COVID-19 - HUB

Here at CPS we depend on our ability to provide our members and contractors with reliable support and uninterrupted service.

Protect Scotland App

The Scottish Government has launched Protect Scotland, a contact tracing app designed to assist NHS Test and Protect and help to reduce the spread of Covid-19. Here is some information for members and their teams to consider in relation to the app.

How does the Protect Scotland app work?

The Protect Scotland app uses the Google/Apple exposure notification system, which is built around the Bluetooth functionality incorporated in smartphones.

The exposure notification system is a decentralised model, which means all data is held locally on the user's device until such time as he or she tests positive for Covid-19. Interactions are recorded using anonymous, randomised codes, together with information on the distance between the individuals and the duration of the interaction. This approach limits the amount of personal data that is collected, as interactions with other devices never leave the phone.

If a user tests positive, then they will be provided with a code by a Test and Protect contact tracer. When this is entered into the app, the app then informs a central database. The app regularly checks the database and if it detects a match between the database and a logged interaction, and that interaction involved the people being in contact at a distance of 2 metres or less for 15 minutes or more, then the user is alerted.

This is the same system as it used in Ireland, Northern Ireland and many other countries around the world. You can read the Information Commissioner's views on the Google/Apple system in this opinion (PDF).

Is the Protect Scotland app compulsory?

No. Use of the app is voluntary, but people in Scotland are being encouraged to download and use it to assist with the Test and Protect contact tracing strategy and to try to reduce the spread of Covid-19.

It is anticipated that the Protect Scotland app will help to alert people of a potential risk more quickly and also detect interactions that may not be possible through manual contact tracing (for example, standing next to a stranger in a queue or on public transport).

Can I require team members or visitors to use the Protect Scotland app?

Employers will need to think carefully about adopting any policy requiring team members to download the app.

The Scottish Government and NHS are the controllers in respect of the Protect Scotland app. No information would be available to a third party, such as an employer. If an individual tests positive for Covid-19, then the app automatically alerts other individuals with whom that person has had a relevant interaction. Contacts (and the employer) may also be contacted by the NHS Scotland Test and Protect manual contact tracers.

However, requiring team members to download and use the app may make the employer a joint controller for the purposes of data protection law. This may be the case even though no personal data would be available to the employer.

More generally, there are a number of practical issues to consider with a mandatory policy. For example:

  • Which device would the app be installed on? If people do not always carry a work phone with them (for example at the weekends or in the evening) then there is likely to be a limited benefit to installing it on the work phone.
  • If it is installed on a personal phone, how would you check whether the app has been installed (and is active and running)?
  • How can you check whether people are always carrying their phone? How will you know whether a team member took their phone to the supermarket at the weekend?
  • What do you do if someone's personal phone is not capable of running the app (because it is not an iOS or Android device or because it cannot run a new enough version of the operating system)?

There are also broader employment law questions. If a team member receives an alert that they may be at risk, what is your policy on what the team member needs to do next?

These issues will require employers to consider a mix of data protection and employment law issues, and the particular infection risks within their workplace.

A better approach may simply be to promote the app within an organisation as part of the organisation's Covid-Secure workplace strategy and highlight the benefits of everyone using it.

Can I turn off the App?

There are very few circumstances where it is advised to turn the App off. Whilst proximity measurements to identify potential contacts cannot take account of whether the encounter was face to face or whether face coverings/screens were in place etc., they are a good measure of the distance and time spent near a confirmed case and therefore of risk if no other protections were in place.

All App users should therefore keep their phone on and with them whenever possible, with the App active on their phone at all times except in a small number of circumstances:

  • If the user is a health or social care worker in a clinical setting, wearing medical grade PPE. This includes community pharmacy. This means that recommended PPE should be worn at all times.
  • If the user is protected by a fixed physical barrier from customers and colleagues such as a Perspex screen for most of the working day. This doesn’t apply for those who constantly move around (e.g. café workers behind tills with a screen who also move around the café)
  • If the user keeps their phone in a locker or equivalent facility at work and not on their person

In these circumstances, ideally individuals should turn off their phone as that means the App will automatically continue to work when the phone is turned back on again.

