PHARMACY PRACTICES COMMITTEE

Meeting held on 3 September 2014 Room 004, Pentland House, 47 Robb’s Loan, , EH14 1TY

Application by The Elixir Pharmacy Group for inclusion in the pharmaceutical list in respect of the address at 55 Muirhouse Gardens, Edinburgh, EH4 4TD.

The Pharmacy Practices Committee met at 1pm on Wednesday 3 September 2014 to consider the above application in accordance with the National Health Service (Pharmaceutical Services) () Regulations 2009, as amended.

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

Peter Johnston (Chair) Peter Jones (Non- Contractor Pharmacist) Mike Embrey (Contractor Pharmacist) Alan Glauch (Contractor Pharmacist) Ian Melville (Lay Member) Stewart Daniels (Lay Member) Catherine Anderton (Lay Member)

In Attendance

Yaseen Yousaf (The Elixir Pharmacy Group, Applicant) Imran Hussain (The Elixir Pharmacy Group, Applicant Support) Yvonne Williams (Lindsay & Gilmour Pharmacy, Interested Party) Philip Galt (Lindsay & Gilmour Pharmacy, Interested Party Support) Tom Arnott (Lloyds Pharmacy, Interested Party) Charles Tait (Boots UK Ltd, Interested Party) Barrie Dear (Dears Pharmacy, Interested Party) Katie Kerr (Administrator, NHS Lothian) Veronique Athukorala (Administrator, NHS Lothian)

1

Application for Inclusion in Board’s Pharmaceutical List

1. The Committee convened to consider an application submitted by The Elixir Pharmacy Group to provide general pharmaceutical services from premises situated at 55 Muirhouse Gardens, Edinburgh, EH4 4TD under Regulation 5(10) of the National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009 as amended. A copy of the application had been circulated in advance to the Committee and the parties.

2. 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.

3. Written representations had been received from Lothian Area Pharmaceutical Committee; Dears Pharmacy; Lloyds Pharmacy; Boots Pharmacy and Lindsay & Gilmour Pharmacy (Interested Parties). Copies of the written representations had been circulated in advance to the Committee and the Interested Parties.

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 September 2013 – February 2014 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 2014 to March 2014. The Committee were also provided with “Pharmacy Profiles” of the nearest pharmacies detailing opening hours, premises facilities and services offered.

5. The hearing was convened under paragraph 3(2) of Schedule 3 to the National Health Services (Pharmaceutical Services) (Scotland) Regulations 2009 as amended (“the Regulations”). In terms of this paragraph, the PPC “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 PPC 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 person whose names are included in the Pharmaceutical List.”

6. 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.

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

8. The Committee agreed to invite the Applicant and those who were present who had made representations, (Interested Parties), to attend before them. The Applicant was represented in person by Yaseen Yousaf, assisted by Imran Hussain. The Interested Parties who had submitted written representations during the consultation period and who had chosen to attend the hearing were Ms Yvonne Williams and Mr Philip Galt (Lindsay & Gilmour Pharmacy); Tom Arnott (Lloyds Pharmacy); Charles Tait (Boots UK Ltd) and Barrie Dear (Dears Pharmacy).

9. The Chair asked the Applicant and Interested Parties to confirm that they were not attending the Committee in the capacity of solicitor, counsel or paid advocate. They confirmed that they were not. 2

10. The Chair explained the procedure that would be followed and no person present objected.

11. 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 Interested Parties and the Committee to ask questions. The Interested Parties would then make their submissions. After each submission, there followed the opportunity for the Applicant and PPC to ask questions of the Interested Parties. The Applicant and Interested Parties were then given an opportunity to sum up. Before the parties left the meeting the Chair asked all parties if they felt that they had had a fair and full hearing. They confirmed that they had.

12. The Committee was required to and did take into 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.

The Applicant’s Case

13. The Applicant thanked members of the Committee for the opportunity to put forward his application for inclusion in the pharmaceutical list.

14. The Applicant began by giving a synopsis of the area and its surroundings. The Applicant stated that Muirhouse is a large public housing estate on the north-west edge of Edinburgh. It is west of Granton and the housing estates of East Pilton and West Pilton and East of Davidsons Mains. It is bounded to the south by and to the East by Pennywell Road. The area is bordered by major roads on three sides and a private housing development on its western edge.

15. The Applicant stated that Muirhouse, together with the neighbouring West Pilton, have been undergoing significant renewal with council owned blocks being replaced by private housing. Despite this major regeneration activity, including demolition and refurbishment of properties, it continues to be comparatively deprived in relation to both Edinburgh and Scotland. The estate is one of the worst areas of multiple deprivation and continues to experience poor housing, high levels of unemployment, and related significant social problems.

16. The Applicant stated that the local population also have a variety of barriers to employment ranging from low skills, physical disability, mental health issues and problems with substance abuse. The area suffers unemployment rates of more than three times the average for Edinburgh, with a larger proportion of long-term unemployment.

17. The Applicant stated that his neighbourhood is that of Muirhouse and can be defined as follows:

18. North – Muirhouse Parkway (at the Muirhouse Gardens Junction) heading East along the dual carriage to the roundabout Pennywell Road (including Salvesen area).

19. East – Pennywell Road (roundabout) heading south along dual carriage to Ferry Road (B9085)

20. South – Ferry Road heading west to Ferry Road/Ferry Gait Drive junction (including the Ferry Gait Development)

21. West – Ferry Gait Drive, Muirhouse Park Junction walking along grassed area to cut between Brae and Craigroyston Grove, following onto new development of Silverknowes 3 Eastway (Old Silverknowes Primary School) following onto Muirhouse Gardens to connect with Muirhouse Parkway.

22. The Applicant referred to Lord Nimmo Smith’s opinion of a neighbourhood and stated that the neighbourhood of Muirhouse can be seen as a neighbourhood for all intents and purposes. It has its own facilities and amenities: Craigroyston Community High School, Primary School, Muirhouse Parish Church, Library, a number of community based projects, Muirhouse Millennium Centre, Convenience stores, post office and fast food outlet.

23. The Applicant stated that existing services to the neighbourhood are provided by pharmacies currently outwith the neighbourhood. The Applicant stated that this is the not the crux of his argument, to suggest that the absence of a community pharmacy in a neighbourhood is sufficient grounds in itself to grant an application. If there is no pharmacy in a neighbourhood, however, there are a number of factors which should be taken into consideration when determining whether pharmaceutical services outwith a neighbourhood are adequate: population size, demographics of the population, routine daily behaviour of the population, ease of access to the existing services, and public consultation findings.

