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Sha/21049 Appeal Against Nhs England

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Sha/21049 Appeal Against Nhs England 1 Trevelyan Square 4 April 2019 Boar Lane Leeds LS1 6AE REF: SHA/21049 Tel: 0113 86 65500 APPEAL AGAINST NHS ENGLAND SOUTH WEST AREA Fax: 0207 821 0029 TEAM, NHS COMMISSIONING BOARD ("NHS Email: [email protected] ENGLAND") DECISION TO REFUSE AN APPLICATION BY A& H PHARMACIES LTD FOR INCLUSION IN THE PHARMACEUTICAL LIST OFFERING UNFORESEEN BENEFITS UNDER REGULATION 18 WITHIN 450m OF COURTYARD SURGERY, 39 HIGH STREET, WEST LAVINGTON, DEVIZES, WILTSHIRE, SN10 4JB 1 Outcome 1.1 The Pharmacy Appeals Committee (“Committee”), appointed by NHS Resolution, quashes the decision of NHS England and redetermines the application. 1.2 The Committee determined that the application should be refused. NHS Resolution is the operating name of NHS Litigation Authority – we were established in 1995 as a Special Health Authority and are a not-for-profit part of the NHS. Our purpose is to provide expertise to the NHS on resolving concerns fairly, share learning for improvement and preserve resources for patient care. To find out how we use personal information, please read our privacy statement at www.nhsla.com/Pages/How-we-use-your-information-- -FHSAU.aspx 1 Trevelyan Square REF: SHA/21049 Boar Lane Leeds APPEAL AGAINST NHS ENGLAND SOUTH WEST AREA LS1 6AE TEAM, NHS COMMISSIONING BOARD ("NHS Tel: 0113 86 65500 ENGLAND") DECISION TO REFUSE AN APPLICATION Fax: 0207 821 0029 BY A& H PHARMACIES LTD FOR INCLUSION IN THE Email: [email protected] PHARMACEUTICAL LIST OFFERING UNFORESEEN BENEFITS UNDER REGULATION 18 WITHIN 450m OF COURTYARD SURGERY, 39 HIGH STREET, WEST LAVINGTON, DEVIZES, WILTSHIRE, SN10 4JB 1 The Application By application dated 12 June 2017, A&H Pharmacies Ltd (“the Applicant”) applied to NHS Commissioning Board (“NHS England”) for inclusion in the pharmaceutical list offering unforeseen benefits under Regulation 18 within 450m of Courtyard Surgery, 39 High Street, West Lavington, Devizes, Wiltshire, SN10 4JB . In support of the application it was stated: 1.1 In response to why this application should not be refused pursuant to Regulation 31, the Applicant stated “the nearest pharmacy is located 1.4 miles away from the proposed site and therefore Regulation 31 is not applicable”. Supporting documentation: 1.2 West Lavington and Littleton Panell form a village on the edge of the Salisbury plain. The village is on the A360 road between Devizes and Salisbury, about 5 miles (8 km) south of Devizes. 1.3 Facilities available within and around the village are typical of those found in larger villages and small towns reflecting the extent to which residents are reliant on the village for their daily needs. These facilities include the following 1.3.1 an independent day and boarding school, Dauntsey's School 1.3.2 a primary school, Dauntsey Academy Primary School, 1.3.3 a pub, the Churchill Arms 1.3.4 a village hall 1.3.5 a shop with a Post Office 1.3.6 a cash machine 1.3.7 a doctors' surgery 1.3.8 a 19 bed care home, Dauntsey House 1.3.9 a 3 bed care home, The Old Dairy 1.3.10 a 8 bed care home, The Haven 1.3.11 hairdresser, Heads on High 1 1.3.12 Churches 1.3.12.1 All Saints' Church plus closed graveyard and burial ground 1.3.12.2 St Joseph’s Roman Catholic Church 1.3.12.3 Ebenezer Baptist Chapel 1.4 The surgery provides a service to patients within a 6-7 mile radius and has a list size of approx. 2640 patients (ref. CQC report 31 December 2016) West Lavington has as a population of 1502 (in 2011). In addition 700 pupils including approx. 350 boarders, for part of the year, are resident in the community together with an additional 240 full and part time staff (approx. 40 of which live in West Lavington). Local population and healthcare needs: 1.5 The resident population of the parish is more elderly than the England average. The proportion of the Parish population aged over 65 is 17.3% compared to 16.4% across England. This is reflected by the provision of Care Homes within the area. 1.6 The Applicant believes the pharmaceutical needs of the residents are greater than might ordinarily be expected in a village of this size. Health and Disability in the Community 1.7 Data for health from the 2011 census indicates that, of a population of 1502, there were 126 in fair health. 32 were in bad health and 10 in very bad health. 1.8 Data for disability published in May 2011 showed 45 attendance allowance claimants in West Lavington aged 65+ (21.4%), which is higher than Wiltshire (15.9%) and England (17.1%). 1.9 Generally, the 2011 census estimates show that compared to England, Wiltshire has a relatively high percentage of its local population at retirement age and above (21.5%). 