PHARMACY PRACTICES COMMITTEE MEETING Wednesday, 12 September, 2012 at 11.30 am Christian Centre, Culduthel Avenue, , IV2 6AS Application by GAELPHARM LIMITED for the provision of general pharmaceutical services at Lochardil Stores, Morven Road, Inverness, IV2 4BU

PRESENT Ian Gibson (Chair) Sandy Cumming (Lay Member) Michael Roberts (Lay member) Ron Shiels (APC Non Contractor Nominate) John McNulty (APC Contractor Nominate)

In Attendance Andrew J Green (Area Regulations, Contracts & Controlled Drugs Governance Pharmacist) Helen M MacDonald (Community Pharmacy Business Manager) James Higgins, Gaelpharm Limited, Applicant Dale Winchester, Gaelpharm Limited, Applicant Support Michael Church, Rowlands Pharmacy Gayle MacDonald, Rowlands Pharmacy Support Charles Tait, Boots UK Limited Fiona MacFarlane, Boots UK Limited Support Wendy Laing, Area Pharmaceutical Committee

Apologies Tesco Pharmacy Superdrug Pharmacy

Observers Okain Maclennan (Chair of NHS PPC Member in training) Dr Susan Taylor (GP Sub Committee Nominate NHS Highland PPC Member in training) Fiona Thomson (APC Non Contractor Nominate NHS Highland PPC Member in training)

1. The Chair welcomed everyone to Inverness. He asked all members to confirm that they had all received the papers for the hearing and had read and considered them. All members affirmed these points.

2. APPLICATION FOR INCLUSION IN THE BOARD’S PHARMACEUTICAL LIST

Case No: PPC – Lochardil, Inverness Gaelpharm Limited, Lochardil Stores, Morven Road, Inverness, IV2 4BU

The Chair asked each Committee member if there were any interests to declare in relation to the application being heard from Gaelpharm Limited. No interests were declared.

3. The Committee was asked to consider the application submitted by Gaelpharm Limited to provide general pharmaceutical services from premises sited at Lochardil Stores, Morven Road, Inverness, IV2 4BU under Regulation 5(10) of the National Health Service (Pharmaceutical Services) () Regulations 2009, as amended.

The Committee had to determine whether the granting of the application was necessary or desirable to secure the adequate provision of pharmaceutical services in the neighbourhood in which the Applicant’s proposed premises were located.

The Committee, having previously been circulated with all the papers regarding the application from Gaelpharm Limited, agreed that the application should be considered by oral hearing. P1 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc Prior to the hearing, the Committee had, as a group, visited the vicinity surrounding the Applicant’s proposed premises, the existing pharmacies at Boots, Southside Road, Tesco, , and Rowlands, Balloan Park, all in Inverness and facilities in the immediate area and surrounding areas of Holm, Slackbuie, Lochardil, Drummond and Culduthel where social housing, two supermarkets with petrol filling stations, four primary schools, residential nursing homes, community halls and a secondary school were pointed out. They were then driven around the boundaries of the neighbourhood as defined by the Applicant, with the exception of travelling some 8 miles along the B862 to the village of Dores. The Committee had agreed in advance that since this route is sparsely populated and the patients of Dores would be most likely to access GP dispensing services in the village of Foyers there was no value in visiting this proposed boundary.The Committee then returned to the Culduthel Christian Centre, Culduthel Road, Inverness where the hearing was to be held. During the tour, the situation of GP practices, dental surgeries along Culduthel and Southside Roads were noted.

The Committee then visited the proposed premises where the Applicant and Applicant Support were on hand to guide the Committee around the premises.

The hearing was convened under paragraph 3(2) of Schedule 3 to the National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009 as amended (“the Regulations”). In terms of this paragraph, the Pharmacy Practices Committee “shall determine an application in such a manner as it thinks fit”. In terms of Regulation 5(10) of the Regulations, the question for the Pharmacy Practices Committee is whether “the provision of pharmaceutical services at the premises named in the application is necessary or desirable to secure adequate provision of pharmaceutical service in the neighbourhood in which the premises are located by persons whose names are included in the Pharmaceutical List.”

The Applicant, Support and Interested parties were invited into the meeting at around 11.40am

4. The Chair welcomed:-

The Applicant, Gaelpharm Limited represented by James Higgins who was supported by Dale Winchester, the Interested Parties who had submitted written representations during the consultation period and who had chosen to attend the hearing, were Michael Church, Rowlands Pharmacy and Gayle MacDonald, Rowlands Pharmacy support, Charles Tait, Boots UK Limited, Fiona MacFarlane, Boots UK Limited support and Wendy Laing of the Area Pharmaceutical Committee, (“the Interested parties”). It was noted that Superdrug and Tesco Pharmacy had submitted apologies in advance to the Health Board. The Chair then invited the Committee members to introduce themselves. Committee members introduced themselves to the Applicant and all other parties.

The Chair asked the Applicant and the Interested Parties to confirm that they were not attending the Committee in the capacity of solicitor, counsel or paid advocate. They each confirmed that they were not.

5. The Chair reminded everyone that the meeting had been convened to hear the application from Gaelpharm Limited for the provision of general pharmaceutical services at Lochardil Stores, Morven Road, Inverness, IV2 4BU. The application would be considered against the legal test contained in Regulation 5(10) of the National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009, as amended.

P2 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc 6. Regulation 5(10) was read out:

An application shall be granted if the Board is satisfied that the provision of the pharmaceutical services at the premises is necessary or desirable in order to secure adequate provision of pharmaceutical services in the neighbourhood in which the premises are located.

7. The Chair then described the format of the hearing, reminding those attending that no new evidence could be introduced at the summing up.

The procedure adopted by the Committee at the hearing was that the Chair asked the Applicant to make his submission. There followed the opportunity for the Interested Parties and the Committee to ask questions. The Interested Parties would then make their submissions. There followed the opportunity for the Applicant and the Committee to ask questions of the Interested Parties in turn. The Interested parties and the Applicant were then given the opportunity to sum up.

The Chair then asked the Applicant to give his statement.

7.1. The Applicant’s Case

James Higgins, Gaelpharm Limited stated “I am very grateful to the Chair, to the Committee and to NHS Highland for affording me the opportunity to appear here today and to present the evidence in support of this application on behalf of Gaelpharm Limited.

I will endeavour to be as concise as possible – you will be glad to know – in presenting quite a large amount of relevant information.

