COVID-19


Section last updated: 18 September 2020

This page contains links to further information both national and local on the COVID-19 coronavirus pandemic.

Please note that this is an area that changes almost daily and the information and guidance will be updated on a regular basis.

We would like to thank you to you and your teams for your unrelenting dedication to your community during the current unprecedented period. The stories we have been hearing about the pressure you are under yet continuing to serve your patients in challenging circumstances and often at personal risk to yourselves makes us proud to represent you and your teams.

In return, we will do our best to support and advise you on any query and it is your feedback and information that you have provided to us that has led us to undertake the following work on your behalf:

  • Liaison with local commissioners regarding existing services and trying to reduce your workload regarding these where possible;
  • Making local stakeholders and commissioners aware of the current issues you are facing and ensuring that you are included in local resilience plans and considered in communications;
  • Raising and resolving issues identified by community pharmacies with key stakeholders;
  • Raising key issues facing community pharmacies at a national level;
  • Liaison with community groups offering support to community pharmacy;
  • Regular e-news updates of key local and national information including three supportive webinars to date;
  • Updating the LPC website with key local and national information;
  • Using social media, twitter and facebook, to raise the profile of community pharmacy issues;
  • Linking in with local MPs to raise the issues that community pharmacy is facing at a national level;
  • Publishing and launching a communications campaign on w/c 27 April 2020 issuing a plea to patients and customers to use their pharmacies responsibly to protect their pharmacies during the Coronavirus crisis – and added a warning that people who misuse the system or are abusive to pharmacists’ teams, risk losing some of their services.

The LPC contact details can be found in the contact us section.

Advice

Hertfordshire’s lead GPs – Dr Prag Moodley and Dr Nicolas Small – have teamed up to provide answers for some common dilemmas facing people concerned about COVID-19.

Subjects tackled include advice on how to tell the difference between the symptoms of a cold and COVID-19, what to do if you can’t get a test, and sources of support and help if you have symptoms or need to self-isolate.

Read their advice

National Updates and Information

A joint letter from the Competition and Markets Authority and the General Pharmaceutical Council regarding pricing during the COVID-19 pandemic has been sent to all pharmacies regarding a small minority of pharmacies seeking to benefit from the coronavirus pandemic by charging unjustifiably high prices for essential products.

 

Nationally the key actions that pharmacy teams are advised to undertake during the pandemic are as follows:

  1. Read the NHSE&I guidance whenever it is updated and implement its recommended actions;
  2. Clearly display the COVID-19 poster at points of entry to your pharmacy;
  3. Implement your business continuity plan where required and seek assistance and advice from your Local Pharmaceutical Committee;
  4. Keep up to date with developments by regularly checking the information on  COVID-19 on GOV.UK, the NHSE&I Coronavirus Primary Care webpage and checking your NHSmail shared mailbox on a regular basis for updates from NHSE&I; and
  5. Where possible, display the public health advice posters on hand washing, social distancing etc.

NHSE&I will be sending the posters to all contractors week commencing 20 April 2020 by Royal Mail.

Please note all changes to the CPCF during Covid-19 can be found here

A wealth of useful and practical information is available from the following key organisations on their websites:

The GPhC has published and will continue to publish new standards in their knowledge hub that helpfully clarifies some of the key areas for COVID-19 that may be causing you queries such as working with other pharmacies and volunteer groups. The standards will continue to be updated with new areas as and when they arise. This can be found on the knowledge hub of the GPhC website.

Pandemic Delivery Service

The commissioned pharmacy delivery service has been set up and funded to assist shielded patients that are unable to access their required medications.

This does not replace any existing delivery service that is offered by the pharmacy or the service that many have been able to make use of via authorised voluntary organisations.

Full details of the service can be found on the PSNC website.

The LPC has developed a Flow Chart for first time users.

If you are familiar with this service please see PSNC Flow Chart

Eligible patient groups for the delivery service

People falling into the extremely vulnerable (shielded) group, please see attached.

NHS Digital have added a ‘Vulnerability flag’ to the NHS Summary Care Record (SCR) of patients who are on the shielded patient list. This enables community pharmacy teams using NHS Digital’s SCR  portal to see an alert when viewing the SCR of such a patient. Full details on the PSNC website.

