The Annual Report of the Director of Public Health 2023 (NHS Highland): 'Medication & Public Health - Do the Right Thing'
Argyll and Bute Council · 7 May 2024
Back to Helensburgh and Lomond Area Community Planning Group — 7 May 2024 and its agenda
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1 Argyll & Bute Community Planning Partnership Area Community Planning Group Partnership update Date: April/May 2024 Partner update – Public Health The Annual Report of the Director of Public Health 2023 (NHS Highland): ‘Medication & Public Health – Do the Right Thing’ (Read the full report here: Director of Public Health Report 2023 | NHS Highland (scot.nhs.uk)) Scotland is facing a predicted 20% increase in levels of illness by 2043, if we continue as we are. An ageing population, with increasing numbers living with at least one long-term health condition and increasingly complex needs. ‘We cannot solve public health challenges simply by prescribing medication for them’ – Dr Tim Allison, Director of Public Health, NHS Highland. The report, published in late January, examines public health challenges and the benefits and drawbacks of prescribed medicines, with a focus on the escalating levels of pharmacotherapy and its impacts on both individuals, and the population and their environment, including the rise of antibiotic resistance and the environmental pollution caused by medications. In addition to an overview of the demography and health inequalities of NHS Highland’s population, a chapter on each of the following key areas is presented: 1. The Environment: How medication can make our environment sicker Medicines now account for 25% of the NHS total carbon footprint, contribute to pollution of the environment and are now classed as emerging environmental contaminants. The report highlights the groundbreaking work of NHS Highland as a founding member of the One Health Breakthrough Partnership (https://ohbp.org), working to reduce the impact of pharmaceuticals on the environment (PiE). 2. Hepatitis C: How medication is transforming treatment and prevention NHS Highland’s Blood Borne Virus Managed Clinical Network (BBV MCN) remains committed to the ambition of eliminating HCV in Scotland by 2024 (six years ahead of the target set by the World Health Organization) with a local elimination strategy. The development of Direct Acting Antiviral (DAA) therapies has significantly increased the efficacy of antiviral treatments which eradicate HCV infection. Effective detection of those who have been infected with HCV combined with the
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2 provision of accessible treatment options enable patients to be treated as early as possible and prior to progression to advanced liver disease, improving health outcomes for individuals, and resulting in cost-savings to the NHS in the longer term. 3. Social Prescribing: How an alternative to medication can work An estimated 20% of people visit a GP with non-medical needs and up to one fifth of GPs’ time is spent on issues related to social needs rather than issues best solved by medical interventions such as medication. The DPH Report considers the scope and evidence of how social prescribing can compliment pharmaceutical prescriptions in supporting and managing health. It discusses the opportunities & challenges faced, with studies showing positive financial returns, with Social Return on Investment (SROI) ranging from £2.30 to £7.08 for every £1 invested. The Highland Community Link Worker Programme is currently being evaluated by the University of Highlands and Islands (UHI), and other social prescribing initiatives active across NHS Highland are discussed in the report. 4. Prescriptions for Pain: How medication can have long-lasting effects on public health Analgesics and opioids (pain medication) carry great benefits to an individual in pain, but they can also bring some serious disadvantages with a risk of dependency, and limited benefit in long term use. An illegal market also exists alongside. Both analgesics and opioids are discussed in the context of drug related deaths, and the benefits of prescribing Opioid Substitution Therapy as a therapy offering great help in reducing the serious consequences of illicit drug use are discussed. 5. Case Study: How medication and other measures can work together to improve health Cardiovascular diseases are among the most common causes of health loss in NHS Highland, contributing to ill health and early deaths. Case studies demonstrate how a combined approach of pharmacology and social prescribing can work alongside each other to produce synergistic benefits for patients with cardiovascular diseases, offering improved health outcomes and reduced healthcare costs. Overall, the report emphasizes the complex interplay between medication use, public health outcomes, and the importance of integrated approaches to healthcare delivery. REPORT AUTHOR AND CONTACT Author Names: Caroline McArthur (Health Improvement Snr). Email: nhsh.abhealthimprovement@nhs.scot