Health Service Focus

An underexploited resource

A recent campaign saw Welsh pharmacies testing for risk factors for both diabetes and stroke. Russell Goodway, chief executive of Community Pharmacy Wales, told NHE more.

Pharmacies have the capacity to offer the NHS precious relief in terms of identifying public health risks, diagnosing chronic conditions and getting to people before they develop illness and disease.

NHE spoke to Russell Goodway, chief executive of Community Pharmacy Wales (CPW), about its public health campaigns and the p o t e n t i a l i m p a c t this could have for both patients and trusts.

The CPW is contracted to deliver six such campaigns a year, and Goodway has found these are often at their most effective when delivered nationally, running through 714 outlets at the same time.

Campaigns can range in their objectives, from raising the profile of a certain public health concern and providing signposting to other services, to carrying out assessments to triage patients for lifestyle risks and life-threatening conditions.

Using community pharmacies allows a significant number of people to take part. In Wales alone 50,000 people go into a pharmacy everyday, resulting in 35 million visits a year.

One stage further

Last year, pharmacies conducted a questionnaire to assess risk for developing diabetes, which led to patients being referred to their GP. Goodway described how this was the start of a more direct care pathway with more accurate diagnostic techniques.

He said: “GPs didn’t like that too much; we were sending far too many people there! They said ‘Look, this is great, but you could go one stage further again and carry out the blood test, to see if somebody actually has the condition and then refer. Because all you’re doing is clogging up our surgeries with people that haven’t got diabetes, they just might look as if they have’.”

“We haven’t got that far yet”, he added, but highlighted it was something they were progressing.

The most recent campaign ran from September 3-17 and sought to identify the 10% of the population at risk of developing diabetes or having a stroke.

Goodway explained: “As people go into the pharmacy to get their prescription dispensed or for advice on other matters, the pharmacist will have a conversation with the individual and say ‘Have you ever thought about this assessment for your risk of diabetes or stroke?’ To allow people to ascertain whether they’re at risk or not.”

Prevention rather than cure

Goodway claimed that a move towards public health integrated services was “critical” for the health service.

He said: “I think the Welsh Government in fairness has understood that they’re not going to be able to achieve their objective of switching the emphasis to prevention rather than cure unless they exploit the potential of all primary care providers. Community pharmacy is probably an underexploited resource, because it’s a massive part of the NHS estate.

“It’s a ‘health and wellbeing centre’ rather than a ‘sickness centre’, which is what the doctors’ surgery is. If the objective is to talk to people before they become sick, you don’t want to be talking to them in the doctors’ surgery, because they don’t go there before they become sick, it’s too late.

“It can’t be done unless we exploit the potential of all the aspects of the primary care providers and that means community pharmacy is critical to the delivery of the Government’s objectives.”

Explaining the potential for greater involvement, Goodway highlighted a range of options for pharmacies; health checks for the over-50s, obesity management services, chronic condition management, dealing with minor ailments and encouraging take-up of the flu vaccination.

Community pharmacies are increasingly being seen as one of the major providers of healthcare services, Goodway added, and concluded: “The more that we can do that, it reduces pressure on illness services like GP services and hospitals; that is having a significant impact on the costs of running the NHS and in the current climate that is clearly vital.”

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