Reflecting on Experience: The Important Role of UK Community Pharmacists’ During The COVID-19 Pandemic
The following post is a case study by Guest Blogger Rajinder Bhandal of a community pharmacist’s critical role during the COVID-19 pandemic in the UK, and the importance of the pharmacy-customer relationship in a time of dire need.
Have you heard of supply chain immunity?
The latest book written by Dr Robert Handfield and Lt Col, Dr Daniel Finkenstadt Supply Chain Immunity: Overcoming our Nation’s Sourcing Sickness in a Post-COVID World was published in March 2023. This seminal work presents serendipity found in supply chains as a result of the COVID-19 pandemic. Handfield and Finkenstadt showcase how the unexpected and unseen situation of the pandemic created new insight from the perspective of supply chain management, health care supply chains, and sourcing. And thus, showcase how this knowledge is valuable towards mending the economy and healthcare systems as a direct result of the pandemic.
“During a pandemic such as COVID-19, the distribution and delivery of critical supplies and services to the affected population is a major undertaking. Providing relief depends on the speed of the response and matching the supply with the need assessed. Response supply chains for vaccines and Personal Protective Equipment (PPE) must be established in anticipation of pandemics and need to be robust” (Handfield & Finkenstadt, 2023, p. 29).
Consistent with the narrative above, it is important to throw light on the distribution of emergency supplies in addition to the services provided by the healthcare sector. I was graced with a wonderful opportunity to speak with Pritpal Grewal who is the Deputy Superintendent Pharmacist of Cornwell’s Chemists Limited based in England, Staffordshire. Pritpal has been practising in the field of community pharmacy for over a decade and has held the position of Pharmacist Store Manager at Cornwell’s Chemists, located in Great Wyrley, since 2019. In his role, Pritpal ensures that the company as a whole adheres to guidance and laws set out by The General Pharmaceutical Council (GPhC); provides support to the Superintendent Pharmacist; advises and supports the provision of pharmacy to private and NHS (The National Health Service) patients.
Cornwell’s Chemists Limited was established in 1835, the organisation was originally made up of a chain of 7 pharmacies, based around the Staffordshire area in England. Cornwell’s Chemists have grown as a result of investment during the pandemic and due to the ever-changing landscape of the healthcare sector by acquiring 5 new pharmacies. At the present moment, Cornwell’s Chemists is operating a chain of 12 community pharmacies.
Vaccination Centre Pharmacist Clinical Lead
During the COVID-19 pandemic, Pritpal worked as the Pharmacist Clinical Lead of Great Wyrley vaccination centre, overseeing the COVID-19 vaccination programme, hiring staff, managing vaccine supply and stock, setting up clinics online, acquiring a vaccination site, hiring an Operation Manager to support the vaccination centre, these are to name just a few duties and responsibilities.
With recognition and gratitude to Pritpal Grewal, Deputy Superintendent Pharmacist of Cornwell’s Chemists for sharing the following reflective accounts summarised below:
- Lessons of resiliency
In March 2020, the healthcare sector shut down the doors. However, the pandemic showed what the field of pharmacy can do and did do! In December 2020 the COVID-19 vaccination programme started. By early January 2021, 500 pharmacies were enrolled to offer jabs. 22 million vaccines were delivered in the first 12 months by community pharmacies. Even before the pandemic landed, thanks to digitisation within the NHS, 99% of prescriptions were done online, via EPS (The Electronic Prescription Service). The EPS system was perfect during the pandemic, as the prescriptions were sent electronically to the pharmacy, allowing for quick response and service to patients needing medication.
COVID-19 kept the door shut, but we kept an open door outside the pharmacy, meaning that we could hand out medication to patients, adhering to the social distancing rules and wearing protective face masks. With the exception to not having a consultation room, as this was closed over the pandemic, everything else went smoothly. We did not run out of medication; however, stock availability is not as it used to be, but remained consistent. The main lessons showed the resilience of pharmacies in excelling in the work that was being done to help serve patients and the local community.
- A home-grown vaccine helped with supply and demand
Supply of the Oxford AstraZeneca vaccine was not an issue, supply was fine. Supply of Pfizer was a little slower as it was coming from the US. In January 2021, roll out of the vaccination began during lockdown. COVID-19 vaccination commenced in the local community centre, which was hired out with rental costs covered. Vaccination started with the oldest age group in the community.
The vaccine arrived already thawed out and had to be immediately stored at fridge temperature. The vaccine had a limited shelf life and therefore the use-by-date had to be updated on the system for each batch number. The vaccine was stored in the fridge at 2-8 degrees centigrade. A multi-dose vial contained 10 doses and could be kept out of the fridge at room temperature for a maximum of 6-hours, therefore a time stamp was marked on the vaccines at the time taken out of the fridge and upon time of use.
Vaccination roll-out was successful due to the home-grown vaccine – this really helped with the supply, as it was locally supplied, quick to arrive, with no delays or issues. A push and pull model was used when it came to vaccine supply and distribution. For instance, at the start of the vaccination programme, the suppliers told you what to work with in terms of vaccine numbers. This meant that every 1-week in advance we would get told how much we would receive, this allowed for some time to plan and set up appointments with patients, make arrangements for enough staff, and generally plan for vaccination at the community centre. Then the supply and distribution situation improved, as we were given a heads up on vaccine numbers every 2-weeks in advance, therefore we could plan much better with the additional time. Then the situation changed as people began returning back to work. This meant that we could place vaccine orders on the system and plan accordingly. For example, we could order 2,000 booster vaccines a week.
The US based company Palantir are experts in military logistics and defence technology, and provided a software platform to plan appointment systems and manage data, and much more. In the UK healthcare sector, Palantir’s services are used to provide a model to plan systems and technology. The following 3 healthcare service providers all use Palantir:
- The NHS
- Pharmacies
- General Physicians
- All the volunteers and all the people
A successful volunteer recruitment campaign ran, and people responded. This helped with recruiting 100 volunteers, with 18 volunteers working on a rota basis every day. The volunteers were those who were furloughed, retired, semi-retired healthcare staff, including nurses from the local area. The volunteers were a friendly face and were truly amazing as the patients were nervous, and the volunteers kept the atmosphere bubbly. All the people involved in the vaccination programme including the pharmacy team at Cornwell’s Chemists, healthcare professionals, local council, and local MP all contributed to the success of the COVID-19 vaccination programme towards serving the local community.
- COVID-19 is not over!
“The COVID-19 pandemic is still not fully over. We are currently providing Spring Boosters to patients 75 years of age or over and to the clinically vulnerable. There is anticipation that there will be another booster programme in Autumn, but we will have to await news from the JCVI* recommendations and ultimately the government. The reason for the prolonged vaccination programme is due to the versatility of covid and its ability to mutate into novel strains. It is important that we continue to remain vigilant for the most vulnerable in society by testing ourselves if we have flu-like symptoms and to take precaution if a positive result is confirmed.”
* The Joint Committee on Vaccination and Immunisation (JCVI) advises the UK government and health departments on immunisation.
All of my thanks to Pritpal Grewal once again for sharing these valuable insights. Extraordinary work, dedication, and solidarity shown during inescapable times.