It would be well advised to emphasise the message that the NHS has used in its communications to patients, that they should try to get a family member, friend or volunteer to collect the item on their behalf, before asking the pharmacy to deliver.

Vulnerable ‘shielded‘ patients, have been sent details on how to access support via the RVS/GoodSam app on a medicines delivery service in the letter they received from the NHS, so they shouldn’t need a referral from a community pharmacist. Shielded patients are the only patient group that can access such direct support from RVS/GoodSam.

Volunteers

Locally the LPC has been approached by a number of organisations that can support delivery of medicines through a network of volunteers along with providing support to the pharmacy where appropriate i.e. opening the pharmacy doors and monitoring numbers of patients with the pharmacy. We have sought advice from GPhC in the best way that the delivery of medicines can be achieved in these unprecedented times without compromising your governance and before the national service is available.

In the first instance patients should be encouraged to identify a family neighbour or relative to pick up their medicines on their behalf where possible. Where this isn’t possible we have therefore agreed with the organisations below that we will promote the relevant organisation’s contact details to community pharmacies that can be provided to the patient as follows.

How to access support

Support Details

Delivery of prescriptions and non-prescription medication

 

For patients unable to collect prescriptions or medication access to transport to deliver these to the most vulnerable residents.
  • Hertfordshire County Council accessible to all patients across Hertfordshire 

If you are an individual requiring support in collecting a prescription, please contact Herts Help on 0300 123 4044.

  • Communities 1st accessible to all patients across St Albans and Hertsmere 

020 8386 4006      memberservices@communities1st.org.uk

  • Welwyn/Hatfield CVS accessible to all patients across Welwyn and Hatfield

whcvscars@yahoo.co.uk

  • London Colney Good Neighbour Scheme accessible to all patients in London Colney

01727 261104      events@londoncolney-pc.gov.uk

  • Watford & Three Rivers Trust (W3RT) accessible to all patients in Watford and Three Rivers

01923 216955      communitycars@w3rt.org

  • North Herts and Stevenage CVS accessible to all patients in North Herts and Stevenage

01462 689402      communitytrs@nhcvs.org.uk

  •  Community Action Dacorum accessible to all patients in Dacorum

01442 212888      ctadmin@communityactiondacorum.org.uk

  •  Harpenden Cares accessible to all patients in Harpenden

01582 460457

  •  Support For All (Wheathampstead) accessible to all patients in Wheathampstead

01582 380910      info@wheathampstead-pc.gov.uk

  •  Colney Heath Community Support Group accessible to all patients in Colney Heath

07803 313525

  •  Redbourn Care Group accessible to all patients in Redbourn

01582 794550      info@redbourncaregroup.co.uk

 

If you are approached by volunteer organisations please do put them in touch with the LPC and we will add them to the list above.

Controlled Drugs Update

As there are several updates from the accountable officer and other regulatory bodies in regard to CDs, we have listed the most important.

  • Reporting Incidents and Concerns

The accountable officer requires only incidents or concerns that you consider are ‘extremely serious’ or have had a ‘catastrophic’ outcome to be reported. Reports must be made as soon as practicable and via www.cdreporting.co.uk. For the avoidance of doubt, they consider serious patient harm or death and any theft or significant loss especially where misappropriation by a Healthcare Professional would meet the above definition. Suspected misappropriation by HCPs at this time is of particular concern to us as colleagues across the system are under intense personal pressure. We receive regular reports of HCPs accessing CDs at work to cope, self-medicate or self-harm. Please do ensure that your governance ensures that the health and wellbeing of your colleagues is protected.

 

  • Authorised persons to witness the destruction of obsolete Schedule 2 controlled drugs 

In primary care we are currently not able to arrange for an authorised person to attend any premises. If you are unable to store expired stock safely please report this as an incident on www.cdreporting.co.uk

 

  • The CGL website is regularly updated and is very comprehensive with lots of useful links.

CGL is going to honour all payments for instalment dispensing even though supplies are now going out in 14-day instalments. Click here for further information.

 

  • Information for community pharmacies to support Health and Justice (HJ) services and released detainees for COVID-19

This guidance   is to provide you with information about supporting people that have been released from prison to access medicines.

The LPC is in discussions about reimbursement for instalment dispensing.

