Choosing health through pharmacy implementation
Choosing health through pharmacy
Pharmacy is ideally placed to help deliver the vision set out in the
Government’s White Paper “Our care, our health, our say”,
said Caroline Flint, Minister of State for Public Health, at a national
conference on implementing “Choosing health through pharmacy”,
held in London last week.
“I am confident that pharmacists and their staff can make a difference
to improve the health of people in England. But pharmacy cannot realise
this potential on its own. It needs support from primary care trusts
and strategic health authorities, and, in particular, directors of public
health, to share the vision and to help deliver it” she said.
Ms Flint asked directors of public health present at the conference to
spread the word that pharmacy must be a core component of health improvement
strategies.
She told participants: “You have my full support to ensure that
primary care trusts and commissioners recognise the valuable contribution
that pharmacy can make and also what a good business case there is for
engaging pharmacies.”
During a panel discussion, David Pruce, director of practice and quality
improvement at the Royal Pharmaceutical Society, said: “We have
a good history with public health. The more we do clinically, the more
the public will begin to recognise it and, more importantly, expect it.
This is a key goal for pharmacy.”
Colette McCreedy, director of practice at the National Pharmacy Association,
said that feedback from NPA members suggests that public health is probably
the most difficult component of the essential services part of the community
pharmacy contract. “Public health is a hard nut to crack. But we
have a huge challenge because we have to crack it. One of the most important
aspects of pharmacy’s position is that we are so accessible to
the public. We sold pharmacy on its ability to do this job so it is really
important that we get to grips with this role,” she said.
Materials to
support pharmacists in delivering the prescription-linked
healthy lifestyle advice component of the community pharmacy contract
were launched at the conference (PJ, 3 March, p237).
Ms McCreedy suggested that linking brief healthy lifestyle advice with
public health campaigns could be the key to success in this area. “If
you start to raise issues with people in a pharmacy … they may not
be receptive. But if there are leaflets and posters around a particular
issue, there is almost an expectation when people go into a pharmacy
that you will talk about something.”
Mr Pruce added that, although lifestyle advice may not appear to have
been accepted, it may be the first step on someone’s road to making
a life-changing decision.
Commissioning of enhanced services
Colette McCreedy, NPA |
Public health minister Caroline Flint said that many primary care trusts
are commissioning enhanced services but the Government also wants to
know where that is not happening.
“We know that some PCTs are trying to balance service delivery
and innovative development at a time of financial constraint — and
that is an issue that has to be resolved,” she said. “Unless
parts of the NHS do get into financial balance, particularly in secondary
care,
we will not have the platform to be innovative at primary care level,” she
added.
Colette McCreedy, director of practice at the National Pharmacy Association,
pointed out that it would be interesting to map the PCTs that supposedly
have not run out of money but are still not commissioning public health
services from community pharmacy.
Pharmacy needs appropriate funding to deliver
“The challenge is for pharmacy to convince the Government and
all the other relevant bodies that pharmacy is tired of pilots,” said
John Goes, a community pharmacist in Coventry. Primary care trusts need
to
support us centrally in order to advance the public health agenda, he
added. “We have a huge role to play and I believe that if we are
funded appropriately then pharmacy will deliver.”
Mr Goes runs a weight management and associated risks programme. Ten
pharmacies are involved in the programme, and 29 patients have enrolled
since its launch on 10 January this year. Participating pharmacists and
support staff took part in two training days. The first focused on training
in the use of equipment to measure blood pressure, cholesterol, body
mass index and HbA1c. The second covered motivational interviewing
techniques.
Mr Goes said that early indications are that the programme is achieving
its targets of one to two pounds weight loss per person per week.
Mr Goes’s vision is to see the service as an integral part of pharmacy,
like dispensing. “This will only be achieved through ring-fenced
money within the contract that allows this instead of commissioning,
which means that services such as these are delivered in isolation in
certain pockets nationally,” he said.
Slides from other public health services presented at the conference
are available
online
Advanced services in public health on cards
Alastair Buxton, head of NHS services at the Pharmaceutical Services
Negotiating Committee, indicated that the PSNC would like to develop
the advanced level of the community pharmacy contract.
“We will be discussing with colleagues at the Department of Health,
over the next month or so, some public-health focused services,” he
said.
The PSNC is particularly keen to see smoking cessation services, to build
on emergency hormonal contraception and link it to chlamydia screening,
and to look at vascular risk assessment and targeted screening, he added.
Martin Bennett, a community pharmacist who runs a substance misuse service
in Sheffield, commented that initial talks about the new community pharmacy
contract mentioned progression of enhanced services into essential services.
“One of the problems with services such as EHC, is that there are
probably 50 or 60 slightly different schemes. It is about time we concentrated
on a standard scheme for which we can all become accredited,” he
argued. |
The
Pharmaceutical Journal