Pharmaceutical Needs Assessment (PNA) in Liverpool - Coursework Example

and Number of the Teacher’s PHARMACEUTICAL NEEDS ASSESSMENT IN LIVERPOOL, ENGLAND INTRODUCTION Pharmaceutical Needs Assessments (PNA) is a strategy document that evaluates deficit areas in health care management and treatment requiring development, enhancement or support. Used as commissioning tools, they help to promote and improve the locally existing pharmaceutical services in various places, as in Liverpool. The aim of PNA is to provide improved services for the benefit of local patients. In this connection, the Joint Strategic Needs Assessment (JSNA) for Liverpool which includes various agencies, produces practical findings that directly address health concerns and shape people’s lives in the city. The JSNA impacts the plans and operations of local services such as the Primary Care Trust (PCT), the City Council, partner agencies and the people of Liverpool themselves, to achieve optimal health outcomes (JSNA 2). Thesis Statement: The purpose of this paper is to investigate the application of Pharmaceutical Needs Assessment as Joint Strategic Needs Assessment in Liverpool, England. Further, the possible pharmaceutical needs that a community pharmacy in Liverpool can offer to patients will be identified, and the reasons for offering a particular pharmaceutical need will be determined. DISCUSSION Pharmaceutical Needs Assessment and its Application in Liverpool, England According to Liverpool PCT (p.3), “for too long Liverpool has experienced some of the poorest health in the country”, and there exists a wide gap in health equalities between Liverpool and the rest of England. With funds available for the purpose, and knowledge regarding the necessary actions to be taken, the JSNA provides an unprecedented opportunity to improve health and well-being in Liverpool. However, the National Health Service (NHS), similar to other public sector organizations, has been unable to work in true partnership. A new approach is required, facilitating NHS Liverpool to combine efforts to improve health and ensure the delivery of world class health services, including support to children, vulnerable adults and elderly people. The guiding principles of the Joint Strategy Needs Assessment (JSNA) process in Liverpool include the most effective use of information and evidence through partnership working between the City Council and the Primary Care Trust. It also ensures that the methods, processes and outcomes are simple and practical, and engages the participation of the community. JSNA uses the latest epidemiological information and current evidence of effective interventions, and aligns its functioning with Primary Care Trusts and City Council delivery plans, whose initiatives are also informed by the JSNA process (JSNA 4). The health care plans should be aligned with the Children and Young People’s Plan and that for adult care (Liverpool PCT 3). The Joint Strategic Needs Assessment is a process that helps people understand and describe the health, care and well-being needs of people in Liverpool, and the relationship of poverty and deprivation to health conditions. Adverse outcomes emerge from “restricted work opportunities, poor living conditions, low incomes, low educational attainment, and limited access to health services” (JSNA 2), all of which directly cause ill health and premature death in Liverpool. For the first time in Liverpool, a comprehensive overview of the city’s needs give extensive information on several aspects of life and death in Liverpool from which some of the key problems can be identified. The overview of need helps in developing the Liverpool Local Area Agreement (LAA) and other plans and commissioning strategies that fuel the actions taken by the public service and other agencies to enhance citizens’ lives in Liverpool. Possible Pharmaceutical Needs Offered by a Community Pharmacy in Liverpool The JSNA process helps in comprehending how serious conditions such as cardiovascular disease, mental ill-health, or cancer impacts differently on people across the city. Moreover, it identifies the sections who are most affected, the extent to which they receive adequate support and treatment, the most effective ways of intervening while taking into consideration “people’s different lives, preferences, and circumstances” (JSNA 3). Key priorities are focused on every year through a programme of work. Each of these priorities is a major source of inequality in Liverpool, with a possible significant impact on the way services are carried out in the different parts of the city. Provision of services by Liverpool pharmacies and available work force need to be improved with the help of pharmaceutical needs assessments that fit with a world class commissioning framework. Integration with primary care trusts and other organizations is essential. a The Joint Strategic Needs Assessment updated annual report (Update 1) presents the latest information for the city of Liverpool, which contributes to the commissioning of public services in the city, particularly health and social care. The health of people in Liverpool is worse than the averages for England, particularly for mental illness, deprivation and adults who smoke. Inequalities by deprivation is immense and affects life expectancy adversely. Similarly inequalities by gender and ethnicity are extensive. Decline in death rates over the last ten years is slower than the national average for England. Additionally, the early death rate from cancer is the