HLP Newsletter - January 2019
UK Health Security Agency sent this bulletin at 11-01-2019 09:53 AM GMT
Gul Root
National Lead Pharmacy Public Health
Health Intelligence Division
Public Health England
Welcome to the January 2019, winter edition of HLP Newsletter.
I am so proud and thrilled that so many community pharmacies have progressed to Level 1 HLP status either through the profession-led self-assessment process and have registered with the Royal Society for Public Health or through the Local Authority accreditation system. There are now just over 9400 HLPs across the country. What a great achievement this is!! This also means that there are at least 9400 qualified health champions on site reaching out to their local communities both within the pharmacy and the local community to help improve their health. Who would have known that when HLPs were first initiated in Portsmouth in 2009, led by the then Director of Public Health, Dr Paul Edmondson Jones, working alongside other colleagues, that we would have 9400 HLPs across the country in 2018. I am so proud of this achievement. Well done to all those pharmacy teams who have believed in the HLP concept, invested time, effort and resources to satisfy all the requirements for becoming a level 1 HLP. We now need to see how this translates into better health for your local communities, as that is what becoming HLPs is about.
You will be aware that one of the Secretary of State’s priorities is prevention. He published his vision for prevention, Prevention is better than cure: our vison to help you live well for longer, on 5 November 2018, which sets out the kind of prevention interventions he is keen to see. Now is the time for HLPs to step up their prevention interventions at scale and demonstrate how HLPs, with their qualified health champions on site, could contribute to the Secretary of State’s priorities. Some evidence of this would be very beneficial.
The NHS Long Term Plan which was published on the 7 January, provides significant opportunities for pharmacy teams working in all sectors. They will play a pivotal role in supporting the delivery of the plan - from pharmacists working in the community, GP practices, hospitals, care homes and urgent care. The Plan recognises the important contribution that pharmacy teams can make to the prevention agenda.
The plan has identified cardiovascular disease (CVD) as a new clinical priority for the NHS to focus on over the coming years. Given that a quarter of all deaths are attributed to CVD, which we know is largely preventable, the plan calls for a greater focus on prevention, early detection and management of high risk conditions such as atrial fibrillation, hypertension and high cholesterol. The plan proposes that we could prevent 150,000 heart attacks, strokes and dementia cases by increasing our efforts in this area over the next 10 years.
Engaging in CVD prevention can bring major benefits for people’s health and cost savings for the health and care sectors. I will be working with the CVD programme team in PHE to embed pharmacy in the CVD programme. This should provide opportunities for both community pharmacy teams and pharmacists within GP practices in CVD prevention, which potentially could also contribute to integrated working between the sectors.
As always, please keep us informed about any innovative delivery models or new developments that you think others could learn from, as well as any challenges you may be experiencing. You can email us hlpnewsletter@phe.gov.uk.
Keep up the great work that you are all doing, reaching out to communities providing health promoting messages, which help to improve the health of your local communities.
Greg Fell
Chair of the Healthy Living Pharmacy Task Group of the Pharmacy and Public Health Forum
Director of Public Health, Sheffield City Council
We have worked quite hard on redeveloping the criteria and standards for Level 2 HLP status over the last few months. A task and finish group has been set up to revise the original work that was done five years ago. We expect to publish it by Summer 2019. We hope this will provide the basis for continuing to develop the HLP concept and provide a strong basis for pharmacies to be commissioned to deliver a wide range of public health services that will improve the health of the communities they serve and are of interest to everybody. It’s well known that pharmacies have a footfall that other providers can only envy at; we should all take opportunities to explore these fully.
Participation in the HLP concept continues to go from strength to strength. There are now more than 9400 pharmacies participating in the scheme, more participate than not, it seems like it’s becoming the new normal.
The publication of the NHS Long Term plan and the forthcoming green paper on prevention should help to further underline the role of pharmacy teams in delivering on prevention and primary care development.
