PRIMARY CARE CONTRACTOR ORGANISATION

PHARMACY PRACTICES COMMITTEE

Application by Reach Pharmacy (Neeraj Salwan Trading As) for inclusion in the pharmaceutical list in respect of the address, 3 Loganlea Terrace, , Loganlea, EH55 8HN.

The Pharmacy Practices Committee met at 11.30am on Thursday 9th September 2010 in The meeting Room, Medical Centre to consider the above application in accordance with the National Health Service (Pharmaceutical Services) () Regulations 2009.

Decision of the Pharmacy Practices Committee

The decision of the Committee was that the provision of pharmaceutical services at the premises was neither necessary nor desirable in order to secure adequate provision of pharmaceutical services in the neighbourhood in which the premises were located by persons whose names are included in the pharmaceutical list and that accordingly the application should not be granted.

Pharmacy Practices Committee

Jack Aitchison (Chair) Peter Jones (Non-contractor Pharmacist) Fiona McCready (Contractor Pharmacist) Patricia Easton (Lay member) Ian Melville (Lay member)

Susan Summers (Administrator to the Pharmacy Practices Committee) (accompanied by Lynda Campbell)

1. The Committee convened to consider an application for inclusion in the pharmaceutical list, dated 9th February 2010, by Neeraj Salwan in respect of the address, 3 Loganlea Road, Addiewell, Loganlea, EH55 8HN. A copy of the application had been circulated in advance to the Committee and the parties.

2. Written representations had been received from Lothian Area Pharmaceutical Committee; Mr Cassie, James White Chemist Ltd; Yvonne Williams, Lindsay & Gilmour Pharmacy; Graeme McBride, MacBride Pharmacy and Emma Griffiths, The Co-operative Pharmacy. The applicant and the interested parties were entitled to comment on the representations received. Further comments were received from Reach Pharmacy (Applicant), 4 Lynedoch Place, Charing Cross, , G3 6AB. Copies of the written representations had been circulated in advance to the Committee and the parties.

3. An unsolicited letter and email of support was received from MSP dated 11th March 2010. This person has no statutory right to make representations on this matter and the Board did not consult them. However the letter was made available to the Committee for information only.

4. The Committee had before them maps of the area surrounding the proposed premises detailing the location of the nearest pharmacies and GP surgeries, deprivation categories and population density. They had details of the numbers of prescriptions dispensed during the months December 2009 – May 2010 by the pharmacies nearest to the proposed premises and the number of prescriptions they dispensed that were issued from the GP surgeries closest to the premises during the months January 2010 – March 2010. The Committee were also provided with “Pharmacy Profiles” of the nearest pharmacies detailing opening hours, premises facilities and services offered.

5. Under paragraph 5(10) of the Regulations the Committee was required to decide whether “the provision of pharmaceutical services at the premises named in the application is necessary or desirable in order to secure adequate provision of pharmaceutical services in the neighbourhood in which the premises are located by persons whose names are included in the pharmaceutical list.”

6. It had been confirmed prior to the meeting that the members present did not have an interest to declare.

7. The Committee agreed to invite the applicant Reach Pharmacy (Neeraj Salwan Trading As) and those who were present who had made written representations to attend before them. They were:

Neeraj Salwan, representing Reach Pharmacy (Neeraj Salwan Trading As) Arvind Salwan, assisting in the presentation of the application Mr S Cassie, representing James White Chemist Ltd Yvonne Williams, representing Lindsay & Gilmour Graeme McBride, representing MacBride Pharmacy

8. The Chairman explained the procedure that would be followed and no person present objected.

9. The procedure adopted by the Committee was that the applicant made an opening submission to the Committee, which was followed by an opportunity for the objectors and the Committee to ask questions. The objectors then made their oral representations and the applicant and the Committee then asked the objectors questions. The parties were then given an opportunity to sum up. Before the parties left the meeting the Chairman asked all parties if they felt that they had had a fair and full hearing. They confirmed that they had.

10. Prior to the meeting the Committee undertook a site visit. The Committee noted the location of the proposed premises, the pharmacies nearest to the proposed premises, the nearest GP surgeries and the neighbourhood as defined by the applicant.

11. The Committee was required to and did take account of all relevant factors concerning the issues of neighbourhood, adequacy of existing pharmaceutical services in the neighbourhood and whether the provision of pharmaceutical services at the premises named in the application was necessary or desirable to secure adequate provision of pharmaceutical services in the neighbourhood in which the premises are located.

