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26 September 2019 REF: SHA/22173 APPEAL AGAINST MIDLAND AND

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26 September 2019 REF: SHA/22173 APPEAL AGAINST MIDLAND AND 26 September 2019 Arena Point Merrion Way REF: SHA/22173 Leeds LS2 8PA APPEAL AGAINST MIDLAND AND EAST (CENTRAL Tel: 0203 928 2000 MIDS) AREA TEAM, NHS COMMISSIONING BOARD Fax: 0207 821 0029 ("NHS ENGLAND") DECISION TO REFUSE AN Email: appeals@resolution.nhs.uk APPLICATION BY NORTHAMPTON MEDICAL SERVICES FOR INCLUSION IN THE PHARMACEUTICAL LIST OFFERING UNFORESEEN BENEFITS UNDER REGULATION 18 AT 1 WESTERN DRIVE, HANSLOPE, MILTON KEYNES, MK19 7LA 1 Outcome 1.1 The Pharmacy Appeals Committee (“Committee”), appointed by NHS Resolution, confirms the decision of NHS England, therefore the application is 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 Arena Point REF: SHA/22173 Merrion Way Leeds APPEAL AGAINST MIDLAND AND EAST (CENTRAL LS2 8PA MIDS) AREA TEAM, NHS COMMISSIONING BOARD Tel: 0203 928 2000 ("NHS ENGLAND") DECISION TO REFUSE AN Fax: 0207 821 0029 APPLICATION BY NORTHAMPTON MEDICAL Email: appeals@resolution.nhs.uk SERVICES FOR INCLUSION IN THE PHARMACEUTICAL LIST OFFERING UNFORESEEN BENEFITS UNDER REGULATION 18 AT 1 WESTERN DRIVE, HANSLOPE, MILTON KEYNES, MK19 7LA 1 The Application By application dated 12 November 2018, Northampton Medical Services (“the Applicant”) applied to NHS Commissioning Board (“NHS England”) for inclusion in the pharmaceutical list offering unforeseen benefits under Regulation 18 at 1 Western Drive, Hanslope, Milton Keynes, MK19 7LA. In support of the application it was stated: 1.1 In response to why the application should not be refused pursuant to Regulation 31, the Applicant stated: 1.1.1 The reason that this is not applicable is that there is no other pharmacy or dispensing appliance contractor premises either adjacent to or in close proximity to the location of the proposed pharmacy. 1.2 Hanslope is a village located in the Borough of Milton Keynes. The village is about 4 miles west from Newport Pagnell, about 4 miles north of Stony Stratford and 8 miles north of Central Milton Keynes. Medical services are provided by Hanslope Surgery (part of The Parks Medical Practice) to the residents of Hanslope and the surrounding villages including Hartwell, Castlethorpe and Tathall End. The total population across these village locations is 5250. The local surgery also provides dispensing services to 4709 patients which represents 99% of the patient list. 1.3 The nearest pharmacies to Hanslope Surgery are: Roade Pharmacy NN7 2NS 4.6 miles Boots, Winchester Circle, Kingston MK10 0BN 8.2 miles Boots, Six Fields Retail Park, Northampton NN5 5DG 9.6 miles 1.4 Roade Pharmacy which is the closest community pharmacy to Hanslope is open Monday to Friday 09.00hrs to 18.00hrs with a one hour lunchtime closure between 13.00hrs and 14.00hrs. There is no Saturday opening. (Source: NHS website). 1.5 There is a bus service provided by Red Rose Travel between Milton Keynes and Northampton (Services 33 and 33A) which includes Hanslope and Roade. The service operates throughout the day. However, any resident of Hanslope who is reliant on public transport to access comprehensive pharmacy services would need to allow between 1 hour and 1½ hours to complete the return journey. 10% of households do not have access to private transport. (Source: NOMIS) 1.6 18% (national average 16.5%) of the population of Hanslope are aged over 65 and 11.6% (national average 10. 3%) of the local population provide unpaid care (Source: 1 Nomis). Unpaid carers as a group are frequently under pressure as a result of their caring responsibilities and their health needs can often go unnoticed thereby exacerbating the medical needs generated by the over 65's. 1.7 In the context of health and pharmaceutical services, the over 65's are a group commonly defined as sharing protected characteristics. In addition to being more susceptible to long tern conditions, this group are: 1.7.1 often prescribed medicines on a long term basis 1.7.2 are frequently prescribed multiple medicines 1.7.3 may require the support of carers 1.7.4 are more susceptible to falls and mobility issues 1.7.5 are less likely to have access to private means of transport to access services 1.8 To conclude, the current provision of comprehensive pharmaceutical services to those residing in the village of Hanslope and surrounding areas is difficult to access in terms of distance and opening times at the nearest community pharmacy to Hanslope. For those sharing protected characteristics, which in the context of Hanslope are the over 65's representing a greater proportion of the population than is the case nationally, the difficulty in accessing a full range of pharmaceutical services is much more acute. Please explain how you intend to secure the unforeseen benefit(s). 