GPhC Public Health Pharmacy — Questions and Answers
Question 1: Under the NHS community pharmacy contractual framework in England, which public health service involves pharmacies providing advice and supplying nicotine replacement therapy without a prescription?
- Medicines Use Review (MUR)
- NHS Stop Smoking Service (Correct answer)
- Flu vaccination service
- Minor Ailments Scheme
Correct answer: NHS Stop Smoking Service
The NHS Stop Smoking Service is a public health service commissioned through community pharmacies. Pharmacists can provide behavioural support and supply NRT (nicotine replacement therapy) products through a PGD or locally commissioned service without requiring a prescription. This is one of the key public health roles of community pharmacy.
Question 2: A community pharmacist is providing the NHS seasonal influenza vaccination service. Which of the following patient groups is eligible for a free NHS flu vaccination?
- All adults aged 18-64 with no health conditions
- Adults aged 65 and over (Correct answer)
- Only healthcare workers in hospital settings
- Children under 5 only
Correct answer: Adults aged 65 and over
Adults aged 65 and over are routinely eligible for free NHS flu vaccination. Other eligible groups include those with chronic conditions (asthma, diabetes, heart disease), pregnant women, carers, and frontline health/social care workers. Pharmacists can administer the vaccine under a national PGD or NHS service specification.
Question 3: A young woman requests emergency hormonal contraception (EHC). She reports unprotected intercourse 48 hours ago. Which option should the pharmacist recommend as the most effective oral EHC at this time point?
- Levonorgestrel 1.5mg (effective up to 72 hours)
- Ulipristal acetate 30mg (effective up to 120 hours) (Correct answer)
- Combined oral contraceptive pill as emergency use
- Both levonorgestrel and ulipristal are equally effective at 48 hours
Correct answer: Ulipristal acetate 30mg (effective up to 120 hours)
While both levonorgestrel and ulipristal acetate are licensed for emergency contraception, ulipristal acetate (ellaOne) maintains its efficacy better over time and is considered more effective than levonorgestrel between 24-120 hours after unprotected intercourse. At 48 hours, ulipristal is the preferred oral option. A copper IUD would be even more effective if available.
Question 4: What is the pharmacist's role in needle and syringe exchange programmes (NSP) as part of harm reduction for injecting drug users?
- Pharmacists should refuse to participate as it encourages drug use
- Provide clean needles/syringes, sharps bins, and advice on safer injecting practices to reduce blood-borne virus transmission (Correct answer)
- Only provide needles if the person agrees to enter a treatment programme
- Refer all clients to their GP without providing any equipment
Correct answer: Provide clean needles/syringes, sharps bins, and advice on safer injecting practices to reduce blood-borne virus transmission
Needle and syringe programmes are evidence-based harm reduction interventions that significantly reduce transmission of blood-borne viruses (HIV, hepatitis B and C) among injecting drug users. Community pharmacies provide clean equipment, sharps disposal, and health advice without requiring engagement in treatment as a precondition.
Question 5: A pharmacy is commissioned to provide NHS Health Checks. Which age group is the target population for this cardiovascular disease risk assessment programme?
- Adults aged 18-39
- Adults aged 40-74 without pre-existing cardiovascular disease (Correct answer)
- Adults aged 65 and over only
- All adults regardless of age or medical history
Correct answer: Adults aged 40-74 without pre-existing cardiovascular disease
NHS Health Checks target adults aged 40-74 who do not already have a diagnosed cardiovascular condition (heart disease, stroke, diabetes, kidney disease). The check assesses cardiovascular risk through measurements including blood pressure, cholesterol, BMI, and lifestyle factors, with the aim of early intervention.
Question 6: Under the public health agenda, what is the pharmacist's responsibility regarding antimicrobial stewardship?
- Prescribe antibiotics for self-limiting conditions to prevent complications
- Promote appropriate antibiotic use, advise patients on self-limiting infections, and support national campaigns to reduce antimicrobial resistance (Correct answer)
- Antibiotics stewardship is solely the responsibility of hospital pharmacists
- Supply antibiotics over the counter to reduce GP workload
Correct answer: Promote appropriate antibiotic use, advise patients on self-limiting infections, and support national campaigns to reduce antimicrobial resistance
Community pharmacists play a key role in antimicrobial stewardship by advising patients that many infections are self-limiting, recommending symptomatic relief, supporting the TARGET toolkit and Antibiotic Awareness campaigns, and ensuring appropriate antibiotic supply. This helps combat antimicrobial resistance, which the WHO identifies as a major global health threat.
GPhC Public Health Pharmacy
Under the NHS community pharmacy contractual framework in England, which public health service involves pharmacies providing advice and supplying nicotine replacement therapy without a prescription?