Healthy Living Pharmacies

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Healthy Living Pharmacies

The Healthy Living Pharmacy (HLP) framework is a tiered commissioning framework aimed at achieving consistent delivery of a broad range of high quality services through community pharmacies to meet local need, improving the health and wellbeing of the local population and helping to reduce health inequalities.

The HLP framework is underpinned by three enablers:

  • workforce development – a skilled team to pro-actively support and promote behaviour change, improving health and wellbeing;
  • premises that are fit for purpose; and
  • engagement with the local community, other health professionals (especially GPs), social care and public health professionals and local authorities.

Quality Payments Scheme
Achieving HLP level 1 (self-assessment) is now a Quality Payment criterion for the Quality Payments Scheme 2017/18. Further details on the Quality Payments Scheme can be found on the Quality Payments hub on the PSNC website.


Click on a heading below for more information.

Introduction and background

The  HLP concept was developed in Portsmouth in 2009 with support from the Department of Health (DH), the Director of Public Health and the Local Pharmaceutical Committee following the publication of the 2008 White Paper, Pharmacy in England: building on strengths, delivering the future. The White Paper described a vision to to develop community pharmacies from being suppliers of medicines to become Healthy Living Centres providing self-care advice and treatment for common ailments and healthy lifestyle interventions, in addition to providing the safe supply and use of prescribed medicines.

The HLP framework was launched and in September 2010, Portsmouth HLPs delivered positive interim results. In March 2011, the national pharmacy bodies started working with DH to launch the HLP pathfinder programme, which resulted in an evaluation being published in April 2013. Following this, Public Health England (PHE) adopted the concept and supported the roll out in pharmacies across the country.

What is a HLP?

HLP is an organisational development framework underpinned by three enablers of:

  • workforce development – a skilled team to pro-actively support and promote behaviour change, improving health and wellbeing;
  • premises that are fit for purpose; and
  • engagement with the local community, other health professionals (especially GPs), social care and public health professionals and local authorities.

The HLP concept provides a framework for commissioning public health services through three levels of increasing complexity and required expertise with pharmacies aspiring to go from one level to the next.  

There are three levels of service delivery within the HLP framework:

  • Level 1: Promotion – Promoting health, wellbeing and self-care (in July 2016, Level 1 changed from a commissioner-led process to a profession-led self-assessment process);
  • Level 2: Prevention – Providing services (commissioner-led); and
  • Level 3: Protection – Providing treatment (commissioner-led).

PHE has published the below set of infographics to illustrate the role of HLPs in the health and care system.

Hlp

Hlp 2

Hlp 3

 

 

 

How to become a HLP Level 1 (includes new PSNC resources)

PSNC Briefing 003/17: Quality Payments – How to become a Healthy Living Pharmacy Level 1 provides an overview of how to achieve the Healthy Living Pharmacy (HLP) criterion of the Quality Payments (QP) Scheme.

Key requirements that must be met before becoming a HLP Level 1

The following requirements must be met before a pharmacy can be registered as a HLP Level 1, therefore contractors should ensure that they meet the requirements before they start working their way through the quality criteria:

How to achieve HLP Level 1

In July 2016, the HLP Task Group of the Pharmacy and Public Health Forum developed a new process for the implementation of Level 1 HLPs. The intention was to move from a totally commissioner-led HLP accreditation system to a profession-led self-assessment process for Level 1 HLPs, based on clear quality criteria and underpinned by a proportionate quality assurance process. PHE has published a letter explaining this in more detail. 

PHE has published the self-assessment guide, which sets out the quality criteria that pharmacies must achieve to gain HLP Level 1 status. Pharmacy teams must be able to provide evidence of their behaviours and activities as well as the physical environment. The quality criteria have been endorsed and ratified by the Pharmacy and Public Health Forum.

Below is a checklist of the 27 quality criteria which pharmacy teams need to achieve to gain HLP Level 1 status:

HLP Level 1 checklist (Word)

HLP Level 1 checklist (PDF)

A HLP Level 1 Evidence Portfolio Workbook which pharmacy teams can use to guide them through the HLP quality criteria and assist them with recording their evidence to show they have reached HLP Level 1 is available below:

HLP Level 1 Evidence Portfolio Workbook (Word)

HLP Level 1 Evidence Portfolio Workbook (PDF)

 

A flow chart detailing the process to follow to achieve HLP Level 1 can also be found below:

HLP Level 1 flow chart (Word)

HLP Level 1 flow chart (PDF)

Action once a contractor has met the requirements for HLP Level 1

Once a contractor has met all the requirements for HLP Level 1, they should use the self-assessment tool available on the Royal Society for Public Health (RSPH) website to make notes on how they meet each criterion.

