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18 October 2018 REF: SHA/19944 APPEAL

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18 October 2018 REF: SHA/19944 APPEAL 18 October 2018 1 Trevelyan Square Boar Lane REF: SHA/19944 Leeds LS1 6AE APPEAL AGAINST MIDLANDS & EAST (CENTRAL Tel: 0113 86 65500 MIDS) AREA TEAM, NHS COMMISSIONING BOARD Fax: 0207 821 0029 ("NHS ENGLAND") DECISION TO REFUSE AN Email: [email protected] APPLICATION BY ASCENT HEALTHCARE LTD FOR INCLUSION IN THE PHARMACEUTICAL LIST OFFERING UNFORESEEN BENEFITS UNDER REGULATION 18 AT THE SHOPPING PRECINT ON HALDENS/SLOANSWAY, WELWYN GARDEN CITY, HERTFORDSHIRE, AL7 1DD/1NB REF: SHA/19952 APPEAL AGAINST MIDLANDS & EAST (CENTRAL MIDS) AREA TEAM, NHS COMMISSIONING BOARD ("NHS ENGLAND") DECISION TO REFUSE AN APPLICATION BY JHOOTS PHARMACY FOR INCLUSION IN THE PHARMACEUTICAL LIST OFFERING UNFORESEEN BENEFITS UNDER REGULATION 18 WITHIN AN 80 METRE RADIUS OF 84 HALDENS, WELWYN GARDEN CITY, HERTFORDSHIRE, AL7 1DD 1 Outcome 1.1 The Pharmacy Appeals Committee (“Committee”), appointed by NHS Resolution, confirms the decision of NHS England. 1.2 The Committee determined that the applications 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/19944 Boar Lane Leeds APPEAL AGAINST MIDLANDS & EAST (CENTRAL LS1 6AE MIDS) AREA TEAM, NHS COMMISSIONING BOARD Tel: 0113 86 65500 ("NHS ENGLAND") DECISION TO REFUSE AN Fax: 0207 821 0029 APPLICATION BY ASCENT HEALTHCARE LTD FOR Email: [email protected] INCLUSION IN THE PHARMACEUTICAL LIST OFFERING UNFORESEEN BENEFITS UNDER REGULATION 18 AT THE SHOPPING PRECINT ON HALDENS/SLOANSWAY, WELWYN GARDEN CITY, HERTFORDSHIRE, AL7 1DD/1NB 1 The Application (1 of 2) By application dated 31 January 2018, Ascent Healthcare Ltd applied to NHS Commissioning Board (“NHS England”) for inclusion in the pharmaceutical list offering unforeseen benefits under Regulation 18 at Shopping Precinct on Haldens/Sloansway, Welwyn Garden City, AL7 1DD/1NB. In support of the application it was stated: 1.1 In response to why the application should not be refused pursuant to Regulation 31 Ascent Healthcare Ltd stated: 1.1.1 No other pharmacy in same or adjacent premises so not applicable. 1.2 As NHS England will be aware, the Haldens area has for many years been served by a branch of Lloyds Pharmacy which was located at the shopping precinct located centrally next to Haldens Medical Practice. 1.3 It was a well used pharmacy that was important to the local community. However unfortunately Lloyds decided to close the branch in January 2018 as part of a wave of planned branch closures. 1.4 In December 2016, amendments to the 2013 Regulations came into force which facilitated pharmacy business consolidations from two sites on to a single existing site. This would protect two pharmacies that choose to consolidate on a single existing site, where this does not create a gap in provision after NHS England approval. It is important to note that Lloyds chose not to consolidate the branch with other sites within their group. 1.5 Ascent Healthcare Ltd are aware that patients have complained about the closing of the only Lloyds pharmacy in the area and, given the size of the Lloyds Pharmacy and the number of patients that relied on it, the closure has left a significant gap in local service provision such that granting this application will secure better access to pharmaceutical services for local people and provide them with reasonable choice which does not currently exist. 1.6 The PNA does not consider the benefits that would accrue from locating a pharmacy in this location as a pharmacy existing at the time of the PNA being written and this application is therefore submitted under Regulation 18 as an unforeseen benefits application. Whilst an updated PNA may well identify the gap created by the unforeseen closure of the Lloyds pharmacy and lead to an identified current need, this has not happened yet, and Ascent Healthcare are therefore asking NHS England to grant this application in order to provide pharmaceutical services in this location. 1 1.7 In addition to providing dispensing services this pharmacy would provide all other essential, advanced and enhanced services that are commissioned by NHS England or the local authority. Providing access to these services will be of significant benefit for patients, particularly those who may have difficulty in accessing other parts of the area, such as the elderly, infirm, disabled or parents with young children (i.e. those who share a protected characteristic). There are several schools located close to the proposed site and parents and children are part of the groups who may be identified as sharing protected characteristics. 