Community Pharmacists – How you can make every Opportunity Count 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 practice – test of change MeOC in pharmacy placement

National and local direction of travel Prevent + Improve + Change + Reduce Health Inequalities

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.

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.

Pharmacies enabling people

Yes No

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 MeOC 3 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

Supporting people at greater risk People who are vulnerable People who are dependent People at greater risk of ill health People with money worries People who are older People with existing health issues People with limited mobility.....

Link to range of videos https://www.hi-netgrampian.org/people-networks/public-health-directorate/health-inequalities/meoc-videos/

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?

Core PHS activities – MeOC helps you to: Promote self care Encourage a more pro-active approach to self-care Provide access to appropriate information, materials and advice Offer opportunistic support to promote wellbeing Use window/frontage /display space in pharmacies to promote health Consider a rolling programme of pharmacy based wellbeing activities

Testing change (1) Keeping it simple Conversation to enable Profile of customers? What does it look like? Expectations of customers on health and wellbeing pharmacy service? Changing expectations? What health and wellbeing priorities are important to your particular pharmacy? Where would you get information for your customers e.g.on concerns about money, benefit, employment? What messaging does pharmacy currently use?  

Testing change (2) What is it about the messaging? Building on good practice? Skills and systems in your pharmacy? How can MeOC approach add value to your pharmacy? Added value – for example - for the role of the Pharmacy Assistant? What links does your pharmacy have with other local services/initiatives ? Provision of materials - tools, messages, signposting? Benefits of a wellbeing ‘card’? Access to videos? Introduce a test of change?

Connecting people to services Making every Opportunity Count – easy tools to help Specific needs Connecting people to services Brief

Agreement with Pharmacy - example To support community pharmacy public health service activities , initial focus: *People who may have a caring role *People who may benefit from accessing information to help young mums/families *People who may benefit from being able to access support for mental wellbeing including stress.

Markers of success agreed - example Number of MeOC conversations Number of people signposted to services Handful of brief case studies captured by staff to illustrate impact.

You Matter! Looking after your health and wellbeing is important Find out about local help if you need it Sample poster created with MeOC proof of concept pharmacy Support & friendship for families Are you a carer? Tips on looking after yourself Money concerns? Want to know more? – ask our Pharmacy staff at the counter

https://www. hi-netgrampian https://www.hi-netgrampian.org/people-networks/public-health-directorate/health-inequalities/making-every-opportunity-count/