However, it is recognised that that is not always possible so alternatively users can choose to disable Bluetooth. It is also possible for users to turn off the Exposure Notification Setting on their mobile phone. This will turn off the ‘contact tracing' functionality until the Exposure Notification Setting is switched back on. The user will need to remember to turn their Exposure Notification Settings and/or Bluetooth back on.

If you receive a close contact alert advising you to self-isolate, but believe you meet one of the above scenarios, you can call the NHS 24 Covid helpline (0800 028 2816) to help you understand the exposure notification and make an informed decision as to whether to self-isolate.

The App should NOT be switched off in the following scenarios:

  • Where PPE, including visors and face coverings, is used in non-clinical settings (e.g. building sites, café’s, transport, by fire and police personnel etc.)
  • In the home or vehicles (signals from adjoining properties or vehicles are unlikely to result in a contact alert)

Updated PPE Guidance for Pharmacy Teams

A joint letter from ourselves and the Scottish Government to contractors provides advice and guidance on a number of key factors in infection, prevention and control within the community pharmacy setting, including physical distancing, use of PPE and environmental cleaning.

Click on the image to the right to download

Health Board Specific Information & Guidance for COVID-19

This section provides pharmacy teams with guidance on COVID-19 Health Board specific information including resilience HUBs and testing for key workers etc.

Changes to PVG Scheme Process

As part of your membership to Community Pharmacy Scotland, when your employees complete PVG Scheme applications, you have the option to send them to ourselves to check and countersign these, before sending to Disclosure Scotland. Many of our members already take advantage of this, so we would like to update you to some changes in our process due to new ways of working for ourselves during COVID-19, and new processes implemented by Disclosure Scotland.

Application Forms

Previously, you may have been supplied with paper application forms to give to your employees, to complete and post to ourselves. Now, as all our team are working from home, we are unable to process paper applications. We would ask that any applicants download and complete the forms electronically. This can be done from the Disclosure Scotland website. If this is the first time they have applied for the PVG Scheme they will need to complete the Application to Join the PVG Scheme. If they have applied before, and but have changed employers since the last time they applied, they will need to complete the Existing Member Application.

Payment

If payment is to be made by the applicant, or if you will be paying for your employees’ application and are not invoiced, payment should be made as outlined here. Please note we cannot accept cheques or postal orders currently. If you have asked to be invoiced, we will do this for you.

Sending the Application

Completed application forms should then be sent, along with scanned copies of three forms of ID, to pvg.enquiries@cps.scot. They should also include in the body of the email what employer they are working for and what position. No change has been made to what ID is acceptable, although you should ensure any scanned images are legible. The following forms of ID will be accepted:

  • Passport
  • Driving License
  • Birth Certificate
  • National Entitlement Card
  • Other (including, bank statements, utility bills, council tax letter)

Please ensure at least one of the documents is photographic, and one confirms the applicant's current address. If they have their previous certificate, this should also be scanned and sent with the application.

COVID-19 Response Workers

If you are applying for a PVG and you fit all three of the following criteria:

  • You only need a disclosure because of their coronavirus work.
  • Your role must only exist in response to coronavirus.
  • You will be working in a qualifying sector (pharmacy would be included in this)

Please contact us before applying, as there is a slightly different process for these applicants.

 

Face Coverings - Guidance for Pharmacy Teams

Following the Scottish Government’s announcement that face coverings would be mandatory in enclosed indoor spaces such as shops and pharmacies as of the 10th of July, an official information page has now been published which should answer most of your and your patients’ questions. We recommend that team members read and understand this page, and have pulled together some supplementary information below that may also be of further use:

COVID Risk Assessments

The emerging evidence surrounding COVID-19 is increasingly highlighting that certain population subgroups are likely to have far worse outcomes than others if they become infected with the virus (for example, BAME colleagues and male colleagues amongst others). We would encourage members to work with their HR partners to undertake individual risk assessments. Having reviewed the available UK materials for those who do not have this facility, we believe that the following resources are the most comprehensive and up to date – these may be used to help you in your approach to risk assessments and risk reduction for the workplace, workforce and individuals within your business. Please note that they are subject to change, serve only to inform your approach, and do not constitute advice.
 
