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Pharmacy bodies lambast PHE lack of advice on BAME COVID-19 risks

PDA: No “meaningful guidance” on actions to reduce the risks faced by the BAME workforce
PDA: No “meaningful guidance” on actions to reduce the risks faced by the BAME workforce

Pharmacy bodies have voiced disappointment that a Public Health England (PHE) review “fails” to offer guidance on how to mitigate the higher COVID-19 risks for BAME people.

“Evidence suggests that COVID-19 may have a disproportionate impact on people from Black, Asian and minority ethnic (BAME) groups”, according to the PHE review, Disparities in the risk and outcomes of COVID-19, published earlier this week (June 2).

However, the review “fails to discuss” the reasons BAME people are more vulnerable to COVID-19 “in any depth” the Pharmacists’ Defence Association (PDA) said in a statement on Wednesday (June 3).

An Office for National Statistics (ONS) report published last month (May 7) had already revealed that BAME people are “at greater risk” from COVID-19 than those of white ethnicity, it added.

The PHE report draws attention to the fact that the BAME community are more likely to live in urban areas, in overcrowded households and in deprived areas and to “have jobs that expose them to higher risk” – increasing the possibility of COVID-19 transmission. It adds that those of a BAME background are also more likely to be born overseas, meaning they could “face additional barriers in accessing services” as a result of cultural or language differences.

However, compared with the ONS report, “the PHE report does not offer much greater insight on first examination”, the PDA said.

Royal Pharmaceutical Society (RPS) president Sandra Gidley said the organisation had hoped for “an action plan to address the issues for BAME patient-facing frontline clinicians”. The review is “disappointing” as it offers “no recommendations or actions and it is unclear how the government plans to proceed”, she added.

The General Pharmaceutical Council told C+D yesterday (June 4) that, as of June 3 there were 26,928 (47%) pharmacists and pharmacy technicians on its register who have given their ethnicity as “Asian or Asian British”, “black or black British”, “Chinese or Chinese British”, “Arab or Arab British”, or “mixed ethnicity”.

No guidance for employers

The PHE report also fails to provide “meaningful guidance” for employers on the actions they could take to reduce the COVID-19-related risks faced by their BAME workforce, the PDA said.

Employers and responsible pharmacists should “work with their employees including BAME and other at-risk groups to assess their risk and put in place all possible reasonable mitigations”, the PDA added.

The RPS called on the government to introduce a “robust risk assessment and protection” for BAME staff and other vulnerable groups.

NHS England is encouraging employers to carry out risk assessments of their BAME staff and those who are at risk due to other factors, such as age or underlying health conditions.

However, when speaking to C+D earlier this week (June 3), Professor Mahendra Patel – pharmacist and a member of the RPS English pharmacy board and C+D’s clinical advisory board – emphasised that the risk assessment is not mandatory. The assessment might also bring challenges for smaller independent community pharmacies, many of whom “run on minimum staff,” he added.

“How are you going to encourage [BAME staff] to work at the back? Who’s going to be at the front [of the pharmacy]? They simply don’t have the workforce to replace them. They’re stretched as it is,” Professor Patel said.

Government should act now

The PDA urged the government to “investigate the issue of increased risks for BAME individuals” to better understand the reasons behind it, using the knowledge to inform what measures to take to safeguard BAME and other at-risk groups.

Ms Gidley said the government must ensure “BAME pharmacists feel as safe as possible” and that to do so, it should consult pharmacy “to bring about real change to support and protect our workforce”.

“There are also opportunities here about how pharmacists can support vulnerable populations and tackle health inequalities,” she added.

Professor Patel said pharmacies can “play a huge role in gathering intelligence around BAME patients and patient groups”, enabling more data to be shared and allowing studies to be carried out to examine how BAME communities might respond to new drugs and vaccinations.

A PHE spokesperson told C+D today (June 5) that its report will "inform the important work the Equalities Minister Kemi Badenoch is now taking forward.”

