Camden and Islington Healthy Living Pharmacy Prospectus Working in partnership
Contents Foreword by the Director of Public Health, Camden and Islington 4 Introduction 6 Background - the new NHS 7 What are the health needs of our local populations? 8 How Healthy Living Pharmacies can contribute to 9 improving the health of the population What is special about a Healthy Living Pharmacy? 10 Why should your pharmacy become a Healthy Living Pharmacy? 11 Where do your current pharmacy services fit? 12 The importance of a trained and informed team 14 Leadership in the pharmacy Role of the Healthy Living Champion Why do you need Healthy Living Champions? Training of a Healthy Living Champion What do Healthy Living Champions do? 16 How does your pharmacy become a Healthy Living Pharmacy? 17 Find out more 18 Apply to become a Healthy Living Pharmacy 19 3
Foreword by the Director of Public Health, Camden and Islington HLPs are now well established in many areas of the country and have been shown to improve the quality and effectiveness of community pharmacy services, contributing to better and more convenient access to health and wellbeing services for local residents. In order to achieve that aim, HLP staff will be proactive in supporting health and wellbeing as a core activity. HLPs will be convenient, accessible and readily identifiable by the public and other healthcare professionals. Dear Colleague, On behalf of Camden and Islington Councils, Camden Clinical Commissioning Group, Islington Clinical Commissioning Group and Camden and Islington Local Pharmaceutical Committee, I am delighted to launch this Healthy Living Pharmacy prospectus. This signals the start of the journey towards the development of Healthy Living Pharmacies (HLP) across Camden and Islington. Community pharmacies are, by definition, embedded within the communities they serve offering convenient access to expertise and advice, as well as to the products they sell. For people who are well or ill, the local pharmacy can be a more appropriate, inviting and readily accessible venue than a hospital or GP surgery. This presents a significant but currently underutilised opportunity for healthcare, ill-health prevention, identification of disease (or risk of disease) and provision of lifestyle advice and support. This prospectus sets out the way we can 4 Camden and Islington Healthy Living Pharmacy Prospectus
develop a group of highly motivated healthcare professionals to move to centre stage in the emerging public health delivery system for the 21st century. A number of pharmacies across Camden and Islington already provide services that are relevant to the HLP programme, such as stop smoking services and minor ailments services. As we launch the HLP programme locally, the commissioning arrangements for these services will not change in the short term. Yet the future development of HLPs will aim to further improve the quality and coverage of such locally commissioned services. Experience elsewhere shows that being a HLP can be good for business, be personally and professionally rewarding for you and your teams and can impact positively on the health of local residents. To be a HLP will require a commitment to, and demonstration of, proactive engagement with both the community you serve and with other healthcare professionals. It will also require a change in ethos and effective leadership both within and beyond the community pharmacy team. This prospectus provides you with more detail on how we currently view the development of HLPs in Camden and Islington. Your input into the programme is welcomed, either as part of our engagement events, though your Local Pharmaceutical Committee or by emailing CIHLP@islington.gov.uk Finally, I would like to invite you, as a valued member of the primary care team and public health workforce, to participate in this exciting programme and apply to become a HLP. Julie Billett Joint Director of Public Health, Camden & Islington 5
Introduction The public health White Paper Healthy Lives Healthy People published in 2010 recognised the contribution that Community Pharmacy can make to the delivery of public health services. A Healthy Living Pharmacy delivers a broad range of services reliably and consistently by teams that are proactive in supporting health and wellbeing in the heart of communities. Healthy Living Pharmacies aim to inspire the provision of high standards of service delivered by dedicated teams working in pharmacies at the heart of each community. The introduction of the Healthy Living Pharmacy programme in Camden and Islington marks the beginning of an exciting journey which will give all local community pharmacies the opportunity to gain the quality mark* that indicates they are a Healthy Living Pharmacy. We, as commissioning partners, believe that Healthy Living Pharmacies are good for community pharmacy, good for contractors and good for the public. Having seen the results of Healthy Living Pharmacy programmes elsewhere, the Camden and Islington public health department has agreed to provide the resources to lead implementation of Healthy Living Pharmacy in Camden and Islington. That development is being undertaken in partnership with Camden Clinical Commissioning Group and Islington Clinical Commissioning and Camden and Islington Local Pharmaceutical Committee. The aim of all Healthy Living Pharmacy activity will be to benefit patients and the public who will remain at the centre of all that is offered at the pharmacy. Healthy Living Pharmacies in Camden and Islington will deliver health and wellbeing services reliably and consistently based on an interventionist Health Promotion ethos instilled by the training required to become an HLP. The entire pharmacy team will be informed and aware of all services offered by their pharmacy. When the need arises, teams will be able to offer advice and support patients effectively with accurate signposting and referral to services both inside and outside the pharmacy. The whole team will work together to deliver important health messages and advice as part of their normal day-to-day activity. Healthy Living Pharmacies will display a quality mark of excellence that gives members of the public the assurance that anyone accessing services in a Healthy Living Pharmacy will enjoy high standards of service and care. 6 * The Healthy Living Pharmacy Quality Mark is the logo shown on the front cover of this prospectus.
