Pharmacists across primary care and community pharmacy have shared how racist and Islamophobic violence across parts of the UK in recent days have affected them and their work.

The situation has left some pharmacists fearful of seeing patients and going to work, and living in what they have described as a state of 'anxiety and paranoia'.

‘I’m wary of patients. You don’t know who’s going to walk through the door’

Pharmacist and Advanced Clinical Practitioner (ACP) Khaleel Loonat works in a GP practice in a predominantly white area of West Yorkshire.

On Monday afternoon, he received a message from his practice manager, who is also South Asian, ‘saying that he's left work, and he's had a group of five lads throw stones at his car’.

The news scared other members of staff who remained in the practice, several of whom were also South Asian, because the route the practice manager had taken was ‘the only way that we can get out’, Mr Loonat told The Pharmacist.

What’s more, the teenagers throwing the rocks ‘are probably patients of ours’, Mr Loonat commented, ‘because we're the only GP practice around that area’.

‘What happens if I saw one of them [in clinic]?’ he asked.

He said that while he ‘likes to see the good in people’, he has ‘subconsciously’ become more wary of patients.

Thoughts of attacks he’s heard about against other South Asian and Muslim people are at the back of his mind now during consultations, he said.

‘I'm just thinking, if I'm doing a review, someone could easily get something out of their pocket and they throw it at me [while I’m] unaware,’ he added.

Staff in GP surgeries ‘can be very vulnerable’ as they conduct clinics ‘behind closed doors’, he said.

And in community pharmacy ‘you don't know who's going to walk through the door’ and ‘you don't know what's going to happen’.

Some GP practices have closed early where they expect to be impacted by riots, while Community Pharmacy England (CPE) has said that community pharmacies may do so if advised by the police.

Meanwhile, health secretary Wes Streeting has reportedly said that abusive patients can and should be refused care.

But considering whether to close is a difficult decision to weigh up. ‘Patients are going to be annoyed that you're closing early, [and] some patients may need to be seen,’ Mr Loonat said.

And for independent pharmacy contractors, closing early will also affect business income.

‘People are salaried. People are feeding their family and kids. If they're closed early, can they even pay their staff members? It's not as if there's a lot of income in community pharmacies at the moment… but then also you need to keep staff, and also patients safe,’ Mr Loonat commented.

With unrest expected to continue throughout the week, Mr Loonat said he is worried about more potential issues happening in primary care and community pharmacy settings.

‘I think you might get a disgruntled patient [who] may not be happy with their outcome, with a GP or a pharmacist. And at that point, [it] can really trigger someone into going down the route of verbally and physically abusing someone,’ he suggested.

And he said he’s concerned about the impact of that the racism and Islamaphobia reported in the news and on social media on staff wellbeing.

‘Imagine, some people just scroll through TikTok, and you're just feeding yourself with all this negativity, with “this is what's happening to people who look like me”, and [then] you're going into your work,’ he said.

‘It is an additional stress alongside everything which is happening.’

‘These attacks have made us feel vulnerable and scared at work’

Ayah Abbas, who works as a general practice and community pharmacist, highlighted the particular impact of the violence on Muslim women and women of colour.

‘I personally think it is very important to highlight that the attacks should be labelled as Islamophobic and racist because we need our voices to be heard,’ she said.

‘I am currently living in anxiety and paranoia,’ Ms Abbas, who is also president of the Pharmacists’ Defence Association (PDA)’s National Association of Women Pharmacists (NAWP), told The Pharmacist.

‘It’s very hard in our job because we love providing patient centred care, but these attacks have made us feel vulnerable and scared at work. I have been talking to my colleagues and we all feel very anxious and disheartened.’

She said she wants other pharmacists feeling that way to know that they are not alone, and that support and guidance from groups like the PDA is available.

‘As women we always have [had to] be alert and sadly most women have faced harassment at work, but this has made our anxiety even more heightened,' she said.

‘I’m Iraqi and Muslim but I don’t wear a hijab, but my heart goes out to pharmacists wearing a hijab that feel very targeted currently.

‘It’s very heart-breaking to see in 2024 where we are celebrating diversity and freedom, [that] hijab wearing pharmacists feel like their choice to wear a head scarf is putting them at risk. What happened to freedom of choice?’

And in community pharmacy, she said she worries about feeling responsible for the safety of staff members.

‘I worry about Muslim women and women of colour locuming who might be working in an unfamiliar area where they feel vulnerable,’ said Ms Abbas.

‘I don’t think it’s fair how vulnerable and paranoid we feel.

‘I’m not going to hide my true feelings: I have been very anxious and sick. I feel like I can’t switch off.

‘We all are feeling very jumpy, but we are a strong community, and these acts are coming from a minority of people that are trying to frighten us.

‘But we are here to protect our patients and provide care.’

And she asked other pharmacists to reach out if they needed any support. ‘You are not alone. We hear and feel you because we all are suffering from the same pain and sadly fear,’ she said.

‘This is abhorrent to all of us, but for some people, this is traumatic’

Community pharmacist Ade Williams told The Pharmacist that he is particularly concerned about colleagues who are ‘not just from a minority background’, but also ‘visibly attired to reflect their culture and their faith’.

He said he woke up the day after the Bristol riots thinking: ‘What does this say about the society or the community that I'm part of?

‘Unfortunately, what these experiences do is they taint the majority. Then you’re angry, actually, because you know that for 99.9% of your of your community and your patients, these sort of views and this sort of behaviour is completely abhorrent for them.’

He said that the violence and intimidation can bring up traumatic memories and expose wider issues, like an ongoing sense of being ‘othered’.

‘Like many minority pharmacy colleagues, I have had throw-away racist comments from patients.' he said.

‘There will be, during your course of your career, or even, sometimes, in the course of providing care, [times] where the fact that you're not like somebody else will be used.

‘You normally shrug it off. But I think one of the things that this whole experience brings up is your sense of physical threat as well, and then also [skewing] the lens through which you look at the community that you are part of.’

He told The Pharmacist that the pharmacy profession should examine whether it has been ‘tolerant of things that, really, we should never have been’, and ask: ‘are we doing enough, is there more we can do?’

He said that he has welcomed messages of support for himself and his team.

‘Is this an opportunity for us, actually, to affirm a sense of value and a sense of somebody else's identity?’ Mr Williams suggested.

And he said that the pharmacy profession ‘must take a collective stance’ against Islamophobia and racism, recognising that some colleagues feel even more personally targeted and at risk than others.

‘We must be able to boldly say that pharmacists can practice anywhere and their value is underpinned by a profession that will stand up for them,’ he added.

Mr Williams said that pharmacy must ‘fix its own house’ as well, citing racial disparities in attainment as an ongoing example of inequality within the profession.

He issued a particular challenge to ‘isolated’ community pharmacy colleagues.

‘I think it's worth a reminder to know: under what circumstances do [colleagues] provide the care that [they] do? And actually, are we, collectively as a profession, really trying to relieve that burden as well?’

He added: ‘While this is abhorrent to all of us, for some people and for their family, this is traumatic.’

‘This may be just an escalation of ongoing trauma. We mustn't forget that, and maybe we haven't spent time to ask the question and know, actually, what is your life like?’

‘We should be asking ourselves, what can we do for the profession to help to shape a better society?’