HEALTH PLUS


isn’t getting into the psyche of the average patient. To date, there hasn’t been one patient, who has come in and even asked about Health Plus Pharmacy or what it entails. Our patients are so used to asking for advice on a wide range of health and wellbeing issues, such as blood pressure, diabetes, weight loss and management that they know that they can come in here - without an appointment - and seek advice and information on an ad hoc basis. They don’t really need to know that we have achieved Health Plus accreditation to receive that service. Where the whole thing has fallen down is, in my opinion, in the fact that we thought we would be able to offer new services, but, to date, there have been no new services and certainly no increased remuneration. All this at a time when we’re reeling from the news that there’s been a six per cent cut in funding in England and that up to 25 per cent of pharmacies could close!


Joe Brogan, Assistant Director of Integrated Care, Pharmacy and Medicines Management, is sympathetic to the pharmacists’ concerns.


‘I think that the confusion has arisen from the impression about Health Plus Pharmacy,’ Joe told PiF, ‘that you get to provide new services and that there’s more funding, but the initiative is part of a new ethos in which we’re trying to promote a culture of health improvement within community pharmacy. Cultural change is the main thing. Through Health+ we’ve basically provided the support to bring community pharmacy up to a new level where pharmacists and their staff are recognised for being health improvement orientated.


‘I fully appreciate that many pharmacists will feel that they were already providing doing this type of work anyway - and they certainly have a case in point - but everyone has to realise that this initiative is still in its infancy and that there is a lot of work to be done before these tangible impacts are made.


‘That’s not to say we’re too far away, however. In October/November of this year, for example, we’re going to be piloting a brief intervention in alcohol scheme, which will be available to those pharmacies who are both Health+ Pharmacy accredited and those who have completed the training and are


undergoing accreditation. This pilot, which will run for six months, will attempt to promote alcohol awareness and identify people, who may have a problem. Through these interventions, people identified with problem drinking will be referred to the necessary services. Through Health+ Pharmacy, pharmacists and pharmacy staff will be given the skills to handle such interventions in a non-threatening and supportive manner.


‘What I would say to pharmacists who say that they were ‘always doing it this way’, is that through Health+ we’re branding the level of their quality interventions and recognising it. The challenge, as far as we’re concerned, is in getting everybody up to the bar. There’s so much good practice out there and Health+ is celebrating that fact.


‘Over the last ten years or so, we’ve had some great pharmacy- led initiatives, such as Building Community Pharmacy Partnership. These initiatives have clearly shown the strength of community pharmacy and the value that it can bring to local communities. Health+ is a clear signal to communities to say ‘here are the guys in your area who are geared up for community health improvement’.


‘I totally accept that it’s frustrating for everyone the time that it has taken to get to this point. We sincerely hope that within the next two years we would reach the point where commissioned services would be available through accredited pharmacies. This alcohol intervention pilot, if successful, may be rolled out to the whole Health+ network and that will give us an indication of the best way in which to implement such initiatives. When that is in place and when we have around 100 pharmacies accredited (we’re hoping to achieve that in about twelve months), then we will wish to build on success and seek to deliver enhanced health improvement activity through the Health Plus initiative. Additional remuneration will follow such commissioned services. Furthermore, it has been evidenced elsewhere that with the Healthy Living Pharmacy ethos, other service delivery is enhanced and there are improvements in both staff morale and customer satisfaction. We have a long way to go but we’ve certainly made great progress - albeit slowly - to date.’ •


‘‘I TOTALLY ACCEPT THAT IT’S FRUSTRATING FOR EVERYONE THE TIME THAT IT HAS TAKEN TO GET TO THIS POINT. WE SINCERELY HOPE THAT WITHIN THE NEXT TWO YEARS WE WOULD REACH THE POINT WHERE COMMISSIONED SERVICES WOULD BE AVAILABLE THROUGH ACCREDITED PHARMACIES.’


ENGLISH INITIATIVE HAS SHOWN


TREMENDOUS RESULTS Although Health Plus Pharmacy is relatively new to NI, it’s very similar to the Healthy Living pharmacy (HLP) initiative, which was first launched in pathfinder pharmacies in Portsmouth in England in 2010. The HLP label is a framework to commission community pharmacies to provide high-quality public health services, with – just as in NI - a focus on improving health and well-being and reducing health inequalities. Examples of HLP services include smoking cessation, alcohol brief interventions and advice, and emergency contraception.


To date, more than 1,000 community pharmacies in England are accredited as HLPs, with bodies such as the Royal Pharmaceutical Society (RPS) and Pharmacy Public Health Forum (PPHF) stating that they want this number to rise rapidly within the next few years.


An evaluation of the HLP pathfinder sites was launched on the 22nd April 2013 and the key findings were:


Twenty-one per cent of people surveyed wouldn’t have done anything if they hadn’t accessed a service or support in the HLP so would have missed out on the benefit of getting advice to improve their health and wellbeing;


Sixty per cent of peopled surveyed would have otherwise gone to a GP;


Public feedback was positive, with 98 per cent saying they would recom- mend the service to others and 99 per cent comfortable to receive the service in the pharmacy


More people successfully quit smoking in HLPs than non-HLPs or prior to becoming a HLP;


The acceptability of community pharmacy as a location for clients to receive an alcohol service and the relatively high levels of activity seen in HLPs com- pared with non-HLPs showed that HLPs could have an important contribu- tion to this harm reduction service.


If the Health Plus Pharmacy produces similar results, then, as Joe Brogan says, the sky may well be the limit for what NI community pharmacy will be able to achieve and that additional remuneration will become available.


HEALTH PLUS STATISTICS Pharmacies who have had staff trained: 225


Pharmacies currently accredited: 11 Pharmacies in accreditation process: 8


PHARMACY IN FOCUS - 27


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