Our application relates to the Lochardil Stores of Morven Road, Inverness. We propose to offer a full pharmaceutical service from these premises during the hours of 8.30am to 5.30pm, Monday to Friday and 9am to 5pm on Saturday with a Sunday closure.

As we have heard, this application is to be judged according to the legal test and this requires us to define the neighbourhood and to consider the provision of pharmacy services within this neighbourhood.

So, I will begin with a definition, defined by the Oxford English Dictionary as a district or community surrounding a particular place, person or object. A neighbourhood is often also defined as an area which has its own distinct identify to which its residents feel they belong and which is, to some extent, self contained and bounded by physical and geographical features both natural and man made.

To illustrate the wider area of the neighbourhood, we take our western boundary as the River Ness and our northern boundary as Drummond Burn. To the east, our boundary line is formed by Culduthel Road, Slackbuie Avenue and the western edge of Fairways Golf Course and the southern edge being in a less populous area is more difficult to define could be reasonably considered as the limits of the Village of Dores, although the population is much less.

On another map the city boundaries of the neighbourhood are more easily discerned. This gives us a resident population of 7,894 people as defined by Mr Cameron Thomas, a Research Officer at The Highland Council.

The neighbourhood is one which has seen significant growth in recent years. The Highland Council data reveals that the data zones which in whole or in part comprise the neighbourhood has increased by more than 30% since 2000.

P3 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc 18% of the population is under 16 and 19% is over 65 years of age, giving us 37% of the population who require a higher than average input from community pharmacy services. Scottish neighbourhood statistics lists the Council Ward containing our neighbourhood as having 23% of residents of pensionable age (15% above the Scottish average).

There are five schools within the areas; three primary, Holm, Lochardil and Bun-Sgoil Ghaidhlig (I hope I have said this correctly), Drummond School for pupils with additional support needs and the large secondary school of . There are three care homes and several community halls and facilities such as this building in which we are meeting in today.

Aside from marked growth in population and housing, one of the most dramatic changes to the area has been in its retail offering. The last two years have seen the opening of both a Tesco and an Asda within the area. These bring with them additional services in terms of petrol stations, grocery and non food retail, opticians, ATMs, a café, recycling facilities, in store collection and 24 hour opening. This has, in many cases, entirely eliminated the need for residents to travel outwith the neighbourhood to access essential services with the exception of pharmacy.

Utilising figures provided by The Highland Council, illustrated on my lovely map, we can clearly define three areas of major growth within the neighbourhood, and these are illustrated firstly, with the continuing development at Slackbuie (the area in blue), is set to add a further 716 homes which are projected to increase the population by 1,360. Secondly, Ness Castle (in yellow) which has planning permission for 984 homes projected to increase the population by 1,930. The preparatory work alone will include a bridge and road widening and the first phase of these comprise 368 homes with 720 expected residents and as well as the access work and road changes being completed, the Scottish Government has contributed £1.9million to kick start the development.

In the red area, Ness Side there is an expectation that this will contribute 500-750 additional homes, although there is some uncertainty about this as it is dependant on the west link road, which is the key to these being developed and is hoped to join to the A82. The Highland Council confirm that development in this area is currently being held back until this is completed. The crossing is at an advanced stage of planning and there is The Highland Council commitment to ensure that it is built. In the longer term development it is expected to contribute a further 980 residents to the community and to include a further primary school. All this information was provided by Cameron Thomas of The Highland Council.

This large scale development, both since 2,000 and over the coming years is being progressed in line with the policy requirement that 25% of all of the homes are required to be of low cost housing.

The burden on all pharmaceutical services is also set to increase across Highland due to other demographic changes. Most notably that of an ageing population. The Highland Council figures show that the number of households headed by 65-70 year olds is projected to rise by 35% and those of households headed by persons 75 years of age or older by 106% in the years 2008-2033 across Highland. It is worth noting that locally the rate of increase of people of pensionable age has been more than twice the Scottish average (according to SNS data) and, if we add this to population growth of 33% in the last 10 years with an expected further increase of over 50% to come, the need for service infrastructure within the neighbourhood is clear.

P4 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc This is recognised in the 2006 Inverness Local Plan which states:-

…”rapid expansion of new peripheral residential areas is outstripping the resources of public agencies to provide infrastructure and key services. Stronger design principles are needed to improve the form and functioning of these neighbourhoods…” It then goes on to say:-

“…a new approach is needed to better engage landowners and developers in securing the proper layout and range of community facilities that future residents will need to enjoy reasonable self containment and a quality environment…”

More recently the NHS Highland Pharmaceutical Care Plan points out the same need, saying

“…significant growth in the general population through planned housing development will necessitate corresponding planned developments in the provision of core and additional pharmaceutical services…”

As shown this is particularly pertinent in our neighbourhood.

Having looked at our neighbourhood and its characteristics we must turn our attention to current service provision.

In accordance with current legislation we conducted a public consultation. A notice was placed in the Inverness Courier on 4 May which invited people to submit their opinions and comments and the early responses to this were submitted with our application, together with the adverts themselves.

In order to widen our consultation, a large number of community groups, elected representatives and stakeholders were also contacted to ensure that all interested parties had an opportunity to present their views.

Further notices were also distributed to all retail outlets, schools and community centres, within the neighbourhood.

In addition, all medical practices in Inverness were contacted, first by letter and then by follow up phone calls. None of the practices wished to raise any objection whilst one state that they felt that the area was not well served at present.

Lochardil and Drummond Community Council and Holm Community Council have both gone on record to say that they support our application.

A concurrent survey or households was conducted to obtain the views of residents on the questions pertinent to the legal test. We were anxious that our survey not be open to dismissal on the grounds of either leading questioning or undue influence by those gathering information. To that end we obtained advice from professionals on its construction and distributed it according to the principles of systematic random sampling. A simple survey put through the letterbox of every seventh house gave us a total of just over 600 households contacted from a total of 3,722 or 16%. A response rate of 26% was returned, giving us a return of 156 households and I have the originals of these with me today should you wish to inspect them.

P5 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc The survey was accompanied by an explanatory letter which laid out the reasons for conducting the survey and an information sheet which explained pharmacy services as defined in the new contract. The latter was included to allow people to measure their experiences against the services a modern community pharmacy might be reasonably expected to provide using information taken solely from the NHS SHOW website.

