Pharmacy: looking to the future

1. Pharmacy: looking to the future Kevin Ratcliffe Consultant Pharmacist

2. Stereotypes…..? • Traditionally, role dominated by dispensing • SMS: needle exchanges and supervised consumption • Role is now evolving • Key benefit: ACCESS

3. Minor Ailments • Already trained • Signposting / referral • Fear • Some minor ailment schemes available but no national standards (and certainly not national coverage)

4. 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).

5. 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

6. PGDs: Naloxone • Overdose response training • Supply and use of naloxone • Inc. partners / carers • Universally available

7. PGDs: Sexual Health • Morning after pill • Chlamydia screening and treatment • Sexual health advice (inc. supply of free condoms and lube)

8. PGDs: antibiotics • A “minor ailments plus” scheme • Defined conditions and defined circumstances • Skin infections / abscesses ?

9. Smoking Cessation

10. Alcohol • Many pharmacists already skilled at brief interventions • Referral pathways in place • Harm reduction measure (esp. as illicit drug use decreases)

11. 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……….?

12. The main challenges:

13. At every crossroads on the path that leads to the future, tradition has placed ten thousand men to guard the past. Anon.