Contribution of pharmacy
Addressing the needs of local populations
To identify key issues affecting the health and wellbeing of local populations and how they should be addressed, each local authority, health and care partnership, health board, or health and social care board is statutorily required to conduct and publish their Joint Strategic (population) Needs Assessment (JSNA) and Pharmaceutical Needs Assessment (PNA) every three years (five years in Wales).
The JSNA is a process built to establish a shared, evidence-based consensus on key local priorities to inform the development of a health and wellbeing strategy for the area, which in turn will influence commissioning decisions to improve health and wellbeing outcomes and reduce inequalities.
The PNA informs commissioning for pharmaceutical needs in the local area. It aims to enable understanding of local needs and, where necessary, uses this information to develop pharmaceutical services to address any identified unmet needs. In Scotland the PNA is called the Pharmaceutical Care Services Plan.
Contribution of pharmacy to public health
There are numerous examples of community pharmacies contributing to public and population health. Indeed, some local innovations have been translated into formally contracted services where evidence has demonstrated effectiveness.
The pandemic led to greater recognition of how the community pharmacy network could connect with the wider NHS – for example, with Covid vaccine delivery – in turn leading to a clearer view of how powerful integration can be.
Some examples of current implementation of public health services within community pharmacies across the UK include:
- Identifying people with undiagnosed high blood pressure by offering opportunistic blood pressure and pulse rhythm testing. In public-facing communications, the service is described as the NHS Community Pharmacy Blood Pressure Check Service
- Community pharmacy-delivered stop smoking interventions that offer an effective and cost-effective way to support smoking cessation
- Access to and provision of sexual health, reproductive health and HIV services. For example, these include:
- Access to emergency hormonal contraception
- Chlamydia screening and treatment as part of the National Chlamydia Screening Programme for 15 to 24-year-olds
- Condom distribution
- Pregnancy testing
- Community pharmacies across Tayside contributed to the elimination of hepatitis c virus (HCV) in Scotland, for the first time worldwide, by testing for, diagnosing and delivering direct antiviral drugs for HCV in people who inject drugs
- Building the Community Pharmacy Partnership (BCPP) brings pharmacy and the community together in Northern Ireland to reduce health inequalities using an asset-based community development approach. BCPP has supported communities and community pharmacists in almost 1,000 funded projects to address locally defined needs. It allows people to make connections, listen to and understand each other better, and work together to address the social determinants of health and health inequalities
- Offering vaccinations (e.g. seasonal flu) has been part of community pharmacy contractual arrangements for several years, complementing the service provided by GP practices. In some areas of the country, pharmacists have been commissioned locally to provide, for example, pneumococcal vaccinations. Since 2020, more than 1,500 pharmacy sites across all four nations have been providing Covid jabs.
Other areas currently in development include:
- Having conversations and offering brief advice to people who may be experiencing mental wellbeing issues. Pharmacy staff trained as mental health champions can also make a positive contribution to creating mentally healthy pharmacies and communities, advocating for the mental health needs of local people and the role of healthy living pharmacies in promoting individual and community wellness
- Supporting healthy ageing. For example, supporting older people and their carers to prevent or reduce falls, increase levels of physical activity, maintain a healthy weight, and reduce the risk of social isolation and loneliness. Also reducing the risk of dementia and supporting people diagnosed with the condition, delaying the progression of dementia and reducing the need for medicines.
Healthy living pharmacies and similar schemes
The Healthy Living Pharmacy (HLP) framework in England aims to achieve consistent provision of a broad range of health promotion interventions through community pharmacies to meet local need, improve the health and wellbeing of the local population, and reduce health inequalities.
Evaluations of HLPs have demonstrated an increase in successful smoking cessation rates, extensive delivery of alcohol brief interventions and advice, and activities such as emergency contraception provision, targeted seasonal flu vaccinations, common ailment advice, NHS Health Checks, and advice on healthy diet, physical activity, healthy weight, as well as other pharmaceutical care services.
There are similar schemes/approaches to healthy living pharmacies in Scotland and Northern Ireland. Scotland’s core public health service includes a requirement for pharmacies to provide a health promoting environment including participating in national campaigns. There is also the NHS Pharmacy First/Plus Service for minor health conditions.
In Northern Ireland, Health+Pharmacies recognises the important role pharmacy has to play in keeping communities healthy and well. To become accredited, a Health+Pharmacy has to show that it meets a variety of standards including staff training, premises and working with a range of organisations to support health and wellbeing.