Health and Social Care Institute, School of Health and Social Care, Teesside University, Middlesbrough, Tees Valley, UK.
BMC Health Serv Res. 2011 Sep 19;11:222. doi: 10.1186/1472-6963-11-222.
In England and Wales, the Department of Health introduced a primary prevention programme, NHS Health Checks, to provide screening for cardiovascular risk amongst people aged 40-74. The aim of this programme is to offer treatment and advice to those identified with an increased risk of cardiovascular diseases (CVD).The North East of England has some of the highest rates of CVD in the UK and prevention is therefore a priority. NHS Tees funded this programme of work under the local branding of Healthy Heart Checks (HHC). These were initially implemented principally through GP practices from October 2008 but, in order to mitigate the possibility that some hard to reach communities would be reluctant to engage with some primary care settings, plans were also developed to deliver the programme through workplace settings and through community pharmacies. This paper reports specifically on the findings from the evaluation in respect of the setting up of HHCs in community pharmacies and aims to offer some lessons for other service settings where this option is seen as a way of providing low threshold services which will minimise inequalities in intervention uptake.
In assessing the community pharmacy component of HHCs, a selection of staff having direct involvement in the process was invited to take part in the evaluation. Interviews were carried out with representatives from community pharmacy, staff members from the commissioning Primary Care Trusts and with Local Pharmaceutical Committee members.
Evaluation and analysis identified challenges which should be anticipated and addressed in initiating HHC in community pharmacies. These have been categorised into four main themes for discussion in this paper: (1) establishing and maintaining pharmacy Healthy Heart Checks, (2) overcoming IT barriers, (3) developing confident, competent staff and (4) ensuring volume and through flow in pharmacy.
Delivering NHS health checks through community pharmacies can be a complex process, requiring meticulous planning, and may incur higher than expected costs. Findings from our evaluation provide insight into possible barriers to setting up services in pharmacies which may help other commissioning bodies when considering community pharmacy as a location for primary prevention interventions in future.
在英格兰和威尔士，卫生部推出了一项初级预防计划 NHS 健康检查，为 40-74 岁人群筛查心血管风险。该计划旨在为那些心血管疾病（CVD）风险增加的人提供治疗和建议。英格兰东北部是英国 CVD 发病率最高的地区之一，因此预防是当务之急。NHS Tees 为本地区的工作提供资金，品牌名为健康心脏检查（HHC）。这些最初主要通过全科医生诊所从 2008 年 10 月开始实施，但为了降低一些难以接触的社区可能不愿意参与一些初级保健机构的可能性，还制定了计划，通过工作场所和社区药店来提供该计划。本文专门报告了 HHC 在社区药店设立方面的评估结果，并旨在为其他服务机构提供一些经验教训，这些机构认为这是提供低门槛服务的一种方式，可以最大限度地减少干预措施接受度方面的不平等。
在评估 HHC 社区药店部分时，邀请了直接参与该过程的部分工作人员参与评估。对社区药店的代表、委托初级保健信托基金的工作人员和地方药剂委员会成员进行了访谈。
评估和分析确定了在社区药店启动 HHC 时应预料到和解决的挑战。这些挑战被归类为四个主要主题进行讨论：（1）建立和维持药店健康心脏检查，（2）克服 IT 障碍，（3）培养自信、有能力的员工，（4）确保药店的流量和吞吐量。
通过社区药店提供 NHS 健康检查可能是一个复杂的过程，需要精心规划，并且可能会产生高于预期的成本。我们的评估结果提供了有关在药店设立服务可能存在的障碍的见解，这可能有助于其他委托机构在未来考虑将社区药店作为初级预防干预的地点时提供参考。
