Published on 18 April 2019
A pilot scheme to improve oral health through pharmacies proved so successful that it is being rolled out across the North East in a bid to save the NHS money.
Poor oral health is a significant public health concern, costing the NHS in England £3.4bn annually, with tooth decay becoming the most common reason for hospital admissions among children aged five to nine.
But a project between the University of Sunderland and the Public Health Team at Durham County Council has harnessed the accessibility of community pharmacies, frequently visited by patients, by offering a venue to deliver vital oral health advice and information.
Five pharmacies in deprived areas of County Durham took part in the pilot in 2016 and introduced a five-minute oral health intervention to patients as they waited for prescriptions or had just popped in for advice and medications.
More than 1,000 patients took part in the intervention, which included advising patients on how to brush their teeth properly, checking they were using the right products and providing key information on how to look after teeth and gums. The results were impressive with 72 per cent of participants reporting that their knowledge of oral health was much better and 66 per cent saying that they would definitely makes changes to their oral health habits. Meanwhile, 64 per cent definitely thought a pharmacy was the right place to receive oral health advice.
Andrew Sturrock, Principal Lecturer and Programme Leader for the Master of Pharmacy programme in the School of Pharmacy and Pharmaceutical Sciences at the University of Sunderland, worked with Durham County Council’s Public Health team to develop the project based on his previous research assessing the impact of community pharmacies.
He explained: “This started as a simple idea, based on my research looking at the role of community pharmacies, who are well trained healthcare professionals, easily accessible and frequently visited by patients, and required to provide healthy living advice to patients - therefore offering a little explored avenue for the delivery of oral health interventions.
“We already know there are lots of people who don’t have a dentist, have phobias about dental treatment or avoid regular check-ups, especially in deprived areas. The pharmacy is certainly not taking over the dentists’ role – this is just about giving some really basic healthcare advice and signposting patients in the right direction.
“It’s also about trying to prevent people from needing dental treatment later on, potentially saving millions on NHS treatment. We know that poor oral health can have a big impact on patients and improving oral health can even have positive benefits in other systemic health conditions, such as diabetes.”
He added: “The study provides evidence that a community pharmacy is perceived by patients as an acceptable provider of oral health interventions and has the potential to provide positive changes to the oral health of the population.”
Claire Jones, Public Health Pharmacy Adviser, Durham County Council said: “The success of this scheme did help to keep oral health training on the agenda for community pharmacies through regional pharmacy training sessions that were subsequently run by the regional oral health team at Health Education England in 2018. In addition, oral health became one of the local targets for HLPs in County Durham in the 2018/19 Award. And lastly, of course, oral health in children is now a focus in the current national quality payment scheme for pharmacies.”
Rachel Lish, Clinical Lead for Multi-Disciplinary Oral Health, Health Education England North East, commented: “We are delighted to have been able to provide educational input into this pilot.
“The Directorate is committed to promoting the importance of good oral health, including its relevance to general health. It currently delivers a comprehensive oral health training programme for community pharmacists which aims to provide a greater understanding of the importance of oral health in general health, including, particularly in relation to diabetes control, dementia and mental health. This supports the objectives set out in ‘The NHS Long Term Plan’ of joined up care at the right time, strengthening prevention and addressing health inequalities.”
The evaluation was performed using a patient evaluation questionnaire and interviews with pharmacy staff. The research has been published in the British Dental Journal: https://www.nature.com/articles/sj.bdj.2017.784