What was the aim?

To continue to provide pharmaceutical services and continuity of medicines supply for patients within the community, during normal working hours in a safe and effective manner.

This included patients attending the pharmacy for their medicines or healthcare advice, and those patients who received their medication by delivery.

With some healthcare services having limited or remote access for patients, community pharmacies up and down the country were the key first point of contact for much healthcare advice and support for thousands of patients

What was the solution?

• Staff, including drivers, were given personal protective equipment (PPE) – masks, gloves, hand sanitisers, face shields – and asked to clean work surfaces regularly throughout the day.
• A one-way system was introduced in each pharmacy for customers to follow, with progress aided by clear messages and barriers.
• The number of customers within each pharmacy was limited, depending on size. This was done via floor markings – each at two metres’ distance – and barriers installed to form orderly queuing systems.
• Magnetic locks were installed which could be activated from the counter, should customer numbers increase beyond safe capacity, and so preventing further customers from entering until it was safe to do so.
• Acrylic barrier screens were installed at each counter position, with customers asked to stand in a designated boxed area in front of the counter, to maintain safe social distancing from staff.
• Items were transferred between staff and customers via a basket fitted through the barrier.

These procedures were explained to customers via posters and notices around the pharmacy and doors/windows, along with further information about COVID-19.

What were the challenges?

• Time and staffing – installing and adapting to the above processes almost overnight was challenging. Some staff had to stop working as they are in the shielding category, and so replacements had to be found at very short notice.
• In the initial stages, communicating to patients the seriousness of the situation was difficult.
• Procuring enough supplies of PPE. Much of the stock had to be sourced from other healthcare professionals who had stock, due to low stock levels with many supplies
• Significant increases in surgeries’ prescription output put a strain on the supply of medicines. Patient expectations were such that they wished to collect medication immediately, meaning prescriptions needed to be dispensed in a very short period.
• Demand for delivery services reached an unprecedented level, and management of this further strained the service.
• Reduced face-to-face appointments at GP surgeries saw a vast increase in patients attending pharmacy for healthcare advice and support.

What were the results?

• Workflow was controlled, safe, and effective.
• Staff working in pharmacies were confident that procedures had been developed and implemented to protect them
• Similarly, customers were also confident they could receive medicines and healthcare advice safely.
• Patients appreciated the professional advice and support offered, recognising community pharmacies can help patients with many minor illnesses and medicines queries.

What were the learning points?

Patients and staff members will have health conditions and risk factors to be aware of, and pharmacies will need to be prepared to cater for this by providing a safe environment to be in.

By risk assessing working practices and staff members, procedures to reduce risk and provide a safe environment for staff and patients can be put in place.

However, it is important to regularly review the effect of any procedures implemented, to ensure they have been effective; and to be adaptable until the right solution is found.

Want to know more?

Email: Sanjeev.Panesar@nhs.net