 

  • Message from Police to Pharmacies regarding transportation, delivery and storage of controlled drugs. Click here for further information.

Dealing with returned medicines during the COVID-19 pandemic

National pharmacy bodies have today published guidance on dealing with unwanted medicines that have been returned to community pharmacies.

PSNC has worked with the National Pharmacy Association, the Royal Pharmaceutical Society and the Community Pharmacy Patient Safety Group to produce the joint guidance for community pharmacies in England.

The contractual requirement for community pharmacies to accept unwanted/out-of-date/waste medicines for disposal from the public remains an important service during the COVID-19 pandemic, but it does bring potential risks for pharmacy teams.

This guidance has been compiled to help contractors determine how best to safely handle returned unwanted medicines at this time. It contains a list of considerations and a suggested procedure, as well as checklists to work through.

Guidance on dealing with patient-returned / unwanted medicines

Checklists on dealing with patient-returned / unwanted medicines

Antibody Testing

 

NHS England and NHS Improvement (NHSE&I) is in the process of rolling out a COVID-19 antibody testing programme. Antibody testing will be open to NHS staff, including community pharmacy teams, with each NHS region managing its own arrangements. As of yet we have not been informed when antibody testing will be available within Hertfordshire. As soon as we are made aware of this we will post details on Herts LPC website and in the e- news.

It is, however, important to note that the NHS Test and Trace guidance for healthcare workers states that a positive antibody test result does not exempt someone from the requirement to self-isolate for 14 days if they are a contact of a confirmed case. Antibody testing can only inform about previous exposure and it is currently unknown whether this leads to protection against future COVID-19 infections.

NHS Test and Trace

Community pharmacy contractors may have seen the HM Government announcement that the NHS Test and Trace Service would commence on the 28th May (see also PSNC’s update on this).

Since then, we know that a number of pharmacy teams across England have already been asked to self-isolate in accordance with the service. This has emphasised the need for contractors to consider the implications of the Test and Trace Service and the mitigations in the pharmacy which may avoid the need for whole pharmacy teams to self-isolate if one member tests positive for COVID-19.

Further information on the NHS Test and Trace Service for pharmacies, including some initial advice on patient and staff contacts, is set out below.

Guidance for pharmacies

PSNC is continuing to urgently seek guidance from the Department of Health and Social Care (DHSC) on whether the Government advice on the management of staff and exposed patients or residents in health and social care settings applies to community pharmacy and on whether pharmacy team members asked to self-isolate for 14 days with no symptoms will be eligible for a coronavirus test – so that if they test negative, they could return to work earlier.

Alongside seeking these clarifications, PSNC will also be having urgent discussions with DHSC about financial support for pharmacies that have to close temporarily if the whole pharmacy team has had to self-isolate.

PSNC Director of Operations Gordon Hockey said:

“The potential implications of the NHS Test and Trace Service for pharmacies are significant, and we are working with DHSC and NHS officials pressing for urgent clarity on these matters. As soon as we have answers we will share them with LPCs and contractors.”


Information for pharmacies on the NHS Test and Trace Service

NHS Test and Trace – Key points for contractors as Q&As
PSNC has been working with NHS England and NHS Improvement (NHSE&I) to clarify how the Government’s NHS Test and Trace programme applies to community pharmacy to help reduce the need for large numbers of pharmacies needing to close.

PSNC has produced a Q&A document to provide further information on the programme, give advice on patient and staff contacts, and outline the relevant mitigations that may help to avoid the need for whole pharmacy teams to self-isolate if one member tests positive for COVID-19.

 

The NHS Test and Trace Service is about breaking transmission chains, so the virus has less chance to spread as Government eases the lockdown restrictions. Key information on the Service applied to community pharmacy and relevant mitigations in the pharmacy include:

1. Close contacts

Anybody who tests positive for COVID-19 will be contacted by NHS Test and Trace and will need to share information about their recent contacts. The new HM Government guidance means those who have been in recent close contact with someone who tests positive must isolate for 14 days, even if they have no symptoms.

A close contact broadly means spending 15 minutes or more within 2 metres of an infected person, or a very close specified personal interaction for a shorter period of time e.g. skin to skin physical contact or travel in the same small vehicle, and applies to those who spend significant time with an infected person within the same household (see below FAQs for a fuller explanation).

