From Strategy to Reality – Delivering Population Health & Neighbourhood Health through Medicines Optimisation, with Minesh Parbat

At our conference today – Building Medicines Strategies around Population Health: A modern approach to meet the needs of local communities

Keynote presentation

From Strategy to Reality – Delivering Population Health & Neighbourhood Health through Medicines Optimisation, with Minesh Parbat (Chief Pharmacist and Clinical Director – Strategic Medicines Commissioning, NHS Shropshire Telford and Wrekin NHS Staffordshire and Stoke-on-Trent Cluster ICB).

Population health can be defined as the approach that aims to improve the physical and mental health outcomes and wellbeing of a defined population, with a focus on whole populations, prevention and inequality, and partnership by design (working with multiple providers, not just the NHS).

It does not replace but rather complements personalised care by proactively anticipating the needs of populations. As well as asking, ‘Why is this patient unwell?’ it proposes the wider question, ‘Why are some groups unwell more often?’ which leads to the further question, ‘What actually drives health outcomes across a population?’.

This last question reveals a perhaps surprising answer. Influences are multiple, with health behaviours and socio-economic factors making up the majority (70%) of the picture. Clinical care only accounting for 20%.

Immediate challenges to improving population health include rising demand from an ageing population, a finite workforce, a growing medicines spend, and the perennial challenge of the health inequalities gap. There is a need to work smarter, to improve the use of technology, save time and improve efficiency. The challenge is to do more within current resources.

Through the lens of populations health, this would include targeted risk stratification, a focus on the pharmacy skills mix and delegation of services to non-pharmacist staff, data-driven prioritisation, and preventing harm at scale. We need to know our populations, use data routinely and effectively, target inequalities deliberately, work in partnership and create novel solutions to problems.

With examples from his home patch of Shropshire, Telford and Wrekin, and Staffordshire and Stoke-on-Trent, Minesh outlined some of the challenges that face patients, including distance and isolation, digital literacy (and the availability of connectivity in remote areas), and persistent deprivation.

Answers include the better use of data, polypharmacy and hubs, looking beyond the prescription to ask why people become unwell in the first place, targeting finite resources, real evidence of how teams work and where efforts can be shared and redeployed, and also medicines optimisation flexed to meet local need.

Challenges are persistent and ongoing – solutions require innovative and genuinely population-based solutions.

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