Background - the new NHS Following the introduction of the Health and Social Care Act, several organisations are responsible for planning, buying and monitoring health and well-being services locally: Clinical Commissioning Groups (CCGs) are made up of local GPs, nurses and other professionals who work together to commission hospital and most community health services Local authorities are responsible for tackling many public health issues including lifestyle issues such as obesity and smoking but also services such as substance misuse, sexual health and contraceptive services NHS England commissions primary healthcare services provided locally and some specialist national services, such as cancer care. This system is coordinated locally by Health and Wellbeing Boards, which bring together the agencies above to plan services that meet both the health and social care needs of the local community. All commissioning partners have aims and objectives designed to improve the health of local people. It is envisaged the Healthy Living Pharmacies will contribute to fulfilling these objectives. 7
What are the health needs of our local populations? In both Camden and Islington, the priorities for all local commissioner organisations are driven by local health needs. The main causes of death in both boroughs are cancer, cardiovascular disease and respiratory disease. These and other diseases are the cause of significant ill-health, resulting in increased use of health and social care services. They are caused by, or modifiable by, lifestyle factors such as smoking, obesity, drug and alcohol misuse, risky sexual behaviours, poor diet and low levels of physical activity. A detailed assessment of the health, wellbeing and social care needs for Camden and Islington are set out in the respective boroughs Joint Strategic Needs Assessment, which are available online at the web addresses below: Camden: camden.gov.uk/jsna Islington: evidencehub.islington.gov.uk/yourarea/jsna 8 Camden and Islington Healthy Living Pharmacy Prospectus
How Healthy Living Pharmacies can contribute to improving the health of the population A significant amount of the burden of ill-health could be avoided if the right interventions were made at the right time. Community pharmacies have an important role to play in engaging with the public, either to provide these interventions or to assist the public in their awareness and use of these services elsewhere. As indicated in the foreword to this prospectus, community pharmacies are well recognised by local communities and are easily accessible to local people, including those who do not seek other sources of health care. A Camden and Islington Healthy Living Pharmacy will provide more than just a range of health and wellbeing services; it will be a place where the public feel they are guaranteed high quality advice, consistent service delivery and have access to a highly-qualified healthcare professional when they need it. The public will recognise that the team working in a Healthy Living Pharmacy will provide good, reliable advice about leading a healthier lifestyle coupled with a commitment to improving general health and wellbeing. Those pharmacies awarded Healthy Living Pharmacy status will be able to display a logo that is becoming increasingly recognised by the public as an indicator of quality. 9
What is special about a Healthy Living Pharmacy? A Healthy Living Pharmacy: is identifiable to the public and other healthcare professionals proactively promotes healthy living and wellbeing as a core activity seeks to reach out to the local community and to work in partnership to improve health in the local area has a pharmacist lead who manages the pharmacy team with enhanced skills in leadership and the management of change has Healthy Living Champions consistently delivers a range of contracted and commissioned NHS services of high quality maintains premises to a high professional standard, with private consultation facilities and with appropriate IT availability and accessibility works closely with other healthcare providers, proactively and reactively. 10 Camden and Islington Healthy Living Pharmacy Prospectus
Why should your pharmacy become a Healthy Living Pharmacy? Healthy Living Pharmacies will become access points of choice for patients seeking solutions to their health and wellbeing needs the public s awareness of community pharmacy s breadth of health and wellbeing services will be increased the pharmacy will be able to demonstrate to commissioners its capability to improve health and wellbeing the pharmacy will have recognisable branding that represents excellent quality to the public and health professionals the engaged and motivated pharmacy team will be able to deliver proactive health and wellbeing interventions the pharmacy team will have increased involvement and engagement in the work of the pharmacy Healthy Living Champions will be part of the pharmacy team and will have skills to support development of their role the pharmacy will have enhanced engagement and collaboration with other health professionals the pharmacy will contribute to the spread of good practice across the wider community pharmacy network. 11
