Section II: Report and Analysis by GP Federation

2. Central Mendip

Pharmacies and Dispensing Practices

The pharmacies and dispensing practices in Central Mendip are shown in the tables below:

Table II.2.1 Pharmacies in Central Mendip Enhanced Advanced Locally Commissioned Services Services Services

Contract Contract

code Name Trading Name Address1 Address2 Address3 Postcode Type Ailments Minor Care) (Palliative Specialist Drugs Reviews Use Medicines Service Medicines New Reviews Use Appliance StomaCustomisation administration Supervised medicine of Hormonal Emergency Contraception Bins Screening Chlamydia Service Smoking Stop exchange Needle Boots Pharmacy The Park Medical Cannards Shepton FLV83 Boots UK Ltd (1390) Practice Grave Road Mallet BA4 5RT 40 hr Y Y Y y y y y y Townsend Boots Pharmacy Shopping Shepton FXL36 Boots UK Ltd (6554) Unit 2a Park Mallet BA4 5TZ 40 hr Y Y y y y y R H Pharma Shepton FFC86 Ltd Pharmacy Victoria Square Evercreech Mallet BA4 6JP 40 hr L

Table II.2.2 Dispensing Doctors’ Practices and Branches in Central Mendip

Contract Code Contract Name Address1 Address2 Address3 Postcode Opening Hours Type L85611 Oakhill Surgery Shepton Road Oakhill BA3 5HT Monday-Friday, 8.30-18.30 dispensing GP practice

L81025 Surgery Carter's Way Chilcompton Radstock BA3 4XH dispensing GP practice branch There are three 40 hour pharmacies in the Central Mendip federation, two in and one in Evercreech. The northern part of the area is also served by Oakhill Surgery dispensing practice and the dispensing branch of Chilcompton Surgery. There are no 100 hour pharmacies in the Federation.

Table II.2.3 Number of Pharmacies and Dispensing Practices – Central Mendip

GP Pharmacies Dispensing GP Pharmacies Providers Total registered /100,000 /100,000 100 hr 40 hr practice branch population Central 3 1 1 5 19,500 15.4 25.6 Mendip 12 91 22 5 130 554,100 18.6 23.5 South West 1048 181 1229 5,301,000 19.8 23.2 Federation and Somerset Pharmacies, Dispensing GP and population figures as at July 2014, rounded to nearest 100

South West Pharmacies and Dispensing GP figures as at March 2013; population mid-2011 ONS estimate rounded to nearest 1000

The number of pharmacies per 100,000 in Central Mendip is below that for Somerset and the South West region as a whole. However, when the number of dispensing practices and the dispensing branch is included, the provision of pharmaceutical services is seen to be above the rate for the county and the region.

Population & context for health

This section is taken from the current Federation Profile for Central Mendip, prepared by Public Health.

The Federation has a similar population age profile to the Somerset average. The Federation has some pockets of extreme deprivation, with 5% of people living in the 10% most deprived areas of Somerset but in general is very affluent with only 5% people living in the 20% most deprived areas.

Wider determinants of health are generally more favourable than average and in many cases the best in the county. The Index of Multiple Deprivation score for the Federation is 14.6. This is much lower than the average for Somerset of 16.9.

Mortality, causes and places of death

Life expectancy is about average. Premature mortality is slightly higher than the county average, with 14% of deaths occurring before age 65 compared to 13% Somerset average. Mortality rates due to COPD are the worst in the county. A high proportion of people die in their own home.

Disease prevalence

Disease prevalence rates are generally lower than would be expected compared to modelled rates. This may indicate a healthier population than modelled or missed need. Rates of diabetes, CHD and cancer are lowest in the county compared to expected and reflected in low absolute levels and low proportions of COPD and dementia cases on registers.

Smoking

Smoking rates are high with 18% of adults 16+ recorded as smokers compared to 16% Somerset average. Low numbers of smokers go through smoking cessation services and lower than average quit rates. Smoking in pregnancy remains a challenge for the whole county with high rates compared to the rest of , although a Federation breakdown is not available.

Excess weight

Rates of excess weight in school children and adults are slightly higher than the county average.

Drugs and Alcohol

Hospital admissions for drug and alcohol related reasons are lower than the Somerset average.

Sexual health

Cervical screening rates (25-49y) are similar to the county average. Rates of teenage deliveries are the lowest in the county.

Immunisations

Childhood vaccination rates are generally low and in some cases the worst in the county. This is a similar situation to last year. DH targets are for 95% uptake for all so there is still room for improvement. Flu vaccination rates are generally about average although rates for those aged <65 at risk are lowest in the county.

Screening

Cancer screening rates are about average for the county. Bowel screening rates have particularly improved from last year. The Federation has the lowest rates of inadequate smears - this is also a great result from the previous position. The Federation has good rates of invitation and checking of those eligible for NHS Health Checks programme, although there is still room to improve against national targets.

Hospital admission rates

Emergency admission rates for falls in over 65s are 33 per 1000 compared to 26 per 1000 county average. As a proxy for mental health, emergency hospital admissions for self-harm and mental and behavioural disorders are lower than the county average.

QIPP Prescribing

Prescribing rates of antibacterial items are the lowest i.e. best in the county.

Suggested public health areas to prioritise

• Increase numbers of smokers referred to smoking cessation services • Increase childhood vaccination rates • Improve respiratory health • Reduce rates of admissions for falls. Population Growth

Central Mendip lies entirely within , which is projected by the ONS to grow by 3.6% between 2012 and 2018. The population structure is expected to age roughly in line with the county average, with an increase in the population aged 65 to 84 of 24.6%, and of population of 85 and over of 21.9% in the same period. The usually annual festival is held in Central Mendip, at Pilton; this has its own arrangements and is not considered in detail as part of this assessment.

Housing allocations suggest that approximately 200 of the 1300 new dwellings expected in Mendip District will be in Central Mendip federation, implying a lower level of growth than in neighbouring federations. Declining household size and limited house building may mean a falling population in some rural parts.

Map II.2.1 Housing Developments and Pharmacy Services in Central Mendip

The map indicates the relatively limited scale of housing development expected in Central Mendip, and that the sites of such development are close to existing pharmacies. Map II.2.2 Deprivation and Pharmacy Services in Central Mendip

The map, showing Somerset quintiles of deprivation in the 2010 Index of Multiple Deprivation, indicates that deprivation levels are low across the Federation, and that where deprivation is highest – in Shepton Mallet – there is pharmaceutical provision.