Insight into community pharmacy during the COVID-19 pandemic and lockdown.
Alongside panic buying of toilet rolls and non-perishables, the March coronavirus lockdown saw patients rushing to their pharmacies to stock up on their prescription medicines. GPs, thinking they were doing the right thing, issued double or even triple quantities of repeat medicines.
Patients who had not ordered medicines for some time, requested ‘when required’ items just in case; particularly inhalers. Over-the-counter paracetamol went out of stock as medicine cupboards across the country were filled.
The supply chain was under extreme and unprecedented stress with a number of medicines unavailable. Wholesaler bills also mounted to reflect the increased items and duration of treatment, resulting in major cashflow challenges.
In response, NHS England provided a welcome advance payment of £300m to the sector in April and May, representing around £17,000 per pharmacy in the first month. In many cases, this was about half of what was needed. This payment is a loan on future earnings and at the time of writing (April 2020), an agreement has not been reached for additional funding required to cover increased COVID-19 related costs.
Personal Protective Equipment Many pharmacies did not receive their Personal Protective Equipment (PPE) until mid-April, and even then, supplies have been limited. Socially distancing as a team in the average dispensary is not practical and yet we don’t have enough PPE to wear routinely. To add further to our anxieties, pharmacists and their teams have faced abusive and angry members of the public.
Thankfully, pharmacies have adapted well to the new normal and put in place measures to protect themselves and patients from the spread of the virus, whilst managing an efficient operation. The Chief Medical Officer wrote to all GPs instructing them to prescribe no more than the normal prescription duration and advised that asthma patients should be reviewed if their symptoms worsen, outside of their normal care plan. Working together has been key, and a greater use of electronic repeat dispensing is being implemented.
Thankfully, we have been allowed to work behind closed doors for up to 2.5 hours per day, to ensure we can catch up and keep both ourselves and our patients safe. We have business continuity plans and will do all we can to keep our communities well. Volunteers in many areas are helping to deliver medicines to those who cannot leave home.
Our new service-orientated contract is largely on hold with our focus on provision of medicines, ensuring delivery to our most vulnerable patients through a new Pandemic Delivery Service and providing advice and support for common illnesses, which still occur alongside COVID-19.
It was and remains critical to maintain an effective pharmaceutical service during the pandemic; it’s unimaginable to consider the impact of not being able to provide millions of patients with their regular medicines such as antihypertensives, immunosuppressants, insulins, anticoagulants, painkillers, respiratory medicines, etc.
Pharmacies have been working hard on the frontline and putting the care of patients at the core of their work. Thank you to all pharmacy colleagues for the brilliant and mostly unrecognised work you do and thank you to our pharmaceutical industry for keeping medicines in the supply chain; the response to the unprecedented demand was swift.
We are all in this together.
Deborah Evans FFRPS FRPharmS FRSPH is Managing Director of Pharmacy Complete, a training and consultancy company working with pharmacy, the NHS and industry.
Go to www.pharmacycomplete.org