MPHM15: Public Health and Pharmacy in the UK

MPHM15: Public Health and Pharmacy in the UK

• The course covers public health aspects through pharmacy in the UK.
• It runs over both semesters.
• Topics covered include: Introduction to Public Health and Pharmacy in the UK, Determinants of health, Tobacco, Cardiovascular Health, Screening, Harm reduction, Communicable diseases, Antimicrobial stewardship, Sexual Health, Health protection, and Public health consultation skills.

What is "Public Health"?

• Public health is "the science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society".

Public Health Issues in the UK

• The UK faces public health issues including poor lifestyle choices that can lead to long-term conditions.
• Public health is addressed by various agencies and professions.

Funding Arrangements for Public Health

• Funding for public health is derived from patients/public (general taxation).
• Parliament and the Department of Health play a role in funding.
• Public health departments are often situated within local authorities.
• NHS England and Integrated Care Systems (ICS) are involved in the provision of services.
• GPs and other primary care contractors, community health services, and secondary care (hospitals) also provide services.

Community Health Services

• Local authorities, charities, GP practices, community pharmacies, sexual health clinics, secondary care trusts (hospitals), social enterprises, and private healthcare providers are involved.

Domains of Public Health

• The three domains are: Health Protection, Health Improvement, and Health Service Delivery and Quality.

Community Pharmacy Contract

• The contract includes essential, advanced, and enhanced services.
• Essential services include opportunistic advice to patients on healthy lifestyles, involvement in public health campaigns (e.g., Stoptober, Be Clear on Cancer), and providing leaflets and prompts.
• Advanced services are commissioned by NHS England (on behalf of Public Health England), and examples include influenza vaccination and hypertension case-finding.
• Enhanced services are commissioned by Local Authorities and may include sexual health services, harm reduction services, cardiovascular screening, smoking cessation programmes, and weight management.

Public Health in Pharmacy Contract: Essential Services

• Disposal of unwanted medicines is part of this service.
• Pharmacovigilance is the process for monitoring and assessing the safety of medications.
• Clinical Governance is the system for continuously improving services and safeguarding high standards of care.
• Key elements of Clinical Governance include patient and public involvement, clinical audits, risk management, clinical effectiveness, information governance, education, and training, and staff management.

PH Commissioned from Pharmacy: Advanced Services

• Advanced services are commissioned by NHS England (on behalf of Public Health England).
• Currently, 9 pharmacies can provide additional services such as influenza vaccinations and hypertension case-finding.

PH Commissioned from Pharmacy: Enhanced Services

• Enhanced services are commissioned by local authorities.
• These services include sexual health services, harm reduction, cardiovascular screening, smoking cessation, and weight management programs.

PH Commissioned from Pharmacy: Enhanced Nationally Commissioned Service

• A Covid-19 vaccination service was commissioned nationally in December 2021.
• Over 1,500 community pharmacy sites were involved.

Healthy Living Pharmacies

• This program started in Portsmouth in 2010 and has expanded.
• The aim is to highlight and support public health activities via community pharmacy environments.
• This program utilises a diverse range of staff and services to support healthy living.
• It's acknowledged in government publications; however, results have been mixed, potentially increasing public health interventions in community pharmacies.
• The program is now national, incentivising through the Quality Payments Scheme.
• It became an essential service in 2020/21.

Summary

• The UK deals with various public health issues, including lifestyle-related long-term conditions.
• Multiple agencies and professions tackle these issues.
• Public health's role in community pharmacy practice is growing.
• Pharmacies have opportunities to significantly contribute to public health.

Further Reading

• Further information regarding community pharmacy contracts can be found on the Community Pharmacy England website.
• Website link provided for reference.