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    Wednesday, 09 May 2018 16:12
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community-pharmacyMay 13 2015

The public have nearer access to community pharmacies than GP surgeries, although access to both types of premises is good, a study has concluded.

The percentage of the population living within a 20 minute walk from a community pharmacy is 89% compared to 85% for GPs. In deprived areas, the figures are even higher with 100% local access (that is under one mile) to pharmacies and 98% to GP practices.

This distribution of premises could have implications for the future commissioning of services from these healthcare providers, say the researchers from Durham University.

Using postcode data and area-level spacial analysis, the study looked at the locations of all GP premises and community pharmacies in England, relative to the population, and compared deprivation and urbanisation. It found that:

  • 84.8% of the population overall is estimated to live within a 20 minute walk of a GP premises:
  • 81.2% in the most affluent areas,
  • 98.2% in the most deprived areas,
  • 94.2% in urban and
  • 19.4% in rural areas.

“This is consistently lower when compared with the population living within a 20 minute walk of a community pharmacy,” say the researchers.

As the higher proportions of people living closer to a GP practice are in more deprived areas, this is described as a ‘positive primary care law’ to reflect the positive trend between a GP premises accessibility and deprivation decile. (The concept of the ‘inverse care law’ is described as being where “the availability of good medical care tends to vary inversely with the need for it in the population served.”)

“Overall, the inequalities in access to a GP premises in England range from 1.4% to 24.4% less access among the more affluent areas, when compared with the most deprived decile: a positive care law. There are no significant spatial inequalities in access in rural areas or town and fringe area, while urban areas have between 0.8% and 10.9% less access when compared with the most deprived decile.

“However, more people live within a 20 minute walk of a community pharmacy compared with a GP premises, and this potentially has implications for the commissioning of future services from these healthcare providers in England,” conclude the researchers.

Dr Adam Todd, one of the research team, described why the significance of the study. “There are major public health issues which are putting huge pressures on the health service, and GPs in particular, such as obesity, smoking and alcohol dependence. More people die from these conditions in deprived areas compared to affluent communities and the gap in life expectancy between these areas has widened,” he said.

“With easy access to high street pharmacies, without a need to make an appointment, community pharmacies are well-placed to help tackle some of these major public health concerns, working alongside GPs. This is particularly important in poor areas to help improve health and narrow the gap in health inequalities.”

Looking to the next stage of research, Dr Todd commented: “Although we now know from our study what access looks like to family doctors and pharmacists, we do not know yet who uses which services and how patients feel about going to their pharmacist or GP for advice on conditions such as smoking.

“Crucially, further work is needed to establish the best way to reduce health inequalities. Should we empower community pharmacies to provide more public health services, for GP practices to do this, or a mix of both?”

Links:

Durham University announcement    

Todd, A. et al. 'Access all areas? An area-level analysis of accessibility to general practice and community pharmacy services in England by urbanity and social deprivation'. BMJ Open 2015;5:e007328    

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