2. A flow diagram setting out the procedure for those with symptoms or  identified as close contacts:

3. When patient contacts in a community pharmacy are not close contacts

A pharmacy team member’s contacts with patients will not be close contacts if the appropriate mitigation has been used, for example, 2m social distancing, an appropriate Perspex screen or the safe use of appropriate PPE (see the PSNC information on the use of PPE in community pharmacies).

4. Contact tracers are likely to scrutinise staff contacts in a community pharmacy

A pharmacy team member’s contacts with other staff members are likely to be scrutinised by contact tracers to determine if they are close contacts. Relevant mitigations which may avoid the need for the whole pharmacy team to self-isolate if one member tests positive for COVID-19 are likely to include:

  • any social distancing of 2m that has been possible;
  • any safe and appropriate use of PPE;
  • any working practices that reduce the transmission of coronavirus, for example, the use of separate staff teams in the pharmacy where contact between the two teams is minimised;
  • lunch and break arrangements for staff; and
  • any other appropriate arrangement that avoid close contacts.

Only those pharmacy team members who have had recent close contact with another staff member who then tests positive for COVID-19 will be asked to self-isolate.

5. Further mitigation of the risks for staff

Pharmacies have already been taking steps to reduce – mitigate – the risks of patient to staff and staff to staff transmission of coronavirus and should review the measures taken so far. Additional measures may be necessary to manage the risks and minimise close contacts between staff and between staff and patients.

Risks should be considered on a pharmacy basis and an individual staff member basis, particularly when considering those most at risk including BAME pharmacy staff. NHS guidance on supporting our BAME NHS people and communities during and beyond COVID-19  provides a helpful starting point and there is ongoing work on this issue by the Royal Pharmaceutical Society (RPS):

BAME communities and COVID-19

Action needed for BAME workforce

6. The NHS coronavirus app is awaited

The NHS coronavirus app is currently being trialled on the Isle of Wight. When this is rolled out across England the app will supplement the other forms of contact tracing now in place.

7. Community pharmacies that have to close

A community pharmacy that has to close should follow its business continuity plan and may also find helpful advice in the PSNC’s Resilience Guidance – Part 3: Emergency Closure developed with NHS England and NHS Improvement (NHSE&I)


DHSC Q&A on the NHS Test and Trace Service

DHSC has issued a separate Question and Answer document for external stakeholders for staff and employers. Key FAQs for employers include:

What is a “contact”?

  • A ‘contact’ is a person who has been close to someone who has tested positive for coronavirus (COVID-19) anytime from 2 days before the person was symptomatic up to 7 days from onset of symptoms. For example, a contact can be:
    • sexual partners or people who spend significant time in the same household as a person who has tested positive for coronavirus (COVID-19);
    • a person who has had face-to-face contact (within 1 metre), with someone who has tested positive for coronavirus (COVID-19), including: being coughed on, having a face-to-face conversation, or having skin-to-skin physical contact, or any contact within 1 metre for 1 minute or longer without face-to-face contact;
    • a person who has been between 1 and 2 metres from someone who has tested positive for coronavirus (COVID-19) for more than 15 minutes; or
    • a person who has travelled in a small vehicle or on a plane near someone who has tested positive for coronavirus (COVID-19).

My staff are exposed to people every day, are they more likely to be told to self isolate? 

  • It is important for employers to play their part by making workplaces as safe as possible and by following the 5 steps to working safely.

If a staff member is notified, do they have to report to us?

  • If an employee is notified to self-isolate for 14 days because they have come into close contact with someone who has tested positive for coronavirus, and are unable to work as a result, they should notify you that they are unable to work within the deadline you have set in you sickness absence policies (or normally within 7 days if you have not set one).

Will my whole workforce be told to self-isolate if someone tests positive?

  • Only those who have had close recent contact with someone who then tests positive for COVID-19 will be asked to self-isolate.

What’s the minimum and maximum time an employee can be told to self-isolate for?

  • As now, those who test positive for coronavirus will be asked to isolate for 7 days from the onset of symptoms and only stop isolating from day 8 once they have been fever free for 48 hours without medication.
  • Those who have had close recent contact with someone who went on to test positive for coronavirus will be asked to self-isolate for the period ending 14 days after they came into contact with the person who has tested positive.

