Brighton & Hove Healthy Living Pharmacy Framework

The Healthy Living Pharmacy (HLP) framework is aimed at achieving consistent provision of a broad range of health promotion interventions through community pharmacies to:

• meet local need
• improve the health and wellbeing of the local population
• help to reduce health inequalities

The Health Living Pharmacy (HLP) framework was first developed in 2009. Public Health England (PHE) has provided strategic leadership for the development, acceleration, and implementation of the HLP programme. In 2016, PHE moved from a commissioner-led to a profession-led, self-assessment process for the attainment of HLP level 1 status, which included the development of the PHE quality criteria.

The PHE quality criteria underpinned the HLP enablers and set out the criteria that community pharmacies needed to meet to attain HLP level 1 status.

Following this, NHS England introduced the achievement of HLP level 1 status, as set out in the PHE quality criteria, as a criterion for payment under the Pharmacy Quality Scheme (previously known as the Quality Payments Scheme) for 2017/18.

Collectively, these initiatives introduced greater consistency in the delivery of public health interventions and saw the number of HLPs rise to over 9,500 in 2019. PHE research published in 2016 showed the impact of HLPs in communities, which is summarised in the infographic below.

The impact of Healthy Living Pharmacies

1. Healthy Living Pharmacies improve the public's health and drive improvements in service quality and innovation. 

2. People walking into a Healthy Living Pharmacy are twice as likely to set a quit date for smoking and then quit than if they walked into a non-Healthy Living Pharmacy

3. Healthy Living Pharmacies consistently deliver high-quality public health services - NHS Health checks, weight management, sexual health and more.

4. Healthy Living Pharmacies reach out to local communities such as schools and community centres, with health improvement advice and services

99% of people are comfortable and happy with the service provided by Healthy Living Pharmacies

99% of people would recommend Healthy Living Pharmacies to their families and friends

60% of people would make an appointment with their GP's if the health improvement service was not available at a Healthy Living Pharmacy.

20% of people would not have gone to another provider, for example, they would have received no support for improving their health.

Amendments to Community Pharmacy Contractual Framework (CPCF) introduced requirements for the promotion of healthy living, which pharmacy contractors must be compliant with from 1 January 2021.Pharmacies will no longer be required to comply with the PHE quality criteria. This has been superseded by the amendments to the terms of service. However, it is important to note that the PHE quality criteria have informed the development of the updated requirements.

The requirements for the promotion of healthy living in the terms of service are detailed in the following document: Guidance on the National Health Service (Charges and Pharmaceutical and Local Pharmaceutical Services) Regulations 2020.

Contractors are advised to work with members of their team to develop an action plan for how they will achieve each of the requirements and demonstrate compliance to NHS England and NHS Improvement.

Community pharmacies are an essential, valued, and well-respected component of the health and social care system in Brighton & Hove. In recognition of the important role of community pharmacies in providing a pharmaceutical service to local communities, including vulnerable groups of people with long term conditions and their carers, the Public Health team thought it timely to review the Brighton & Hove HLP framework.

The purpose of this document is to propose a local HLP programme of support for all Brighton & Hove community pharmacies to compliment the requirements of the CPCF and to deliver the local public health, social care, and NHS priorities.

The Brighton & Hove HLP programme is supported by the National Institute for Health and Care Excellence (NICE) guideline, Community pharmacies: promoting health and wellbeing.

This quality standard covers how community pharmacies can support the health and wellbeing of the local population. It describes the overarching principles of good practice for community pharmacy teams.

The Brighton & Hove HLP programme also aims to support actions defined in the recent publication of the Joint National Plan for Inclusive Pharmacy Practice.

The joint initiative aims to provide training and resources to develop and embed inclusive pharmacy professional practice into the ongoing care of patients and communities, to support the prevention of ill-health and address inequalities.

In the delivery of this service, commissioned by Brighton & Hove City Council, contractors will offer a user-friendly, non-judgemental, person-centred, and confidential service which links into existing networks of local support services. In addition, pharmacy staff must show awareness of key health issues for the residents of Brighton & Hove and be responsive to them.

The service will be delivered by pharmacy teams consisting of a HLP leader and health champion as defined by the NHSE &I document referenced above.

Pharmacy contractors will deliver health promotion and self-care advice using the principals of the Making Every Contact Count (MECC).

Pharmacy contractors will proactively engage with local communities to promote health campaigns, address health inequalities and signpost or directly refer to local health and community services as appropriate.

Pharmacy Contractors must also sign up to provide at least one of the following public health locally commissioned service, either the sexual health and contraceptive or the stop smoking service (refer to the service specifications). Pharmacies must actively promote and recruit people into the services.

Pharmacy contractors are encouraged to link in with their local Primary Care Network (PCN) to promote services available within the pharmacy and encourage signposting to the services from GP practices and other community services.

To support Brighton & Hove community pharmacies to meet the HLP component of the Community Pharmacy Contractual Framework (CPCF) as defined by Guidance on the National Health Service (Charges and Pharmaceutical and Local Pharmaceutical Services) Regulations 2020.

To remunerate pharmacies who participate in enhanced local health promotion campaigns based on the needs of local Brighton & Hove communities.

Pharmacy contractors are required to review public health intelligence information provided by the local PH team and discuss with the wider pharmacy team. Information provided will enhance the awareness of the local public health and pharmaceutical needs outlined in the Joint Strategic Needs Assessment (JSNA), Pharmaceutical Needs Assessment (PNA) and Health Profiles for the local area.

