GPs, Pharmacists and Dentists: Managing ongoing risk and protecting vulnerable staff

GP practices, pharmacies and dental surgeries have changed significantly in the last few months. More GP consultations are taking place via telephone or video call than ever before and face-to-face appointments are happening only if absolutely necessary. Pharmacies have of course remained open throughout lockdown and have been forced to adapt their frontline services to meet unprecedented demand. Dentists, on the other hand, initially found themselves much quieter, with routine procedures postponed and only emergency treatment provided.

As pre-COVID levels of service begin to return across all professions, the risk is far from over. With much still unknown about the threat of the virus, and concern over local outbreaks and a potential second wave, the safety of staff and service users remains of paramount importance.

Ongoing risk assessment, control measures, and infection control policy

Amidst the challenge of continuing to provide services, every practice or pharmacy should have conducted a risk assessment at the outset of the pandemic. It is vital that this is reviewed regularly and whenever there is a significant change to your business practices or personnel, new or updated government guidance, or if there is reason to believe your controls are no longer effective.

Sector-specific risk assessment templates and up-to-date supporting guidance can be found on Ellis Whittam’s Coronavirus Advice Hub.

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Protecting vulnerable staff

With GPs and dentists having operated a reduced service, staff absences may have been manageable in the early stages of the pandemic; however, a lack of core staff will become more problematic as demand increases. Some staff are more vulnerable to COVID-19 than others and will have justifiable reason to be concerned about their safety and measures in place to protect them. With shielding set to end on 31 July, high-risk individuals will be able to return to the workplace, and it is vital that they can do so confidently and with minimal risk. An individual vulnerable person risk assessment will help you to determine whether this is possible and, if not, you will need to explore other options, such as whether they can work from home, remain on furlough, or take unpaid leave.

How to conduct a vulnerable person risk assessment

During the coronavirus (COVID-19) outbreak, the government has defined some people as clinically extremely vulnerable (shielded). Shielded workers are at increased risk of severe illness from coronavirus.

With shielding due to end, ensure vulnerable persons are included within your current COVID-19 risk assessment by:

  • Talking to the shielded worker about their working arrangements/activities to ensure aspects of their role have been considered
  • Ensuring you have done everything which is ‘reasonably practicable’ following the government guidelines including:
    (a) Toilets have a regular supply of hot and cold water complete with soap and towels and hand sanitiser available (where required).
    (b) Hand contact points cleaned every hour along with toilets and kitchen area to be regularly cleaned throughout the working day.
    (c) Plexiglass barriers are installed at regular contact points (where feasible) and are cleaned and disinfected regularly in line with standard cleaning procedures.
    (d) Contactless payments encouraged to reduce contact with customers.
    (e) COVID-19 posters warning patients who are showing symptoms not to enter the pharmacy.
    (f) Staff are working side-by-side or facing away rather than face-to-face.
    (g) Management will implement controls to prevent overcrowding and ensure two metres between all persons entering the premises.
    (h) If unable to maintain two-metre social distance guidance, PPE (fluid-resistant [type IIR] surgical mask) will be worn to prevent inhalation of COVID-19.
    (i) Layouts and processes will be reviewed to allow people to work further apart from each other.
    (j) Floor tape installed to mark areas and to help workers keep a two-metre distance (where feasible).
  • Lastly, ensuring the shielded worker has read and signed the risk assessment, and reassure the worker the risk assessment will be reviewed/amended if or when the guidelines change.

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Looking after BAME employees and managing refusals to return to work

Whilst not expressly declared as part of either the clinically extremely vulnerable or clinically vulnerable categories, employers should also consider the additional risks to any Black, Asian and Minority Ethnic (BAME) employees. It is widely reported that this group appears to be at greater risk from COVID-19, suffering a disproportionately higher number of cases and deaths. With NHS England urging Trusts to take steps to protect BAME employees, healthcare providers should consider what additional safeguarding precautions can be taken to protect these individuals, such as removing them from patient-facing roles or providing additional PPE. Guidance on the risk assessments to be undertaken for BAME employees is soon to be released but it is clear that employers do need to give special consideration to these employees in their return to work plans.

Ensuring the wellbeing of staff under these circumstances is all about giving them enough confidence to return. Patients and customers may have similar concerns about visiting the setting for non-emergency treatments or services. This links back to the importance of a thorough risk assessment and resulting control measures, as well as a programme of communication to all concerned parties about what you are doing to minimise risk.

Don’t forget to document the steps you have taken to ensure compliance with the latest guidance and relevant legislation; not only can this be shared with employees to provide reassurance, but it can also be pivotal in protecting your position should an employee refuse to work or an incident occur. Be aware that the guidance is changing all the time, so it is important to have a system in place for keeping up with the latest sector guidelines and best practice.

Ellis Whittam’s Coronavirus Advice Hub is updated on a daily basis and we recommend this as a free resource to access the most up-to-date content.

These are trying times, and as more workplaces reopen to reinvigorate the economy, the risk of exposure in surgeries and pharmacies may increase, particularly as more face-to-face appointments take place. However, by engaging with staff and communicating effectively about your plans and safe working practices, healthcare providers will be in a stronger position to minimise disruption and respond to whatever the “new norm” has in store.

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Ellis Whittam helps over 17,500 British businesses and organisations to create great, safe places to work through fixed-fee Employment Law, HR and Health & Safety support. 

Download free healthcare sector guides, templates and risk assessments, as well as further COVID-19 employer support resources, from its Coronavirus Advice Hub.

While all reasonable care has been taken to ensure that the information provided is correct, no liability is accepted by Lloyds Bank for any loss or damage caused to any person relying on any statement or omission. This is for information only and should not be relied upon as offering advice for any set of circumstances. Specific advice should always be sought in each instance.

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While all reasonable care has been taken to ensure that the information provided is correct, no liability is accepted by Lloyds Bank for any loss or damage caused to any person relying on any statement or omission. This is for information only and should not be relied upon as offering advice for any set of circumstances. Specific advice should always be sought in each instance.