The cost-of-living crisis is adding to already widening health inequalities, which are determined by circumstances beyond an individual’s control. They result in differences in life expectancy, health status, access to care and quality of care.
It is frustrating that it has taken COVID-19 for us to hold a mirror up and properly consider health inequalities.
Equally frustrating is that research by the Company Chemists’ Association has found that between 2015 and 2022, over 40% of permanent community pharmacy closures took place in the 20% most deprived parts of England.
That means that the people who most need our services are unable to access them. If the dire funding situation for community pharmacy continues, this will only worsen.
Read more: Health inequalities: Time to see beyond words, accent or history, RPS says
Our pharmacy teams are key to tackling health inequalities.
I also don’t want to dismiss the fact that many pharmacy staff tend to be from their local population. This means that helping to tackle health inequalities will also have a directly positive impact on our teams.
Read more: Cost-of-living crisis: How are pharmacies supporting their staff?
We gauge the mood of our communities and are a trusted part of the community. One example is the sensitive conversations we have with patients about prescription charges.
I have certainly been having more of these conversations and have been receiving more enquiries about prepayment options available.
According to a recent Healthwatch survey, one in 10 people avoided taking up one or more NHS prescriptions in December because of the cost.
In the same month, one in 10 also avoided buying over the counter medication they normally rely on. This is an additional concern for patients already struggling to heat their homes.
Read more: Teva alerts health secretary to energy prices impact on pharmacies
Properly considering health inequalities means we have to have some uncomfortable conversations with our teams.
We need to ensure that we are aware of our biases. Are we prejudging patients who come into our pharmacy?
Do we just presume someone speaks English, for example, or that they can read?
According to UNESCO, despite the steady rise in literacy rates over the past 50 years, there are still 773 million illiterate adults around the world, most of whom are women.
That means that the directions on the labelled medication we are providing are inaccessible to some of our patients.
We need creative solutions to help our patients and we shouldn’t be scared of asking for more feedback on how we can assist better. We owe it to our patients as part of offering patient-centred care.
Following the publication of the Royal Pharmaceutical Society's ‘Tackling health inequalities: Delivering accessible pharmaceutical care for everyone’ paper, there are some practical steps we can take in the short term.
For example, when I have had the opportunity to speak to charity representatives, they tend to say they wish the pharmacy team could come to them. With the pressures we are facing, that is definitely tricky, but video links and digital communication may help bridge the gap.
Read more: Cost of living: Pleas to scrap script charge as patients forced to reduce meds
During the COVID-19 pandemic, I was privileged enough to support a patient who was hard of hearing. They chose to use our services and I was able to use an app to communicate with them. They chose to access our service over others because they knew they would be able to communicate seamlessly with us this way.
Ensuring that the full list of services available from the pharmacy is clearly communicated, and considering the range of media that can be used to do this, is another practical step that can be adopted.
Finally, being more proactive and offering the consultation room for discussions with patients before they even ask is another practical step that we can take.
Perhaps even asking their reasoning if they decline would be another step, so we can better understand patient needs.
Thorrun Govind is a pharmacist and healthcare lawyer. She is writing in a personal capacity
