Community Pharmacists Making every Opportunity Count – a systems approach Dr Linda Leighton-Beck Head of Social Inclusion Public Health NHS Grampian 3/18

Pharmacy practice – today Transformation of services – policy direction Adding Public Value Implementing Contract - Public Health Service Implementing NICE guidelines Making every Opportunity Count (MeOC) MeOC in pharmacy MeOC in pre-service education

Transformation - better health, better value, better care Transform culture through systems and high quality services: Cross-sector focus on prevention Behaviour and underlying conditions Integrated services to support individuals, families communities Better value from all our resources Equality of opportunity Realistic medicine SUSTAINABLE improvements.

Prescription for Excellence Integrated delivery of care requires ...new and innovative models ...in collaborative partnerships ...to deliver the best possible health outcomes ... Pharmacists undertake enhanced role in preventing ill-health, co-production and minimising health inequalities. Pharmacists and the wider pharmacy workforce are trained appropriately for their enhanced role, pre and post qualification.

Transforming the way we go about Transformation people and services Transforming the way we go about our business – personally and professionally Each person doing a little to make a big difference Volume and value How you/pharmacy can help.

Your role as a health professional  Best ways to reduce inequities through: workforce capacity and capability practical actions in interactions with patients working in partnership role of advocacy. Meaningfully & easily managed using MeOC Marmot, M et al (2013) Working for Equity: The Role of health Professionals, UCL

NICE Guideline - Community pharmacies: promoting health & wellbeing Appointments not necessary Opening hours long Understand local community, culture and norms. Consultation - https://www.nice.org.uk/guidance/GID-NG10008/documents/draft-guideline

Overarching principles of NICE good practice Use a standard approach Personalised approach , continuity, under-served groups, knowledge of local area, using staff skills. Promote community pharmacies – Pharmacies form part of the care service, often first point of contact. Use every opportunity – signposting and referral

Community Pharmacy Contract – Public Health Service Public Health Service covers three core activities: health promoting philosophy health promoting activities health promoting environment.

Evolving roles for all services Doing things with Working with other disciplines Seeking broader set of outcomes Finding solutions outside ‘normal’ activity Doing something now – preventing Evidencing ‘social value’...

HOW? Our ambition Harness untapped partner ‘power’ Enable public/third sector to enable people Maximise assets Build from proof of concept Win hearts and minds.

MeOC progress in NHSG Outpatient Clinics, Aberdeen Royal Infirmary Clinic Shuttle bus drivers Royal Cornhill Hospital Kildrummy Day Hospital Peter Brunt Clinic Pre-assessment Radiology & Cath Labs Outpatients Dr Gray’s Hospital, Elgin Dermatology & Rheumatology ITU Antenatal Screening Woodend Hospital Outpatients Aberdeenshire HSCP Moray HSCP Aberdeen City HSCP Community/ Third Sector Timmermarket

How are we doing overall? 23 clinical areas - 2016 -17 14082 people benefited from wellbeing conversations 0 wellbeing conversations, previously. Record in e-health record

Power of brief conversation makes every opportunity count Aveyard, P et al Screening and brief intervention for obesity in primary care: a parallel, two-arm, randomised trial Lancet 2016; 388: 2492–500.

signposting and referral Three tiered approach Complex needs 3. Structured wellbeing conversation for complex needs 2. Specific conversation e.g. alcohol, money concerns, wellbeing, home energy, smoking, housing etc Specific needs 1. Light touch conversation - signposting and referral Brief

Making every opportunity count (MeOC) Integrated, sustainable, inclusive approach to prevention and self care Suitable across public and third sectors Builds on national & local proof of concept Enhances person-centred approaches Links well with direction of travel Contributes a systematic approach Building block is brief wellbeing conversation

Building a system SFRS ARI Woodend RCH Dr Gray’s Pharmacy HSCPs X3 DWP Public Dental service City SACRO Victim Support Action for Children Foyer- Aberdeen ARI Woodend RCH Dr Gray’s Pharmacy Families Outside HSCPs X3 DWP X 3 Primary Care Criminal Justice Social Work Cash in Your Pocket Care Providers Pathways SFRS

Ownership is ALL Key Messages Hearts & minds Granular markers for journey Enabling approach for prevention & self-care Everyone/ sector doing a little for a big difference Positive effects on staff health Acceptable, inclusive, feasible & transferable Sustainable Suitable across public and third sectors Your contribution?

Link to range of resources https://www.hi-netgrampian.org/people-networks/public-health-directorate/health-inequalities/making-every-opportunity-count/