1.10 1.3% of the adult population are in long-term nursing residential or residential care and this has risen from 1.2% since 2007. They are mainly in the 85+age group. It is predicted that by 2025, if the current trends continue, there will be 6,930 people in Wiltshire in long-term residential care, compared to around 4,600 today. Existing healthcare provision: 1.11 There is currently no pharmacy in West Lavington. The nearest Pharmacy is located in Market Lavington, a distance of 1.4 miles by road. The next nearest is Boots, Rowlands and Morrison’s some 5.3 miles away in Devizes. 1.12 There is one medical centre within the village that has recently increased the number of GPs. Courtyard Surgery, 39 High St. West Lavington. In the West Lavington neighbourhood plan reference is made to the fact that dementia is a key issue within a local ageing population and transport is an issue (see extract below), thus indicating the need for access to pharmaceutical services that does not require public transport. 'In the absence of alternative transport, heavy reliance is put on the local Care & Link scheme (locally called The Care Group), which relies on voluntary co-ordinators and drivers using their own cars. The main pressures are time and distance for the volunteer drivers. An additional burden is that drivers are asked to wait an indeterminate amount of time before the patient is ready for the return journey. As most drivers themselves are elderly, this places what is probably an unsustainable burden on this particular local facility. 2 Access to hospitals, for visitors and family, as well as patients, from a location like West Lavington is a major issue which has not been addressed by the NHS and should be regarded as a priority. If the NHS could take steps to facilitate co-ordination of hospital appointments by community areas then transport to hospital by bus (including perhaps a community bus) might become practicable.' 1.13 The residents of the village do not currently have reasonable choice with regard to obtaining pharmaceutical services due to: 1.13.1 the distance to the nearest pharmacies 1.13.2 relatively infrequent public transport 1.13.3 a proportion of the resident population will not have access to a car at such times when to access pharmaceutical services is required Proposed site: 1.14 The proposed site for the Pharmacy is within the village centre and will therefore be easily accessible to residents and visitors going about their daily business. As specific premises have not yet been secured this application has been made using a 'best estimate' of location. Securing better access and choice 1.15 There is currently no Pharmacy in West Lavington. Given the distance to the next nearest pharmacies, there is no reasonable choice for residents in terms of existing pharmaceutical services. 1.16 The nearest pharmaceutical services in Market Lavington do not meet the opening times of the surgery in West Lavington by some 11.5 hours. 1 hour each day Monday - Friday 8am-9am, 30mins each day Monday - Friday 1pm- 1.30pm, 30 mins in the evening each day Monday - Thursday 6pm-6.30pm and on Fridays an additional 2 hours 6pm- 8pm. Most of which the Applicant proposes to meet as core hours in the application. 1.17 There is evidence that residents would welcome a pharmacy and shop in the village. In the Neighbourhood plan the Parish Council made the following comments: 'Shops Historically, the villages had many shops. From south to north, there was a post office at The Old Post Office, Church Street, a bakery at The Old Bakery, High Street, a garage at the site of the Courtyard Surgery, a petrol station opposite the Millennium Cross, a chemist at the current Cost cutters site, a Post Office also there, a former post office at the cross roads, a cycle shop at the Stage Post pub site and more. All of those have gone. Future Three retail outlets remain. Basic groceries are available at two sites, hair dressing at another. There appears to be a general desire for no more closures but only so long as there is tangible public support will local shops remain viable.' 1.18 Current public transport between West Lavington and the closest Pharmaceutical services is poor and mentioned in the neighbourhood plan (see enclosed bus timetable). Patient groups sharing protected characteristics 3 1.19 In the Applicant’s opinion, pharmaceutical services are currently difficult to access for all residents of West Lavington and the scale of access problems will increase as the population grows and ages. As previously mentioned there is a high elderly population and as age is a protected characteristic, the specific needs of this population must be taken into account.
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