What is a rapid antigen test?
Most of us have heard plenty about rapid antigen tests. In essence they are a type of diagnostic test that detects the presence of viral proteins (antigens) expressed by the Covid-19 virus in a sample from a person’s respiratory tract. Results are usually available after 15 minutes. They are relatively inexpensive and can be used at the point-of-care. So, if it’s that simple, and we are living in a pandemic, why are community pharmacists not offering this service to the general public?
On 3 November the World Health Organisation announced that as of 1 November, nearly 46 million cases and 1.2 million deaths have been reported globally. The further acceleration of the incidence of new cases was most notable in the European Region. That makes pretty scary reading.
Are these tests approved by the Government?
We have now seen three rapid antigen tests that have passed Public Health England’s assessment. The clear benefits of these tests are self-explanatory – fast and rapid screening. Testing results can be found here.
However, there is still limited data to guide the use of rapid antigen tests as screening tests on asymptomatic persons to detect or exclude Covid-19. The current large-scale trial in Liverpool will hopefully give everyone the reassurance they are looking for. They are using the rapid antigen testing and then any positive cases will also be swabbed using a PCR test, which will need to go to the lab. Fingers crossed the results will correlate.
What is the General Pharmaceutical Council (GPhC) stance on community pharmacy offering these tests?
Most community pharmacists will be fully aware that on 21 July this year, the GPhC wrote to pharmacy owners and superintendent pharmacists to highlight their position concerning both the sale and provision of rapid antibody tests from their pharmacies. Many pharmacists who had started this service, rapidly stopped, worried about the consequences should they continue. It is understood that the GPhC are now reviewing their position in regards to the offering of rapid antigen tests, so we will watch this space.
Are pharmacists prepared?
In a recent Twitter poll I conducted, all pharmacists who answered felt they would need some level of training before they felt comfortable to perform these tests. That is understandable. It is not within their normal scope to swab people’s noses or throats (unless they perhaps have already been trained to offer a Strep A test and treat service where throat swabbing is required). This training can be delivered either face-to-face or online, depending on their preference.
Do pharmacists want to offer this service?
After another small Twitter poll, interestingly, only 52% of pharmacists who answered said they would offer this service, should the GPhC change their stance. I found this quite surprising and would have expected the percentage to be much higher. Is that because they don’t feel they have time? They are worried about more people coming into their pharmacy? They have been scared off? I plan to dig deeper into that.
From a personal opinion, as a nurse who works with thousands of community pharmacists, from large multiples to small independents, I think this is the perfect setting for this service. It is estimated that most people live within a 20-minute walk of a pharmacy – what better coverage can you get. Secondly, we know that clinical services are the way forward for community pharmacies to survive, therefore grabbing opportunities like this to demonstrate what you can achieve as a sector is worth considering.
As with all clinical services, pharmacists need to be competent in the skill, have the resources to be able to deliver, processes in place and with this service they would need to feed results back into Public Health England, which will shortly be a requirement.
I am happy to offer both guidance and advice around all of the above, if anyone would like to get in touch. Good luck, and keep looking after your community.