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COMMUNITY PHARMACY'S ROLE IN THE MANAGEMENT AND PREVENTION OF STIs: THE
VIEWS OF NHS STAKEHOLDERS
Harris R, Anderson C
Centre for Pharmacy, Health & Society, University of Nottingham, Nottingham
NG7 2RD
(Mail to: Richard.Harris@nottingham.ac.uk)
Introduction
The prevalence of Sexually Transmitted Infections has substantially
increased in the United Kingdom and is now high on the political agenda.
In 2001 the Government published the National Strategy for Sexual Health
and HIV [1] and a number of further policies have followed [2-7]. A vision
for developing the role of Community Pharmacy has been proposed as part
of a comprehensive, integrated service, despite the literature showing
little evidence of the effectiveness of the sector in Westernised Countries.
A qualitative study was undertaken to canvass the opinions of key NHS
Stakeholders in Doncaster, South Yorkshire to explore the potential contribution
that Community Pharmacy can make and how development can be facilitated.
Methodology
Key NHS Stakeholders were invited to take part in semi-structured
interviews, which were recorded and transcribed verbatim. The transcripts
were coded and analysed according to the principles of constant comparison.
Key themes were identified amongst the data and used to synthesise responses
to three sub-questions that were posed as a result of the initial research
question:
1. Should Community Pharmacy be developed in the area of the management
and prevention of STIs?
2. If services are to be developed, what should they look like?
3. How should change be brought about?
Key findings
14 subjects were interviewed, consisting of 6 Community Pharmacists,
5 representatives of the local Primary Care Trusts, 1 General Practitioner,
1 Nurse and an expert from the local GUM Clinic.
The participants agreed that the problem of STIs is of growing concern
in Doncaster and that more could be done to alleviate the situation. However,
development needs to be taken in context with other healthcare issues
and it does not necessarily follow that more should be done.
Community Pharmacy has certain attributes that mean that it could be developed
in circumstances where needs are identified and the where the sector is
the most appropriate place for delivery. It was agreed that the major
role for Community Pharmacy is in educating the public and signposting
patients to other services. However, consensus was not achieved on screening,
treating and contract tracing for STIs. All participants believed that
training is required for pharmacists to acquire adequate knowledge and
skills in dealing with these sensitive issues, before any developed service
is delivered.
The data indicated that the development of Community Pharmacy should be
planned in conjunction with other healthcare services and it must be ensured
that full integration with the NHS is achieved. The pharmacists especially,
believed that this would help to overcome problems with acceptance from
both the public and other healthcare professionals.
The Community Pharmacists expressed a desire to develop their role, but
this may be a manifestation of a general desire for professional development,
rather than in Sexual Health specifically. For development to take place
there needs to be greater political and professional will at local level.
A number of operational issues need to be resolved, such as pharmacist
workload and premises design, but there was hope that the New Pharmacy
Contract will address them.
References
1. Department of Health. The National Strategy for Sexual Health and
HIV. 2001: London.
2. Department of Health. The National Strategy for Sexual Health and HIV
- Implementation action plan. 2002: London.
3. Department of Health. Effective Commissioning of Sexual Health and
HIV Services. 2003: London.
4. Medical Foundation for AIDS and Sexual Health. Recommended Standards
for Sexual Health Services. 2005: London
5. Department of Health. Annual Report of the National Chlamydia Screening
Programme in England, 2003/04. 2004: London
6. Department of Health. Chlamydia Screening on the Highstreet. 2005.
7. Department of Health. Choosing Health: Making Choices Easier. 2004:
London
Presented at the HSRPP Conference 2006, Bath
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