“ICHP involvement helped the Local Pharmaceutical Committees start conversations with key stakeholders and voluntary services that we were unaware of. We have since been able to build relationships and undertake projects wider than volunteering. The LPCs are now well equipped with the system intelligence, ready to remobilise volunteers if required and pleased that our community pharmacies have built ongoing support from some volunteers.”
Marsha Alter, Consultant Pharmacist, The Middlesex Pharmaceutical Group of LPCs
Helping pharmacies deliver medicines to shielded and vulnerable people
Challenge / problem identified
Due to COVID-19, pharmacies in North West London struggled to meet the greatly increased demand for medicine deliveries to the homes of shielded and clinically vulnerable residents.
Pharmacies were only reimbursed by NHS England for medicine deliveries for the shielded list residents, but not those clinically vulnerable residents choosing to shield due to their medical condition(s) or other risk factors.
Local experience found that only two out of 70 deliveries a day were for shielded residents, indicating the extensive demand to be met by local pharmacies without additional financial or personnel resources.
Imperial College Health Partners (ICHP) helped the Local Pharmaceutical Committees (LPCs) respond to the increased demand for medicine deliveries and the need to ensure patient safety by avoiding missed medicine doses (which may lead to hospital admission). They carried out a scoping exercise as part of a wider project being conducted by the North West London Volunteering Working Group, to identify potential volunteering services in the area able to support community/trust pharmacies and individual patients with their medicine deliveries.
Volunteering resources in North West London were then collated into easily accessible flow diagrams enriched with hyperlinks so that pharmacists could access the right documents to request volunteers within seconds. These flow diagrams were distributed to trust and community pharmacists in six NWL boroughs on 14 May 2020.
ICHP undertook an evaluation of the uptake of volunteers. Although, the uptake with the smaller voluntary services indicated a 100% increase, with a large week-on-week increase in the use of the GoodSam volunteers after the flow diagrams were circulated, there was insufficient data breakdown to indicate the % increase in medicine deliveries. After implementation, ICHP also found that one local authority had funded a bike courier service, which impacted uptake of local voluntary services.
Impacts / outcomes
The flow diagrams have been distributed to 520 pharmacies across North West London. Both the distribution of the flow diagrams and the initial scoping exercise have led to increased collaboration between local authorities, council volunteering schemes, third sector organisations and the LPCs.
The LPCs are now working with some of the borough volunteering schemes to develop sustainable ‘neighbourhood’ models to ensure future support for clinically vulnerable and shielded residents beyond medicine deliveries, such as grocery shopping, emotional support, and transport.
After initial calls to the local borough voluntary services and councils, ICHP discovered extensive volunteering resources in the community that weren’t fully utilised by the system. For example, the National Volunteer Responder Scheme (supported by the GoodSAM app) launched on 7 April 2020 and has 750,000 registered volunteers, but matching to available opportunities has been slow.
There were complaints on Twitter and other social media channels that volunteers weren’t being used effectively during the response to the pandemic. ICHP identified available volunteers from the national scheme, as well as local volunteering schemes set-up by local councils, who could respond to the need from local pharmacies for support with medicines delivery.
As a second step, ICHP worked in collaboration with CCG colleagues to map out all available volunteering schemes, including guidance on how to request a volunteer and whether the schemes met the LPC leads’ requirements, such as DBS-checked volunteers for multiple pharmacy medicine deliveries.
This information was collated and fed into the development of borough-specific pharmacy volunteer flow diagrams, guiding the pharmacists through different steps to request a DBS-checked volunteer for medicine deliveries or other ad-hoc support in the pharmacy. The flow diagram also gave details of how a patient could arrange their own representative.
The ICHP project team worked in an agile and flexible way, collaborating efficiently and effectively with the LPCs and volunteer services and as a result was able to respond to the identified need within a four-week period.
Future plans / next steps
This project was an initial response to gaps in care due to the COVID-19 pandemic. It has shown the value of mobilising volunteers that meet the LPCs’ needs for medicines deliveries and how to work with both temporary volunteers (such as furloughed council workers) and established voluntary organisations that may not have undertaken medicine deliveries in the past. It also helped those organisations utilising the GoodSam app to understand that appropriately vetted (DBS-checked) volunteers were required.
To build on the existing volunteer offer to community pharmacies, the NWL Collaboration of CCGs is now working with the LPCs and Mutual Aid Groups to develop sustainable volunteer deployment models for primary and secondary care, including care homes and pharmacies, that draw on a pool of ‘neighbourhood volunteer support’ able to offer a range of responsive support to residents and health services for the longer term. This offer may replace or augment the GoodSAM offer, which the Government is extending during the ongoing waves of the pandemic.
In August 2020, the Pharmaceutical Services Negotiating Committee have issued further guidance to community pharmacies on the use of volunteers, including the indemnity/liability position and safeguarding arrangements of RVS Good Sam volunteers and other volunteer services / local self-organised groups.
“The collaboration did put systems in place, especially through the local council and fire brigade in the context of providing DBS checked volunteers. Also, many individuals that volunteered during lockdown, while furloughed etc, have remained in their volunteer roles, continuing to provide vital support to those who most need it.”
Clare Leahy, Community Development Manager, H4All