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Evaluation of Anticipatory Care Community Pharmacy programme

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Published: July 2011

Aim

To evaluate the Anticipatory Care Community Pharmacy (ACCP) programme, which aims to support the delivery of Keep Well, Scotland’s flagship programme for preventing ill health before it occurs, by offering people health checks in community pharmacies.

Findings

Access to GP patient records is a key challenge for ACCP

Negotiating with local GPs to use their patient records to identify people eligible for pharmacy-based health checks was a key challenge for partnership working in ACCP.

Key factors behind more successful partnership working with local GPs include:

  • building on existing local relationships with specific GP practices;
  • targeting pharmacy checks on geographic areas where GPs were not currently providing their own Keep Well checks;
  • highlighting the potential benefits to GPs of pharmacies delivering checks (e.g. cases where pharmacy-based checks identified undiagnosed conditions).

Delivering ACCP involved major IT challenges

Health Boards experienced substantial challenges in working out how pharmacies could securely and easily record and transfer data from health checks for use by the local Keep Well Team and to update GP patient records.

As the solutions discussed were viewed as far from ideal, support was expressed for a national IT solution.

There was wide variation in the number of checks delivered by ACCP in different areas The highest numbers of checks were achieved when:

  • health checks were delivered by NHS staff not employed by pharmacies (as pharmacy staff were often too busy to deliver high numbers of checks);
  • pharmacies received referrals from GP practices or the central Keep Well team, rather than relying on ‘opportunistic’ approaches to customers.

Engaging target groups depends on a range of factors

  • Offering health checks in pharmacies may help engage men – who are known to be less likely to attend their GP for a health check - with anticipatory care.
  • Pharmacy-based health checks did seem to identify a significant minority with either significant heart disease risk factors or with high blood pressure.
  • Engagement of those in the most deprived areas was highly variable and depended on the level at which areas define deprivation (GP practice, postcode or individual) and who was responsible for ‘screening’ people for eligibility.

Methodology

  • Quantitative analysis of monitoring and cost data.
  • Qualitative interviews with service users and staff in three case study Health Boards.
  • Interviews with local ACCP leads in all seven participating Boards.

Read the report