As the NHS made drastic changes to prepare for a surge in covid-19 cases, Scotland’s pharmacies were left as almost the last ones standing when it came to providing walk-in healthcare.

What pharmacy teams started experiencing over ten weeks ago as lockdown loomed, was “the very tip of the tidal wave of chaos”, says Stirling based community pharmacist Jonathan Burton.

That Scots rushed in vast numbers to make sure they had adequate supplies of their medication when faced with the onslaught of coronavirus was “quite understandable”, he says.

“Pharmacy just became incredibly, incredibly busy…Many of us were doing several times the number of prescriptions we would usually be doing on a daily basis – and trying to do that safely and still give people the advice and standard of care they were accustomed to meant things got very, very busy very quickly.”

The chair of the Royal Pharmaceutical Society Scotland board says this meant radical changes had to be made, and fast.

From managing the number of people allowed in pharmacies at any one time, to carrying out confidential consultations, Mr Burton says a “massive culture change” took place. 

“All health services needed to plot a way forward through lockdown and many health services quite rightly decided to close their doors.

“It is important to note that all GP practices are open, it’s just that they are operating slightly differently with lots of remote working.

“Pharmacies generally don’t have that option though, being the point of supply for medicines.

“Because of that we have seen the whole mix of emotions from the public – there’s been immense gratitude for just being there through to frustration and unfortunately sometimes the antisocial behaviour that comes with that and everything in between.”

Unlike many of the other health professions in Scotland, pharmacy students were not fast-tracked out to work during the pandemic – a decision that has been key to avoiding any disruption to profession’s staff pipeline in the coming months, says Mr Burton.

Meanwhile the current workforce has “fared well” throughout the pandemic.

“I think that reflects first of all that we were very quick to the social distancing measures in place, and secondly that PPE supplies have been reasonably well-organised and arrived in a timely fashion.

“I think the third factor is that pharmacy teams are very hard-working and committed and want to be there helping the public so adhered to the key messages around symptoms.

“We have to take time out like everyone else, but we have quick access to testing locally.

“There have of course been local issues as you would expect but generally speaking we have been able to keep our services going with our existing staff.”

Asked whether the pandemic has perhaps done more than anything to cement the role of community pharmacists as the first port of call for people with common conditions, Mr Burton says this was a journey community pharmacy was already on, and that with every year that goes by this becomes more embedded in the public psyche.

“The pandemic has brought this into sharp focus – the importance of that walk-in service – especially because we really were the last man standing in terms of open-door access.

“I would hope our role has been cemented…What professional representatives have been talking to government, the health and sport committee and others about is that a community pharmacy network is absolutely vital.

“We’re everywhere in towns, cities, small villages, rural areas, deprived areas and we are ultra-accessible – that is a real tool for NHS Scotland.”

The launch of the new Pharmacy First service was put on hold at the beginning of April while the existing Minor Ailment Service was extended to all members of the public for the duration of the pandemic – a move that meant pharmacists could “very easily and smoothly”  make sure everyone, including people coming into the pharmacy or those shielding, got access to the medicines and services they needed.

“The most important thing about widening access to everyone was it made it easier to get over any disparities between different patient groups…It meant the basic stuff we could just get sorted easily and that will track through to the new Pharmacy First service which includes a slightly expanded range of common conditions that we can manage and that is free to everyone.”

Working as a community pharmacist on the Stirling University campus gives Mr Burton a particular insight into the impact of the pandemic on young people’s mental health. Although many went home before lockdown, pharmacy services are still serving hundreds of students, many of whom seeking help as they struggle to sleep at night.

“What I have noticed in the day-to-day practice in community pharmacy is there is certainly a need for members of the public to have points of contact and health professionals to speak to about their mental health. Probably the most key thing we have noticed are the sleep issues.

“The reasons behind that are many and varied but one of the key things here is a loss of routine because were not able to do the things we usually can.

“Some of us have work or studies to focus on, but some of us may be dealing with very little structured time and be worried about catching covdi-19 or worried about our friends and family.

“But also for young people they are worrying about the pathway for completing their studies and future job prospects. There are so many difference things that come into play in these sorts of situations and it’s fair to say that does absolutely have an impact on people’s mental health.

“It’s important people who need a first point of contact for mental health issues have that person to speak to, including the pharmacy team, and for people with severe and enduring mental health issues to be to keep in contact with the usual team of people looking after them.”