1.8 Ascent Healthcare Ltd therefore ask NHS England to approve this application. REF: SHA/19952 APPEAL AGAINST MIDLANDS & EAST (CENTRAL MIDS) AREA TEAM, NHS COMMISSIONING BOARD ("NHS ENGLAND") DECISION TO REFUSE AN APPLICATION BY JHOOTS PHARMACY FOR INCLUSION IN THE PHARMACEUTICAL LIST OFFERING UNFORESEEN BENEFITS UNDER REGULATION 18 WITHIN AN 80 METRE RADIUS OF 84 HALDENS, WELWYN GARDEN CITY, HERTFORDSHIRE, AL7 1DD The Application (2 of 2) By application dated 15 February 2018, Jhoots Pharmacy applied to NHS Commissioning Board (“NHS England”) for inclusion in the pharmaceutical list offering unforeseen benefits under Regulation 18 within an 80 metres radius of 84 Haldens, Welwyn Garden City, Hertfordshire, AL7 1DD. In support of the application it was stated: 1.9 In response to why the application should not be refused pursuant to Regulation 31 Jhoots Pharmacy Ltd stated: 1.9.1 There are no pharmacies at this location. The previous pharmacy has closed. 1.10 A Pharmacy at the 84 Haldens has recently closed – January 2018. This closure has left a gap in the provision of pharmaceutical services. The Pharmacy was dispensing in excess of 4,000 prescription items month and evidence of a demand for access and provision of pharmaceutical services at this location. The Haldens Medical Centre is within 100 metres of the proposed site and this supports the need for access to pharmaceutical services at this location. 1.11 There are a range of shops on Haldens. This includes off licence, Nisa grocery store, Ladbrookes, newsagent, bakers, hairdresser and take-aways. 1.12 Haldens supports a large residential area that also contains primary schools (Rowans) and Holy Family Catholic Primary School), and the Waterside Childrens Centre (It provides activities such as Early Talk, Disco Duck, Baby Sensory and Baby massage Child health clinic and development checks run from the centre). 1.13 In terms of levels of deprivation The Haldens Ward is ranked 13,325 out of 32,844 where 1 is most deprived and therefore within the most 50% neighbourhoods in England. 1.14 The nearest pharmacy is well over half a mile away on the other side of the main railway line to London. 1.15 There is a large community that would confer significant benefits from a pharmacy at the proposed site particularly due to the lack of reasonable choice, and to the benefits that would be to groups who share a protected characteristic. 2 1.16 Jhoots Pharmacy are aware (through MP) of local concern at the closure of the previous pharmacy and of the vital lifeline it provided and the benefit it would have to the local elderly population Jhoots Pharmacy therefore ask NHS to approve this application to allow a restoration of pharmaceutical services. 1.17 By opening a pharmacy at the Marina Health Centre site as listed above. The gap in provision of pharmaceutical services would be closed. 2 The Decision (1 of 2 – 19944) NHS England considered and decided to refuse the application. The decision letter dated 26 June 2018 states: 2.1 NHS England has considered the above application and are writing to confirm that it has been refused. 2.2 The full reasoning for this decision has been enclosed along with this letter. Ascent Healthcare Limited’s application for inclusion in the pharmaceutical list: routine application offering to secure unforeseen benefits at the best estimate proposed premises of Shopping Precinct on Haldens/Sloansway, Welwyn Garden City AL7 1DD/1NB 2.3 NHS England – Midland & East (Central Midlands) Pharmaceutical Services Regulations Committee ((hereafter referred to as the PSRC) has considered Ascent Healthcare Limited’s application for inclusion in the pharmaceutical list and this is to advise that the submission has not been approved. 2.4 The PSRC acknowledged that it must have regard to the NHS (Pharmaceutical & Local Pharmaceutical Services) Regulations 2013 and the initial consideration made was in regard to Regulation 31 [quoted in full]: 2.5 The PSRC concluded that the proposed premises to which the application relates, or adjacent premises, there are no existing listed NHS contracted pharmacies operating within the vicinity of Haldens Shopping Centre and therefore, under this provision, regulation 31 would not cause the application to be refused. 2.6 Due to the determination in regard to Regulation 31, NHS England PSRC then considered the applicant’s submission against the regulatory criteria for this routine application for “unforeseen benefits”, Regulation 18 (1) [quoted in full]: 2.7 The PSRC noted that the Hertfordshire 2018 Pharmaceutical Needs Assessment (PNA) - shows an analysis of the situation as it was assessed at the date of publication (April 1st 2018) and there had been no revised assessments issued, in the form of a Supplementary Statement under Regulation 6(3), in regard to this area. The current regulations consider that any benefit is regarded as unforeseen at the time of the pharmaceutical needs assessment simply if it is not mentioned in the document and it can be noted that the benefits proposed in the application are not mentioned.
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