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Lloyds and Well advise pharmacy teams not to ‘enforce’ face mask rule

From July 24 it will be mandatory for patients to wear face masks in pharmacies
From July 24 it will be mandatory for patients to wear face masks in pharmacies

Lloyds and Well are advising teams not to insist patients wear face coverings and that enforcing this is up to the police, ahead of the rule taking effect in England on July 24.

New legislation that making it mandatory for the public to wear face coverings in shops in England, including in pharmacies, was announced by the government on Tuesday (July 14).

From next Friday (July 24), people who fail to comply with the new legislation could receive a fine of up to £100. Just as on public transport, children under 11 and people with “certain disabilities” are exempt from this measure.

In a letter to pharmacy teams on the day of the announcement (July 14), seen by C+D, Lloydspharmacy outlined that its company policy around this measure is that staff should “not insist or enforce” the legal requirement, if patients refuse to wear a face covering.

While pharmacy teams can “remind people” of the requirement to wear one and suggest they purchase a face mask or covering from he pharmacy if they don’t have one, they should continue to serve patients as usual even if they do not comply – although they should adhere to social distancing measures.

When asked for further information about its company stance yesterday (July 16), Lloydspharmacy told C+D that enforcing the legislation is “the responsibility of the police”, while the pharmacy’s role is to provide medicines to patients, at the same time as “making sure that our colleagues and customers feel safe and are protected from COVID-19”.

“Our pharmacy teams will ask customers to wear a face mask but we do not expect them to enforce this legislation,” a spokesperson for Lloydspharmacy told C+D yesterday (July 16).

Well: Pharmacy teams should remind patients

Well has taken a similar position and told C+D yesterday that it encourages teams to “remind patients and customers about the law and the reduced risks for everyone that face coverings provide”, but that the responsibility for enforcing this will lie with the police.

“Obviously too, our teams will need to be mindful of the exemptions for certain groups,” a spokesperson for Well told C+D yesterday.

“We are planning on communications to our teams about this early next week in readiness for the law coming in from Friday,” they said.

“Our teams have full PPE to protect themselves as well as Perspex screens at the till points,” they added.

Boots: Some patients exempt

Boots will be “asking all customers shopping at Boots and visiting [its] pharmacies to wear a face covering from July 24”, a spokesperson told C+D today (July 17).

“While we need to ensure that this guidance is being followed, we understand that some [customers] are exempt from wearing them due to a pre-existing health condition,” they added.

Dangers of challenging patients

Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp) told C+D yesterday patients should be “well informed about the legal requirement” to wear a mask, but that challenging a patient who isn’t wearing one “could cause [them] to become violent”.

Since the start of the pandemic, there have already been “many more instances than usual of members of the public becoming abusive and violent when asked to adhere to social distancing”, she said.

“Pharmacies are also in a different legal position to retailers because while they can legally choose not to sell their goods to any customer, we must legally dispense prescriptions we are presented with,” she added.

The Company Chemists’ Association chief executive Malcolm Harrison told C+D yesterday that he “hopes there will be a pragmatic application of this well-intentioned legislation to allow healthcare professionals to care for patients without inadvertently breaking the law”.

In Scotland, those visiting pharmacies have been required to wear a face covering since last week (July 10).

NPA: Use professional judgement

Jasmine Shah, head of advice and support services at the National Pharmacy Association said it is “advising members to be pragmatic and use their professional judgement as healthcare professionals”.

“It is not for pharmacists to police the new law. Rather, it is to explain to customers the importance of protecting staff and fellow pharmacy users,” Ms Shah continued.

“Pharmacies will wish to set clear expectations about what they want customers to do, which includes wearing a face covering in most cases,” she added.

