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PSNC CEO: 'Blunt' test and trace programme could 'close pharmacies'

Simon Dukes: There's already been "an instance of a pharmacy closing as a result of track and trace”
Simon Dukes: There's already been "an instance of a pharmacy closing as a result of track and trace”

The NHS test and trace service is a “blunt instrument” on which the Pharmaceutical Services Negotiating Committee (PSNC) is seeking urgent clarity, its CEO Simon Dukes has said.

Mr Dukes voiced his concerns about the programme – which launched in England last week (May 28) – at a virtual PSNC press briefing on Wednesday (June 3).

This is “yet another example of new systems and services that are made and announced by politicians while details are being worked out”, he said

The programme could “close pharmacies pretty rapidly”, Mr Dukes added. “I believe we have already had an instance of a pharmacy closing as a result of track and trace,” he said. He explained that PSNC is still awaiting clarification from the Department of Health and Social Care (DH) on the implications of the scheme for community pharmacy.

Association of Independent Multiple pharmacies (AIMp) CEO Leyla Hannbeck told C+D earlier this week (June 3) that the organisation has approached the DH to raise awareness of the potentially detrimental impact the scheme could have on the provision of pharmacy services. AIMp has already received reports of a pharmacy being forced to close due to a staff member testing positive for the virus and the organisation is “concerned to hear” this, Ms Hannbeck said.

“We have raised this issue with NHS England and the DH and they have confirmed that they will look into this. The sector is also working together to issue advice on contingency planning,” Ms Hannbeck added. Different versions of the NHS test and trace scheme have been introduced in the four UK countries. Here is what we know so far about their implications for pharmacy teams across the UK.

England

Under the NHS test and trace service, launched on May 28, anyone with COVID-19 symptoms will be tested and those who have been in contact with someone who has the virus will be asked to self-isolate for 14 days even if they don’t have symptoms.

PSNC said in an update on its website on Wednesday that “a number of pharmacy teams across England have already been asked to self-isolate in accordance with the service”. It added that the PSNC will be “having urgent discussions” with the DH about financial support for pharmacies who find themselves forces to close.

PSNC also said that “a pharmacy team member’s contacts with patients will not be close contacts if the appropriate mitigation has been used” – for instance, if the two-metre social distancing has been followed or if Perspex screens have been installed.

A DH spokesperson told C+D earlier this week (June 1) that if healthcare staff have worn “appropriate personal protective equipment (PPE)”, they will not be asked to self-isolate.

However, pharmacies in England have repeatedly told C+D that they are experiencing difficulties sourcing PPE and the UK guidance on the use of PPE recommends pharmacy teams wear fluid-resistant surgical masks (FRSMs) only “for contact with members of the public with possible or confirmed COVID-19”.

Wales

A contact tracing system was launched in Wales on June 1. As with the English programme, those who have been in close contact with someone who has tested positive for the virus will be asked to self-isolate for 14 days.

A Welsh government spokesperson told C+D this week (June 2) that a contact tracer will identify and assess the “potential contacts” of anyone who tests positive.

“The assessment will take into consideration any additional circumstances, including the correct use of PPE, protective screens in the workplace and adherence to the two-metre distancing rule which – if correctly followed – means the individual will not be regarded as a contact for these purposes. When these measures are not followed, individuals will be deemed as a contact,” they added.

Scotland

Under Scotland’s test and protect programme, which also launched on May 28, people are being told to “isolate with their household as soon as they have [COVID-19] symptoms” and urged to book a test “as soon as possible”. If they test positive, they will be asked to share the details of all their recent close contacts.

Unlike in Wales and England, “there will be no exemption to the test and protect measures for key workers”, a Scottish government spokesperson told C+D earlier this week (June 2).

To protect themselves and their community, pharmacy teams should continue to implement the “two-metre physical distance, wear PPE as required and practise good hand and cough hygiene”, the spokesperson added.

Community Pharmacy Scotland said in an update on its website on June 2 that it’s awaiting updated guidance on PPE use from Health Protection Scotland. In the meantime, it recommends “team members wear FRSMs at all times in the pharmacy – even on breaks”.

Northern Ireland

Public Health Agency (PHA) started piloting Northern Ireland’s contact tracing system as early as April 27, with the scheme rolled out across Northern Ireland on June 1.

