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Letters to the Editor
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Public health
Simvastatin may pave way for public health role for pharmacists
From Mr D. V. Nandha, MRPharmS
Several recent articles cite the role of the pharmacist in public health.
Pharmacists can have a significant bearing on matters that might be high
on the public health agenda, a view that has been echoed by the health
minister Rosie Winterton. Generally speaking, pharmacists’ involvement
with patients is on a one-to-one basis, either in the community pharmacy
setting or in hospital. By contrast, public health requires participation
by pharmacists in the wider health issues of the locality. It requires
the addressing of any health inequalities that may exist, ensuring a
strategy for health improvements, particularly to deprived and vulnerable
groups.
Any pharmacist seeking to fulfil this role will need to be proficient
in health needs assessments and be able to procure and interpret health
data for the relevant locality. Moreover, the pharmacist should be able
to demonstrate a need for a given pharmacy service by formulating and
submitting a detailed business plan to the primary care trust, in a manner
that will be both convincing and persuasive.
Since coronary heart disease is a key priority for the Government and
many primary care organisations, one can quite realistically envisage
pharmacists with relevant experience pursuing proposals for pharmacy-based
hypertension and cholesterol clinics. Cholesterol clinics have not always
been viable because the burden of the cost is on patients and they can
have these tests done free of charge at the GP surgery. This situation
could well change though, given the planned POM to P switch of simvastatin.
Many of the patients who purchase OTC simvastatin will want to see the
benefit of the medicine they are taking and will increasingly request
a cholesterol test from their GPs. However, because primary prevention
is not in the quality and outcomes framework of the new general medical
services contract and many GPs are struggling to achieve secondary prevention,
pharmacists could find themselves paving the way for improvements in
primary prevention. To do so, they must first integrate in discussions
about local and national public health issues and understand the mechanics
by which successful bids can be lodged. Only then can they expect to
convince their paymasters of the benefits and receive necessary funding.
Dipak Nandha
London W3
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The
Pharmaceutical Journal