Almost all areas of the country have a continued focus on social prescribing. The look and feel of this will vary from place to place, as will be opportunities for pharmacy teams to participate and become involved. I would strongly encourage you to go talk to your local Director of Public Health to explore the opportunities for pharmacy teams being involved in this, if you aren’t already doing so.
The MECC approach in community pharmacy
Making Every Contact Count (MECC) is an approach to behaviour change that uses the millions of day-to-day interactions that organisations and people have with other people to support them in making positive changes to their physical and mental health and wellbeing.
The Yorkshire and Humber MECC Community of Improvement (CoI) have been working with Community Pharmacy West Yorkshire to align the MECC approach with the broad range of health improvement interventions that are already taking place within Community Pharmacy.
What has been done to date?
- Local Authority MECC Leads in Bradford, Wakefield, Kirklees, Leeds and Calderdale have worked in partnership with Community Pharmacy West Yorkshire (CPWY) to deliver a programme of MECC CPD events for Pharmacy teams to access over Summer 2018. Each CPD evening covered the core principals of MECC and showcased the local support services that are available in each of the Local Authority areas.
- The MECC CoI has commissioned the development of a short role modelling MECC film within a Pharmacy setting. This can be viewed on the Yorkshire and Humber Public Health Network website www.yhpnetwork.co.uk by searching for ‘Making Every Contact Count’.
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The MECC CoI has also developed a simple signposting tool called MECC Link mecclink.co.uk which enables HLP’s to embed and extend prevention and promotion of wellbeing and resilience into everyday practice, by providing:
- Easily accessible information on key healthy lifestyle topics
- Suggested open questions using the Ask, Assist, Act model
- Information on a range of primary Self-care tools and resources
- Signposting to recommended national and local support services.
Next Steps
Further work is underway to build upon the strong partnerships developed to date by making it easier for the MECC approach to be applied to a diverse range of Public Health Campaign resources going forward.
For further information please contact Chris Sharp, Workforce Development Manager, Public Health England Y&H: Chris.Sharp@phe.gov.uk
Free physical activity e-learning modules available on BMJ
The British Medical Journal (BMJ) is currently hosting 9 online modules on physical activity available for free until 1st April. We would encourage you to notify your Health Champions so that they can update their learning, where necessary and continue to advocate the importance of physical activity during appropriate healthy lifestyle consultations.
PHE runs free physical activity workshops
Public Health England is running free physical activity workshops for pharmacy teams in the North West. They are led by the new Physical Activity Clinical Champion, Lauren Worrall. She is a community pharmacist and works as part of the translational research group Community Pharmacy Patient Safety Collaborative. She has worked towards achieving Level 1 HLP status in her previous health centre pharmacy manager role and now focuses on supporting pharmacy teams inspire their communities to become more active. To stay healthy she plays tennis, boulders and runs.
Healthy Living Pharmacies have already shown they can deliver high quality innovative services when it comes to smoking, weight management and sexual health for example. The objectives of the physical activity workshops are to give the pharmacy team the latest current knowledge on the clinical benefits of physical activity and show how they can incorporate brief interventions in their own clinical and public health practice. The workshop is designed to give pharmacy teams the confidence to engage with and best support their community to engage in physical activity.
There is strong evidence that physical activity can prevent and manage over 20 different medical conditions including depression and certain types of cancer. Inactivity costs the UK economy up to £7.4 billion a year and can be attributed to one in six UK deaths. Given that there are 1.2 million visits to a pharmacy for health-related reasons every day, we need to ensure we make every contact count.
Look out for training sessions in your area but to book for your organisation directly contact lauren.worrall@phe.gov.uk or physicalactivity@phe.gov.uk.
2019 CVD Prevention Conference: save the date
The Cardiovascular Disease (CVD) Prevention Conference 2019: Saving Hearts and Minds Together will be held on Thursday, 14th February at the Old Trafford Stadium in Manchester. For more information, please visit the conference website.
CVD is one of the clinical priorities highlighted in the NHS England Long Term plan. This new focus on CVD prevention provides us with a tremendous opportunity to work together to prevent many thousands of heart attacks, strokes and dementia cases by scaling preventative interventions which we know work.
