Community pharmacies: promoting health and wellbeing

Work with local health and social care organisations to ensure community pharmacy interventions are delivered according to local need and as part of wider services in the local area.

Use a tailored approach when providing community pharmacy health and wellbeing interventions to maximise their impact and effect.

Local providers should ensure interventions are carried out only by staff members with the skills and competencies to do so. For example, follow NICE's recommendations on training in the guidelines on:

• behaviour change: individual approaches

• tobacco: preventing uptake, promoting quitting and treating dependence.

When possible, the same member of staff should deliver all sessions of an intervention (if multiple sessions are needed) to promote continuity of care.

Use information, resources and support aids available from statutory, community and voluntary sector organisations (for example, Healthwatch and Public Health England). Ensure the materials used are:

• not based solely on commercial interests or incentives

• clear and professionally produced.

Address health inequalities by working with other agencies to identify underserved groups. Tailor health and wellbeing interventions to suit their individual needs and preferences and maximise their impact. For example:

• use knowledge of the local community (particularly from staff who live in the community where they work) to take into account the context in which people live and work (their physical, economic and social environment)

• make use of the skills staff members already have (for example, if they speak languages commonly used in the area)

• take into account other personal factors such as gender, identity, ethnicity, faith, culture or any disability that may affect the approach taken (for example, provide information in an appropriate format for people who may have difficulty reading).

Consider promoting community pharmacies. For example:

• Local commissioners could make it clear that community pharmacies are an integral part of NHS primary care services and offer people a link into the local health and care network.

• Individual pharmacies could publicise the skills and competencies of their staff to increase the public's knowledge of and confidence in the health and wellbeing services on offer.

Proactively seek opportunities to promote people's physical and mental health and wellbeing. This includes: awareness raising and information provision, advice and education, behavioural support and referral and signposting to other services. Describe the interventions on offer and the benefits. Do this for example, when someone:

• Regularly buys over-the-counter medicines, such as painkillers. For example, if relevant offer advice on other ways of reducing lower back pain including self-management and exercise. (See recommendations on non-invasive treatments in NICE's guideline on low back pain and sciatica.)

• Regularly collects a prescription for themselves or someone they care for. For example, provide education and advice on how improving their diet, being more physically active or reducing alcohol intake may help the condition and improve their physical or mental health and wellbeing.

• Regularly uses the pharmacy for over-the-counter medication or one-off prescriptions and, where appropriate, routine or occasional non-healthcare purchases. For example, offer behavioural support for stopping smoking (see NICE's guideline on tobacco: preventing uptake, promoting quitting and treating dependence); or information on effective sun protection (see NICE's guideline on sunlight exposure).

• Is planning a pregnancy or is pregnant. For example, raise awareness of the benefits of, and provide information on, folic acid and other supplements (see NICE's guidelines on maternal and child nutrition and on vitamin D: supplement use in specific population groups).

Local commissioners and pharmacies could consider establishing a formal referral process with other pharmacies and service providers. This includes GP services and those offered by local authorities and organisations in the community and voluntary sectors. Specifically:

• Consider basing pharmacy assessments, triage activities and referrals on agreed tools that support continuing treatment.

• Consider designing triage activities to reduce multiple assessments and waiting times after people are referred. For example, after identifying harmful or dependent alcohol consumption, consider providing access to alcohol services that does not require reassessment and a return to the start of the treatment pathway. (Harmful and dependent alcohol consumption could be identified using the AUDIT tool or another threshold used locally.)

Consider referring people to other services and triage within the agreed local care or referral pathway to give fast access to an appointment if needed. For example, refer people to:

• GPs or other healthcare providers for:

  • ongoing contraception

  • assessment for sleep apnoea if agreed local assessment tools are in place

  • support for high risk or dependent alcohol consumption

  • drug misuse recovery support

  • weight reduction services

• local authority, NHS or community and voluntary sector organisations for:

  • weight loss programmes or support groups

  • mental health and wellbeing support

  • specialist treatment and recovery support for drug misuse and dependence

  • support for carers

• adult and children's social care.

When making a formal referral to another service, explain to the person why they are being referred, where they are being referred to and the service they can expect. Provide them with written information about the service if it is available.

When the pharmacy accepts a formal referral from another service:

• ensure all relevant information has been provided so that care can start at the first opportunity without the need for a reassessment

• offer care as a walk-in service or, if this is not available or suitable, agree an appointment time and date with the person and give them the name of the staff member they will see.

If the community pharmacy cannot support specific needs or offer a formal referral, signpost people to other local services. For example:

• sexual health services

• stop smoking services

• social care services

• mental health and wellbeing support

• other community services such as: Citizens Advice; housing, benefits or employment advice; support services for carers; and government and third sector debt advice websites.

Consider using minimum data sets and summary care records to encourage record keeping and auditing, particularly when exchanging information through formal referrals in the local care network.