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PDA Pandemic Series Update – 6 June 2020

With each edition, we aim to bring to your attention important issues either those that we are working on or general background information that helps you with your practice.

Sat 6th June 2020 The PDA

In this issue:

  • Updated NHS Risk Assessment Guide
  • Review on “Disparities in the risk and outcomes of COVID-19”
  • Test and Track – Specific update on NHS Guidance for healthcare staff
  • UK retailers to re-open but fitting rooms remain closed
  • A new Lancet report on 3 simple interventions to reduce transmission of COVID-19
  • Annual Flu letter
  • MHRA halts the sale of finger prick antibody tests
  • Refusal to supply Methadone in advance leads to spitting and abusive behaviour

Updated NHS Risk Assessment Guide

Ministers are rightly concerned about the risks faced by frontline healthcare workers. In order to minimise that risk and identify individuals, the NHS has updated its risk assessment guide. Whilst it may seem a lengthy document, we would urge all members to read the guide.

As working environments move to a new “normal” it becomes even more important that comprehensive risk assessments are carried out at the individual level, at the workforce level and at the workplace level. It is a legal duty for all employers, especially those that provide NHS funded healthcare, to have in place measures to reduce risks to their workforce and the public.

It is a specific requirement that all risk assessments take into account specific risk factors for each individual (including co-morbidities, age and BAME status).


Review on “Disparities in the risk and
outcomes of COVID-19”

This report was commissioned by Ministers as a matter of urgency following the initial data that showed the disproportionate impact of COVID-19 on certain groups. This initial data showed that it was BAME staff that were being disproportionately affected. One early report noted that 95% of doctor deaths from COVID-19 had been in the BAME demographic. Individual NHS risk assessments must now take into account ethnicity together with other known factors (such as co-morbidities).

You can read more about the initial publication prior to the review here.

You can read the full disparities review here.

Test and Track – Specific update on NHS Guidance for healthcare staff

The test and track system will become a key pillar in containing the spread of COVID-19. The NHS has recently updated the guidance for healthcare staff including steps to follow if a co-worker tests positive for COVID-19.

One notable change is that NHS workers who have been notified through the NHS test and trace or other national (Northern Ireland, Scotland or Wales) contact tracing service, that they are a contact of a confirmed case of COVID-19 in the community (outside the health or social care setting or their place of work) should inform their line manager and self-isolate for 14 days, in line with the NHS test and trace guidance.

The guidance states that this advice should be followed regardless of the results of any SARS-CoV-2 antibody testing as the antibody test only confirms prior infection but there is no evidence that this prior infection provides immunity to reinfection and transmission.

You can read more about the track and trace system here.

You can read the updated guidance for NHS staff here.

UK retailers to re-open but fitting rooms remain closed

As lockdown rules ease, many retailers are making changes to protect their staff and other customers from contracting COVID-19 whilst on their premises. Two large retailers, John Lewis and Marks and Spencer have announced plans to open their stores but their fitting rooms will remain closed. As NHS funded premises, pharmacies need to take extra care to ensure that their frontline healthcare staff and the patients they serve are protected from contracting COVID-19 from the unnecessary use of pharmacy consulting rooms.

A 2m social distancing rule cannot be observed in the majority of pharmacy consulting rooms and strict measures (documented in operational SOPs) need to be in place when their use is absolutely essential (for example, supervising methadone consumption). There can be little justification for using small cramped consulting rooms for face to face MUR or NMS consultations, especially when these could be delivered by other means. However, Boots is still advertising its “Medicines Check Up Service” where it advertises “Speak to our pharmacist in a private consultation room”.

Details about the John Lewis policy can be found here.

Details about the Marks and Spencer policy can be found here.

Details about the Boots “medicines check” service can be found here.

A new Lancet report on 3 simple interventions to reduce transmission of COVID-19

A recent review published in the Lancet noted that the optimum use of three common and simple interventions, a physical distancing of up to 2m, the wearing of a face mask and the wearing of eye protection would help to reduce the spread of COVID-19.

The paper also makes a notable observation “Eye protection is typically under-considered and can be effective in community settings.”

Interestingly, the Annals of Internal Medicine recently withdrew its paper that had suggested that face masks were ineffective in preventing the spread of COVID-19.


Annual Flu letter

We published a briefing paper last month regarding the 2020 Flu vaccination season. We anticipate that this years programme will pose considerable challenges across the NHS, especially in light of the effect of the COVID-19 virus on higher risk groups (such as those over age 65).

The Annual Flu letter has now been published and acknowledges: “We recognise that delivering the flu immunisation programme is likely to be more challenging because of the impact of COVID-19 on our health and social care services. Further guidance will be issued about how to manage the immunisation programme to reflect circumstances nearer the planned start of the progamme in September 2020.”

We will provide further regular updates as they become available.

You can find our original briefing here.

You can read the Annual Flu Letter 2020 here.

MHRA halts the sale of finger prick antibody tests

The MHRA has taken action to temporarily halt the sale of home finger prick COVID-19 antibody tests. The validity of the results for those tests that have already been sold is in doubt and the MHRA stated:

People who have purchased one of these sampling kits, and received an antibody test result, should not consider the result to be reliable and should not take any action based on it.”


Refusal to supply Methadone in advance leads to spitting and abusive behaviour

Our briefing on the arrangements to supply Controlled Drugs during a pandemic highlighted the considerable risks to pharmacy teams if they were to refuse the supply of controlled drugs. These emergency pandemic measures have NOT yet been activated but a recent case in Scotland highlights the potential problems and the risk mitigation strategies that should be in place to minimise the threat of abuse and violence to pharmacy teams. Pharmacy teams across the UK have reported facing intimidating and abusive behaviour from a small minority of the public during the pandemic.

You can read our PDA briefing here.

You can read about the spitting and abusive behaviour here


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