Coronavirus testing in Hertfordshire

The national NHS ‘Test and Trace’ programme is fully operational across Hertfordshire and drive through testing has been expanded from 13 June.  Read here on how to book a test and see the new locations added

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The range of locations and eligibility criteria for coronavirus (COVID-19) testing across Hertfordshire has been significantly extended, following the introduction of local arrangements supported by the military and new government guidance.

In addition to the testing arrangements below the Hertfordshire CCGs have sent through an update to the LPC of local testing arrangements also being available to community pharmacies and their staff at Welwyn Garden City and Harpenden. Please read the letter to find out further details on how you can access this testing service.

In summary, testing arrangements are as follows:

For essential workers (as defined by the government at gov.uk/coronavirus) and their household members aged over five with active symptoms who have access to their own transport:

  1. tests at Stansted, Wembley and a range of other locations across the country can be booked online now via an online portal at www.gov.uk/coronavirus. These are available every day of the week.
  2. drive-through tests will be available
  • on Saturdays between 10am-4pm in Hertford at County Hall, SG13 8DQ
  • on Sundays between 10am-4pm in Watford at the Central Watford leisure centre, WD17 3HA
  • on Mondays between 10am-4pm in Stevenage at Hertfordshire County Council’s office on Six Hills Way, SG1 2ST
  • on Thursdays between 10am-4pm in Watford at the Central Watford leisure centre, WD17 3HA

Please bring a mobile phone to the test centre if you have one.  Drive-through tests are available at a range of other locations on different days of the week across the country. Book online or order a mail order test via www.gov.uk/coronavirus.

Coronavirus testing in Hertfordshire updated arrangements as outlined above including booking and eligibility is outlined in this letter.

For all essential workers who are within the first three days of having suspected symptoms who do not have access to their own transport: a mail-order test can be requested through GOV.UK website.

A letter with full information on testing available in Hertfordshire has been disseminated.

Further information on testing at a national level for pharmacy staff can be found on the PSNC website.

Smartcard multi-site code added to cards of pharmacy professionals

NHS Digital are adding the multi-site FFFFF Smartcard code to Smartcards with the pharmacist or technician role, for the duration of the pandemic. The initiative has been supported by PSNC and NHS England and NHS Improvement. The bulk activity performed by NHS Digital is scheduled to take place across this week and to be finished by the end of the week.

A temporary Smartcard position has been created to provide greater flexibility for pharmacists and technicians during the ongoing pandemic. This will help pharmacy staff if they unexpectedly find themselves working at their non-usual pharmacy – e.g. because of staff shortages.

Covid-19 Hot Hubs

COVID Hot hubs (GP practice services) have been set up across Hertfordshire whereby patients with suspected COVID-19 can be referred to attend for a face to face consultation. Most of the emergency medicines will be made available at the hub but there may be instances where they prescribe medicines that will need to be picked up from the pharmacy. These hubs are in each locality.

The following hot hubs went live in HVCCG on the dates listed below.

• Elstree Way Hot Hub went live on 08/04/2020
• The Stewarts Hot Hub went live on 14/04/2020
• Hemel Hempstead Hospital Hub went live on 15/04/2020
• Garston Clinic Hub went go live on 16/04/2020

The LPC has strongly recommended that prescriptions should be sent to the patient’s usual pharmacy via EPS. However if this is not a possibility in rare cases then the prescription should be emailed to the generic nhs.net pharmacy email address with the prescription sent in the post i.e. using the provisions within the regulations for an emergency supply to be provided at the request of a prescriber with the prescription being sent to the contractor within 72 hours of the request. The patient should be told not to attend the pharmacy and the patient should identify an individual, ideally carer, family, neighbour in first instance, to collect the dispensed prescription from the community pharmacy and then to deliver it to the patient’s house. To reduce the spread of infection, this should NOT be a person from their household and we have requested that ideally this should not be a paper prescription. If necessary we are working with Hertfordshire County Council to potentially deliver medicines using their volunteer network if they have no one who may be able to pick up these medicines.

