Community pharmacies represent credible and trustworthy services across the UK, which could be key to COVID-19 vaccination campaigns, especially when addressing vaccine hesitancy.
Pharmacy. Image Credit: Aleksandar Malivuk/Shutterstock.com
One of the four pillars of the UK primary care system
New research led by Aston University in Birmingham, UK, in collaboration with UK and international researchers, shows how community pharmacies play a 'key clinical role' in the future role of COVID-19 vaccination programs.
The study published in the journal BMJ Open found that community pharmacists provide an extensive 'skilled clinical workforce', which could positively contribute and support the community in which they serve. Community pharmacies are viewed as one of the four pillars of the primary care system in the UK, along with general practice, optical services, and dentistry.
As of March 2019, there were more than 11,500 community pharmacies in England alone according to the King's Fund. With the recent COVID-19 pandemic, these pharmacies have helped to deliver COVID-19 vaccinations across the UK.
The present study reviewed over one hundred documents including peer-reviewed articles, blogs, and websites on the role of community pharmacies during COVID-19 and other previous pandemics. The team then corroborated with more than 30 health professionals and members of the public to ensure the reliability of findings in real-world applications. These professionals included pharmacists, pharmacy technicians, dispensers, counter assistants, and GPs, together with members of the public from a range of diverse ethnic backgrounds
Following the data collection and result discussion, recommendations and measures of guidance were made by the researchers based upon the analysis. Importantly, the researchers found policy and practice needed to focus on the clinical role of community pharmacy
We need to use community pharmacy to a much greater extent for COVID-19 vaccination, particularly for boosters against new variants such as the Delta (Indian) variant. The current model (for example, the large hubs) may not be sustainable in the longer term, particularly if annual COVID-19 vaccination is required.
Our work found some key ways to make this happen. The easy access and local convenience of high street pharmacies make them an ideal location for vaccinating at-risk populations."
Dr. Ian Maidment, Aston University
Policy advice to maximize the effectiveness of community pharmacies
Several measures were elaborated to guide policymakers into using community pharmacies to their greatest effects during the current or any future pandemics.
These recommendations included the determination of a clear role for community pharmacy in response to the public health agenda, to involve frontline community pharmacists in the development of policy and service specification in relation to vaccination.
Additionally, policymakers should focus on providing prompt, clear, consistent guidelines with adequate detail and enough flexibility to allow community pharmacies to adopt the guidelines to meet the needs of their local population, to provide adequate funding and reimbursement for the delivery and necessary adaptations of any new services community pharmacies are asked to deliver.
Finally, policies should also aim to provide pharmacy teams with adequate systems to deliver this new role and then trust them to deliver.
If such measures are enforced, then community pharmacies may serve as key centers for prevention, treatment, and vaccination efforts. This is particularly significant as they are often situated in areas further away from other major pharmacies and provide services for many ethnic minorities, which are at the forefront of COVID-19 impacts.
Hadar Zaman, head of pharmacy and medical sciences at University of Bradford and a community pharmacist, describes the research findings: "Our research has highlighted the important role community pharmacy has played in overcoming vaccine hesitancy, particularly in ethnic minority communities who have been disproportionately affected by COVID and subsequent mortality.”
He then added, "What comes out very strongly, especially in areas of high social deprivation, is that community pharmacists have worked very closely with their local communities addressing concerns around vaccine safety. It is through these strongly rooted relationships in local communities that we will ensure vaccine uptake rates in ethnic minorities and the wider population can be further improved. Therefore, community pharmacy needs to be seen as an essential delivery partner if the Government is to achieve its national vaccination coverage in the short and long term."
Looking forwards and outwards for the role of community pharmacies
Thanks to the international basis of the research team as well as the collection of international data, the findings extend beyond the United Kingdom, providing a basis to other countries around the world. Further research could provide more detailed differences in approaches between countries or across regions while maintaining a key contact with frontline workers as this study integrated.
Community pharmacies, therefore, serve as frontline bases to act against the current pandemic and must be wielded with clear guidelines as discussed in this study.
This research provides a timely examination of the role community pharmacy teams have played in supporting their communities to fight back against COVID-19. These findings will help guide policy in the later stages of the pandemic and guide practice in any future pandemics."
Alastair Buxton, director of NHS Services at the Pharmaceutical Services Negotiating Committee
By keeping their doors open throughout, pharmacies have maintained day-to-day activities, and managed increased demand for many services - including advice on the management of minor illness. They have also substantially increased the number of vaccinations administered and played a key part in the COVID-19 vaccination program.
Maidment I, Young E, MacPhee M, et al Rapid realist review of the role of community pharmacy in the public health response to COVID-19. BMJ Open 2021;11:e050043. doi: 10.1136/bmjopen-2021-050043