LFD service – Myth busting

The LFD service is no longer available from community pharmacies.
Wrong! The LFD service is still commissioned, so pharmacy owners who have signed up to the service can still supply eligible patients with LFD tests following the requirements set out in the service specification.

Only pharmacists can provide the service.
Wrong! All appropriately trained members of staff can provide the service. However, pharmacy staff may need to consult with the pharmacist or pharmacy technician if the patient/patient representative does not present with a letter confirming eligibility, as access to the NCRS may be needed to confirm eligibility.

I can supply two boxes of LFD test kits if the patient requests this.
Wrong! No. The maximum number that can be provided in a single transaction is one box of five tests.

We can provide the LFD service from an off-site location, for example, if we are providing the COVID-19 Vaccination Service at a designated vaccination site.
Wrong! No. The provision of the service can only be undertaken from the pharmacy premises.

NHS Profile Manager was automatically updated when I registered for the service on MYS to show on my pharmacy profile that I provide the LFD service. Therefore I do not need to update NHS Profile Manager.
Wrong! There was no automatic update therefore the pharmacy owner needs to ensure that someone has updated NHS Profile Manger so it shows on the pharmacy’s NHS website profile that they provide the service. This will also ensure that the pharmacy is listed as a provider of the service on the NHS website’s Find a pharmacy that offers free COVID-19 rapid lateral flow tests search tool.

Eligible patients must have symptoms of COVID-19, before obtaining LFD tests via the service.
Wrong! Wherever possible, eligible patients should obtain LFD tests via the service in advance of developing symptoms.

All patients who are eligible for a COVID-19 vaccination are also eligible for LFD tests via the LFD service.
Wrong! There are differences in the eligible groups for the COVID-19 Vaccination Service and the LFD service.

The eligible groups for the LFD service can be found in our Eligible patient groups for the LFD service factsheet.

Care and nursing homes can obtain free LFD tests for all their patients via the LFD service.
Wrong! Care homes can still obtain LFD test kits from community pharmacies who offer the LFD service. However, they can only obtain free test kits for patients who are eligible for the service.

In May last year, the eligible groups for the service were reduced and this removed eligibility for some patients who were residents in care homes. However, some patients will still be eligible.

The care or nursing home would need to check which of their patients are eligible; we have an eligible patient groups for the LFD service factsheet, which could be shared with them or they can review NICE’s guidance which lists the risk factors for progression to severe COVID-19 in young people aged between 12 and 17 years and adults. These patients are therefore potentially eligible for COVID-19 treatments should they catch COVID-19 and are eligible to access free LFD test kits from community pharmacies under the LFD service.

A representative of the patient, such as a care worker employed by the care home, can request LFD tests at the pharmacy. They would need to provide their name and address as the representative, as well as the patient’s details (name, NHS number (if available), date of birth, address and reason for eligibility).

If patients are not eligible for the LFD service, the pharmacy could offer to sell LFD tests to care homes.

All patients aged 85 years and over are eligible for LFD tests via the LFD service.
Wrong! Last year there was an update to the National Institute for Health and Care Excellence (NICE) guidance on antiviral treatment for COVID-19,  which removed some of the cohorts of patients eligible for these treatments. These changes were reflected in the eligibility for the Lateral Flow Device (LFD) service.

One of the patient cohorts no longer eligible to receive free LFD tests through the service is all patients aged 85 years and over. Some patients aged 85 years and over may still be eligible for the service if they fall into another cohort, for example, if they also have a medical condition listed in the above NICE guidance; however, they are not eligible just based on their age.

If someone asks for free LFD test kits, I can supply these under the LFD service without checking for eligibility.
Wrong! Pharmacy teams are required to confirm the patient’s eligibility for a supply of an LFD test kit. This could be by:

• Seeing the patient’s NHS letter which confirms eligibility (not all patients will have been sent a letter);
• Having a discussion with the patient or their representative about the patient and their medical history, confirming they have a qualifying condition or qualify due to age. The pharmacist or pharmacy technician may wish to review the pharmacy’s PMR or the National Care Records Service (NCRS) and then use their clinical judgement; or
• Referring to the pharmacy’s clinical records for the service, where the pharmacy has previously seen and made a record of having seen a copy of the patient’s NHS letter confirming eligibility or has previously had a discussion with the patient or their representative which confirmed their eligibility and a record of this was made.

The pharmacy team should satisfy themselves that the patient is eligible, i.e. has at least one risk factor for progression to severe COVID-19 as set out in the NICE guidelines.

The LFD service is only available for adults.
Wrong! Children aged 12 and over who have risk factors for progression to severe COVID-19 (as detailed in NICE guidelines Supporting information on risk factors for progression to severe COVID-19) are eligible to access the service.

A patient must have a letter advising that they are eligible to receive free LFD test before we can make a supply under the LFD service.
Wrong! If the patient does not have a letter there are other ways to confirm eligibility such as:

• Having a discussion with the patient or their representative about the patient and their medical history, confirming they have a qualifying condition or qualify due to age. The pharmacist or pharmacy technician may wish to review the pharmacy’s PMR or the National Care Records Service (NCRS) and then use their clinical judgement; or
• Referring to the pharmacy’s clinical records for the service, where the pharmacy has previously seen and made a record of having seen a copy of the patient’s NHS letter confirming eligibility or has previously had a discussion with the patient or their representative which confirmed their eligibility and a record of this was made.

I need to notify the patient’s GP practice that I have supplied the patient/patient representative with an LFD test kit.
Wrong! You do not need to notify the patient’s GP practice.

If I decide to stop providing the LFD service, I don’t need to notify anyone.
Wrong! If you wish to stop providing the LFD service, you must notify the commissioner that you are no longer going to provide the service via the MYS portal, giving at least 30 days’ notice prior to stopping the service.

You should also update NHS Profile Manager to remove the LFD service as a service that is being provided by your pharmacy.