30 Comments
Question: 
How do you intend on enforcing the face covering legislation?

Emma Harrison, Pharmacy owner/ Proprietor

Surely by now everyone is aware that they need to wear a mask? Some patients suffer from conditions that allows them not to wear one.  The point raised about patients getting violent is right and we have seen this over the COVID period. It is not my job as a pharmacist or my team's role to enforce the law and challenge anyone that walks through the door if they are not wearing one. My role is to deliver care to my patients.

What I can do is put a sign up in my pharmacy reminding people that they need to wear one and I also protect my team by ensuring they have PPE.  I am tired of pharmacy organisations telling us to use our professional judgement, they only say that because they have no clue about what to say.

Getting Shorter, Community pharmacist

Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp) told C+D yesterday .... “Pharmacies are also in a different legal position to retailers because while they can legally choose not to sell their goods to any customer, we must legally dispense prescriptions we are presented with,” she added.

 

I would have thought she'd be aware of the changes that came in 2013:

NPA says:

Refusing to supply items on a prescription in England is permitted only in those circumstances stated in the "Terms of Service of NHS Pharmacists" in the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013. ... The following reasons are all valid reasons for refusing to supply an item on a prescription or repeatable prescription according to the Regulations: ...

3) The person who presents the prescription threatens or subjects the pharmacist and/or members of the pharmacy team with violence, or commits or threatens to commit a criminal offence - a. This also includes if someone accompanying that person does so.

 

 

So, if face coverings are a legal requirement, then we have the ability under the regs to refuse to dispense scripts for people who refuse to wear them. Whether there's any need or point is another matter, but IMO it's important that we know we already have the right/power to deal with this if we choose to.

Emma Harrison, Pharmacy owner/ Proprietor

It is not incorrect to say that by law we are required to dispense medicines, not all patients can wear a mask because they may suffer from a condition that prevents them from doing so. I do not see this being our role to enforce the law. We have enough on our plate already.

Angela Channing, Community pharmacist

I hate to play Devil's advocate here guys, but there is a pub a few doors down from us, and no mask is needed!, also if I visit to Cardiff, I can go in Tesco there with no mask, but Tesco down the road from me, I will need a mask. So as well as the virus being on holiday itself until the 24th, it also is unable to get into pubs, or into Wales, or into, I believe gyms, where you will be huffing and puffing! 

What does all this tell you? It tells me that the original advice was probably right and they don't do that much, but with the public seemingly scared of its own shadow, Boris has decided to follow 'Wee Krankie motor mouth' and advise on using them. But do you really think if a person isn't wearing one, that you are really going to dial 999? 

My other 2 concerns on masks is the way they are worm, with constant touching and popping on and off, plus where are they all being discarded? Are we going to have an ocean full of them in 6 months' time? There has already been a picture on a news app of a gull being untangled from one! And observations of them tossed on the ground and in hedges. All, remember, bacteria and virus reservoirs. They are basically clinical waste. Although I'm sure the British public will be putting them on a boil wash every night to sterilise them for the next day! ;)

Personally, I would, and will be advising people of the law, but won't be taking any action if they refuse, other than to maintain 2m distance and offer free hand sanitiser if on the counter. 

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

All good points Angela. This Dis-united Kingdom we live in could really do with some coherent policies that cover the entire nation rather than all of the respective leaders trying to score points off the others. Mask wearing is probably pointless at this point anyway. Infection rates are still falling (which is a wonder when you see things like those idiots who go to illegal raves or the anti-mask protestors in London (if ever there's an anti-protest protest, count me in!) whose selfish behaviour could put us back in lockdown). If there was a time when it would have made a difference, it would have been right at the start to try to control transmission that way rather than wrecking so many lives by bringing in lockdown.

You're quite right to say no-one is using them correctly - the paper ones are designed for single use then discard for incineration yet people are going to wear them until they fall apart while the cloth ones are a good way of saving up germs of all kinds nice and close to your face. Environmentally, they could be very damaging as you say (there will be kids on beaches this summer using discarded ones as flags for their sandcastles I bet) and we could be picking these things out of hedges for years to come.

