Community pharmacy can be a dangerous place to work, with customers and patients posing the biggest threat. What can you do to reduce the risk to the team?

There are about 500 robberies, burglaries and attempted burglaries at pharmacies around the UK, and more than 350 incidents of violent crime. More than a third of pharmacists have personally suffered physical violence at work, and over 40 per cent have been threatened. These events are not easy to predict – more than three- quarters of perpetrators are not drug addicts – so staff must be constantly vigilant and implement bespoke safety measures at their pharmacy.

Community pharmacies are not obliged to serve abusive or violent customers – a fact that should be clearly stated on practice leaflets. But pharmacies are in a vulnerable position due to their often relatively remote location, long opening hours and a predominantly female workforce. Independents are by far the most vulnerable because they lack the head office infrastructure for support and robust security can be quite costly, says Mimi Lau, Numark’s director of pharmacy services.

‘Pharmacies, like other retailers, have always been vulnerable to shoplifting and pharmacists and staff are equipped to deal with this in terms of prevention and what to do when an incident occurs,’ she says. ‘However, when it comes to violent crime, many independent pharmacists are unprepared for it.’

Although a series of Numark workshops on security has received excellent feedback, the take-up suggests that pharmacists don’t prioritise this issue until they have been on the receiving end of a serious incident. Ms Lau urges independents to undertake a review of their premises and consider how they can protect themselves, their staff and their business. ‘Everyone in the pharmacy has a role to play to ensure the safe welfare of each other and of their customers,’ she says. ‘As such, this is one element of your business planning that must be taken seriously and dealt with proactively.’ threatened

Staff should be trained on security matters – what is a security risk, how to react to a crime, who and what to report, and so on. Pharmacies should also work with their local communities, for instance their parade of shops or part of a wider community. Numark also suggests taking the following steps:

  • Discuss with your LPC who should go to the local security management specialist (LSMS) within the CCG or health board to ask for more support for pharmacy contractors
  • Every incident in the pharmacy, however small, should be reported to the CCG or health board so that this data can be captured and reported back to the NHS Security Management Service
  • Ensure your LPC approaches local acute trusts to identify opportunities for contractors to attend any security training workshops
  • Look at the NHS Security Management website, which has an abundance of resources.
One-third of pharmacists have personally suffered physical violence at work, and more than 40 per cent have been threatened

Security tips for pharmacies

Numark suggests the following safety tips:

  • GPhC premises standards 3.4, 4.3 and 5.2 require that premises, medicines and equipment are secure and safeguarded from unauthorised access. As part of any inspection, pharmacies will need to provide evidence that they have met these standards.
  • A premises security risk assessment should include dispensary, shop front and any related premises such as store rooms and warehouses. This may be a requirement for commercial shop insurance policies. The risk assessment should consider:
  • Who has access to keys and alarm codes and how regularly these are changed, particularly after staff members leave the business
  • Alternative means of entry to the premises, such as windows, roofs and roof-lights
  • Staffing levels at the start and end of the day to ensure no one is left alone. G When transferring cash, for example when depositing the takings with a bank or post office:
  • When transferring cash, for example when depositing the takings with a bank or post office
  • Do this regularly to minimise loss, should the worst happen
  • Vary the time of day that cash is transferred, as well as the staff member who carries it
  • Ensure cash is hidden from public view when it is carried.

 

  • Review your business continuity arrangements in case of serious crime such as arson or burglary
  • Report all crime, however minor, to the police
  • Never confront or fight back against violent or threatening behaviour – your premises and contents are insured and costs can be recovered, but your life cannot
  • Make sure your insurance is current and appropriate.

Incident policy

The National Pharmacy Association encourages members to have a policy in place for dealing with incidents of crime or where there is violence or a threat of violence to staff. All staff should be aware of this policy, which should include information such as the location of any emergency buttons, who to call if there is an incident, and any warning words/codes that staff can use if there is an issue. There should be specific policies in place for dealing with out-of-hours work (for example, evenings or bank holidays).

Those in charge of pharmacies should familiarise themselves with NHS policies on preventing crime, says Leyla Hannbeck, NPA’s head of pharmacy. ‘Pharmacists and their staff should be security aware and not discuss closing- up procedures or things such as who is carrying keys in front of members of the public.’

Put a policy in place for dealing with patients who pose a higher crime risk, suggests Ms Hannbeck. And make agreements with patients receiving treatment for drug abuse (or any other patient who has previously posed a threat to the pharmacy) that include statements such as when they are, or are not, allowed in the pharmacy, and how their treatment would be altered if they commit a crime against the pharmacy or the staff.

Be aware of any type of local security watch, where stores notify each other of recent shoplifting events or other security issues, for example. A risk assessment might include ensuring adequate lighting at staff entrances and putting pass codes and spy holes on doors. Staff safety in consultation rooms should be considered, while ensuring patient confidentiality is maintained.

The NHS Security Management Service

The NHS Security Management Service is responsible for the security of NHS staff and property in England – the first time a dedicated organisation has had such a remit. This includes:

  • Protecting NHS staff from violence and abuse
  • Taking appropriate action against those who abuse, or attempt to abuse, NHS staff G
  • Helping to ensure the security of property, facilities, equipment and other resources such as drugs. www.nhsbsa.nhs.uk

Support available

The organisation Pharmacist Support has dealt with cases over the past few years from pharmacists affected by violence, both in and out of the workplace. In one case, a pharmacist was left with hearing problems following an attack.

Pharmacists in England, Wales and Scotland can access help through Pharmacist Support if they are having difficulty dealing with an incident, and in Northern Ireland, pharmacists can access advice through the Pharmacists Advice and Support Service. Other staff members not entitled to help through these organisations can access help through Victim Support.

‘Incidents of violence and abuse can be very traumatic for the people involved, and even for those who witness it,’ says Pharmacist Support charity manager Diane Leicester-Hallam. ‘It can also affect a person’s physical and/or mental health, lead to a loss of confidence and it may even affect their work, in some cases possibly leading to a reluctance to go into the workplace or return to the place of the crime.’

Pharmacist Support signposts affected callers to Victim Support, for example, and provides information on finding a counsellor and directs them to its free and confidential Listening Friends helpline. Its website contains information on domestic violence, victims of crime and on witnessing a crime.

If the case involves an incident at work, the charity may refer the pharmacist to its specialist advisors at the Citizen’s Advice Bureau for advice on employer’s responsibilities, if relevant. Pharmacist Support could also provide financial assistance if appropriate.  

Employer responsibility

Employers are primarily responsible for ensuring that risk reduction measures are installed, says the Pharmacists’ Defence Association. Failure to do so could leave the employer liable in the event of harm caused to employees. This is particularly the case if these measures have been previously suggested by employees.

But employers don’t have a particularly good record in this area, according to a PDA survey. While 84 per cent of pharmacists assaulted at work reported the incident to their employers, only 35 per cent believed that appropriate action was taken.

Test case law shows that the penalties for employers who disregard the concerns of their employees can be extremely severe. In a landmark case (Simmons vs British Steel plc, House of Lords, 29 April 2004) where an employer refused to act on the safety concerns of an employee who then went on to sustain an injury and psychological trauma, the employee was awarded nearly £500,000 in compensation.

In the event that a PDA member is injured in a violent attack and it can be shown that risk management suggestions made by employees had been disregarded by the employer, the PDA will ‘robustly pursue’ the employer to seek a prosecution under Health and Safety legislation, damages through civil action, as well as referring the case to the GPhC for disciplinary action through a breach in the Code of Ethics. Members can access a PDA personal safety resource pack via its website, which contains risk assessment and risk management tools.

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