Review of the Distribution of Healthy Start Vitamins Through Community Pharmacies

6. Distribution of Healthy Start Vitamin Tablets and Drops

Data on distribution of Healthy Start vitamins through NHS and community pharmacies show the extent to which community pharmacies are contributing to uptake. It should be noted that data is based on the number of claims made by NHS and community pharmacy contractors for healthy start coupon repayment. Claims may be submitted irregularly or in batches which may not reflect when the vitamins are distributed (therefore where figures show spikes this may reflect when NHS and community pharmacies submitted bulk claims). Data on uptake does not take into account NHS Board funded distribution (as data is only based on reimbursement claims).

Figure 2 below shows that the distribution of women's healthy start vitamins through NHS Health Boards has declined since the introduction of the national trial scheme in March 2013, while community pharmacies have increased distribution. The figure shows NHS Boards distribute more vitamins and drops in comparison to community pharmacies. While overall uptake in women's vitamins is in decline, distribution through community pharmacies alone has not increased uptake^[2].

Figure 2: Distribution of women's Healthy Start vitamins

Distribution of Healthy Start children's drops in Figure 3 below shows a similar tend with a decline in distribution through NHS and an increase in distribution through community pharmacies (although NHS Board continue to distribute more). A greater increase in community pharmacy distribution contributing to the increase in overall uptake is shown in Figure 1.

Figure 3: Distribution of children's Healthy Start vitamin drops

6.1 Distribution though NHS Boards

When the data is analysed at NHS Board level, we see some variation across NHS Boards in the extent to which community pharmacies actively distribute Healthy Start vitamins (see Appendix 1). NHS Boards where community pharmacies were more actively involved in distribution tended to be in areas with large population (Glasgow) or wide geographical areas which included rural areas (Borders, Dumfries and Galloway, Grampian, Orkney, and Shetland). In some NHS Boards, although community pharmacies were increasingly active, distribution was higher through NHS Services (Ayrshire and Arran, Tayside, Lanarkshire, Forth Valley).

In addition to distributing vitamin tablets and drops to eligible families, at least one NHS Health Board (Fife) had made the decision to fund distribution of vitamins to ALL pregnant women (not just those who are eligible for the Healthy Start scheme). Vitamins distribution was through existing NHS Board services and community pharmacy distribution in this Health Board was therefore negligible.

6.2 Distribution through Community Pharmacies

The survey indicates that, where community pharmacies were distributing Healthy Start vitamin tablets and drops, this tended to be infrequent with around a quarter of most respondents indicating they dispensed Healthy Start vitamins on a monthly or 6 monthly basis, with over a third dispensing Healthy Start vitamins on an annual basis (see Appendix 2). Amounts distributed were very low with the majority of respondents indicating 1-2 packets dispensed in any one time period.

Community pharmacies were also able to sell Healthy Start and other brand vitamin tablets and drops to customers who were not in receipt of the Healthy Start Coupons. The survey showed just under a third of respondents sold Healthy Start vitamins on a monthly or annual basis. Amounts sold of both Healthy Start and other branded vitamins were very low with most respondents indicating 1-2 packets in any one time period.

It is not clear why women tend to buy vitamin tablets and drops. It should be noted that women who buy Health Start Vitamins may not be eligible for the Healthy Start Scheme however chose to purchase Healthy Start as opposed to other brands.