Dispensing public health
In some areas, public health in Britain is taken for granted. An example of this is the provision of clean drinking water. But it was not always so. A pioneer in the public health arena was John Snow. He worked out
that it was the public water pump in Broad Street, Soho, that was the
source of London’s 1854 cholera outbreak in which nearly 700
people died, all of whom lived within 250 yards of the pump. A simple
intervention, removing the pump handle, made a significant impact:
it stopped the epidemic. Could such simple interventions in the pharmacy
have similarly dramatic consequences for public health in 2007? We
believe they could.
Pharmacists should not be fazed by public health. It is very much part
of their day-to-day life and, this week, we are devoting a sizeable section
of The Journal to the topic. We hope that we can make pharmacists realise
that they are already engaged and that they should be confident about
what they do. We have tried to be as practical as possible in order to
show pharmacists that they are on the right tack and to point out simple
and decisive interventions that they can make. Smoking cessation is one
of the major public health services that pharmacists provide. Others,
including emergency hormonal contraception (p19), are described in this
issue. And if, or when, there is an influenza pandemic, pharmacists — who
are freely accessible at the centre of communities — will be at
the heart of the Government’s public health campaign, since it
will want to keep the population as healthy and informed as possible
in order to reserve resources for the seriously ill.
What pharmacists might find hard is the practicalities of communicating
public health issues. In a busy pharmacy it is difficult enough to ensure
that patients know the basic details about the medicines they are receiving
without worrying about striking up opportunistic conversations about
somebody’s weight or smoking status. To help with this, tips for
running successful public health campaigns are covered in this issue
(p17).
To be most effective, however, pharmacists need to be aware of the wider
determinants of public health, including environmental and psychosocial
influences, at all levels of society (pp13–14). They especially
will need to be au fait with these if they are to be successful in signposting
patients to other sources of care and information (p20).
There are concerns around the recording of public health interventions
in the pharmacy. Of course records are essential, but the worst thing
that could happen is if time is wasted on form filling and bureaucracy
at the expense of getting on with the job. There is no doubt that pharmacists
will have to manage their time better (pp15–16) and perhaps patients
will need to make appointments if they want to discuss health issues
with their pharmacist. A side effect of that might be that patients will
view pharmacists in an even more professional light, and that can only
be a good thing.
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