24. The Applicant stated that all of the factors are important and only when there is a conflagration of problems, does services provision become inadequate. The Applicant stated that in this case, a conflagration has occurred, and made existing services in the neighbourhood inadequate.

25. The Applicant first turned to population size and demographics of the population stating that the population is a sizeable number and applications have been granted for population numbers much smaller and in less deprived areas.

26. The Applicant then looked at routine daily behaviour of the population. The Applicant stated that there are local amenities located in Muirhouse and residents gravitate towards Muirhouse Gardens, which is the focal area of the neighbourhood. Residents can purchase their daily provisions from within the neighbourhood, as there are convenience stores, a fast food outlet and a post office. Ordinarily, residents in the area do not need to necessarily leave the neighbourhood, as part of their daily routine.

27. The Applicant then looked at ease of access to the existing services. The Applicant discussed pedestrian access to the neighbouring pharmacies involves negotiating busy roads and that there are territorial issues with regards to criminal activities. The Applicant discussed that there are high levels of substance misuse patients at the other pharmacies which deters residents from using the existing services. The Applicant discussed that with the exception of Lloyds Pharmacy patients are required to take a bus to other pharmacies. The Applicant also pointed out that there is a Food Bank located in North Edinburgh.

28. The Applicant then looked at the public consultation findings and discussed the findings as detailed in his application.

29. The Applicant discussed the National Records for Scotland projections for 2010 to 2025 which show a 15% increase in total Lothian population from 836, 711 to 965, 007.

30. The Applicant then looked at data zone figures for neighbourhoods in north Edinburgh. The Applicant stated that for comparative purposes this information is extremely useful in determining how important healthcare is in each of these neighbourhoods and how each neighbourhood merits its own pharmacy, as there is a link between socio-economic deprivation and multi-morbidity and how this impacts on primary care service delivery. 4

31. The Applicant stated that the total population of both Muirhouse and West Pilton is 12,358 people and that one pharmacy, Lloyds Pennywell Road, cannot cater for this size of population. Especially as there is higher than average users of pharmaceutical services living in these areas.

32. The Applicant then stated that for comparative purposes he would show areas in Edinburgh that are affluent and that have more than one pharmacy within them. The Applicant provided information on the data zones for Blackhall, , , Morningside and Stockbridge. The Applicant stated that it can clearly be seen that more affluent neighbourhoods are being given precedence over more deprived areas. Some of the GP practices are highly subscribed and running at capacity, of which a significant percentage of practice patients are living in data zones defined as the 15% most deprived.

33. The Applicant stated that the Edinburgh Evening News revealed in March 2014, that the Lothian region needs 33 new GP surgeries to cope with an ageing and growing population. The Applicant cited that in line with delivering the key objectives discussed in The Right Medicine, a Strategy for Pharmaceutical Care in Scotland, 2002, community pharmacies should be based in the heart of communities, in rural as well as deprived inner city areas. By engaging with communities, providing employment as well as services, pharmacists make a contribution to the wider public health agenda, beyond NHS Scotland.

34. The Applicant stated that community pharmacists are often the patient’s first point of contact and for some their only contact, with a healthcare professional. This creates a unique opportunity to improve the gateways for signposting, accessing and providing services and information on health and health issues to a broad spectrum of the population.

35. The Applicant then referred to the Scottish Governments Action Plan, ‘Better Health, Better Care’ launched in December 2007. It is patient centred and aims to help people to sustain and improve their health, especially in disadvantaged communities, ensuring better, local and faster access to health care.

36. The Edinburgh City Council Health and Social Care plan also outlines how the number of older people in Edinburgh will increase. As the prevalence of dementia increases with age, there will be a significant rise in dementia among the growing very old population.

37. The Applicant stated that as age is one of the biggest predictors of use of health and social care services, this increase in an ageing population will therefore translate into a significant increase in demand for health and social care services. There will be an increasing number of people living at home with long term conditions. There is a considerable under diagnosis of mental illness in older people as well. It is estimated that one in seven older people will have a major depression and one in four will experience a depression which impacts on quality of life.

38. The Applicant stated that demographic changes will add to existing pressures of demand for services. Advances in health care and healthier lifestyles mean that people are living longer generally. The number of older people and people living with long term condition, disabilities and complex needs is increasing as is their need for care and support. Raising the profile of community pharmacy will mean addressing the concerns of people who cannot access pharmacy services because of mobility problems or other disabilities. Patients, especially older people and those with chronic conditions, often received treatment with four or more medicines. The Applicant stated that many older people have complex medication needs which go unrecognised and increased pharmaceutical input would greatly enhance the care provided to older people. 5

39. The Applicant then went on to discuss judicial guidance which he believed had a great bearing on the application. The Applicant cited the case of Lord MacPhail in Rowlands v The National Appeal Panel – Bonnyrigg (2006) in which Lord MacPhail stated that the National Appeal Panel were entitled to have regards to the number of items dispensed and the number of patients on the GP lists when reaching a view as to the adequacy of the existing provision in the future.

40. The Applicant then stated that the legal test states that need to consider future changes. The Applicant also highlighted the decision of Lord Drummond Young in the Judicial Review – Lloyds Pharmacy Limited v The National Appeal Panel 2004 at paragraph 10, which indicates that there is a requirement to consider probable future developments.

41. The Applicant stated that the future developments can be considered probable rather than speculative. The Applicant said that in his opinion, the implementation of the core pharmacy services at this moment and in the future will have a major impact on the already very busy pharmacies near the vicinity to his proposed neighbourhood and premises.

42. The Applicant stated that the NHS Lothian Pharmaceutical Care Services Plan 2014 also mentions that there is a need for acute and chronic medication services and that Minor Ailments Service is likely to increase. The Applicant stated that with the new housing developments and subsequent population increase, population density and the already high levels of substance misuse patients within the neighbourhood and vicinity, current capacity in the existing pharmacies may become stretched. This is especially the case, when implementing the core services of the pharmacy contract, in already very busy pharmacies, which are dispensing substantially more than the NHS Lothian average number of prescription forms and items.