As to enforcement, I'm not a policeman, I'm not getting into an argument with anyone over this, we've survived several months without them so if someone isn't wearing a mask I'll be doing exactly as I do now, which is keep a lot more than 2 metres distance from them.

Caroline Jones, Community pharmacist

OMG.....this is absolutely ludicrous........masks are there for when 2meters can’t be adhered to....i.e when in a pharmacy!

It’s well seen the welfare of pharmacy staff in community is not valued; just look at how well the staff at GP’s, dentists and opticians are treated........

This is appalling; companies should be insisting on keeping their staff safe......I think this may well mean workplaces are not ‘COVID Secure’ and should really be reported!

To say ‘there are times when the information we give are patients is clear and this cannot always be fine with a mask on’ is daft.....if we are relating important information to a patient it’s likely to be in the consultation room - exactly the most important time when a mask is needed!

Let’s remember the use of a mask is to stop the person wearing it spreading it if they are asymptomatic........

Maybe if a pharmacy gets a COVID outbreak; they might think differently.......

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Have you seen all of those people protesting in Hyde Park against mask wearing? It just shows the utter selfishness and stupidity of some people. I hate wearing a mask but I'm doing it now for the sake of others. Would be ironic and not a little amusing if a lot of those protestors copped a dose now except for the fact that they would then, through their selfishness, spread to loads of other people and probably bring about a return to lockdown.

As for your point on the consultation room - I'm refusing to use one because there is no way you can even adhere to the 1 metre + rule in most of them.

ABC DEF, Primary care pharmacist

Sounds about right. Money and profits before staff wellbeing as usual. Nothing surprising here. It merely show the big boys have always been same as before - they don't give a single f about your safety. Poor leadership as usual and zero backbone, perhaps that's why pharmacy has always been seen as an easy target to funding cuts! Grow a pair and show your staff some support instead of leaving the mess with them. Surgeries in the mean time have at least the guts to tell patients "masks or gtfo". 

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I wore a mask into my surgery today - they asked me to pull it down cos they couldn't tell what I was saying. Admittedly there was a glass sliding door in the way but even so......

Leon The Apothecary, Student

Management needs to learn to tell customers no. It is, unfortunately, something that we have failed to do in the past and now we are dealing with the expectation that has caused.

Adam Hall, Community pharmacist

Wearing a face covering when entering the pharmacy sits in the same box as 'please don't punch the staff' - comply, or go elsewhere! My personal safety, and that of my staff, trumps everything.

Lisa Ray, Dispenser Manager/ Dispensing Assistant

As an independent we have been asking customers to wear a face covering since 1st July when the changes for public transport came into affect. This is mainly because our pharmacy is in a health centre with 3 surgeries and they insisted on it. We put a sign on the door and for the most part people have been compliant. If people are not wearing a face covering we take their name and ask them to wait outside. We then take the prescription to them once its completed.
There has only been a handful of people causing problems.

Concerned Pharmacist, Community pharmacist

In Wales coverings are not being made mandatory but retailers may choose to request them. But 3 layers not just one as in England! Will the multiples support their staff by requesting that the public wear coverings inside branches?
It is clear that we cannot rely on people to socially distance consistently.

Pear Tree, Community pharmacist

I had to visit a dentist last week and had to go through three rounds of telephone interviews to check I didn't have Covid symptoms. Then I had to consent to wear a face mask and a temperature check at reception before seeing the dentist or no dental appointment at all.  I was informed this policy was non-negotiable in no uncertain terms. I do completely agree the measures they have taken to protect themselselves. I wish pharmacy movers and shakers had some guts to say to the general public: you're welcome as long as you are willing to protect us. 

I don't think you can compare the risk for a dentist performing an oral examination often using aerosolised water and the majority of patients seen by a community pharmacy team. The majority of time it is no different to any other retail outlet and you can get away with going nowhere near a patient. Yes, when it comes to flu vaccination services or any other close patient contact service, we will have to insist on more checks.