12. The Chair of the Committee informed the hearing that at the site visit a representative from the local Community Council and a representative from Pit Stop had been present. The applicant had made these representatives aware of when the site visit was to take place. As they had not been invited by the Committee and did not have the right of representation, the Committee were aware that these unsolicited verbal representations were not to be considered in their final deliberation.

Neighbourhood - Applicant

13. The Committee noted that the applicant, Reach Pharmacy, had defined the neighbourhood as;

North: Open countryside with its junction at Blackburn Road and Faraday Place following the line of residential and commercial development to which the village of Addiewell extends.

East: Deepdale Branch Road surrounded by open countryside

South: the south is a natural boundary following the line of the A71 which is a major trunk road.

West: Ross Court bounded by countryside down to the A71

The applicant clarified in his oral submission that the neighbourhood could be defined as the boundaries on the north, east and west comprising and enclosing all of the village of Addiewell and the adjoining localities extending beyond these axes, along which lies rural farmland and Greenfield.

Neighbourhood – Interested Parties

14. Yvonne Williams, Lindsay & Gilmour; Stephen Cassie, James White Chemist Ltd and Graeme McBride, MacBride Pharmacy, agreed with the Applicant’s definition of the neighbourhood.

Adequacy of Existing Pharmaceutical Services and Necessity or Desirability - Applicant

15. Mr Salwan submitted to the Committee that Addiewell is a poor neighbourhood which faces a number of challenges in terms of health care issues due to the area being income deprived with high levels of unemployment, low car ownership and high levels of drug addiction. Mr Salwan went on to say that there are no proper health care facilities in Addiewell such as a pharmacy or GP practice and it would therefore be highly desirable to have a pharmacy located in Addiewell to help address some of these issues.

16. Mr Salwan informed the Committee that there are pharmacies out with the neighbourhood which provide services to the neighbourhood population but he did not believe that the current provision was adequate for those members of the population who find difficulty in accessing the services i.e. the housebound, the elderly, terminally ill patients and people who are working.

17. Mr Salwan submitted that Addiewell is made up of the locations known as Loganlea and Addiebrownhill and that these have collectively come together to be known as Addiewell. New housing has increased the population by over 600 residents. Mr Salwan added that there were two local primary schools, a parish church, a post office and a community based miner’s welfare and social club, known as the Pit Stop, which houses various community based services. These include a Credit Union, Fitness Suite, nutrition advice, advice on smoking cessation, under 5’s play area, broadband and internet connection, homeopathic surgeries, eat well food co-op, walking group, GP exercise classes, youth club, baby clinic, senior citizens association and shopping facilities.

18. Mr Salwan added that there was also an active Community Council who backed the proposal for a new pharmacy.

19. Mr Salwan informed the Committee that the residents of , which is a small community to the west of Addiewell, make use of the local services available in Addiewell on a regular basis. The two schools in Addiewell have pupils who live in Breich on their registration list. With the opening of the new prison in Addiewell, visitors and staff also make use of the local amenities and would also be served by a new pharmacy.

20. Mr Salwan informed the Committee that he had determined that Addiewell was made up of two data zones. These data zones are groups of Census output areas and have populations of between 500 and 1000 household residents. Where possible, they have been made to respect physical boundaries and natural communities. One of these data zones is one of the 15% most deprived in Scotland. The 2009 mid year estimates show that the population of the neighbourhood (excluding Breich residents) is in excess of 2000. These figures take into account the increase in population due to new housing. The 2001 census population was recorded as 1500. Mr Salwan added that if the 748 Breich population was added to the 2009 figure the population would be around 2800 which would be the number of clients that a pharmacy in Addiewell would be servicing.

21. Mr Salwan submitted that previous applications had been granted for neighbourhoods with a similar or smaller population size and not as economically deprived. He gave an example of Logan, a small village in Ayrshire which has many similarities to Addiewell.

22. Mr Salwan submitted that Addiewell is an isolated community with extreme deprivation and poor community health, low car ownership and unreliable, poor public transport. Statistics clearly show that Addiewell has a terrible health record compared to the Scottish average and is further compounded by social problems. Figures suggest that the demand for NHS services in this area will be significantly greater than across Scotland as a whole and that a pharmacy located at the heart of an area with such high demand could only help to address these serious issues.

