APPENDIX 31
Memorandum by Lloydspharmacy (OB 54)
1. INTRODUCTION
TO LLOYDSPHARMACY
1.1 Lloydspharmacy is the UK's largest community
pharmacy chain with over 1,350 pharmacies, offering widespread
access to healthcare services and advice. Over two million people
visit Lloydspharmacy each week and 90% of our business is directly
related to healthcare.
1.2 Our pharmacists and healthcare assistants
have daily contact with a large number of individuals seeking
help and advice on a wide range of health topics. This includes
information on general health issues, minor ailments, chronic
conditions and advice on the medicines used to treat such conditions.
We see individuals who are ill, those who are well and those who
are "apparently well". This daily access offers community
pharmacy a key opportunity to provide services that promote healthy
lifestyle and potentially identify individuals who are at high
risk of developing certain conditions.
1.3 Lloydspharmacy is fully committed to
exploring, developing and implementing professional services such
as prescription collection, repeat dispensing and medicines management
however we believe more can be done to maximise the skills of
our community pharmacists, to the benefit of the local communities.
Through various initiatives, Lloydspharmacy has demonstrated the
contribution community pharmacy can bring to raising the awareness
of certain conditions and helping to identify those affected.
During 2002 two services were introduced into a number of our
pharmacies. The "Blood Pressure Measurement Service"
was introduced across 250 of our pharmacies and the Type II Diabetes
Testing Service was launched in the three cities of Bradford,
Glasgow and Cardiff. Both services have been successful in highlighting
the risk factors associated with the conditions and both have
been well received by the local communities.
1.4 Many individuals have been identified
as being at risk of developing either hypertension or diabetes
and all have been given lifestyle advice. This included information
on healthy eating and physical activity. Others fell into the
"high-risk" category and following advice from our pharmacist
were referred to their doctor for further investigation. Early
results indicate that many of these individuals have subsequently
been diagnosed and are being treated.
1.5 In this way the most accessible healthcare
professional can help to raise awareness through effective health
promotion, counsel on healthy lifestyle and encourage positive
adjustment, help prevent the onset on certain conditions and help
identify people with undiagnosed conditions.
2. COMMUNITY
PHARMACY AND
TACKLING OBESITY
2.1 The National Audit Office Report on
Tackling Obesity outlines the alarming rate of growth of the condition
and by the year 2005, 20% of men and 25% of women will be obese.
As stated above, community pharmacy comes into daily contact with
a wide variety of people from all sections of the community and
in many cases the community pharmacist is the one healthcare professional
that many of these people have contact with on a regular basis.
2.2 Obesity is also linked to many serious
conditions including diabetes and coronary heart disease. Tackling
obesity is therefore vital if many of the key targets in the National
Service Frameworks are to be achieved. Lloydspharmacy believes
the community pharmacist, working with other healthcare professionals,
can play a significant role in a number of ways.
2.3 Firstly the biggest key to tackling
obesity is through prevention. Community pharmacy offers access
to health information to their local communities through the provision
of health education leaflets and in some cases by holding health
awareness days. Lloydspharmacy has produced a range of leaflets
covering a wide variety of topics such as "Your Diet and
Heart Disease" and "Your Diet and Diabetes". We
believe community pharmacy is an ideal channel to promulgate the
"health message" and would encourage the Government
to work in partnership with community pharmacy to fully take advantage
of its accessibility to the public and utilise the skills of the
pharmacist in areas such as obesity.
2.4 The next key element is to identify
individuals who are already obese, but have not yet started to
show signs of any complications. If these individuals can be motivated
to make adjustments in their lifestyle it can prevent the development
of serious conditions. As part of the Lloydspharmacy Type II Diabetes
Testing Service measurements of both body mass index (BMI) and
waist circumference are made and recorded. The pharmacist and
healthcare assistant can then offer appropriate advice on healthy
eating and physical activity. This could be considered as a precursor
to a more comprehensive service that deals specifically with obesity.
When talking about obesity we feel it is important to discuss
with patients the health-related risks of it. The BP and Diabetes
services offer the opportunity to do this and hence provide a
motivational tool to help individuals make lifestyle adjustments.
This service can be offered on a number of levels starting with
raising awareness and screening, up to a full weight management
service giving structured advice, agreement of targets and ongoing
support.
2.5 Help needs to be available to those
who are already overweight or obese and are being treated for
a related condition. Community pharmacists are in regular contact
with most individuals who have chronic conditions due to the frequency
of their prescriptions. This gives community pharmacy an ideal
opportunity to offer support and advice on a regular basis provided
through a programme centred on healthy eating and physical activity.
Further development into a structured health promotion programme
covering all elements of their condition including controlling
weight could also occur.
2.6 While the three elements above discuss
the implementation of services centred on healthy lifestyle, consideration
should also be given to the area of pharmacotherapy. In recent
years a number of treatments have been introduced to help those
individuals who find difficulty in losing the required amount
of weight for a healthier lifestyle. NICE guidance has placed
restrictions on their use to patients who have demonstrated that
they have made a serious attempt at weight loss. The guidance
also states that "arrangements should exist for appropriate
healthcare professionals to offer specific advice, support, and
counselling on diet, physical activities and behavioural strategies
to those receiving medication".
2.7 Community pharmacists can work in partnership
with their primary healthcare colleagues to provide a weight management
service that combines the use of medicines. Information can be
shared with the individual's GP, and where necessary, the pharmacist
can provide medicines management support for those prescribed
medication. This could be further developed through the use of
a Patient Group Direction, allowing the pharmacist to supply medication
directly to the patient. With the introduction of supplementary
prescribing community pharmacists can take over the management
of the patient following an initial diagnosis by the independent
prescriber.
2.8 Lloydspharmacy is introducing consultation
areas into each of our pharmacies, as we believe the introduction
of a wider range of professional services requires appropriate
facilities. This will provide a quiet area where individuals can
discuss any healthcare issues in privacy.
3. CONCLUSION
3.1 Lloydspharmacy welcomes the opportunity
to become involved in the discussions surrounding improvements
to obesity services.
3.2 Lloydspharmacy has demonstrated that
community pharmacy can provide a range of healthcare services
designed to raise awareness and provide support to those at high
risk of developing conditions such as hypertension and diabetes,
both of which are related to obesity.
3.3 The natural extension of these will
be the provision of weight management services with the focus
being on health improvement.
3.4 A range of services can be offered through
community pharmacy ranging from raising awareness, measurements
of BMI and waist circumference, as part of healthcare screening
such as blood pressure, cholesterol and diabetes, up to a full
weight management service with the possibility of supply of prescription
medication when appropriate.
3.5 For the maximum benefit to be derived
from these services Lloydspharmacy will encourage the development
of partnerships with other primary healthcare professionals.
3.6 Lloydspharmacy would encourage the Government
to fully engage with community pharmacy and maximise the skills
of the accessible healthcare professional, in this way a large
target audience can be reached, including those at risk of developing
long-term medical conditions.
| 
