Public health 2

Question 1

The public health function of community pharmacist

Answer 1

-Provision of appropriate information, advice and support to the public on 
\+Contraception 
\+Medicine 
\+Alternative treatments 
\+Lifestyle 
\+Plus others 
-Sign posting 
\+Referring patients to other appropriate health professionals and community organisations 
-Participate in: 
\+Health promotion campaigns 
\+Needle exchange 
\+Advice on self care 
\+Sexual health support

Question 2

Evidence base

Answer 2

-Community phaemacy can make a positive contribution to improving the publics health across a wide range of disease states 
\+Smoking cessation 
\+CHD 
\+Obesity 
\+Skin cancer prevention 
\+Drug misuse 
\+Diabetes 
\+Asthma

Question 3

Pharmacy in England DH 2008

Answer 3

• White paper
• Sets out a vision for building on the strengths of pharmacy, using that capacity and capability to deliver further improvements in pharmaceutical services over the coming years as part of an overall strategy to ensure safe, effective, fairer and more personalised patient care

Question 4

Pharmacy in England DH

Aims

Answer 4

• Showing the oppertunity for community pharmacy to provide an extended range of services
• Shifting the emphasis from dispensing and volume to clinical services, outcomes and quality, utilising pharmacy skills more fully
• Rewarding quality and better health and service outcomes from those who embrace the new contract

Question 5

Vision document

Answer 5

• Pharmacist and pharmacies engaged in
• Helping to improve the health of the population and reducing health inequalities by focussing as much on prevention as sickness
• Working alongside other clinicians, social care professionals and community health teams to improve access
• Greater range of services in their local communities that fit the need of the public and patients

Question 6

Main themes for public health

Answer 6

-Vascular checks
-Sustainable development
-Healthy living centres
-Sexual healthy
+Chlamydia screening
+Contracaption
-Health trainers
-Diabetes

Question 7

Vascular checks

Answer 7

-A single universal, integrated check for all aged 40-74
+Measure risk of CVD, diabetes and CKD
-Estimated 3m checks per year
-Cost about £250m before savings

Question 8

Vascular checks- burden of disease

Answer 8

• Causes 170,000 deaths in England each year
• Largest single cause of ill heath and disability
• Burden falls disproportionately on socioeconomically deprived and on certain ethnic group (south asain)
• Vascular disease accounts for the largest part of health inequalities in our society

Question 9

Vascular diseae

Answer 9

-Will prevent at least
+9,500 heart attacks and strokes
+2,000 deaths
+4,000 people developing diabetes
NB these are annual
-Aim is to be accessible to all sections of the population
-Will be provided in a variety of settings including community pharmacy

Question 10

Health check evidence base

Answer 10

-There is no evidence base that it works

Question 11

Sustainable development

Answer 11

-Sustainable development and climate change are one of the biggest threats to health and well-being
-High on government agenda
-If not addressed
+Will counter the dramatic improvements in health and life expectancy so far
-Positive health impact of measures to reduce emissions
+Promoting active transport= increase physical health and decrease obesity
+Improvements in air quality= decrease respiratory illness

Question 12

Sustainable development- community pharmacy

Answer 12

• Integral part of local community
• Trusted professionals
• Community leaders
• Should be one of the first professionals to take a lead on sustainable development

Question 13

Healthy living centres

Answer 13

• Community pharmacies being repositioned recognised and valued as HLCs
• Promoting healthy living, health literacy and supporting self-care (limiting retail part and focus on health)
• Opportunistic and prescription linked healthy lifestyle advice
• Engaging in other public health initiative such as immunisation programmes

Question 14

HLC

Answer 14

• Have been re-branded as healthy living pharmacies
• An expert health resource clost to home
• Focussing on precention as much as treatment
• Exploiting pharmacies ready availability in deprived areas to expand access to healthcare
• Evidence shows no difference between smoking cessation rates between HLC and non HLC

Question 15

Chlamydia screening

Answer 15

• Most common STI in young people
• PCTs should consider pharmacy as a potential provider of screening services
• Easy access- especially out of hours and at weekends
• Anonymity

Question 16

Contraception

Answer 16

-Pharmacy should be involved in drive to improve access to a full range of contraceptive methods
+Aim- decrease unintended pregnancy especially teenage pregnancy
-Innovation in pharmacy sapply
+Contraceptive pills through PGDs
+Free access to condoms through vending kiosks
+Pharmacies becoming primary source of information, sign posting and campaigns

Question 17

Other PH priorities in pharmacy in England

Answer 17

Health trainers
-Community pharmacy staff (NOT community pharmacist) to be accredited as health trainers
+WHY- staff are usually members of local community (pharmacists tend to travel in to work) therefore are more trusted
-Diabetes
+Some pharmacies already offering testing
+High level consideration being given as to how to maximise the safe and effective contribution of pharmacy, within a team, for the care of people with diabetes

Question 18

Focus on biomedical models

Answer 18

-Strong adherence to biomedical model of health and illness
+Pharmacists give little emphasis to the ways that health and illness are influenced by wider social econmonic and psychological factors

Question 19

Low level co-operation

Answer 19

-There is a low level co-operation between the fragmen and isolated section that make up the proffesion
+Hospital/community
+Community/Primary
+Multiples/Independents
-Pharmacy has a unprofessional culture that understates the value of partnership

Question 20

Business versus professionalism

Answer 20

-Contradiction
+Public health mindset versus commercial environment
-Retail pharmacies are business enterprises with the primary aim of generating financial reward for their owners
-Commercial focus at odds with patient best interest

Question 21

Business versus professionalism example

Answer 21

-Compaines are sensitive to public opinion and may react to please shareholder rather than patients
+Tesco ceasing supply of free EHC to under 16s
+Swine flu- Sainsbury’s refuses drugs to protect shoppers and staff
+Homeopathy- boots ‘We sell homeopathy remedies because they sell not because they work’

Question 22

Public percaption and the use of pharmacies

Answer 22

-The publics use of pharmacies as a source of advice and information may be limited
+94% of the UK population use a pharmacy at least once in there life
+The greatest use of pharmacies is for prescriptions (89% of respondents using a pharmacy for this purpose)
+However, use of pharmacies for advice, whether specfic or general, is much lower (34% and 11% respectively)

Question 23

Barriers

Answer 23

• Pharmacy apathetic to the public health agenda
• Lack of awareness as to what public health is and how it affect pharmacists in their individual practise
• Undergraduate training covers little of the sceince of public health and there is little exposure to public health in the day to day practise of community pharmacy