Where do your current pharmacy services fit? There are many services provided by community pharmacies across Camden and Islington; some of these are provided as part of the current national contractual framework, and others are commissioned locally to meet identified needs - the Locally Commissioned Services (LCS). Essential Services must be delivered by all pharmacies, as detailed in the current contractual framework: Dispensing Repeat dispensing Supply of appliances Disposal of unwanted medicines Support of public health Signposting Support for self-care Clinical governance The provision of these services sits as a core requirement of the Healthy Living Pharmacy framework. Advanced Services are delivered by pharmacists who are appropriately accredited. Healthy Living Pharmacies will embrace the opportunities to maximise the benefit of Medicines Use Reviews (MURs). MURs can help meet treatment goals by supporting patients in gaining the intended benefit from their medicines. Effectively delivered and targeted MURs have demonstrated improved adherence to treatment. Evidence from five anonymised MURs will be required for accreditation. 12 Camden and Islington Healthy Living Pharmacy Prospectus
The New Medicines Service provides support for people with certain long-term conditions newly prescribed a medicine, to help improve medicines adherence. Healthy Living Pharmacies will embrace this new service to ensure the public gets the most from their new medicines. Locally Commissioned Services - a range of services are commissioned locally by both local authorities (through public health) and by CCGs. We want to increase the number of people making community pharmacies their provider of choice for the management of certain ailments, the promotion of self-care and support to live healthier lifestyles. Pharmacies are also well placed to offer service provision opportunistically and at a time that is right for members of the public. We will expect Healthy Living Pharmacies to be active participants in a number of these services. A Healthy Living Pharmacy will be required to provide two core services (currently the minor ailments service and the stop smoking service) and at least two other Locally Commissioned Services. Healthy Living Pharmacies will use the opportunities in nationally or locally commissioned services as a platform to offer and refer to other relevant services as well as delivering public health awareness messages and healthy lifestyle advice 13
The importance of a trained and informed team The most important person in a pharmacy is the first point of contact. Implementation of the Healthy Living Pharmacy framework requires education of the whole pharmacy team. Healthy Living Pharmacies will have highly skilled, informed teams that can speak with knowledge and understanding of the services they offer at their pharmacy, provide appropriate advice, and signpost correctly. The team will be able to deal appropriately with requests of a personal nature. Services will be offered in a non-judgmental manner and according to service specifications. In the event that their accredited pharmacist is absent, Healthy Living Pharmacy teams will know where services can be accessed, and signpost accordingly. It is important to remember that continuity of service is important to the public and commissioners. Therefore, pharmacy managers and contractors are expected to take responsibility for ensuring that new pharmacists and staff are appropriately trained to continue the leadership and health promotion activities. Leadership in the pharmacy To lead the team and ensure the adoption and development of the ethos of the Healthy Living Pharmacy, the pharmacy manager will undertake appropriate leadership training to increase their skills in workforce development. Two training courses designed for Healthy Living Pharmacy are available; pharmacy managers and contractors can choose which to use. The Leadership for Healthy Living Pharmacy e-course is available from the Centre for Pharmacy Postgraduate Education s website: www.cppe.ac.uk/learning/programmes. asp?format=e&id=47&theme=31 Leadership Training for Healthy Living Pharmacy is available from the National Pharmacy Association. Information is available at the website below: npa.co.uk/developing-teams-careers/npa- Learning/Leadership-Training-for-Healthy- Living-Pharmacy Pharmacy leaders interested in developing their leadership skills may wish to complete further training. 14 Camden and Islington Healthy Living Pharmacy Prospectus
Role of the Healthy Living Champion Pharmacy managers will need to identify nonpharmacist members of the pharmacy team who have the motivation to become Healthy Living Champions. Healthy Living Champions will actively promote healthy living and lifestyle support services to both the public and other members of staff. The pharmacy manager will work with the Healthy Living Champion(s) to identify the activities which will best match the needs of their community with services offered by the pharmacy. Pharmacy managers are encouraged to train more than one Healthy Living Champion to ensure continuity, particularly where part-time staff are employed. Why do you need Healthy Living Champions? Healthy Living Champions will have a nationally recognised qualification allowing them to deliver brief interventions (where appropriate), healthy living advice and refer or signpost to into specialist services as appropriate. Healthy Living Champions also provide an excellent opportunity not just to engage with customers, but reach out to the communities and community organisations in the areas you serve. Training of a Healthy Living Champion The minimum qualification for Healthy Living Champions in Camden and Islington is the Royal Society of Public Health Level 2 Award Understanding Health Improvement. Information about the qualification and training providers is available at the address below: rsph.org.uk/en/qualifications/qualifications/ qualifications.cfm/level-2-award-in- Understanding-Health-Improvement Motivated staff may wish to complete further training to complement this core requirement. 15
