Providing care to marginalised communities: a qualitative study of community pharmacy teams

Problem

The NHS Long Term Plan (2020) emphasises action is required to reduce health inequalities. Recent evidence shows that health inequalities in the UK are widening, with recent government data showing that the most deprived areas of society have been disproportionately affected by the pandemic, particularly in the North of England. Community pharmacies are the most visited healthcare provider in England with approximately 1.6 million visits a day. Given recent expanded roles in community pharmacy to include health prevention and health screening, community pharmacists are ideally placed to provide and facilitate access to care for those most disadvantaged. However, little is known about the contributory role of community pharmacists in reducing health inequalities. Against this backdrop, this study aimed to explore the current and potential role of community pharmacy teams in relation to reducing health inequalities with a focus on how their role has changed since the COVID-19 pandemic.

Approach

Data collection took place between March and August 2022. Individual qualitative interviews were conducted with 26 community pharmacy team members. The sample included a range of independent and ‘chain’ community pharmacies based in deprived communities across the North and North West of England. A topic guide was developed and informed by the literature and subsequently reviewed and discussed with the Community Pharmacy Patient Safety Collaborative team at The University of Manchester, which is comprised of 7 community pharmacists working across Greater Manchester. All interviews were audio recorded and transcribed verbatim. Data was analysed thematically drawing on techniques of a grounded theory approach, including open coding, constant comparison, and analysis of negative cases.

Findings

Most participants acknowledged that since the start of the covid-19 pandemic, community pharmacies had become busier due to the increased demand for a face to face consultation. This demand was compounded by patient difficulties in navigating remote digital systems. Few participants had received any formal training on working with marginalised communities however organisational barriers (such as limited access to translation services and limited time and resources) combined with inter-organisational barriers (lack of integrated working with GPs), made it more difficult to provide care for some marginalised groups. However, the continuity of care provided by many community pharmacists was viewed as an important factor in enabling marginalised groups to access and receive care.

Consequences

In the context of a post pandemic society in which remote care and digital technologies are increasingly relied upon to navigate healthcare systems, the roles of community pharmacy teams are more important than ever. More flexible and collaborative working across health and community organisations, in addition to translation services, would be advantageous in enabling community pharmacists to provide access to safer and equal care for marginalised communities.