Pharmacy: looking to the future

Kevin Ratcliffe

Consultant Pharmacist

Stereotypes…..?• Traditionally, role

dominated by dispensing

• SMS: needle exchanges and supervised consumption

• Role is now evolving• Key benefit: ACCESS

Minor Ailments

• Already trained• Signposting / referral• Fear• Some minor ailment

schemes available but no national standards (and certainly not national coverage)

BBV – some scary stuff

• Nationally, 40% IDUs have HCV (marked variation of prevalence)

• Half of these are unaware of their status

• 20% IDUs infected with HCV within 3 years of starting

• Uptake of Hep B vaccine better, but completions still low.

• HIV rates rising again (1/3 of IDUs unaware of their status).

BBV: options

• Pilot studies of Hep B vaccination completions via pharmacies hugely successful.

• HCV screening (dried blood spot sampling)

• HIV as well ?• NX and SC

PGDs: Naloxone

• Overdose response training

• Supply and use of naloxone

• Inc. partners / carers

• Universally available

PGDs: Sexual Health

• Morning after pill

• Chlamydia screening and treatment

• Sexual health advice (inc. supply of free condoms and lube)

PGDs: antibiotics

• A “minor ailments plus” scheme

• Defined conditions and defined circumstances

• Skin infections / abscesses ?

Smoking Cessation

Alcohol• Many pharmacists

already skilled at brief interventions

• Referral pathways in place

• Harm reduction measure (esp. as illicit drug use decreases)

Non-medical prescribing

• Effective use of skill mix

• Many benefits• Already present in

primary care, specialist teams and prison service

• But, could we take this further……….?

The main challenges:

At every crossroads on the path that leads to the

future, tradition has placed ten thousand men

to guard the past.Anon.