worst in England, as is the poorer health of children and young people. According to Liverpool PCT (pp.6-17), the pharmaceutical needs that a community pharmacy in Liverpool can offer to patients is related to health care facilities delivering adequate health care support, providing a better understanding of self care, customer-focused care, eliminating long waiting periods by the National Health Services (NHS), and the provision of multidisciplinary care through combined services. The areas most in need of improvement include inequalities in health, coronary heart disease, stroke, cancer, diabetes, respiratory disease, alcohol, infant mortality, dementia, sexual health and genito-urinary medicine, help for elderly people, the physically or sensorily impaired, those with learning disabilities; and support for carers, children and young people. Primarily, it is essential to improve the facilities for monitoring health and identifying illnesses through the testing of vital physiological parameters related to blood pressure, cholesterol levels and blood sugar. In England health priorities impact changes to “policy, planning and service delivery and can make the greatest potential difference to the health and well-being of the city’s population in a relatively short period of time” (JSNA 26). The health priorities in Liverpool that need changes in health care policies, as well as their implementation through community pharmacies are largely related to deprivation in different aspects. Thus, high rates of morbidity and mortality related to deprivation need to be addressed. The core areas of concern relating to children’s health which impact pharmaceutical needs assessment include: addressing higher infant mortality rate, childhood obesity due to low physical activity and poor nutrition, controlling rise in teenage pregnancy, reducing poor oral health through early years preventive work promoting oral hygiene, improving acute hospital services associated with paediatric accident and emergency work handled in different settings, in connection with Primary Care Trusts. Children’s JSNA focuses on “the needs of children with disability, special education needs, young carers, children in care and those from underachieving black and minority communities will help to address the gap in health inequalities for these groups” (Update 6). In the overall population of Liverpool, the lower life expectancy is related mainly to premature death caused by cardiovascular diseases (CVD) and cancer. The Health Inequalities National Support Team (HINST), November 2009 used interventions with short-term effects, focusing on primary care “optimal coverage for CVD treatment, diabetes management, chronic obstructive airways disease management, brief alcohol interventions” (Update 8) and reduction of smoking. Efforts to prevent CVD and cancer in the long term should be maintained through comprehensive methods targeted at inequalities in life expectancy across the city, and the lowest life expectancies in the smaller geographical areas in the north and south of Liverpool. The Joint Health Unit is a new collaboration between Liverpool Primary Care Trust and Liverpool City Council, to strengthen JSNA partnership working in the city (Update 1). CONCLUSION This paper has highlighted the application of Pharmaceutical Needs Assessment as Joint Strategic Needs Assessment in Liverpool, employing a partnership between the NHS’ Primary Care Trust, the City Council, partner agencies and the people of Liverpool themselves. In Liverpool, the main priorities for improvement of health and well-being relate to the most significant cause of morbidity and mortality being health inequalities related to deprivation and poverty, across the city. To meet the inequalities in health and reduce the incidence of diseases, the root causes of deprivation need to be addressed. Education and employment opportunities have to be increased to empower the general population of Liverpool. Community health awareness needs to be raised through posters, advertisements and free health camps. Government funds should be channelised towards improving community pharmacies according to the findings and suggestions put forth by the Joint Strategic Needs Assessment document. Pharmaceutical Needs Assessment in the context of work done by Primary Care Trusts and other agencies is an essential requirement. Liverpool pharmacists need to be better trained and informed with adequate knowledge to meet the health requirements of the local communities in relation to cardiovascular diseases, cancer, diabetes, dementia and other diseases. Qualified specialists from all medical disciplines and social work services should form a strong base for Liverpool pharmacies, to meet inequalities in different geographical areas of the city, and improve the health needs of the community. WORKS CITED JSNA. Better together: Joint strategic needs assessment (JSNA). Liverpool NHS Primary Care Trust. (September 2008). Retrieved on 12th March, 2010 from: http://www.liverpool.gov.uk/Images/tcm21-146821.pdf Liverpool PCT (Primary Care Trust). A new health service for Liverpool. Strategic plan 2008-11. National Health Services (NHS). (December 2007). Retrieved on 12th March 2010 from: http://www.centralliverpoolpct.nhs.uk/Library/about_us/Docs/strategic-business-plan/stratplanfull_08-11.pdf Update. Joint strategic needs assessment update for 2009. (2009). Retrieved on 12th March, 2010 from: http://www.liverpoolpct.nhs.uk/Library/Needs/JSNA%20Update%20for%202009%20FINAL.pdf Read More