FP10 Prescribing in the absence of EPS

Whilst the LPC position is that ideally EPS should be available for dispensing of FP10s this is not currently possible for all providers as outlined below. It is essential that community pharmacies ensure locum pharmacists or a member of the community pharmacy team is able to access the shared generic nhs.net pharmacy email address when the pharmacy is open. 

Community Trusts
The Community Trusts that support patients locally do not currently have access to the EPS system and are setting up contingencies to support virtual clinics. The LPC has therefore agreed that in these cases that as the risk of posted prescriptions not arriving in time for a patient is a genuine concern, we have recommended that the prescription is scanned and emailed via nhs.net which will be auditable and traceable. This should then be followed by the original prescription being posted to the community pharmacy. We have been assured that the number of prescriptions should not be too onerous but wanted to make you aware that you might receive some prescriptions via this route at the current time until a better process can be identified.

Hertfordshire Partnership University NHS Foundation Trust (HPFT) 
Medicines prescribed in HPFT community outpatient appointments are usually done so through issuing FP10 prescriptions which are dispensed by community pharmacies. To support (a) the government’s social distancing and isolation measures, (b) avoid any unnecessary clinic appointments and (c) support any staffing shortages the following actions have been recommended to be taken by HPFT prescribers:

  •  FP10 prescriptions (including prescriptions for Controlled Drugs) can be posted via the royal mail tracked service to the service users preferred pharmacy. The pharmacy must be told in advance that they should expect these FP10s in the post and an NHS.net email address requested. Prior to posting the FP10 prescriptions they should be scanned and emailed to the chemist and the envelope labelled “FAO Responsible Pharmacist”. The service user should be informed once the FP10 prescriptions have been posted.
  • Prescription quantities must not be changed from normal practice as increasing quantities will put the medicines supply chain at risk.
  • In order to provide an increased supply of medication several FP10s can be written at the same time to cover the next couple of months but each prescription must be clearly post-dated for example one dated for now, another dated for the next month and thereafter. However this must only be done if the patient is stabilised on their medication and the prescriber does not anticipate any dose changes.
  • If the patient is stable on their medication and the medication being prescribed is within the HPFT formulary then GPs should be encouraged to take over prescribing responsibilities as per normal practice.

Dentistry
Remote prescribing may be undertaken for some dentistry patients where necessary. Dentists have been advised to follow the below steps for remote prescribing:

STEP ONE:

  • Complete prescription and sign.
  • Scan copy and email securely to pharmacy email address.
  • Contact pharmacy via phone or by other appropriate means to advise them you will be emailing scanned prescription.
  • Attach copy to patient’s clinical records.

STEP TWO

  • Send original signed copy to pharmacy postal address within 72 hours.
  • Log all sent prescriptions, confirming receipt with pharmacy.

We would also like to remind all pharmacists that you can dispense private prescriptions from a private dentist as an Emergency Supply at the request of a prescriber. This can be in the form of a secure email followed up with the paper prescription sent in the post as per the process for NHS prescriptions.

Business Resilience and Contingency Planning

Please ensure you update your Business Continuity Plan, it may be useful to consider the following areas:

  1. Update emergency contact details for staff, key holders. Make all staff aware of this. Can consider your own ways in which to manage risk to staff ie. limiting members of the public into the pharmacy during busy periods.
  2. Know who to contact in case of a COVID-19 risk as outlined within your SOP. 
  3. Who you would signpost to in the event of you being unable to open? Can you operate services remotely. Consider nearest pharmacy not NHS 111 at current time.
  4. Buddy up with a local pharmacy/s to support in the event of an issue arising from either side.
  5. Speak to your local GP practices to understand their emergency plans and how this would affect you and their patients.
  6. Have contingencies in place to support your delivery services if you run one eg. family, friends, patient or community groups.
  7. Contractors are advised to consider how they protect delivery drivers and you could consider a method of communicating with delivery patients in advance of the delivery where possible. Having rung the patient’s doorbell, delivery drivers may also be able to step 2 metres back from the door, before asking whether the patient is self-isolating, prior to handing over a prescription.
  8. Ensure you have enough administration supplies eg. prescription forms
  9. Do you have staff at risk who will self isolate or if schools/care facilities have to close? Have a plan to deal with this. Consider flexi hours, lunch time closures, TOIL, holidays.
  10. Consider your isolation area and disinfection plans and display relevant posters to the public.