Part 1 of the assessment of compliance should then be completed which relates to the key requirements that the pharmacy must have in place before HLP Level 1 status can be granted and the HLP logo displayed. Pharmacy professionals must be able to indicate YES to all statements by ticking the appropriate boxes to be compliant (this web-based form must be completed by a registered pharmacy professional (pharmacist or pharmacy technician) in the pharmacy, who must provide their General Pharmaceutical Council registration number).

Part 2 of the assessment of compliance should then be completed, which is the section of the framework that asks the pharmacy professional to state the evidence they possess in the pharmacy, which they can use to demonstrate compliance with the requirements. Evidence must be provided against all requirements.

Part 3 requires the pharmacy professional to declare compliance with the HLP Level 1 quality criteria and to submit this electronically.

Once submitted, the form will be sent electronically to the RSPH and after receipt and review, a copy will be sent to the pharmacy email address that the pharmacy professional provided in Part 3. A copy of this email should be retained in the pharmacy so it is available for inspection.

RSPH will endeavour to contact contractors by mail or email within 10 working days after they have received the submitted online assessment of compliance form to confirm registration and provide the HLP logo and certificate.

The HLP logo and if possible, the certificate, should then be displayed in the pharmacy.

Other resources for pharmacy contractors and their teams

Action plan template – A template that can be used to outline actions that need to be achieved, by whom and by when to achieve HLP level 1 status. 

Making it happen – This document provides guidance for LPCs and contractors on the things that work well and the things learned along the way by those already involved in establishing HLPs.

The role of the Health Champion – This document provides more information on the role of the Health Champion, who can become a Health Champion and the training available.

Pharmacy staff that wish to become a Health Champion have to have undertaken the RSPH Level 2 Award in Understanding Health Improvement.

The Professional Standards for Public Health Practice for Pharmacy provide a framework to help pharmacy teams, commissioners and those contracting services to design, implement, deliver and monitor high quality public health practice through pharmacy.

PHE publish a quarterly e-newsletter to provide updates on national HLP development and share innovative practice from across the country.  To sign up to receive future quarterly issues, please email hlpnewsletter@phe.gov.uk.

PharmOutcomes support for HLP Level 1

If an LPC or a commissioner has a full PharmOutcomes licence, they can make available a HLP Level 1 framework for contractors to access on PharmOutcomes free of charge. This framework will allow contractors to track their progress with achieving the HLP quality criteria. If contractors would like to consider using the framework, they should contact their LPC to see if this is available in their area.

Where the assessment has been made available by a commissioner, contractors who own multiple pharmacies can view the progress that each of their pharmacies are making to achieving the HLP Level 1 quality criteria by using their PharmOutcomes head office/administrator viewer login.

Where an LPC has a licence for PharmOutcomes, they will be able to view the progress their contractors are making to achieving the HLP Level 1 criteria by making the framework available. This will help identify additional support that contractors require.

To support the HLP initiative, Pinnacle Health LLP has introduced a new low cost HLP licence starting at £995 plus VAT. This allows organisations such as LPCs to make the assessment available across a whole area. The licence type provides access to the communications functionality and the assessment functionality only. Please contact the PharmOutcomes helpdesk for more information.

Once a contractor has logged into PharmOutcomes, the framework can be accessed by clicking on the ‘Assessments’ tab on the PharmOutcomes homepage.

If a contractor requires PharmOutcomes login details for one of their team members, these can be obtained by sending a message to the PharmOutcomes helpdesk. Contractors will need to provide details of the pharmacy, contact information and an email address to issue the login details to.

If a contractor does not have a head office/administrator viewer login this can be obtained by sending a message to the PharmOutcomes helpdesk. Contractors will need to provide details of pharmacy sites, contact information and an email address to issue the login details to.

Training providers

Some LPCs are arranging local HLP training for their contractors; contact your LPC to see if they are organising any training.