I do agree though that face masks should be mandatory in pharmacies and head offices should support branch staff. If they decide not to serve someone because they don't wear a covering, they should have the backing of their company. The difficulty for the pharmacy will be consistency in enforcing the rule, will they send the 90 year old wearing no face cover away who has hobbled in to get their meds? Or the person who turns up 5mins before closing on a Saturday for their methadone with no mask? I think that's what the NPA mean by using "professional judgement"

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

The thing is, and I said this elsewhere, professional judgement smacks of passing the buck and leaving the pharmacist high and dry if there are any consequences.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Trouble is, the whole ethos of pharmacy has been based on appointment free access to the pharmacist and that has been expected to continue come what may. I think it is nothing short of miraculous that we have not lost pharmacists in droves to this disease (as far as I am aware anyway). Perhaps this shows that the precautions taken by dentists and doctors were a bit excessive?

Caroline Jones, Community pharmacist

The issue with dentists is completely different.....they will be ‘up close and personal’ so to speak and the risk caused by ‘aerosol generating procedures’ make the precautions warranted - for the most part

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I have to agree - a dentist is taking more of a risk than any of us. However, I stand by my thought that GPs have acted rather less than heroically throughout this. I do wonder how Pear Tree's dentist managed to do an oral examination while they were wearing a mask though....

Just a thought - how are dentists managing to disinfect their surgeries between patients? I would hope there has been a lot of investment in fogging machines.

 

Tim Hames, Community pharmacist

We are a small pharmacy so retail sales are not massive. We have already started "mask on" or don't come in and it is working fine. If someone cannot wear a mask then our first action is to serve them from outside if possible. If they need to come in to pay by card or if the pharmacist deems in necessary to see patient for a confidential discussion then maskless patient will be temperature checked and asked about COVID symptoms before being allowed in.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I hope this works well for you. I guess it's easier in a small pharmacy because you will have your regulars that you know by name and who will support you in whatever you do. THAT'S proper pharmacy to me.

Another Pharmacist, Community pharmacist

I can see the potential difficulties involved but this smacks of weak leadership, with branch teams being left to mop up a confusing mess. Show some support to your your staff in communicating a strong and consistent message to their patients and customers.

Leon The Apothecary, Student

Indeed, all I am thinking here is grow a pair. 

Benie Locum, Locum pharmacist

 Get your popcorn and sit back, this is going to be very interesting. Multiples already telling their pharmacists that they are on their own when they get assailed by an unhappy patient. There you have it folks. No doubt some of the more colourful incidents will make the national press.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Benie - we are in the strange situation of being in total agreement on this one! I just KNEW you were a decent soul. It seems however, that a lot of people disagree with us (particularly me). Let's see who is right shall we?

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Oh I just love that phrase - 'use their professional judgement' - which just smacks of buck passing. It effectively says 'Do what you want but be prepared to face the consequences if anything goes wrong cos we won't back you up'

I've survived this far with hardly anyone wearing a facemask, so frankly, my dear, I don't give a damn if people wear them or not. I ain't getting into a pagga over a layer of material (sorry, THREE layers) with who knows what kind of psycho for ANYONE.

Emma Harrison, Pharmacy owner/ Proprietor

Agree. I also get fed up when they say 'use your professional judgement'! They should come and work in a pharmacy for a day!

Leon The Apothecary, Student

Only in pharmacy would someone be allowed to not follow the rules because they don't like it. Every other shop and industry would kick them out and tell them to never come back. Pharmacy puts up with so much, there are plenty of people out there who go into the premises and kicks off a barrage of aggressive insults and intimidation, and gets what they want for it.

It is not right. 

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Not off me they don't Leon! 30 years of practice makes you rather good at not giving in to a bully!

Conor M, Community pharmacist

Wholeheartedly agree.

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