Questions from Ms Yvonne Williams to the Applicant

43. The Applicant confirmed when asked by Ms Williams that they were including the nursing home in their definition of the neighbourhood and that the eastern boundary of their neighbourhood is Pennywell Road to Ferry Road.

44. Ms Williams asked whether there is a Lloyds Pharmacy on Pennywell Road. The Applicant stated that this is a subjective matter on whether it is included in the neighbourhood or not. The Applicant stated that one pharmacy serving two neighbourhoods is not plausible. Ms Williams asked the Applicant whether it could be argued that it is within their defined neighbourhood. The Applicant agreed that this could be argued.

45. Ms Williams asked the Applicant whether he would agree that it is a reasonable walking distance to Lloyds Pharmacy at Pennywell Road from the neighbourhood. The Applicant stated that factors are different in a deprived neighbourhood due to residents having more chronic conditions, diabetes etc. The Applicant stated that for someone with multiple morbidities it would be difficult. Ms Williams asked whether a 10 -15 minute walking distance to a nearest pharmacy is reasonable. The Applicant agreed that this was a reasonable distance.

46. Ms Williams asked the Applicant to confirm where the nearest pharmacy is for residents in Ferry Gait Drive. The Applicant confirmed that this would be Boots Pharmacy. Ms Williams asked the Applicant to confirm where the nearest pharmacy is for residents in Royston Drive. The Applicant confirmed Lloyds Pharmacy. Ms Williams asked the Applicant to confirm where the nearest pharmacy is for residents in Pennywell Road. The Applicant confirmed Lloyds Pharmacy. There was then clarification that the question was including the Applicant’s proposed pharmacy. The Applicant then clarified that for Ferry Gait Drive the nearest pharmacy would be Boots Pharmacy and for Royston Drive and Pennywell Road it would be 6 their proposed pharmacy. The Applicant stated that it would depend what part of Pennywell Road you were on as to whether you would be nearer Lloyds Pharmacy or the proposed pharmacy.

47. The Applicant confirmed when asked by Ms Williams that it is the same secretary for both the MPs letters. The Applicant confirmed that he believed that the reason that the Muirhouse Community Council withdrew their support of the application was a result of a misunderstanding with regards to alcohol being sold in the premises. The Applicant confirmed when asked by Ms Williams that he had experience of dealing with these issues. The Applicant pointed out that the pharmacy at Wallyford was granted and that their premises are bigger.

48. Ms Williams asked the Applicant whether he thought that population statistics indicate inadequacy in existing services. The Applicant replied that he thought it was reasonable to assume any contractor servicing their needs is going to be busy and that affects adequacy. The neighbourhood is in 15% most deprived data zones so this is going to impact service delivery.

Questions from Mr Tom Arnott to the Applicant

49. Mr Arnott asked the Applicant whether there is a pharmacy in his proposed neighbourhood. The Applicant stated that Lloyds Pharmacy is on the cusp of the neighbourhood. Mr Arnott stated that the pharmacy is either inside the neighbourhood or not and the Applicant responded that wasn’t the crux of the argument and that it is one of the most deprived areas in Scotland, with a food bank in North Edinburgh. The Applicant confirmed when asked by Mr Arnott that Lloyds Pharmacy at Pennywell Road provides all four core services but has high levels of substance misuse and long waiting times.

50. Mr Arnott stated that it had been established that a 10-15 minute walk is acceptable and asked the Applicant what the distance from Lloyds Pharmacy to the proposed pharmacy is. The Applicant stated it was 0.3miles.

51. Mr Arnott asked the Applicant which is the closest pharmacy to Muirhouse Avenue. The Applicant confirmed that he thought it was Lloyds Pharmacy. Mr Arnott asked the Applicant which is the closest pharmacy to Muirhouse Crescent. The Applicant confirmed that he thought it was Lloyds Pharmacy.

52. Mr Arnott asked the Applicant what he thought was an acceptable waiting time. The Applicant stated 10 minutes and that they had conducted market research and the average waiting time in the area is 40 minutes. Mr Arnott asked the Applicant if there had been any complaints to the Health Board regarding pharmacy provision. The Applicant stated that he didn’t think that there had been.

53. The Applicant confirmed when asked by Mr Arnott that Crewe Road North, Pilton, Granton and Silverknowes are not in the neighbourhood.

Questions from Charles Tait to the Applicant

54. Mr Tait asked the Applicant if he would accept that he had mentioned housing areas in 10-12 areas in his presentation. The Applicant stated that both Pennywell Road and Muirhouse Avenue are in the neighbourhood. Mr Tait stated that he did not think that the Applicant had treated the information on data zones in the different neighbourhoods in the same way and had not applied the same criteria to the conclusions drawn.

7 55. Mr Tait asked the Applicant if he knew what the bus services are like in the neighbourhood. The Applicant confirmed that there are a number of buses every 10-15 minutes.

56. The Applicant responded when asked by Mr Tait what difference his pharmacy would make to GP capacity that it will help residents in the area that are deprived and stated that he had clearly cited in his presentation judicial guidance with regards to the decision makers being allowed to look at GP list sizes.

57. Mr Tait asked the Applicant whether the owner of the premises is against substance misuse services being provided and the Applicant confirmed that there was not a problem. The Applicant confirmed that Mr Hussain’s (the other Applicant) father owns the convenience store and Mr Hussain confirmed that there is no issue. The Chair of the PPC read out the lease agreement which was included in the papers sent to all parties.

58. The Applicant confirmed when asked by Mr Tait that the proposed neighbourhood includes the care home and that they would expect to provide pharmaceutical services to it.

Questions from Barrie Dear to the Applicant

59. The Applicant confirmed when asked by Mr Dear that Dears Pharmacy are providing all core pharmaceutical services. Mr Dear asked the Applicant what the name of the shopping centre on Pennywell Road is. The Applicant stated that it was West Pilton Post Office with Muirhouse Shopping Centre.

60. Mr Dear pointed out that the Applicant hadn’t provided a plan of the pharmacy. The Applicant stated that the Committee had been on a site visit and was happy to discuss the proposed layout.

61. Mr Dear asked the Applicant if he thought that he would ever have stock issues. The Applicant said that he did not envisage this as they will use 5 or 6 wholesalers. Mr Dear then asked how the Applicant would circumvent manufacturer problems with an item. The Applicant stated that this could not be helped. Mr Dear asked the Applicant whether the pharmacy would make a dispensing error or ever have long waiting times. The Applicant stated this could only be established once the pharmacy opened.