NHS Employers risk assessment framework: This gives a broad overview of how to approach COVID risk assessments in general, with some specifics around higher risk groups.

NHS Wales Workforce risk assessment tool: This is a more practical tool, going into further detail and including a scoring tool to aid with risk stratification (please be aware that this scoring system is based on evidence which is currently under peer review pre-publication.

PCA(P)(2020)09 - Smoking Cessation Service Delivery During COVID-19

Circular PCA(P)(2020)09 aids community pharmacy teams in supporting people through their smoking quit attempt by outlining some temporary flexibility in how the national service can be delivered and support that may be available from local specialist smoking cessation teams.

Personal Protective Equipment (PPE for COVID-19) Guidance for Pharmacy Teams

UPDATED 05/06/20 - You will now all have received supplies of fluid-resistant surgical facemasks for wearing at all times in your pharmacies to help protect yourselves, your colleagues, and your communities from the spread of COVID 19. It should be noted that every effort should still be made to maintain the 2 metres social distancing. Guidance on how to wear the masks is available at appendix 2 of the Primary Care Guidance - https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance-for-primary-care/

Disposal of PPE

At the end of a session involving the use of PPE, masks should be placed in a disposable plastic bag, then placed in a secondary disposal bag, tied and held for 72 hours before being placed in the pharmacy’s domestic waste bin. If the pharmacy has a clinical waste contract or arrangements have been put in place with your local NHS Board, masks once removed can be placed into the clinical waste immediately. 

Reordering PPE - 0300 303 5550

A telephone reordering system specifically for pharmacies to order face masks will be in place from Monday 20 April. This can be accessed on the following number, 0300 303 5550 – this line will be supported Monday – Friday between 08:00 – 20:00. You will be required to have your contractor code and postcode to hand when ordering. Orders will be limited to 2 boxes of 50 masks each time to help manage supply. We would ask that you do not place an order until it is necessary and be mindful of the expected delivery time of 2 working days. Orders will be delivered by courier.

Please note: stock supplied may include those from the national stockpile that had an original expiry date dating back typically to 2016. As per the Interim Chief Medical Officer, Dr Gregor Smith’s letter of 17 March to Boards, this stock has been subject to rigorous assessment and shelf-life extension by the manufacturer and is therefore safe to use.

Test and Protect: PPE Guidance for Pharmacy Teams

UPDATED 05/06/20 - The Test and Protect scheme which is central to Scotland being able to ease out of lockdown is now live in Scotland. There are no special arrangements for key workers, so if a member of your pharmacy team becomes symptomatic, a contact tracer will carry out an interview with them to determine whether the rest of the team, or any individual, are likely to have been exposed through close contact to the virus or not.

The three key things that help to reduce the risk of your team being classed as exposed to the virus are to undertake regular and frequent handwashing, to maintain physical distancing of 2m between colleagues and to wear the recommended PPE of fluid-resistant surgical masks at all times in the pharmacy. We know that maintaining 2m physical distancing will be a challenge in some environments, even where adaptations to layout and working patterns have been made, so this makes the use of PPE even more critical. Doing so will give you the best shot at keeping your pharmacy open for the people in your communities that you work so hard to look after each day.

There will be a small minority of team members with medical conditions for whom wearing this type of mask may pose a challenge. For these colleagues, a risk assessment of  the individual’s environment and their role should be undertaken to identify any reasonable changes that might need to be made to achieve 2m physical distancing.

We are also working with NSS on the PPE ordering process in terms of quantities and streamlining the experience, which we will share more detail on as we have it.

Harry McQuillan (CEO) & Matt Barclay (DoO) have put together some video messages to advise our network around the current issues surrounding the COVID-19 outbreak in Community Pharmacies in Scotland:

CPS's Harry McQuillan provides guidance concerning this week's hot topic of mandatory face coverings in pharmacy, updates the network around finances, and has a quick reminder for our pharmacy owners out there.

