Service case study: Pharmacy teams provide 9,922 interventions to support patients to be ‘winter fit’
During March 2023, eighty pharmacies in South West London supported people over the age of 65 by providing information, support and referrals to winter related programmes such as winter warmth, prevention of falls, social and activity groups and frailty support services. The eighty pharmacies made 9,922 interventions through the Winter Fit service.
Winter Fit was a winter care programme provided by community pharmacies in South West London that aimed to support people over the age of 65. The service aimed to help keep older people well and out of hospital through the winter using appropriate interventions made by community pharmacy teams. The service was a key part of protecting the over 65s population during a winter fraught with the ‘cost of living’ crisis.
The service was commissioned by the South West London Integrated Care Board (SWL ICB) for a four week period through March 2023. It provided a holistic package of support, utilising a Making Every Contact Count (MECC) approach to provide information, support and referrals to winter related programmes such as winter warmth, prevention of falls, social and activity groups and frailty support services.
Harnessing the strength of community pharmacy
In commissioning the service, SWL ICB sought to harness the central role that community pharmacies hold in community engagement and support around the older population. The ICB recognised that:
- Community pharmacies are highly accessible;
- Substantial numbers of over 65s have long term conditions or repeat prescriptions;
- Patients (or their carers), are regular clients at pharmacies and a relationship develops between pharmacists and patients which enables pharmacists and pharmacy teams to easily speak to patients about healthcare matters;
- Pharmacies are now Healthy Living Pharmacies with Health Champions who pro-actively approach the public with advice and information to promote health and well-being; and
- The uptake of the annual seasonal flu and pneumonia vaccinations in London’s community pharmacies has been increasing since the service started in 2013 with 80% of users being over 65 years of age.*
The purpose of the pilot was to demonstrate the value of community pharmacy in:
- Helping the older population to be ‘winter fit’ during the winter period;
- Integrating and personalising care around the patient;
- Supporting the local community to cope with winter pressures; and
- Reducing the burden on wider healthcare by preventing avoidable admissions to hospitals.
It is intended that the learning from the pilot will be used to help shape and embed a future sustainable winter pharmacy offer throughout South West London.
Scope of the service
Winter Fit required active engagement by pharmacy staff with visitors to the pharmacy who fall into the target group and involved a 15-minute intervention provided to customers aged 65 years and older in South West London. It utilised appropriate referrals and connections to preventative help and services, winter warmth schemes, local support groups etc as well as advice on self-management and care.
It worked on the basis that many people might not be aware of the range of help that is out there. Moreover, that not everyone over the age of 65 might be able to navigate the vast amount of information on the internet and would welcome someone taking the time to talk through what they can do to stay fit and healthy during winter.
Interdependence with other services/providers
During the pilot it was expected that the community pharmacy service may impact other services including:
- Secondary care – reduction in attendances relating to falls and winter illnesses;
- General practices – fewer preventable appointments, however there may be an increase in referrals from the pharmacies partaking in the scheme (e.g., patients seeking advice/help around dementia);
- Emergency and Urgent care – reduction in attendances relating to falls and winter illnesses;
- Warm spaces and other local authority initiatives – increase in usage by the over 65s cohort;
- Voluntary services – increase in usage as customers/patients are referred into them; and
- Social prescribing services – increase in referrals, where referrals by participating pharmacies are enabled in local areas.
A review of the pilot will help to clarify the accuracy and extent of these impacts.
Outcomes and potential impact
Eighty pharmacies provided 9,922 interventions across a four week period.
The Winter Fit program has the potential to create a significant positive impact on the health and wellbeing of the elderly population in South West London. These potential impacts include:
- Enhanced health outcomes: By connecting older individuals to relevant support services and providing tailored advice on self-management. Winter Fit can contribute to improved health outcomes, particularly during the challenging winter months. This may result in fewer instances of illness and injury, which may result in increases in overall quality of life for this population.
- Reduction in healthcare burden: The program may lead to a decrease in preventable hospital admissions and GP appointments, which could alleviate pressure on the healthcare system. This, in turn, can allow healthcare providers to allocate their resources more effectively, ultimately enhancing patient care and outcomes.
- Strengthened community relationships: Winter Fit’s personalised approach and emphasis on local connections could foster a greater sense of trust and engagement between pharmacists, patients, and other local service providers. This could result in stronger, more cohesive communities and improved coordination of care for the older population.
- Empowered pharmacists and pharmacy staff: By providing training and resources for pharmacy staff to actively promote and support the ‘winter fit’ concept, Winter Fit can help empower pharmacists and their teams to make a meaningful difference in the lives of their elderly customers.
The service has been entered as a nomination into the Integrated Care Awards and the HSJ Patient Safety Awards.
Speaking about the service, Amit Patel, Chief Officer of Sutton, Merton and Wandsworth LPC, said:
“Winter Fit is a unique opportunity for community pharmacies to play a pivotal role in supporting the health and wellbeing of our older population.
“By leveraging our accessibility and the trust our patients place in us, we can help bridge the gap between individuals and the support services they need during the winter months, ultimately reducing the burden on the healthcare system and improving overall community health outcomes.”
More information on the Winter Fit pilot can be found under Intervention Services on the PSNC Services Database.
*Communication from NHSE (London) on internal reports on uptake of vaccinations in London pharmacies. (10th October 2022)