The language used in our letter was deliberately non prejudicial as can be seen and the survey consisted of a series of statements which people were invited to strongly agree, agree, neither agree nor disagree or strongly disagree with. The exception to this being questions related to neighbourhood or to expected use and awareness of contract services.

I would like to draw the attention of the Committee to some of our results.

Current Pharmaceutical Services in my neighbourhood is adequate – 19.3% feel this to be true but 62.9% did not think this was the case and either disagreed or strongly disagreed with this statement. The wording is designed to reflect the legal test and patients are responding from an informed position. To put this in context only one in five households feel that current pharmaceutical service is adequate.

I find it easy to obtain a consultation with a pharmacist whenever necessary – 24.2% agreed with the proposition whereas 37.9% report difficulty. 37.9% were undecided. This is a worrying result given that so much of modern pharmacy is dependent on the access to and availability of the pharmacist for delivery of patient centred services which in this case resulted in just under a quarter feeling at ease with.

A new pharmacy is necessary to ensure adequate provision of pharmaceutical services in my neighbourhood – 72.5% agree this is the case, 12.2% disagree and 15.4% are undecided. Interestingly, here is the actual strength of feeling 7 out of ten households feeling with the necessary of this application and more than half of these strongly agreeing whilst just one in ten disputes this. Again, I would like to point out that these households received just a single survey and the results are representative of deep conviction on this subject.

At this stage, I must say that I find myself in disagreement with the assertion made by Rowlands Pharmacy in their written submission that

“…if asked, patients will always say “yes” to a pharmacy in their neighbourhood so this should not be taken as an indications of need…”

It is neither fair nor wise to state that residents faced with a question formulated on the basis of the legal test and in possession of the relevant information are incapable of answering that question and that if they do their opinions are not valid or answered.

Having garnered this information from people resident within the neighbourhood, let’s then look at the access that these people have to pharmaceutical services to find out what is behind these results.

The neighbourhood as defined does not contain any pharmacies and has, therefore, no pharmaceutical services to speak of. Residents are obliged to travel outwith the area to access pharmaceutical services.

Residents may travel to access services via public transport, by walking or by private car. How far, then, are these people travelling and how long does that take? To calculate this we selected four points within the neighbourhood and measured the distances to the nearest three pharmacies from here. The selected points were, Morven Road, Drummond Road, Essich Gardens and Drumfield Road.

P6 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc The mean travel times for accessing a pharmacy were 81 minutes walking – for a return journey, 14 minutes driving – if parking is available and 100 minutes by bus. This does not take into account time spent waiting in a pharmacy but travel alone. The mean distance for a return journey was four miles. As pointed out by residents in responses to consultation, some residents are even making these long journeys twice for a single prescription, one to hand it in and another to collect it.

Effectively then, access to a pharmacy and the services it provides is really only available to those with private transport. Even households which do have a car may not have it available at key times due to its use for commuting. Such a scenario being very likely in an area of the city with few employers and very little industry. This is supported by comments made in our survey and by responses obtained from Lochardil and Drummond Community Council, both to our consultation and that of NHS Highland. Many of the respondents to our survey also commented on this, to quote a few of these:-

“The nearest pharmacy at present is Tesco which is too far to walk and it is not always possible by car”.

“Access at present depends on motorised transport”.

“Currently we have to use Riverside, which is five miles away”.

Councillor Alasdair Christie also spoke to the Inverness Courier or 13 July, 2012 on the subject, saying:-

“I am hoping that they take into account that large proportion of the population in Lochardil is elderly and do not have access to transport that would get them to suitable alternatives except for the town centre”.

Delivery of prescriptions is available into the area from at least one pharmacy and whilst this can be useful it is no substitute for the full pharmaceutical service including the new contract services and the potential for improved health outcomes and quality of life that these can provide. Such services as PHS, smoking cessation, MAS and CMS are not deliverable from a van.

As regards the adequacy of service provision we have firm evidence that current services are under severe strain.

To begin with, Rowlands Pharmacy at Balloan Park – this is a small pharmacy dispensing a very high number of prescriptions. With a monthly average of approximately 9000 per calendar month (according to a 2011 FOI request by another party) it struggles to maintain this whilst being accessible to the needs of patients and delivering the pharmacist contact time necessary for a modern community pharmacy.

Evidence of this is clear in the submissions by Lochardil and Drummond Community Council, which states:-

“The wait to have a prescription made up was 30 minutes and one pharmacist was on duty. How do you get a consultation with a pharmacist in such circumstances?”

Comments obtained as a result of our consultation such as “…the pharmacy we use is far too far away and it is too busy…” support this view.

P7 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc More evidence is available in the form of a critical incident which recently occurred. During our four week consultation period, Rowlands, Culloden Branch was left without a pharmacist. On 4 June, 2012, the Responsible Pharmacist at Balloan Park left the branch for two hours to cover Culloden, returning to Balloan Park after this time had elapsed. During the periods where no pharmacist was present, no prescriptions could be dispensed, no “P” medicines sold, pharmacist consultations undertaken and all new contract services were suspended at the affected branches – both affected pharmacies. Patients having made often substantial journeys found them to be wasted. Culloden Pharmacy was again without a pharmacist on 6 June, 2012.

Responsible Pharmacists, acting as the sole pharmacist at more than one branch on the same day, have also, in other instances attracted GPhC (meaning General Pharmaceutical Council) censure and according to the RPS (meaning Royal Pharmaceutical Society), this practice is not supported by their interpretation of current Responsible Pharmacist legislation.

In their written submission to NHS Highland, Rowlands have stated that they are not aware of patients having difficulty accessing services – not just in our neighbourhood, but at their closest branch is available for the asking.

The City Centre pharmacies including Superdrug and the Boots Stores at Southside Road and Eastgate Shopping Centre also present barriers to patients. The first two having virtually no parking and the latter having ample paid parking should patients have access to a vehicle. They were rarely mentioned in consultations, except to note their remoteness, difficulty in reaching them or how busy they were. Clearly, residents and householders within our neighbourhood see them as no solution to the poor access to service they face and, in this, I agree totally with them.

Another of the pharmacies to which travel times were listed, and did appear on our consultation, was Tesco pharmacy at Inshes. Again, the Freedom of Information data shows us a picture of a pharmacy at capacity. Averaging of 8000 items is indicative of a very busy dispensary but the very low levels of EHS and smoking cessation paint a picture of a pharmacy struggling to maintain all but a most basis level of a service and certainly not in a position to deliver what is required of it in the current pharmacy contract.