GPHC has confirmed where no locum cover can be secured at the pharmacy, and recognising the potential effects of the current pandemic, it would be in the patient’s best interest for medicines already dispensed to be supplied from the pharmacy. They have also relaxed the inspection process. Please see full details on the GPHC website.

Pharmacy staff are included in the list of Government key workers of school provision for children. Please see full details on the PSNC website.

If you need further support and advice on business resilliance please contact the NPA or your local Head Office.

Community pharmacy security

The Metropolitan police has issued guidance specifically for community pharmacy premises offering advice on security of premises, and safety and well-being of staff and customers during the pandemic.

Personal Protection Equipment (PPE)

Updated 16 June 2020: Please click here for the latest advice from PSNC regarding the use of wearing face masks and face coverings.

All community pharmacies have received an email from Community Pharmacy Hertfordshire on 21 April 2020 with the latest position on PPE. Please refer to this for further information. If you believe that you did not receive the email please contact the LPC office.

Please find below the latest information around the use and ordering of PPE. Here is a link to the government’s PPE Plan. The national plan is split in to three strands:

Strand 1 – Guidance
The national PPE plan describes national guidance in detail. Table 2 shows the recommended PPE for community settings. PHE have been advised that there is now sustained transmission of COVID-19 within the community in the UK, so table 4 shows PPE recommendations in these circumstances.

Strand 2 – Delivery
A new website (sometimes referred to as the e-commerce solution) is being rolled out in the coming weeks to improve distribution and will enable primary, social and community care providers in England to order critical PPE.

Until this website becomes fully operational, please continue to order PPE through your Business As Usual (BAU) method direct with your usual wholesaler. If the stock is not available through your BAU route then please try alternative suppliers.

Strand 3 – Future Supply
This is being managed through the Government’s PPE Plan which also sets out the national stance on future supply of PPE.

Donations or Locally Manufactured offers of PPE
We understand that health and social care providers are being contacted by members of the public or local businesses either offering donations of PPE, or to turn their production capabilities to manufacture new PPE. Some providers are also looking to import PPE from untested new sources of supplies from abroad.

All offers of donations are appreciated and demonstrate the willingness of the community to support key workers during this time. Whilst no one wants to discourage the support that members of the public and local business are offering, we need to ensure that all PPE is safe for health and social care professionals to use.

Donated PPE should not be accepted if it does not meet certain criteria, including 1) being in its original and undamaged packaging, 2) within its expiry date, and 3) has been correctly stored. Please see IPCT PPE Donations Checklist for donated items of PPE.

The UK has clear standards that all recommended PPE must adhere to. It is therefore recommended that any new local manufacturers of PPE are in the first instance directed to the Government’s webpage.

There is also a local checklist for those who wish to manufacture or produce PPE for Hertfordshire health and social staff: HCC Guidance on Manufactured PPE.

If you have any queries about the quality or safety of any PPE that you have received (paid for or donated), please contact PPEinfo@hertfordshire.gov.uk who will work with Trading Standards to address your concerns.

Installing protective screens in pharmacies – to support the installation of such barriers, NHSE&I is making a £300 payment to all pharmacies, except distance-selling pharmacies. The payment will be made automatically to all contractors (bar distance selling pharmacies) and it is expected to be paid by the NHSBSA in the payment which will be made on 1 May 2020. Full details on the PSNC website.

Medicines Supply Chain

  1. OTC Paracetamol: National messages have been confusing regarding the shortage of paracetamol and whether you can repackage POM packs. Please see updated recommendations on the NPA website and  RPS website that has clear guidance on this that allows you do so that does not require a prescription from a GP. Please seek any guidance from your head office if in a multiple company and make your own business and professional decisions regarding this.
  2. The situation of medicines shortages is being monitored at a national level. Community pharmacy contractors are encouraged to use the reporting tool on the PSNC website to help PSNC build their evidence base to medicine shortages. Please see full details on the PSNC website.

