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Get to know the needs of your community

Changes within health and social care provide opportunities for pharmacy to address health inequalities within local communities

By Alia Gilani, MPC, MRPharmS

In the 21st century one of the biggest hurdles to overcome for healthcare professionals is an acceleration in the prevalence of certain chronic conditions leading to challenges in prevention and treatment. Much emphasis in healthcare delivery is placed on modern medicine, which has undoubtedly contributed to an increase in life expectancy in the UK population.

Yet, in spite of this increase, the gap in health inequalities has widened over the past century. The eminent epidemiologist Geoffrey Rose was clear about what our focus should be: “The primary determinants of disease are mainly economic and social, and therefore its remedies must be economic and social.”1  

In Scotland the “Equally well” report (2008) and in England the Marmot review “Fair society, healthy lives” (2010) provided evidence of the extent of health inequalities and the huge amount of work required to improve the situation. The latter report in particular offered strategies to address the social determinants of health.

Key Government policy drivers encourage the NHS to make reducing health inequalities a priority, for example, by collaborating with social care providers. Indeed, new and forthcoming legislation in England and Scotland, respectively, supports the notion of the NHS and social care working together to deliver innovative services to meet the needs of the community.

Since the causes of inequalities are social and economic, I believe that current models of care may have to be adapted to make real and lasting improvements in areas of deprivation. Ultimately health inequalities are preventable. So what does this mean for pharmacy?

Stronger links are required that enable pharmacists to work within wider multidisciplinary teams — and this includes being more proactive in signposting to other appropriate services as well as in the management of disease. To give an example, the Glasgow pharmacy medication review model was reconfigured to establish a “minority ethnic long-term medication service” (MELTS) — a linguistically sensitive initiative that allows those with chronic conditions to be referred to the wider health and social care team.

I believe that to have a meaningful impact, pharmacy as a profession needs to take a less parochial approach to healthcare delivery. To that end, undergraduate education and training needs to broaden future professionals’ views of healthcare to include social justice and cultural beliefs. And today’s pharmacists should get to know and understand their community, its needs and what inequalities exist; only then will we be in a position to contribute to decisions about service provision.

With changes in social care, now is the time for our profession to cement its place within the primary care team and be at the forefront of tackling inequalities.

Alia Gilani is health inequalities pharmacist for the NHS in Glasgow.



  1. Rose G. The strategy of preventive medicine. Oxford: Oxford University Press; 1992.


Citation: Clinical Pharmacist DOI: 10.1211/CP.2013.11127236

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