An Evaluation of the Tees Healthy Living Pharmacy Pilot Scheme

1 Executive Summary

The concept of the Healthy Living Pharmacy (HLP) represents a commissioning framework that is designed to achieve a consistently high standard of delivery for key public health services within the community pharmacy setting (National Pharmaceutical Association, 2013). According to the evaluation of the national pathfinder scheme, the concept of the HLP builds upon the role of community pharmacies and attempts to establish them as a key element within public health services. It aims to do this through the delivery of high quality services, advice and intervention as well as regular health promotion activities (NPA, 2013).

Given the nature and convenience of the community pharmacy service, it is not surprising that their potential to engage with and deliver a wider range of public health services is being recognised. In accordance with the recommendations of the Pharmacy in England: Building on strengths, delivering the future (2008) White Paper. The HLP project framework supports pharmacy to adapt to become ‘healthy living centres’ that operate to pro-actively promote health and wellbeing within their community. By delivering a consistently high level of quality commissioned services the HLP is said to meet local need for improving health and wellbeing within the community as well as helping to reduce health inequalities. The ultimate goal of the HLP is to engage the entire pharmacy team with the healthy living ‘ethos’ and turn every customer encounter into a health promoting interaction.

The Tees HLP project has been tailored to meet the public health needs of the local population. It offers a bespoke approach building on the national pathfinder programme since there is more flexibility in the range of services that it incorporates.

It is the scope of this evaluation to provide an additional qualitative evaluation that will:

• Evaluate perceived barriers and facilitators to accessing the services
• Identify aspects of service that have:
a. Worked well
b. Could be improved
• Capture information about lifestyle changes consequent on the initiative
• Identify gaps in service provision, e.g. where customers have not been referred to specific pathways.

The evaluation was designed across three phases, in order to incorporate a range of views taken from those who have had direct involvement with the project.

• Phase 1: Postal Questionnaire
• Phase 2: Interviews with pharmacy teams and project manager
• Phase 3: Telephone interviews with customers.

Results demonstrate that the HLP pilot scheme was viewed very positively by pharmacy teams and customers alike.

The availability and quality of the training events attended by the pharmacy teams were very good, with some of the service specific training being highlighted as particularly influential on the everyday practice of the pharmacy teams. Though some issues were highlighted around timing and relevance of training, for the most part training was well received and accessible.

Two factors appear to be crucial in terms of their impact on the extent to which the pharmacy teams have been able to engage with the pilot scheme: firstly, the location of the pharmacy and secondly, the type of organisation. It is evident that the independently owned and, largely, community-based pharmacies are engaging with this pilot scheme particularly well. The much busier stores, particularly those which form part of a national multiple chain, have many more restrictions imposed on them that ultimately restrict their ability to engage with the pilot scheme to the same degree.

Where pharmacy teams are in a position to know their customers they have found it easier to approach them proactively about relevant services, since they are already conversing with them about more general issues and the customers are therefore very responsive to them when they introduce these new services. Pharmacies with a more transient clientele (e.g. supermarket in-store pharmacies) offer fewer such opportunities. The development of strong relationships with customers would therefore appear to be of significant benefit to the participating pharmacies, since these customers are likely to become regular, loyal customers who go on to recommend services to friends and family

Customers reported that they were coming to regard the pharmacy as a real alternative to visiting their General Practitioner (GP). Pharmacy is considered to be more accessible than the GP, since services are often offered ‘there and then’ with no appointments necessary. All of the customers describe a much more personal service from the pharmacy team, where they feel that the pharmacist has more time for explanation or that the team simply offers friendlier, informal support when they visit the store

Health promotion zones within pharmacies play a vital part in supporting the public health role of the pharmacy. These displays are seen as a ‘way in’ so that staff can talk to customers about the services they offer whilst the customers engage with the displays. Some of the displays have been particularly effective and have triggered customers to access services like smoking cessation. Networking events will give the opportunity for staff in all participating stores to come together and share their ideas around the displays and other issues.

Some of the pharmacies suggested that there was a lack of marketing around the HLP ‘brand’ and they suggest that few customers would recognise the HLP logo. Further marketing will increase customer recognition of the HLP scheme.

The report recommends:
• Increasing the accessibility, standardisation and relevance of training
• Prioritising membership of the scheme to amongst local community pharmacies
• Developing more networking opportunities to share good practice amongst pharmacies
• Raising awareness of HLP amongst customers through ongoing campaigns.