1.9 The proposed pharmacy in Hanslope will ensure that the population will have easy access to a complete range of pharmaceutical services and advice. In addition to Essential Services and commissioned services, the Applicant will implement their own free or private services which will target the health priorities of the locality - notably those affecting older people and the management of long term conditions. Specifically the Applicant will include in their services: 1.9.1 Healthy Heart Screening 1.9.2 Weight Management Support Services 1.9.3 Healthy Eating Advice 1.9.4 Compliance Aid Service 1.10 One of the principle objectives will be to meet the criteria necessary to gain Healthy living Pharmacy (HLP) status thereby providing Enhanced Services which will seek to engage with patients at the three defined levels of engagement i.e. 1.10.1 Promotion 1.10.2 Prevention 1.10.3 Protection 1.11 HLP's generally offer at least two services from the following: 1.11.1 Smoking Cessation support 1.11.2 Alcohol Interventions 1.11.3 Emergency Hormone Contraception 2 1.11.4 Health Checks 1.12 The Healthy Living Pharmacy Scheme is an excellent vehicle for providing high quality pharmaceutical services working in conjunction with other health and social care professionals and will be particularly appropriate in meeting the needs of the population of Hanslope. 1.13 The Applicant is committed to providing opening hours which will meet the needs of the community - including Saturdays. Closing times will mirror those of the Surgery so that patients who have attended a late appointment with their GP and have been prescribed medicines may get these dispensed without having to make a further journey or wait until the following day. 1.14 The choice of having a pharmacy located within Hanslope Surgery will make a difference by offering immediate and convenient access to pharmaceutical services without the current difficulties associated with additional travel and access. The pharmacy will be accessible for those with mobility issues and have the added benefit of disabled parking facilities and the avoidance of an extra journey. 1.15 The co-located pharmacy will conduct its Medicines Use Review (MURs), subject to informed patient consent with patients identified by Hanslope Surgery. The Applicant will concentrate on areas where there is a need for poly-pharmacy patients to reduce medicines burden, diabetes, COPD, asthma and hypertension to optimise medicines use in line with best clinical practice. 1.16 It is intended to employ a qualified pharmacist who will be able to prescribe to help support the care of patient's long term conditions. The 'New Medicines Service' (NMS) will be used to check back with patients to clinically assess progress of new therapies, the follow up will allow informed titration of medicines, for example, respiratory inhalers, anti-hypertensives and rate control medicines. Summary 1.17 Granting this application will ensure that the community of Hanslope have a choice of provider and improved access to comprehensive pharmaceutical services. 1.18 Northampton Medical Services Ltd wish to work with commissioners and local Health and social care professionals to ensure an appropriate range of pharmaceutical services are available to the community. This will be achieved by ensuring the pharmacy is accessible when patients need it to be, by becoming a Healthy Living Pharmacy and providing services which are targeted to the health priorities identified locally and specifically those with protected characteristics. 2 The Decision NHS England considered and decided to refuse the application. The decision letter dated 14 June 2019 states: 2.1 NHS England has considered the above application and is writing to confirm that it has been refused. Please see the enclosed report for the full reasoning. The Report stated: 2.2 NHS England - Midlands & East (Central Midlands) Pharmaceutical Services Regulations Committee (PSRC) has considered the above application for inclusion in the pharmaceutical list, on 31 May 2019, and this is to advise you it has been refused. 2.3 The PSRC must have regard to the NHS (Pharmaceutical & Local Pharmaceutical Services) Regulations 2013 and the initial consideration required is in regard to Regulation 31: 3 2.4 The PSRC first considered Regulation 31 of the regulations [quoted in full] 2.5 The PSRC determined that there is no requirement to refuse this application, under the provisions of this regulation, as there is no-one on a pharmaceutical list who is undertaking to provide pharmaceutical services from either the proposed premises or adjacent premises. 2.6 Application made under Regulation 18 of the NHS (Pharmaceutical & Local Pharmaceutical Services) Regulations 2013 must be assessed against Regulation 40.
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