Public health 1 Flashcards
What is public health
-Public health refers to
+Health of a population
+The longevity of its members and
+The extent to which they are free from disease
-Focus on the health states of populations rather than individuals
-Focus on prevention rather than treatment
-The science and art of preventing disease prolonging life and promoting, protecting and improving health through organised effort of society
Professionalisation
-The process by which an occupation transforms itself into a profession
Usually involves
-Uniformity of (high-level) qualifications
-A professional body
-Demarcation between the qualified ‘professional’ and the unqualified amateur (We can do something unqualified people cant)
-Political struggles and power conflicts between occupation
Proffesionalisation continued
-Professional status creates social distance between the members of the profession and the public
+Mystique around professional activities
-Professions persuade society to grant them a privilege position
+Autonomy
+Self-regulation (GPHC is not self-regulation as lots of lay people)
+High incomes (Pharmacist dont earn as much as other professions)
+Power
Deproffesionalisation
- The process of an occupation being deprived of professional status
- Society no longer believes that professional status is merited
- Social distance between the members of a profession and the public is small/non-existent
The proffesionalisation of pharmacy
-Early 1800’s
-Conflict between apothecaries (like GPs) and chemist and druggists (Like pharmacist)
-Apothecaries tried to make the supply of medicine by C&D illegal
-Pharmaceutical society of GB (PSGB) formed by C&Ds in 1841
+Protect C&Ds from attacks by vested interest (apothecaries)
+Formalise education and qualification
-PSGB became regulator (University education wasn’t compulsory until 1970s)
Pharmacy practice in the 20th century
Stuart anderson (2002)
3 Distinct phases of pharmacy
1) Pre-1948: the ‘traditional’ pharmacist
2)1948-1982: The ‘disappearing’ pharmacist
3)1982- : The ‘re-invented pharmacist
Pre-1948: the traditional pharmacist
-Front of shop
+Dispensing left to apprentices
+Important and well-known members of community
+A readily available source of wisdom and advice about whole range of health-related issues
1948-82: The ‘disappearing’ pharmacist
-1948- NHS established
-State prescriptions quadrupled overnight
+70-250 million
-Pharmacists had little option but to spend much of their working day in the dispensary
-Many prescriptions still needed to be made extemporaneously
-Public face of pharmacy was now the counter assistant
+Pharmacist only appearing if the customer insisted on seeing him
-Other developments
+Transfer of responsibility for the making of medicines from the pharmacist to the manufacturer
-Depersonalisation of medicinal products (drug companies would make lots of products as oppose to pharmacist making extemporaneous mixtures)
1948-1982: The ‘disappearing’ pharmacist
1)Technological advances
+Pharmacy computer system
+Repackaging of drugs from loose pots of 1000+ into standardised original packs
+Automation of tasks within pharmacy
2) Commodification of medicines
+Drugs increasingly available for purchase from non-pharmacy outlets (petrol stations and supermarket)
+Reduces drugs to a commoddity, with the connotation that no associated expert’ supervision and advice is required
3) Corporatisation of community pharmacy
+Historically, most community pharmacies were owned by self-employed community pharmacists
+This pattern fo ownership was eroded by the takeover of independent pharmacies by large chains (boots)
+Decrease pharmacy oweners and increase employees
= decrease professional autonomy
1948-82
-End result of all these developments
+deprofessionalisation of community pharmacy
+Community pharmacists over-trained for whay they did and under-utilised in relation to what they new
-One knew that there was a future for hospital pharmacist and industrial pharmacist by not community pharmacist
The re-invented pharmacist
-Reproffesionalisation of community pharmacy
-Role extension
+Move away from technical paradigm toward patient-orientated paradigm
+Pharmaceutical care (medicines management/optimisations
+Pharmacist do public health functions
The extended role: Policy 1980-2000
-Early 1980s
+National pharmacy aassociation ‘ask your pharmacist’ campaign
-1986
+Nuffield report
+Supported the extended role of community pharmacy
+There is a role for pharmacists in health education, in co-operation with other health care professionals
1987- Pharmacy healthcare scheme launched
+First national distribution of health education leaflets through pharmacy
-1996- RPSGB- pharmacy in New age (PIANA)
+For the role of pharmacists as advisers on healthy lifestyle to be fully recognised and properly integrated into the work of the NHS
Embraced many ambitions of PIANA
- Pledged to develop the role of pharmacist prescribers
- Pharmacists would spend more time focusing on the clinical needs of individual patients
- Community pharmacists would become increasingly involved in promotion of good health
- Contract for community pharmacies would be developed to reward high quality services at the expense of those prepared only to provide the basic minimum
Pharmacy contracts
-1994- Health promotion became a contractual obligation for community pharmacy with remuneration being received for the display of health promotion (posters and leaflets)
2005- public health designated as an essential service obliging each pharmacy to take part in 6 public health campaigns (health promotion), co-ordinated by the local PCT each year
A vision for pharmacy in the new NHS
- A stratergy for taking pharmacy into the future
- 10 key roles of the pharmacist