62. Mr Dear asked the Applicant whether he thought the new housing developments will have any bearing of the population of Muirhouse. The Applicant stated that the closer developments will have an impact. Mr Dear asked the Applicant what was the net gain or loss population over the past 20 years in the neighbourhood. The Applicant responded that he didn’t have a figure but that there had been a continued spiral of deprivation. Mr Dear asked the Applicant what was the number of average people per house. The Applicant said he didn’t know. Mr Dear pointed out that it was going down by 10% each year and that there was a lot of development but not a lot of new people.

63. The Applicant confirmed when asked by Mr Dear that the criminality in the area that he mentioned was based on SIMD figures. The Applicant confirmed when asked by Mr Dear that the shops at Muirhouse Gardens are busy.

Questions from the Committee to the Applicant

64. Mr Glauch asked where the food bank that the Applicant had mentioned in his presentation was located. The Applicant stated that it was called the ‘North West Edinburgh Food bank’ and was located opposite the Morrisons Supermarket on Granton Road. 8

65. The Applicant confirmed when asked by Mr Jones that the western boundary of his neighbourhood did not include the concentric roads at Silverknowes.

66. Mr Jones asked the Applicant whether he was aware that the current owner has concerns with regards to the pharmacy. The Applicant stated that he could assure the Committee that there are no concerns and that the alcohol currently sold in the convenience shop will be removed. The Applicant stated that the pharmacy will be bigger than the Wallyford Pharmacy and the shop there still provides alcohol. Mr Jones noted that there are no plans; the Applicant stated that he was confident that the plans would be approved and was happy to discuss the layout. Mr Jones noted that the Applicant had emphasised the deprivation population and that he was implying that it’s directly related to inadequate services. The Applicant stated that some contractors have over 100 substance misuse patients and that these are the people that need catered for. Mr Jones asked the Applicant what evidence he had that they are not being catered for. The Applicant stated waiting times was an indicator.

67. Mr Jones asked the Applicant where he thought that residents in the defined neighbourhood do their shopping. The Applicant stated that they don’t ordinarily have to leave the neighbourhood as there is a convenience store etc.

68. Mr Jones asked the Applicant who he would classify as elderly. The Applicant responded those over 65. Mr Jones pointed out that those over 65 have free transport.

69. The Applicant confirmed when asked by Mr Daniels that they will provide a methadone service. The Applicant confirmed when asked by Mr Daniels that they had identified a pharmacist for the pharmacy and confirmed that he is a pharmacist. Mr Daniels asked the Applicant what the waiting times of the pharmacy would be. The Applicant responded that they would be 5-10 minutes.

70. The Applicant clarified when asked by Mr Melville that Muirhouse Avenue and Muirhouse Green were the same development and that access would be from Ferry Road and north end of site. The Applicant also confirmed when asked that the development would be finished by the end of the year.

71. The Applicant confirmed when asked by Mr Melville that his argument is that the other developments are going to put pressure on to the other pharmacies which will be detrimental to the population in the Muirhouse neighbourhood. The Applicant also confirmed when asked by Mr Melville that he believes that the premises are best placed for a pharmacy in the neighbourhood.

72. Ms Anderton asked the Applicant how the pharmacy will operate in conjunction with the convenience store opening hours. The Applicant confirmed that there will be a secure shutter as the convenience store opens slightly earlier and closes slightly later than the pharmacy.

The Interested Parties Case – Ms Yvonne Williams of Lindsay & Gilmour Pharmacy

73. Ms Yvonne Williams stated that on behalf of Lindsay & Gilmour Pharmacy that she would like to object to the application for an additional NHS pharmaceutical contract on the grounds that the application is neither necessary nor desirable to secure adequate provision of pharmaceutical services to the neighbourhood.

9 74. Ms Williams stated that in terms of neighbourhood she had no objection to the neighbourhood as the Applicant had defined it.

75. Ms Williams stated that she would like to look at the consideration of the adequacy of the existing services provided to the neighbourhood. As per the legal test this consideration takes into account services provided by pharmacies located in the neighbourhood itself, of which Ms Williams would argue that there is one pharmacy located which is Lloyds Pharmacy at Pennywell Road, and services provided by other pharmacies not located in the neighbourhood (of which there are a further four on the consultation list).

76. Ms Williams contended that given the proximity of the proposed premises to Lloyds Pharmacy on Pennywell Road (0.4 miles) and the fact that there are another 2 pharmacies within a mile and a further 2 within 2 miles that the services provided to the neighbourhood are more than adequate. These pharmacies are accessible to patients from the Applicant’s neighbourhood by car or one of the 9 frequent bus routes in around Muirhouse. Ms Williams stated that given in particular the spread of Lloyds Pharmacy in Muirhouse, Boots in Davidsons Mains and Dears on Ferry Road at least one or more of these pharmacies is easily accessible to all residents of Muirhouse, no matter where they live, by foot. Ms Williams stated that at even the furthest points within the Applicant’ neighbourhood no one has to travel further than 0.7 miles to access a pharmacy. At an average walking pace of 4 miles per house this is a 10 minute walk which the Applicant has said was reasonable.

77. Ms Williams stated that each of these pharmacies and the two Lindsay & Gilmour branches on the consultation list provide a variety of services and opening hours. The Applicant has not demonstrated that he will be providing any services not currently available to the residents of Muirhouse from other pharmacies in the neighbourhood and immediate area and as such the question of necessity/desirability should end there.

78. Ms Williams stated that as far as Lindsay & Gilmour is concerned, although both their branches are located outside the defined neighbourhood, they provide more than adequate pharmaceutical services to this neighbourhood day in and day out. Ms Williams stated that they offer a twice daily prescription collection service from Crewe Road Medical Practice and their reception staff continually hand prescriptions in to the pharmacy during the day and they also have a daily collection service from both Muirhouse Surgery and the surgery at Davidson’s Mains. These surgeries are the three which serve the majority of residents in the defined neighbourhood. Ms Williams stated that in addition to this they pick up prescriptions from a further five surgeries across Edinburgh.

79. Ms Williams stated that Lindsay & Gilmour Pharmacy provide a free, on demand, delivery service to patients in the neighbourhood and beyond, with some of these prescriptions being delivered the same day. This service has been in operation for many years and their driver is a familiar face around the area. In addition they have developed strong links with the surgeries over the many years that both pharmacies have been offering pharmaceutical services to the wider neighbourhood.

