The webinar – hosted by NHSE&I in partnership with the Royal Pharmaceutical Society and the Association of Pharmacy Technicians UK – was the first of a series of events aiming to support the work of community pharmacists and their teams in providing a more tailored service within their local community.

It follows last year’s publication of a ‘joint national plan for inclusive pharmacy practice in England’, which according to Mahendra Patel, co-chair of the national improving practice and engagement board, aims to “address equality, diversity and inclusion across our daily working lives and across many parts of healthcare”.

It also aims to “deliver healthcare services that can be tailored more effectively to the needs of the local population that we are all serving”, he said.

Understanding these communities better is a vital step forward  in meaningfully combatting “decades of health inequalities”, Professor Patel added in an interview with C+D last year.

 

Live demonstrations

 

Last month’s webinar took a stab at that with a live demonstration of data-driven population health management tools and guest speakers from Day Lewis and Green Light Pharmacy, who touched upon how their respective pharmacy teams had tailored their offering to the local community’s needs.

“Many of our community pharmacies are already doing some great work as we know in this space,” Professor Patel – who chaired the webinar – explained.

“We want to showcase some of the tools that we have to help you understand the needs of the population better ”, he said, adding that he was keen to “open [pharmacy teams’] eyes” to the resources available to them in supporting inclusive practice.

 

Population health management tools “tell the story”

 

Sarah Preece – principal knowledge transfer facilitator for the Department of Health and Social Care’s local knowledge and intelligence service – kicked off the webinar with an explanation of population health management. The concept involves “looking at the health and wellbeing of an entire population when we're looking to reduce health inequalities”, instead of “the needs of the individual”, Ms Preece explained.

“It’s all about turning data into useful information so you can make effective decisions,” she said.

Data can reveal “at-risk cohorts or groups of the population” and can be used as a springboard “to design interventions to prevent ill-health or improve care appropriately”, she commented.

Population health management tools – such as Fingertips, Shape and Local Health – help to “translate the raw data into something that can be understood and interpreted in order to ultimately make those decisions”, Ms Preece explained.

They “provide quick and easy access to a huge range of data”, including “demographic information around age, sex, ethnicity”, “data around behavioural risk factors such as smoking prevalence or obesity or alcohol abuse”, and “diagnosis of different health conditions such as [chronic obstructive pulmonary disease]”.

Pharmacy teams can also find out “the rate of people accessing different services, such as diabetes or flu vaccinations” and get data on hospital admissions, mortality rates, “behavioural risk factors” and “areas of greatest deprivation”.

 

Digesting the information

 

Population health management tools make this breadth of information digestible in the form of “graphs and tables and maps”, and by “offer[ing] comparisons between different areas”, thus turning the raw data into intelligence which can “tell the story of [a] population” and inform the decisions pharmacy teams take to cater to their community’s needs.

Pharmacy teams, for instance, “can look at areas of [their] population where smoking prevalence, for instance, is higher, and target [their] activity appropriately”, Ms Preece said.

She encouraged pharmacy teams needing support or information around population health intelligence and tools to get in touch with their “local knowledge intelligence service team”.

Charlotte Bamford – principal knowledge transfer facilitator for the DH’s local knowledge and intelligence service – offered a live demonstration of Fingertips later in the webinar.

 

Day Lewis: Reversing diabetic conditions with tailored services

 

Although few community pharmacies have tried their hand at population health management tools, many have used more old-fashioned methods to tailor their care to their diverse local communities.

One such example is Day Lewis.

The chain’s executive director, Jay Patel, joined the webinar to describe how a pharmacist at their Tower Hamlets branch ran a diabetes clinic specially geared towards the area’s South Asian community.

The team used the healthy living pharmacy (HLP) framework to promote the health interventions available to the local community.

 

Although pharmacy owners were required to become HLPs by 2020/21 under the five-year community pharmacy contract, Mr Patel said Day Lewis “started on this journey of HLP about 12 years ago [in] 2010” as they “believed in the programme”.

Pharmacist manager Brian Hoppie, who has worked at the Whitechapel Day Lewis branch for about 30 years, “achieved a reversal of type 2 diabetes in 33 patients, predominantly South Asians of Bangladeshi origin”, Mr Patel said.

He started by giving a talk at the local mosque – attended by 200 community members – illustrating the cause-and-effect relationship between poor diet and diabetes prevalence.