A PHA spokesperson told C+D earlier this week (June 2) that no exceptions will be made for pharmacy teams under the scheme – they will be asked to isolate for seven days if they test positive, or to self-isolate for 14 days if they have been in direct contact with someone who has had a positive test result.

The same day (June 2), a spokesperson for the Department of Health in Northern Ireland told C+D that a “range of business continuity arrangements have been established for community pharmacies, including daily sitrep [situation reports] on services, staffing and supplies”.

“In addition, action has been taken to support workforce resilience, including redeployment of dental staff to community pharmacy and a dedicated locum pharmacist portal,” the spokesperson added.

8 Comments
Question: 
What do you make of the new test and trace programmes?

Lucky Ex-Locum, Superintendent Pharmacist

As a total irrelevant aside, has anyone noticed the C and D job of the week? WOW!!!!!

Lucky Ex-Locum, Superintendent Pharmacist

Someone's let the cat out of the bag. Remember that the DoH stated aim is to reduce the number of pharmacies and now they have, in Covid-19, the perfect tool to achieve their aim without actually getting their hands dirty in any way. The job is done for them! I think we can now look forward to pharmacies being a particular target of test and trace with all the consequences of that.

david wayles, Locum pharmacist

If your staff wear appropriate ppe then they will not be considered to be close contact even if they have worked within 2m of each other. However, a cautionary tale.

In a care home I am aware of 3 residents tested positive and 15 members of staff. Further investigation revealed the staff were careful around residents but in the staffroom, especially at lunchtime, they were close together without ppe. I have seen this in several pharmacies, i work as a locum, and commented on it to staff with little positive response to suggestions such as you might like to have lunch separate sat in your car.

Are you SURE that at NO POINT during the working day your staff have not been closer than 2m, for longer than 15 minutes, whilst not wearing ppe. If you are not sure then when the tracers call you will either have to close the business for 14 days or lie and as professionals we would not do that, would we.

Lucky Ex-Locum, Superintendent Pharmacist

If the 15 minutes is cumulative it is totally impossible to not be closer than 2m for 15 minutes in a dispensary. That is just a fact of life.

mark straughton, Pharmaceutical Adviser

So as things stand. If, say, an independent pharmacy with 8 part timestaff working mon-sat and one of the staff should test positive then the WHOLE team needs to self isolate? Yes? Then surely that pharmacy must close because even with locum pharmacists and dispensers there is no pharmacy team and the pharmacy wouldn't even be able to open the next day. What happens here? Does NHS England have to be notified? These measures would close the pharmacy for good.

Lucky Ex-Locum, Superintendent Pharmacist

The pharmacy would have to close for a deep clean even before locum or replacement staff could be brought in. That's the first couple of days taken care of, then is there ANYONE out there who would be happy to pull a 9-10 hour shift in somewhere where you KNOW the virus has been? I definitely wouldn't touch that place with a bargepole

Joan Richardson, Locum pharmacist

The whole problem comes down to the fact that the Department of Health is under the impression that pharmacy staff can maintain social distancing at all times!  They need to look at most pharmacies and realise that a lot of dispensaries are corridor-like and social distancing is well nigh impossible.  Pharmacy teams must have access to adequate supplies of PPE with fluid-resistant masks as a minimum.  Until this happens the track and trace scheme will result in the closure of pharmacies.

The ramifications of a pharmacy closure are a major issue.  Once a pharmacy has downloaded an electronic prescription, whether they have dispensed it or not, it cannot be accessed by another pharmacy - the first pharmacy has to return it to the spine and cannot do so if they are closed.  Potentially this leaves patients without medication unless they can beg for another prescription from their surgery or arrange a CPCS via 111.

There is also the issue of loss of income for the pharmacy that is forced to close.

Kevin Western, Community pharmacist

"He explained that PSNC is still awaiting clarification from the Department of Health and Social Care (DH) on the implications of the scheme for community pharmacy."

"We have raised this issue with NHS England and the DH and they have confirmed that they will look into this".

Im sure they will get round to it some time never. THEY DONT RESPECT YOU UNLESS YOU MAKE A NOISE! 

This situation will continue happening while its pain free to shaft Pharmacy. They dont dare make similar mistakes with GPs cos the BBc would be knee deep in representatives calling the DoH a load of idiots and complaining about their funding.

Job of the week

Pharmacist Manager
Wrexham , North Wales
Great Salary & Bonus.