From giving advice on healthy living to supporting patients in self-management of minor illnesses, community pharmacists now play a bigger role in primary health care.
People are living longer than ever before across the world, thanks to advanced medical care. While life expectancy is rising, people are not necessarily living those extra years in good health. Aging is a major risk factor for many chronic diseases such as atherosclerosis, cardiovascular disease, cancer, arthritis, cataracts, osteoporosis, type 2 diabetes, hypertension and dementia. However, studies have shown that healthy habits and behaviours such as regular physical activity, maintaining a healthy weight, eating a balanced diet, and avoidance of smoking and other health-harming behaviours can delay or reduce the risk of developing age-related diseases, disorders, and disabilities, as well as improve quality of life and function at older ages.
The UK’s National Health Service (NHS) is working with partners across health and social care to support people to age well, starting with interventions based on preventative healthcare and early identification of diseases.
Community pharmacy is an integral part of the NHS and plays a vital role in the promotion of healthy living and wellbeing of population, through the provision of clinical preventive services.
As qualified healthcare professionals, pharmacists provide health information, self-care advice, vaccinations, screenings, behavioural support, and make referrals to improve population health.
Pharmacists are also trained in managing minor illnesses and offer clinical advice and over-the-counter medicines for a range of common conditions, such as coughs, colds, sore throats, tummy trouble and aches and pains.
Role of community pharmacy in improving population health
A vision document for community pharmacy developed by The Nuffield Trust and The King’s Fund has described how local pharmacists can contribute to achieving key policy goals around population health, prevention and increasing levels of demand in primary care. The report, however, warned that these cannot be achieved without changes to the law, and additional funding.
The think tanks have projected that community pharmacy will undergo a significant transformation in the next decade, becoming central to the delivery of “joined-up, responsive and person-centred community-based health and care services,” driven by more investment from commissioners.
In particular, they have envisioned community pharmacies to play a significant important role in supporting people and communities to stay healthy and well, acting as ‘local wellbeing hubs.’
Let’s look at some preventive services that most local pharmacies in England provide:
Smoking Cessation service
Through this service, patients who have started a stop smoking attempt in hospitals are referred to community pharmacies to continue their journey after their discharge. Beginning March 2022, the service was made available in community pharmacies across the country.
Smoking is considered one of the biggest avoidable causes of disease and premature death in the UK and it is estimated to cost NHS England £2.6 billion per year.
Latest statistics published by NHS England showed an estimated 408,700 hospital admissions due to smoking in 2022-23, an increase of nearly five per cent from 389,800 in 2021-22.
As per the health service’s Statistics on Public Health 2023 report, smoking accounted for around one in six (16 per cent) of all hospital admissions for respiratory diseases last year, eight per cent of all admissions for cancers and seven percent of admissions for cardiovascular diseases.
The smoking cessation service is provided by a pharmacist or pharmacy technician.
Point-of-care testing
Focussing on prevention of ill-health, community pharmacies also deliver several NHS-commissioned point-of-care testing (POCT) services including:
- blood pressure monitoring
- urinalysis to identify urinary tract infections
- chlamydia testing for the under 25s
- COVID-19 rapid antigen testing
- blood glucose tests for diabetes prevention
- pulse oximetry to assess people presenting with breathing difficulties
- peak flow measurements for asthma patients.
Heart checkups
Heart checkups are being offered at high street pharmacies across England as part of a programme to prevent heart attacks and strokes.
Pharmacists offer blood pressure tests to people showing symptoms of cardiovascular disease
and will also offer cholesterol tests, and use electrocardiograms to detect irregular heartbeats.
High blood pressure, high cholesterol and irregular heart rhythms (atrial fibrillation) – are risk factors of heart disease and stroke, and are also linked to many cases of dementia.
Those patients who are found to have concerning results are given lifestyle advice by the pharmacist and referred to their GPs.
Weight management services
Obesity is a major contributor to the global burden of chronic disease and disability, and the second most common preventable cause of death in Britain after smoking. Being obese can lead to many chronic diseases such as diabetes, cancer and heart disease, as well as make patients vulnerable to psychological problems such as low self-image and confidence.
Unfortunately, the levels of obesity in the UK are the highest in Europe. The 2021 Health Survey for England revealed that more than 25 per cent of adults in the country were obese and over 37.9 per cent were overweight, meaning over 63 per cent of adults who were either overweight or obese.
Men were more likely than women to be overweight or obese, and higher prevalence of excess weight was seen in people aged 45-74 compared to other age groups.
As stated by Community Pharmacy England (CPE), community pharmacists have a greater role to play in obesity and weight management through the dispensing of medication, provision of supporting advice to patients to address their diet and lifestyles and of weight management services.
Flu vaccination service
Community pharmacies in England have been providing flu vaccinations under a nationally commissioned service since September 2015.
The NHS runs a seasonal flu vaccination campaign every year from September through to March targeting patients who are at risk of developing more serious complications from the virus.
A community pharmacy has become a popular destination for patients seeking vaccinations, given its accessibility, extended opening hours and the option to walk in without an appointment.
Pharmacies providing the winter 2023/24 COVID-19 vaccination service are offering both flu and COVID vaccinations at the same time, where possible, to make it more convenient for people to get this life-saving protection ahead of winter.
New community pharmacy advanced services
Pharmacy First Service will be available at pharmacies from 31 January 2024 to give you advice and treatment for the following conditions: sinusitis, sore throat, acute otitis media, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women.
Now, women in England can get contraception pills directly from their local pharmacy without needing to contact their GP first, thanks to the expanded Pharmacy Contraception Service, which was launched from 1 December 2023.
With the expansion of the Hypertension Case-Finding Service, trained and competent non-registered members of the pharmacy team can now deliver blood pressure checks. Earlier only pharmacists and pharmacy technicians are authorised to deliver the service. NHS England estimated that up to 2.5 million blood pressure checks per year could be carried out under the scheme, which could help prevent more than 1350 heart attacks and strokes in the first year.
The expansion of primary care services is expected to free up to 10 million GP appointments a year by next winter, while improving patient care.
References:
https://cpe.org.uk/wp-content/uploads/2013/08/Public-health-Weight_Management.pdf
https://researchbriefings.files.parliament.uk/documents/SN03336/SN03336.pdf
