COVID-19 ‘test and trace’ scheme may lead to temporary closures, say pharmacy leaders

There is concern among pharmacy leaders that the systems designed to isolate new COVID-19 cases and trace contact in Great Britain will impact on pharmacy services.

Samples taken at coronavirus testing facility

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The Royal Pharmaceutical Society has made this article free to access in order to help healthcare professionals stay informed about an issue of national importance.

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Anyone identified as having been in contact with someone who has tested positive for SARS-CoV-2 infection must self-isolate for 14 days

Pharmacy leaders are seeking urgent clarification about what pharmacies should do if a member of staff is found to have COVID-19 under the new ‘test and trace’ rules introduced in May 2020.

Representatives are warning that pharmacies may have to temporily close if a member of staff develops COVID-19 under current rules that stipulate anyone who has been in close contact must self-isolate for 14 days.

In Scotland, pharmacies are being advised to look at preparing lists of vulnerable patients who require medicines deliveries in case closure is necessary.

The ‘Test and Protect’ system went live in Scotland on 28 May 2020. In England, ‘NHS Test and Trace’ began operating on 29 May 2020 and Wales launched the ‘Test, Trace, Protect’ system on 1 June 2020. The systems are designed to isolate new infections and give an early warning if levels of the virus are increasing again, both locally and nationally.

Under all three systems, anyone identified as having been in contact with someone who tested positive for SARS-CoV-2 infection is required to self-isolate at home for 14 days, starting from the date of most recent contact.

Speaking at the government’s daily coronavirus briefing on 27 May 2020, Matt Hancock, health and social care secretary, said self-isolation “will be voluntary at first because we trust everyone to do the right thing, but we can quickly make it mandatory if that’s what it takes”.

However, in a statement published on 28 May 2020, Alastair Buxton, director of NHS services at the Pharmaceutical Services Negotiating Committee (PSNC), said that “greater clarity needs to be provided by the government on how the requirements for self-isolation apply to healthcare workers.

He said: “Where a pharmacy team member tests positive, the implications of this new approach could be the need for all their colleagues to self-isolate for 14 days, with the subsequent immediate, temporary closure of the pharmacy”.

Buxton added that the PSNC has “sought urgent clarification on the application of the requirements from DHSC and [NHS England and NHS Improvement]”.

In a video update posted on 28 May 2020, Harry McQuillan, chief executive of Community Pharmacy Scotland, asked pharmacy teams to “prepare a list of vulnerable patients that would need to be treated in the absolute event that a pharmacy had to suddenly close”.

McQuillan also asked pharmacy teams to continue to enforce two-metre distancing, adding that pharmacies will need to “get creative” with measures, including the possibility of shift work.

On 29 May 2020, the Royal Pharmaceutical Society said it was aware of “concerns about the potential implications around pharmacy teams having to self-isolate if they have been in contact with someone who tests positive for COVID-19”.

The Society added that it is working with governments in England, Scotland and Wales on how to “ensure the safety of pharmacy teams and to reduce any unintended impact on practice and patient care”.

After being approached by The Pharmaceutical Journal, the Department for Health and Social Care (DHSC) said that if staff have been wearing appropriate personal protective equipment (PPE), they will not have to self-isolate.

A DHSC spokesperson said: “We’ve launched NHS Test and Trace to reduce the spread of coronavirus and save lives. This a completely new, large-scale end-to-end service which allows people to check their symptoms, order a test and help identify people they came into close, recent contact with who may be most at risk of having caught the virus.

“If a positive case is traced to a health or social care work setting, this is escalated to the local health protection team to ensure all necessary contingencies are in place.”

A spokesperson for the Scottish government said: “As the Community Pharmacy Scotland [chief executive] made clear, there will be no exemption to the Test and Protect measures for key workers, and so to protect yourselves and your community, pharmacists should continue to apply these Health Protection Scotland guidelines: including implementing the two-metre physical distance, wearing PPE as required and practising good hand and cough hygiene.

“Maintaining these public health measures is the way to avoid becoming a close contact of someone who tests positive for COVID-19.”

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Citation
The Pharmaceutical Journal, COVID-19 'test and trace' scheme may lead to temporary closures, say pharmacy leaders;Online:DOI:10.1211/PJ.2020.20208022

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