The potential implications of the national ‘test and protect’ programme has caused some concern in pharmacy circles both north and south of the Scottish border.
Test and Protect, NHS Scotland’s approach to controlling the spread of COVID-19 in the community was rolled out across all health boards from Thursday, May 28.
From that date, everyone aged five and over who has COVID-19 symptoms of a new continuous cough, temperature or loss or change in sense of taste or smell has been asked to go to NHS Inform online or call 0800 028 2816 to book a test.
Under the system, people need to isolate with their household as soon as they have symptoms and, if they have a positive test result, they will be asked to provide details of all recent close contacts to NHS contact tracers. Those people will be contacted and asked to isolate for 14 days.
As things stand, the Test and Protect programme in Scotland described above may have implications particularly for community pharmacy teams in Scotland and beyond. If a member of a community pharmacy team develops symptoms they may potentially have to isolate from the rest of the team. To compound this, the contact tracer may deem the rest of the team to have been exposed.
The consequence in the worst case could be a lack of staff to open the pharmacy.
Community Pharmacy Scotland has strongly suggested that to mitigate this risk all community pharmacy team members should wear fluid-resistant surgical masks even when taking a lunch or tea break. Harry McQuillan mentioned the issue on one of their YouTube updates recently which we highly recommend you watch. You can access the video here.
CPS also made a statement on their website which you can view here.
Although the Pharmacist Defence Association (PDA) does not represent pharmacy contractors they have said that pharmacy must give the test and trace scheme its full support. That said they do recognise that the measures due to start in the next few weeks also bring significant challenges.
In a statement published this week the PDA commented:
“The track and trace system depends heavily on the mobile phone app and in order to fully support the measures pharmacy staff need to be allowed and encouraged to keep their mobile phones with them while at work. This basic step will be a change for some employers but is a necessary contribution to the success of the system.
“Pharmacy employers already have a duty to keep their staff safe from infection while at work and that continues. Potentially the track and trace scheme could lead to scenarios where if one member of the pharmacy team develops COVID-19, others, possibly all of their colleagues could be instructed to simultaneously self-isolate. The scheme is likely to build up its capacity over the next few weeks and therefore its impact upon society generally. Pharmacies must use this window of opportunity to prepare certain mitigation measures, whilst simultaneously still maintaining the existing health and safety measures to protect staff from the virus.
The PDA have suggested some potential mitigation measures which include the following:
- A & B teams; Dividing the pharmacy team into 2 or more shifts that never work at the same time, so that they cannot be impacted by contact with a staff member of the other shift.
- Preparing a compliment of locums by making them familiar with the pharmacy ahead of any track and trace consequences and calls for self-isolation so that if the incumbent regular pharmacist and/or pharmacy technician needs to self-isolate another is readily available to keep the pharmacy open.
- Agreeing in advance how, in the worst-case scenario, staff from several pharmacies from different businesses in a local area may work together to maintain a service from one premises in a locality.
- Considering now, how those isolating but not sick might still be able to undertake meaningful work at home in a way that still helps the public, but in a way that maintains the self-isolation, keeps patient data protected and which is compliant with regulations.
“Pharmacies are also reminded that self-isolation and any periods of COVID-19 recovery where members of the team are unavailable for work, will be due to a global pandemic and not because of the individual’s conduct. Employers are therefore encouraged in the interest of fair treatment to discount any such absence from absence management processes and to safeguard individuals’ pay.
The PDA has recognized that these measures may have financial impact for the sector:
“All of the above will have financial impacts on the sector. The PDA does not represent contractors, in fact, we are proud to be certified as being free of their control, however, we wholeheartedly encourage the contractors’ representatives to lobby government to provide the financial support the sector needs to maintain this vital frontline service. Our members in hospitals, in England at least, are now working in more financially secure organisations thanks to the government writing off over £13 billion of hospital trust debt. In contrast, the community pharmacy sector has been underfunded for a long time, especially in England, and there has been minimal extra support as this pandemic has impacted. While employers are obliged to make sure that all appropriate safety measures are in place in any event, we urge the government to do more to support the extra costs.”