Why pharmacists should be involved
The community pharmacist is a trusted source of information and advice for their patients. This is particularly important for those issues which can have high media attention e.g. introduction of a new vaccine or an outbreak of an infectious disease.
Further information and advice can be found in the Health Protection Topics section of this website. Examples of topics included are:-
Infection Control
Knowledge of infection control principles is important to protect yourself and your patients.
And
Immunisation and Storage of Vaccines
Advice on safe storage of vaccines which must be stored in the ‘cold chain’ between 2oC and 8oC at all times.
Communicable Disease, Outbreak Control and Emergency Planning
Pharmacists can recognise symptoms of a notifiable disease in order to appropriately refer patients
Understand how an outbreak is being managed to be able to offer appropriate advice and reassurance to the public.
Maintain Business Continuity Plans to ensure minimal impact on the delivery of patient care in the event of an emergency situation.
Screening for Health Protection
Pharmacists can encourage uptake of screening programmes against several cancers e.g. cervical, breast cancer and bowel. More information may be found on the Screening – Health topics – Public Health Scotland website.
For any enquiries regarding health protection please contact:
PharmacyPublicHealth@ggc.scot.nhs.uk
Blood Borne Virus
Three blood borne viruses are the main cause for concern in Scotland, Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C.
There is an effective vaccine only for Hepatitis B. However, there are few effective treatments for Hepatitis C and HIV.
More information
- Health Protection Scotland (provides surveillance of blood borne virus).
- Hepatitis Scotland
- HIV Scotland
- Reach Community Health Project (Offers support to BME patients with Hepatitis C).
Key points for community pharmacy
- Signpost patients to appropriate support organisations.
- Prevent accidental transmission of disease by following NHS Community Pharmacy Website (scot.nhs.uk) in practice.
- Promote vaccination against Hepatitis B.
Some pharmacies may
- Offer support for dried blood spot testing for Hepatitis C and HIV.
- Dispense antiviral medicines for Hepatitis C.
- Provide ‘Injecting Equipment’ to prevent spread of disease.
Communicable Disease
Public Health Protection Unit – NHSGGC in NHSGGC has a key role in monitoring and responding to the incidence of notifiable diseases e.g. meningitis.
For more information visit
- Health Protection Scotland (HPS) collects information about the incidence of notifiable illness and collates this in monthly reports available on their website.
- The Induction for Infection Control module provides useful training on recognising communicable (and notifiable) disease. This is available on Infection Prevention and Control – NHSGGC (note registration is required).
- ‘Immunisation against Communicable Disease’ (The Green Book) available on line.
- The Meningitis Research foundation and Meningitis Now have useful websites.
Key points for community pharmacy
- Recognise and refer patients with symptoms suggesting a serious or notifiable disease to the GP or acute services as necessary.
- Compliance with prophylactic therapy e.g. tuberculosi
Community Pharmacy & Infection Control
The NHS GGC Community Pharmacy Infection Control Guidelines provide basic advice.
To reduce the incidence of infection due to antimicrobial resistance in the population, NHSGGC has launched https://clinicalguidelines.nhsggc.org.uk/adult-infection-management/ to be followed in primary care and the prescribing support team has developed a non-prescription pad to encourage patients to seek non antibiotic remedies for viral infections.
More Information
- https://handbook.ggcmedicines.org.uk/guidelines/infections/mrsa-eradication-policy/
- The Hepatitis C Action Plan for Scotland
- Infection Prevention and Control – NHSGGC
Key points for community pharmacy
- Provide antibiotic stewardship.
- Offer advice to patients on appropriate infection control techniques to reduce spread of disease such as norovirus or influenza.
Health Screening
The NHS GGC Public Health Screening Unit is responsible for a range of health screening programmes.
Key points for community pharmacy
- Encourage patients to participate in screening programmes.
Immunisation Programmes
Immunisation is one of the most effective health interventions.
There are several formal immunisation progammes in the UK. They are Childhood, Adult and Seasonal Influenza.
More Information
- Health Scotland’s website – Offers up to date advice to the public.
- TRAVAX – a comprehensive guide to required travel vaccination and other travel health protection issues. (Access to TRAVAX requires registration but is usually free for those working in and for NHS Scotland).
- ‘Immunisation against Infectious Disease’ (‘The Green Book’) – provides detailed information on UK vaccination.
- NES offers training ‘Promoting Effective Immunisation Practice’
Key points for community pharmacy
- Encourage patients to engage with national and childhood programmes.
Some pharmacies may
- Offer travel and influenza vaccination clinics.
Outbreak Control
Public Health Specialists from NHS GGC Public Health Protection Unit – NHSGGC are involved in identifying and managing outbreaks of disease. They will liaise with infection control teams for example in the case of a norovirus outbreak in an institution or with local authorities if an outbreak is linked to a food supplier in an E. coli outbreak.
Chemical Biological Radiological and Nuclear (CBRN) outbreaks
Local authorities and health boards are required to have plans in place to manage accidental events such as major oil or chemical spills or deliberate terrorist acts. A specialist on line training module is available from TOXBASE
More Information
- The Health Protection Scotland website.
