This time last year…

Philip Galt is Superintendent Pharmacist and Managing Director at Lindsay & Gilmour.

 

This time last year, it would have been impossible for any of us to imagine just what challenges lay ahead in the coming months.

 

In truth, it’s hard to overstate what a significant year this has been for community pharmacy in Scotland. More than ever I have watched with pride as colleagues across the community pharmacy network have worked together tirelessly to offer nothing short of a lifeline to some of the most vulnerable members of our communities at a time they needed us most. And it’s not gone unrecognised.

 

National polling carried out by the National Pharmacy Association in June found that there is strong public support for a greater role for pharmacies within the NHS.

 

  • 74% want pharmacies to provide more NHS services.
  • 89% of people believe pharmacies play an essential role.

 

Yet at the same time, the survey reported that only 3 out of 10 people are “definitely aware” that community pharmacies are part of the NHS, despite the fact that pharmacies are the most visited of all settings where NHS care is offered. Indeed, throughout the pandemic community pharmacies were one of the few healthcare settings that kept their “doors open”, providing much needed, face to face convenient access to healthcare services to the public.

 

Community pharmacies provide a range of NHS services and pharmacy teams work with other professionals, such as doctors and nurses, to give you the best possible care as part of the local healthcare team.

 

Community pharmacists demonstrated incredible resilience and fortitude from the front line of the COVID crisis, ensuring that as many people with minor medical needs and long-term conditions were kept safe at home. At Lindsay & Gilmour, both our online prescription management service and free home delivery service grew in demand exponentially.

 

This, in turn, played a vital role in protecting hospital beds and secondary care resources available for those who were directly affected by COVID-19.

 

The recent introduction of NHS Pharmacy First Scotland means even greater access to your community pharmacist to discuss a wide range of health and healthcare issues, not just about medicines. Sometimes people go to a doctor or even a hospital for problems that could be sorted out more conveniently at the pharmacy. It’s estimated that up to 18 million GP appointments per year and 3.7 million A&E visits could instead be handled in a pharmacy.

 

So please, do remember to Ask Your Pharmacist for:

 

  • Advice and treatment for minor illnesses such as coughs, colds and earache
  • Advice on staying well and preventing disease
  • A range of vaccinations
  • Help to quit smoking
  • Personalised support to get the most from your medicines

 

Pharmacy teams deliver prompt, professional health care advice when and where it is needed. The community pharmacy network in Scotland and beyond is a precious resource. We are proud to be part of the NHS team and privileged to be able to serve our community.

 

Philip Galt is Superintendent Pharmacist and Managing Director at Lindsay & Gilmour.

 

 

The dramatic lockdown workload took an emotional toll

 

I suppose the impact of COVID-19 really hit home on my 40th birthday.

 

At the beginning of the year we were all hearing about a new virus spreading around the world and we’d started planning from a business perspective, but it didn’t seem real somehow. But on 13th March I went away on a surprise birthday break to Berlin and whilst there, restaurants and bars started closing.

 

The atmosphere was very strange at that moment.

 

I ended up getting one of the last flights out of the country on the Monday before all planes were grounded.  By the time I returned to work in Glasgow on Tuesday things had really started to take off in the UK too.

 

Every day became a bit of a blur, the advice changed hourly and it was a real challenge adapting to what we had to do to keep ourselves, our patients and colleagues safe.

 

We had to make physical changes to our warehouse and provide clear guidance to all colleagues. Who would have thought I would be talking about hand washing the whole time and posting reminders everywhere?

 

We identified the main areas where social distancing would be difficult, separated tables in the canteen, staggered breaks and finishing times and asked drivers to have lunch in their vehicles where possible.  There were new floor markings showing two metre spacing, more cleaning and new protective equipment such as visors for drivers.

 

At night on TV we watched the scenes from Italy with hospitals overwhelmed and the number of people dying increasing every day. The impact on my colleagues was significant; they were fearful. Some were concerned about their level of vulnerability, or that of their families.

 

It took its toll emotionally on everyone.

 

Group communication was more challenging with social distancing. We had to think quickly and creatively as we had lots of important messages to get to our teams. I created a WhatsApp group to keep people in touch and I recorded a weekly video.  I tried to reflect the government message and talked about staying safe, treating each other with respect and reminding everyone of their important role in helping patients.

 

And then the workload suddenly rocketed with three or four weeks of a continuous demand that we’d never experienced before. The volume was like that of the Christmas period, but every single day. The government had asked people with symptoms to self-isolate so we didn’t know who was coming in to work from one day to the next and we couldn’t plan ahead with any certainty.

 

Sky-high volumes and a diminishing workforce…

 

We took on temporary workers, but we were able to prioritise friends and family of our colleagues to help those that had lost their job or were suffering financial hardship.

