Regrettably, updated guidance issued in March 2023 by the UK Health Security Agency may have been misinterpreted by some employers to mean that pharmacists and pharmacy staff who ‘feel well enough’ despite having tested positive for Covid-19 could still attend work.
Not only would this interpretation increase the risk for staff and customers in general, but Covid-positive pharmacists who are part of the autumn vaccination campaign might be instructed to continue to participate in the vaccination service, which would expose the most vulnerable patients to risk of infection.
This approach would permit those with current Covid-19 infections to work in patient-facing roles with clinically vulnerable patients and colleagues, in what should be considered a safe healthcare setting. The ability for individuals without symptoms to spread Covid-19 has been a documented phenomenon since relatively early in the pandemic.
The PDA will be seeking clarification since members have raised concerns that some pharmacy staff are being expected to attend work if they feel well enough, even if symptomatic, on the pretext that this is ‘in accordance with’ the government’s ‘Living with Covid guidance’.
NHS Guidance
Vulnerable patients and vulnerable colleagues should have a reasonable expectation of rigorous infection control procedures in any healthcare setting. However, they could be exposed to the Covid-19 virus if positive Covid-19 employees administer their vaccinations.
The Joint Committee on Vaccination and Immunisation released a statement on the autumn Covid vaccination programme in May 2023. It included the following statement:
“The risk of developing severe Covid-19 continues to be strongly associated with increasing age and underlying health conditions”.
Any practice which places Covid-19-positive staff in close proximity to elderly or immunocompromised patients would increase the risk of vulnerable patients contracting Covid-19. These are the very patients which the vaccination programme was set up to protect, and appears at odds with the latest NHS Guidance on ‘Managing healthcare staff with symptoms of a respiratory infection or a positive Covid-19 test result’ which states:
“Healthcare staff whose job does not primarily involve providing direct inpatient care to severely immunosuppressed patients, who have symptoms of a respiratory infection, and who have a high temperature or do not feel well enough to go to work, are advised to stay at home and avoid contact with other people.
If these staff members have a positive Covid-19 test result, regardless of whether they have symptoms, they should follow guidance for the general public who have a positive test result.”
The general public guidance for those with a positive result includes the following:
“Although most people will no longer be infectious to others after 5 days, some people may be infectious to other people for up to 10 days from the start of their infection.
You should avoid meeting people at higher risk of becoming seriously unwell from Covid-19, especially those whose immune system means that they are at higher risk of serious illness from Covid-19, despite vaccination, for 10 days after the day you took your test.”
Whilst pharmacy staff are not providing inpatient care, those working in the vaccination service will be coming into close contact with some of the most vulnerable patient groups in what are often poorly ventilated and cramped consultation rooms. The PDA advises that it is neither safe nor appropriate for any staff members who have tested positive for Covid-19 to be present in a healthcare environment and totally unacceptable for them to be in direct contact with the patients who are currently attending for vaccination as part of the autumn Covid-19 vaccination campaign.
The PDA believes that employers should provide full sick pay in these circumstances to ensure any staff who cannot undertake patient-facing activity due to being Covid-positive can afford to stay at home and do not have to choose between keeping their patients safe and being able to pay their own bills.
Advice for Members
The GPhC Professional Standards require pharmacists to “use their professional judgement so that they deliver safe and effective care”.
The RP Regulations require the RP “to secure the safe and effective running of the registered pharmacy when it is operational”.
The RP when faced with a confirmed Covid-19 positive member of the pharmacy team presenting for work or suffering with symptoms themselves should therefore:
- Familiarise themselves with the latest NHS Guidance: Managing healthcare staff with symptoms of a respiratory infection or a positive Covid-19 test result.
- Inform the pharmacy superintendent of any risks to patient/colleague safety, preferably in writing.
- Check if a specific risk assessment has been undertaken by the pharmacy.
- Undertake their own assessment of the risk of vulnerable patients and staff being exposed to Covid-19 infection.
- Consider requiring the member of staff to work in a non-patient-facing role away from the pharmacy and other members of the team.
- If the above is not possible, inform the line manager that the only option is to send the member of staff home.
- If removing a confirmed Covid-19-positive member of staff leaves the pharmacy under-resourced, the workload should be managed accordingly, and consideration given to closing the pharmacy, if a safe and effective reduced level of service cannot be guaranteed.
Whistleblowing
Pharmacists who raise legitimate concerns about infection risks to their employer as set out above will be protected by whistleblowing legislation. The whistleblowing provisions protect any ‘worker’ who makes a ‘protected disclosure’ of information, from being dismissed or penalised by their employer because of the disclosure.
PDA members who require advice on raising concerns about Covid-19 infection risks at work can contact the PDA Member Support Centre.
Learn more
- Guidance for the general public who have a positive test result
- NHS Guidance: Managing healthcare staff with symptoms of a respiratory infection or a positive Covid-19 test result
- PDA signs the Covid-19 Safety Pledge
- Pharmacists should be aware of the end of the pandemic stage of the Covid-19 virus
- PDA supports calls for complete transparency in Covid-19 Public Inquiry
- Scottish Health Secretary responds to parliamentary question about Well Pharmacy’s Covid-19 policy
Not yet a PDA member?
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