As the COVID-19 pandemic continues, it is vital that community pharmacies continue to employ risk reduction and prevention practices, including screening patients who may arrive on site with COVID-19 symptoms and assisting patients who are isolating at home.

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Staying prepared

As the COVID-19 pandemic continues to change, it is important that all pharmacists stay up to date with local outbreaks, changing regulations and advice for managing infection risks and supporting patients.

  • The NSW Health website - COVID-19 - Health professionals is updated daily
  • The NSW Health Pharmaceutical Services website – What's New
  • The NSW Health website - COVID-19 (Coronavirus) resources (posters, signage and factsheets)
  • Pharmacies should have established points of contact with the Pharmaceutical Society of Australia and the Pharmacy Guild of Australia NSW branches.

COVID-19 regulatory changes

In response to the COVID-19 pandemic several regulatory changes have occurred. These include provision for image-based prescriptions, continued dispensing, serious shortage substitution, communication of prescriptions to pharmacists by prescribers, and emergency '3-day rule' supply.

Pharmacists must keep up to date with extensions to these regulations. Updates are announced on NSW Pharmaceutical Services 'What's New'.

Pharmaceutical Society of Australia also publishes a helpful summary of COVID-19 regulatory changes for NSW.

Assisting patients who are self-isolating or who need additional support

For practical advice for pharmacists for managing the supply of medicines in the pandemic and assisting patients in home isolation and for physical distancing, refer to Advice for pharmacists assisting patients in home isolation.

Advice is provided on:

  • obtaining a prescription
  • home delivery service process
  • supply and handling of dose administration aids (DAAs)
  • sending medicines via mail or courier
  • mental health support.

Limits on dispensing and sales

There are specific limits on the supply of prescription and over-the-counter medicines to ensure equitable access to medicines during the COVID-19 pandemic. Details are published on the TGA website and it is recommended pharmacists regularly review information provided by the TGA. Limits on orders from wholesalers apply to ensure equitable distribution of stock, including to regional and rural pharmacies.

Screening patients for COVID-19

Implement systems to triage and assess the risks posed by patients presenting to pharmacists for direct clinical services (e.g. vaccination) through pre-screening prior to the visit (for scheduled appointments) and on arrival. For example:

If a patient has an acute respiratory condition, wear a mask and offer them one to wear also.

Further guidance on implementing a pre-screening process and other example questions are provided in the CEC's COVID-19 Infection Prevention and Control guidance for Primary, Community and Outpatient Settings.

Assisting patients who have COVID-19 symptoms

On presentation to the pharmacy, the symptomatic patient should:

  • be identified by the pharmacy screening process
  • self-identify through use of signage in the pharmacy or screening questions where they are receiving direct clinical services such as vaccination.

Pharmacists dealing with symptomatic patients should:

  • provide patients with COVID-19 symptoms with a mask to self-fit before assisting
  • wear appropriate personal protective equipment and maintain social distancing where possible
  • prioritise symptomatic patients; wherever possible, isolate the patient in a separate area
  • call 000 for an ambulance if the patient has severe symptoms such as difficulty breathing.

Practical infection prevention and control steps for patients, staff and managers

For patients

  • Display signage/posters in the pharmacy to encourage patients with symptoms to identify themselves early to pharmacy staff so they can be triaged accordingly. Signage is available from NSW Health.
  • Display signage/posters to encourage patients with symptoms to seek testing for COVID-19.
  • Encourage physical distancing of 1.5 metres where possible, for example through floor markings and barriers to create space at counters, seated areas, etc. Speak to patients from a safe distance to avoid contact with respiratory droplets.
  • Put alcohol-based hand rub dispensers in prominent places around the pharmacy, including the entrance and at counters where surfaces are touched.
  • Inform patients of places where they can wash their hands with soap and water (for a minimum of 20 seconds).