Repeat Prescription and Prescription Duration

We have been working with local CCGs to get the following messages out:

  1. GP Practices should be encouraging patients to order repeat prescriptions online or through their normal channels. Patients should not be directed to the community pharmacy who would normally drop their prescriptions to the GP practice in person as according to CCG guidelines.
  2. GP practices should not extend prescription duration at the current time which could potentially affect the supply chain detrimentally. This was included in Nikki Kanani’s letter to general practices nationally. Pharmacies are also reminded they should also not be advocating this approach for any of their patients.
  3. GP practices and pharmacies are asked to consider the opportunity for electronic repeat dispensing which will also decrease requests from patients.

Pharmacy Closures

For full information on the regulatory and contractual requirements of opening hours for pharmacies during the current period please refer to the PSNC website.

The SOP for community pharmacy (revised on 22 March 2020) gives pharmacies some flexibility in the hours in which they need to open to the public during the COVID-19 pandemic.

Please remember that you must inform the DOS when the pharmacy is closed and the best way to do this is to use the DOS Profile Updater. If you have any problems with using the DOS Profile Updater please email the DOS team.

PharmOutcomes has developed a reporting template allowing pharmacies to record their operational status. This will allow pharmacies to record the level at which they are operating against a Red, Amber and Green traffic light system and provide feedback to LPC leads and Head Offices about the challenges they are facing. For sites recording an Amber status, the template allows a pharmacy to record and feedback details of their operational challenges and also provide information on planned closures, in line with the revised COVID-19 SOP. For pharmacies faced with no alternative other than to close, i.e. recording a RED status,  all information recorded and saved will prepopulate a form that can be printed when data is saved. This form can then be emailed to the East NHS England and Improvement (NHSE&I) office to inform them of the closure.

The PharmOutcomes template would be very useful for the LPC to help monitor service delivery and support you better and we recommend that you use this template going forward to record your operational service where possible.

Important Contact Details

We are doing our best to support you through this difficult and unprecedented time, but please do continue to contact us with feedback and queries so we can advocate on your behalf. We have developed local media releases, increased regular communications to you, undertaken a webinar and are troubleshooting your queries and liaising with local commissioners.  Thank you for your unrelenting dedication to your local community. Key contact information for the LPC is below.
Please contact the office in the first instance for all queries preferably by email on info@hertslpc.org.uk. Mobile contacts are available below.
  • Office (Sara Norwood, Monday – Thursday): 07949 219737
  • Ann-Marie Carrey (Wednesday – Friday): 07494 099156
  • Ingrid Cruickshank (Tuesday – Thursday): 07494 099160
  • Helen Musson: 07738 948220

Key Local Commissioner Emails

•Drug and Alcohol Services:  Herts@cgl.org.uk
•Sexual Health Service: PublicHealth@hertfordshire.gov.uk
•Directory of Services NHS 111:  herts.dos@nhs.net
•East and North Herts CCG:  enhertsccg.covid-19@nhs.net
•Herts Valleys CCG:  hvccg.pmot1@nhs.net

Information for COVID-19 SOP

•Regional/local health protection teams

Find your local health protection team at www.gov.uk/health-protection-team

•NHS Regional Pharmacist: Richard Seal  richard.seal1@nhs.net
•NHS Local Pharmacy Network (LPN) chair: Jane Newman  england.eastpharmacylpns@nhs.net
•Local NHS lead for commissioning: Andrea Patman  apatman@nhs.net
•Local NHS Incident Room: england.eastofengland-COVID19@nhs.net
•Local Infection Prevention and Control Team: Frances Bolger, Head of Infection Control and Prevention frances.bolger@nhs.net.

Wellbeing

NHS England and NHS Improvement (NHSE&I) have issued information on the first in a series of psychological support for all NHS staff, including those working in primary care, during the COVID-19 outbreak. NHSE&I note the importance of healthcare workers looking after their own health and wellbeing, whilst supporting patients and their family. The initial offer involves free access to a number of wellbeing apps (Unmind, Headspace, Sleepio and Daylight) from now until the end of December 2020 to support healthcare workers’ mental health and wellbeing. Information on how to access this support is available on the NHS Employers website; an NHSmail email account may be required to access some of the apps.Access the support via the NHSE&I website     Information on how pharmacy staff can obtain an NHSmail account.  Mental Health Foundation has a useful article to also share with your teams. Training Matters advice for taking some time during your busy day. Resources for health and care staff from the Mindfulness Initiative.