What do you make of the PHE report?

mark straughton, Pharmaceutical Adviser

It's an extremely difficult area to approach because any discussions to address disproportionality in the incidence of covid could lead to conclusive measures which could be deemed racist. It's almost easier, safer and less controversial at this point to withdraw and accept the critism surrounding lack of advice.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Surely BAME people are human beings, the same as white people, the same physiology (although there does seem to be a genetic component to the increased risk) - the same precautions apply, just more so. I'm in a not-particularly-at-risk group and I'm still being very alert. If I was high risk, I'd be doing everything possible to stop myself getting this thing.

Once upon a time, common sense applied . Nowadays, everything seems to be someone else's problem and no-one wants to take responsibility for themselves any more. It's not as if Covid-19 hasn't been in the news very much lately......

Interleukin -2, Community pharmacist

You sound like you want to say something but dont quite have the courage to say it? 

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

No, I just think that everyone, as they say, is in this together and we all have the responsibility to manage our own risks. If BAME people are at higher risk, for whatever reason, it is, at this moment in time, their responsibility to take the precautions they need to stay safe while out and about. It's no good taking unnecessary risks then trying to blame it onto someone else. If I cop covid now, it'll be my fault. I know the risks, I know how to avoid them.

Workplace risks should be assessed the same for everyone. If a white, aspenic, over 70, asthmatic etc etc person is in the workplace, the risk is higher, therefore more care and extra measures should be in place. BAME people are at higher risk so more care should be taken there as well. As I say, it's common sense.

I think your inference is that I want to say something racist but don't have the nerve. Not so. I don't give a toss what colour someones skin is. It's how they act which is the only important thing to me.

I'd suggest that the reason the PHE report ' “fails to discuss” the reasons BAME people are more vulnerable to COVID-19 “in any depth” the Pharmacists’ Defence Association (PDA) said in a statement on Wednesday (June 3).' is for the simple reason that they don't know why yet. This thing has only been around for six months, is still running it's course and until it is over, investigations cannot show the full story. The reasons are far more complex than a quickly drawn up report can address and take a lifetime to play out. The only important thing AT THIS EXACT MOMENT is that BAME people appear to be at higher risk, for whatever reason and therefore, the same as any other higher risk group, need extra protection, but this extra protection is the same regardless of a persons race. This discussion has it's time and it's place but that is not here and now. Get the protections for ALL at risk groups in place, let the virus run it's course until the protections can be relaxed, then look into the whys and wherefores of why BAME are disproportionately affected. It's a massive, complex issue and cannot be addressed in a rush.

Benie Locum, Locum pharmacist

'Black Lives Matter' and BAME and covid19 seems to be topic du jour.........

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Do you see them as the same or as different issues? There is a definite crossover in that it seems that socio-economic factors come into it, but also cultural ones whereby for BAME to lower their risk they would have to abandon their culture (I'm talking about things like the way many look after their elderly so much better than white people do and the way family seems much more important.)

Benie Locum, Locum pharmacist

I wonder if  RPS, GPhC are looking at themselves or looking the other way hoping for everything to blow over....

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

If they are I've a feeling they'll be waiting a long time.....

This thing is not going away this time. I don't agree with throwing bikes at horses but that statue should have gone years ago. They should pull it out of the river, leave it on its side in a museum looking exactly as it does now with a prominent display telling the whole story.

Benie Locum, Locum pharmacist

The RPS/GPhC are no better than many of these institutions being exposed right now. Same with these multiples that dominate the industry. Horror stories from some that have worked for the.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

The trouble is, if you dig far enough, any institution more than a hundred or so years old will have links at the very least to colonialism and/or slavery. Where do you stop? Should Guy's hospital be razed to the ground because it was founded by Thomas Guy? Those students who are demanding the removal of the Cecil Rhodes statue are benefitting from the education that his legacy provided. It's a really difficult situation and I don't have any idea of what the answer is. You can't say 'Let sleeping dogs lie' because then nothing changes, but Britain was built by it's colonial past and therefore, anyone living here today, benefitting from a relatively decent standard of living could be considered complicit. I don't think there is any answer to this, just time. After all, we aren't seeking reparations from Denmark for the Viking invasions, nor Italy for the Romans. Racism and racist attitudes WILL die out - I can see it happening already because it isn't considered acceptable as it was when I was a kid, but it literally has to die at the same time as the people who are racist. Changing a mind set is all but impossible.

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