1. Healthy Living Pharmacy

2. How it all started
The LPC and PCT recognised a high level of need for public health and wellbeing services and there was a small range of the usual commissioned services available from pharmacy. For all the obvious reasons such as accessibility, convenience pharmacy was an obvious provider. But is was not joined up and we knew more could be done; both the LPC and PCT knew that pharmacy could deliver more and it was in the interests of everyone to improve both quality and productivity. With the last pharmacy white paper indicating a place for pharmacy as healthy living centres, the LPC and PCT, working together, started on the journey of Health Living Pharmacies. The DH recognising this work, invited NHS Portsmouth to lead on national development with their experience in Portsmouth informing this work.

3. Click here for video www.pompey-pharmacy.info
Show video clip and then describe a HLP:
Delivers broad range of services to a high quality consistently
Proactive team supporting health & wellbeing
Supports people with long term conditions
Accessible , approachable, valued & trusted
Works closely with other healthcare providers, reactively and proactively
Will be identifiable by the public and other healthcare professionals
These features will be recognised by many of you, maybe in your own pharmacy. A kitemark is awarded to those pharmacies who demonstrate all of these, have proven delivery and an ethos of proactive support towards health and wellbeing. It is a quality kitemark that can be recognised by the public and other HCPs and demonstrates to commissioners that this provider can be relied upon.

4. PROMOTES HEALTH WELL BEING OPTIMISES MEDICINES INTERVENTIONS
LOCAL HEALTH NEED
ROLE
CORE
LEVEL 1
LEVEL 2
LEVEL 3
PROMOTES HEALTH WELL BEING
& SELF CARE
Health promotion, Self care, Healthy lifestyles & Signposting
Smoking cessation
EHC service
Harm reduction
Weight management
Chlamydia
screening
NHS Health Checks
Health screening
OPTIMISES MEDICINES INTERVENTIONS
Risk management, Counselling & MURs
Targeted MUR+
(respiratory)
Supervised consumption
Adherence support programmes
Clinical medication review
PROVIDES TREATMENT
Dispensing supply, RDS and OTC sales
Minor ailments
EHC PGD
PGDs for MAS, STIs, smoking cessation
Pharmacist
Prescribing
WORKFORCE
DEVELOPMENT
Core
competencies
Health Trainer Champion
(Assess & signpost)
Leadership skills
Health Trainer
(Assess & coach)
Clinical skills
Advanced
clinical/PH skills
(PhwSI, Prescriber)
PREMISES
Fit for purpose
consultation room
(Drug Tariff spec) &
IT capability
consultation room(s)
(Enhanced spec) &
ENGAGEMENT
Operational
(RDS, EPS, collection & delivery services)
Primary Care
(Referral protocols, integrated care pathways)
Community
(Integrated with local authority priorities
& carers)
Local Leader
(Driving service redesign and delivery)
SERVICES
Portsmouth Healthy Living Pharmacy Framework
FOUNDATIONS
PHARMACY CAPABILITY

5. What has made this work? Engagement and ownership
Support for leadership and change management skills
Health Trainer Champions
Communication
Joint working and project management
Public awareness

6. Outcomes

7. Outcomes: Stop Smoking
559 quitters
36% increase
23% PCT target
560 quits in 2009/10; an increase of 36% on previous year (15% across pharmacy in UK)
23% of total PCT target
Data over 5 months in 2009 was 139 quits; since implementation of HLP initiative and launch of prospectus this rose to 333 in same period of 2010 (increase of 140%; community pharmacy has more than doubled the number of quits during this period

8. Pharmacies accredited as HLPs and those as HTCs show more quits than non HTC pharmacies
During 5 month period, 25.1 quits in HLPs, 13.2 in HTCs, 3.7 in non-HTCs
HLP: average 25.1 quits HTC: average 13.2 quits Non-HTC: average 3.7 quits

9. Outcomes: Alcohol Services
Alcohol Audit:
3649 adults took part
1784 took brief advice
830 had more in depth consultation
29 referred to Alcohol Intervention team
Alcohol IBA Service:
670 interventions
51% increasing or higher risk
15% possible dependence
This alcohol audit with a scratch card was introduced by the PCT as part of the essential services health promotion activity. It was implemented across all pharmacies. 32 pharmacies actively participated and have submitted data. 44.5% male, 55.5% female responded with a range of age groups targeted (greatest in the groups). More detail in interim report.
40% of respondents were drinking at levels considered at risk (scored 5-9)
8% possible dependence (10 or more)
New Alcohol Identification and Brief Advice (IBA) LES – 400 interventions in first month:
30% increasing or higher risk (5-9) – 30% of these accepted Level 2 advice and support
15% possible dependence – 10% of these accepted referral into Alcohol Intervention team

10. www.pompey-pharmacy.info Comparing the number of surveys taken between
HTC and non-HTC pharmacies 20 40 60 80
100
120
140
160
180
Types of Pharmacies
No of Surveys
Average of HLP
Average of HTC
Average of Non-HTC
HLPs more effective than HTCs than non HTCs at collecting the data (170, 106, 53)

11. Outcomes: Respiratory MUR
700 patients seen
35% not seen by another HCP in previous 12 months
29% were smokers, 76% recruited for stop smoking
Average asthma quality of life score = 16/25
70% uncontrolled
74% with adherence issues
6% referred to GP
60% seen second time improvement
In 2008/09 22 pharmacies engaged in MURs, in 2009/2010 this is 36 of 37 pharmacies
PCT has supported MUR delivery since 2005
Increased delivery since targeted MUR service launched
23 pharmacies engaged in respiratory MUR service
ACT validated tool to assess symptom control – under 20 suggests uncontrolled symptoms; early results from recall shows improvement (low numbers)
At this point (august 2010), average of 42 targeted MURs in HLPs, HTCs have average of 6.5 MURs and non-HTCs average of 4.2

12. Other services Emergency hormonal contraception
Weight management services
Supervised consumption
Needle exchange
Minor ailments
Chlamydia screening
NHS Health Checks
And these are some of the other services you as pharmacies and HLPs are delivering; all showing better engagement and delivery. The success of HLP has led to more services being commissioned and, in the case of NHS health checks a preference (where there is a local health need) for HLPs to be commissioned.

13. In-store awareness www.pompey-pharmacy.info
The PCT has been providing extensive support to help pharmacies promote their HLP status and inform the public. These are the logos in-store.

14. Public awareness www.pompey-pharmacy.info
And this is just some of the public communications campaign materials used – in GP surgeries, on buses, the website, leaflets
Public facing media coverage online, via social media and on air – Express FM interview. In addition to the trade press articles. Everybody is talking about HLP!
Roadshow at five locations starting today. Staffed by Health Trainer Champions, Pharmacist and NHS Staff. Information, free blood pressure testing, DVD, free gifts. Anecdotally, 3 people walked into one pharmacy the Monday after the roadshow and requested stop smoking support.

15. Where nEXT?

16. Optional

17. What can you do? http//:tinycc/hlp hlp@pompey-pharmacy.info