Again, this pharmacy has had problems during our public consultation. As well as its lack of privacy and cramped dispensing area for its workload it has struggled with chronic under re- sourcing. Unusually for any pharmacy this branch has operated with a single PC. This causes many problems for staff but never more so than when, on 2nd June this year, the computer failed totally and, incredibly, was not repaired until 6th June, 2012. During these five days, the dispensary turned away non urgent prescriptions and used handwritten labels on items where patients were unable to return. Due to the length of this service disruption, many patients returned several times expecting the situation to have been resolved.

A second equipment failure concerned the pharmacy fridge having failed. This was still not operational at the end of last week, meaning that during a period of at least 9 weeks, all fridge lines were stores in a fridge with fruit and vegetables situated some distance from the pharmacy itself. The pharmacy elected to stop holding fridge lines in stock until a prescription required them resulting in return journeys. Yet more unnecessary travel and inconvenience in the case of every patient prescribed one of these products.

The keyboard within the dispensary was also allowed to become so worn as to cause staff to be concerned about its impact on patient safety.

Pharmacists and support staff raised these issues and several agreed dates for new equipment passed without this being made available.

P8 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc It seems incredible to think that pharmacy could be badly mis-firing for want of three pieces of equipment – a PC, a keyboard and a fridge – when all three of these items are available for sale by that same retailer!

Despite all of this, Tesco state in their written submission that “…we do not see that there are any gaps in the current level of services provision…”

We disagree – and we feel strongly that the service available from at least two of the outlets our residents are forced to travel to use is demonstrably partial, unreliable and certainly not adequate to meet the needs of the population.

I would draw to the attention of those present the fact that all of these failures listed are not historic nor have they accumulated over years but rather all have occurred in the short period since our consultation began in May of this year. What is more, on 4th June, 2012, two pharmacies suffered a simultaneous failure of services, one due to an absent pharmacist and the other due to IT failures.

In summary, then, the neighbourhood has been clearly defined and not only are pharmaceutical services absent within this neighbourhood but those outwith this area have proven themselves incapable of providing an adequate level of service even to those who find themselves in the fortunate position of being able to travel to access these.

With the added pressure of a greatly increased population and with further and greater increases to come, Gaelpharm Limited respectfully submit that this application be granted in order to secure adequate provision of pharmaceutical services within this neighbourhood.

The Chair thanked Mr Higgins for his statement on behalf of Gaelpharm Limited and invited the Interested Parties and then members of the Committee to ask questions of him.

7.2 Questions from Michael Church, Rowlands Pharmacy to the Applicant

Mr Church enquired whether Mr Higgins would be the Responsible Pharmacist at the proposed pharmacy.

Mr Higgins replied that he would not. Mr Church then asked who this would be. Mr Higgins advised that he would presume they would employ a Pharmacist Manager as per the model of the other pharmacies the Company owned but that they had not looked into recruiting at this point in time as they did not wish to do so prior to any contract being awarded.

Mr Church enquired whether Gaelpharm had a qualified independent pharmacist prescriber as part of their workforce.

Mr Higgins advised that there were three in the business in total and that he himself was qualified as an independent prescriber and held 3 prescribing clinics from 2 of the pharmacies owned and therefore it was appropriate to utilise the skill mix of staff and how to share this across the company where required..

Mr Church enquired whether the premises had been secured. Mr Higgins advised that this would be firmed up formally if the application was granted.

7.3 Questions from Mr Charles Tait, Boots UK Limited to the Applicant

Mr Tait commented that he had heard Mr Higgins mention a couple of definitions of neighbourhood and asked if he could explain this applying it to his neighbourhood, some of which crossed roads and parks.

P9 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc Mr Higgins advised he would be happy to do so and explained that he had looked at a number of physical aspects, whether they be natural or man-made. To the west of his neighbourhood, there was the River Ness and to the East it followed Culduthel Road and Slackbuie Avenue and the areas of Drummond and Lochardil and Hilton and Castle Heather as far as Fairways Golf Course which was a physical barrier and could not be crossed. To the North the boundary was at Drummond Burn and the Southern edge was more different with an area of trees. He had taken the definition of this from a previous application in Highland for the Village of Newtonmore where the next settlement was as far as Dalwhinnie.

Mr Tait then enquired what made half way down Culduthel Road a definitive boundary as it did extend to Slackbuie and there was no population at Fairways Golf Course. Mr Higgins agreed there was no real population to include after the Golf Course.

Mr Tait then enquired whether his definition of the neighbourhood was based around a sense of being then and, if so, where that had come from. Mr Higgins advised that this was not entirely true.

Mr Tait enquired if he would say he lived in Drummond and Mr Higgins agreed that he possibly would.

7.4 Questions from Wendy Laing, Area Pharmaceutical Committee to the Applicant

Ms Laing had no questions for the Applicant.

7.5 Questions from the Committee to the Applicant

Mr Shiels enquired if you were to ask someone who was resident in Dores whether they were a resident in Lochardil were it not true that they would disagree with that.

Mr Higgins replied that possibly but that there was no real obvious dividing line prior to Dores that he could see, however, he would serve that community, should they so wish, by a delivery service, if the contract was awarded.

Mr Shiels then wondered of Mr Higgins what his reasons were for including Dores in his neighbourhood.

Mr Higgins advised that the purpose of the application was to serve the population which were not currently serviced by a community pharmacy and that if the residents of Dores were making their way into Inverness then, if granted, the new pharmacy may be able to service their pharmaceutical needs.

Mr Roberts had noted that the Applicant had highlighted the Oxford English Dictionary definition of a neighbourhood in his submission but that he was then saying that he included other areas such as Ness Castle, Dores and Slackbuie in his neighbourhood and was the majority of the neighbourhood not resident in Drummond and Lochardil.

Mr Higgins advised that at present, Ness Castle was essentially a building site.

But, Mr Roberts enquired – you would serve Dores?

Mr Higgins replied in the affirmative that he would be happy to and he was not surprised that he only received one piece of feedback from the Dores area regarding his consultation.

The Chair asked if The Highland Council, in providing their figures, whether they projected the population increase in the area over the next one to two years.

P10 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc Mr Higgins replied that not exactly, that the blue area on his map was fluid and ongoing development was being progressed with the expectation that Slackbuie would be completed prior to commencing the development of Ness Castle but that The Highland Council had advised that there would be a period of 18 months before the Ness Link was developed and that the first phase of Ness Castle would not start until after that and the area highlighted by him in red would take longer still.

