‘Community pharmacies critical to sustainable Welsh NHS’
Pharmacies are often found in the heart of communities and in hospitals. Here, pharmacist Elin Hooper describes to the NHS Confederation how their role is expanding
PHARMACY refers to the scientific field of safe and effective use of medication. The traditional role of the pharmacist was that of compounding and dispensing medication, with a specialist knowledge that ensured the best health outcomes for patients through the correct use of medicines.
Fast forward to 2017 and pharmacies can be found in all corners of Wales, as part of hospitals, clinics or extended care facilities but also in the heart of the community.
The vast majority of the UK population now live within a 20-minute walk of their local pharmacy, with a large number visiting one at least once every 28 days.
Community pharmacies dispense medication but also provide an individual service that engages directly with patients, providing advice and guidance on a wide range of healthcare and clinical services in a safe, friendly environment.
While history can trace back the origins of the pharmacy many centuries, the future landscape of the pharmacy is changing.
With a growing, ageing population with complex needs, there is greater demand on all parts of the health service which requires new models of healthcare for the future.
Community-based models of healthcare can deliver positive outcomes for patients, reduce health inequalities and help people avoid hospital admissions.
With so much of society’s contact with the health service taking place in the community setting, the role of the community pharmacist is critical to the health and wellbeing of the population and a sustainable NHS in Wales.
At Mayberry Pharmacy in Caerphilly, Elin Hooper works as the community pharmacist with a small team, including a technician, to ensure all prescriptions and medications are correct.
Elin says: “The traditional role is in the dispensary, so we have a prescription, we check it and make sure that people have the correct medication.
“But in recent years the role has changed, so we are really trying to utilise our clinical skills in the services we provide.”
Services that community pharmacies offer include the flu vaccine.
“Although the flu jab can be done by GPs, anyone who hasn’t had one and is in the risk category we would offer there and then in store,” Elin added.
She went on to stress the importance of the discharge medication review (when you leave hospital) and annual reviews.
“We have found that many asthma patients, for instance, don’t attend their annual medication review which means they are at higher risk of hospitalisation. So it is a case of asking people if they have had their annual review and, if they haven’t, we could perform it in the pharmacy.
“Asthma is a chronic disease which means you need to take preventative medication every day so this is where counselling and increase direct patient understanding has been really important”.
To support the services, Mayberry Pharmacy in Caerphilly has a consultation room which facilitates informal, open discussion between the pharmacist and the patient in privacy.
Asked how patients find this oneto-one approach, Elin said: “I think perhaps we can be a approachable than GPs.”
However, Elin stressed the importance of the GP and pharmacy working together as an integral part of the service.
And, with the consent of the patient, the pharmacist is in continuous communication with the GP in their area.
Of past interactions with patients in the store, Elin recalled: “I always remember one patient who would never have a review with me or have a conversation about his medication, but one day he had a stroke and he came back and asked me lots of questions.
“We sat down and did a review, I think it must have been the way he saw I was with everybody when he came in for his prescriptions every month and he knew that we were always here to help when he needed it.” little more
Earlier this year Elin won a prestigious Welsh Pharmacy Award for her work with helping members of the community give up smoking through regular face-to-face check-in sessions, online initiatives and even direct mobile phone contact.
“I saw a professor a few years ago who told me if you can help someone to stop smoking, it is the biggest intervention you will make to their life and that has always stuck with me.”
Elin added: “A lot of people who smoke don’t want to smoke, but don’t know how to give up.
“By empowering people and giving them the capacity for willpower we can provide direct support as the first appointment lasts 40 minutes compared to a 10-minute GP appointment.”
From direct patient interaction and more emphasis on clinical services, the level of responsibility of the community pharmacist is high.
But, as Elin explained: “The ‘Choose Pharmacy’ initiative is coming at the end of the year where we are going to be prescribing minor ailments. This will free up doctors’ time and make sure patients know where to go for the right advice.”
The role of the community pharmacist is growing to meet the requirements of the population.
But members of the public as the wider community also have a critical role to play.
“A lot of people think if they take a tablet it will solve all their problems but it is more about taking ownership and the choices we make such as a healthy lifestyle.”
Community pharmacists like Elin and her team help contribute to better health – reducing unnecessary admissions to hospital, alleviating pressure on GP surgeries and helping people remain independent for longer.
By making every contact count and using their position at the centre of communities, community pharmacists can use every interaction as an opportunity to provide medication as well as direct quality support to individuals.
Passion and enthusiasm for delivering services to ensure people have all the tools they need to live healthier lives is what drives Elin and other community pharmacists across Wales.
“It’s about opening up those conversations and making sure people are aware of the services that we offer,” Elin added.