23. Mr Salwan informed the Committee that the new pharmacy contract relies on face to face contact and this is inadequate in Addiewell. He added that there are gaps in service provision which can be backed up by the Smoking Cessation clinic set up in the Pitstop. Currently this service is offered on a weekly basis. There is currently no funding available to run any more group sessions but would be keen for more counselling to be given and for similar group sessions to be run from the proposed pharmacy.

24. Mr Salwan submitted that eMAS and CMS can currently only be accessed in neighbourhoods outside of Addiewell which is inadequate as the services must be delivered at a local level. Most of the residents of Addiewell would be eligible for eMAS and if the new contract was granted, these residents would be able to access locally free advice and treatment. Mr Salwan added that CMS has been designed to reduce GP workload and to direct key services to a pharmacy with easy local access. The residents of Addiewell would be losing out as there is neither a GP practice nor pharmacy in Addiewell.

25. Mr Salwan added that Health Boards are encouraging individual pharmacies not to take on too many patients on the Chronic Medication Scheme as they may find it difficult to cope with the numbers of patients and the time required to complete individual elements of CMS such as the Primary Care record. A pharmacy in Addiewell will help compliment the CMS and be able to offer a focused service to local residents.

26. Mr Salwan submitted that the proposed pharmacy would, through an independent prescriber and CMS, be a walk in healthy living centre and would seek to reach out to the population by providing a wide range of diagnostic services many of which are not being offered at present.

27. Mr Salwan informed the Committee that Addiewell has a higher than average unemployment figure as well as a higher than average number of households with one or more carers. 44% of the population do not have cars and there is a higher than average number of economically inactive people who are permanently ill or disabled. Mr Salwan added that there were high numbers of adults on means tested benefits such as income support, incapacity and lone parent benefit. There is also a higher than average number of teenage pregnancies.

28. Mr Salwan addressed the issue of public transport by informing the Committee that the residents and local Community Council have advised that local transport services are inadequate. There are two services that operate and it can take as long as 50 minutes to get to West Calder using public transport. Mr Salwan added that the cost of the bus journey was £3.20 which was a considerable amount for the high numbers of residents who were on benefits. Mr Salwan informed the Committee that there were going to be major budget cuts by Council, one of which would be subsidised bus services.

29. Mr Salwan informed the Committee that it is a 3 mile walk from Addiewell to the nearest pharmacy along a busy, poorly lit road.

30. Mr Salwan submitted that he believed that the nearest pharmacies to Addiewell served far more than the average patient population of 4,400. As pharmacies have additional and new services to provide the expectations of pharmacies can only increase. A new pharmacy in Addiewell would enable the local population to access vital services, advice and free treatment. The proposed pharmacy would be easily accessible with ample parking and be completely Disability Discrimination Act compliant. It would provide a consultation room and a public health display including a touch screen health information point. The staff would be well trained, highly skilled and would take an active role in all local and national initiatives and would be recruited locally. There would be a dispenser and two part time counter assistants and a driver would be recruited in time as the business gets busier.

31. Mr Salwan concluded by saying that Addiewell should be considered a neighbourhood for all purposes and that the population is below the national average in terms of health, employment and transport. In order to access pharmacy services, residents have to travel over a mile to busy pharmacies in surrounding neighbourhoods, a trip which can take up to 2 hours. The proposed pharmacy has the support of the local Community Council and the granting of a contract would enable the local population to readily access pharmaceutical services.

32. In answer to questions from Ms Williams of Lindsay & Gilmour, Mr Salwan answered that he had used the 2001 census figures and figures from a government website which gives a mid-year population estimate on new housing. Mr Salwan added that there had been a housing development built on the western side of Addiewell and in Addiebrownhill, a total of 200 houses.

33. Ms Williams asked Mr Salwan if he was aware that any restrictions placed on pharmacies for the number of CMS patients would be lifted. Mr Salwan agreed that this would be the case but that busy pharmacies would still face time management issues and that his definition of a busy pharmacy would be 4000 to 5000 patients located near a health centre.

34. In answer to Ms Williams’ question about inadequacy, Mr Salwan replied that the stop smoking service currently offered at the Pit Stop was inadequate and he confirmed that he was aware that a pharmacist from MacBride’s was currently providing this but it wasn’t being offered extensively enough.

35. Mr Salwan responded to a question from Ms Williams about complaints by saying that he was aware of one letter written to the Health Board by the local MSP. This letter focused on the lack of services offered to the residents of Addiewell and the restricted services over lunchtime which proved inadequacy.

