Call for increased public health role for pharmacy

A new report shows how pharmacies could be key to keeping local communities healthy

Lloyds Pharmacy
Community pharmacies could be making more of a difference to public health in local communities, a UK study has shown.

Liverpool John Moores University (LJMU) and the Medway School of Pharmacy (The Universities of Kent and Greenwich) have produced the first baseline map of service commissioning by local authorities (LAs) in community pharmacies across England.

Published in the BMJ Open, the report has been described as the most comprehensive picture of public health services commissioned through community pharmacies by local authorities.

Highlighting that, for some people, the local pharmacy will be the first or only point of contact, with a healthcare professional, the study highlights that local pharmacies play a “pivotal role in leading public health programmes, such as early detection and management for diseases like heart attacks and stroke.”

It adds that with almost 90% of the population living within a 20-minute walk of a community pharmacy, which rises to 99.8% in the most deprived decile, the local pharmacy can help provide people living in areas of higher deprivation with greater access to healthcare.

The authors of the study add that the healthcare map of LA commissioned public health services from community pharmacies means that data can be gathered to work out where key services are required.

Co-author and reader in Public Health Pharmacy at LJMU, Dr Adam Mackridge, said: "With in excess of one million people visiting a community pharmacy every day, they have long been championed as a potential setting for the delivery of public health services to the local communities in which they are located.

“At the moment, this is not matched well enough to potential need and so we may be missing opportunities to support health and wellbeing. For example, we know that the NHS Health Checks and screening for risky alcohol use are not available in many areas with significant potential to benefit from these services. If we commission the right services in the right areas using local pharmacies, we could provide better value for money for the NHS and improve the health of local communities.

“There needs to be a better link between local health needs and use of pharmacies to address this, particularly where there are gaps in current provision,” he concluded.

Royal Pharmaceutical Society director of England, Robbie Turner, said: "This study reveals a mismatch between the health needs of local populations and the services commissioned which is concerning. England has wide variations health outcomes across local authority areas and commissioners need to work with local pharmacists to provide a clear strategy of where the greatest health gains can be made by providing services that meet the needs of local populations.”

He added: “Pharmacy teams can make an impact on public health when population health needs and services are aligned. The Healthy Living Pharmacy is a successful model aimed at achieving consistent delivery of a broad range of services to reduce health inequalities. Better public health has a vital role in reducing costs to the NHS and social care and the accessibility and reach of pharmacies mean they can make a unique contribution to improving health outcomes. Unfortunately, public health services are being reduced in some areas as local authority budgets are squeezed which could see health inequalities worsen to the detriment of individuals and society as a whole.”

In a similar move to champion public health developments, the Optical Confederation (OC) and LOCSU’s response to the recent London Assembly 2017 inquiry into preventing sight loss in London highlighted that there is a clear role for public health teams to commission Healthy Living Optical Practices, which are already in place in other parts of the country.

The OC and LOCSU explained: “These optical practices become community public health resources by capitalising on their interactions with patients, thus supporting the national policy of ‘Making Every Contact Count.’ These practices can conduct a variety of NHS health checks, as required by local public health teams, to identify people at risk of developing cardiovascular disease, stroke, diabetes, kidney disease and dementia. They can also conduct health interventions on smoking cessation, weight management, alcohol consumption and physical activity. They can provide advice on oral health, men’s health, travel health, breastfeeding, and nutrition, which can also be related to eye health. They may help raise awareness of issues such as mental health, cancer, and the benefits of falls assessment and support for older patients. In addition, optical professionals can refer patients to other experts and services as required.”

OT has also contacted LOCSU for further comment.