 

Ordering patterns changed rapidly with never-seen-before demand for some products. We had to quota paracetamol and we were selling strange formulations and quantities – everything was flying out of the door.  GPs started prescribing for longer periods to help those shielding and self-isolating which caused a spike. There was an extremely challenging two weeks when we were unable to satisfy all the demand from our site and we had to stop supplying non-critical products to prioritise medicines.

 

The team rose to the challenge and stepped up beyond our expectations.  Everyone came together, starting earlier, finishing later.  All understood that every packet they dealt with represented a patient that was depending on them.

 

I am proud that we never failed the NHS for any product.

 

We all looked after each other and learnt as we went along, adapting and improving our new ways of working.

 

Although we were classified as key workers, we weren’t able to have priority at supermarkets as we weren’t NHS workers. I was concerned when the panic buying started that my team wouldn’t be able to get essentials such as toilet roll or hand sanitiser.  I contacted local suppliers and bought supplies for everyone, so they didn’t have to worry.  It was a small thing to do that gave them peace of mind.  People only took only what they needed and now things have calmed down, we’ve been able to donate the surplus to the local food bank along with Easter eggs that we normally give as a thank you to the workers.  It says a lot about the team that even in these times they thought of others.

 

We’ve got a whole new language now. Who’d ever heard of ‘furlough’, ‘self-isolating’ or ‘social distancing’ three months ago?

 

I’m thankful that no one from our Glasgow site has tested positive yet for the virus and I hope everyone continues to keep safe.

 

It was tough.  Many of us are exhausted. But actually, it was incredibly rewarding. We got critical drugs to patients and the NHS.  It’s what we do.

 

Gavin Curran is an AAH regional general manager working in Scotland.

 

MHRA gives hydroxychloroquine trial green light to recruit

 

The MHRA has approved the recruitment of further participants for a clinical trial investigating hydroxychloroquine in the prevention of COVID-19, by the University of Oxford.

The submitted justifications and supporting information were reviewed by the MHRA, with independent advice obtained from the Commission on Human Medicines. On 26 June it was agreed that sufficient measures had been taken to support the safe recruitment of further participants.

 

The decision follows the MHRA’s instructions, on 8 June, to UK clinical triallists using hydroxychloroquine to treat or prevent coronavirus (COVID-19) to suspend recruitment of participants until further data, which justifies continuation, have been provided, and any additional safety measures have been implemented.

 

Dr Siu Ping Lam, Director of Licensing at the MHRA, said:

 

“We have reviewed the University of Oxford’s request to recommence recruitment for the ‘COPCOV’ trial, investigating the use of hydroxychloroquine in the prevention of COVID-19.

 

“After analysing the additional risk mitigations and consulting the Commission on Human Medicines, we have given the clinical trial the green light to recruit more participants.

 

“Participant safety is our priority, so we will continue to monitor the trial to ensure ongoing appropriate measures are in place to maintain continued high levels of safety.

 

“The MHRA received a request from the University of Oxford, on 17 June, to recommence recruitment to the ‘COPCOV’ trial investigating hydroxychloroquine in the prevention of COVID-19.

 

This circular is being shared under the Open Government Copyright licence.

Alcohol consumption increases during the pandemic

 

Nearly a third of people (29%) are reporting that they have drunk more alcohol than they normally would, according to a major new study by the Policy Institute at King’s College London in partnership with Ipsos MORI.

 

The study also showed that 43% of people in the UK have felt more lonely than usual and 35% have postponed seeking medical advice or treatment unrelated to Covid-19.

 

This is the second survey that has been run across the UK since the pandemic began and the percentage of people reporting that they have drunk more alcohol than normal is up from 19% when the same survey ran in early April.

 

Commenting on the findings from the survey, Colin Drummond, Professor of Addiction Psychiatry from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London said:

 

“There is extensive evidence that the population level of alcohol consumption is highly correlated with health harm. So with a substantial increase in alcohol consumption during the COVID-19 pandemic, as shown in the latest Ipsos MORI survey, we can expect in due course a surge in alcohol-related ill health including alcohol-related liver disease admissions and deaths. This will place an increased burden on our already over-stretched NHS.

 

“For people living with more serious alcohol problems, the pandemic has had a dual effect of increasing their vulnerability to relapse at a time when the support available from specialist alcohol treatment services has been significantly curtailed due to social distancing. There is likely to be a surge in people seeking help for alcohol problems as the pandemic progresses.

 

“But alcohol treatment services are already depleted due to cuts to the local authority’s public health grants over the last 5 years, leaving them ill-equipped to respond to a surge in demand.

 

“Alcohol consumption and mental health are intimately linked. An increase in isolation, mental distress, depression and anxiety is likely to have been a factor driving increased alcohol consumption during the COVID-19 pandemic. In turn, that increase in alcohol consumption is likely to increase the prevalence and severity of mental disorders, leading to increased demand for mental health care.”