CPS's Matt Barclay is back with the latest Pharmacy Update with latest developments and guidance around the "new normal". Topics in today's video include Test, Trace, Isolate and Support, PPE, NHS Near Me and much more.

Test, Trace, Isolate and Support (TTIS) Approach to COVID-19

You may have seen that the Scottish Government has published a paper outlining their plans to manage viral spread in the general population, focusing in the main on testing, contact tracing, and self-isolation. The document reads as though this approach may have a significant impact on community pharmacy workforce, but we understand that it is only one piece of a wider strategy.

Please be assured that we are working with our Scottish Government and NHS colleagues to better understand what the future approach for key workers might be, and as soon as we have further information we will share this with you.

Prison Health Centre Contact Details

Early release of prisoners – handwritten prescriptions. Below are the contact numbers for the prison health centres who may be able to confirm prescription details if you feel this is necessary. click on the image to view

Prisoner Release Letter

The following letter from Quentin Fisher, Deputy Director of the Community Justice Division concerns the powers in the Coronavirus (Scotland) Act 2020 which allow for the early release of certain prisoners: click on the image to view

Management of patients in primary care Including general dental practice, general medical practice, optometry and pharmacy (17/4/2020).

Letter from the Deputy Chief Medical Officer (17/3/2020) clarifying the shelf life extension to facemasks

A letter from the Chief Pharmaceutical Officer, Dr. Rosemarie Parr. (9/4/2020)

A letter from the Chief Pharmaceutical Officer, Dr. Rosemarie Parr. (30/3/2020)

April 2020 Drug Tariff Reset (1/4/2020)

Community Pharmacy Scotland and the Scottish Government agreed upon a 3-year funding deal which comes into effect as of today the 1st April 2020.

This is a hugely positive step forward, providing stability and predictability for the community pharmacy network, Scottish Government and NHS Health Boards and allowing adequate time and space to develop and embed pharmaceutical care services. We detailed all aspects of the funding package for 2020/21 to 2022/23 in our key facts document complimenting the Scottish Government Circular PCA (P)(2020) 2 and want to highlight in particular today the two aspects agreed around the mapping further monies, as we have done in previous years from the tariff, into the global sum for guaranteed income and using this same method of tariff reduction to pay back what is owed by the network to NHS Health Boards. This removes the need for a clawback mechanism.

We understand during this unprecedented time the pressures that you are experiencing in all daily ways of working. We continue to work in supporting you in all ways we can from securing a 3-month advance payment in April to cover costs to workforce support, to our daily videos of updates and morale-boosting shout outs.

Therefore, we felt it only right to highlight to you that there are a significant number of changes for April in this tariff reset, published today, to go in hand with the above-mentioned agreements with the Scottish Government. We recognise in this current climate the ongoing concern regarding medicine cost and shortages you are experiencing and these changes to the tariff may exacerbate this further. In conjunction with the Scottish Government, we believe the agreement laid out above should continue and if the tariff comes under pressure this is treated separately and any necessary actions are then taken.

You will also note the number of adjusted price lines have reduced on the website due to this tariff reset.  We are implementing in the coming days, a temporary measure to make it quick and easy for you to report shortages to us. We will continue to monitor these and negotiate with the relevant departments at NSS agreements for adjusted prices as we do on a weekly basis, with Sertraline being a recent example. 

If you have any questions about the April Drug Tariff please do not hesitate to contact the Pharmacy Services team on 0131 466 3540 or email pharmacy.services@cps.scot

Support & Resources

We are currently looking at a number of ways in which we can offer support and protection to our members throughout this outbreak. CPS is continuing to have detailed discussions with Scottish Government officials in order to get the best support and resources for community pharmacies in Scotland that have been impacted by the COVID-19 pandemic.

