Community Pharmacy North-East London won Best Supporting Representative Group at the Independent Pharmacy Awards. Saša Janković talks to its CEO Shilpa Shah about the innovative ways it supports contractors…

With a network of 375 contractors spanning seven boroughs including City and Hackney, Tower Hamlets, Newham, Waltham Forest, Redbridge, Barking & Dagenham, and Havering, Community Pharmacy North-East London’s (CP NEL) reach, influence and responsibilities are significant.

“CP NEL is keenly aware of the diverse challenges posed by the various populations across North-East London,” says its CEO Shilpa Shah, who runs the LPC alongside an office manager and two pharmacy services managers – one of whom is funded by the ICB specifically to support national services such as the hypertension case finding service.

Shilpa says pharmacists in the region have encountered some people who are unable to pay for over-the-counter medicines due to the ongoing cost-of-living crisis.

“This situation puts pressure on GPs as patients seek prescriptions for items, leading to higher demand for walk-in urgent treatment centres and A&E services”, she explains, “plus people who pay for their medicines are sometimes forced to choose between essential items due to cost constraints, which results in adverse health outcomes.”

As a result, in deprived areas, Shilpa says CP NEL observes higher levels of obesity; the mental health of the population is also affected, with various conditions arising from worry and stress; and cases of cardiovascular diseases, diabetes and other health issues are on the rise.

Moreover, some boroughs within North-East London are experiencing alarming rates of smoking and drug misuse, with pharmacists often in the frontline of recognising people with these health concerns.

Innovative thinking

“With the support of the LPC, pharmacy in North-East London is dealing with these issues in different ways”, Shilpa says, “by looking at how we can change this by thinking of the person and the community as a whole.”

A good example of this in North-East London is the vaccination hesitancy service, which was initiated during the Covid pandemic and ran between June and December 2022 with great success.

“During the pandemic the rate of uptake for covid vaccinations in Tower Hamlets – which has a predominantly Bengali population – was 20 per cent behind the national average”, Shilpa says, “so we came up with the service to ask people who came into the pharmacies if they had had the vaccine, if not then why, and then give them information to help them make an informed decision about vaccination.

“The result was 45 per cent out of 3,000 interventions went on to have the vaccination – some immediately if the pharmacy was a Covid vax site, or else we’d signpost them to the nearest Covid vaccination pharmacy site.”

Support for services

The LPC's proactive approach in seeking funding from the ICB has also been instrumental in supporting services, enabling the training of surgery staff and pharmacists while implementing necessary IT systems, and funding PharmAlarms for pharmacies – a USB key for the pharmacy computer which flashes when a referral comes through to PharmOutcomes from the GP for Pharmacy First, hypertension and oral contraception services.

“We have sent two members of staff into every surgery in North-East London to train staff on the Pharmacy First, oral contraception and hypertension services and how to refer into community pharmacy, as well as going into all the pharmacies to see how they are getting on”, Shilpa says.

“The ICB paid for this, and also paid for the IT platform so we can train staff on how to use this, so we know the ICB does value us.”

She adds that North-East London ICB is set to commission a self-care service – called a minor illness service – because it has registered a need for this.

“Having this in place will be a huge benefit for many people”, she explains, “because, for example, if someone has CVD a minor illness will affect them more than a generally healthy person, and the same for someone with diabetes. Because we are an area with high levels of deprivation it’s also important people don’t have to take time off work, as potentially they don't get paid.

“It’s a vicious circle we are trying to break in North-East London by dealing with the cause not the symptoms.”

Help for contractors

The LPC has also come up with its own innovative ways to help contractors.

“We keep exploring ways to work more efficiently so we are not duplicating workloads or doing things out of the remit of the LPC,” Shilpa says.

“For example, in March 2022 we sat down with our treasurer and office manager to look at where we could save money and decided that we didn’t need to be spending thousands of pounds a year having an office when we could be working from home, or out at meetings, and all our paperwork could be shared and stored electronically.

“Our staff were happy with this arrangement and the money we saved we passed back to contractors in the form of a six-month levy holiday at the end of 2022-2023.”

Next steps

Next for the LPC is an air quality and asthma service which, Shilpa insists, they are “really excited about as Newham has the highest air pollution in the country.”

“We’ve been given funding for pharmacies to help people with inhaler technique,” she says, “to talk to children about their walking routes to school and which side roads could be less polluted, and we have a letter for people living in mouldy or damp accommodation to take to their landlords – and we are hoping to evaluate this and get more funding to roll it out further.

“Then in May or June we are launching a self-care scheme which will help eligible patients referred in by Pharmacy First who can’t afford to pay for OTC medicines to get them for free so they don’t have to be referred back to the GP for a prescription.

“And then beyond that, we hope to roll out the vaccination hesitancy service across North-East London to include flu and MMR.

“It’s all about closing the loop in terms of consistency of service, and while patients are there, they learn everything else their local pharmacy can do.”

Main picture: Community Pharmacy North-East London’s CEO Shilpa Shah (centre) and her colleagues alongside Dr Maria Mantzourani, UK head of medical and scientific engagement at PMI Science, sponsors of the award.