Community pharmacy is in the vanguard of the prevention agenda
29 Nov 2018
By Steve Brine, Minister for Primary Care and Public Health.
With all the recent talk around prevention in the health and care space, you’d be forgiven for thinking it’s being talked up as the newest kid on the block. In truth, we’ve known the ‘…better than cure’ truism for as long as medicine has been practised in civilised society.
As those of you working in – or with – community pharmacy know, prescribed medication is not all about treatment after the fact, it’s also about helping people manage existing conditions and mitigate or prevent more severe health issues developing in the future.
Prescribing, as a verb, is not even limited to pills, potions and lotions these days. Precede it with the word ‘social’ and you have a growing trend for GPs and other clinicians to recommend pool swims, Pilates and park runs as much as tablets, tinctures and tonics. Community pharmacists are likewise increasingly empowered to give advice across a wide range of common illnesses.
So, perhaps it would be better to say that – as we seek long term solutions to creating a sustainable health and care system – prevention’s time has truly come; and in our villages, towns and cities, community pharmacists and general practices are its vanguards.
That’s why the launch of Health and Social Care Secretary Matt Hancock’s ‘Prevention Vision: Prevention is better than cure’ has filled me with so much enthusiasm, excitement and hope for what can be achieved in our communities to support a growing, ageing and increasingly complex population.
Meanwhile, the Prime Minister’s recent announcement of a £3.5 billion a year funding boost for primary and community healthcare by 2023/4, is another welcome shot in the arm for the prevention agenda.
Of course, the Government is already encouraging local pharmacies to play a more significant role in helping people stay well in the community. Part of this involves an important shift in emphasis towards dispensing health and wellbeing advice, not just prescriptions and pamphlets.
To this end, there are already almost 9,500 community pharmacies registered as Healthy Living Pharmacies in England. Their staff deliver a wide range of lifestyle and health interventions, and promote wellbeing and self-care services.
Now, what interests me particularly about this initiative is the greater prevalence of community pharmacies in some of the most deprived areas of our country.
Anyone who knows me well will know my passion for early diagnoses, intervention and community outreach. This becomes of critical importance in these areas where a higher percentage of local populations haven’t registered with a GP. Sometimes, the community pharmacy is an individual’s only interaction with local health services – which makes it a potential gateway to the support and advice they need.
I am equally passionate about reducing health inequalities between the richest and poorest in society and doing what we can to realise the PM’s Ageing Society Grand Challenge of an extra five years of healthy, happy, independent living by 2035.
More broadly, in 2016, the Government committed to expanding the general practice workforce by an additional 5,000 doctors and another 5,000 practice staff (of which around 2,000 should be pharmacists by 2020).
An intended benefit of this expansion is greater collaborative working – within and between practices and community pharmacies.
There are already some great examples of this across the country. I have nothing but praise for ‘Heartbeats on the high street’, which involves ten Essex based pharmacies joining forces to offer free blood pressure checks to test for high blood pressure and atrial fibrillation. As you know, the latter is a heart condition that significantly increases the risk of stroke and heart failure when undiagnosed. This is the prevention agenda in action. More schemes like this please!
Meanwhile, let’s not forget the other great work community pharmacies do to enhance the health and wellbeing of their local populations; from advice on sexual health, smoking cessation and healthy eating, to medicine consumption guidance, alcohol interventions and vaccination programmes.
On this latter point, in a very tough winter for flu globally, more than 14m people – an increase of almost 1.5m compared to the year before – have received their flu vaccines. Lives are being saved and community pharmacies deserve a large share of the credit.
Whether it’s something specific like flu vaccination or more general health advice, it’s abundantly clear that focusing more on prevention to stop or slow down future ill health can give people extra years of life, reduce premature deaths and mitigate long-term illnesses.
The upcoming NHS Long Term Plan provides a further opportunity to maximise efforts to improve health outcomes and reduce inequalities – and we must all grasp this opportunity.
This is not simply about cutting costs or saving money, but about improving quality of life and helping people lead healthy and happy lives alongside work, education and caring obligations.
Spending more money doesn’t necessarily improve outcomes but what we do spend it on matters a lot. When it comes to investing in community health services, like our pharmacies, I’d say that’s money well spent.
Steve Brine MP