More people live within a 20-minute walk of a pharmacy than live as close to a GP surgery, a study has shown, adding proximity to the reasons that community pharmacists are well placed to offer some of the public health services currently provided by GP surgeries.
As well as being physically more accessible for patients, pharmacy opening hours are more convenient for patients who may respond better to their informal approach, say the researchers, led by Adam Todd of the division of pharmacy, school of medicine at Durham University, Stockton-on-Tees.
“We’re not necessarily saying that pharmacists are better at delivering these services, we don’t know that, but what we do know is that their reach in the community is better so they might be able to target patients that don’t have easy access to a GP surgery,” says Todd.
The researchers drew 1.6km buffers around each GP premises (to represent a 20-minute walk at approximately three miles per hour) and calculated the population living inside the buffer areas. These data, published in BMJ Open
on 7 May 2015, were then compared with the same data for community pharmacies
Although most people lived within a 20-minute walk of a GP surgery, even more people lived as close to a community pharmacy. This trend persisted, regardless of whether the premises were in a deprived, affluent, urban or suburban area.
Overall, 84.8% of people lived within a 20-minute walk of a GP premises, while 89.2% lived within this range of a pharmacy.
Proximity to a GP surgery was highest in the most deprived areas where 98.2% of people lived within a 20-minute walk. In these areas, almost everyone lived that close to a community pharmacy (99.8%). In the most affluent areas, 81.2% of people lived within a 20-minute walk of a GP surgery and 90.2% lived that close to a pharmacy.
In urban areas, a 20-minute walk would take 94.2% of people to a GP surgery and 98.3% to a community pharmacy, and 68.1% and 79.9%, respectively, in town and fringe areas. Only in rural areas were more people within a 20-minute walk of a GP premises than a community pharmacy: 19.4% compared with 18.9%.
Todd suggests that pharmacies should take on a greater role in delivering some public health interventions, such as influenza vaccinations and smoking cessation services.
“They are open weekends without appointments and later in the evening – I think that helps,” he explains. “A real advantage of a community pharmacy is that you can pop in without an appointment and I think many of the interactions that we are talking about around public health – flu vaccination, smoking cessation – it could be quite opportunistic.”
Todd also believes that tackling certain issues around public health and health inequalities could potentially damage the doctor-patient relationship if done at the wrong time in the consultation process. “A consultation with a pharmacist is different,” he says. “It is a lot more informal, so some patients might find it easier to approach a pharmacist and in many cases it might be easier for the pharmacist to approach the patient about smoking cessation and those sorts of things.
“You could have a patient come in to collect a prescription, for example, and on the back of that interaction you could get into some smoking cessation advice.”
David Branford, chairman of the Royal Pharmaceutical Society’s English Pharmacy Board, is more cautious about the findings. “Community pharmacies benefit those who are either not registered with a GP or don’t want to visit one – so defining accessibility through the prism of location alone omits other important factors which impact patient care,” he says.
Maureen Baker, chair of the Royal College of GPs (RCGP), says she is encouraged by the finding that patients have easy access to GPs and pharmacies, especially in areas of deprivation. “However, access to a local surgery is one thing – being able to see a GP is another.”
Elizabeth Wade, director of policy at Pharmacy Voice, which represents three community pharmacy associations, says the findings reinforce the message that there should be more consistent commissioning of public health services from pharmacy. “These data show that there is very good access to pharmacies as well as GPs and both should be looked at for delivery of public health services. We need to invest in the primary care network if we are going to tackle health inequalities.”
 Todd A, Copeland A, Husband A et al. Access all areas? An area-level analysis of accessibility to general practice and community pharmacy services in England by urbanity and social deprivation. BMJ Open 2015;
 Todd A, Copeland A, Husband A et al. The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England. BMJ Open 2014;4:e005764. doi:10.1136/bmjopen-2014-005764.