Pharmacists have an important role to play in combating pressures on health and social care services caused by an increasingly older population, according to a leading academic.
Nina Barnett, consultant pharmacist for older people and visiting professor at King’s College London, said the industry was ideally placed to work with older people on preventive interventions.
Pharmacists could also contribute to the care of people with multiple morbidities, she added.
Her comments come as new research published in The Lancet
(online, 23 May 2017) suggests the NHS would have to cope with significantly more older people needing care over the next decade.
Barnett, also the Royal Pharmaceutical Society’s spokesperson on older people, says pharmacists should get involved in encouraging lifestyle changes in older patients: “Community pharmacists have that long-term relationship with patients. They are ideally placed to have these conversations.”
But she suggests that pharmacists will need upskilling in order to adopt a more patient-centred ‘coaching’ approach in conversations, although this is already becoming more widespread, she says. Pharmacists in all settings, including those working in GP surgeries, could also play a part in multi-morbidity clinics.
Interventions that pharmacists could make include helping people realise they may have hidden conditions, such as high blood pressure, suggesting ways to combat them and working with patients on what lifestyle changes they are prepared to make.
Helen Stokes-Lampard, chair of the Royal College of GPs, warns that to help people live longer with a better quality of life, a properly funded and staffed health and social care service is needed.
The Lancet paper highlights both the growing number of elderly people and the challenges of dealing with ill-health and disability among them.
It warns that the number of people aged over 65 needing care could reach 2.8 million by 2025 — an increase of 25% on 2015. In contrast, it predicts the number aged over 65s will increase more slowly — by 19% in the same period. Dementia rates are forecast to increase by 49%.
In the paper, lead author Maria Guzman-Castillo, of the University of Liverpool, calls for greater emphasis on preventive interventions to counter poor diet, smoking, high alcohol consumption, high blood pressure, being physically inactive, and diabetes.
“Sufficient and swift intervention in these policies could lead to substantial cost savings and help the ageing population live more healthily in the future,” she says.
Guzman-Castillo highlights the cost implications of the study’s findings: “More cost-effective health and social care provision will be needed, such as increased availability of institutional care, and better financial support — such as tax allowances or cash benefits — for family members providing informal and home care,” she says.
Last week, the Conservative Party manifesto stated that people who receive care at home would no longer have their house value disregarded when their assets were assessed for payment liability, but that they would not have to pay for care once their assets fell below £100,000. This week, prime minister Theresa May backtracked, suggesting there could be an upper cap on how much individuals had to contribute to their care on top of the £100,000 lower limit.
 Guzman-Castillo M, Ahmadi-Abhari S, Bandosz P et al. Forecasted trends in disability and life expectancy in England and Wales up to 2025: a modelling study. Lancet Online, 23 May 2017. doi: 10.1016/ S2468-2667(17)30091-9