36. In answer to questions from Mr MacBride, Mr Salwan advised that he did not live locally but he had carried out extensive research in the Addiewell area and had spoken to the local Community Council and all stakeholders in the neighbourhood to determine satisfaction of the current pharmaceutical provision. Mr Salwan added that he had experience of similar applications in the past and the ability to provide services to deprived local communities.

37. Mr MacBride asked if Mr Salwan was aware that the stop smoking service had been offered in the Pit Stop for 8 years and that the service was weekly due to demand. Mr Salwan replied he was aware of this and that he had got information from the Pit Stop and the Community Council. He added that residents would require access every day to a smoking cessation service and would require free patches and gum. Mr Salwan acknowledged that some patients would qualify for free prescriptions but currently can only access this once a week. Mr Salwan added that he would not have had the support from the Pit Stop and the Community Council if the current service was not inadequate and that a weekly service does not meet HEAT targets.

38. Mr MacBride asked if Mr Salwan was highlighting that the Health Board service was inadequate to which Mr Salwan replied that it was the residents in Addiewell that were highlighting this as a problem.

39. In response to a question from Mr MacBride about the numbers of new houses in the area, Mr Salwan confirmed that from the statistics and figures which had been made available to him, 200 new houses had been built and that this information had been backed up by the local MSP.

40. Mr MacBride asked about the letter written by the MSP and what was meant by ‘more joined up medical provision’ to which Mr Salwan replied that he couldn’t comment on this as these views were the MSP’s.

41. Mr Salwan confirmed that he had not spoken directly with the GP’s at the West Calder Medical Practice and that it was the resident’s views that were important and had to be considered.

42. In response to a question from Mr MacBride, Mr Salwan advised that he was not aware of the Health Board’s complaints procedure.

43. Mr Salwan agreed that Breich residents would be likely to travel to West Calder for pharmaceutical services but that he had found in his research that Breich residents also access a lot of local services available in Addiewell.

44. Mr MacBride asked if Mr Salwan had been active in drumming up support from the Community Council to which Mr Salwan replied that he was not in a position to stop anybody from appearing at the site visit which was undertaken by the Committee earlier that day.

45. The Chair then reminded the hearing that the Community Council had no right of representation and that any comments made by the Community Council representative that morning would not be taken into consideration.

46. In answer to questions from Mr Cassie, James White Chemists, Mr Salwan confirmed that he had not asked the GP practice in what their views on a new pharmacy were.

47. Mr Salwan confirmed to Mr Cassie that he was aware of the path through the field leading from Addiewell to Stoneyburn but that in his opinion it was not a suitable walkway and had poor lighting.

48. In answer to questions from the Committee Mr Salwan confirmed that his defined neighbourhood was the same as the local Community Council boundary. He agreed that the 2 data zone areas that he had provided did not equate to the boundaries of the defined neighbourhood but that they were the best fit and that there were minimal areas of the data zones outside the neighbourhood.

49. Mr Salwan confirmed that there were two schools in Addiewell and that pupils from Addiewell and Breich attended them.

50. The Committee asked about the bus services and Mr Salwan confirmed that there were two service providers but that in his opinion the service was poor.

51. In response to a question from the Committee, Mr Salwan advised that he was not sure where local residents work but that some would be employed by the local school and businesses and that some would be likely to work in Livingston. He added that as deprivation was high there was a high percentage of unemployment.

52. Mr Salwan advised the Committee that he had contacted the planning department and there were no applications in the pipeline but may be longer term.

53. Mr Salwan was asked by the Committee why he thought the smoking cessation service should be offered every day to which he replied that people need flexibility as certain days may not suit everybody.

54. Mr Salwan confirmed to the Committee that he had contacted the local Community Council in the first instance for support and back up to the application.

55. In response to a question from the Committee about the lease of the new premises, Mr Salwan confirmed that he had confirmation that the lease would be made available and that the unit had in fact been held for their use for over 1 year.

56. Mr Salwan responded to a question from the Committee about the new prison in the area by saying that there were 250 staff employed there as well as visitors to the prison who make use of the services in the local area and would use the services of a local pharmacy.

57. Mr Salwan confirmed to the Committee that he had four pharmacy businesses.

58. In response to a question from the Committee about the local surveys he had carried out, Mr Salwan advised that the local Community Council had helped in drafting the statements and that the respondents were asked not to look at convenience but at dissatisfaction with current service provision.

59. The Committee asked Mr Salwan where local residents do their shopping to which Mr Salwan replied that there was a small supermarket in Addiewell which residents used on a day to day basis.

