As the responsibility for public health is put into the hands of local councils, the pressure is on for clinical commissioning groups to improve the quality of service provided to the public. A new report, The Wells Family Challenge: A Pharmacist First Approach, suggests that pharmacists could transform the improvement of health and wellbeing in local communities.
The report, which 2020health worked on closely with the Sainsbury's Pharmacy team, assesses the impact of in-store pharmacy advice on the health and lifestyles of 10 families. Although undertaken on a small scale, the results suggest minimum intervention from a pharmacist over a small amount of time could have a significant impact on public health if replicated on a larger scale. The pharmacists involved in the challenge improved health literacy levels, and in doing so provided much more than a service to treat coughs and colds. They actually helped prevent illness – a function that GP surgeries are not always able to fulfil due to competing demands. This demonstrated that they could play a role in alleviating pressure on GPs who currently undertake 57 million consultations each year for minor ailments that could have been dealt with by a pharmacist.
Even more importantly, they could help detect the early signs of cardiovascular disease. In the initial pharmacist visit of the study, 81% of family members who were diagnosed with high cholesterol (68% of the total sample) were completely unaware beforehand, as were almost as many of those suffering from high blood pressure. The health advice given by the pharmacists over the 12 months led to measureable improvements including 65% of adult participants losing weight (an average 4kg), 58% reducing their risk of stroke or heart attack and over a 50% reduction in unhealthy levels of cholesterol. The families found simple advice and strategies offered by the pharmacists such as putting a fruit bowl by the front door to encourage healthy snacking and reducing dinner plate sizes useful in contributing to these kinds of reductions.
Cardiovascular disease costs the NHS £19bn per year. If pharmacists can detect the signs early enough, through providing monitoring services for cholesterol, blood pressure and weight management, and offer the guidance to change habits and prevent the serious effects of prolonged poor lifestyle choices, they could alleviate pressure on NHS services and help reduce costs in the long run.
So within the new NHS landscape, and as local health delivery systems take shape, we need to increase the understanding of the pharmacist's role and the value they bring to preventing ill health and assisting the public in self-managed treatments.
A three-pronged approach needs to be adopted. First, to help clinical commissioning groups succeed in maintaining the health of the population, the measurable impact our 80,000 pharmacists could have on public health should be recognised; pharmacists have a wealth of knowledge and expertise which should be drawn upon in terms of shaping and designing health and wellbeing strategies and addressing the wider determinants of health. Second, Public Health England needs to develop a clear strategy for how local authorities can partner with pharmacies more effectively in order to deliver the range of mandated public health services which they are now responsible for. And third, the NHS Commissioning Board needs to give a clear steer as to the contribution that pharmacists should make in the delivery of services which prevent those illnesses so sadly common in the UK today.
Gail Beer is director of operations at the thinktank 2020health. She worked in the NHS for over 30 years as an executive director at Barts and the London NHS Trust
Guardian
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