Mr Cumming referred to the topic of public transport, enquiring how the public might access his proposed pharmacy by that means and whether an analysis of that was available for the Committee to view.

Mr Higgins replied that every one of the points he mentioned, which he had previously prepared the analysis of to travel to the existing pharmacies were all within a mile of the proposed pharmacy and one of which was the proposed premises themselves. He did not have bus times for this, however, he pointed out there was a bus stop immediately outside the proposed premises which may make it easier to travel into town and that it may be easy to get a bus to the proposed premises from Essich and perhaps from Holm but that he could not definitely say so.

Mr Roberts enquired of the whereabouts of the local GP Surgery, which he had thought were mainly near the centre of the City so could Mr Higgins explain to him why people would still use the pharmacy at the proposed premises.

Mr Higgins replied that, firstly, though the proposed premises may not be immediately obvious he would engage with the public and advertise for publicity. Secondly, regarding GP services there were none at present within the neighbourhood but that acute prescriptions did come to pharmacy and if granted, would be more aware of this. Additionally, the aim of a new contract would be it would become more necessary to position a pharmacy where there was no GP to readily access.

Mr Roberts commented that 3,700 homes with a 25% increase in social housing it was still an affluent area and did not most residents have ownership of a car.

Mr Higgins replied this was true, however, not all and the population was elderly.

Mr McNulty enquired what pressure had he received from the community to not loose their local grocery store and what, if anything, he intended to do to address this.

Mr Higgins advised that he would like to continue merchandising milk, bread, newspapers and that his company had experience of this in other stores, such as their one in Aberchirder where there was a Post Office and explained that he did not wish to remove convenience services and would prefer to acquire the additional unit next door in order to provide this.

8. The Interested Party’s Case – Mr Michael Church, Rowlands Pharmacy

Mr Church stated “thank you for allowing me to present my views on the application at Lochardil Stores on behalf of Rowlands Pharmacy today.

In terms of neighbourhood, we would accept the boundary given by the Applicant, and agree with his boundary definitions. For clarity reasons, these are:-

To the West, the River Ness; To the North, Drummond Burn; To the East, the road running south that contains Culduthel Road, Slackbuie Avenue and the B861. To the South, Dores.

P11 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc Using this neighbourhood boundary, you can see that there is currently no pharmacy service within the neighbourhood and I think it’s important to highlight that not every neighbourhood needs its own pharmacy. An adequate service can easily be supplied by pharmacies in the adjoining neighbourhoods, normally ourselves at Rowlands in Balloan Park, along with the ten other pharmacies in the Inverness area.

I think it’s worth noting at this point that the population of Inverness can be registered at any GP across the city – so people from this area may be registered with a GP on the other side of the city, and as a result, most people will quite often access a pharmacy outwith their “home neighbourhood” anyway.

If we have a look at the population in this neighbourhood I would class this as a reasonably affluent area. It has lower than average claimants of income support and job seeker’s allowance and a higher than average percentage of households with cars. Speaking generally, it is mixed, with young families living alongside the elderly population. As already alluded to, there is no GP surgery so there is no requirement for a pharmaceutical service. If we have a look in the neighbourhood, what facilities are there? A couple of schools, a couple of small convenience stores, but as far as I am aware there is an absence of banks, post offices, libraries or GP surgeries. As a result, the population will be used to travelling in their day-to-day lives to access these services, along with any pharmaceutical services they need. There are extended hours pharmacies in Inverness, so any working member of the population can easily access services at a time to suit them. As a whole, I believe the working families; young and older residents will generally have access to a car and find no problem with using existing pharmacies. Consequently, I see no problem with access to pharmacies from this neighbourhood.

All pharmacies in Inverness are providing full pharmaceutical services insofar as I am aware. I certainly don’t see the applicant bringing anything new, nor is there anything to say that current provision is poor, which is a view supported by the Area Pharmaceutical Committee. At Balloan Park, we have a pharmacy with a consultation room providing all core elements of the pharmaceutical contract. We provide a full collection service from all the GP surgeries in Inverness and a full delivery service to the surrounding area, including the defined neighbourhood. Jen Lumsden is the Pharmacy Manager there and has been since April this year. She has developed excellent links with the locals and GPs alike. The team as a whole work well, exceeding national and NHS Highland average service figures for providing smoking cessation, eMAS and CMS. Indeed, at Rowlands we do our best to go above and beyond contracted services. Gayle MacDonald, who is with me today, recently qualified as a prescriber and manages our pharmacy in Culloden and runs an asthma clinic with Dr Kelly at Southside Surgery one day per fortnight.

So, it is our opinion the applicant is bringing no new services to the area and the opening hours offer nothing in addition to what is already being provided. The population in this neighbourhood move freely around the City and access services as and when they need them. As a result I don’t believe this application is necessary or desirable.

The Chair thanked Mr Church for his statement and invited the Applicant, Interested Parties and then members of the Committee to ask questions of her.

8.1 Questions from the Applicant to Mr M Church, Rowlands Pharmacy

The Applicant asked if Mr Church thought services were adequate on the 4th of June, 2012. Mr Church refuted the suggestion which the Applicant was making that they were not. Mr Higgins then enquired the reason that the Rowlands Pharmacies had been unable to fulfil their contractual obligations on that date. Mr Church advised that there had been a road traffic accident on the A9 and due to that the locum had been unable to travel to Inverness from Glasgow.

P12 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc Mr Higgins then enquired then if on the 6th June, 2012 if the reason Rowlands were unable to fulfil their contractual obligations was due to a further road traffic accident.

Mr Church advised that the locum pharmacist who had been booked for the 6th June, 2012 had cancelled on the day and that as a result of that Rowlands Pharmacy have now put measures in place to increase the pool of locums available to them to call on.

Mr Higgins again enquired if Mr Church felt that services were adequate on these days

Mr Church advised that they had done their best to reduce disruption and that services were adequate at the branches in question whilst the pharmacist was on the premises. Mr Higgins referred to Mr Church’s reference that car ownership was higher than the Scottish average in the area and wondered whether he was aware that the figure for this was higher against the Scottish average in any event, due in part to its geography.

Mr Church advised that he did not know that.

