A pharmacist has given a first-hand account of the difficult experiences he and pharmacy teams faced during the Covid-19 pandemic, as part of an independent inquiry into the UK’s response to the outbreak.

From major issues with ordering and storing stock, working night shifts to keep up with demands, and sourcing their own personal protective equipment (PPE) from a local school, Jonathan Rees told the UK Covid-19 Inquiry how pharmacies had to become ‘the front door to the NHS’ during the crisis.

Mr Rees, who is a National Pharmacy Association representative in Wales, said that while his staff were able to take on extra overtime hours, with one pharmacist – Mr Rees' wife – even returning from maternity leave early, this was not viable for all pharmacy teams.

Difficulties ordering, storing and dispensing medications

During the pandemic, scripts were issued with longer cycles, meaning that pharmacy teams had to order triple the amount of stock they would normally, in order to supply patients with three months rather than one month of their medicines.

Ordering stock was difficult because 'phone lines were constantly in use from patient queries', said Mr Rees.

And he told the inquiry that space to store the increased quantity medication became an issue and was 'very difficult to organise'.

He described the levels of patient frustration when his pharmacy was unable to fulfil some prescriptions, or when in nearby pharmacies, patients were queuing for several hours to find out their medicines were not there.

In a statement to the inquiry on Thursday, Mr Rees said the dispensation given by the Welsh Government which allowed pharmacies to close for up to two hours a day to process prescriptions was 'invaluable'.

And Mr Rees said he split his pharmacy team into two groups, so that one group could work in the dispensary, often out of hours, while the other dealt with patients and vaccinations.

This also reduced the number of people in each part of the pharmacy, in an attempt to aid social distancing and reduce the need for the whole team to isolate.

To mitigate dispensing delays 'as much as possible', the pharmacy tried to do dispensing overnight, he explained.

But he noted that while he had staff willing to work overtime and both Mr Rees and his wife could work as pharmacists with each sub-team, it wasn't ' always viable for everyone else [in other pharmacies] to do that'.

The pharmacy also employed a new delivery driver to be able to deliver medicines five or six days a week, with Mr Rees and his wife also doing deliveries themselves on the weekends 'to try and meet the demand'.

'The front door of the NHS'

With limited access to healthcare more generally during the pandemic, pharmacies had to become 'the front door of the NHS', Mr Rees told the inquiry.

'We were triaging patients that we wouldn't really otherwise see in a pharmacy environment, and we had no real control of [whether] those patients coming into us... had Covid or not. It was impossible for us to ascertain that, but it just meant we were trying to direct those patients as best as we could to the most appropriate care provider at the time,' he told the inquiry.

Pharmacy left out of key worker status, PPE and life insurance

Mr Rees also told the inquiry about the impact of not initially being included in key worker status, personal protective equipment (PPE) provision, and the life insurance scheme.

For some staff locally, not being able to send their children to school under key worker status 'was prohibitive to some of them working', Mr Rees said.

And being initially categorised as a retail rather than a healthcare setting meant that at the start of the pandemic, whole pharmacy teams had to isolate if one staff member tested positive.

In his case, his pharmacy was given plastic face masks made by a design and technology teacher at the local comprehensive school.

'It was marvellous that someone put the effort in, but being what they were, they weren't really conducive to work for eight hours in a day, or particularly fit for purpose moving forward... they were the best thing we had at the time,' Mr Rees told the inquiry.

He and his wife had even created their own hand gel for use by patients and staff, based on a recipe shared by the World Health Organization, before a local brewery took over production and supply.

By May/June, the PPE was provided by the local health board, which Mr Rees said was 'fairly well controlled'.

Increased workload led to 'real issue' with cashflow

Mr Rees also highlighted to the inquiry the impact of increased workload on community pharmacy cash flow.

While the pharmacy must pay for the stock it has ordered within 30 days, it is not reimbursed by the NHS or paid for that work until three months later.

'In a general month, that's fine, because you're constantly being paid for what you've previously done, but if your workload were to double or triple in a certain month, you need to be able to find that money within 30 days, rather than wait for when you are reimbursed for the work that you've done,' he said.

'That became a real issue for people... into April, start of May [2020], before they got reimbursed then in June for what they had done.'

Would community pharmacy be able to respond as well next time?

Mr Rees noted that since the pandemic, 'even though our workload has increased astronomically, you still see four pharmacies a week closing, which is reflective of the revenue that you drive for the work that you do actually undertake'.

While he said that during the pandemic, 'the whole pharmacy network really did stand up to what was thrown at it', he had concerns that 'moving forward, I'm not sure that same resilience will be there', due to pharmacy closures and the 'fragility of the network'.

'If it were to happen again, I'm not sure the pharmacy network would stand up quite as well as it did the first time,' Mr Rees told the inquiry.

Pharmacies helped increase vaccine uptake in ethnic minority communities

Also at yesterday's Covid-19 inquiry hearing, Professor Habib Naqvi, chief executive of the NHS Race and Health Observatory, highlighted the importance of community pharmacies in increasing vaccine uptake, particularly in ethnic minority communities.

Read more on X from our reporter Joanna Robertson, who was present at yesterday's hearings.