 

 

RPS seeks clarity on three areas to protect pharmacy teams

 

The RPS in England has written to Parliamentary Under-Secretary of State for Health Jo Churchill MP, seeking reassurances and clarifications on three policy areas to protect pharmacy teams and support them looking after patients.

 

As Government and the NHS begins to look at how the health service will need to adapt in future in light of COVID-19, the letter calls for all pharmacy teams to be included in support for the workforce to deliver frontline care safely.

 

The letter calls for:

 

  • Assurances that pharmacists and all health professionals in primary care will have equal access to the new PPE portal.
  • Clarification on the new Test and Trace programme, the circumstances in which staff members may have to self-isolate, and the potential impact on patient access to services.
  • Assurances that all staff in pharmacy teams who want an antibody test will be offered one as quickly as possible.

 

An extract of the letter from RPS President Sandra Gidley and RPS England Chair Prof Claire Anderson to Parliamentary Under-Secretary of State for Health Jo Churchill MP is available below:

 

“As we begin to look at how the health service will need to adapt in future, it is vital that all pharmacy teams are included in support for the workforce to deliver frontline care safely. With this in mind, we had sought assurances from you, including in our letter of 23 April, that community pharmacy would be able to access the new PPE portal. We were given the strong impression that, once the robustness of the system had been tested then pharmacy would be included.

 

“The announcement on 26 May mentioned GP practices and small care homes “during this phase of the roll-out”, but did not include pharmacy or wider primary care. We would welcome confirmation that pharmacists and all health professionals in primary care will have equal access to the PPE portal.

 

“Can you confirm the date that pharmacists will be able to access the scheme?”

 

“We are awaiting further details on the announced Test and Trace programme, in particular, whether there is guidance on the implications for the health and care workforce. For example, would staff in a pharmacy or GP surgery, often working in close proximity, all have to self-isolate for 14 days if a patient or member of the team was tested with COVID-19? Given the potentially significant impact on patients if a pharmacy has to close for two weeks with short notice, we are seeking urgent clarification.”

 

“While it has been reported that community pharmacy teams will be able to access the antibody testing programme, a letter from the NHS on 25 May notes that ‘each NHS region is coordinating its own specific arrangements to roll out antibody testing to NHS staff’. It adds that further scientific guidance and decisions from DHSC are awaited as to whether staff will be tested once or repeatedly. We would welcome further detail on this phased approach, confirmation that all staff in pharmacy teams who want an antibody test will be offered one, and assurance that you would seek this to be made available to all health and care staff as quickly as possible.”

 

 

 

NHS Scotland ready to ‘Re-mobilise, Recover and Re-design’

 

NHS Scotland will begin resuming some services that have been suspended, delayed or deferred due to coronavirus (COVID-19), whilst continuing to protect emergency, urgent and maternity care.

 

Re-mobilise, Recover, Re-design, The Framework for NHS Scotland’ sets out how Health Boards will follow national and local clinical advice to safely and gradually prioritise the resumption of some paused services. Health boards will introduce these plans while maintaining COVID-19 capacity and resilience and providing appropriate support for social care.

 

The Interim Chief Medical Officer and National Clinical Director have provided an initial outline on what services could be prioritised in the next phase of Health Board mobilisation planning. These include:

 

  • cancer services, especially referrals and postponed treatments
  • expanding treatments for non-cancer urgent inpatients and outpatients
  • outpatient therapies where delay will increase the risk to patients, such as management of macular degeneration, paediatrics and respiratory services
  • mental health support
  • treatment room services such as blood monitoring and B12 injections

 

Health Secretary Jeane Freeman said:

 

“The coronavirus pandemic has seen an unprecedented response from our NHS and care staff. Our fantastic staff have delivered a massive reorganisation of services in just a matter of weeks. This has ensured that our NHS has not been overwhelmed.

 

“We are taking an evidence-based, cautious and phased approach to resuming services to ensure the virus continues to be suppressed. While NHS Scotland will remain on an emergency footing, this framework sets out our approach for the next phases as we continue to respond to this pandemic.

 

“Our approach is not only driven by clinical priorities but also what matters to people’s quality of life like pain clinics, dental treatment and preventative work like cancer screening.”

 

Interim Chief Medical Officer Dr Gregor Smith said:

 

“Re-mobilise, Recover, Re-design, The Framework for NHS Scotland sets out the steps being taken to safely resume some paused NHS services across Scotland. It ensures that the successful steps taken to maintain services during the pandemic are learnt from and built upon. This includes the significant innovations introduced across the NHS to assess patients utilising digital technology.

 

“The reality is coronavirus is likely to be with us for some time to come, and so many changes made in the coming weeks and months have to be measured against the need to keep the virus under control, continuing to protect the NHS and save lives.

 

“Our approach will be informed by national and local clinical priorities. We will continue to work with health boards, local authorities, Royal Colleges, professional bodies, unions and other key stakeholders to ensure this is robust and up to date.”

 

 

This circular is being shared under the Open Government Copyright licence.