8.2 Questions from Mr C Tait, Boots UK Limited to Mr M Church, Rowlands Pharmacy

Mr Tait had no questions for Mr Church.

8.3 Questions from Ms W Laing, Area Pharmaceutical Committee to Mr M Church, Rowlands Pharmacy

Ms Laing had no questions for Mr Church.

8.4 Questions from the Committee to Mr M Church, Rowlands Pharmacy

Mr Cumming asked Mr Church to tell him about their delivery service. Mr Church replied that there was a delivery driver available Monday to Friday.

Mr Roberts asked to whom Rowlands Pharmacy were delivering. Mr Church advised to patients of the pharmacy.

9. The Interested Parties’ Case – Mr Charles Tait, Boots UK Limited

Mr C Tait thanked the Chairman and spoke of a different take on the definition of neighbourhood which he felt was defined in law and the basis of the definition had come from Lord Justice Banks in 1932. Mr Tait quoted this as follows:-

“…It is impossible to lay down any general rule. In country districts people are said to be neighbours, that is to live in the same neighbourhood, who live many miles apart. The same cannot be said of dwellers in a town where a single street or a single square may constitute a neighbourhood ... Again, physical conditions may determine the boundary or boundaries of a neighbourhood, as for instance, a range of hills, a river, a railway, or a line which separates a high class residential district from a district consisting only of artisans’ or workmen’s dwellings.”

P13 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc This is still the definition of a neighbourhood in the main but to add to that Lord Nimmo Smith said:-

“Neighbourhood is not defined in the Regulations and must therefore be given the meaning which would normally be attributed to it as an ordinary word of the English language. As the word is ordinarily understood, it has connotations of vicinity or nearness ... the word “neighbourhood” in regulation 5(10) of the 1995 Regulations means an area which is relatively near to the premises in question, which need not have any residents, and which can be regarded as a neighbourhood for all purposes.”

These words of Lord Nimmo Smith expand on what was said by Lord Justice Banks and leaves a decision on natural boundaries and could be hills, roads, mountains although these would be difficult to show neighbourliness in.

Lochardil is separated from Drummond by green areas and a couple of schools. Culduthel Road forms a boundary to only Culduthel Woods, which you could not get a car down. Unfortunately, half way down Dores Road there is no way round the line of trees. These are genuine physical boundaries and that’s why the chosen neighbourhood only has a small convenience store. The area is in the top 30% least deprived in Scotland if measured against deprivation measures – that is good going. Buses and travel leaves from the site itself every half hour going into the town centre – the applicant mentioned that himself. If you left from the west a bus would not bring you to the east as they do not travel across the neighbourhood. This construes a smaller population which has high wealth and mobile but mixed in age which is slightly above the Scottish average and the young currently access all services outwith the neighbourhood.

There is a Post Office in Holm Mains but I think that is outwith the neighbourhood but you would require to drive to get there.

Is this application necessary? I don’t believe so – the bus route is very busy as well as folk exiting the area in their cars.

Is it desirable? That is hard to say but if the community are not driving a big pharmaceutical need and there are deliveries into the area – we (Boots) do too and the applicant says he would also do this.

I believe the neighbourhood to be for Lochardil. Is it necessary or desirable? Given the accessibility to all services I believe this application will fail.

The Chair thanked Mr Tait for his statement and invited the Applicant, Interested Parties and then members of the Committee to ask questions of him.

9.1 Questions from the Applicant to Mr C Tait, Boots UK Limited

The Applicant asked Mr Tait to clarify if he felt that the neighbourhood should be Lochardil alone. Mr Tait replied in the affirmative.

The Applicant then asked Mr Tait if he was aware that the Drummond and Lochardil Community Council considered themselves as one Community Council covering both areas. Mr Tait felt that it was a political decision to join the two areas.

9.2 Questions from Mr M Church, Rowlands Pharmacy to Mr C Tait, Boots UK Limited

Mr Church had no questions for Mr Tait.

P14 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc 9.3 Questions from Ms W Laing, Area Pharmaceutical Committee to Mr C Tait, Boots UK Limited

Ms Laing had no questions for Mr Tait.

9.4 Questions from the Committee to Mr C Tait, Boots UK Limited

Mr Cumming commented that he understood where Mr Tait was coming from, however, did he not feel that Holm was within the neighbourhood.

Mr Tait said that that could be argued, however, the neighbourhood was defined by physicality and nature and how folk moved around it.

The Chair mentioned Mr Tait’s reference to the lack of services in the neighbourhood in his submission and wondered did he not feel that services should then be created within the neighbourhood. Mr Tait felt that that would be sensible - where they could be accessed - but not only for people in the immediate vicinity but for those who will travel to a site where more than one service is available and a variety experience of shopping, banking and other services would come into play.

10. The Interested Parties’ Case – Ms Wendy Laing, Area Pharmaceutical Committee

Ms W Laing stated “I am here to represent the Area Pharmaceutical Committee and provide the opinion of the Area Pharmaceutical Committee (APC). I will therefore endeavour to answer questions at the end but will refrain unless it is an area where there has been previous discussion by APC and I therefore know the opinion of the Committee. Firstly, to bring to your attention there were a number of Committee members who declared themselves either as an interested party or an employee of an interested party and these members refrained from the discussions regarding the application.

In terms of the neighbourhood, the APC agrees with the Applicant’s proposed boundaries and definition of the neighbourhood. This opinion has been influenced by the recent supermarket developments which allow the population of this neighbourhood to access the majority of their daily amenities within the area.

In terms of adequacy of current pharmaceutical services or necessity, the APC does not believe the Applicant has demonstrated that pharmaceutical services to their proposed population are inadequate. There was some reference to the distance to pharmacies and that current pharmacies are too busy to provide the services required, however, there have been no complaints to the Board about services to patients within the Applicant’s neighbourhood or, on that note, outwith the neighbourhood. So, on this basis APC does not believe it is necessary to grant the application to secure adequacy.

However, in terms of desirability, as previously mentioned, there have been recent supermarket developments which allow the population of the proposed neighbourhood to increasingly access the majority of their everyday needs locally. This change introduces the need for a pharmacy in the neighbourhood since pharmaceutical services will be one of the few necessities of life which will not be available within the neighbourhood. On this basis the APC does believe it is desirable to grant the application to sustain pharmaceutical adequacy. In summary, in light of the recent developments within the area, the professional advice of the APC to the Pharmacy Practices Committee is that the application is not necessary but is desirable to sustain pharmaceutical adequacy.