There are a number of organisations that provide HLP training for pharmacy staff and those that PSNC has been made aware of are listed below for information (listing on this website does not constitute endorsement of the course or provider by PSNC):

Buttercups Training Ltd

Centre for Pharmacy Postgraduate Education

National Pharmacy Association

Numark

Pharmacy Complete

Tees LPC

Quality assurance visits for HLP Level 1

The quality assurance (QA) process, overseen by the RSPH, is intended to assure the public, commissioners, and other healthcare professionals that the HLP quality criteria are met consistently across the country.

Contractors may be required to provide evidence to the RSPH to show that they have met the HLP Level 1 criteria. Several HLP Level 1 pharmacies will be chosen at random to be visited by an examiner, working on behalf of the RSPH, to have their compliance of assessment document and supporting evidence verified.

If your pharmacy is selected for a QA visit, you will be notified in advance by the RSPH.

Further information about the QA process is available on the RPSH website

Resources for LPCs

A number of LPCs who have HLPs up and running in their areas or on their way to having pharmacies accredited as HLPs have advised that they are happy to provide support and advice to other LPCs who are looking to approach commissioners about the HLP concept or to provide guidance on the implementation of HLPs. Their contact details can be found below:

LPC contact details

HLP prospectuses

A number of commissioners/LPCs have created prospectuses to provide further information on HLPs:

Dudley Healthy Living pharmacy prospectus 2015

Hampshire Healthy Living Pharmacy Prospectus 2014

Hampshire Healthy Living Pharmacy (service requirements and quality criteria) 2014

Hertfordshire Healthy Living Pharmacy Prospectus

Lancashire Healthy Living Pharmacy Prospectus 2014

Tees Healthy Living Pharmacy Prospectus 2015/16

West Yorkshire Healthy Living Prospectus Level 1, Wave 3

Other resources

Making it happen – This document provides guidance for LPCs and contractors on the things that work well and the things learned along the way by those already involved in establishing HLPs.

A PowerPoint presentation for LPCs on HLPs can be used by LPCs/community pharmacists as the basis for a presentation on the HLP concept to:

  • local patient groups;
  • local government officers and councillors;
  • CCGs;  and
  • other groups that have an interest in community pharmacy.

The Professional Standards for Public Health Practice for Pharmacy provide a framework to help pharmacy teams, commissioners and those contracting services to design, implement, deliver and monitor high quality public health practice through pharmacy.

PHE publish a quarterly e-newsletter to provide updates on national HLP development and share innovative practice from across the country.  To sign up to receive future quarterly issues, please email hlpnewsletter@phe.gov.uk.

Resources for commissioners

The why, the how and the what – This document provides more information on HLPs.

Information for CCGs and General Practices – Further information on HLPs aimed specifically at Clinical Commissioning Groups (CCGs) and General Practices.

Information for LAs – Further information on HLPs aimed specifically at local authorities.

The Professional Standards for Public Health Practice for Pharmacy provide a framework to help pharmacy teams, commissioners and those contracting services to design, implement, deliver and monitor high quality public health practice through pharmacy.

Gul Root (Pharmaceutical Public Health Adviser in PHE’s Health and Wellbeing Directorate) is the strategic lead for HLP and commissioners can contact her to discuss HLPs.

PHE publish a quarterly e-newsletter to provide updates on national HLP development and share innovative practice from across the country.  To sign up to receive future quarterly issues, please email hlpnewsletter@phe.gov.uk.

HLP evaluations

HLP pathfinder sites evaluation

The evaluation of the HLP pathfinder sites was launched on the 22nd April 2013 and the key findings were:

