Pharmacy: looking to the future Kevin Ratcliffe Consultant Pharmacist

Stereotypes…..? Traditionally, role dominated by dispensing SMS: needle exchanges and supervised consumption Role is now evolving Key benefit: ACCESS

Minor Ailments Already trained Signposting / referral Fear Some minor ailment schemes available but no national standards (and certainly not national coverage)

BBV – some scary stuff Nationally, 40% IDUs have HCV (marked variation of prevalence) Half of these are unaware of their status 20% IDUs infected with HCV within 3 years of starting Uptake of Hep B vaccine better, but completions still low. HIV rates rising again (1/3 of IDUs unaware of their status).

BBV: options Pilot studies of Hep B vaccination completions via pharmacies hugely successful. HCV screening (dried blood spot sampling) HIV as well ? NX and SC

PGDs: Naloxone Overdose response training Supply and use of naloxone Inc. partners / carers Universally available

PGDs: Sexual Health Morning after pill Chlamydia screening and treatment Sexual health advice (inc. supply of free condoms and lube)

PGDs: antibiotics A minor ailments plus scheme Defined conditions and defined circumstances Skin infections / abscesses ?

Smoking Cessation

Alcohol Many pharmacists already skilled at brief interventions Referral pathways in place Harm reduction measure (esp. as illicit drug use decreases)

Non-medical prescribing Effective use of skill mix Many benefits Already present in primary care, specialist teams and prison service But, could we take this further……….?

The main challenges:

At every crossroads on the path that leads to the future, tradition has placed ten thousand men to guard the past. Anon.