Section II: Report and Analysis by GP Federation 3. Chard, Crewkerne and Ilminster Pharmacies and Dispensing Practices The pharmacies and dispensing practices in Chard, Crewkerne and Ilminster are shown in the table below: Table II.3.1 Pharmacies and Dispensing Practices in Chard, Crewkerne and Ilminster Enhanced Advanced Locally Commissioned Services Services Services Contract code Contract Name Trading Name Address1 Address2 Address3 Postcode Type Ailments Minor Care) (Palliative Specialist Drugs Reviews Use Medicines Service NewMedicines Reviews Use Appliance Stoma Customisation administration Supervised medicine of Hormonal Emergency Contraception Bins Screening Chlamydia Service Smoking Stop exchange Needle Boots Pharmacy FRG31 Boots UK Ltd (384) 5 Fore Street Chard TA20 1PH 40 hr Y Y Y y y y y Lloydspharmacy FC475 Lloyds Pharmacy Ltd (6201) 59 Fore Street Chard TA20 1QA 40 hr Y Y S y Lloydspharmacy Unit 1 Stringfellows Holyrood FN897 Lloyds Pharmacy Ltd (6202) Gallery Street Chard TA20 2AJ 40 hr Y Y S y y Boots Pharmacy Crewker FF819 Boots UK Ltd (441) 8-10 Market Street ne TA18 7LA 40 hr Y Y y y y y y Crewkerne Healthcare Crewkerne Crewkerne Health Middle Crewker 100 FTC75 LLP Pharmacy Centre Path ne TZ18 8BX hr Y Y Y y y y National Co-operative Co-operative Crewker FG726 Chemists Ltd Pharmacy (200282) Middle Path ne TA18 8BG 40 hr Y Y y y y y Boots Pharmacy FA296 Boots UK Ltd (444) 6 East Street Ilminster TA19 0AJ 40 hr Y Y Y y y y y y FD623 John Preddy Co Ltd Minster Pharmacy 15 Silver Street Ilminster TA19 0DH 40 hr L Y y y y y FJ699 John Ware Ltd Merriott Pharmacy 2 Broadway Merriott TA16 5NQ 40 hr Y Y Y Table II.3.2 Dispensing Doctors’ Practices and Branches in Chard, Crewkerne and Ilminster Contract Code Contract Name Address1 Address2 Address3 Postcode Opening Hours Type L85054 Summervale Ilminster Canal Ilminster TA199FE dispensing GP Surgery Medical Centre Way practice L85061 The Meadows Ilminster Canal Ilminster TA199FE dispensing GP Surgery Medical Centre Way practice L85624 Church View Broadway Road Broadway Ilminster TA199RX Monday, Wednesday, Friday 8.30 -13.00, 14.00 - dispensing GP Surgery 18.00; Tuesday, 8.30-13.00, 14.00-19.00; practice Thursday 8.30-13.00 Chard, Crewkerne and Ilminster are supported by eight 40 hour pharmacies, three in Chard, two in Crewkerne, two in Ilminster and one in Merriott. Crewkerne Health Centre also operates as a 100 hour pharmacy while three dispensing GP practices serve the rural areas around Ilminster. Table II.3.3 Number of Pharmacies and Dispensing Practices – Chard, Crewkerne and Ilminster GP Pharmacies Dispensing GP Pharmacies Providers Total registered /100,000 /100,000 100 hr 40 hr practice branch population Chard, Crewkerne 1 8 3 12 46,700 19.3 25.7 & Ilminster Somerset 12 91 22 5 130 554,100 18.6 23.5 South West 1048 181 1229 5,301,000 19.8 23.2 Federation and Somerset Pharmacies, Dispensing GP and population figures as at July 2014, rounded to nearest 100 South West Pharmacies and Dispensing GP figures as at March 2013; population mid-2011 ONS estimate rounded to nearest 1000 The number of pharmacies per 100,000 in Chard, Crewkerne and Ilminster is below that for Somerset and the South West region as a whole. However, when the number of dispensing practices and the dispensing branch is included, the provision of pharmaceutical services is seen to be above the rate for the county and the region . Population & context for health The Federation has a lower proportion of the population aged 0-14 than the Somerset average and slightly higher aged 75+. The Federation has low levels of deprivation with no people living in the 10% most deprived areas of Somerset and only 9% in the 20% most deprived areas. Wider determinants of health are generally more favourable than average. The Index of Multiple Deprivation score for the Federation is 15.0. This is much lower than the average for Somerset of 16.9. Mortality, causes and places of death Life expectancy is well above average. Premature mortality is similar to the county average, with 11% of deaths occurring before age 65 compared to 13% Somerset average. Mortality rates in specific groups and for specific conditions are in general much lower than for other areas. A higher than average proportion of people die in their own home. Disease prevalence Disease prevalence