COVID-19 Policy Asks

24 Recognition

During this national emergency we are, as always, representing the profession, working with Governments, NHS bodies and other major stakeholders.

We're making sure they are fully aware of your professional requirements to operate safely and efficiently, and ensuring pharmacy teams are included in their policies, their guidance and the available resources.

See also our Future Policy Asks.

Policy Wins

We've been working hard to make sure you get the tools, the backup and the credit for all your efforts during the pandemic - find out more on our policy wins page.

What are our policy asks?

1. Ensure that our front-line staff are protected

  • Ensure adequate supplies of quality personal protection equipment (PPE) are available across primary and secondary care
  • Provide COVID-19 testing including antigen and antibody testing once they are approved for use as a priority for front-line staff delivering NHS services, including primary care contractors such as community pharmacies
  • Work with police forces to ensure that all pharmacy teams across the NHS are kept safe and protected against any forms of aggressive, violent and abusive behaviour
  • Provide mental health and wellbeing support for pharmacists and pharmacy teams
  • Ensure robust risk assessment and protection is in place for BAME staff along with other vulnerable ‘at high risk’ groups, such as staff with existing health conditions
  • Contact tracing services are being explored and implemented across Great Britain to help in the fight against COVID19. We are working with Governments across England, Scotland and Wales to ensure the safety of pharmacy teams and the public whilst minimising any unintended impact on practice and patient care.

2. Government recognition of pharmacy in national communications and support

Pharmacy teams are working under huge pressure to support the public and the NHS during these challenging times. 

We're demanding the government show greater support, encouragement and recognition of the work you are doing every day.

3. Essential medicines supply: Patients must have continued access to medicines during the COVID 19 pandemic

Medicines shortages are a common occurrence and unfortunately sourcing medicines for patients has become a necessary routine part of pharmacy practice. 

Government must make sure contingency planning is in place to mitigate the effects of any worsening of shortages due to the COVID-19 pandemic.

Critical and end of life care

Specialist medicines are crucial in managing symptoms and easing discomfort and pain for people at the end of life. To meet the unprecedented demands for critical and end of life care that will occur during the coronavirus outbreak, robust plans must be in place. 

These plans must take into account flexible plans for returning, re-use and storage of medicines and the possibility that supply of these medicines will become increasingly difficult.

  • National guidelines across all four countries are required to give consistency of messaging to the public and clear directions to professionals on repurposing medicines in extremis
  • Regulations need to be flexible to support professional decision making and allow scope of practice to expand to ensure the medicines patients require can be made available.
Substance misuse services are essential core services which must be maintained during the COVID-19 pandemic.

Pharmacy provision of Opioid Subsititution Therapy (OST) and needle exchange programmes (NSP) has a vital role in protecting patients and communities. 

People who use drugs (PWUD) are a particularly vulnerable risk group who must continue to receive the level of service required to keep them safe and to avoid an increase in drug deaths during the COVID-19 pandemic.

  • Interruption to the existing provision of OST and injecting equipment will put people at increased risk of overdose, bloodborne viral infections and drug-related death.
  • Service interruption is likely to result in people not obeying the staying at home rules as they source illicit drugs as an alternative and so increasing the risk of COVID19 exposure or transmission in our communities.

Contingency plans should include:

  • Flexibility in regulations to allow supply of regular medication even when prescriptions are not readily available
  • Risk assessments by prescribers and /or community addiction teams carried out in collaboration with pharmacists to identify those who could cope with any reduction in their supervision or instalment requirements
  • Prescriptions should be clearly annotated to indicate risk assessment has been carried out to enable pharmacy teams to make necessary arrangements for the workload required
  • Naloxone provision should be extended and available for all people who use drugs

Further information: www.rpharms.com/coronavirus/#additional

Repeat Medicines

In order to ensure that shortages are not made more acute during the COVD 19 crisis we have the following recommendations.

Prescribers

Public and Patients

Pharmacists

Prescribers must NOT change their regular prescribing patterns.

Some prescribers are issuing 56 day prescriptions (or even longer), which has the potential to precipitate unnecessary medicines shortages.

Continue to take your medication as prescribed.

Respect the pharmacist’s requirement to maintain stock levels and give you 28 day supply instead of 56 or 84

Liaise with local prescribers and GP practice colleagues on how best to manage stocks and shortages including:

  • Messaging to patients on changes to repeat prescribing process
  • Minimising overprescribing and overordering

Post-dated prescriptions should be issued if clinically appropriate, rather than immediate supply.

This will help to reduce footfall through GP practices, without adding pressure to the medicines supply chain.

Do not order more than your normal repeat prescription requirements. 

Stockpiling medicines at home can lead to shortages of medicine for other patients.

If shortages do occur refer to RPS best practice guidance.

Electronic or batch repeat dispensing should be used if available and appropriate.

 

Giving community pharmacies more flexibility on medicine supply, stock control and workload, as well as helping to reduce GP workloads and NHS pressures.

Stay at home as much as possible and obey the social distancing guidelines for essential trips.

If self-isolating please ask a neighbour, friend or family members to pick up your medicines from the pharmacy. If this is not possible a volunteer may be able to help.

