Agenda item - Pharmaceutical Needs Assessment

Report of Director of Public Health (copy attached).

  44.1  The Board considered a report of the Director of Public Health which informed members that the Health & Wellbeing Board has a statutory responsibility to produce and maintain a statement of the needs for pharmaceutical services of the population in the area, referred to as a Pharmaceutical Needs Assessment (PNA).  NHS England uses the PNA in deciding if new community pharmacies are needed and to inform decisions on which NHS funded services should be provided by pharmacies.  The regulations require every HWB to publish its first PNA by 1^st April 2015.  The report set out the proposed approach by Brighton and Hove.  Paragraph 5.1 set out the consultation process. The report was presented by the Consultant in Public Health. 

44.2    The Chair asked if it would be possible for the Board to see a draft version of the PNA in the autumn.  The Consultant in Public Health confirmed that a draft copy would be circulated informally to the Board. 

44.3    Sarah Creamer, Director of Commissioning, NHS England, informed the Board that NHS England was encouraging Health & Wellbeing Boards to provide as much detail as possible in the PNA.  The PNA determined market entry and needed to be as robust as possible.         

44.4    Councillor Meadows considered that the report was very positive.  However, she expressed concern that Moulsecoomb and Bevendean, which had the highest deprivation in the city, does not have a pharmacy.   People in Bevendean have to travel by bus to use a pharmacy in Lewes Road.  Councillor Meadows stated that she would like to see pharmacies going back to localities.       

44.5    Councillor Meadows noted that there were two pharmacies in Coombe Road.  She asked why one of those pharmacies could not move to the Bevendean area?  Councillor Meadows stressed that GPs surgeries should be serviced by a pharmacy. 

44.6    The Consultant in Public Health explained that the report under consideration was about market entry, but these matters could be looked at as part of the process.

44.7    Councillor Shanks asked if matters such as the opening hours of pharmacies could be considered.  The Consultant in Public Health explained that the process of approving pharmacies was a permissive rather than instructive process.  However, a pharmacy that opened later, where needed, was more likely to get approved by NHS England.  

44.8    Councillor Bowden referred to the list of consultees under paragraph 5.1 of the report.  He asked if the Older Peoples Council could be included.  The Consultant in Public Health agreed that this was a sensible suggestion which would be taken on board.

44.9    The Chair asked if a list of who was consulted would be included on the draft report.  It was confirmed that the draft report would include this information.

44.10  Geraldine Hoban suggested that Patient Participation Groups be included in the consultation.

44.11  Sarah Creamer stressed that the development of the PNA was a discrete piece of work about market entry. The PNA was designed to do a particular set of things.

44.12  The Chair suggested that there should be a separate report for future discussion on the better use of pharmacies. 

44.13  Councillor Bowden asked if Ms Creamer was talking about matters such as diabetes testing and hearing testing.  Ms Creamer confirmed that these matters would be considered.  Other matters to consider were overprescribing and drugs taken in the wrong order. 

44.14  The Chair asked if the CCG had looked at co-pharmacies and co-location with GP surgeries.  Geraldine Hoban replied that this was something that the CCG was eager to explore with the NHS England Area Team – given that primary care commissioning is an NHS England rather than a CCG responsibility.

44.15  Councillor Bowden asked if pharmacists were included in integrated teams.  Geraldine Hoban explained that there were pharmacists who visited care homes.  They were not community pharmacists, but part of a CCG team.

44.16  Councillor Bowden asked about access to records.  If a pharmacist carried out a diabetes test that indicated a problem, did they refer the matter to the patient’s GP?  The Deputy Director of Public Health replied that the data was not shared and the patient would be responsible for arranging to visit their GP.    Sarah Creamer stressed this was about patient choice.

44.17  RESOLVED – (1) That it is noted that it is a statutory requirement for the Board to produce and keep up to date the PNA as set out in 3.6 of the report.

(2)       That the Director of Public Health be instructed to:

o       produce a revised PNA for approval by the HWB by 1 April 2015 (and subsequent updates) and

o       develop and maintain a process to identify any changes to pharmaceutical services and consider if they are substantive enough to require a revised PNA or whether this would be a disproportionate response to those changes.