Written evidence submitted by the Pharmaceutical Services Negotiating Committee (PHS0494)
Community pharmacists and their teams are some of our most accessible public health practitioners. They already offer a number of prevention-focused public health services and over the years pharmacies have been developing into neighbourhood health and wellbeing centres, becoming the go-to destination for support, advice and resources on staying well.
The Committee’s inquiry could look at what community pharmacy already does, and what more it could do to help in preventing disease, particularly from the perspectives of cost-effectiveness, ease of access and patient choice. We have set out below some brief examples of how pharmacy is already supporting the prevention agenda, as well as what future roles could be explored by the Committee.
Physical activity and cardiovascular disease prevention
In October 2021 a pharmacy hypertension case-finding advanced service was launched. To date more than 8,500 pharmacies have signed up to offer the service. Everyone in England over the age of 40 is eligible for this service which aims to find cases of high blood pressure in the general population for onward referral to General Practice or A&E via a free blood pressure check, preventing serious illness from developing. We would like to see an expansion in this community pharmacy service to include a hypertension management service. This would allow pharmacies to help the people who are diagnosed with hypertension to manage this condition and their medications, potentially preventing deterioration of their condition, keeping them well, and saving on general practice resources.
Community pharmacy also has the potential to do more to provide care on obesity, building on the current inclusion of a signposting element in the Pharmacy Quality Scheme (PQS). We would like to see a nationally commissioned pharmacy weight-management service.
From March 2022 pharmacies have been able to take referrals for smoking cessation advice from secondary care following patient discharge from hospital. To date more than 3,800 pharmacies have signed up to offer the service. In the future, our ambition is to see a national pharmacy smoking cessation service commissioned to which the public could self-refer. We would then expect to see many more pharmacies wanting to offer this service. Such a service would help contribute to the aim set out in the NHS Long Term Plan of making England a smoke-free society. Pharmacies are ideally placed within the community to offer this service, and the overwhelming majority of them now have the facilities needed to do so, including a consultation room to ensure patient privacy.
We would like to see the community pharmacy offer on sexual health developed to include nationally commissioned STI testing for patients and the public, as well as an expansion in the recently commissioned Pharmacy Contraception Service. If properly supported, pharmacies could also better support women’s health via the introduction of a nationally commissioned Emergency Hormonal Contraception Service (EHC). This latter service is already widely commissioned locally, but national commissioning would ensure that women in all postcodes can receive the same service.
In future, we envisage community pharmacies being the go-to health setting for vaccinations. Since pharmacies first began to offer flu vaccinations over five years ago, community pharmacy has become the first choice for vaccinations for millions of people due to their accessibility.
For example, in this flu season alone, pharmacies have already delivered 4,912,111 flu vaccines. Last year pharmacies also delivered over 22 million COVID vaccines. Pharmacies could do significantly more to support vaccination efforts, with the right incentives and support in place. This would be cost-effective, an efficient and accessible service for patients, and it would free up other parts of the NHS, particularly GP practices, to focus their efforts on other priorities. Vaccines for shingles, pneumococcal, children’s flu and travel vaccines are just some examples of vaccines that pharmacies could offer in the future.
As agreed in the Community Pharmacy Contractual Framework (CPCF), all pharmacies are required to be ‘healthy living pharmacies’ (HLP). The adoption of HLPs marked a significant development for community pharmacy and its contribution to health promoting interventions. The HLP framework aims to improve people’s health, help reduce health inequalities and ensures community pharmacy can continue to contribute to the Government’s ambition of putting prevention at the heart of the NHS, as set out in the NHS Long Term Plan. More use could be made of this framework aligned with NHS disease-prevention priorities.