Community Compliance Aid for Patients

The Covid-19 pandemic poses one of the biggest challenges that community pharmacy has ever faced. Pharmacies will start to lose team members either through infection, self-isolation or parental / caring responsibilities and as we are aware the dispensing and checking of community compliance aids is a highly labour-intensive task. The risk therefore of keeping this service going will, eventually be greater than the benefits it provides

As part of business continuity planning all patients therefore need to be assessed to determine the level of risk posed by removing the service (low / medium / high). An Equality Act assessment1 may also be required to determine any additional compliance support necessary in relation to their long-term disability. For patients who are low risk, it would be prudent to start removing this service as soon as possible, thus freeing up capacity to undertake assessments with patients who are in the medium risk group. The local community that each pharmacy serves will have its own individual demographics and therefore, the outcomes of this review will be different for each pharmacy. It is therefore important that every pharmacy starts the review process from the perspective of: If I have less than half of my workforce, then who will have to go without? This is also not about removing the service from all, but protecting the most vulnerable in society who need it. To support the patient review process, a template letter (see page 2) has been provided for pharmacies to share with their patients explaining the reasons behind the review and emphasising that this is about ensuring that all patients receive the care they require in these challenging times. Dear I am writing to update you on our pharmacy’s plans to ensure that we continue to care for all of our patients during the Covid-19 pandemic. As you are aware the escalation of cases in the UK has meant increased pressure on all aspects of the health system, including GPs and hospitals and community pharmacy is no different. Our core responsibilities are to ensure that all patients receive their medication in a safe and effective way. The national pharmacy body, the PSNC has issued guidance that all pharmacies should consider the services they provide to patients with regard to the compliance aids for medicines. In order to protect the whole supply chain for medicines and to ensure all

1 Avon LPC Compliance Aid webpage (includes an Equality Act assessment; https://psnc.org.uk/avonlpc/pharmacy-funding/how-to-increase-you-pharmacy-turnover/charging-for-services/

patients are cared for, pharmacies have been told to review these services in light of the fact that their workforce is likely to become reduced. To support this recommendation, we are therefore proposing that from the next time your medicines are due and until such time as Covid-19 is no longer a significant threat, that you will receive medication in original packs with a pre-printed administration chart that will allow you to track when you have taken your medicines and will act as a reminder.

This measure is also in line with current best practice guidelines from the Royal Pharmaceutical Society who recommend that “use of original packs of medicines, supported by appropriate pharmaceutical care, should be the preferred intervention for the supply of medicines.”1

I hope you understand that this measure is being taken in these extreme circumstances to protect all patients who access services from this pharmacy so we can continue to care for all of them. If you have significant concerns then please contact our pharmacy. Yours faithfully,

1 Royal Pharmaceutical Society; Improving Patient Outcomes, The better use of multi-compartment compliance aids; https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Support/toolkit/rps-mcajuly-2013.pdf [accessed 16th March 2020]