Innovation for social good could be the basis of transformational change in community pharmacy, says Elspeth Kirkman, Chief Programmes Officer at Nesta
As we emerge from one of the hardest years our health system has experienced, health inequalities have been laid bare. Yet we have also witnessed a huge capacity and capability for new ways of working to improve the health of the nation. How then can we build on this and ensure better health outcomes in the decade ahead, to reduce inequalities and deliver the best impact for our society?
Following many months of work, Nesta – the UK’s innovation agency for social good – is changing the way it operates to deliver impact at scale, specifically in three missions: narrowing childhood inequality, tackling household emissions, and finally, helping people live healthier lives. We believe these three missions will allow us to drive meaningful social change.
People and data are two key tenets in our vision of how such change happens. The relationships we build, the communities we live in, and the trails of data each of us leaves behind as we navigate the world are all powerful assets that can be used for good.
Looking at pharmacies through this lens, it becomes clear that their role in improving our health can and must spread far beyond that of clinical transaction.
Let’s begin with people. Imagine a line at the pharmacy. Each person in it has a story that brought them there: the young woman who needs the morning-after pill, the man collecting the antidepressants no one knows he takes, people who have been told to lose weight, who are too scared to check their blood pressure, who are waiting to collect a prescription for an elderly parent, barely able to stand the weight of loneliness they feel as they transition from child to caregiver. The pharmacist collects those stories, keeps them safe, moves them forward. They deal in discretion and sensitivity. They are trusted with secrets people will not tell their closest friends.
Now imagine if that relationship between the pharmacist and their customers was not just incidental to the service: if we designed the space, the activities the pharmacist undertakes and the experience in-store to strengthen that foundation of trust.
Imagine, for example, a counter designed for private conversation instead of one built off the same plan as the front-of-store till. Or if the pharmacist could text the customer afterwards with tips on how to have those difficult conversations with an ageing parent or stick to a weight loss plan.
Imagine if a pharmacist could – with permission – introduce people to others who have gone through the same experience. We would almost certainly see better health outcomes.
For example, in a study where diabetic patients with uncontrolled blood sugar were given either standard care from a doctor, a financial incentive, or a peer mentor, those who had the peer mentor saw the largest improvements in blood sugar control. Relationships and relatability matter, and pharmacists could be a missing link in brokering these bonds.
Data too is an undervalued asset. Used responsibly, it is likely we could improve health outcomes considerably if we systematically drew insights from prescribing and prescription fulfilment data.
We might be able to target social prescribing more effectively by understanding which medications are typically used to address the symptoms of loneliness and designing processes that give prescribers viable alternatives.
We might be able to see where options such as exercise-on-prescription are underused and work with GPs and pharmacists to figure out why.
We might be able to identify outliers: which local areas do we see the highest compliance and the most positive outcomes with specific types of prescription? What can we learn from them? How can we scale it?
We already know that data-driven feedback loops can help regulate prescribing activity. For example, simply letting GPs know that they were in the top 80% of antibiotic prescribers and reminding them alternative approaches reduces overprescription of antibiotics. We can systematise this kind of approach to help professionals do their jobs more effectively.
Pharmacies and pharmacists are at the heart of communities – they are in a position to be at the vanguard of innovation in health in the next decade. They must be supported with persistent and dogged approaches to testing and evaluating new approaches to healthcare, harnessing data and new approaches for the benefit of the people they serve, to improve community health outcomes significantly and, importantly, for the long-term.
At Nesta, we believe innovation has a big part to play in driving large-scale change. Our new strategy will see us design, test, and scale solutions to big social problems. Our goals are ambitious, but by harnessing the potential of people and data we believe we can succeed.
Nesta’s strategy will address three societal challenges: how we can give every child a fairer start, how we can help people to live healthier lives, and how we can decarbonize household activity for a sustainable future.