Report highlights potential of pharmacy sector in tackling health inequalities
The report from Optum identifies the barriers holding the pharmacy sector back from an enhanced role in addressing health inequalities and issues recommendations to allow the sector to take a more prominent role in tackling persistent disparities.
A report from health service innovation company, Optum, has called for an enhanced role for the pharmacy sector to help drive progress on health inequalities. The report, Action on health inequalities: Perspectives from the pharmacy profession, finds that there is an appetite within the sector to contribute more to the health inequality agenda, but that it is stymied by systemic issues and day-to-day challenges which make it difficult to go beyond day-to-day functions.
The report describes the key insights garnered from a roundtable discussion that took place in October 2023. Around 30 senior pharmacy professionals attended the roundtable from across primary and secondary care, integrated care board (ICB) leadership and community pharmacy to answer the question “how can pharmacy and medicines teams take a leading role to close the gap on health inequalities in their communities?”.
Participants were asked to give their views on a range of subjects, including how to define pharmacy’s role in tackling health inequalities; the opportunities for pharmacy professionals to achieve better outcomes for marginalised groups; the barriers from preventing pharmacy from making a broader contribution within their integrated care systems; and possible measures that would enhance the sector’s influence on the health inequalities agenda.
The report makes five recommendations to the pharmacy sector around how it can be empowered, and its role enhanced to help deliver health inequality improvements. These are:
- Create a stronger, system-wide understanding of the value pharmacy can bring.
- Achieve greater coherence and impact by building a single professional voice.
- Give pharmacists the means to make better use of data in a safe, smart and sensible way.
- Enhance the training and continuous professional development opportunities available for pharmacists.
- Put patients and citizens at the heart of everything we do.
Reframing the value of pharmacy
Pharmacy and medicines management have assumed increasingly prominent roles in recent years, and the two have been placed at the heart of the drive to improve preventative services and tackle health inequalities in the NHS in both the Major Conditions Strategy and NHS England’s Core20PLUS5 programme.
However, the report finds that pharmacy’s potential impact on health inequalities is hampered by the fact that medicines management is too often perceived as a “cost-saving opportunity” by NHS England and ICB financial teams. It calls for a reframing of the debate around pharmacy’s offering, arguing it should centre on the role of pharmacy in creating value for systems, rather than a short-term approach focusing on cost-reduction.
While short-term savings can be found in many areas, the report finds that these savings could be eclipsed were substantive action on health inequalities taken today. It cites figures that the cost of socio-economic inequalities to the NHS acute sector is £4.8bn every year, while people in the most deprived fifth of neighbourhoods account for 72 per cent more emergency admissions than the most affluent fifth. Addressing these trends, the report contends, would contribute more to the health inequalities agenda than any efficiency savings could over the long-term.
The report notes that ICSs, through the work of integrated care partnerships (ICPs), have a clear mandate to reduce the health inequalities gap and that pharmacy has a key role to play in achieving this. However, it identifies a lack of influence of the pharmacy profession at senior levels within ICSs, typified by the fact that not all ICSs have appointed a Chief Pharmacist and not all have full board representation. The report calls on the pharmacy sector itself to organise and come to resemble a single, coherent professional group to strengthen its voice and the impact of its advocacy. It also suggests that the development of “pharmacy collaboratives”, mirroring structures that exist in the provider and primary care sectors, would help the sector to improve its collective presence and impact.
Among other barriers discussed was the sector’s ability to access high-quality patient data from which it can generate meaningful population intelligence about specific cohorts or groups. Data linkage – drawing together data from multiple sources – was identified as being of particular concern, but this remains a troublesome issue across many ICSs. It was noted, however, that data alone cannot tell the whole story about a patient or population group, and that data insights must be paired with community intelligence and co-production to develop truly impactful interventions that will shift the dial on health inequalities.
In his foreword to the report, Chief Medical Officer at Optum UK, Dr Martin McShane, said: “My experience has shown me that the pharmacy profession is one of the NHS’s hidden jewels: agile, inventive, wholly focused on the needs of their patients, pharmacists do so much across primary and secondary care to keep people safe and supported. The recognition they are now getting — as key agents in the national drive to address health inequalities and drive up-stream improvements in preventative care — is both long overdue and a testament to their unique skill set.
“Yet if we want our pharmacist colleagues to make the fullest possible contribution to this agenda, we need to do something the NHS hasn’t always been very good at over the course of my career. And that is, to listen to them, act on their concerns and make them a genuine partner in change.”
The full report can be accessed here.