Dr Mark Timoney, owner and superintendent pharmacist at Timoney Pharmacy In Lambeg, Northern Ireland, talks to Saša Janković about his involvement in social prescribing.
Service type: Social prescribing.
Name and location of pharmacy: Timoney Pharmacy, Lambeg, Lisburn, Northern Ireland.
Name of pharmacist: Dr Mark Timoney, owner and superintendent.
Why did you start offering this service?
I started offering this service in April 2020. The most significant impact of the March 2020 lockdown was the concern over the increased number of self-isolating or shielding patients who could not present at the pharmacy to collect their medicines. Our prompt liaison with a local church minister resulted in the identification of a group of 10 volunteers prepared to assist with the pharmacy arrangements for delivering to vulnerable patients’ homes.
We then engaged the Community Development Health Network (CDHN) at the outset of the volunteer delivery initiative and as a result our volunteer group was enveloped into a local community support organisation (the Resurgam Trust) who were able to provide indemnity, identification and mileage expenses for the volunteers.
The initiative was a huge success and ran from April to September 2020 supporting in excess of 200 patients during lockdown. When the volunteer component of the service came to an end in September 2020, we were able to maintain this initiative through the Health and Social Care Board (HSCB) commissioned delivery service. This allowed us to employ one of the volunteers as a driver and to maintain the delivery arrangements for those patients unable to attend the pharmacy in person.
We currently provide 250 deliveries to patients per month. This engagement has also afforded an opportunity to become formally engaged in a social prescribing referral service through the local social prescribing initiative SPRING project, operated locally through the Resurgam Trust (https://www.springsp.org/).
I was appointed as the community pharmacy representative to the South Eastern Local Commissioning Group (SELCG) in July 2020. This offered me the opportunity to raise awareness of the value of community pharmacy’s contribution to optimising the health and social care of local populations participation in support for public health messaging; new vaccination services; and the integration of community pharmacy into social prescribing initiatives among GPs, dentists, nursing, social care/community groups and local representatives.
This in turn stimulated a renewed interest among a range of HSC disciplines as to the contribution that community pharmacy made throughout the pandemic in reducing pressures in both primary and secondary care sectors. I was subsequently appointed as chair of the SELCG and, in line with Ministerial priorities, am currently reviewing enhancements to mental health services for the population which include community pharmacy support for social prescribing which is hoped will be introduced as an additional service.
How much did it cost to set up the service?
The service is largely cost-neutral.
What, if any, training did you or other team members have to undergo?
Staff have been acutely aware of the impact that the pandemic has had on the mental health of patients. As a result of this initiative they have been apprised of the types of support available to vulnerable patients through the SPRING initiative and of the referral mechanisms to support these patients.
In a nutshell, what does the service involve?
The SPRING local social prescribing initiative operates through the involvement of the pharmacy team looking out for the social, emotional and practical needs our vulnerable patients and providing community pharmacist referrals to the coordinated sources of support within the local community to improve individuals’ health and wellbeing.
Are there any opportunities to sell OTC or prescription products during or after the consultation?
Yes, attendant opportunities exist to assess patients’ medicines-related needs and offer tailored services ranging from adherence support to responding to common symptoms.
How have patients responded to the service?
As a result of the SPRING initiative, a number of patients suffering from isolation, cognitive decline and a range of other mental health issues have been identified and referred for a social prescription, and patients and their representatives have been enormously positive about the service.
One patient was shielding in the first lockdown so in the early days I delivered the prescription to their home on several occasions. They wrote to tell us that, as they had been suffering from “some significant anxiety issues” during the pandemic, one of the things that helped them come to terms with the difficulties they were facing was “knowing that my local pharmacy was prepared to go the extra mile to ensure that I got my medications and could answer queries I had about my treatment”.
In another case, a patient was suicidal and was admitted for mental health care, another has now been diagnosed with dementia and receives daily visits from a volunteer, and another received domiciliary support following a fall.
Roughly how often each month do you carry out the service?
The initiative is in its early stage and involves around one patient per month at present.
How much do you charge for the service?
The service is offered free of charge.
Roughly how much a month do you make from offering the service?
There is no tangible profit to be realised at this stage as the service is currently not commissioned by the Health Board. Nonetheless there is immense goodwill generated by the service and we are of the impression that the public interest in the pharmacy and the range of services it can provide has been stimulated by access to the extra social care provision.
Would you recommend offering this service to other contractors?
Yes. In 2021, working with the local integrated care partnership (ICP), we have engaged a coalition of local community pharmacies to participate in social prescribing referrals as part of the SPRING project. This approach aims to present pharmacy as a collaborative player within an integrated care system closely aligned with the Health Minister’s new mental health strategy.
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