Healthy Living Pharmacy (HLP)


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.

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.

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).

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

PSNC Briefing 016/17: 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 Scheme.

How  to meet this quality criterion

Contractors can meet this quality criterion in the following ways:

HLP status of pharmacy Action required
Contractors whose pharmacies have not been previously accredited as an HLP

Contractors will need to meet the requirements of a HLP Level 1 as defined by PHE.

Once contractors have met the requirements, a pharmacy professional will need to register the pharmacy as an HLP Level 1 on the Royal Society for Public Health (RSPH) website.

Follow stages 1-3 below.

Contractors whose pharmacies became HLPs locally between 1st December 2014 and 28th April 2017

Contractors will need to retain a copy of the signed and dated documentation that demonstrates that between 1st December 2014 and 28th April 2017 the pharmacy was accredited as an HLP Level 1 locally.

Contractors do not need to complete the profession led self-assessment process led by PHE to meet the quality criterion.

Contractors do not need to register their pharmacy as an HLP Level 1 on the RSPH website.

Contractors whose pharmacies became HLPs locally before 1st December 2014

Contractors will need a copy of the signed and dated documentation that demonstrates that the pharmacy was accredited locally as an HLP Level 1 prior to 1st December 2014.

Contractors will also need to meet the requirements of a HLP Level 1 as defined by PHE.

Once contractors have met the requirements, a pharmacy professional will need to complete an assessment of compliance.

Contractors do not need to register their pharmacy as an HLP Level 1 on the RSPH website.

Follow stages 1, 2 and 4 below.

Distance selling pharmacies

Any pharmacy that wishes to be an HLP must fully meet the requirements defined by PHE (except contractors whose pharmacies became HLPs between 1st December 2014 and 28th April 2017). These requirements were developed for bricks and mortar pharmacies, not pharmacies that operate via a distance selling model. Distance selling pharmacies (DSPs) are also prohibited from providing Essential Services, including the Public Health (Promotion of Healthy Lifestyles service), on the pharmacy premises. NHS England or PHE have not issued any guidance on this matter, but for the reasons set out above, PSNC believes it is unlikely that a DSP could fully meet the requirements for being an HLP.

Stage 1 – 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:

Stage 2 – 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 v2 (Word)

HLP Level 1 Evidence Portfolio Workbook v2 (PDF)

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

HLP Level 1 Flow Chart v2 (Word)

HLP Level 1 Flow Chart v2 (PDF)

Holding a health promotion event/campaign

Holding health promotion events/campaigns and documenting details of these are a way for pharmacy teams to demonstrate that they meet several of the quality criteria that pharmacy teams need to meet to achieve and maintain HLP Level 1.

PSNC Briefing 011/17: Healthy Living Pharmacy – Holding a health promotion event/campaign

To assist pharmacy teams when planning a health promotion event/campaign, a suggested checklist can be found below:

Checklist for holding a health promotion event/campaign (Word)

Checklist for holding a health promotion event/campaign (PDF)

Pharmacy teams may wish to use a questionnaire to help them evaluate their health promotion event/campaign and to make improvements to future events/campaigns. A template questionnaire can be found below:

Event/campaign questionnaire (Word)

Event/campaign questionnaire (PDF)

Health promotion ideas

health promotion ideas for pharmacy teams hub page has been created that contains links to different topics which pharmacy teams can use as a focus for their HLP Health Promotion Zone or they can be used in other health promotion work within and outside the pharmacy depending on the needs of the local community.

The hub page is ‘work in progress’ and new topics will continue to be added.

Stage 3 – Action once a contractor has met the requirements for HLP Level 1 (for contractors whose pharmacies have not been previously accredited as HLPs)

PHE has appointed RSPH as the organisation that will register pharmacies that have successfully completed the self-assessment process for Level 1 HLPs and to provide a QA process. Please note that registration with the RSPH is only open to those pharmacies that have undertaken the profession led self-assessment process and have not been previously accredited as an HLP. This registry is a pilot and is open to a limited number of pharmacies for a limited period.

Once a contractor has met all the requirements for HLP Level 1, they should use the self-assessment tool available on the 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.

Confirming registration

Contractors should be aware that when members of staff complete the RSPH Level 2 Award in Understanding Health Improvement course, which is provided by several national and local organisations, it may take a few weeks after completion of the assessment before staff members receive their certificate from the course provider (RSPH return certificates to the course provider and aim to do that within 10 working days).

There is also a time delay, after completing the assessment of compliance on the RSPH website (RSPH will endeavour to contact contractors by mail or email within 10 working days) before registration is confirmed.

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

Quality assurance visits

The 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.

Stage 4 – Action once a contractor has met the requirements for HLP Level 1 (for contractors whose pharmacies became HLPs before 1st December 2014)

Although contractors whose pharmacies became HLPs before 1st December 2014 are not required to register with the RSPH, a pharmacy professional (pharmacist or pharmacy technician) will be required to complete the assessment of compliance to declare that the pharmacy meets the requirements of a HLP Level 1 as defined by PHE.

Assessment of compliance (Word E-form)

Assessment of compliance (PDF)

Part 1 of the assessment of compliance should be completed which relates to the key requirements that the pharmacy must have in place before HLP Level 1 status can be achieved. Pharmacy professionals must be able to indicate YES to all statements.

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.

The assessment of compliance should be retained in the pharmacy and contractors should also ensure they have the signed and dated documentation that demonstrates that the pharmacy was accredited as an HLP Level 1 prior to 1st December 2014.

Other resources for pharmacy contractors and their teams

e-Learning for Healthcare: West Midlands Making Every Contact Count e-learning – A web-based learning resource for frontline staff. It has been developed by Health Education England’s local team in the West Midlands in collaboration with Public Health England West Midlands.

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.

Training providers

There are a number of organisations that provide HLP training for pharmacy staff however KCW LPC are working in collaboration with Pharmacy Complete. We have arranged a special deal with them to give special rates to pharmacies in Kensington, Chelsea & Westminster so please mention this when speaking to them.