Managing the sale of e-cigarettes through community pharmacies could have prevented soaring levels of vaping among children, shadow health secretary Wes Streeting has suggested.

In response to an audience question at NHS Confed Expo yesterday afternoon, Mr Streeting said that there a role for community pharmacies to play a bigger part in preventing ill health and supporting and promoting good public health.

He highlighted the financial pressures facing the community pharmacy sector and said that viable activity needed to be commissioned through the sector.

Mr Streeting added that he was ‘instinctively in favour’ of community pharmacy teams doing more to prevent ill health.

‘I think there is a role for those highly qualified, highly expert people behind the counter in the pharmacy, to take on a bigger load in terms of supporting and promoting good public health in the community,’ he said.

‘I'm instinctively in favour of that, which is why I've been visiting pharmacies as much as I've been visiting hospitals and GP practices,’ he added.

He highlighted e-cigarettes as an example of where community pharmacy was well placed to support public health.

And he suggested that if community pharmacy had been given the responsibility to manage the sale of vapes then issues of nicotine addiction among children from vaping could have been avoided.

‘I do wonder – in fact I think I know the answer to this – I don't think we would be in a situation where a whole generation of children would be addicted to nicotine if that programme was being managed through community pharmacy, rather than through shops popping up on our high street and flogging vapes to kids, or shepherding them out through Snapchat and social media platforms, as is happening, with teachers picking up the pieces,’ he said.

Mr Streeting also said that if Pharmacy First was to be a success, ‘we need to think about the activity that we can commission through community pharmacy to make it viable’.

He highlighted the challenges facing community pharmacy, citing the recent closure of LloydsPharmacy Sainsbury’s branches, as well as visits he had made to community pharmacies in recent months.

‘It's a pretty difficult time. I think if we're serious about Pharmacy First, we need to think about the activity that we can commission through community pharmacy to make it viable,’ he said.

The Company Chemists’ Association this week called for the government to invest in a more ambitious Pharmacy First service, including making use of independent prescribing (IP) in community pharmacy.

Community pharmacist Ade Williams told The Pharmacist that in his opinion, when the NICE guidelines identified e-cigarettes as having a clinical value in smoking cessation, they should have been regulated under a medicinal framework which could have been used by healthcare professionals, rather than being sold subject to market forces.

‘That would have changed the whole context of it. That would have meant that some of the concerns that we have now would have been avoided,’ he said.

He added that even though the sale of vapes through community pharmacy for smoking cessation still would not have been an ideal solution, it would have been ‘the best way’ to ensure that the use of e-cigarettes was ‘much safer and more ethical’.

And he said that the sector could learn from this to respond to emerging evidence and innovation more quickly.

‘Innovation is, more than ever before, less likely to be driven through established pharmacological channels,’ he said.

‘We need to be in a position to understand, how do we bring innovation under a regulatory framework?’ he added.

And he said that pharmacy professionals had ‘the best expertise’ and were ‘best suited’ to direct that.

He said that pharmacy professionals should ‘take ownership of how things will be, rather than waiting for things to be shaped in a way that we can take ownership of it’.

He acknowledged the health concerns around e-cigarettes in particular, but said that the sector should respond to evidence-based clinical guidelines.

‘We should be saying: “OK, if we are now saying that this has got possible patient benefit, then we want to change how it is regulated”,’ he said.

And he added that pharmacists leading the calls for this sort of regulation would reinforce their position as the profession with the legal and professional expertise to ensure that the public can benefit from pharmacological interventions, as well as ensuring that they are used safely and effectively.

A spokesperson for the Association of Independent Multiple Pharmacies (AIMp) said that making e-cigarettes a regulated pharmacy-only product ‘could bring much needed control to this very random market and stop young people using vaping as a gateway to smoking’.

‘We understand that there is evidence that e-cigarettes can be effective to help people stop smoking in conjunction with face-to-face advice – which community pharmacy excels at,’ they added.

Thorrun Govind, England board chair of the Royal Pharmaceutical Society (RPS) told The Pharmacist that the availability of licensed e-cigarette products through community pharmacies ‘would give confidence and reassurance about what is being recommended and supplied’.

‘Community pharmacies already play a key role in helping patients stop smoking by providing all the cessation options available so that they find the one that’s best for them,’ she said.

‘Pharmacies are at the heart of their communities and will be crucial to supporting government ambitions around prevention and helping people stay well,’ she added.

And she said that investing in more clinical services through community pharmacy could help manage demand across the health service.

While Pharmacy First was a ‘really positive step on this journey’, Ms Govind said that it needed to be backed by a workforce plan ‘so we can ensure patients continue to have equal access to care from highly skilled pharmacists and their teams’.

A Department of Health and Social Care spokesperson said that community pharmacies play a ‘vital role in the NHS’ and highlighted the recent £645m additional investment for Pharmacy First, blood pressure checks and oral contraception consultations.

And they said that the government was taking ‘bold action to crack down on youth vaping’ with a £3m ‘illicit vapes enforcement squad’ that tackles underage sales of e-cigarettes to children.

‘We are also currently considering the results of our call for evidence which was launched to identify opportunities to reduce the number of children accessing and using vape products, exploring a range of issues including the marketing and promotion of vapes,’ they added.