A key requirement of the HLP programme is to understand local health needs and focus on the priorities where pharmacy can have the greatest impact. This can be achieved by engaging with the local community, commissioners and other providers of health and wellbeing services. Look at:
• Joint Strategic Needs Assessments (JSNA)
The local NHS, CCGs and local authorities are required to consider the needs of their local populations and how they prioritise effective commissioning of services to address these needs. Your local assessment can be found on your local authority or CCG website.
• Pharmaceutical Needs Assessments (PNA)
This document assesses the needs of the local population and includes dispensing services, as well as public health and other services that pharmacies may provide. Your PNA should be on your local authority website.
• Health profiles
These provide an overview of health for each local authority in England and can be used to develop local promotional campaigns. See fingertips.phe.org.uk/profile/health-profiles.
It is important to be proactive and establish a dialogue with local CCGs, public health and GP practices to understand the specific challenges faced by local commissioners and other health and wellbeing providers to see where community pharmacy could offer effective and cost-effective solutions.
As a minimum, this builds relationships, facilitates understanding and creates two-way referral opportunities, but could also lead to commissioned services. Find out what your LPC is doing and how they can support you.
Use local relationships and connections to put together a programme of health promotional activity in the community. This feature of HLPs makes a real difference and is both fun and effective in promoting pharmacy and what it can do. These activities can be linked into national campaigns such as those from Public Health England and the calendar of national campaigns hosted by NHS Employers.
Having one full-time equivalent health champion is the minimum requirement for a HLP. This is usually a healthcare assistant who has the RSPH level 2 award in Understanding Health Improvement.
Many successful community pharmacies have invested in this qualification for all their team who have patient contact, including pharmacists and home delivery personnel, to give them the knowledge, skills and confidence to make every contact count.
A motivated workforce is more productive – HLP teams have been shown to deliver more services than non-HLPs.
While most people envisage that HLP will remain in the QPS for 2018/19, this has yet to be agreed. Whether it does or not, or whether it evolves beyond the existing scheme’s criteria, is partly down to the sector’s ability to demonstrate what it can achieve. One reason why HLP has come this far is the evidence that has been collected. It is essential that pharmacy continues to capture the difference it makes.
Looking at current NHS, public health and consumer priorities, some future options could include:
• Workforce development
Developing the knowledge and skills of the team, through a formal ‘Making every contact count’ (MECC) course and the RSPH health improvement awards, will demonstrate that the sector is both willing and able – and more likely – to move funding from less accessible providers to pharmacy.
• Customer experience
The days of relying on a quick turnaround of FP10s as a measure of customer service are over. The public’s expectations continue to rise – they no longer buy product; they buy an experience. A great pharmacy feels different because there is a buzz about the experience that results from the ethos that the whole team lives and breathes. HLPs deliver a great customer experience.
• Health interventions
With an estimated 1.6 million contacts per day, pharmacy is well placed to implement the ‘making every contact count’ (MECC) approach. Rolling out MECC to the pharmacy workforce would make a significant difference to the health of the population.
• Risk assessment and management
The early identification of people at risk of hypertension, atrial fibrillation, diabetes, cancer and a range of other critical health risks based on the local health profile is an opportunity. This could be locally commissioned, but could also be a privately offered service covering health awareness, detection, prevention interventions and support (e.g. healthy weight and diet, physical activity) and referral as appropriate. We would like to see a quality payment that pulls together the strength of the pharmacy workforce to make a tangible difference in outcomes in one of these priority areas.
Community pharmacy must embrace digital advancement. Further embedding the use of smart recording of interventions and referrals or signposting in routine practice would be a great place to start. Some HLPs are using information screens to promote healthy living messages, campaigns and services; tablet devices to engage and illustrate key health issues within proactive conversations; and websites and social media to promote what the local population and businesses can access from their pharmacy.
The sector must constantly adapt to evolving needs in order to remain relevant and compelling to commissioners and consumers of our services. We hope the NHS continues to recognise the significant investment teams are making in changing their behaviours and business models, and gives the HLP programme further time and support to truly embed as a central aspect of practice.
One reason why HLP has come this far is the evidence that has been collected
The Healthy Living Pharmacy (HLP) was first raised as a concept in the 2008 Pharmacy White Paper (Building on Strengths, Delivering the Future), when the Department of Health stated that pharmacies could be healthy living centres, making more of a difference to the public’s health.
Portsmouth led the development of the prototype HLP programme and since then it has been supported and nurtured through an NHS reorganisation and two changes in Government.
It is testament to the community pharmacy sector and all that work within it that the concept has successfully scaled up to the national programme it is today. Following a successful pathfinder initiative where 66 primary care trusts participated, HLP is now recognised within the NHS Quality Payments Scheme for community pharmacy and led by Public Health England.
Article authored by Mike Holden and Deborah Evans from Pharmacy Complete.