Community Pharmacy Access to Vulnerable and Hard-to-Reach People

I have made the point before that 1.8million people enter a community pharmacy every day and 85% of adults visit a pharmacy every year, but it seems that simple facts like that don’t always have meaning.

Most pharmacies are in high streets and neighbourhoods, rather than the feeling that they are in supermarkets or ‘out of town’ developments. Many have been in their local communities for decades, having stripped out Victorian fittings to provide a clean and professional environment. They have served generations of customers.

Within a recent conversation, I was surprised to hear high level doctors asking whether community pharmacy reached out to ‘hard to reach’ communities and vulnerable people.

The real problem is that CCGs, NHS England and Public Health England do not reach out to community pharmacy. They don’t really understand.

Most people aren’t hard to reach – they are in the pharmacy. I can reach out to them when I deliver the supervised administration service, offer needle exchange, free condoms and emergency hormonal contraceptives, sell nappies and all of the other medicines that are on the shelf. And it is well within my ability to leave the pharmacy and visit then where they live – after all it is usually just around the corner.

Do we have contact with the frail and elderly? We deliver their prescriptions, our drivers meet them and we chat with their children and carers who collect medicines from the shop.

We are slap bang right in the middle of the community, often one of the few surviving small shops. Our staff on the shop floor, cleaning the pharmacy, making deliveries come right from the community. They are the relatives and the neighbours of the people you struggle to reach. They speak the same language and share the same problems. We actually spend our whole time serving that community with people from the community.

So why does Community Pharmacy need to explain this. Saying that the hint is in the title might seem rude, but lazy commissioning, spending large sums of money on additional layers of service, just undermines one of the most important assets that the NHS has. It is unsustainable and a major cause of financial pressure.

Commissioners at all levels of the NHS and all advisory layers of public health should reach out to community pharmacy. We don’t need to reach communities. We have been there for years – working away, serving the community. Commissioners should spend more time in the pharmacy and see our members of the community, supporting community pharmacy to deliver more, rather than jumping to the tax-payer cheque book to commission something new. Surely it makes good sense to build from the main building blocks of the NHS?

Before someone from the HPA within Public Health England has to point out that England will soon have more cases of Tb compared to the whole of the USA. Let me just say ‘Community Pharmacy’ is within those communities already. If we can supervise the administration of methadone effectively then we can do the same for Tb medication.

And before we worry about the relatively few children who haven’t had their MMR, I should admit that we have seen them. They a have been coming into our shops for a few years now with their mothers, fathers or carer. It is a pity that you didn’t ask us to give them their vaccine.


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