Journal of Pharmacy Management - Jan 2022

Journal of Pharmacy Management • Volume 38 • Issue 1 • January 2022 within primary care. However, in March 2020, as the COVID-19 pandemic began to take hold, the whole of the NHS enacted business continuity plans. Within primary care and MO teams that meant a move to working from home/ remote working in line with government guidelines. A notable shift in our ability to engage with practices occurred, as the opportunity to quickly catch a GP in between patient consultations to discuss a case or attend the practice meeting to discuss any prescribing priorities had suddenly ceased. Here we describe some of the challenges faced by our teams: Business continuity Actioning business continuity plans required large parts of the NHS to make substantial changes to routine working practices. In primary care this meant practices and primary care teams moving to remote working. This was challenging as the necessary infrastructure was not fully established, including: • not all staff had laptops • not all practices allowed staff (both employed and other) to access clinical systems remotely • telephony systems were not properly linked • networks were not designed for complete Virtual Private Network (VPN) or remote access. This meant the first few weeks of the pandemic were focused on trying to resolve these issues. Within our MO team we were able to assign laptops to all staff, however, not all staff had remote access rights into the practices they routinely worked with and getting access was not easy as practice staff were, rightly, prioritising their own operational issues to ensure that they could maintain the delivery of patient care. Switching to business continuity plans meant that ’routine’ day-to-day work had to be reprioritised to, firstly, focus on key activities that had been identified as needing to continue to maintain fundamental service provision and, secondly, to allow staff, including pharmacists and pharmacy technicians, to be released to support local systems through workforce redeployment into local trusts, care homes and later into vaccination centres. To enable this to happen, a review of activities as part of the business continuity plans helped us to separate essential and non-essential activities carried out by the team. While we did not know the full impact that the pandemic would have on GP workload, we knew that we did not want to add unnecessary pressure. Linked to this, the wider NHS was asked to put on hold activities that would not support direct patient care. One of the workstreams that fell into this directive was audit and cost saving - or quality, innovation, productivity, and prevention (QIPP) - as, while valuable, these types of initiatives increase GP workload and could lead to pressures elsewhere in the system, e.g. community pharmacy or the medicines supply chain. Early feedback from practices was that this shift to remote working and reduced face-to-face practice support led to them feeling they had lost opportunities for contact and query support. Reduction in communication During the early phase of the pandemic, a decision was made to reduce unnecessary communication to practices from our MO team. There were two main reasons for this: 1. time was needed to understand the impact of service changes and the need for redeployments within the team 2. it was recognised that practices would be having similar challenges in moving staff to a remote working situation and that the last thing they needed was unnecessary communications. Therefore, newsletters, prescribing practice visits and practice work were all put on pause. We continued to ensure phone lines and email inboxes were monitored to respond to queries that may come in. We knew that when we started to reconnect with practices that we wanted to add value. This was in recognition of the immense pressure practices were under following the first national lockdown. Practices were faced with a reduced workforce, increased requests for prescriptions as patients remained concerned if they would be able to access their medication, challenges with adjusting to remote working and additional pressures with preparing for a COVID-19 vaccination programme. 26