creating new roles for community pharmacy

Scotland already enjoys one of the most equitable pharmaceutical care systems in the world. However, Delivering for Health highlights the importance of using community pharmacy as a provider of healthcare to promote health improvement and using pharmacies as 'walk-in' healthy living centres where care services can be provided.

For Lothian, this shift to aid the health improvement agenda within communities encourages the use of 178 locations throughout the region for delivery of public health messages and interventions. Pharmacists are already public health practitioners and have an input to make in many public health related areas. These vary depending on local needs and arrangements but can include advice and support on lifestyle changes (smoking cessation, healthy eating), sexual health (emergency hormonal contraception, chlamydia testing), cancer prevention and screening (oral health, safety in the sun), travel health, immunisation and many more areas. To allow the development of the role of pharmacists in provision of pharmaceutical care as described in Delivering for Health, a new NHS contract for services has been and continues to be developed.

While pharmacies will continue to concentrate on dispensing prescription medication and selling medicines over the counter, this new contract contains four strands promoting better health.

1. Minor Ailment Service

This is the provision of a service which allows community pharmacists to treat common conditions and ailments on the NHS, enabling patients who are exempt from prescription charges (excluding pre-payment certificates) to use their community pharmacy as the first port of call for the treatment of such conditions. This improves access to treatment for minor ailments, particularly for patients who don't pay for their prescription to treatment for minor ailments.

2. Public Health Service

The service involves a two-tiered service. It requires more pro-active involvement of pharmacists and their staff in supporting self care, in making pharmacies more of a health promoting environment, offering opportunistic interventions to promote healthy lifestyles and contributing to national and local campaigns. There are core elements to this service plus an optional element relating to health promoting windows/frontages. This option involves use of the window/frontage space of the pharmacy by the NHS to promote health and health improvement messages via four national campaigns run annually.

3. Acute Medication Service

This is the provision of pharmaceutical services for acute prescriptions, based on current dispensing and counselling services and is similar to the current dispensing service for prescriptions.

4. Chronic Medication Service

This is the continuity of pharmaceutical care for patients with long term conditions and brings together serial dispensing (repeat dispensing), the pharmaceutical care model schemes and supplementary prescribing. It provides potential to provide care to patients with long term conditions at a local, accessible level.

Additional services can be negotiated locally, based on requirements of a local area, for example methadone supervision, needle exchange, oxygen provision, smoking cessation services and provision of emergency hormonal contraception.

The planning of pharmaceutical care services within NHS Lothian will be determined by the Pharmaceutical Care Services Plan that will be a statutory requirement for each NHS Board. Public health will support this plan through its input into the pharmaceutical needs assessment required in the coming year as part of the plan. This will ensure that the services provided in NHS Lothian meet the pharmaceutical needs of the population for all 4 strands of the new contract. This means that equity of access and adequate provision of pharmaceutical care will occur in the provisions for the new contract. The development of these new services is underway with the minor ailment scheme and public health service already in place. The acute medication service and chronic medication service are planned for implementation in 2007.