There will be particular focus on scaling up interventions for high risk conditions, such as high blood pressure, cholesterol and atrial fibrillation. As well as this, we will hear about community mobilisation to improve detection and management of these key risk factors and other non-communicable diseases. This includes research, evidence and evaluations, as well as sharing knowledge, innovation and learning.
Registration for the CVD Prevention Conference 2019 is now open here.
PharmacyEXPRESS "Walk After Work" event
Under the guidance of their manager, Kevin Duggan, Health Champion Leama Cheall and the pharmacy team at Pharmacy EXPRESS, Eaglescliffe have successfully run health campaigns that have significantly engaged the public. One of such campaigns was the Walk after Work event.
Walk after Work
Organisations worked with:
- MIND
- PHE
- Preston Park
Background
This event took place at Preston Park in the month of May, National Walking Month. The walk was an idea born out of the statistics of Stockton, which showed the “levels of obesity are higher than the England average1”, and one of the aims of Stockton council being to “reduce levels of obesity and increase levels of physical activity2”.
The idea was to have the public, particularly workers who might have sat in the office all day, get some exercise after work before going home. We hoped to show how easy it could be to exercise briefly with a brisk 10-minute walk.
With this aim in mind, the National Walking Month was a good opportunity to play our part.
Objectives
The objectives set out for the “Walk after Work” event were to:
- Motivate members of the public to increase their weekly exercise time.
- Increase the public’s knowledge of how a “brisk 10-minute walk” can be part of their daily exercise routine.
- Raise awareness of the NHS “Active 10” app to aid people during their walk.
Raise awareness of how exercise can help with mental health.
Method
A budget was set to organise and publicise the event on social media and in print. PHE were excited about the event and created a poster to help advertise it in the community and especially to local businesses.
The team collected leaflets and various information aids and distributed these during numerous patient engagements in store and during the walk.
The team actively used social media to advertise the walk and the response on Facebook was remarkable.
Results
Overall, the event was a huge success with the team engaging with over 100 people prior to and during the walk.
After each day, a survey was filled out by each participant. The results of the survey showed the following:
- 100% of participants where happy with the walk experience.
- 100% of participants gained some information about exercise during the walk.
- 80% of participants agreed that the walk has helped them realize that they can get their weekly quota of exercise by walking.
- 80% of participants will think about increasing their weekly exercise.
We believe this event contributed to meeting Stockton council’s objectives set out above. The team is excited and already looking through their years’ Health Campaign planner to organise more such events.
Reference: 1,2 - https://www.stockton.gov.uk/media/1384/joint-health-and-wellbeing-strategy.pdf
The value of clinical pharmacists in GP practices
By Karen Acott, Executive Partner, Wallingbrook Health Group
Pharmacists working in GP practices are growing in numbers and have a great opportunity to embed public health interventions in their daily practice. This can be both individually and as part of a wider primary care team approach.
As a pharmacist in GP practice, I see patients from all walks of life. Many will have one or more long term conditions, or care for someone that does. As pharmacists, we tend to focus on medicines optimisation and harm reduction. We often forget the value of conversation. During consultations, I allow my patients to lead the conversation and I try to listen to what they say. Very often, they wish to improve their health, take fewer tablets, stop smoking or lose weight – however, some people are not confident or have failed previously and lack the motivation to take the first step. I usually provide brief interventions and signpost, where I can, to my colleagues in community pharmacy and other third sector organisations or community activities.
In addition, as an independent prescriber, I manage patients with long term conditions, such as high blood pressure, diabetes and chronic pain, as well as minor illnesses. Therefore, public health interventions form part of my daily practice. This includes:
- Antibiotic stewardship – our practice is one of the lowest practices in the CCG that prescribe antibiotics.
- Helping patients reduce long term opioid medication, by ensuring that plans are in place to reduce high dose opioids over an agreed timescale.
- Increasing self-care – encouraging patients to monitor their own blood pressure at home and use more digital health tools e.g. blood pressure monitoring apps and fitness trackers to aid further increase in physical activity levels.
