Public health services
Public health services
The UK home countries all commission national public health services through their respective community pharmacy contracts. There are differences in the balance between nationally commissioned and locally commissioned services.
The four countries
In England, there are two public health services as part of the essential services: the Healthy Living Pharmacy and Public Health (Promotion of Healthy Lifestyles). Pharmacies in England can opt in to provide four of the national advanced services:
- NHS Seasonal Flu Vaccination Programme
- Smoking Cessation Service
- Hypertension Case-Finding Service
- Hepatitis C Testing Service.
Wales includes public health campaigns as an essential service.
In Scotland, the Public Health Service (PHS) is a core community pharmacy service with four requirements:
- Ensuring that there is a health-promoting environment in the pharmacy including promoting national campaigns using a combination of window posters, promotional materials and staff training
- Offering a sexual health service (EHC)
- Offering a smoking cessation service
- Offering access to prophylactic paracetamol for childhood vaccinations where appropriate.
In Northern Ireland a Living Well service provides key public health messages and advice and nearly 300 pharmacies offer flu and Covid-19 vaccination.
Additional public health services are also commissioned locally throughout the UK. In England, for example, locally commissioned public health services include Alcohol Screening & Brief Intervention, EHC, blood borne virus screening.
Terminology in public health
Different terms can be confusing so what follows is a summary of the meaning of relevant public and population terms.
Public Health is defined as “the art and science of preventing disease, prolonging life and promoting health through the organised efforts of society”.
Population Health is an approach aimed at improving the health of an entire population. It is about improving the physical and mental health outcomes and wellbeing of people, while reducing health inequalities within and across a defined population. It includes action to reduce the occurrence of ill-health, including addressing wider determinants of health and requires working with communities and partner agencies.
Population Health Management is an “emerging technique for local health and care partnerships to use data to design new models of proactive care and deliver improvements in health and wellbeing which make the best use of the collective resources”. Population health describes an approach that can be applied across all of healthcare, while public health takes a broader approach across the whole of society, including in healthcare.
Pharmaceutical Public Health (PPH) has been described as “the application of pharmaceutical knowledge, skills and resources to the science and art of preventing disease, prolonging life, promoting, protecting and improving health for all through organised efforts of society”.
Integrated Care Systems (ICSs) are “geographically based partnerships that bring together providers and commissioners of NHS services with local authorities and other local partners to plan, co-ordinate and commission health and care services”. Although they have been developing for several years, they only became statutory organisations in July 2022.
Community pharmacies are part of Primary Care Networks (PCN) which are groups of general practices in local areas serving patient list sizes of 30-50,000 and working together with community, mental health, social care, pharmacy, hospital and voluntary services to meet local health needs. ICS and PCNs are geographies used in England.
Nationally, the Inclusive Pharmacy Practice (IPP) (a joint initiative by NHS England with the Royal Pharmaceutical Society and the Association of Pharmacy Technicians UK (APTUK) and 13 other national partner organisations) is increasing the focus on pharmacy teams engaging with local communities, helping to improve their health and addressing inequalities, particularly among those from ethnically diverse and disadvantaged backgrounds. It also focuses on making the workplace more inclusive for pharmacy professionals, through having greater awareness, acknowledgement and understanding of religious and cultural beliefs and attitudes, with senior leadership that reflects the diversity of both the pharmacy technician and pharmacist professions.