Mackridge Adam John, Gray Nicola Jane, Krska Janet
School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK.
Green Line Consulting Limited, Manchester, UK.
BMJ Open. 2017 Jul 10;7(7):e015511. doi: 10.1136/bmjopen-2016-015511.
This study aims to provide a national picture of the extent and nature of public health services commissioned by local authorities (LAs) from community pharmacies across England in financial year 2014/15.
Cross-sectional survey of public health services commissioned in community pharmacies by LAs, gathered via freedom of information requests and documentary analysis.
All 152 LAs in England.
A total of 833 commissioned services were reported across England (range 3-10 per LA). Four services were commissioned by over 90% of LAs: emergency hormonal contraception (EHC), smoking cessation support, supervised consumption of methadone or other opiates and needle and syringe programmes (NSPs). The proportion of pharmacies commissioned to deliver these services varied considerably between LAs from <10% to 100%. This variation was not related to differences in relevant proxy measures of need. NHS Health Checks and alcohol screening and brief advice were commissioned by fewer LAs (32% and 15%, respectively), again with no relationship to relevant measures of need. A range of other services were commissioned less frequently, by fewer than 10% of LAs.Supervised consumption and NSPs were the most frequently used services, with over 4.4 million individual supervisions and over 1.4 million needle packs supplied. Pharmacies provided over 200 000 consultations for supply of EHC, over 30 000 supplies of free condoms and almost 16 000 chlamydia screening kits. More than 55 000 people registered to stop smoking in a community pharmacy, almost 30 000 were screened for alcohol use and over 26 000 NHS Health Checks were delivered.
There is significant variation in commissioning and delivery of public health services in community pharmacies across England, which correlate poorly with potential benefit to local populations. Research to ascertain reasons for this variation is needed to ensure that future commissioning and delivery of these services matches local need.
本研究旨在呈现2014/15财政年度英格兰地方当局委托社区药房提供的公共卫生服务的范围和性质的全国情况。
通过信息自由申请和文献分析收集地方当局委托社区药房提供的公共卫生服务的横断面调查。
英格兰所有152个地方当局。
英格兰各地共报告了833项委托服务（每个地方当局范围为3 - 10项）。超过90%的地方当局委托了四项服务：紧急激素避孕（EHC）、戒烟支持、美沙酮或其他阿片类药物的监督服用以及针头和注射器计划（NSPs）。委托提供这些服务的药房比例在不同地方当局之间差异很大，从不到10%到100%不等。这种差异与相关需求替代指标的差异无关。较少的地方当局委托进行国民健康检查以及酒精筛查和简短建议（分别为32%和15%），同样与相关需求指标无关。一系列其他服务委托的频率较低，不到10%的地方当局委托提供。监督服用和美沙酮或其他阿片类药物的监督服用以及针头和注射器计划（NSPs）是使用最频繁的服务，提供了超过440万次个人监督以及超过140万个针头包。药房提供了超过20万次紧急激素避孕供应咨询、超过3万次免费避孕套供应以及近1.6万个衣原体筛查试剂盒。超过五万五千人在社区药房登记戒烟，近三万人接受了酒精使用筛查，超过两万六千次进行了国民健康检查。
英格兰各地社区药房公共卫生服务的委托和提供存在显著差异，与对当地居民的潜在益处相关性较差。需要进行研究以确定这种差异的原因，以确保这些服务未来的委托和提供符合当地需求。