- Promoting the ‘5 ways to wellbeing’ and signpost patients to community activities that reduce social isolation e.g. walking groups and singing classes.
Many patients find the education provided around their medication one of the most useful discussions they have with me. By extending the conversation towards how they can improve their health and wellbeing, such as goal setting for some interventions (e.g. increasing activities through the ‘couch to 5K programme’, improving diet using the sugar swaps chart and connecting to the wider social networks within their communities) has the added benefit of contributing to the improvements of the health of their families and communities too.
Pharmacy "WELL" placed for healthy living
WELL Pharmacy, Kenton achieved Healthy Living Pharmacy status in October 2017, which was a steep learning curve for all the team. What changed for us as a pharmacy and what impact did it have on the local community? In reality the difference was the pharmacy team itself. Staff had renewed confidence, armed with knowledge from the health champion training and a clear vision of what was achievable.
The pharmacy’s Healthy Living Action Plan allowed each team member to focus on a health issue that resonated with them personally and would benefit the local community. Initiatives such as healthy eating and weight loss, in conjunction with the “Newcastle Can” campaign, were a great success. Significant results were recorded locally, as well as a personal result for a pharmacy team member with an 18kg weight loss!
Other successful campaigns included a consultation room turned into an area for alcohol awareness, and people completing questions via a scratch card. A mini holiday area during summer resulted in healthy conversations about skin cancer and safety in the sun.
Currently in the pharmacy we’re running a successful flu vaccination campaign and a Stoptober campaign, which includes referrals received from the local surgery.
WANTED: Sexual and reproductive health case studies
We are seeking case studies that demonstrate effective delivery of sexual health, reproductive health and HIV services within community pharmacies. We would like to know:
- What service you are delivering
- How you are delivering them
- What impact providing the service has had on the community
- Any barriers/challenges you may have experienced
Please send your case studies to hlpnewsletter@phe.gov.uk or email us for more information.
Health Champion Corner - Symia Gulfaraz
Symia Gulfaraz from Evergreen Pharmacy, Halesowen, Dudley.
Symia has always taken her role of Health Champion very seriously. She takes every opportunity to learn and then pass on her knowledge to people. All of her Health Promotion Zones displays have been handmade with enthusiasm and are always a talking point in the pharmacy.
This year the pharmacy held an evening event in the pharmacy where they talked about diabetes and Ramadan, inviting local GPs and pharmacists. Symia organised the whole event and designed posters to advertise. Her pharmacist gave a clinical talk about diabetes and the implications of fasting and then Symia gave a fabulous talk on healthy eating while fasting.
The campaign that Symia put together for Bowel Cancer involved Symia's own artwork plus she contacted Bowel Cancer UK and asked if they could supply resources - she received posters, leaflets, balloons and more. The campaign increased Symias own knowledge of the disease and whilst the campaign was running she recognised a patient with suspicious symptoms:
Mr S is a regular patient, always happy and beaming when he visits the pharmacy. He came in one day complaining about a bout of constipation and asked for something over the counter. Symia spoke to the patient, asking about his symptoms and then immediately called the pharmacist as she was concerned. The pharmacist asked if Mr S had experienced the symptoms before and was told no. He carried on talking and mentioned that his poo was ‘the colour of cardboard’. At this point, Symia said ‘Mr S, I suggest you see the Dr sooner rather than later. Please don’t leave it.’ The next day, the patient arrived with a prescription for Movicol. Symia and the pharmacist discussed the prescription and were actually quite relieved that perhaps they were being overly cautious. However, a few days later Mr S ended up in hospital with severe abdominal pain. He was unfortunately diagnosed with pancreatic cancer and was operated on within days. He had part of his pancreas removed during an emergency operation. He was very weak for a while and Symia often dropped off his medicines to him and his wife. Mr S came back to the pharmacy last week looking really well. He had put weight back on, and was his usual happy self. He kept thanking Symia and the pharmacist saying ‘This is where it all started, and I am so grateful to you!’.
