Pharmaceutical Needs Assessment 2011 Published: January 2011 Review date: January 2014 Contents 1 Foreword ......................................................... 2 13 References..................................................... 74 2 Purpose and use of this PNA ........................... 3 14 Acknowledgements ....................................... 75 What is a PNA? .......................................... 3 How to use this PNA .................................. 4 15 Appendices ................................................... 76 Appendix 1 - List of community pharmacies 3 Executive summary .......................................... 5 in Kirklees showing code for maps ........... 76 Appendix 2 - List of general medical practices 4 Background to community pharmacy contract.. 7 in Kirklees showing code for maps ........... 80 Essential services ......................................... 7 Appendix 3 - How the PNA was developed 83 Advanced services ..................................... 7 Appendix 4 - Consultation list .................. 85 Enhanced services ....................................... 8 Appendix 5 - Equality impact assessment .. 86 5 Who provides services to NHS Kirklees? .......... 9 16 Table 1 demonstrates pharmacy opening hours, dispensed items and population per 6 Populations now and in the future ................ 10 locality .......................................................... 92 Table 2 highlights the provision of directed 7 Key issues improving health and well being services by community pharmacies ............. 100 inequalities .................................................... 13 17 Maps ........................................................... 108 8 Current pharmaceutical service provision in Map A - features the spread of primary care ................................................. 15 pharmacies (including the only GP Locality map and summaries ..................... 19 dispensing practice) within Kirklees Including: against a background showing Population and health needs deprivation index of the population. ....... 109 Current pharmaceutical provision Map B – demonstrates pharmacy position vs Service gaps/pressures population density. ................................. 110 Map C – Community pharmacies with 9 Stakeholder views ......................................... 62 weekend/100 hours opening. ................ 111 Patient and public ..................................... 62 Map D – Community pharmacies providing GPs and Commissioners ........................... 64 sexual health services ............................. 112 Local authority .......................................... 66 Map E – Community pharmacies providing supervised consumption of methadone and Urgent Care provider ................................ 66 buprenorphine ........................................ 113 Community pharmacists ........................... 66 Map F – Community pharmacies providing needle and syringe exchange service ...... 114 10 Identified pharmaceutical needs .................... 67 Current service gaps/pressures .................. 67 Map G – Community pharmacies providing stop smoking services ............................ 115 Looking to the future ............................... 71 18 Glossary ...................................................... 116 11 Summary of recommendations ...................... 72 12 Control of entry : Exempt applications .......... 73 PHARMACEUTICAL NEEDS ASSESSMENT 1 1 Foreword The White paper, Equity and Excellence : Liberating the NHS, published in 2010 sets out the long term vision for the future of the NHS. This Pharmaceutical Needs Assessment (PNA) provides the base from which to deliver some of the aspirations of the white paper e.g. continuous service improvements through evidence based commissioning using local needs assessments and to promote integration of community pharmacy and GP led commissioning by providing the intelligence to make informed decisions on the future commissioning and provision of pharmacy services. NHS Kirklees has a statutory duty to carry out and publish a PNA. Working with representatives of community pharmacy contractors we will use this assessment to develop NHS pharmaceutical services and plan for the years ahead. There are 93 pharmacies across Kirklees of which 38 (40%) are independent contractors and the remaining are part of large chains. There are 72 general practices, 17 having branch surgeries with a total of 267 family doctors. We have 59 dental practices, and 46 opticians (plus 25 others who provide services to patients in their own homes), as well as hospitals within the Kirklees boundaries. An important part of our job is to develop and work in partnership with other key statutory stakeholders including Kirklees Council, Calderdale and Huddersfield NHS Foundation Trust, The Mid Yorkshire Hospitals NHS Trust and the South West Yorkshire Partnership NHS Foundation Trust. Other partners include the community and voluntary sector. We are all working together to make sure the health services you need are right for you. The PNA will be used as a tool in ensuring that all future commissioning decisions for the provision of pharmaceutical services meet the pharmaceutical and relevant health needs of the Kirklees population. It will inform both commissioning of pharmaceutical services and decisions on new pharmacy contract applications. The PNA and Joint Strategic Needs Assessment (JSNA) are closely aligned and future strategic responsibility for these documents is likely to sit with the Health and Well-being Board. The PNA will be regularly reviewed and updated by the appropriate authorised statutory body. The document has been fully consulted on as required by the regulations. A consultation report and equality impact assessment are published alongside this PNA. All documents are available on the NHS Kirklees website www.kirklees.nhs.uk/public-information/publications/reviews-and-assessments/. NB The contents of this publication were accurate as of 30 November 2010. 2 PHARMACEUTICAL NEEDS ASSESSMENT 2 Purpose and how to use this PNA What is a PNA? Section 128A of the NHS Act 20061 requires Primary Care Trusts (PCTs) like NHS Kirklees to assess the pharmaceutical needs for its area and to publish a statement of its assessment and of any revised assessment. Termed Pharmaceutical Needs Assessment (PNA), the National Health Service (Pharmaceutical Services) Amendment Regulations SI 2010/914 outline the minimum information to be contained in a PNA and the process to be followed for its development. This document sets out the pharmaceutical needs of our local population both now and in the immediate future in accordance with these aforementioned regulations. Community pharmacies provide people with access to medicines in a variety of ways without an appointment. In addition they offer a range of other services which promote self care and help people to use medicines safely and effectively. Patients are free to choose which community pharmacy to go to and do not need to be a registered patient of the pharmacy. In this document we will tell you how we will make sure all local people have equal access to community pharmacy services and how we will commission and develop future community pharmacy services. The aim of a PNA is to enable NHS Kirklees and our stakeholders to understand the pharmaceutical needs of our local population and to help us plan future services. This PNA will require a fundamental review every three years. However where there is a change to the availability of services following the publication of this PNA that could have an impact on the determination of an application, a supplementary statement will be issued. The objectives of this PNA are: • To support a robust decision making process for applications for NHS community pharmacy contracts within NHS Kirklees • To have a clear picture of the current services provided by community pharmacies and identify gaps in service provision in relation to NHS pharmaceutical services • To be able to plan for future services to be delivered by community pharmacy and make sure that any gaps in services are addressed • To make sure reasonable choices of pharmaceutical services are available for the people of Kirklees • To stipulate the range of directed enhanced services expected from community pharmacies entering the pharmaceutical list under the exempt category within the ‘Control of Entry’ Regulations 2005, (e.g. 100 hour pharmacies and wholly internet pharmacies) 1 http://www.legislation.gov.uk/ukpga/2006/41/section/128 PHARMACEUTICAL NEEDS ASSESSMENT 3 • To stipulate the range of directed services expected from pharmacies with previously called ‘exempt’ type contracts (as per the 2005 regulations), in anticipation of additional regulations due for publication in 2011 which support the use of PNAs in determining pharmacy applications • To provide the basis for a robust commissioning process for enhanced services from community pharmacies which enables community pharmacy to fully participate in service re-design • To encourage the use of community pharmacies as a means of reducing health inequalities • To encourage multidisciplinary working between independent pharmacy contractors and other healthcare professionals. Associated policies and procedures are: • Joint Strategic Needs Assessment (JSNA 2009 and 2010)2 • Five Year Strategic Plan 2008-133 How to use this PNA The PNA should be used as a tool to help deliver World Class Commissioning competences such as delivering better