We will be looking at several areas to agree arrangements for such as:

  • Safety and protection of the pharmacy team using available and current guidelines.
  • Financial stability (Particularly for those pharmacies who have to temporarily close due to the COVID-19 outbreak)
  • Operational support (i.e. resources to support the pharmacies day-to-day functions)

There will continue to be updates regarding these circumstances as and when we get them.

Important Service Changes from Alliance Healthcare 

Alliance Healthcare has announced some important service changes due to the COVID-19 pandemic. This will impact returns that are ordered in error, cut off times for AM & PM orders, and the picking process with priority moving to essential POM medicines. Click the links below to read the announcement in full.

Key Worker's Template Letter for Pharmacy Teams

Pharmacy Teams - Key Workers

Pharmacy Teams are in Category 1

We have produced a template letter for Pharmacy Owners and Superintendents to use for their teams to provide the necessary details to schools and local authorities.

We understand that the next stage is for schools to make contact with parents and carers with details of plans for the coming week. Some local authorities have already done this.

As we receive more information, we will publish it on the website.

Details of John Swinney’s Statement can be found here:

https://www.gov.scot/news/update-on-school-closures-and-exams/

Please send any questions to enquiries@cps.scot

COVID-19: Key Workers Police Scotland Letter

We are aware of police officers stopping pharmacy team members on their way to and from work, as well as stopping delivery drivers on their routes. We have been in contact with Police Scotland who have confirmed that this patrolling is likely to continue as a potential enforcement measure for those not following government advice. Whilst NHS and Local authority workers have standardised proof that their work is essential, community pharmacy workers do not. We have agreed with Police Scotland to draft a covering letter which should be filled out with your details and branch-stamped. This will be available on our website shortly in the COVID-19 area. Each member of the team should carry a copy to speed up the process if stopped, and we are told that this will be accepted by officers.

COVID-19: NHS Community Pharmacy Teams Dedicated Shopping Slot Letter

As of Thursday 26th March 2020 both Tesco and Morrison's are on board to accept our letter - we will update you as soon as we have more information about any other supermarkets.

Coronavirus Communications Toolkit

NHS Scotland and the Scottish Government have created a Coronavirus Communications Toolkit. It contains information on procedures/processes for managing risk, key messages & links to resources. You'll find the communication toolkit and more information at https://www.nhsinform.scot/coronavirus 

Health Protection Scotland has developed guidance and other information concerning COVID-19 at https://www.hps.scot.nhs.uk/a-to-z-of-topics/covid-19/ you can also find specific guidance for pharmacists on their website.

Coronavirus: Guidance from Health Organisations for Pharmacy Owners

As the coronavirus outbreak develops in Scotland, various organisations have released guidance for healthcare professionals – some of this relates directly to community pharmacy businesses, so we have pulled together the resources that we are aware of for you to use in considering how to preserve the continuity of care for your patients below:

  • NHS Inform website – this will always be kept up to date with the latest information and advice.
  • GPhC and other regulators’ statement – As with the Beast from the East, the regulators have come together to acknowledge that in challenging times, healthcare professionals may need to operate in ways that they wouldn’t normally to look after patients. It is recommended that any decisions to work differently should be recorded so that the full context can be taken into account should anything untoward happen as a result. As always, individual professional judgment must be applied, and it may be worth speaking with your superintendent if you are considering a departure from SoPs or the law.
  • The RPS in Scotland have endorsed and supported this move, commenting that: 

“We are very pleased to see this statement from GPhC which reassures pharmacists that they have a flexible approach to regulation and encourages the use of professional judgment in the best interests of patients. Sometimes there are circumstances where you can’t follow normal procedures. This is fine provided what you do has been thought through, can be justified professionally, and is then properly recorded. For RPS Members - The MEP and a quick reference guide to Professional Judgement gives helpful support and guidance on how to think through the professional decision-making process. Updates and links to the latest guidance on the Novel Coronavirus (Covid-19) are available on our website hub page which also has the contract details for the confidential support helpline for any queries on practice issues or wider matters.”

Coronavirus Stop & Think Poster

Click on the poster below for a printable version.

Coronavirus Poster

Coronavirus your Help Poster

Click on the poster below for a printable version.