By the start of April 2020, COVID-19 was dramatically impacting on day-to-day life. As pharmacy teams made changes so they could continue providing vital healthcare services, PSNC’s focus was on securing the support, monies and tools that contractors needed.
041 | Contractor support in the first wave
The emergence of a global pandemic saw community pharmacy teams rushing to respond to the most significant healthcare crisis they and the NHS had ever faced. Initial problems included the huge operational challenges, the need for protective measures, and a likely cashflow crisis for contractors. PSNC spoke urgently with officials and Ministers, stressing the need to protect the services that pharmacies provide. In response to our case, Government quickly agreed to inject a total of £370 million of advance funding into community pharmacies through the spring and summer months of 2020.
After further discussions a free of charge Personal Protective Equipment (PPE) portal for pharmacies was eventually opened and contractors got the green light to claim for any PPE costs incurred before this portal had become available. Similarly, free Lateral Flow Tests were made available to pharmacy staff through the Primary Care Support England (PCSE) portal. Additional funding for pharmacies to remain open over the Easter Bank Holidays was agreed, and PSNC began collecting evidence of the impact of the pandemic on contractors’ costs via a monthly survey: this began a lengthy campaign to ensure contractors’ COVID-related costs were all covered by Government.
‘At the beginning of the first wave of COVID-19 LPCs were, like everyone else, trying to make sense of the chaos in the health system, and of course to get pharmacy teams all the help they needed. The quick set-up of a PSNC-LPC Rapid Action Team (now evolved into the PSNC and LPC Operations Team) was hugely valuable both for its original members and for all the other CEOs who they cascaded to – it allowed for the effective sharing of local and national intelligence, helping everyone to better help the contractors we all represent.‘
Shilpa, Shah, CEO, KENT LPC, September 2021
042 | Contractual dispensations
A key challenge that all pharmacies faced was the need to divert resources to the pandemic response: this was critical in the first COVID-19 wave, and continued, with one in four consultations in January 2021 involving advice relating to COVID-19. PSNC fought hard to reduce the burden on contractors during this time and gained some significant dispensations.
Firstly, during the first waves of the pandemic contractors were not required to undertake an NHS England and NHS Improvement (NHSE&I) determined national clinical audit, a contractor chosen clinical audit or the annual Community Pharmacy Patient Questionnaire (CPPQ). Contractors were also not required to submit data returns for the New Medicine Service (NMS) and Medicines Use Reviews (MURs) or to update their practice leaflets. It was agreed that no action would be taken against contractors who had not completed the Data Security and Protection Toolkit for 2019/20, and the Pharmacy Quality Scheme (PQS) was redesigned to provide funding for activity relating to the pandemic response. The requirement for patients (or their representatives) to sign the back of NHS prescription forms or Electronic Prescription Service (EPS) tokens was also waived, along with several other pandemic-related additions to the Terms of Service.
Finally, the introduction of the Hepatitis C Testing Service and the Discharge Medicines Service (DMS) was postponed, and a verbal consent model was introduced for flu vaccinations, the NMS, and Appliance Use Reviews (AURs). As well as easing the workload pressure for community pharmacy teams, PSNC held discussions with NHSE&I which led to emergency regulations granting contractors greater flexibility regarding opening hours and temporary closures being introduced. To help keep contractors informed, a COVID-19 hub page was also added to the PSNC website, daily COVID-19 update emails were launched and an LPC Rapid Action Team was created to strengthen the link between PSNC and the LPCs.
043 | National services
In April 2020, a new national community pharmacy medicines delivery service was launched to support clinically vulnerable (‘shielding’) patients to continue receiving their medicines.The largest-ever community pharmacy flu vaccination programme also launched on 1st September 2020. PSNC successfully negotiated key flexibilities to help contractors provide this service at a scale not seen previously and in a COVID-secure manner. Among other things, these removed the need for face-to-face training updates, and allowed pharmacies to offer flu vaccinations outside of the pharmacy consultation room, off the pharmacy premises, and in care homes.
044 | COVID-19 vaccinations
In late 2020, the first COVID-19 vaccines passed clinical trials. Despite the practical challenges of providing a COVID-19 vaccination service using the Pfizer/BioNTech vaccine, community pharmacy contractors actively supported the NHS programme: PSNC and the other national pharmacy organisations lobbied extensively and by the end of January 2021, playing to the strengths of community pharmacy as socially inclusive healthcare providers, nearly 300 community pharmacy COVID-19 vaccination sites were in operation.