In Services development

Follow this topic

Bookmark

Record learning outcomes

Registered nutritionist Keely Sunderland, who is working as a vitamin D coordinator across Lambeth and Southwark, explains why a local pharmacy-based scheme is working so well

The launch of a pharmacy- based free Vitamin D Scheme has been turning heads across Lambeth and Southwark. Community pharmacies have been trained and set up to give out free vitamin D supplements to mothers and children across both boroughs as part of a new initiative to reduce the cases of rickets and osteomalacia, which are reaching an all-time high.

Vitamin D deficiency is not just a problem across Lambeth and Southwark, but across the whole of the UK, with mothers and children being identified as high-risk groups. In February 2012, the National Diet and Nutrition survey demonstrated that up to a quarter of people in the UK had low levels of Vitamin D, and information from the 2005 Infant Survey suggests that the majority of women do not take vitamin D supplements during pregnancy.

Vitamin D is essential for bone health as it helps to regulate the amount of calcium and phosphate in bones and around the body. Typical diseases caused by vitamin D deficiency are rickets in children and osteomalacia in adults. Vitamin D deficiency is associated with an increased risk of cancer, hypertension and autoimmune disease. It is also related to depression, fatigue, muscle weakness and chronic pain syndrome.

The sunshine vitamin

We can only obtain 10 per cent of our daily requirements of vitamin D from our diet so for the rest we have to rely on the sun. Populations at particular risk of deficiency include children under five, all pregnant and breastfeeding women, people who have no or low skin exposure, such as those who cover up for religious reasons, older people over the age of 65, and darker skinned populations such as African, Afro-Caribbean and South Asian populations.

With a high proportion of black and minority ethnic (BME) populations across Lambeth and Southwark, vitamin D deficiency is likely to be more prevalent than in other areas of the UK. There have been 393 cases of rickets and 5,122 cases of Vitamin D deficiency recorded across both boroughs. High levels of deprivation can also increase the risk of poor diet and nutrition and can cause vitamin D deficiency.

There have been 393 cases of rickets and 5,122 cases of Vitamin D deficiency recorded across both boroughs

As a result, an increasing number of cases of vitamin D deficiency and rickets across Lambeth and Southwark have cost the two boroughs £383,103 a year, causing health experts to label it the most dangerous vitamin deficiency.

A new scheme has been launched to provide free vitamin D through the Healthy Start vitamins to all pregnant women, mothers with children under one and all children until their fourth birthday. The scheme is in line with the UK Health Departments’ recommendations of Vitamin D intakes of 10mcg for mothers and 7mcg for children and is funded by Lambeth and Southwark councils and the NHS.

Community pharmacies are at the front line of the scheme, with 20 pharmacies in Lambeth and 20 in Southwark participating. They will be responsible for registering eligible patients onto the scheme and giving out the ‘vitamin D card’. Once registered, this card will enable patients to go to any of the participating pharmacies to get the vitamins, enabling reimbursement and funding for the pharmacists.

It is too early to see the full impact of the scheme but the response from parents has been extremely positive. With so many pharmacists signed up to the scheme the easy access to the vitamins means that mothers can do more to create a healthier lifestyle for themselves and their children – not to mention the economic benefits. The free vitamin D scheme is an exciting new opportunity for all pharmacists as well, with staff enjoying carrying out a new health promotion initiative.

Front line pharmacies

Community pharmacies are ideal places for health promotion initiatives. In a similar way to the vitamin D scheme, community pharmacists are well placed to offer women advice about the importance of the use of folic acid before and during pregnancy. Community pharmacists can also help patients to reduce their risk of developing diabetes and help to manage the condition.

Pharmacists could promote healthy eating and exercise to reduce the risk of developing diabetes, educate the public on the signs and symptoms of the disease and ensure that patients are taking medication correctly. Community pharmacists could also have a role in advising on the importance of nutrition and exercise. Many conditions are the result of poor diet and this advice could potentially contribute to the prevention of these diseases later in life.

Overall, the message is clear throughout the UK that pharmacies can make an important contribution to improving health and reducing health inequalities. The vitamin D scheme has come at an exciting time, with the potential to highlight the impact that pharmacies can have on health promotion initiatives. In the future, I hope that pharmacies will become more involved in a nutritional role in the community, providing a wider public health workforce.