New research by YouGov commissioned for Dispensing Health Equality, published today by Pharmacy Voice, shows that, if faced with a closure, more than one in four people (29%) who would normally seek advice first from their local pharmacy on common ailments would instead make an appointment with their GP practice. According to NHS research, this rises to as many as four in five people in areas of high deprivation such as Fleetwood in Lancashire.
The government has indicated that its proposals will lead to up to one in four local pharmacies closing. The report argues that an uplift in GP appointments is untenable in any part of the country, but especially so in those areas that find it difficult to attract GPs in the first place.
This will affect communities such as Fleetwood and Easington Lane, a former coal mining village where there is no GP surgery, and just one local pharmacy serving the needs of more than 2,000 people. The report urges the government to take note of this in context of its proposed funding cuts, and seeks reassurance that in both urban and rural areas of high deprivation access to this much needed community asset will be protected.
Dr Mark Spencer, a GP in Fleetwood Lancashire, co-chair, NHS Alliance, and himself a coal miner’s son, comments: “At a time when there is an entirely unacceptable widening gap in life expectancy between rich and poor, extreme pressure on GPs, and increasing public awareness of the role pharmacy is playing in delivering services to support public health, it would be catastrophic if the areas that most need it, are deprived of access to this crucial community asset. Easington Lane and Fleetwood are two cases in point.”
Perspectives from Easington and Fleetwood are included in the report, which argues that “good health follows a social gradient: life expectancy increases according to postcode rather than genetic code”.
This comes into sharp focus after the age of 60, when the life expectancy gap is more than 30 years between those living in affluent areas and those living in deprived ones, according to research published last week by Cass Business School. Described as the ‘inverse care law’, the country’s most deprived areas are frequently under-doctored, which can exacerbate health inequalities and life expectancy. Community pharmacy offers a ‘positive care law’. Local pharmacies, a health hub offering expert advice and support from highly trained healthcare professionals without an appointment, are within a 20 minute walk of almost 100 per cent of people. The government’s plans may adversely affect this positive care law.
The report states: “The underlying reasons for health inequalities are complex but recent research indicates the immediate causes are predicated on “lifestyle choices’ such as smoking”. Research by Durham University has shown that most people in England can get to a community pharmacy easily, with the greatest access in deprived areas. This means our high street pharmacies could be key in tackling some of society’s major public health concerns such as obesity, smoking and alcohol.” A recent study published in BMJ Open stated: “Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services.”
The cost is both human and fiscal. Professor Rob Darracott, chief executive of Pharmacy Voice says: “We should be outraged that there is now more than a 30 year life expectancy gap between our richest and poorest. And no general practice can afford to take on additional appointments to advise on common ailments that can be self-treated. People are increasingly aware of the role of local pharmacy plays in not just dispensing their medicines, but in dispensing vital health services. Advising and helping people to treat minor ailments is a starting point, but increasingly, pharmacy is playing a key role in helping people lead healthier lives through interventions like smoking cessation and weight management programmes. These are important stepping stones to increasing life expectancy in some our most disadvantaged communities. Losing a local pharmacy in these areas is simply not an option.”
Notes to editors:
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YouGov research: Survey figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2054 adults. Fieldwork was undertaken between 27th – 28th April 2016. The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).
Pharmacy Voice is an association of trade bodies, which brings together and speaks on behalf of community pharmacy. Pharmacy Voice is formed by the three largest community pharmacy owner associations. Together we are a stronger, unified voice for community pharmacy. www.pharmacyvoice.com
New NHS Alliance: New NHS Alliance is a movement of people and organisations who are committed to building a sustainable, community-based health service. They are an entirely solutions focused organisation, unique in its approach bringing together more than 10,000 passionate individuals and organisations across primary care who believe innovation, connections and integration are key to the sustainability of a health service that remains free to all at the point of need. New NHS Alliance promote greater connection and collaboration between organisations within the NHS and between the NHS, communities, local authorities, innovative enterprises and other local enablers of prevention and health creation.
4 John Appleby, Chris Deeming, The King’s Fund, Inverse care law http://www.kingsfund.org.uk/publications/articles/inverse-care-law
5 Adam Todd, Alison Copeland, Andy Husband, Adetayo Kasim, Clare Bambra, BMJ Open, The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England http://bmjopen.bmj.com/content/4/8/e005764.fu
7 The positive pharmacy care law Todd et al http://dro.dur.ac.uk/13306/
8 Community pharmacy-delivered interventions for public health priorities http://bmjopen.bmj.com/content/6/2/e009828.full