60. Mr Salwan responded to a question from the Committee about accessing services by bus to which he replied that he did not think that the residents who are on low incomes should be punished by the high cost of bus travel.

61. In response to a question about waiting times, Mr Salwan advised that he had researched this and that the pharmacies were busy due to high patient numbers.

62. Mr Salwan confirmed to the Committee that the proposed pharmacy could be open within a 2-3 month period and that planning permission was not an issue.

Adequacy of Existing Pharmaceutical Services and Necessity or Desirability – Interested Parties

63. Ms Williams, on behalf of Lindsay & Gilmour, stated in her oral presentation that the application should not be granted as it was neither necessary or desirable to secure adequate provision of pharmaceutical services to the neighbourhood.

64. Ms Williams submitted that given the proposed premises are less than half a mile on foot from James White Chemists in Stoneyburn and 2.3 miles by road from the pharmacy in the Health Centre in Burngrange, West Calder plus the fact that there are a further 8 pharmacies on the consultation list that the services provided to the neighbourhood were more than adequate.

65. Ms Williams went on to say that each of the pharmacies is easily accessible to patients from the applicants neighbourhood by car or one of the 4 bus companies operating from Addiewell to Stoneyburn, West Calder, Livingston and . Ms Williams added that there were in fact 5 buses every hour running from Loganlea Square and not 1 per hour as had been suggested by the applicant.

66. Ms Williams submitted that as far as Lindsay & Gilmour were concerned, although located outside the defined neighbourhood, they provided more than adequate pharmaceutical services to the neighbourhood. Ms Williams went on to say that prescriptions are collected from West Calder Medical practice, where the majority of Addiewell patients are registered, throughout the day and prescriptions are collected on demand from Stoneyburn Medical Centre. These surgeries are the two which service the majority of residents in the defined neighbourhood.

67. Ms Williams informed the Committee that Lindsay & Gilmour offer a full range of pharmaceutical services including contracted services such as the Minor Ailment Service, the full Public Health Service which includes smoking cessation and sexual health services including Emergency Hormonal Contraception and the Acute Medication Service and CMS.

68. Ms Williams went on to list the other services provided by Lindsay & Gilmour including the methadone service which has spare capacity as well as the monitored dosage system service which also has spare capacity. Ms Williams added that Lindsay & Gilmour are also using a Cardiopod machine which can calculate cholesterol levels, BMI and blood pressure in several branches. Ms Williams submitted that all these services were available to all patients within the neighbourhood of Addiewell.

69. Ms Williams informed the Committee that each of the 10 pharmacies on the consultation list provide a variety of services as described to the neighbourhood of Addiewell including Saturday afternoon opening, extended hours and Sunday and public holiday opening. Ms Williams added that the applicant had not demonstrated that he will be providing any services not currently available to the residents of Addiewell from other pharmacies in the area.

70. Ms Williams submitted that in terms of population, General Register Office statistics for 2006 show a population of only 1360 for the locality and that there has been only a limited amount of housing development in the area over recent years. This explains the limited population growth demonstrated by the GRO 2008 figure of 1460 – an increase of 100. Ms Williams added that the houses in the small development of Ross Court are large, executive family homes and bring to the neighbourhood a different type of population other than the deprived one which the applicant described.

71. Ms Williams submitted that the applicant had made much of the distances of the other pharmacies in relation to the proposed premises and how such a deprived population should not be forced to pay bus fares. Ms Williams added that if distance was cited as an indicator of inadequacy, the distance of 500m by foot from James White Chemists in Stoneyburn could be taken to mean that there should be pharmacies located every 500m across Scotland which is not acceptable.

72. Ms Williams informed the Committee that this year a PPC and a NAP hearing rejected the granting of a contract in Cramond where it was deemed that a distance of more than one mile over difficult terrain was acceptable and easily acceptable. Consistency would dictate that this application should be rejected on these grounds alone.

73. Ms Williams submitted that she did not believe that a Pharmacy business at the proposed location, with this size of population would be viable and even if services were currently inadequate, the new pharmacy would not secure provision. Ms Williams added that she did not believe that any inadequacy in the existing services has been demonstrated although a case can always be made for desirability. Ms Williams went on to say that however this should not be confused with convenience which is something the applicant has done and she would urge the Committee to reject the application.

74. In answer to questions from Mr Salwan of Reach Pharmacy, Ms Williams answered that she thought that the pharmacy at Polbeth was providing a good service to the population of Polbeth and that the population of Addiewell was a different type of community.