- National and Local plans for Winter Planning work are hosted on the Greater Glasgow & Clyde Winter Planning site
Key points for community pharmacy
- Provide reassurance to patients.
- Keep Business Continuity Plans up to date.
Patient Group Directions (PGDs)
Patient Group Directions (PGDs) are legal documents that enable suitably qualified healthcare professionals to administer and supply medicines (P or POM) in a defined clinical situation where the patient may not be individually identified before presenting for treatment. The individual using the PGD must have signed and been authorised to use the PGD prior to administering or supplying any medicines named in the document.
NHS GGC uses PGDs to allow nursing staff and Health Visitors to administer vaccines for the routine child immunisation programme and travel in specialist clinics.
More Information
- Information about working under PGDs National health Education Scotland NES
Key points for community pharmacy
- Community pharmacy PGDs authorised for use in NHS GGC may be obtained from the Community Pharmacy Development team or GGC PGD administration at Clarkston Court, 56 Busby Road, Clarkston, Glasgow G76 7AT
Telephone No. 0141 232 1728.
Seasonal Influenza
Individuals are most likely to catch influenza in the winter months. The season runs from October to the end of February occasionally into March, peaking in December/January.
Seasonal influenza can affect anyone. It is an acute viral infection of the respiratory tract. There are three types of influenza virus: A, B and C. Influenza A and influenza B are responsible for most clinical illness.
It is difficult for an individual to develop long term immunity to influenza as the make up of the viral strains change slightly on a regular basis. So vaccination against seasonal influenza has to be undertaken annually.
More Information
The government resource Immunisation against infectious disease – ‘The Green Book’
In the United Kingdom immunisation for influenza for certain groups including ‘at risk’ patients is provided on the NHS and in Scotland the Chief Medical Officer (CMO) will send a letter detailing which groups are eligible for vaccination. Letters from the CMO are available here.
Egg allergy isn’t always an absolute contraindication for receiving flu vaccine. The British Society for Allergy and Clinical Immunology website advises on managing individuals with egg allergy
An e learning course for healthcare professionals undertaking immunisation is available. Registration is required to undertake this course.
NHS Inform has key patient information on all types of immunisation
NHS GGC: Immunisation – NHSGGC
Key points for community pharmacy
- Encourage at risk patients to attend for vaccination
- Advise on management of symptoms
- Some pharmacies offer private flu vaccination clinics
Sexual Health
Sandyford co-ordinates a wide range of sexual health services in NHS GGC.
The Free Condoms web-site provides, support for practitioners involved in condom distribution, information on how to sign up as a distribution point, where to find condom distribution points and general advice on condom use and products offered
It is important that pharmacists and their staff understand what they should do if they have any concerns about a child and sexual health issues. Access information at NHS GGC Child Protection Unit’s website
More Information
Key points for community pharmacy
- Be able to recognise and differentiate between symptoms of sexually transmitted diseases.
- Refer all men consulting with symptoms of discharge or thrush infections to Sandyford or their GP.
- Be aware that there is no charge for vaccine supplied by a Sandyford Clinic.
- Supply of emergency hormonal contraception or bridging contraception under PGD.
Substance Misuse
Pharmacists play an important part in providing information and advice about substances liable to misuse controlling the availability of medicines, and the associated risks and in providing harm reduction programmes e.g. methadone and the supply of injection equipment.
More Information
- NHSGGC Standards for the Supervision of Substitution Therapies in Community Pharmacies (Only available via N3 connection)
- The Management of occupational and non-occupational exposures to Blood borne virus
- Alcohol and Drug Recovery Services – NHSGGC
- Narcotics Anonymous
- Know the Score
- Talk to Frank
Key points for community pharmacy
- Give advice on wound care and management, safer injecting practices and remind clients of the importance of safe disposal of syringes.
- Know which pharmacies are ‘Injecting Equipment Providers’
- Be able to sign post clients to other services as necessary.
- Know how to deal with needle stick injuries
Travel
Two websites are highly recommended for those living in Scotland seeking travel health guidance. Fit for Travel which gives the most up to date information for the public and the professional site TRAVAX.
Access to TRAVAX requires registration but it is free for Community Pharmacists in Scotland to register.
More Information
- Healthcare Abroad
- Travelling with controlled drugs provides advice from the government on travelling with prescription medicines.
Key points for community pharmacy
- Provide patients with pre-travel advice.
- Encourage the use of sunscreen with a minimum SPF15.
- Advise on the carriage and storage of medicines abroad e.g. insulin.
Vaccine Storage
NHS GGC Guidelines on Vaccine Storage and Handling are available in the NHSGGC Guidelines Repository
More Information
- LearnPro (available for staff working directly for the NHS) has an NHSGGC Cold Chain module, click on ‘More learning’ then the ‘Pharmacy’ tab).
- A NES module The Storage and Handling of Vaccines
- National Guidance on Vaccine Storage and Handling
- The Green Book
Key points for community pharmacy
- Remind patients collecting travel vaccine of the storage requirements. It is preferable that they collect vaccine immediately before their appointment for administration.