For all staff

  • Be familiar with your pharmacy's COVID-19 Safety Plan.
  • Don't go to work if you have one or more COVID-19 symptoms. Make alternative arrangements with your workplace and get tested as soon as possible. Do not return to work until you receive a negative test result and are feeling well.
  • Staff who are close or casual contacts should only return to work when advised by NSW Health.
  • Know where the nearest COVID-19 testing clinics are located and encourage patients seeking cold and flu preparations to get tested.
  • Follow patient screening protocols and be prepared to follow the steps to minimise COVID-19 risk if providing services to a patient who has COVID-19 symptoms.
  • Be ready to respond to enquiries about COVID-19 vaccinations by referring to COVID-19 vaccination in NSW and COVID-19 vaccination FAQs .
  • Practice effective hand hygiene, wash hands thoroughly or use an alcohol-based hand rub throughout the work day and avoid touching your face as much as possible.
  • Keep a distance of 1.5 metres between staff and patients where possible.
  • Limit the number of people in the consultation room to the pharmacist, patient, and carer (where necessary).
  • Wear a mask if you are in an area where there is active or recent community transmission, if providing services to a patient with an acute respiratory condition, or if otherwise indicated by NSW Health.
  • Pharmacists undertaking direct clinical services (e.g. vaccination or examining a skin rash) should follow standard precautions – personal protective equipment, such as a mask or gloves, would not be required routinely unless there is a risk of exposure to blood or body substances. Hand hygiene remains the cornerstone of infection prevention. Wearing gloves is not a substitute for hand hygiene.

For managers

  • It is recommended that community pharmacies have a COVID-19 Safety Plan. A template plan is available. This plan should consider the unique circumstances and location of the business, and routinely be reviewed and updated.
  • Ensure patient screening processes are understood and followed by all staff.
  • Incorporate recommendations on infection prevention into each step of service models. This includes handwashing facilities, hand sanitiser provision, physical distancing and wearing masks.
  • If there is active community transmission, NSW Health strongly recommends that pharmacists and staff working directly with patients wear masks. Pharmacies should consider the Clinical Excellence Commission advice on when healthcare workers in different contexts should wear masks.
  • Staff who are close or casual contacts must follow NSW Health advice and only return to work when advised by NSW Health.
  • Prepare staff to refer patients to information about how NSW is implementing parts of the Australian COVID-19 vaccine program.
  • Encourage staff to get vaccinated for influenza when vaccines become available next flu season. This is to protect themselves, their families and vulnerable patients from seasonal flu. See information about the importance of influenza vaccination during the pandemic.

Cleaning and waste management

Key recommendations for pharmacies include:

  • increasing the frequency of environmental cleaning, particularly high touch surfaces like benchtops and handles
  • timing scheduled appointments to support physical distancing and appropriate cleaning of surfaces
  • ensuring closed bins are provided for safe disposal of tissues by staff and patients.

Cleaning and waste management should be included in the pharmacy's COVID-19 Safety Plan (recommended). A template plan is available for use.

COVID-19 Infection Prevention and Control guidance is available for Primary, Community and Outpatient Settings.

Further information is available on cleaning and disinfection in the workplace. The Australian Department of Health has also issued guidance on cleaning and disinfection for health facilities and in the community.

Emergency temporary closure of a community pharmacy

It is recommended that all pharmacists consider this possibility and develop a contingency plan in the event of a local outbreak of COVID-19. Pharmacists and business managers should consider:

  • complying with regulations with regards to supply and storage of medicines
  • being familiar with your emergency locum options
  • that any closure is communicated to customers, with a sign on the pharmacy premises as a minimum.

Although it is otherwise illegal for anyone to take or supply anything from a pharmacy in the absence of a pharmacist, a non-pharmacist staff member could, on the direction of the pharmacist:

  • take possession of the prescriptions and repeats (other than S8 and S4B) which had been left at the pharmacy for safekeeping/convenience, then:
    • take the prescriptions to a different pharmacy, advising patients to phone that other pharmacy if a medication is required
    • deliver the prescriptions/repeats to the patient's address for the patient to organise the dispensing at another pharmacy
    • offer a courier/delivery service taking the prescription/repeats to another pharmacy (perhaps in the next town) to have the medication dispensed and then delivered to the customer. Note, in the case of S8 and S4B (androgenic anabolic steroid) original and repeat prescriptions, these must remain on the premises of the pharmacy which first dispensed them. If a patient requires a further supply whilst the pharmacy is closed, another pharmacy will require a new prescription.
    • take possession of dispensed (non-S8) medicines then deliver them directly to the patient.

More information

Current as at: Thursday 25 March 2021
Contact page owner: Health Protection NSW