Public Health and Pharmacy Service Development Flashcards
Healthy Lives, Healthy People: overall strategy
- Placing local communities at the heart of public health by ending central control and giving local government freedom, responsibility and funding to innovate and develop own ways of improving public health locally
- Introducing a new dedicated public health service ‘Public Health England’
- Promoting innovation by working with industry and other partners
Healthy Lives, Healthy People:
Policy commitments
• Local authorities, i.e. Councils (not NHS)
– have responsibility for public health (PH) locally to improve health and wellbeing
– allocated ring-fenced budgets for PH
– established health and wellbeing boards to co-ordinate services
– responsible for commissioning of Public Health Services
• Commission pharmacy services e.g. Smoking cessation
• Need to build relationships with local authorities- must understand role and skills of pharmacists.
Healthy lives, healthy people: implications for pharmacy:
• Pharmacy can utilise its strengths to promote healthy living
– Pharmacies are accessible, located in the community
– No need for appointments
– Relaxed atmosphere
– Private areas
• Develop services
• Collect evidence of impact of pharmacy on PH
What is Public Health England
- Public Health England was established on 1 April 2013 to bring together public health specialists from over 70 organisations into a single public health service.
- An executive agency of the Department of Health and Social Care, (has operational autonomy).
- Provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support.
- Employ 5,500 staff mostly scientists, researchers and public health professionals.
- Have 8 local centres across 4 regions (north of England, south of England, Midlands and east of England, and London).
PHE
Pharmacy: A Way Forward for Public Health
- Published 2017
- Sets out a ‘menu of interventions to realise the potential for one of the most frequented healthcare settings in England to make a sustainable impact on the lives of people, communities and the nation.’
NICE Guideline on PH in Community pharmacy
• Set of recommendations including: – Having an integrated approach – Addressing health inequalities – Promoting CP – Being proactive – Providing advice and education – Behavioural support – Referrals and signposting
PH Pharmacy services commissioned:
- Weight management
- Smoking cessation
- Alcohol interventions
- Sexual health
- Health checks/ vascular risk
- Cancer screening and detection
- Immunisation programmes
Healthy living pharmacies (HLPs):
• Demonstrate consistent, high quality delivery of a range of services e.g.
– Smoking cessation
– Weight management
– EHC
– Chlamydia screening
• Indication that HLPs have –> productivity and –> quality services pg 42 ‘Healthy lives, healthy people’
• Achieving HLP level 1 (self-assessment) is now a Quality Payment criterion for the Quality Payments Scheme (20 points) and will be part of gateway criteria.
HLP Framework
• A framework for commissioning PH services through three levels of increasing complexity and required expertise.
• Three levels of service delivery within the framework:
– Level 1: Promotion – Promoting health, wellbeing and self-care (self-assessment process)
– Level 2: Prevention – Providing services (commissioner-led)
– Level 3: Protection – Providing treatment (commissioner-led)
Pharmacy service development
Service proposals/business cases:
A service proposal or business case is a means for making a case for developing a new service to stakeholders, such as a commissioning organisation or a healthcare organisation who will be implementing the service. It sets out the need for the service, the expected outcomes and a plan of how the service will be run and evaluated.
Service developments are more likely to be successful if they are;
• Based on need
• Fulfilling the drivers of the purchaser e.g. local or national priorities
• Delivering quantifiable health gain or improved service e.g. improved access, improved clinical outcomes
• Evidence based
• Cost-effective
• Supported by robust clinical governance structures
• Designed to ‘fit’ with and complement other existing or planned services
David Pfleger, Developing pharmacy services, in Pharmacy in Public Health
What is included in a service proposal?
- Title and aim of service
- Background and alignment with policy
- Identifying need
- The evidence base
- Service design
- Cost implications
- Evaluating effectiveness
Background of service proposals:
• What is the current policy in this area?
• How does your idea fit with this?
– Is your idea a national priority?
– Is it a local priority?
• What are the current trends in the prevalence of the particular condition/problem you have identified?
• What can pharmacy offer -unique selling points?
Service proposal. “Needs assessment”
• Needs assessment formally defined as ‘a systematic method for reviewing the health and wellbeing needs of a population, leading to agreed commissioning priorities that will improve health and wellbeing outcomes and reduce inequalities’.
The overall aim of a Health Needs Analysis is to provide information to the organisations that are responsible for planning and ensuring delivery of health and social care services, to help them improve the health of the population for whom they are responsible. (Stevens, A.et al 2004)
Identifying need: assessments and data :
• Joint Strategic needs assessment (JSNA)
– ‘Goal to accurately assess the health needs of a local population in order to improve the physical and mental health and well-being of individuals and communities’
– Health and Wellbeing Board of LA is required to produce a JSNA of the local community
– Each LA will have produced a JSNA
• Pharmaceutical needs assessments (PNA)
– Health and Wellbeing Boards have responsibility for the on-going review, development and publication of PNAs
– Used to make decisions on market entry
– Used to make decisions on commissioning
– Usually available on the internet as with JSNA
• Health Profiles
– Set up by PHE
– Provide a ‘snapshot’ of overall health of local population and compare with other areas and national average
– Aim to assist local government and health services identify key problems in their area
• Local GP Data
• Dispensing data