80. Ms Williams stated that both Lindsay & Gilmour Pharmacies offer a full range of pharmaceutical services including the four core contracted services of the Minor Ailment Service, Public Health Service including smoking cessation services and sexual health services including emergency hormonal contraception, the Acute Medication Service (otherwise know as Electronic Transfer of Prescriptions) and the Chronic Medication Service. Both also offer additional NHS services including supervised methadone, the ostomy service and the gluten free food service. Non NHS services include provision of monitored dosage systems and a free prescription collection

10 and delivery service. In addition their Crewe Road pharmacy participates in the needle exchange service.

81. Ms Williams stated that these services are all available to all patients within the neighbourhood of Muirhouse and beyond and they still have ample capacity for both Methadone patients and patients on Monitored Dosage Systems.

82. Ms Williams stated that there has admittedly been some housing development in the area over recent years. However, due to the recent economic downturn this development is only now beginning to get back on track. Even now there is no way of knowing when, or if, all the planned building work will be completed. Whilst it is clear from the various judicial reviews cited in the application that known future changes must be taken into account since there has been no inadequacy in the existing services demonstrated it does not automatically follow that the existing pharmacy network will not be able to cope with any change in population. Ms Williams stated that she believes it can. The type of housing planned in the area is a mix of social and private and as such those moving into these properties may well be relocating from another part of the neighbourhood rather than being new to the area. The population will be further divided across the five existing pharmacies and not just one or two.

83. Ms Williams stated that it is also true that Muirhouse is a deprived area. However, research from Durham University published in the last 2 weeks has shown that certainly in England the inverse care law does not apply to community pharmacies. In other words those in the most deprived areas already have the best access to pharmacy services. Ms Williams stated that given that the current system in Scotland also focuses heavily on deprivation it would be likely that this research could also be extrapolated north of the border.

84. Ms Williams stated that much has been made of the distances of the other pharmacies in relation to the proposed premises, however, at a distance of less than half a mile or just over 800 yards from Lloyds Pharmacy if distance was to be cited as an indicator of inadequacy and apply this same definition across the country there would have pharmacies located every 800 yards across the country. Ms Williams stated that this is clearly not a viable situation.

85. Ms Williams stated that in the past few years both the PPC and the National Appeal rejected the granting of a contract in , just a short distance away. In the case of Cramond it was deemed that a distance of more than one mile, over difficult terrain, was acceptable and easily accessible. Therefore consistency would dictate that this application should be rejected on these grounds alone.

86. Ms Williams stated that she does not believe that any inadequacy in the existing services has been demonstrated. Ms Williams stated that a case can always be made for desirability; however, it should not be confused with convenience and she believes this is something that the Applicant has done. This is further reinforced by the comments received during the public consultation.

Questions from the Applicant to Ms Yvonne Williams

87. Ms Williams confirmed when asked by the Applicant that Lloyds Pharmacy in the Granton area had recently relocated to a smaller unit and that she wasn’t aware of what the Granton population figure was. Ms Williams confirmed when asked by the Applicant that she thought Muirhouse was a deprived area and that Blackhall is a more affluent area. Ms Williams stated when asked by the Applicant that she didn’t recall what the population of Cramond was and that the number of substance misuse patients in Granton was commercially sensitive information. 11

88. The Applicant asked Ms Williams which pharmacies cater for the Waterfront Gait development. Ms Williams stated that the residents there are more mobile so they are likely to access services where they work.

89. Ms Williams confirmed when asked by the Applicant that she was aware of the developments in the Waterfront area but didn’t believe that it was relevant to the application.

Questions from Mr Tom Arnott to Ms Yvonne William

90. Ms Williams confirmed when asked by Mr Arnott that if there was an increase in population then staffing levels would increase. Ms Williams confirmed that Lloyds Pharmacy has recently relocated and staffing had increased.

Questions from Mr Charles Tait to Ms Yvonne Williams

91. No questions.

Questions from Mr Barrie Dear to Ms Yvonne Williams

92. No questions.

Questions from the Committee to Ms Yvonne Williams

93. Ms Anderton asked Ms Williams whether the application discussed at Cramond was comparable as it is a more affluent area. Ms Williams stated that she was only comparing distances, not demographics, in order to demonstrate distance shouldn’t be deemed an inadequacy.

94. Mr Embrey asked how far would be unreasonable to walk to a nearest pharmacy. Ms Williams stated anything beyond 1 or 1 ½ miles or about 20 minutes to half an hour. Further than this would be difficult for those with mobility issues.

95. Mr Embrey asked Ms Williams if they have received any complaints. Ms Williams stated she was not aware of any complaints being made. Ms Williams responded when asked by Mr Embrey that it is patient’s choice to use Lindsay & Gilmour pharmacy.

96. Ms Williams confirmed when asked by Mr Daniels that none of their pharmacy services are at capacity or near capacity.

97. Mr Glauch asked if there was any capacity on services. Ms Williams responded that all branches are under contracts reviews. They have 15 branches across Lothian and although none of them are near to capacity that some services could be moved if they ever reached capacity.

The Interested Parties Case – Mr Tom Arnott of Lloyds Pharmacy

98. Mr Arnott stated that the Applicants main argument seems to be that there is no pharmacy within his defined neighbourhood. Mr Arnott stated that he was surprised at the Applicant’s lack of knowledge of this neighbourhood as Lloyds Pharmacy, 55A Pennywell Road is within the eastern boundary of his defined neighbourhood, 0.3 miles from his proposed site, and currently provides adequate pharmaceutical services to the residents of Muirhouse and meets the demands of all core services. 12

99. Mr Arnott noted that in the vicinity of Lloyds premises there is a Hair and Beauty Salon, RS McColl, a Community Shop, Café, Salvation Army, William Hill, Greggs, Opticians, Medical Centre, Day to Day Convenience Store Babas Cave Gift Shop, African Stores, Drug and Alcohol Centre Library and Edinburgh Arts Centre. Mr Arnott stated that he believed this to be Muirhouse Shopping Centre.

100. Mr Arnott stated that the Area Pharmaceutical Committee do not support the application as they see existing services as adequate. The 2014 NHS Lothian Pharmaceutical Care Services Plan does not indicate any requirement for another pharmacy in this part of Edinburgh.

