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.
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