Encourage and promote use of repeat dispensing for your location as much as possible to standardise quantities and help manage workload both at community pharmacy and GP surgery.

  • Electronic Repeat Dispensing - England
  • Batch Dispensing - Wales
  • Care and Review- Scotland

Encourage patients to order their next prescription 7 days in advance of when they need it to provide time for it to be written / printed and sent to the pharmacy for dispensing.

Order your medication 7 days in advance, or as suggested by your community pharmacy.

Clearly communicate with people when they should order their next prescription.

 

Easing the workload of medicines shortages

A legal framework across Great Britain would allow community pharmacists to make professional decisions and take appropriate steps to minimise the impact of medicine shortages on patient care. 

Medicines legislation should be amended to allow pharmacists to make minor amendments to prescriptions, such as:

  • Different quantities
  • Different strengths
  • Different formulations
  • Generic versions of the same medicine (generic substitution)

For pharmacists in secondary care these substitutions have been standard practice for years. It is time to address this imbalance and improve access to medicines by enabling community pharmacists to make these simple change

4. Funding and resourcing to help the pharmacy network support the public

An NHS-funded delivery service is urgently needed for patients who are unable to reach pharmacies. At present, deliveries are a discretionary “good will” service’ for which pharmacists receive no payment.

Pharmacies must be allowed to focus on patient care, so a flexible approach to contract requirements is needed

Additional funding to pharmacies to support their resilience and sustainability, helping to prevent closures, improve cash flow and reduce the risk of job losses

Ensure that all pharmacy teams are listed as ‘Key NHS Workers’, and receive all benefits e.g. childcare, supermarket protected access.

5. NHS funded/state-backed indemnity insurance support and fast-tracked DBS checks for all pharmacists, their support teams, proposed return workers and volunteers

We're calling on government to ensure that all pharmacists, pharmacy teams, proposed return workers and volunteers continue to be covered under a state back/NHS funded indemnity scheme to support any COVID-19 pandemic service delivery including the ability to ensure they have access to funded fast-tracked DBS checks, for as long as is necessary.


6. Remove Prescription Charges in England

We're calling for a pause in prescriptions charges for patients in England during the COVID-19 pandemic. This would free up pharmacist’s time, reduce risk of COVID-19 transmission and support patients access to medicines.

7. The role of pharmacists in the COVID-19 Vaccination Programme

The distribution and administration of the COVID-19 vaccination programme will require concerted action across the NHS. With unique insight and expertise in medicines and the delivery of vaccination programmes, pharmacists have a clear role in contributing to the success of this programme. This includes strategic planning, oversight of distribution arrangements, and operational roles in the preparation and administration of COVID-19 vaccines.

Delivering a vaccination programme which incorporates pharmacist expertise will be an effective approach to the COVID-19 crisis. The mobilisation of the profession in the COVID-19 vaccination programme must be undertaken in a way which not only makes the best use of their skills but does not unduly impact on the health and wellbeing of the profession and its capacity to deliver routine care and services.

We fully support a programme where the appropriate resources, infrastructure, procedures and support are put in place. The pharmacy profession must be able to contribute to a COVID-19 vaccination programme that:

  • Draws on the appropriate expertise and leadership of pharmacists from all sectors of the NHS
  • Utilises the knowledge and skills of pharmacists in helping citizens understand the way the vaccine works and what to expect when they have it
  • Fosters collaboration with other health professionals at strategic and operational levels
  • Minimises disruption to routine practice and business as usual in all sectors
  • Utilises the skills of all pharmacists as part of a networked approach, as appropriate
  • Supports community pharmacies to engage in the vaccine programme
  • Ensure processes are in place to clarify the parameters of the role of the pharmacist
  • Ensures pharmacists undertake appropriate training and have access to up to date information about the specifications of all COVID-19 vaccines
  • Invests responsibility in the pharmacy profession to advise clinical colleagues about the vaccine and provide high quality information to the general public to maximise uptake of the vaccine
  • Is underpinned by adequate human and financial resources on par with the support provided to other healthcare professions to allow pharmacists to undertake their roles without compromising patient care or their own wellbeing
  • Guarantees the supply of clinical consumables for appropriate vaccination use.

The safety of pharmacists, their teams and patients must be paramount and must be assured through sustaining COVID-safe environments. Access to priority vaccination is essential for front line pharmacy staff in community, primary care and hospitals at the same time as other professionals who have an equivalent level of potential COVID-19 exposure. The provision of appropriate levels of personal protective equipment to cope with demand must also continue without question.

The role of pharmacists in the COVID-19 vaccination programme must be made clear to the pharmacy profession itself.  Professional and representative pharmacy bodies have an important role to play in providing the right level of information to the profession to support their roles in the vaccination programme. Steps must also be taken by governments and the NHS to build public confidence and manage expectations in the administration of vaccines from pharmacists and others involved in the vaccination programme.  

Mentoring articles published in the Pharmaceutical Journal

There are more useful articles on mentoring in The Pharmaceutical Journal, with more context around the benefits of mentoring, and it’s impact on your professional development.