75. Ms Williams confirmed that the bus fare to West Calder was £3.20 when asked by Mr Salwan.

76. In response to a question from Mr Salwan, Ms Williams advised that the pharmacy regulations allow pharmacists to be away from the pharmacy for up to 2 hours a day and this would provide the opportunity to visit housebound patients to provide ‘remote’ CMS and eMAS. Ms Williams also confirmed to Mr Salwan that patients did not need to come in person to a pharmacy to register for these services as registration can be done remotely with the patient’s agreement and that the Patient Care Record can be filled out at a later date.

77. Mr Salwan asked Ms Williams if she thought that this arrangement was against the spirit of the scheme and asked what would be happening in a pharmacy if the pharmacist was away. Ms Williams replied that the spirit of the scheme is to provide CMS to a patient and this does not mean that the patient has to be in the pharmacy. Ms Williams added that Lindsay & Gilmour pharmacists are encouraged not to leave the premises however although initial consultation may mean the pharmacist visiting the patient at home, subsequent consultations can be conducted by speaking to the patient by telephone.

78. Ms Williams responded to a question from Mr Salwan by saying that there was currently a charge of £10-£15 for use of the CardioPod scheme but negotiations were being carried out to offer this as a free service.

79. Mr Salwan asked Ms Williams if she agreed that the population of Cramond was totally different from that of Addiewell. Ms Williams agreed that this was the case but that did not mean that patients were any less likely to require pharmacy services.

80. In response to a question from Mr Salwan, Ms Williams said that she could not comment on the figures quoted by the applicant in his presentation but that she queried the viability of a pharmacy opening in Addiewell.

81. Mr Salwan asked Ms Williams about the granting of the contract in Polbeth and if the issue of accessibility was not the same for Addiewell. Ms Williams replied that objections had been made by Lindsay & Gilmour to the granting of a contract in Polbeth because it was felt that existing services had been more than adequate and that this was the same in Addiewell.

82. Mr MacBride and Mr Cassie had no questions for Ms Williams

83. In answer to questions from the Committee, Ms Williams advised that Lindsay & Gilmour, West Calder currently had 150 patients registered for eMAS while MacBride Pharmacy had 1400.

84. Ms Williams confirmed that Lindsay & Gilmour would lose a substantial number of deliveries to Addiewell if the proposed contract was granted and that staffing levels would have to be looked at if this was to happen.

85. The Committee asked Ms Williams how long patients have to wait in the new Lindsay & Gilmour pharmacy to which Ms Williams replied that the average waiting time is 10 minutes with a maximum of 20 minutes if there were patients who needed to consult with the pharmacist. Ms Williams confirmed that there were 2 full time and 2 part time technicians working in that pharmacy.

86. In response to a question from the Committee, Ms Williams advised that in her opinion there would need to be a population of 2000 in order for a pharmacy to be viable.

87. Mr MacBride of MacBride Pharmacy, in his oral presentation, informed the Committee that he has been the pharmacist in MacBride’s pharmacy for 24 years and has been looking after the pharmaceutical needs of patients in Addiewell during that time.

88. Mr MacBride submitted that the pharmaceutical services in the neighbourhood were adequate and was unaware of any complaints of poor service in the 24 years that he had been involved in the community.

89. Mr MacBride went on to say that MacBrides pharmacy in conjunction with West Calder Medical Practice have developed a repeat medication service to meet all the needs of patients and this has led to close professional relationships with doctors and healthcare workers. Mr MacBride added that he has always worked with the GP’s in helping patients, an example of this would be the provision of monitored dosage systems.

90. Mr MacBride advised the Committee that a pharmacist from MacBride pharmacy has run a smoking cessation class in the Pit Stop, Addiewell in conjunction with the Health Board for the last 8 years.

91. Mr MacBride informed the Committee that MacBride pharmacy operate a daily delivery service for patients and if a request is made by a GP for an extra delivery out with the normal period, this can be accommodated. Mr MacBride added that with the onset of the responsible pharmacist regulations, there is an opportunity for pharmacists to be away from the pharmacy for up to 2 hours and on occasion this has been the case in his pharmacy, however there are 2 pharmacists working on 4 days a week in the pharmacy.

92. Mr MacBride submitted that there is a good bus service every 15 minutes from Addiewell to West Calder and Livingston which allows the public to access medical services, council services and grocery supplies in West Calder and a larger range of shopping facilities in Livingston. He added that it should be noted that Senior Citizens are eligible to travel free on public transport.

