Keeping vulnerable patients out of hospital through the pandemic

How LloydsPharmacy Clinical Homecare’s compounding unit continued to manufacture life-saving medicines despite COVID-19

LloydsPharmacy Clinical Homecare provides care to more than 80,000 people in their own home so that they can receive treatment outside hospital and enjoy a better quality of life. An important part of the service they provide is compounding medications – preparing unique formulations for patients that need tailor-made preparations to suit their condition.

Aglia Durlai is an Aseptic Technician working in the compounding unit in Harlow. Aglia works in what would seem to many to be a strange environment. Working in small units, alone or alongside only one other person, she and her colleagues compound prescribed products and repeatedly sanitise all the materials required to compound a patient’s medicines.

“The patients these medicines go to may have cancer, they may need to be fed through a tube,” says Aglia. “I always look at the name on the medication and think about the person who is receiving it and how much they are depending on it.”

All bulk fluids, additive ingredients, syringes, needles, infusion devices and various pieces of clinical equipment go through two stages of sanitisation before entering the sterile clean rooms where the intricate compounding process is undertaken. Different clean room facilities produce various products such as parenteral nutrition, chemotherapy, antibiotics and line flushes. The work is very demanding and requires very high levels of concentration and training.

Whilst PPE has become an everyday term for most of us only in the last three months, it’s nothing new to the technicians who wear full barrier protective equipment such as gowns, masks and gloves.

As a key worker, it was more important than ever to Aglia and her colleagues that patients continued to receive their medicine through the COVID-19 pandemic.

“My job is the same, the routine is exactly the same,” she says. “The patients don’t have a choice, they don’t get a break from their illness. And the last thing most of them would want at the moment is to go into hospital where they would come into contact with other people.  Our work is essential to keep them safe as well as mange their health condition.”

Although their day to day work hasn’t changed that much, the team at Spire Green in Harlow have seen the world change around them. A faster journey into work with quiet roads. Staggered breaks to maintain social distancing. One way systems round the site and plenty of the all-too-familiar sterilising.

Site lead Graham Alder says: “Many of us have been grateful to continue to work through the crisis and it’s wonderful to think how we are helping people on the receiving end of what we do. But during the first few weeks of the coronavirus, there were a lot of changes we had to implement really quickly – and unlike many businesses – keep operating at the same time.  We needed to identify which of our colleagues were at risk and those that were very high risk were later furloughed, when the scheme came in, to protect them.

“It was difficult to take in all the advice from the government in such a short space of time, sort out key worker letters and understand the impact on our workforce when schools closed. We introduced a site ‘COVID forum’ for colleagues to tell us about their concerns and help us decide how to implement social distancing.

“Through April and into May we were dealing with a high absence rate due to people with symptoms self-isolating but we had to ensure that there was no impact to patient service which was challenging.”

The teams are now well adapted to the unusual circumstances, the absence rate has dropped significantly and the vital medicines continue to flow through to patients.

As Aglia says: “We do our job in the best way we can to keep people safe.”