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‘Pharmacy is reaching a state of critical emergency with COVID-19 pressures’

With mammoth COVID-19 vaccination efforts and staff absences on top of already burgeoning workloads, pharmacy is reaching a crisis point. But the pandemic has also brought out the best in some, says Salim Jetha

Having stepped back a little from my duties as Avicenna chairman, I turned my detailed attention to the real world of pharmacy practice and it has certainly given me some new perspectives of the ramping up of workload pressures on pharmacy teams

We launched as a COVID-19 vaccination site in March last year, and on the first day of opening, I had a call from (then vaccines minister) Nadim Zahawi’s secretary that he would like to be vaccinated at my pharmacy. He would attend with Nikita Kanani, medical director of primary care at NHS England and some national press.

I thought it was a hoax at first and needed convincing that it was reality. The minister came again for his second jab, and at that time, having gained some experience, I was able to share my thoughts on the vaccination programme with him.

 
But the past five weeks have been a blur.
 
Over the festive period, we were open every day (except Christmas day) including Sundays, New Year’s Eve and Day and on normal opening days until 8pm, providing pharmacy services and COVID-19 vaccinations. I was pleasantly surprised to see people coming into the pharmacy on Boxing Day and over New Year’s – even late evenings. We were offering walk-in COVID-19 vaccinations as well, but had to suspend these for a week as bookings soared.
 
Lewisham has a high level of COVID-19 rates and the clinical commissioning group (CCG) –  Erfan in particular – encouraged us and provided lots of support to help us increase vaccination coverage. Charlotte, our local system vaccination operation centre team representative, was excellent in ensuring we had enough vaccines to meet the demand and both St Johns Ambulance and Royal Volunteer Service reps joined the efforts.
 
It’s amazing that we had volunteers from all walks of life – priests, high level executives, lots of young professionals and the retired too. Without their help, this would all just be a dream.

 

The good news is that we have seen an increasing number of pregnant people coming in

 

And of course, my heartfelt thanks and admiration go out to my pharmacy team, who worked ever so hard. Over the past five weeks, 7% of COVID-19 vaccinations administered were first doses; 13% second doses; and the rest boosters.
 
The uptake seems to increase with age; the younger age group (16-25) we have seen least of and uptake continues to be lower in black, Asian, and minority ethnic groups. The good news is, however, that we have seen an increasing number of pregnant people coming in.
 
Next step is vaccinating 12–15-year-olds. All the due diligence has been done and we’re just waiting for final sign off.
 
Perhaps the biggest challenge for us was helping the non-English speaking population, but at most times we were able to communicate using our multilingual staff and other patients queuing up. Another challenge we faced is those who received a previous vaccination abroad. We were able to find equivalent UK doses from NHS documents, but patients faced problems when it came to merging the two sets of records. The NHS can help, but there is a long wait.
 
The fact that pharmacies use the national booking service (NBS) to manage appointments, while primary care network and mass vaccination sites tend to use their own processes, has long caused us issues.
 
Such parallel systems don’t talk to each other, which often results in double bookings and no-shows, as appointments are not automatically cancelled on the NBS for those who have been vaccinated in non-pharmacy outlets. This is a waste of resources for pharmacies, in staff time and vaccine reserves. Walk-ins also prove challenging, as you don’t know how many staff to allocate.
 
Despite all this, the population has been very understanding and extremely grateful for the services pharmacies across the country provide.

 

 

“Ongoing staff shortages crippling for pharmacy” 

 

Pharmacy staff require lots of training and there is a requirement to keep up to date with endless regulation and paperwork. It’s more stressful than their friends who work in say, supermarkets, have it, and often they earn more. We have seen hardly anyone walk in looking for a job at the pharmacy and advertising for jobs results in many responses, but many no-shows at interviews.
 
Increasing pay helps, but against ongoing cutbacks in the wider sector, it is challenging. Locum rates have gone up substantially, as pharmacists opt for primary care network (PCN) jobs and stints at vaccinations sites – both of these roles are much less stressful. GPs had their targets suspended and funds increased in recognition of these pressures, while pharmacy still lags behind.
 
My pharmacy has been lucky so far in that we've only had the odd one or two COVID-19-related absentees, but I know lots of contractors who got much harder hit and had to work very late nights to manage the workload from missing staff.
 
The government is advising businesses to prepare for 25% of staff being off sick. Pharmacy will not be able to cope with such high contingency and in my opinion should be rated in the same critical category as hospitals are.

 

“GPs, PCNs and pharmacy are all trying to manage their own workload”

 

I know we tend to blame GPs a lot, but having seen my daughter and her husband’s (who are both GPs) workload, they too have their own pressure points. PCNs are supposed to bring all parties together, but as it stands – and I am a PCN pharmacy lead – all parties are busy trying to manage their own daily workload. Talk after talk with very little action is getting us nowhere. 

 

The PQS should be scrapped and funding transferred to essential services

 

In my opinion, the pharmacy quality scheme (PQS) should be scrapped and funding transferred to essential services to help us overcome some of these challenges. The recent relaxation of some red tape is welcome, but doesn’t go far enough.

 

“Crises bring people together”

 

Despite these pharmacy pressures – which at times can seem unbearable – one thing I will always remember is that the pandemic has brought a lot of goodness from the population.

People helping their neighbours, families looking after each other, staff and volunteers coming together and working towards one aim of helping people be and stay well. Pharmacists even found time to share best practice and respond to requests for help on social media, and in WhatsApp and Telegram groups.

While it is undoubtedly tough out there, it definitely takes crises to bring out the best in people.

Salim Jetha is Avicenna chairman and pharmacist at Lewis Grove Pharmacy in Lewisham, south-east London

Have you/your pharmacy been involved in the COVID-19 vaccination efforts? Share your experiences on the C+D Community

 

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