The barriers that community pharmacy faces in reaching its potential to improve public health have been highlighted in new research commissioned by Public Health England (PHE) and the Royal Society for Public Health.
The findings, published on 29 November 2016 in the ‘Building Capacity’ report, were based on the views of pharmacy teams, members of the public, NHS commissioners and chief officers of local pharmaceutical committees (LPCs).
Just over three quarters of NHS commissioners (76%) said that pharmacy is underused. A similar proportion (74%) of pharmacy team members held the same view, although the figure fell to 63% for staff working in healthy living pharmacies.
Commissioners also said that the lack of pharmacy representation on local authority health and well-being boards was hampering progress. Fewer than one in five (18%) of the 99 commissioners questioned said that their board had a pharmacy representative.
The report also revealed the general public’s lack of awareness of the range of services available in pharmacies. Only 51% of the 2,000 members of the public questioned were aware that community pharmacists offered influenza vaccinations; 48% knew that they offered emergency hormonal contraception and 44% were aware that the profession could provide NHS health checks.
Nearly three quarters (74%) of the general public were aware that they could be treated for minor ailments at their local pharmacy, the report highlights. However, 50% of the public said they were more likely to visit their GP than a community pharmacist because a family doctor can carry out full examinations, with 44% citing the fact that GPs can refer patients to other services as the reason for seeking advice from a GP.
The report also highlights pharmacists’ lack of access to patient records as another barrier to the public being willing to see a pharmacist rather than their GP.
The research was based on an online survey carried out between 12 January 2016 and 14 February 2016, which attracted 492 responses from pharmacy team members, 99 NHS commissioners and 37 LPC chief officers. As well as the poll of 2,000 members of the general public, the research was also based on the results of 57 semi-structured interviews and the views of two focus groups.
The report’s key recommendations say: commissioners should enhance their understanding of community pharmacies; local authorities should seek to increase the number of community pharmacies accredited as healthy living pharmacies; greater joint working between community pharmacy teams and GPs should be promoted and supported; and local pharmacy leaders should be more engaged with commissioners and more involved in local system leadership and planning.
Shirley Cramer, chief executive of the Royal Society of Public Health, an independent health education charity, says that while the profession has a “clear appetite” to support public health, she is concerned about the challenges that exist “particularly within the commissioning landscape”.
Jonathan McShane, chair of the Pharmacy and Public Health Forum, a high ranking group of public health specialists from pharmacy organisations, the Department of Health and others, which leads on the contribution pharmacy can make to the government’s public health agenda, says: “It’s time to stop talking about the potential of community pharmacy in relation to public health and start seizing the opportunities.”
He adds that the report challenges all parts of the system to work together to make a positive impact on the public’s health.
Sandra Gidley, chair of the Royal Pharmaceutical Society English Pharmacy Board, says the report “shows us nothing new”.
“The bigger problem is that local authorities have now slashed their public health budgets — now that they are no longer ring fenced — and pharmacy public health services are being decommissioned. This is a real shame as healthy living pharmacies have so much to offer,”
Gidley adds that the lack of representation on local authority boards continues to be a problem. “We do not have the ‘boots on the ground’ making the case for community pharmacy. We missed a trick when the newly formed Royal Pharmaceutical Society did not advocate for pharmacists to have a place on the clinical commissioning group boards because this would have sent a clear message to local authorities.”
Elizabeth Wade, director of policy for Pharmacy Voice, which represents the interests of a number of pharmacy trade associations in England, says: “The report gets to the heart of the issues many of our members encounter as they seek to expand their role in public health delivery.
“The absence of community pharmacy leaders within local planning processes, alongside a lack of awareness and understanding among commissioners and the public, present real barriers to unlocking the potential that community pharmacy teams have to offer.”
She adds that the problems highlighted in the report will be exacerbated by cuts to NHS funding for pharmacies and calls on the government to support the report’s proposals through the development of nationally commissioned public health services and investment in the community pharmacy workforce.