Closures of community pharmacies in deprived areas could be “catastrophic” and place an “untenable” burden on local GPs, warn leading health organisations
New research by YouGov commissioned for Dispensing Health Equality, published today by Pharmacy Voice, shows that, if faced with a closure, more than one in four people (29%) who would normally seek advice first from their local pharmacy on common ailments would instead make an appointment with their GP practice. According to NHS research, this rises to as many as four in five people in areas of high deprivation such as Fleetwood in Lancashire.
The government has indicated that its proposals will lead to up to one in four local pharmacies closing. The report argues that an uplift in GP appointments is untenable in any part of the country, but especially so in those areas that find it difficult to attract GPs in the first place.
This will affect communities such as Fleetwood and Easington Lane, a former coal mining village where there is no GP surgery, and just one local pharmacy serving the needs of more than 2,000 people. The report urges the government to take note of this in context of its proposed funding cuts, and seeks reassurance that in both urban and rural areas of high deprivation access to this much needed community asset will be protected.
Dr Mark Spencer, a GP in Fleetwood Lancashire, co-chair, NHS Alliance, and himself a coal miner’s son, comments: “At a time when there is an entirely unacceptable widening gap in life expectancy between rich and poor, extreme pressure on GPs, and increasing public awareness of the role pharmacy is playing in delivering services to support public health, it would be catastrophic if the areas that most need it, are deprived of access to this crucial community asset. Easington Lane and Fleetwood are two cases in point.”
Perspectives from Easington and Fleetwood are included in the report, which argues that “good health follows a social gradient: life expectancy increases according to postcode rather than genetic code”.
This comes into sharp focus after the age of 60, when the life expectancy gap is more than 30 years between those living in affluent areas and those living in deprived ones, according to research published last week by Cass Business School. Described as the ‘inverse care law’, the country’s most deprived areas are frequently under-doctored, which can exacerbate health inequalities and life expectancy. Community pharmacy offers a ‘positive care law’. Local pharmacies, a health hub offering expert advice and support from highly trained healthcare professionals without an appointment, are within a 20 minute walk of almost 100 per cent of people. The government’s plans may adversely affect this positive care law.
The report states: “The underlying reasons for health inequalities are complex but recent research indicates the immediate causes are predicated on “lifestyle choices’ such as smoking. Research by Durham University has shown that most people in England can get to a community pharmacy easily, with the greatest access in deprived areas. This means our high street pharmacies could be key in tackling some of society’s major public health concerns such as obesity, smoking and alcohol.” A recent study published in BMJ Open stated: “Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services.”
 John Appleby, Chris Deeming, The King’s Fund, Inverse care law http://www.kingsfund.org.uk/publications/articles/inverse-care-law
 Adam Todd, Alison Copeland, Andy Husband, Adetayo Kasim, Clare Bambra, BMJ Open, The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England http://bmjopen.bmj.com/content/4/8/e005764.fu