The Chair thanked Ms Laing for her statement and invited the Applicant, Interested Parties and then members of the Committee to ask questions of her.

P15 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc 10.1 Questions from the Applicant to Ms Laing, Area Pharmaceutical Committee

The Applicant enquired that when the Area Pharmaceutical Committee met and discussed necessity, were they aware of the problems at Tesco and Rowlands over the Jubilee bank holiday weekend, referred to by him earlier. Ms Laing advised that that had not been discussed, rather based on patient complaints of which there had been none.

10.2 Questions from Mr M Church, Rowlands Pharmacy to Ms W Laing, Area Pharmaceutical Committee

Mr Church had no questions for Ms Laing.

10.3 Questions from Mr C Tait, Boots UK Limited to Ms W Laing, Area Pharmaceutical Committee

Mr Tait referred to the statement from the Area Pharmaceutical Committee where it had been mentioned that there had been a major change in retail services in the neighbourhood and wondered if there was no supermarket would their opinion have been different. Ms Laing advised that she could not say but that that would have made it a totally different situation.

10.4 Questions from the Committee to Ms Laing , Area Pharmaceutical Committee

The Committee had no questions for Ms Laing.

11. Summing up

The Applicant and Interested Parties were then given the opportunity to sum up.

11.1 Ms W Laing, Area Pharmaceutical Committee stated “to summarise I would just say that the application is desirable really because patients would be able to access facilities they could not before”.

11.2 Mr C Tait, Boots UK Limited stated “the neighbourhood as I see it is unsustainable for a pharmacy and perhaps the Applicants definition is more sustainable when looking at necessity and desirability but everyone within the neighbourhood presently leaves on a day to day basis to access other services, therefore, the application is neither necessary nor desirable”.

11.3 Ms M Church, Rowlands Pharmacy stated “As previously discussed there is adequate provision of pharmaceutical services at present, therefore the application is not desirable”.

11.4 Mr James Higgins for Gaelpharm Limited, Applicant stated “In summary, we have demonstrated a clearly defined neighbourhood recognisable to any resident of it. Our application has the support of our Westminster MP, the Right Honourable Danny Alexander, MSPs, the only local councillor to have gone on record, Lochardil and Drummond Community Council, Holm Community Council, a number of private individuals and the vast majority of respondents to our survey.

The Area Pharmaceutical Committee feel that the granting of our application is desirable to secure adequate pharmaceutical service and our survey response agrees.

We have demonstrated that there is a clear inadequacy of current pharmaceutical service on three fronts. Pharmaceutical service is currently inadequate as evidenced by recent failures and inadequate in the eyes of residents as evidenced by our survey opinions of households and by submissions to public consultation.

P16 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc And, finally, current pharmaceutical service is inadequate in light of the future needs of the neighbourhood and its population.

It is necessary and desirable to grant this application and doing so will improve the quality of life and health of residents and meet the health outcomes of this large and previously overlooked area of the City”.

At the conclusion of the summing up, the Chair asked the Applicant and all of the interested parties if they considered that they had had a fair hearing. Mr Higgins, Mr Winchester, Mr Church, Mrs MacDonald, Mr Tait, Ms MacFarlane and Ms Laing replied yes, that they did consider they had had a fair hearing.

The Chair advised that a written decision would be sent out within 15 working days. A letter would be included with the decision advising of the appeal process. The Chair then thanked the parties for attending.

Mr Higgins, Mr Winchester, Mr Church, Mrs Gayle MacDonald, Mr Tait, Ms MacFarlane, Ms Laing and Mr Andrew Green, Area Regulations, Contracts & Controlled Drugs Governance Pharmacist left the meeting.

12. DECISION Having considered all the evidence presented to it, and the Committee's observations from the site visits, the Committee had firstly to decide, the question of the neighbourhood in which the premises to which the application related, were located.

The Committee took into account a number of factors in defining the neighbourhood including the natural and man-made boundaries, who resides in it, neighbourhood statistics, the location of existing shops, health services and schools, land use and topography, and the distance and the means by which residents are required to travel to existing pharmacies and other services.

In addition it anticipated future developments including plans for the further expansion of housing estates in the lower Slackbuie area, particularly those by Tulloch, Builders in the Greenfields and Culduthel Farm developments and the Duke’s View estate and surrounding area.

Special regard was made to the requirements of the Equality Act 2010:

 the need to eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act;

 advance equality of opportunity between people who share a protected characteristic and those who do not;

 foster good relations between people who share a protected characteristic and those who do not.

The Committee considered the Applicant's definition of the neighbourhood and how this compared to those put forward by the Interested Parties as well as comments received from the public consultation, and it was unanimously agreed that the neighbourhood was not as defined by the Applicant in his submission.

P17 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc 12.1 Neighbourhood: The Committee considered that the neighbourhood should be defined as follows:

North: the northern boundary was agreed to end at the Crossroads of Culduthel Road and Drummond Road, but not as far as Altnaskiach Avenue, extending west to the Drummond Burn which runs under Island Bank Road and out into the River Ness just prior to Elm Park, at Bellfield as the area beyond these points became part of the City Centre and outwith the Lochardil Community Council boundary;

East: the eastern boundary was agreed as bounded by Culduthel Road and Slackbuie Avenue which marked a boundary as there was a clear definition for local people between the Hilton and Lochardil/Drummond areas in addition to the area bounded on the west by the Indoor Bowling Stadium, Business Park and Fairways Golf Course sites, after which there was no right of access, creating a physical boundary;

South: the southern boundary was agreed to be bounded by Holm Road and Culduthel Avenue, including the Tulloch Builders housing developments of Culduthel Mains Farm, Greenfields and the Duke’s View Estate and others on the southern side of Holm Road and including the ASDA Supermarket and petrol filling station, as this represents the extent of residential housing and the start of the countryside;

West: the edge of the western boundary was agreed to be as marked by the roundabout joining Dores Road to Holm Road and the road leading to the TESCO Supermarket. The neighbourhood should also include the sparse housing on the west side of Dores Road leading towards the northern boundary, whose residents would consider themselves part of the Holm neighbourhood back to Drummond Burn, along Island Bank Road. In addition, the River Ness is the physical boundary on this side of the neighbourhood.

There is an undeveloped spur road from the roundabout on the western boundary referred to above which is to be used at some point in the future to link transport to Holm Road from the A82 on the other side of the City.

