Dr Adam Todd, a Reader in Pharmaceutical Public Health, is in a team leading Newcastle University’s work in community pharmacy research.
Is access to healthcare equal and fair?
For a healthy population, it is important that people are able to access effective medical services when they need to.
Unfortunately, research has shown that this isn’t always possible and, in some cases, it’s not equal or fair.
The inverse care law states: “the availability of good medical care tends to vary inversely with the need for it in the population served”. This phrase was first used in the early 1970s by Dr Julian Tutor-Hart, a doctor who worked as a General Practitioner in Wales. Although hard evidence was not provided at the time to support this theory, there is a large body of research to suggest this is a huge problem for the NHS – and it isn’t going to go away anytime soon.
But what does this mean?
People living in areas of high deprivation have less access to good healthcare. This is a huge challenge because people who live in more deprived communities tend to have more long-term conditions, experience poor health for longer, and have a reduced life expectancy.
Introducing the positive pharmacy care law
Newcastle University research has shown that when it comes to the inverse care law, community pharmacies go against the grain.
The research highlighted that community pharmacies are the most accessible healthcare provider in England, and the majority of the population can reach a community pharmacy within 20 minutes’ walk from home.
In the most deprived communities, this figure increases to almost 100%.
This has been called the positive pharmacy care law and shows community pharmacies are well placed to reach people that need the most care.
This is how community pharmacies are supporting patients and taking pressure off other services
In addition, to be well placed in our local communities, community pharmacies can also support other parts of the healthcare system.
It is estimated that Emergency Departments (EDs) in England receive more than 20 million attendances per year, while General Practice (GP) also face unsustainable pressures with over 370 million GP consultations per year.
These services are facing insurmountable pressure. And a significant percentage of these consultations are for minor illnesses, such as coughs, colds, sore throats, or heartburn. Treating minor illnesses in these locations is not only costly but also reduces the healthcare providers’ capacity to treat more serious conditions.
Our research has shown that community pharmacists can help people with minor illnesses in an effective way that saves the NHS money.
Introducing the Digital Minor Illness Referral Scheme
Now, when someone calls the NHS for help, and they have symptoms of a minor illness, they are referred directly to a community pharmacy for support. This is a national service, known as the Digital Minor Illness Referral Scheme (DMIRS) and, as well as being acceptable to patients, has been shown to save appointments in other parts of the NHS, like in GP surgeries.
As well as helping people who are acutely unwell, research has also shown that community pharmacists can provide healthy lifestyle advice and offer services to support people with unhealthy behaviours. This type of service focuses on preventing ill health, and includes people who smoke, drink too much alcohol, or who need to lose some weight.
Developing services from community pharmacy – aimed at treating minor illnesses and preventing disease - not only has the potential to free up time for other healthcare professionals working in other parts of the NHS, by going against the trend of the inverse care law, it has the potential to reach people who are in need of the most care. Find out more about our cutting-edge research in ageing and health on our blog.