Pharmacists want clarity on COVID-19 infection mitigation for dispensary–based staff, however, there has been controversy surrounding recent guidance from NHS and Public Health England regarding which types of PPE should be used in community pharmacy and under what circumstances.
PHE guidance published on 2nd April 2020 stated that staff working in pharmacies where adequate social distancing is not possible should wear fluid-resistant surgical masks (FRSMs). At a Webinar on 8th April, Dr Susan Hopkins, Public Health England’s National Incident Director for COVID 19 stated that the masks were only for use on the shop floor and pharmacy counter when dealing with members of the public and not for providing protection between colleagues in the dispensary or back office. This view was reiterated in an NHS England Primary Care COVID bulletin of 9th April which contained the following:
“Updated guidance on Personal Protective Equipment (PPE) was published by Public Health England (PHE) on 2 April 2020. If social distancing of 2 metres from patients attending the pharmacy can be maintained there is no indication for PPE in a pharmacy setting. If this distance cannot be maintained, use of fluid resistant surgical masks (FRSM) is recommended.
It would be extremely helpful, both to protecting longer term supplies to pharmacies and to keeping supplies going to other health professionals, if pharmacies limit the number of staff that have to be within 2 metres of the public to help manage the use of masks and maintain availability.”
However, the advice also made reference to dispensary-based staff and proposed that;
“ ….Pharmacy staff working in dispensaries but unable to maintain 2 metres from their work colleagues do not necessarily need to wear masks….”
Allow pharmacists and teams to manage their personal risks
Given the evidence that anyone (including staff members) can be pre-symptomatic and spread coronavirus, a fact recognised by the UK government, the PDA is concerned about the way in which this advice is being provided. There are undoubtedly significant shortages of PPE leaving front line workers exposed. At least one NHS Trust Hospital (Wolverhampton) has appealed to their local community to donate PPE to assist with their critical shortage. The PDA represents pharmacists across the entire profession, including hospitals, it is understandable that the NHS would seek to ensure that the limited stocks it has are distributed to those workers in the most hazardous settings such as Intensive Care Units as a priority; However, this situation does not remove the increased risk to individuals working within a pharmacy with regular exposure to possible asymptomatic carriers of coronavirus and the inability to socially distance themselves.
The government must redouble its efforts to secure more supplies of PPE so as to protect all staff providing front line services to patients.
In the meantime, the PDA believes that PHE should change its advice on dispensary based staff; it should provide the facts based on the science and the availability, clearly communicate the risks and then allow pharmacists and their teams to decide how best to manage those risks.
PDA advice to pharmacists
In dispensaries where 2m distancing is impossible and in the absence of NHS provided PPE, the PDA advises that members have 4 options:
- Request that their employers provide the required protective equipment.
- Provide their own masks to wear at work and seek recompense from the employer.
- Ask to be moved to a less hazardous work area where protection measures may be in place or where 2m distancing is possible, or ask to be furloughed (if they are high-risk individuals or share their home with high-risk or vulnerable individuals).
- Work without a mask in the dispensary (if they feel their risk is relatively low and they do not have at-risk individuals at home).
Employers responsibility under Health and Safety legislation
Staff safety is an area where healthcare guidance is not the only governing factor – the primary responsibility for the protection of employee’s in the workplace and the provision of PPE in the workplace lies with the employers.
Those employers who do not take their responsibilities under Health and Safety Legislation seriously during the crisis, run the risk of action being taken against them under the H&S legislation once the crisis is over. The PDA has been made aware of many examples of poor employer behaviour related to the wearing of PPE by pharmacy staff, including locums being informed that they would no longer be booked because they chose to provide their own face mask and wear it at work. One of the worst examples was an email to staff at a chain of pharmacies which banned the wearing of PPE by any staff in any pharmacy.
Employers cannot simply point at the PHE advice; which has been changing and still clearly leaves some staff members exposed. Employers are reminded that should an employee come to harm as a result of working unprotected, they have a legal obligation to report this under RIDDOR regulations.
The PDA is keen to receive information about unacceptable employer practices and will raise Health and Safety issues with regulatory and other bodies as appropriate.
Related article:
Personal Protective Equipment – rationale and recommendations for a pragmatic approach