From a concept in the 2008 Pharmacy White Paper, Healthy Living Pharmacy (HLP) was first developed in Portsmouth, then supported and nurtured through a pathfinder programme, an NHS reorganisation and two changes in Government. It is testament to community pharmacy and the gritty determination of a few that it has become the national quality mark it is today.
From the start it was clear that the sector must adapt to the ever-changing landscape in which it operates. Commissioners were and still are looking to pharmacy for more consistent delivery of high quality services as a solution to some of its worsening health inequality challenges and evidence that they provide good value for money.
Aside from the focus on improving the public’s health through proactive health promotion and engagement in the local community, HLP is built on principles of organisational development and change management. The core enablers of HLP are developing the workforce, the pharmacy environment and engagement with other providers, commissioners and the community – these are the fundamental elements of any good business development strategy. The outcome is having the right people with the right skills doing the right things to create excellence in customer experience, meeting a market need from premises that are fit for purpose and promoting what we do.
Becoming an HLP is just the beginning and if pharmacies stop at the point of self-declaration then nothing will change and the many benefits of HLP will not be achieved. What we do next to build further on these foundations will enable a healthier future for community pharmacy and the communities we serve.
What can you do now that you have achieved HLP accreditation?
- Understand your market opportunities – One of the HLP criteria is to understand local health needs and having done so, focusing on the priorities where pharmacy can have the greatest impact. This is your market research and should be constantly developed through broader engagement with your local community, commissioners and other providers of health and wellbeing services. The starting point is your local Joint Strategic Needs Assessment (JSNA) and Pharmaceutical Needs Assessment (PNA), both will be on your local authority website. Your local Health Profile also provides a snapshot of needs and priorities.
- Engage with others – Do not wait for someone else to do this, be proactive by opening and continuing a dialogue with local GP practices and other providers, CCGs and public health commissioners. Use open questions and active listening to understand their challenges to see where community pharmacy could offer an effective and cost-effective solution. As a minimum this builds relationships, facilitates understanding and 2-way referral that could lead to commissioned services and increased footfall. You should also speak to your LPC to understand what they are doing and how they can support you.
- Effective campaign planning – Use local relationships and connections to put together your health promotion campaign programme both in the pharmacy and out in the community; this makes a real difference and is both fun and effective in promoting the pharmacy and what it does. These activities can be linked into national campaigns such as those from Public Health England and the calendar of national campaigns hosted by NHS Employers. We are developing a Health Promotion Zone starter pack and a suite of campaign packs for 2018.
- Develop capability – A developed, engaged and motivated workforce is more productive and this has been frequently demonstrated in HLPs where teams deliver more. Having one full-time equivalent Health Champion is the minimum requirement for HLP, but many pharmacies have invested in this qualification for all their team who have patient contact, including their pharmacists and home delivery person, to grow their knowledge, skills and confidence. This will also improve customer experience, loyalty, footfall and job satisfaction resulting in increased productivity and retention. It is important that Health Champions and colleagues are empowered to undertake their role and this is where the ability to delegate appropriately and effectively is a critical leadership skill. Check out the training section of our website.
What next for HLP?
Whether HLP will remain in the Quality Scheme for 2018/19 has yet to be confirmed, but a healthier future is partly down to the sector itself and its ability to demonstrate what it can achieve and shape its own future in the ever-changing landscape. One of the reasons HLP has come this far, is the evidence that has been collected; we must continue to capture and demonstrate the difference we make.
If we explore the current NHS, public health and consumer priorities some future options could include:
- Consumer experience – the public’s expectations of the quality of their experience and accessibility to services continue to rise. People no longer buy product, they buy an experience which is the outcome of an interaction between an organisation and a customer over the duration of their relationship. The days of relying on quick turnaround of FP10s as a measure of customer service has moved on. A great HLP feels different, there is a buzz and a positivity about the experience which results from the ethos that the whole team live and breathe. Everything about the pharmacy including your premises, website, promotional materials and social media must reflect this ethos.
- Health interventions – Making every contact count (MECC) is an approach to behaviour change that utilises the millions of day-to-day interactions that organisations and people have with other people to encourage changes in behaviour that have a positive effect on the health and wellbeing of individuals, communities and populations. With an estimated 1.8 million contacts per day, pharmacy is well placed to implement this approach and make a difference in supporting people to stop smoking, improve their diet, increase physical activity, lose weight and reduce alcohol consumption.
- Risk assessment and management – the early identification of people at risk of hypertension, atrial fibrillation, diabetes, cancer and a range of other critical health risks based on your local health profile is an opportunity. This could be locally commissioned, but could also be a privately offered service covering health awareness, detection, prevention interventions and support and referral as appropriate. We would like to see a Quality Scheme criteria which pulls together the strength of the pharmacy workforce to make a tangible difference in outcome in one or more of these priority areas.
- Digital – community pharmacy must embrace technological advancement through integration, information and communication. Further embedding the use of smart recording of interventions and referrals or signposting in routine practice would be a great place to start. Some HLPs are using information screens in the pharmacy to promote healthy living messages, campaigns and services; tablet devices to engage and illustrate key health issues within proactive conversations then capture those interventions; and using their website and social media to promote what the local population and businesses can access from their pharmacy.
Whilst this a very challenging time for pharmacy contractors, the landscape in which community pharmacy is operating will continue to change. The sector and the profession must constantly adapt to these evolving needs to remain relevant and compelling to commissioners and consumers of our services. Becoming a Healthy Living Pharmacy is the beginning; it is not a bolt-on, it should be business-as-usual. Continual improvement and investment in quality and experience will remain a critical success factor for a healthier future for community pharmacy and our communities.