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P3pharmacy caught up with Pharmacy2U superintendent Phil Day after the online dispenser published a study on a recent initiative that saw it team up with PocDoc to offer at-home cholesterol testing

Why did Pharmacy2U decide to team up with PocDoc on this project?

We’ve been horizon scanning about what’s happening in the future and how we can get involved. I think we’ve shown with Covid we’re not just box shifters; we like to play a full role within pharmacy and contribute to better quality outcomes for patients rather than just sending things in the post. 

The project is part of looking at the 10-year plan and the changes from analogue to digital, treatment to prevention and hospital to community. We thought we could do something with this.

We’ve been working with PocDoc for a little while, and we constructed this in light of cardiovascular disease being such a devastating problem: the fact there are 175,000 deaths a year from this, most of which could be prevented. 

The idea was to see if we could tailor a package of care around a home test and then some wraparound pharmacist care to see if that would improve outcomes. 

The primary thing we were looking at was whether people would engage with and, if it would reach people equitably and whether people would be happy to use it. 

We’ve taken people in our NHS prescription base aged 40-74 who weren’t already on cholesterol medicines and reached out to them to invite them. 

We invited just under 4,000 people in two weeks. Then they went through a programme where they got an initial PocDoc test for all the cholesterol markers. 

They go through a health assessment about lifestyle, family history and so on. It’s a simple, do-at-home finger prick test and the questions are on the PodDoc app, which calculates their BMI and NHS heart age.

Patients were then invited to have a free consultation with the pharmacist to talk about what those numbers mean and give them behavioural advice.

Are these prescribing pharmacists who could then put the patient on medication? 

They’re not, but that could be a future development. It was purely advice provided by them in a free phone call at the start. What then happened was they went into an eight-week programme of tailored advice via email depending on their scores. 

We weren’t expecting in eight weeks to see significant improvements in cholesterol levels, it’s too soon for that. The point was to see whether we could engage with people and they would take up the baton of looking after themselves. I think in that regard it did a really great job. 

NHS health checks get around 44 per cent uptake among eligible patients, but for this we had 69 per cent of people who tested themselves having received a kit.

Seven in 10 said it was more convenient than going to their GP, nearly eight in 10 said they’d be more inclined to make healthy choices after going through this. 

Nearly half had self-reported a health improvement of some kind in that eight-week period, which could be a change in their BMI or cholesterol numbers. 

We find with NHS health checks there is less uptake in deprived areas, but it was flat across the board with us. Engagement was the same across all postcode areas. 

Do you see this as complementing the hypertension case finding service? 

Absolutely. And I think there is a long-term potential here to have something like this offered by, pharmacists anywhere. There’s no reason why this couldn’t be a scaled-out model with pharmacists in other places doing blood pressure checks at the same time.

Is Pharmacy2U considering other home testing services? 

We do think this idea of people knowing their numbers and taking control of their own health is really important. In terms of other ideas we can look at, an obvious one might be type 2 diabetes screening. I always use the phrase, ‘it’s these conditions where your future self would thank you’. 

The company is also delivering NHS services like the New Medicines Service (NMS) and Pharmacy First. Why is that a priority?

It comes down to equitable access. If you are only able to access some of these pharmacy services at a weekend or an evening, then we might be able to assist with that. You can do an NMS or Pharmacy First consultation digitally and remotely in your lunch break. We think there’s a real place for that. But we’re not trying to be all things to all people. We see this as a complementary offering to existing pathways.

There is a lot of downwards pressure on prescriptions income. Is that part of the reason Pharmacy2U is looking into services?  

Diversification is the name of the game there. I think all pharmacies have to think about that seriously.

The primary driver for me is, is that you can dispense prescriptions and that’s fine, but we are also very invested in ensuring patients have access to these additional services as well. 

It’s important to us that we have a rounded offering for people so that if they have a related health need we’re able to assist or signpost them.

There are a lot of wider areas relating to the unpredictability of funding but the most important thing for us is to be fully participating in NHS services.