To remunerate attendance at health champions training on local health and social care priorities at least every 3 months. Initially, training will be accessible via an online platform and capped at 20 attendees per session. Face to face training will be offered when it is safe to do so.

Pharmacy contractors will be encouraged to share best practice and contribute to the quarterly Brighton & Hove HLP newsletter. The HLP newsletter details health promotion priorities and key local public health objectives. Contractors are expected to agree to publication of successful campaigns and best practice in the newsletter.

To support contractors to provide high-quality, accessible and consistent public health locally commissioned services. A directory of LCS services will be available to other healthcare providers to enable signposting to community pharmacy services.

To remunerate contractors who refer people directly into other public health commissioned services such as weight management. A referral template will be provided on PharmOutcomes.

Health promotion materials promoting the availability of public health locally commissioned services and local health promotion campaigns are displayed within the pharmacy and on the community pharmacy social media platform (if appropriate) according to the commissioner’s brief.

Pharmacy contractors have signed up to provide at least one public health locally commissioned service (as defined above) and are achieving the quality indicators defined in the service specification. A minimum of 3 LCS provisions are required per month.

Health Champions attend 2 training sessions per year and complete the online training evaluation questionnaire.

The HLP training evaluation questionnaire will indicate that 70% of attendees scored the training as good or excellent.

Pharmacy contractors signing up to the service will achieve at least 12 referrals into a public health commissioned healthy lifestyle service (e.g. weight management) per year.

Pharmacy contractors will evidence that they have linked in with the GP practices in their local PCN (and other community providers) to promote PH LCS services and encourage signposting into the service.

Training sessions (no longer than 2 hours) will be provided by Brighton & Hove City Council every 3 months via an online platform. The training programme and dates will be published at least 6 weeks before each event.

A representative from the pharmacy can attend the training if the Health Champion is unable to attend. Attendees are expected to cascade the training to the rest of the pharmacy team.

Training attendance will be remunerated at £50 per pharmacy for online participation. While more than one representative from each pharmacy may attend, each pharmacy will only be reimbursed for one attendee.

Completion of a training evaluation questionnaire is required at the end of each training session. Payment for attendance will be authorised once the questionnaire has been completed.

Brighton & Hove City Council will ensure that pharmacies have up to date details of local support services to facilitate the signposting and referral of individuals who require it. Brighton & Hove City Council will also ensure that pharmacies have access to a directory of services.

Brighton & Hove City Council will ensure that pharmacies receive health promotion materials to support local health promotion campaigns.

Brighton & Hove City Council will provide a data capture system and framework for the recording of relevant service information for the purposes of audit and claiming payment.

Brighton & Hove City Council will provide health intelligence profiles so that teams are better equipped to respond to needs of the local population. These will be updated every 2 years.

Attendance at HLP training to a maximum of 20 attendees per session - £50 per pharmacy for participation in online training.

Participation in enhanced local health promotion campaigns - £100 per campaign per pharmacy. Involvement in local health promotion campaigns will be decided by the commissioner based on local need.

Referral to priority public health services via PharmOutcomes £5 per referral. To support the recommendations of the Joint National Plan for Inclusive Pharmacy Practice (mentioned above) referrals for people from Black, Asian, and Minority Ethnic backgrounds will be remunerated at £10 per referral. This will initially be capped at a total of 300 i.e. the maximum number of referrals from all participating pharmacies in B&H.

Payment will be made quarterly on receipt of appropriate documentation and completion of the data capture templates on PharmOutcomes and submitted to Brighton & Hove City Council.

1. Termination and Change Requirements

Termination can be made earlier by either party at 1 months’ written notice.

Training

RSPH Level 2 Understanding Health Improvement (for workplace health champions) can be accessed by community pharmacies free of charge. Training sessions are available via Brighton & Hove Learning Gateway.

Quarterly training will be accessible via a specific Pharmacy tab on the Brighton & Hove Learning Gateway. The HLP training scheduled will be informed by local campaigns, local public health intelligence and feedback from pharmacy teams.

Quarterly training courses will be communicated to pharmacy teams 6 weeks before the date of the training via email

Guidance on how to enrol on the Brighton & Hove Learning Gateway can be provided if needed.

Campaign materials

Local campaigns will be decided quarterly by the public health team and will be informed by locally collected intelligence.

Display materials will be provided by the Health Promotion Library based in the Audrey Emerton building on Eastern Road.

Health Champions as part of their role are required to manage the ordering of leaflets, posters and booklets to support the campaigns. Effective display training and the process for ordering show materials will be incorporated into the HC training days. Pharmacy contractors can also use their own display materials to support the health campaigns.

Additional show materials required during the interim quarters can be requested from the library. (To download form type Health Promotion Resources into the search application).

Go to the Brighton and Sussex NHS Library and Knowledge Service website.

Roland Christopher manages the health promotion materials. Send an email to Roland.Christopher@nhs.net or phone 01273 523 300.

Public Health contacts

Senior Health Improvement Specialist

Roisin Thurstan

Brighton & Hove City Council

Send an email to Roisin.Thurstan@brighton-hove.gov.uk.

Public Health Team Office Manager

Ellie Katsourides

Brighton & Hove City Council

2nd Floor, Hove Town Hall, Norton Road, Hove, BN3 3BQ 

Send an email to publichealth@brighton-hove.gov.uk.