101. Mr Arnott noted that the Applicant had stated that his application is supported by the local people and has submitted supporting documentation. Muirhouse and Salvasen Community Council in a letter dated 20 th February 2014, which followed a council meeting, clearly states that they do not support this application.

102. Mr Arnott noted that the Applicant states that there is a new development, and agreed that this is the case, however having spoken to some local people, it is his understanding that the new housing will indeed be less densely populated than that which has been replaced.

103. Mr Arnott stated that the Applicant refers to a petition which has been signed by 792 people. Mr Arnott stated that he believed that the petition was placed in the Costless Express and that this is the premises where the Applicants 800 square ft pharmacy is to be situated and presumably the owners of Costless Express may have had an interest in encouraging people to sign the petition.

104. Mr Arnott noted that also on the parade of shops is an empty unit, a Turkish kebab takeaway and a further convenience store which he believes is hardly the hub of the community of Muirhouse.

105. Mr Arnott stated that the Applicant has provided data from a survey, however some of the statements are ambiguous, for example ‘there is always a queue’, ‘waiting times are too long’, ‘the pharmacy did not stock the products required none of this is quantified’.

106. Mr Arnott stated that the Applicant has included the residents of Muirhouse Avenue, Muirhouse Crescent, Muirhouse Terrace, Muirhouse Green and numerous other streets in his perceived neighbourhood, these residents actually live closer to the Lloyds pharmacy and it could be argued that the residents of Ferrygait Drive could access Dears Pharmacy more easily than the Applicants site. Mr Arnott noted that on visiting this part of the neighbourhood (Ferrygait) it appeared to be reasonably affluent with many cars parked.

107. Mr Arnott stated that in summary the Area Pharmaceutical Committee do not support the application as they see existing services as adequate. The Muirhouse and Salevesen Community Council do not support the application. There have been no complaints to the Health Board regarding the adequacy of existing pharmaceutical services. There is no mention of any need for further provision of pharmaceutical services in this part of Edinburgh in the 2014 NHS Lothian Pharmaceutical Care Services Plan. The Applicant has shown no inadequacies in current pharmaceutical provision. Mr Arnott therefore asked the panel to refuse the application as it is neither necessary nor desirable in order to secure the adequate provision of pharmaceutical services in the neighbourhood in which the premises are located.

13 Questions from the Applicant to Mr Tom Arnott

108. Mr Arnott confirmed when asked by the Applicant that there is one pharmacist at their pharmacy and then double cover on certain days. Mr Arnott responded when asked by the Applicant whether Muirhouse and Pilton are separate neighbourhood that if you asked someone they would say they are from Muirhouse or they would say that they are from Pilton.

Questions from Ms Yvonne Williams to Mr Tom Arnott

109. Mr Arnott confirmed when asked by Ms Williams that they have capacity and would employ extra staff if required.

Questions from Mr Charles Tait to Mr Tom Arnott

110. No questions.

Questions from Mr Barrie Dear to Mr Tom Arnott

111. No questions.

Questions from the Committee to Mr Tom Arnott

112. Mr Arnott confirmed when asked by Mr Daniels that Lloyds Pharmacy is not at or near capacity.

113. Mr Arnott confirmed when asked by Mr Jones that there had been no complaints to the pharmacy regarding the level of services.

The Interested Parties Case – Mr Charles Tait of Boots UK Ltd

114. Mr Tait stated that there is no suggestion that Muirhouse is not a deprived neighbourhood. The population has gone down by 10% in 20 years. Mr Tait stated that there is a brilliant bus service with16 buses per hour all over the place. Mr Tait explained that he had looked at the distance issues to the neighbourhood, measuring the walking distance from 24 sites to the nearest pharmacy. Mr Tait explained that the furthest is a 17 minute walk to a pharmacy. Mr Tait explained that the quickest walk would not be to the Applicants proposed site. Mr Tait stated that the area is well serviced and it is within the top 20% SIMD of access to services including pharmacies and GP’s etc. Mr Tait explained that in a recent study regarding how deprivation and age increase pharmaceutical service it was shown that wealthy people live longer as they receive more medication and deprived people who tend to have an unhealthy lifestyle don’t live as long so there is no direct correlation. Mr Tait stated the Applicant’s argument was based on developments outwith the neighbourhood. Mr Tait stated that it is an urban area and current services are adequate. Mr Tait stated that there had been no complaints within the last 12 months. Mr Tait concluded that there was no case and asked that the Committee should reject the application.

Questions from the Applicant to Mr Charles Tait

115. The Applicant asked Mr Tait what percentage of people who reside in the Muirhouse area use Boots Pharmacy. Mr Tait responded that it was probably about 10%. The applicant stated that bus fares are expensive and Mr Tait responded that bus fares in Edinburgh are the cheapest in Scotland.

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Questions from Ms Yvonne Williams to Mr Charles Tait

116. Mr Tait stated when asked by Ms Williams that Boots Pharmacy has plenty of capacity.

Questions from Mr Tom Arnott to Mr Charles Tait

117. No Questions.

Questions from Mr Barrie Dear to Mr Charles Tait

118. No Questions

Questions from the Committee to Mr Charles Tait

119. Ms Anderton asked Mr Tait if there had been any complaints. Mr Tait confirmed that there had been none based on pharmacy provision.

120. Mr Tait confirmed when asked by Mr Melville that the 10% scripts from Muirhouse he mentioned would be a mixture of delivery and people going to the pharmacy.

121. Mr Tait stated when asked by Mr Embrey about the methadone demand at the Boots Pharmacy that that there is an area which is low view in the pharmacy which they believe is adequate for the service.

The Interested Parties Case – Mr Barrie Dear of Dears Pharmacy

122. Mr Dear stated that he didn’t believe that 20-50% increase is a significant workload and that all pharmacies within that area have spare capacity and will be able to manage steady increases. He stated that his pharmacy had relocated twice and that they adapt to what is put in front of them. Mr Dear stated that Dears Pharmacy used to provide the Needle Exchange service, which was well used, but that this was withdrawn from the Health Board. Mr Dear stated that there had been no complaints to the Health Board. Mr Dear stated that residents would struggle going to the shops next to the proposed pharmacy on a daily basis. Mr Dear stated that there was no net increase in population to the neighbourhood. Mr Dear stated that they have a high number of methadone patients but that this is dealt with effectively and that there is a separate entrance/private area. Mr Dear stated that they have a number of staff that deal with methadone and that if the pharmacy becomes busy they can help. Mr Dear stated that he believed that it is a convenience rather than any kind of inadequacy. Mr Dear stated that Dears Pharmacy had moved to their premises 8 years ago and there is more space if needed. Mr Dear stated that he doesn’t believe that there is any case for this application to be granted.

