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Diabetes affects over 537 million people worldwide; by 2045, this is estimated to increase to 783 million. [1] With the growing prevalence of diabetes, it's even more important to utilise all options to support people with diabetes (PwDs) in managing their daily life with diabetes. Where do PwDs most often access healthcare support? On average, PwDs visit the pharmacy three-to-eight times more than the general population to obtain medicines and testing supplies.[2] It is clear that pharmacists play an integral role in empowering the self-management needs of PwDs beyond the traditional role of supplying medicines. This relationship, however, may be underutilised. Research suggests there is a lack of broad recognition of pharmacists as a key source of diabetes care, and that resource constraints - particularly following the COVID-19 pandemic - can interfere with patient education provision and training.[3,4] Furthermore, the circumstances and role of the pharmacy vary, nationally and internationally. At Roche Diabetes Care we would like to shine a light on the increasing value of community pharmacists as important figures in the well-being of PwDs.

With GP waiting times on the rise and the secondary NHS care system under pressure, there is a further opportunity for pharmacy to support the general public with self-care. The men's health category is one category where pharmacists can play a leading role - specifically Erection Problems (EPs) where pharmacists can be key to building awareness, destigmatising the condition, and providing support and solutions for the patient. Training for pharmacists is essential - helping them to understand how they can assist those looking for treatment whilst also breaking down barriers and normalising the conversation around EPs. EPs are when a man regularly cannot get and keep an erection. EPs can happen to any adult man, not limited to the older generation, though they are particularly common in men over the age of 40. EPs may happen in some situations over others and so it is increasingly important for men to speak about and identify the cause of their symptoms, particularly because EPs can often be an indication of other serious health conditions like cardiovascular disease, high blood pressure or diabetes. If pharmacies can encourage men to seek help with their EPs, they may also be able to identify additional serious and undiagnosed conditions earlier, thereby supporting men's health more widely.

In partnership with the pharmaceutical company Boehringer Ingelheim, Leeds Teaching Hospitals Trust (LTHT) has recently established an innovative cardiometabolic clinic. The clinic focuses on reducing cardiovascular risk in people with diabetes who have recently been discharged from LTHT following a heart attack. It is delivered jointly by the cardiology department at Leeds General Infirmary and the diabetes services at the Trust. This is a patient-centred approach to reducing that risk, with pharmacist-delivered clinics scheduled for six to eight weeks after the heart attack. Stephen Wheatcroft, Professor of Cardiometabolic Medicine and Consultant Cardiologist at LTHT, said: "This is an exciting and innovative development, one of the first in the country. Previously, Type 2 diabetic patients presenting with heart issues would have been treated by two separate specialty teams. This is the first time there has been a specific clinic combining the cardiac and diabetes team working together. "We aim to reduce the risk for patients, with earlier multidisciplinary hospital care, to help discharged patients achieve better diabetes control, through improved medication support and optimisation, reducing the need for further treatment and future hospital stays. Overall, it will mean a better patient experience, with improved monitoring and information about treatment options, along with a reduction in waiting times for review in a specialist clinic."

There is no doubt that the pandemic has changed the way healthcare professionals work within the primary care setting. The advent of Covid-19 meant that we all had to rapidly modify the way we supported and met the needs of patients, some of whom saw the services they usually took for granted, virtually cease overnight. There are around 15 million people in England living with long-term health conditions including asthma. These people have the greatest healthcare needs of the whole population with 50 per cent of all GP appointments and 70 per cent of all bed days taken by this cohort of patients, and their treatment and care absorbing 70 per cent of acute and primary care budgets in England. This situation isn't going to improve any time soon. In the past, most people had a single condition, today multi-morbidity is becoming the norm. At the start of the pandemic, the Royal College of General Practice and British Medical Association issued guidance to practices on prioritising workload. This included the importance of maintaining long-term condition reviews in asthma, COPD and diabetes, along with appropriate transition of at-risk warfarin patients. These reviews were deemed as essential workstreams for patients considered to be at high risk. Traditionally, the unique skills set of a pharmacist has meant that we have played a major role in supporting these patients. I work with a team of over 90 clinical pharmacists who, in partnership with individual practices, PCNs, CCGs and STPs, help with the long-term management of people with chronic conditions. But the onset of Covid-19 meant that we now had to plug a potential gap in service provision, and quickly.

The Pharmaceutical Services Negotiating Committee (PSNC) has launched a four point plan at its parliamentary drop-in event for MPs and peers hosted on Tuesday (15 November). The event lasted for two hours, during which MPs had the opportunity to drop-in and have their blood pressure measured by pharmacists with experience of working on the front-line and were briefed on the urgent need for action to address the pressures on the sector. Outline of the four-point plan: Resolve the funding squeeze: Community pharmacy needs an immediate funding uplift to prevent large-scale pharmacy closures, as well as emergency business relief to get through this winter. Tackle regulatory and other burdens: Pharmacies must be protected from medicines market shocks, supported to help them weather the workforce crisis, helped to free up capacity and freed from red tape that does not enhance patient care. Help pharmacies to expand their role in primary care: Pharmacies could do more to support the delivery of primary care for example through offering clinical services for long-term conditions - like hypertension, diabetes and respiratory disease, supporting people to adopt healthier lifestyles and prevent the development of long-term conditions, medicines optimisation, and a much wider variety of NHS vaccinations.