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Health promotion — moving beyond leaflets

Yve Buckland, the new chairwoman of the Pharmacy Healthcare Scheme, talks to Clare Bellingham about health promotion and the future of the PHS

Yve Buckland sees pharmacists as having an increasing and expanding role in health promotion. In her vision, pharmacists would offer a “one-stop shop” with information technology facilities, screening and testing services, as well as providing advice and information and running small clinics in conjunction with an allied professional. And as chairwoman of both the Pharmacy Healthcare Scheme (PHS) and the Health Development Agency (HDA), Mrs Buckland’s views are likely to be influential over the future direction of pharmacy in health promotion. “Pharmacies provide a non-stigmatising, one-stop shop that attract a clientele that other professions find it difficult to reach. Pharmacists are an under-exploited resource that we need to use to deliver a broader public health agenda,” she said. In the past, pharmacists’ roles in health promotion have been geared simply towards health education. But in the future pharmacists will have the opportunity to play a more direct and broader role in supporting people to take responsibility for their own health, Mrs Buckland said. The public health White Paper “Saving lives: our healthier nation” published in July 1999 looks at strategies to persuade people to take more responsibility for their health. Mrs Buckland thinks that the accessibility of pharmacists could be used proactively to promote the public health agenda by offering different services such as health screening, testing facilities and advice. Some community pharmacists are already doing this, she said, by, for example, opening clinics, such as the smoking cessation clinic at Green Light pharmacy in north London, and offering health promotion services within pharmacies. The number of services that pharmacists could offer was open-ended. “Part of our approach will be to talk to pharmacists to see what they can offer,” Mrs Buckland said. But will all pharmacists be expected to offer the kinds of services outlined in her vision? “It is more realistic for some pharmacies in some areas than others,” she said. “We would like to encourage all pharmacists to become involved but it will depend on the business and the local area’s needs.” For many pharmacists the obstacle to developing such services is cost. Resources are needed not only to redesign space within the pharmacy to allow clinics to operate, but also for training and pharmacist time to run services. Mrs Buckland acknowledges that this is a problem. “My personal view reflects the [House of Commons] health select committee view that if we are going to expect community pharmacists to get involved then we have to look at remuneration for these activities,” she said. However, she added that, while not underestimating the issue, “we must applaud pharmacists who are already offering services.” Role of the PHS So where does Mrs Buckland see the PHS fitting in with her vision of pharmacists’ roles in health promotion in the future? “The role of the PHS is to promote and support the development of models of best practice, and to lobby Government for a wider role for pharmacists,” she said. In 1997/98, the PHS sought consultancy advice over its future direction and that advice is now being implemented. Earlier this month, it was announced that major changes were being made to its board of directors and Mrs Buckland was elected as chairwoman. “The board membership has been expanded to reflect areas where the PHS has a broader role,” she said. This included greater involvement in public health, research, developing key relationships with other professional bodies and training organisations and representing the needs of both independent and multiple pharmacies. “It is an important and challenging time, and everyone nominated and approached to become involved was keen to do so,” she said. Currently, many pharmacists see the PHS solely as a supplier of patient information and the PHS itself admits that it has, in the past, mainly focussed on leaflets. But things are to change. Health promotion is expanding and the role of pharmacists within this is changing. Mrs Buckland hopes that the PHS will be seen as a source of advice and information. In addition, it aims to promote the value of pharmacy in public health to the Department of Health. The PHS will also become more involved with academia and research to develop the best, up-to-date evidence based policy and also to commission new research in the health promotion area. “Health education will remain important and leaflets are an important part of giving advice but we also need to change our approach to reach more people, such as those who cannot or will not read them,” she said. Health Promotion England (HPE), which took over the supply of health promotion leaflets from the Health Education Authority which was closed last year, will be represented on the PHS’s board of directors. “We will be working with the HPE in the area of leaflets. We will improve and develop the range of leaflets that the PHS offers and keep them up-to-date with national health promotion campaigns,” she said. HDA The HDA was set up in April 2000. It aims to improve the health of people in England and, in particular, to reduce health inequalities. As chairwoman of both the HDA and the PHS, does Mrs Buckland have any plans to integrate the PHS within the HDA? “The HDA is a separate body to the PHS. Of course they share allied interests and have a close relationship but the HDA has a distinct and separate role and function,” she said. Equally, the PHS does not plan to offer services to a wider audience. “The PHS is about pharmacy and the roles that pharmacists play in public health. The scheme should be of relevance to pharmacists,” she said. Mrs Buckland also has an influential role in the United Kingdom Public Health Association pharmacy special interest group which was recently launched to develop the contribution of pharmacy to public health. On a topical note, should public health be an important issue in the general election campaign? “Absolutely,” said Mrs Buckland, “I hope it will be.”

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Clare Bellingham is on the staff of The Pharmaceutical Journal

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