In considering this area the Committee were of the opinion that the neighbourhood contained all the requirements of daily living, such as a post office, churches, a hotel, 4 primary schools (one for special needs children) and one secondary school. There was also access to optical services, two supermarkets with automated teller machines (ATMs) and two fuel filling stations.

It was agreed that the village of Dores, which lay eight miles outwith the area as defined by the Committee should be excluded from the neighbourhood as residents of that village would not consider themselves to be residents of the neighbourhood as defined.

In general, the above areas described are within the Community Council areas of Lochardil, Holm and the Lower Slackbuie portion of the Inverness South Community Council boundaries, which contain Holm and Upper and Lower Drummond within them.

It was agreed that residents from Holm access services, such as shops, bar and restaurant in the Lochardil area and that, as Holm Primary School is located off Stratherrick Road, very close to Lochardil residents. Access to Holm Primary School is challenging with a steep footpath up from "lower" Holm, and many parents will drive through Lochardil when taking children to and from Holm School and, as such, would therefore, consider themselves as part of that neighbourhood.

It was obvious from the very title of the letter received by the Health Board from the Community Council that residents of both Drummond and Lochardil considered themselves to be a single community/neighbourhood.

P18 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc 12.2 Adequacy of Existing Provision of Pharmaceutical Services and Necessity or Desirability:

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

The Committee noted there were no pharmaceutical services in the area but pharmaceutical services were provided by pharmacies outwith the neighbourhood.

Taken into consideration was a letter dated 12 August 2012 to the Health Board from the Lochardil & Drummond Community Council which provided a concise overview of the area, services currently accessed and the nature of the population, which was noted to have a particularly high proportion of elderly in age. The letter went on to state that much of the population did not have transport of their own and had grown old in a community, mainly of bungalow type housing, after their children had moved away. The letter further informed of the mix of newer, much younger residents moving into the area, causing issues for families with young children in accessing pharmaceutical services and the feeling by the community that they currently were inadequately served in comparison to people on the north side of the City vis a vis pharmaceutical services.

The Committee were disappointed to note that, despite the efforts to consult, no response had been received from any of the Members of Scottish Parliament, Members of Parliament or Councillors they had written to, with the exception of a late email from Mrs Caddick, Inverness South Community Councillor, on the day of the hearing in support of the application, as it was considered that as elected representatives of the people living in the neighbourhood they could reasonably be expected to have been able to support their views.

No member of the public responded to the NHS Highland public consultation, however, attention was paid to the consultation which was available for inspection at the hearing undertaken by the applicant with the public, and which demonstrated a high percentage of the community who considered themselves to be a resident of the Drummond/Lochardil areas and either agreed or strongly agreed a pharmacy was necessary to secure adequacy of pharmaceutical services in the area. There was evidence of disagreement or strong disagreement that pharmaceutical services currently in the neighbourhood were adequate.

The Committee took into consideration submissions by Rowlands Pharmacy and Boots UK Limited by their representatives and noted the letters sent by Tesco Pharmacy and Superdrug Pharmacy, although they had submitted their apologies for attending the hearing in advance.

There was evidence of long travelling times and difficulty in accessing existing pharmaceutical services in other neighbourhoods and due to this that perhaps the elderly population were unable to access such services as the Chronic Medical Service, Minor Ailments Service or Smoking Cessation Services, however, these can currently be accessed outwith the neighbourhood.

Advice from the Area Pharmaceutical Committee was also considered and that although they were not aware of any reasons that current pharmaceutical services were inadequate to the neighbourhood, did believe that with recent and current developments in the area it would be desirable to grant the application in order to sustain pharmaceutical adequacy into the future.

P19 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc The Committee had access to the Scottish Neighbourhood Statistics which were in agreement with those submitted by the Applicant through Mr Cameron Thomas of The Highland Council.

The Area Pharmaceutical Committee, when writing their response, had not been aware of any pharmaceutical inadequacies, however, there was evidence in the PPC Members information pack that those referred to by the Applicant in his submission had, in fact, been known to the Board although no complaints from members of the public had been received. Also included in the pack was information regarding engagement by existing pharmacy contractors in the pharmacy contract which did not highlight any inadequacies.

NHS Highland were aware of the problems experienced on 4th and 6th June, 2012 by both Rowlands Pharmacy and Tesco Pharmacy who had contacted the Health Board to bring the issues to their attention and who had subsequently worked and supported them in their efforts to rectify the situations as soon as practicable. Tesco have since purchased a second computer which is now operational (as evidenced in the Members information pack) and Rowlands have put measures in place to increase their locum pool and out of hours contact information, as advised by their Area Manager.

The Committee, in determining the adequacy of existing provision of pharmaceutical services in the defined neighbourhood, took account of the evidence provided by the Applicant, and the Interested Parties and made available from other sources and concluded that the level of existing pharmaceutical services was adequate at the present moment.

The Committee then considered whether it would be desirable to grant the application to maintain adequacy into the future. They concluded that predicted increased demand with the current and future developments would make it difficult for existing pharmacies adjacent to the neighbourhood to sustain adequacy and render them less likely to be able to offer residents from this neighbourhood core pharmaceutical services such as Minor Ailments Service, Chronic Medication Service, Public Health Services (including smoking cessation and emergency hormonal contraception) and for this reason they considered that the application was desirable.

The Committee did comment that they would have preferred the premises to be more centrally located within the neighbourhood but acknowledged that the proposed premises were the only site available to the applicant.

The non-voting pharmacists then left the room.

P20 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc 12.3 In accordance with the statutory procedure the Pharmacist Contractor Members of the Committee, and Board Officers were excluded from the decision process:

DECIDED/-

The Pharmacy Practices Committee (PPC) was satisfied that the provision of pharmaceutical services at the premises of the Applicant was not necessary at the current point in time but that it was desirable in order to secure the adequacy of provision of pharmaceutical services into the future within the neighbourhood, as redefined by the Committee.

The Chair invited members of the Committee to vote on the application by Gaelpharm Limited to provide pharmaceutical services at Lochardil Stores, Morven Road, Inverness, IV2 4BU. The Committee unanimously agreed to grant the application.

The non-voting pharmacists were invited into the room and advised that the application had been granted.

The Hearing was then closed.

Ian Gibson as Chair of the PPC

Date: 20 September 2012

P21 Gaelpharm Limited Lochardil _ PPC 12 September 12 NOTES.doc