Health and Social Care Secretary Matt Hancock announced a green paper this week which focused on prevention. The paper, entitled “Prevention is better than cure” argues for a shift towards primary and community care services, which help people stay well. The paper hints at the need for patients to take ‘greater responsibility’ for their own health as the modern NHS evolves.
The role of community pharmacy in achieving these goals are mentioned a number of times and the paper encourages the increased use of community pharmacy services. One case study cited relates to the role of community pharmacists in identifying patients with atrial fibrillation;
“Early diagnosis of atrial fibrillation in Hampshire. Atrial Fibrillation, when the heart beats irregularly, is a risk factor for stroke. Sufferers may notice palpitations but often have no symptoms at all. If patients are identified and treated early with blood thinners, we can more than halve that risk. Badgerswood Surgery in Hampshire has been working collaboratively with the local hospital, community pharmacies and the Academic Health Science Network (AHSN) to improve patient care and outcomes. The surgery first worked with hospitals to improve how they treat patients and then piloted a gadget that enables patients to track their own heart rate using a smartphone. By picking up the condition early, and treating it promptly, the Practice has reduced the risk of stroke amongst its patients.”
The green paper indicates that the Government wants to encourage more people to make the most of their local pharmacy, and for local pharmacies to play a stronger role in helping people stay well in the community. The report goes on to suggest that the Healthy Living Pharmacies scheme in England is one such way to achieve this.
“There are already almost 10,000 community pharmacies registered as Healthy Living Pharmacies in England. They deliver a wide range of lifestyle and health interventions and promote wellbeing and self-care services.”
The green paper concludes that prevention means stopping problems before they arise and that if issues are identified earlier they may be treated more effectively.
Commenting on the publication of the green paper the RPS England Board Chair Sandra Gidley said:
“We welcome the Government’s renewed focus on prevention and helping people stay healthy, but after continued pressure on local authority budgets and cuts to public health services, this vision will need to be matched by appropriate investment. The Government’s publication today rightly recognises the key role of Healthy Living Pharmacies in offering accessible lifestyle advice or stop smoking services, but as we ask pharmacists to do more the resources, support and training also need to follow suit. Prevention also means improving medicines safety, especially when patients are transferred between care settings, as well as reducing unplanned hospital admissions due to medication-related issues.”
Responding for the National Pharmacy Association, chief executive Mark Lyonette said:
“We welcome the government’s commitment to shift the balance of resources towards community-based care, prevention and early identification of disease. Prevention is better than cure and this commendable approach is the basis of the vision published by Matt Hancock today. Community pharmacists daily encounter millions of apparently healthy people as well as people seeking treatment for known ill-health. So the opportunity for health promoting interventions and disease prevention in pharmacies is considerable.
“Community pharmacy can be seen as the front door to health, being both a key part of the NHS frontline and a neighbourhood facility offering wellbeing services and support for independent living. The Secretary of State has confirmed that a large proportion of the investment attached to the forthcoming Long Term NHS Plan will be directed to primary and community care. The NPA and other pharmacy leaders have already briefed officials developing the plan about the potential of community pharmacy to prevent disease and maintain good health. We argued that more screening, diagnostic capacity and ongoing monitoring services in pharmacies would help improve outcomes in relation to cardiovascular disease, respiratory conditions and cancer – three of the clinical priorities identified by NHS England.
“Matt Hancock highlighted today the injustice that children born in the poorest parts of our country will die years earlier than children born in the richest areas. That is indeed a scandal, in this 70th anniversary of the NHS, which was created out of the ideal that good healthcare should be available to all, regardless of wealth. Pharmacies are unusual in the health service in that they are present in greater numbers in the most deprived areas, therefore bucking the so-called inverse care law.”
Commenting on the speech, Malcolm Harrison, Chief Executive of the Company Chemists’ Association (CCA), said:
“We are pleased that community pharmacy is recognised as being an important part of this vision for the role of prevention in the NHS. Community pharmacy already helps prevent illness through its advocacy of self-care, provision of flu vaccinations, stop smoking support, blood pressure checks and more. We believe that better integration with other parts of the health system, along with the right commissioning and funding frameworks, would allow community pharmacy to become the natural home of health promotion and prevention of ill health. We look forward to seeing the development of the long-term plan and Green Paper, which we hope will provide further opportunities for community pharmacy to be integrated into the future health and social care system.”