What do Healthy Living Champions do? Managers within a pharmacy should consider what activities they should ask their Healthy Living Champion to undertake to best meet the needs of their community and services offered by the pharmacy. To help with this, it is expected that a Healthy Living Champion would be engaged in some or all of the following: work with the whole pharmacy team to develop ideas on how the pharmacy can be more proactive in improving health and wellbeing; making the most of every interaction as an opportunity for an intervention take an active role in delivering the health and wellbeing services provided by the pharmacy be available to advise customers and patients about health and wellbeing be able to signpost customers and patients to health and wellbeing services, both within the pharmacy and outside develop different health and wellbeing campaigns in line with local health priorities and develop a health zone in the pharmacy take responsibility for keeping health promotion materials up to date and sourcing new leaflets and posters from organisations with an interest in public health develop window displays to attract the public into the pharmacy and increase use of health and wellbeing services consider whether the pharmacy is a healthy workplace and propose ideas to make it healthier for the staff that work within it complete an audit of the difference they are making. 16 Camden and Islington Healthy Living Pharmacy Prospectus
How does your pharmacy become a Healthy Living Pharmacy? Before a pharmacy can be considered as a Healthy Living Pharmacy, it must already be achieving the standards required and be active within the contractual framework for Essential and Advanced Services. The pharmacy must also adhere to all standards set out by the General Pharmaceutical Council. In addition there will be a set of locally assessed quality criteria that pharmacies must meet in order to be accredited as a Healthy Living Pharmacy. The details of these requirements will be set out in a separate Quality Criteria and application documents that will be available in the coming weeks. However, the broad requirements are set out below. Requirement Healthy Living Champion (a non-pharmacist staff-member) HLP Leadership (by a pharmacist or non-pharmacist manager/supervisor) Internet Connection to relevant computers Medicines Use Review New Medicines Service Locally Commissioned services Community engagement Evidence Enrolment and completion of Royal Society Public Health Understanding Health Improvement Level 2 Award. Certificate from approved training organisation (i.e. CPEE or NPA), as detailed on page 14 of this prospectus. Self-declaration. Active and consistent delivery self declaration and evidence. Active and consistent delivery self declaration,0 (to be reviewed in line with national review of NMS). The pharmacy must be active in delivering two core services (currently minor ailments service and stop smoking service), plus two other services locally commissioned by Camden and Islington public health, or their local CCG. Your pharmacy must demonstrate engagement with local healthcare teams and the local community, for example, GP practices and community groups. 17
Find out more The Centre for Pharmacy Postgraduate Education has produced an extended e-course on Healthy Living Pharmacy available online at: www.cppe.ac.uk/learning/details. asp?templateid=hlpintro-e-01&format=e &ID=115&EventID=42389 The National Pharmacy Association has produced resources for Healthy Living Pharmacies available online at: npa.co.uk/business-management/ Service-Development-Opportunities/ Healthy-Living-Pharmacy/HLP-Resources An evaluation of the Healthy Living Pharmacy Pathfinder Programme is available online at: www.instituteofhealthequity.org/ projects/evaluation-of-the-healthyliving-pharmacy-pathfinder-workprogramme-2011-2012 18 Camden and Islington Healthy Living Pharmacy Prospectus
Apply to become a Healthy Living Pharmacy In order to be awarded Healthy Living Pharmacy status the pharmacy must meet the criteria detailed in the Quality Criteria and Service Requirements (available by the end of March 2014). When you as a pharmacy team feel ready to become accredited as a Healthy Living Pharmacy you may complete the application form to become a Healthy Living Pharmacy. The HLP Accreditation Panel will give you a date of assessment for your application within one month of receipt. 19
Summary CCGs and Local Authorities are committed to supporting pharmacies to optimise their contribution to public health and reward them appropriately through remuneration for Advanced and Locally Commissioned Services. Camden and Islington public health department is leading the implementation of Healthy Living Pharmacy in Camden and Islington. That development is being undertaken in partnership with Camden Clinical Commissioning Group and Islington Clinical Commissioning and Camden and Islington Local Pharmaceutical Committee. We would like you and your team to be part of this exciting development.we would like you to be part of this exciting development. We will issue quality criteria and service requirements in a few weeks time, which will give details of exactly what pharmacies must do become Healthy Living Pharmacies. We look forward to receiving applications from community pharmacies in Camden and Islington to be awarded their Healthy Living Pharmacy quality mark. Contact us To comment on this prospectus, or keep up to date on the proposed Healthy Living Pharmacy programme for Camden and Islington please contact Paul Fox, Deputy Director of Public Health at CIHLP@islington.gov.uk You can also speak informally about the programme with: - Yogendra Parmar, Camden and Islington Local Pharmaceutical Committee on 07737 081273 - Brian McKenna, Islington Clinical Commissioning Group on 020 3688 2942.