93. Mr MacBride informed the Committee that in his pharmacy acute prescriptions are dispensed in less than 5 minutes in 90% of cases.

94. Mr MacBride submitted that a new pharmacy is neither necessary or desirable to secure adequate pharmaceutical services to the neighbourhood and that the viability of new premises should be questioned.

95. In answer to questions from Mr Salwan, Reach Pharmacy, Mr MacBride advised that he would query the content of the letter from the local MSP as he has regular meetings with the local GP’s and Practice Managers to discuss patients needs.

96. Mr Salwan asked Mr MacBride if he thought that more people would take up smoking cessation services if available on a regular basis. Mr MacBride replied that currently there was a weekly service offered through the Pit Stop and that it was improbable that this would be able to meet daily. He added that the service is well advertised in the Pit Stop and a smoking cessation adviser is available in the Health Board and will direct patients to a local pharmacy or the group.

97. Mr Salwan went on to ask Mr MacBride if he thought that the smoking cessation service would be enhanced if available in a pharmacy in Addiewell to which Mr MacBride disagreed.

98. Mr Salwan asked Mr MacBride to confirm what the set up of his company was. Mr MacBride advised that he was a director of MacBride Pharmacy and the parent company is Red Band which owns Lindsay & Gilmour. Mr MacBride confirmed that he was the superintendent pharmacist of MacBrides pharmacy.

99. Mr Salwan asked if Mr MacBride would comment on current national stock shortages and if he thought that it would be preferable that more pharmacies would mean that a wider range of wholesalers would be used. Mr MacBride advised that he is able to access stock held in 26 pharmacies and will inform GP’s if there is likely to be a shortage of a product although he has never been in the position of not being able to supply what a patient needs.

100. Ms Williams and Mr Cassie had no questions for Mr MacBride.

101. In answer to questions from the Committee, Mr MacBride confirmed that there were not a high number of patients using methadone dispensing service in West Calder as he believed that they were accessing this service elsewhere. This was likely to be in Livingston as there was a clinic there.

102. The Committee asked Mr MacBride if there were a high number of housebound patients in the area to which Mr MacBride replied that there was and that there were currently 15-20 Addiewell patients which have been assessed.

103. The Committee asked if there had been any transport problems during the recent extreme winter. Mr MacBride informed the Committee that he had always been able to get to the pharmacy and Addiewell patients but he knew that the Polbeth pharmacy had been unable to open for 2 days due to the weather.

104. Mr Cassie, James White Chemists, in his oral presentation advised the Committee that he was the owner of this pharmacy which had a low turnover and employed only two members of staff, himself as pharmacist and one assistant.

105. Mr Cassie submitted that the proposed pharmacy would be very close at only 0.6 miles from his pharmacy and thus would have a detrimental effect on his business and may affect the services provided.

106. Mr Cassie informed the Committee that Stoneyburn and Addiewell are physically close, separated by a public field about 500m wide. He added that there were several paths crossing the field which were used by local residents to go from one village to the other. Crossing the field only takes about 10 minutes.

107. Mr Cassie advised that there was an hourly bus service from Addiewell to Stoneyburn but that the majority of patients were registered with West Calder Medical Centre to which there was a bus every 15 to 20 minutes.

108. Mr Cassie submitted that he offered a prescription collection and delivery service which operates personally so personal advice can be offered to patients using this service. Mr Cassie added that he works closely with the local GP’s to ensure that the best possible service is offered to the patients and that his opening hours reflect this as they can adapt when required.

109. Mr Cassie advised the Committee that there was no need for another smoking cessation service in the neighbourhood as this service was widely available in the local area. Mr Cassie added that consultations for smoking cessation could be carried out over the phone with patients representatives picking up appropriate nicotine replacement treatment.

110. Mr Cassie submitted that there are no medical practices or dental surgeries in Addiewell and that he believed that the proposed new pharmacy business would not be financially viable. Mr Cassie added that he believed that the proposed pharmacy was neither necessary or desirable and would ask that the application be refused.

111. In answer to questions from Mr Salwan of Reach Pharmacy, Mr Cassie agreed that the path across the field was not suitable for wheelchairs or prams but that he was not aware of any wheelchair users using his pharmacy.

112. Mr MacBride of MacBride Pharmacy asked if Mr Cassie was aware of any problems with stock to which Mr Cassie replied that he was unaware of any.