Mr Hoppie was “overwhelmed by the response” he received after the talk and went on to work closely with several community members, developing a nutritional protocol that focused on cleaning up patients’ diets, encouraging them to exercise and introducing intermittent fasting, which he linked to their faith.

Patients adhered to the protocol alongside their conventional diabetes therapy.

Mr Hoppie’s success in establishing the programme was due to his “good understanding of the population, of their issues and how to communicate with them”, Mr Patel said.

“It’s a recipe that any community pharmacy across the country can engage in,” he continued. “They can target what they do around their local community needs.”

 

Green Light: Employ locally

 

Meanwhile, Nuhel Choudhury – a pharmacy technician and dispensary lead at Green Light Pharmacy – spoke about the virtues of recruiting locally.

Since there is a wide range of languages and dialects spoken in London, where the chain’s branches are situated, employing locally means that Green Light Pharmacy staff can often speak the local languages, Mr Choudhury explained.

Not only does the chain avoid having to employ translators to effectively communicate with their patients, he said, but Green Light Pharmacy teams have “extensive local knowledge”.

Mr Choudhury is himself “a local boy”, as he grew up close to Green Light’s Euston branch.

Like Day Lewis, Mr Choudhury and Green Light’s founder, John Foreman, visited a mosque in Euston to engage with their patients. They held talks there – “particularly on smoking cessation” – and invited community members to visit the pharmacy afterwards, which led to good uptake of services, Mr Choudhury said.

He also made use of his local knowledge by visiting the Bengali and Indian restaurants close to the Euston branch to perform NHS health checks.

Mr Choudhry knew “there were a lot of men aged 30 and above [working there] who would be eligible for NHS health checks [but] would never come into a pharmacy”, Green Light’s head of education, Simon Harris, explained.

“So […] we went into the kitchens, we spoke to the chefs, the waiters, the staff, and we invited them to come to our pharmacy,” he continued.

“And they suddenly were aware of what the pharmacy environment can offer.”

Mr Choudhury and Mr Foreman also held monthly health talks at the branch after the pharmacy closed on topics ranging from taking medication during Ramadan, to diet and diabetes and organised walks for their local communities to join.

 

“Walk a mile around the pharmacy”

 

Speaking more generally about how pharmacy staff can get to know the needs of their patients, Mr Harris said that Green Light encourages its new staff members to “walk a mile around [their] pharmacy” to get a sense of the communities, organisations, and businesses in its radius, as well religious groups and “community centres”.

“Some of the tools we've described this evening will help to really put some data on that,” he continued, on top of “what you see and what you hear with your own eyes and ears”.

 

How to share more widely?

 

Teams at Day Lewis and Green Light have not yet had the chance to try their hand at data-driven tools like Fingertips, but seem eager to do so.

“There's always more we can be doing and with his data, with these tools,” Mr Harris said of Green Light Pharmacy.

“We can really start to see some of the gaps we're not aware of.”

Mr Patel echoed Mr Harris in saying the tools would be particularly helpful “where it's not always obvious what the issues are” or when intersecting health inequalities “localised to certain parts of the neighbourhood [and] different parts of the same town have different issues and needs”.

The data intelligence to tools would ensure “the training of teams [is] more aligned with the conditions in those areas”, he added, and would help “match” pharmacists’ “passion” around certain conditions “with an actual need”.

Ms Preece said that integrated care systems (ICSs) and boards “are currently developing strategies around population health [and] improving health and wellbeing […], hopefully using the population health intelligence to do that, and looking at risk groups and targeting appropriately and developing their priorities”.

“I would say that pharmacists will play a constructive role in that,” she stated, as they currently “play an important role…across ICSs”.

Including population health intelligence “within the education of pharmacy” at a university level would be “an excellent approach” to ensuring pharmacy teams start making wider use of these tools, Ms Preece added.

  

Key takeaways

 

Population health management is about pharmacists getting to know their local communities deeply, Professor Patel summarised, whether through tools like Fingertips, or simply taking a walk in their local areas and getting to grips with their surroundings.

“This is not just about rhetoric; this is about getting on with it and actually doing something,” he stressed.

Professor Patel urged pharmacy teams “to have a look and see what [their] own locality, your local community population looks like” and to examine how to make best use of their diverse workforces in supporting inclusive practice to help improve health and health inequalities.

You can watch the NHSE&I webinar on demand here: https://bit.ly/3NZ2s6h

Have you or your team made strides in tackling inequality in your pharmacy? Enter the Diversity and Inclusion category in the 2022 C+D Awards today