There is widespread inconsistency in areas where key public health services are being offered in pharmacies, according to a report published in the British Medical Journal.

It found that four services – emergency contraception, smoking cessation support, supervised methadone and needle and syringe programmes – are commissioned by over 90% of local authorities.

However, the proportion of pharmacies commissioned to deliver these services varied massively between areas and was not related to health needs.

Pharmacy-based NHS Health Checks were commissioned by little over 30% of authorities, while screening for alcohol use was offered by just 15%. Several other services were commissioned by less than 10% of local authorities.

The report is the first to map service commissioning by all 152 local authorities in community pharmacies across England.

Missed opportunities

Dr Adam Mackridge, co-author of the study, said the gaps in provision may lead to missed opportunities to protect public health.

He said: ‘If we commission the right services in the right areas using local pharmacies we could provide better value for money for the NHS and improve the health of local communities. There needs to be a better link between local health needs and use of pharmacies to address this, particularly where there are gaps in current provision.’

Professor Janet Krska, Professor of Pharmacy Practice at Medway School of Pharmacy and lead author of the study, said: ‘Our findings demonstrate the significant extent to which community pharmacies already contribute to public health improvement, but also illustrate how much better the many services they can offer could be distributed.

‘We hope that our study will be of use to local authorities in developing their Pharmaceutical Needs Assessments, as for the first time they will be able to compare the services they commission to those provided across England.’

Findings ‘concerning’

The Royal Pharmaceutical Society (RPS) suggested the study reveals a ‘concerning’ mismatch between local health needs and service provision.

Director of the RPS in England Robbie Turner said: ‘Pharmacy teams can make an impact on public health when population health needs and services are aligned’, describing the Healthy Living Pharmacy model as an example of how pharmacies can reduce health inequalities.

He added: ‘Better public health has a vital role in reducing costs to the NHS and social care and the accessibility and reach of pharmacies mean they can make a unique contribution to improving health outcomes.’

However, local authorities need the funding to provide these public health services, and many are seeing their budgets being cut, not boosted.

Use rates of public health services commissioned through community pharmacies

Supervised consumption – 4.4 million

Needle and syringe packs – 1.4 million

Emergency contraception – 200,000 consultations

Stopping smoking aids – 55,000

Free condoms – 30,000

Alcohol use screening – 30,000

NHS Health Checks – 26,000

Chlamydia screening kits – 16,000