Questions from the Applicant to Mr Barrie Dear

123. Mr Dear responded when asked by the Applicant that he didn’t know what percentage from the Muirhouse area use Dears Pharmacy. Mr Dear also confirmed when asked by the applicant that the methadone dispensing was above average from Dears Pharmacy and agreed that it is a relatively deprived neighbourhood.

Questions from Ms Yvonne Williams to Mr Barrie Dear

124. No questions.

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Questions from Mr Tom Arnott to Mr Barrie Dear

125. No questions.

Questions from Mr Charles Tait to Mr Barrie Dear

126. No questions.

Questions from the Committee to Mr Barrie Dear

127. Mr Dear confirmed when asked by Mr Melville that the pharmacy does not operate a home delivery service but this is a service that they would consider providing in the future.

128. Mr Jones asked Mr Dear what the pharmacy strives to achieve in terms of waiting times. Mr Dear confirmed that if it is 2 or 3 items that their waiting time would be 5 minutes. If it was a large number of items, for example 10 items, they would discuss a time with the patient. Mr Jones pointed out that when they visited the pharmacy that there were three positions serving at the counter and asked Mr Dear if they ever look at waiting times. Mr Dear confirmed that they don’t as they have never had a problem with regards to waiting times.

Summing Up

129. The Applicant and Interested Party were then given the opportunity to sum up:

130. The Applicant stated he believed that the granting of this pharmacy contract will ameliorate the situation and will greatly benefit the demanding needs of the local population. The Applicant stated that the new pharmacy will be able to raise public health awareness, meet the demands of the local populations and influx of new patients, thereby allowing the smooth implementation of the four core pharmaceutical services. The Applicant stated that the overall objective should be to determine what effect the application has on access and delivery of pharmaceutical services for patients and not the overall effect it will have on the other contractors, although their viability will not be affected with the granting of this application.

131. The Applicant stated that the application is both necessary and desirable to secure adequate pharmaceutical services in the defined neighbourhood, as there is and will be an increased need for pharmaceutical services in the area, owing to changes in the demography and the growth of the population, as illustrated by the new housing developments and an already significant, growing and ageing population. The Applicant stated that there should be better, local and faster access to healthcare available from within the neighbourhood, as stated in the Government’s “Better Health, Better Care: Action Plan”. Changes in pharmaceutical practice and know probable facts, will also affect the standard of adequacy in a particular neighbourhood. Something that was adequate before can become inadequate over time, due to a number of factors. The extensive judicial guidance cited clearly demonstrated this.

132. The Applicant stated that there is a significant elderly and deprived population residing within Muirhouse and this poses risk factors for poor medicines management. The area, as well as other neighbourhoods on the cusp, is rife with substance misuse patients and therefore, the population has challenging and demanding pharmaceutical needs. These needs will further increase, due to people living longer and being on multiple medications. There will also be an increase in multimorbidity – the existence of several chronic health disorders in on individual – and a pharmacy in the area will be suitably located to help manage this. The Applicant stated 16 that securing pharmaceutical services provision from within the neighbourhood will allow these patients to be seen locally and in a timely fashion, and ensure that their needs are adequately addressed, thereby achieving and improving health outcomes and HEAT targets, which are a core set of ministerial objectives, targets and measures for the NHS. The Applicant stated that the respective pharmacies have their own neighbourhoods to cater for and those residing within the Muirhouse area should be able to access a pharmacy locally, from within the neighbourhood, which for all intents and purposes, is a neighbourhood. Given the population number and population demographics within Muirhouse, the neighbourhood is one which exhibits a significant requirement for ease of access to a full range of pharmaceutical services.

133. The Applicant then cited Part 2 from the Equality Act 2010. The Applicant stated that the granting of this contract in the area is necessary, given the extended role of the pharmacy and the opportunity to provide the population with access to the wider services provided by the pharmacy contract. The Applicant stated that the demographic composition of the neighbourhood also suggests the population comprises above average elements of those groups who traditionally make use of pharmacy services e.g. the elderly, substance misuse patients and women of child bearing age. The Applicant stated that he hoped that the Committee concurred with his findings and unanimously agree with having a new pharmacy contract established in Muirhouse.

134. Ms Yvonne Williams of Lindsay & Gilmour Pharmacy stated that she didn’t believe that any inadequacy had been demonstrated. Ms Williams stated that much had been made of the distance to a nearest pharmacy but residents do not have to travel more than 0.7 miles and that recent research shows deprived areas have better access. Ms Williams stated that those in urban areas will visit a pharmacy based on shops, schools etc. Ms Williams stated that she did not believe that any inadequacy in the existing services had been demonstrated. Ms Williams stated that a case can always be made for desirability however, it should not be confused with convenience and she did not believe that this is something that the Applicant had shown. Ms Williams stated that this is further reinforced by the comments received during the public consultation.

135. Mr Tom Arnott of Lloyds Pharmacy stated that the Area Pharmaceutical Committee do not support the application as they see existing services as adequate. The Muirhouse and Salevesen Community Council do not support the application. There have been no complaints to the Health Board regarding the adequacy of existing pharmaceutical services. There is no mention of any need for further provision of pharmaceutical services in this part of Edinburgh in the 2014 NHS Lothian Pharmaceutical Care Services Plan. The Applicant has shown no inadequacies in current pharmaceutical provision. Mr Arnott stated that he would therefore ask the panel to refuse this application as it is neither necessary nor desirable in order to secure the adequate provision of pharmaceutical services in the neighbourhood in which the premises are located.

136. Mr Charles Tait of Boots UK Ltd stated that he believed that there had been no case made for granting an application. Mr Tait stated that the residents are catered for adequately by existing services and will continue to be catered for adequately in the future. Mr Tait stated that the distance to travel to a pharmacy is not excessive and there has been no increase in the population shown.

