How our pharmacy-led medicines information service supported clinicians on the COVID-19 frontline

As pharmacists, many of us are taking time to reflect on our role in the response to the COVID-19 pandemic so far, and for us — the Medicines Information and Governance (MI&G) Team at NHS Greater Glasgow and Clyde (NHSGGC) — it’s no different.

We’re a team of 29 pharmacy professionals with a wide range of responsibilities, including the provision of a clinical enquiry answering service for healthcare professionals in acute and primary care at NHSGGC, and a number of key governance resources, medicines policies, audits, guidelines and prescribing resources.

And our work doesn’t stop there: our team also contributes to Scottish and UK national initiatives, medicines Q&As for the Specialist Pharmacy Service and training resources for pharmacists in various settings. We still have a significant patient-facing clinical commitment too.

And when the pandemic struck — as attention turned to the pressures community pharmacies were under and the challenges in intensive care units — the priority for our team was to support the delivery of safe and evidence-based care at a time of uncertainty and fast-paced change. Like workforces everywhere, we had to adapt to new ways of working that involved social distancing, enhanced cleaning regimens and new technology.

Working from home became the norm for some of us, while others were redeployed entirely to patient-facing clinical roles. One member of our team was also redeployed for a month to support the contact tracing team rolling out the Test and Protect scheme.

Well-established resources, such as our Therapeutics Handbook and our ‘Medicines update’ blogs, quickly emerged as key routes of communication to prescribers across our six acute hospitals and in primary care.

In the absence of the usual governance structures, our team supported the development of revised approval processes to allow prescribing resources — from guidelines and prescription charts to update blogs — to be available across the health board.

We published 27 blogs relating to COVID-19 between April and June, and we created a new chapter in our Therapeutics Handbook to house key guidelines, subject to regular updates.

The team also supported the development of COVID-19 guidelines for local use, including high-risk areas, such as thromboprophylaxis prescribing.

We developed a new system to identify the risks emerging from our changed ways of working, so that guidance could be reviewed, reinforced and publicised as required. For example, we developed guidance on the safe use and disposal of drugs belonging to patients with COVID-19 and we collaborated with intensive care pharmacists for a new paper pre-populated prescription chart.

Our team has a clear role within governance structures at NHSGGC and we have strong working relationships with the multidisciplinary team: these factors were so important for our MI&G pharmacists to deliver an efficient response during this time.

Another crucial aspect of our work is proactively managing shortages, since medicines shortages were a major risk during the initial outbreak of COVID-19. We were lucky enough to secure expertise from the health board’s public health pharmacy team to lead on medicines shortage advice for non-critical care medicines in acute services.

Despite all this work, our enquiry-answering service stayed open and we turned around 465 enquiries between April and August.

And we have even been involved in training too. The Scottish Medicines Consortium team offered help to Scottish medicines information services during the pandemic, and our team provided training to three of their pharmacists and collaborated with other Scottish medicines information centres to develop a standard operating procedure for this work.

Before the pandemic, the team already had a significant training commitment to preregistration and foundation pharmacists across NHSGGC. After a brief pause in March, we resumed in April and we’ve given training to six foundation pharmacists since then.

Our sessions for preregistration pharmacists are usually delivered face to face in August, with a full induction week to the medicines information service and a teaching session on preregistration projects. We’ve redesigned this training and delivered it virtually through Microsoft Teams, and we’ve had really positive feedback so far.

Our team of pharmacy professionals is proud of what we have achieved this year, and of the role we play in our health board as it continues to adapt to the COVID-19 pandemic.

This pandemic has only made it more evident that medicines information and governance are at the heart of a safe and evidence-based healthcare system.