113. Ms Williams had no questions for Mr Cassie.

114. In answer to questions from the Committee, Mr Cassie advised that there were 173 patients registered with Stoneyburn Health Centre who lived in Addiewell and that there were approximately 20 minor ailment patients from Addiewell registered with James White Pharmacy.

115. Mr Cassie confirmed to the Committee that he was unaware of any complaints about his pharmacy and the service offered.

116. In response to a question from the Committee, Mr Cassie advised that he was unaware of the bus times on Saturdays.

117. The Committee asked if there had been any transport problems during the recent extreme winter. Mr Cassie informed the Committee that at times there had been difficulties but he had always been able to get to the pharmacy.

Summing Up

118. Ms Williams of Lindsay & Gilmour summed up by making the following points:  She disputed the statistics used by the applicant and the 2008 population figure of 1460 was well short of the figure required to make a pharmacy viable  There were 10 local pharmacies on the consultation list which proves in itself that the pharmaceutical services in the area are adequate

119. Mr MacBride of MacBrides Pharmacy summed up by making the following points:  No evidence has been provided that pharmaceutical services are inadequate  There have been inaccuracies in the applicants information specifically about the smoking cessation service and number of new houses in the area  The proposed pharmacy is not necessary or desirable to secure pharmacy provision in the neighbourhood

120. Mr Cassie of James White Pharmacy summed up by making the following points:  There is no evidence to suggest inadequacy of existing services  There have been no complaints received about existing services

121. Mr Salwan of Reach Pharmacy summed up by making the following points:  Background research had been extensive and Addiewell residents had been surveyed and 150 letters of support had been supplied  The smoking cessation service is inadequate as it is only offered currently on a weekly basis  The statistics used were accurate and were from Scottish Government websites  Pharmacies should be at the heart of a community and it is not the geography of an area that makes up the neighbourhood but the population  Bus services in the area are poor and council cuts will result in the worsening of the current service  There is a duty of care to be given to deprived communities  Current services are inadequate

Decision

Neighbourhood

122. Having considered the evidence presented to it, the Committee’s observations from the maps before it and the site visit undertaken prior to the meeting, the Committee had to decide the question of the neighbourhood in which the premises, to which the application related, were located.

123. The Committee agreed that the neighbourhood was that which had been defined by the applicant and agreed by the interested parties:  North – open countryside with its junction at Blackburn road and Faraday Place  South – A71  East – Deepdale Branch Road surrounded by open countryside  West – Ross Court bounded by countryside south to A71

Adequacy of Existing Provision of Pharmaceutical Services and Necessity or Desirability

124. Having reached that decision the Committee then required to consider the adequacy of existing pharmaceutical services in that neighbourhood, and whether the granting of the application was necessary or desirable in order to ensure adequate provision of pharmaceutical services in that neighbourhood.

125. The Committee agreed that the existing pharmaceutical services were adequate. This was due to the following:

 There are currently 3 pharmacies in the local area two of which are in West Calder and one is in Stoneyburn, the latter only being approximate 500m from the proposed new pharmacy, which provide full pharmacy services. The Committee appreciated that the 500m distance is accessed by two foot paths easily walked by the overwhelming majority of residents who are ambulant, however, wheelchairs users and mothers with prams may have difficulty.  There is a bus service which runs every 15 minutes to West Calder (Monday-Friday) with a slight reduction in schedule on a Saturday.  All pharmacies in the area offer a delivery service with domiciliary visits on request.  There is no evidence of complaints received by the Health Board relating to pharmacy provision in the local area.  During the horrendous winter conditions over Christmas & New Year 2009-2010, there was no disruption to existing pharmacy services provided by the pharmacists in West Calder & Stoneyburn.  There will be limited population growth in Addiewell due to the geography of the local area i.e. old mine workings.  Concerns about viability of new pharmacy due to the small population in the neighbourhood.

126. At this stage the contractor pharmacist left the meeting and the vote was taken.

127. The Committee agreed unanimously from the information made available that the existing pharmaceutical services in the neighbourhood were adequate.

128. Accordingly, the Committee agreed that the provision of pharmaceutical services at the premises was neither necessary nor desirable in order to secure adequate provision of pharmaceutical services in the neighbourhood in which the premises were located by persons whose names are included in the pharmaceutical list

129. In these circumstances, it was the Committee’s unanimous decision that the application should not be granted.

Signed …JACK AITCHISON…….. Date …15 SEPTEMBER 2010 Jack Aitchison, Chair Pharmacy Practices Committee