Self care is a fundamental area of importance for the PAGB (Proprietary Association of Great Britain), the UK trade association representing manufacturers of branded over-the-counter (OTC) medicines and food supplements.
John Smith is chief executive of PAGB, previously general manager at Pfizer Consumer Healthcare. He tells P3 why the organisation feels this is so important for healthcare. “With the NHS facing unprecedented financial challenges, we need, more than ever, to support and empower people to self care.” It has been estimated that there are at least 57 million consultations in general practice each year for minor ailments, such as backache, coughs and colds, headaches, indigestion, skin problems and allergy.
Self care should be central part of healthcare policy, suggests Mr Smith. “My worry is about self care and the national health agenda — we’re not seeing that change and it’s got to happen soon. Everyone keeps telling me now is the time for people to step up. We’d also like self care to play a major part in future plans for pharmacy being discussed with the government.” Community pharmacy is an important area of focus for the organisation, and there are strong links with the sector. PAGB has worked closely with Pharmacy Voice over a number of years, he says: “We try to be united in driving our message going forward.”
PAGB also works in partnership with the Self Care Forum, an organisation that words to “further the read of self care and embed it into everyday life”. The annual Self Care Week is in November.
The forum is aiming to re-establish itself as an independent charity, allowing it to do even more than it has in the future, explains Mr Smith. “We’re working with them to support that,” he comments.
He points out useful resources to support self care that pharmacies can access. “On the Self Care Forum website there are posters and resources for Self Care Week, as well as self care factsheets, which have been designed for use in a consultation, in a GP or pharmacy setting. These explain to consumers about the condition being discussed, what you can treat yourself and when you need to seek the advice of a healthcare professional.”
Community pharmacy is a key place for the public to be receiving and asking for advice about self care.
“We want to see more people going into pharmacy; we want to see pharmacy stepping up and to provide a stronger service for self care. Between us we want to help drive more people into pharmacy.”
“We strongly believe that people should be thinking differently and feeling confident to walk into their pharmacy and seeing it as healthcare on the high street.” He points to healthy living pharmacies as being key to promoting self care.
He suggests that more pharmacists could see self care as an opportunity, and that healthcare as a whole could be promoting the concept more strongly.
“For example, it’s important that people don’t give up on self care too early. Yes, if you’ve still got a really bad cold beyond ten days, you need to speak to a healthcare professional, but at three days you can still carry on with self care. Community pharmacy is a really important part of getting that message across, he says.
PAGB research has looked at attitudes to colds and flu, for example. “An average cold lasts seven to 10 days. People are likely to self-treat initially, but then give up after three days because they don’t feel better, and they go to the doctors for antibiotics. They might start taking the antibiotics on day
seven, and feel better by day nine – as they would have done anyway without the prescription. “If people are going to pharmacies, it’s normally because they want that little bit of help. Pharmacists are there to help people maintain the best health they can. Think about what products you put on your shelves, and make sure you give the right space to the right products. Having the right blend of products will help people to choose the product that’s right for them.”
He points out the trends for people to want to support their local community shops and services, which puts pharmacy in the right position to meet local needs. “People want to go to their local bakery and choose nice bread. They want to go to the greengrocer and get advice on fruit and vegetables. They want to go to the butcher and talk about what the best cut of meat is. People want that interaction now; it’s not about going to the faceless hypermarket. Most people still do the big shop but there’s more resurgence of the high street shops actually providing a much more personal service, and pharmacy is perfectly placed to do that.”
He encourages pharmacies to look closely at demand for different products and categories to help plan what to stock. “The bigger categories are vitamins and minerals and adult oral analgesics, for example. Look at vitamins and minerals: there are so many products but what are the right ones for your customers? It’s about thinking about what is happening out there in the marketplace, how can I make sure that my pharmacy reflects what people want.”
Minor ailments and self care are areas that community pharmacy has the opportunity to firmly take “as its own”, he suggests. “Community pharmacy should be saying ‘We are healthcare on the high street - we are here to provide advice, guidance, services and the right products.”
Mr Smith emphasises the opportunity for consumers and patients to receive great quality advice, on minor ailments and other conditions, from community pharmacy. Having the right products in stock, and offering a range of services will help attract more people in, he suggests. Linking in events and advice around public health campaigns and awareness weeks, is also a good idea, to encourage people in to talk about their health conditions.
Are there also more services that community pharmacies could set up that customers might pay for? he asks.
“Self Care Week is coming up later this year. We encourage pharmacies to get prepared for that, think about what you can do, engage services for your community. We hope that pharmacies will be positive about the initiative and to go out there and make things happen.”
PAGB is leading a revolutionary project that is looking at making OTC medicine packs more user-friendly for the public. Medicalised ingredient names and jargon are confusing for people, says Mr Smith.
“We want to challenge ourselves to be ambitious and to drive change. We’re working on a packaging project at the moment to make the packaging of products more people-centric and easy to use.” Having the ingredient name of a medicine as the main feature of the packaging isn’t particularly helpful for customers, but clearly signposting the ailment and what the product is intended to be used for “has got to be beneficial,” he says.
“We’ve been conducting research and our hypothesis is that it will help people and support self care if product packaging is more people- centric. We’ve been doing research to prove or disprove our hypothesis.”
An ideal situation would be to have information on the front of the pack aimed solely at the customer, and the detail for the pharmacy team on the back of the pack, he suggests.
“A list of ingredients is great for a pharmacist – that information needs to be on the product, but does it need to be on the face of the product? If there’s a level of standardisation, and more consistency in the information on the back of pack, that will make it easier for pharmacists as well.”
The forward-looking proposals are being discussed with the MHRA.
Self care and improved access to consumer health can relieve pressure on health systems providing economic and social benefits, a white paper written by the Economist Intelligence Unit (EIU) has concluded. Better access to non-prescription medicines and greater regulatory harmonisation could improve the ability of patients to care for themselves and reduce needless costs to health systems, says the report. Consumer health: time for a regulatory re-think? is based on interviews with experts from industry bodies, regulators, academia and patient groups. The paper recommends that there should be a set of WHO Guiding Principles established, “to which governments, industry, regulatory bodies and healthcare system decision makers can adhere to encourage self care and make self care more accessible to more people.” The specific role of self care is not clearly defined or recognised by decision makers, says the paper.
PAGB, the industry body for OTC medicines, has worked with RB and the Economist Intelligence Unit, linked to the Economist magazine, to produce the report. “Until self care is taken seriously at a national and international health and medicines policy level it will be difficult to break down many of the barriers to make self care more accessible,” said Zephanie Jordan, vice president, global regulatory affairs at RB.
PAGB celebrates its 100th anniversary in 2019. “We are the trade association representing the consumer healthcare industry, and we have done since 1919,” says Mr Smith.
“We self-regulate the marketplace for all of our members, making sure that advertising is not misleading and that it’s factual, truthful and evidence-based. This includes products that are registered with the MHRA and food supplements, and we’re also bringing in medical devices into our membership. We have a seminar for all our members in April. Making sure that we’re giving a world class service to all our members is the backbone of what we do.
“We also act as the voice of the industry. We’re well positioned to have an opinion, and if we’re not, we’ll make sure we speak to experts from member companies who put us in the right direction.
“Also key for us is influencing the marketplace – how we can encourage more people to self care. In doing that, you save money for the NHS and improve people’s health.”
We’ve been conducting research and our hypothesis is that it will help people and support self care if product packaging is more people-centric