Symia has also organised a Macmillan Coffee morning which raised £242. She made most of the cakes herself and even delivered cakes to people who were unable to get to in to the pharmacy!
Symia is now getting ready to hold talks at local colleges on sexual health and will be providing opportunistic Chlamydia Screens whilst she is there. She is also planning some ‘let’s walk together’ sessions for the local older people.
Michelle Dyoss, Public Health Specialist and Healthy Living Practice Lead and Director of Selph Consultancy, provided this quote: “I have been into this pharmacy on numerous occasions and every time I am there I see older people pop in just for a chat. The patients absolutely love her; she is a champion Health Champion.”
Know an exceptional Health Champion?
- Does your Health Champion go above and beyond to help your community?
- Do they take every opportunity and interaction to make every contact count?
- Do they show initiative and enthusiasm in their everyday work?
If you answered ‘yes’ to these questions and would like to nominate your pharmacy Health Champion to be featured in the next newsletter, email us at hlpnewsletter@phe.gov.uk. Please provide a few paragraphs on why you think they deserve to be featured and attach any photos that showcase them and their work.
Events & Campaigns
'HELP US HELP YOU' Campaign
Help Us Help You’ is a new overarching brand that brings together a family of campaigns incorporating messages about flu, staying well in winter, NHS 111, pharmacy and extended GP hours. It aims to help people understand how to navigate the NHS and get the right help and advice they need in the most timely and appropriate way.
The ‘Help Us Help You Stay Well This Winter’ campaign, which launched in September until the end of December, encouraged people most at-risk of falling seriously ill during the winter months to get the flu vaccination and to seek advice from their pharmacist at the first signs of feeling unwell. This campaign will be followed in February 2019 by a pharmacy campaign ‘Help Us Help You Before It Gets Worse’ that aims to encourage the public to use their local pharmacy as a first port of call for clinical advice and self-care treatment for minor health concerns. The campaign presents the pharmacist and pharmacy technician as a team of experts ready to give people the care and help they need.
To help encourage people in your community to visit your pharmacy for the flu jab, clinical advice and self-care treatment, we have created a range of digital resources which are available to download at: https://campaignresources.phe.gov.uk/resources
'Smokefree Health Harms' Campaign
The ‘Smokefree Health Harms’ launched on Friday, 28 December 2018, continues to encourage smokers to stop smoking in the New Year, by highlighting the immediate, irrefutable, personal harm every time you smoke a cigarette. The campaign features a TV ad that highlights how every cigarette you smoke causes poisons from the tar to enter your bloodstream and spread to every part of your body. There are a range of resources available for pharmacies to order and download at: https://campaignresources.phe.gov.uk/resources.
Plus, don’t forget to look out for other exciting campaigns launched by PHE this year, including a new mental health campaign called ‘Every Mind Matters’, launching in late Spring and a cervical screening campaign, launching in March.
Some recent updates
- Public Health England cardiovascular disease prevention initiatives, 2018 to 2019. This document demonstrates work that PHE is leading and involved with to help meet the challenge of cardiovascular disease in 2018 to 2019. You can read it here. The document follows publications from 2016 and 2017. As well as showcasing current projects and new resources, the publication updates on the progress of initiatives highlighted in last year’s Action plan.
- Better health for all: A new vision for prevention. PHE’s Chief Executive Duncan Selbie explains why the Secretary of State’s prevention vision is a transformative moment for public health. You can read the post here.
- Reducing salt to tackle preventable diseases. Our latest assessment of the food industry’s progress towards meeting salt reduction targets shows a mixed picture. Find out more about the progress that has been made to date here.
- Reducing health inequalities in mental illness. Read the latest edition of Health Matters, our professional resource, for advice on how to deliver and commission services for those with severe mental illness. You can read the post here.
- Change4life campaign was launched on 2 January 2019 and provides fun ideas to kids stay healthy.
If you have any suggestions or would like to be involved in an upcoming HLP newsletter or event, please contact Theresa Nguyen, Senior Pharmacy Programme Officer at hlpnewsletter@phe.gov.uk.