  • early results seen in Portsmouth can be replicated in other areas of the country as the benefits of the scheme were shown not to be dependent on levels of local health need and deprivation;
  • the HLP concept was consistent with increased service delivery and improved quality measures and outcomes;
  • 21% of people surveyed wouldn’t have done anything if they hadn’t accessed a service or support in the HLP so would have missed out on the benefit of getting advice to improve their health and wellbeing;
  • 60% of peopled surveyed would have otherwise gone to a GP;
  • public feedback was positive with 98% saying they would recommend the service to others and 99% were comfortable to receive the service in the pharmacy;
  • more people successfully quit smoking in HLPs than non-HLPs or prior to becoming a HLP;
  • the number of people who accessed sexual health services and were provided with additional sexual health advice was greater than in non-HLPs;
  • the acceptability of community pharmacy as a location for clients to receive an alcohol service and the relatively high levels of activity seen in HLPs compared with non-HLPs showed that HLPs could have an important contribution to this harm reduction service;
  • HLPs were effective at delivering increased support for people taking medicines for long term conditions, through both Medicines Use Reviews and the New Medicine Service. Activity was higher for both services in HLPs than non-HLPs or before HLP implementation in all but one site; and
  • pharmacies were also positive about the scheme; with 70% of the contractors surveyed saying it had been worthwhile for their business.

Duncan Selbie, Chief Executive of PHE, highlighted the results from the HLP evaluation in his weekly message on 26th April following the evaluation launch:

‘Pharmacies have a major role to play in helping improve the public’s health, with 1.8 million people visiting a pharmacy each day. On Monday, the evaluation of the Healthy Living Pharmacy Programme was launched at the Royal Pharmaceutical Society. Led by a collaboration of all the national pharmacy bodies and supported by the Department of Health and the public health organisations, there are now 508 Healthy Living Pharmacies in England. The results are really impressive. The public ‘strongly’ approved of the pharmacies which have signed up, with over 98% saying they would recommend them. Results have been equally encouraging in Stop Smoking services, with the Healthy Living Pharmacies delivering a significant improvement in the number of quits. The public and patients have also been much more positively engaged in other lifestyle areas where advice and support have been given by pharmacy Health Champions accredited by the Royal Society for Public Health’.

HLP evaluation executive summary

HLP evaluation (full document) 

Other evaluations on HLPs

University of Bradford – Evaluation of the West Yorkshire Healthy Living Pharmacy Programme (January 2014)

Teeside University – An evaluation of the Tees Healthy Living Pharmacy Pilot Scheme (August 2013)

FAQs

Q. What are the criteria for becoming a Healthy Living Pharmacy (HLP) Level 1?
The Healthy Living Pharmacy: Level 1 quality criteria set out the criteria that pharmacies must achieve to gain HLP Level 1 status.

Q. My pharmacy achieved HLP status before the self-accreditation process was announced. Does this mean my pharmacy meets the HLP Level 1 status?
PSNC has asked NHS England to consider a ‘grandparenting’ approach for pharmacies that have achieved HLP status or have been re-accredited as HLPs within the last two years (two years prior to 1st December 2016), in order that their prior accreditation would enable them to automatically meet the requirements of this Quality Payment criterion. This is still being considered by NHS England; further information on this matter will be published as soon as it become available.

If pharmacies were last accredited as a HLP over two years ago, they would need to complete the HLP Level 1 self-assessment process to meet the requirements of the Quality Payments Scheme HLP criterion.   

Q. Do I need to complete a form or any paperwork prior to registering as a HLP to notify RSPH that my pharmacy intends to become a HLP Level 1?
No. Contractors do not need to notify RSPH that they intend to become a HLP Level 1. Contractors  only need to notify RSPH once they are ready to register as a HLP Level 1 by completing the assessment of compliance on the RSPH website.

Q. How often (if at all) will the leadership and RSPH training need to be repeated?
There is no reference to the need for repeated training in the HLP quality requirements, so as long as a contractor has staff in post that have undertaken the relevant training, that will meet the requirements.

Q. Is there any clarification regarding grandparenting from existing HLPs available yet?
No, NHS England is still considering PSNC’s suggestion of grandparenting pharmacies that have been accredited as HLPs within the two years prior to 1st December 2016.

Q. I have completed the RSPH assessment of compliance, does that mean my pharmacy is now a HLP Level 1?
No. A pharmacy is not a HLP Level 1 until RSPH has confirmed registration and provided the HLP logo and certificate. RSPH will endeavour to contact contractors by mail or email within 10 working days after they have received the submitted online assessment of compliance.

Contractors are therefore advised to consider this time frame when planning how long it will take to achieve HLP Level 1 to ensure this ‘processing time’ does not prevent contractors from achieving the Quality Payment criterion at the April 2017 or November 2017 review point.

 

Other frequently asked questions (FAQs) on HLP can be found on the RSPH website.

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