137. Mr Barrie Dear of Dears Pharmacy stated that he didn’t believe that 20-50% average is a significant workload. Mr Dear stated that the existing pharmacies have spare capacity and are going to manage steady increases. Mr Dear pointed out that his pharmacy has relocated twice and have adapted to what is put in front of them. Mr Dear stated that Dears Pharmacy provided the needle exchange service but this was withdrawn by the Health Board. Mr Dear stated that 17 there had been no complaints to the Health Board. Mr Dear stated that residents would struggle going to only the shops at Muirhouse Gardens on a daily basis. Mr Dear stated that there had been no net increase in population of the neighbourhood. Mr Dear stated that Dears Pharmacy does have a lot of methadone but they have a separate entrance and private area and that clients can still come within the store. Mr Dear stated that they have a number of staff preparing methadone; if the pharmacy is busy these staff can help. Mr Dear stated that he believes it is convenience rather than any kind of inadequacy and that there is no case for this to be granted.

138. 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 and full hearing. The Applicant and Interested Parties all agreed that they consider that they had had a fair and full hearing and there was nothing further that they wished to add.

139. The Chair advised that the Committee would now consider the application and representation and make a determination. A written decision with reasons would be prepared and a copy sent to them as soon as possible. A letter would be included with the decision advising of the appeal process. The Chair then thanked the parties for attending.

140. The Applicant (Mr Yaseen Yousaf and Mr Imran Hussain), Interested Parties (Ms Yvonne Williams, Mr Philip Galt, Mr Tom Arnott, Mr Charles Tait and Mr Barrie Dear) and Board Administrators (Ms Katie Kerr and Ms Veronique Athukorala) then left the meeting.

Decision

141. 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.

142. In addition to the oral submissions put before them, the PPC also took account of all written representations and supporting documents submitted by the Applicant and the Interested Parties and those who were entitled to make representations. The written representations received and considered by the Committee were:-

i. Letter from the Lothian Area Pharmaceutical Committee ii. Letter from Yvonne Williams of Lindsay & Gilmour Pharmacy iii. Letter from Charles Tait of Boots UK Ltd iv. Letter from Matthew Cox of Lloyds Pharmacy v. Letter from Barrie Dear of Dears Pharmacy vi. Letter from Muirhouse Salvesen Community Council

The Committee also considered:-

vii. The location of the nearest existing pharmaceutical services viii. The location of the nearest existing medical services ix. The maps of the area surrounding the proposed premises detailing the location of the nearest pharmacies and GP Surgeries, deprivation categories and population density x. Information regarding the number of prescriptions dispensed by the pharmacies nearest to the proposed premises xi. Information regarding the number of prescriptions dispensed that were issued from the GP surgeries closest to the premises 18 xii. Pharmacy profiles of the nearest pharmacies detailing opening hours, premises facilities and services offered xiii. NHS Lothian Pharmaceutical Care Services Plan

Neighbourhood

143. 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, and the Committee had to decide the question of the neighbourhood in which the premises, to which the application related, were located.

144. The Committee considered the neighbourhood as put forward by the Applicant, and the Interested Parties, as well as comments received during the public consultation.

145. The Committee took into account a number of factors in defining the neighbourhood, including those who were resident there, that it had natural and man made boundaries, the presence of schools, shops and the distance which residents are required to travel to obtain pharmaceutical and other services.

146. The Committee agreed with the neighbourhood as put forward by the Applicant and is defined as follows:

North - Muirhouse Parkway (at the Muirhouse Gardens Junction) heading East along the dual carriage to the roundabout Pennywell Road (including Salvesen area)

East – Pennywell Road (roundabout) heading south along dual carriage to Ferry Road (B9085)

South – Ferry Road heading west to Ferry Road/Ferry Gait Drive Junction (including the Ferry Gait Development)

West – Ferry Gait Drive, Muirhouse Park junction walking along grassed area to cut between Silverknowes Brae and Craigroyston Grove following onto new development of Silverknowes Eastway (old Silverknowes Primary School) following onto Muirhouse Gardens to connect with Muirhouse Parkway.

147. The Committee identified that there are physical boundaries (roads) to the North, East and South and different housing stock to the West.

148. The community is served by shops, post office, fast food take away and has its own community council. The Committee also noted that there has been no dispute from any of the interested parties regarding the Applicant’s definition of the neighbourhood.

Adequacy of Existing Provision of Pharmaceutical Services and Necessity or Desirability

149. Having reached that decision the Committee were 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.

150. The Committee in determining adequacy of existing provision of pharmaceutical services in the defined neighbourhood took account of the evidence provided by the Applicant, interested parties and made available from other sources.

19 151. The Committee considered the existing services within the neighbourhood. The Committee noted that there is one pharmacy, Lloyds Pharmacy on Pennywell Road, within the neighbourhood. The Committee also noted that there are 2 further pharmacies (Dears Pharmacy on Ferry Road and Boots Pharmacy at Davidson’s Mains) on the cusp of the neighbourhood and these were both within 1 mile. The Committee noted that these pharmacies all provide pharmaceutical services to the neighbourhood.

152. The Committee then looked at the adequacy of existing services. The Committee noted that the current services are adequate to meet the neighbourhood’s substantial needs. The Committee noted that there are no issues regarding current capacity within the other pharmacies and that there is potential expansion to meet any reasonably foreseeable future developments. The Committee noted that the full range of pharmaceutical services is currently provided by nearby pharmacies. The Committee noted that there are good walking routes to all nearby pharmacies. The Committee agreed that the area is serviced by excellent bus services. The Committee therefore agreed that the current provision is adequate.

153. In considering whether the application was necessary or desirable. The Committee noted that the Lothian Area Pharmaceutical Committee did not support the application. There are no needs identified by the Pharmaceutical Care Services Plan 2014 for services in this area and that there had been no complaints received to the Health Board regarding provision in the area.

154. In accordance with the statutory procedure the Pharmacist Members of the Committee (Mr Mike Embrey, Ms Alan Glauch and Mr Peter Jones) left the meeting and were excluded from the voting process.

155. The Committee agreed unanimously from the information made available and reasons outlined above that the existing pharmaceutical services provided to the neighbourhood were adequate.

156. 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.

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

158. The Board Administrators were then invited back into the room and the decision of the Committee was recorded.

Signed …Peter Johnston…………………… Date …11 th September 2014 ……………….. Peter Johnston Chair Pharmacy Practices Committee

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