or anxiety.

Safeguarding children  

While schools and colleges have reopened, there is still a significant number of children who are not attending on a regular basis, either because of parental decision-making, or the need to self-isolate when classmates test positive.

As a result, some young people are spending more time at home. Some of these children will have become more vulnerable to abuse, especially if they are not being seen by professionals such as teachers or GPs. 

What to do if you suspect abuse or neglect?  

Do:  

• Act on any concerns, suspicions, or doubts.  
• In an emergency, if there is immediate risk of abuse, call 999.  
• Try to ensure the immediate safety of those concerned – but not at the risk of your own safety.  
• Listen to what has happened to clarify what the concern is.  
• Provide reassurance and comfort.  
• Assure the person that the matter will be taken seriously.  
• Ask the person what they want to be done.  
• Explain what you will need to do and who you may need to inform.  
• Try to gain consent to share information, as necessary.  
• Consider the person’s mental capacity to consent and seek assistance if you are uncertain.
• Respect privacy as far as possible.  
• Report all your concerns in line with organisational procedures.  
• Make an accurate written record of what has occurred and what action has been taken.   
   

Don't:*

• Ignore the abuse or neglect.
• Promise confidentiality to a victim – explain how and why the information might need to be shared.
• Rush the person talking about abuse or neglect.
• Probe or question the victim – just record the facts and seek clarification where necessary.
• Interview witnesses – but do record any information volunteered by them.
• Panic or show shock or disbelief.
• Be judgmental.
• Jump to conclusions.
• Approach the alleged abuser.
• Gossip about the abuse or neglect – only inform others on a need-to-know basis.

Pharmacy professionals can find out more about the safe spaces initiative on the UK Says No More campaign website. Medicine delivery drivers can access training for spotting signs of abuse on the National Society for Prevention of Cruelty to Children website.

Remember the importance community pharmacy plays in ensuring the safety and wellbeing of our patients. Doing nothing is never an option.

Janice Perkins is chair of the Community Pharmacy Safety Group, which includes representatives of all of the larger pharmacy chains. The group has produced guidance to provide advice for dealing with safeguarding concerns during the COVID-19 pandemic.

*Correction November 16: Typing error "do" changed to "don't"