is generally lower than expected compared to modelled rates. However the Federation has the highest rates compared to expected levels for hypertension and thyroid conditions. Disease levels compared to the rest of Somerset mirror these patterns. The proportions of people with diabetes, COPD and dementia who have been diagnosed is similar to other areas in the county. Smoking Smoking rates are high with 19% of adults 16+ recorded as smokers compared to 16% Somerset average. Low numbers of smokers go through smoking cessation services. Smoking in pregnancy remains a challenge for the whole county with high rates compared to the rest of England, although a Federation breakdown is not available. Excess weight Rates of excess weight at in school children and adults are in general higher than the county average. The county has the highest rate of overweight children at reception age. Drugs and Alcohol Hospital admissions for drug and alcohol related reasons are similar to the Somerset average. Sexual health Cervical screening rates (25-49y) are better than the county average. Rates of teenage deliveries are similar to the county average. Immunisations Childhood vaccination rates are above average with absolute levels generally increased from last year. DH targets are for 95% uptake for all so there is still room for improvement. Seasonal flu vaccination rates are above average although the Federation achieves the highest rate for vaccination of carers. Screening The Federation has the highest rates of bowel screening in the county. Breast cancer and Cervical screening rates are about average. Rates of inadequate smears have risen slightly since last year and now are one of the worst in the county. On average the Federation has good rates of invitation and checking of those eligible for NHS Health Checks programme, although there is still room to improve against national targets. Notably only 17% of those in the most deprived population quintile are being checked so a greater focus on this population segment is recommended to reduce inequalities. Hospital admission rates Emergency admission rates are in general lower than average although rates for under 18s are one of the highest in the county. The Federation also has the highest rate of elective admissions for under 18s. As a proxy for mental health, emergency hospital admissions for self-harm and mental and behavioural disorders are about average in the county. QIPP Prescribing QIPP Prescribing indicators show a mixed picture in comparison to other Federations. The Federation has the worst (lowest) rates of the county for use of ACE inhibitors - a similar position to last year. Suggested public health areas to prioritise • Increase numbers of smokers referred to smoking cessation services • Increase practice based chlamydia screening rates • Increase delivery of health checks, especially for those in the most deprived population segment Population Growth Chard, Crewkerne and Ilminster lies entirely within South Somerset District, which is projected by the ONS to grow by 3.7% between 2012 and 2018. The population structure is expected to age roughly in line with the county average, with an increase in the population aged 65 to 84 of 21.9%, and of population of 85 and over of 23.1% in the same period. Housing allocations suggest that approximately 1,200 new dwellings are expected in Chard, Crewkerne and Ilminster. Declining household size and limited house building may mean a falling population in some rural parts. Map II.3.1 Housing Developments and Pharmacy Services in Chard, Crewkerne and Ilminster The map indicates the relatively limited scale of housing development expected in Chard, Crewkerne and Ilminster federation, and that the sites of such development are relatively close to existing pharmacies. Map II.3.2 Deprivation and Pharmacy Services in Chard, Crewkerne and Ilminster The map, showing Somerset quintiles of deprivation in the 2010 Index of Multiple Deprivation, indicates that deprivation levels are low across the Federation, and that where deprivation is highest – the areas around Chard, Crewkerne and Ilminster towns – there is good pharmaceutical provision. Chard, Crewkerne and Ilminster Federation shows low levels of deprivation and good levels of pharmaceutical provision. Where population growth is likely to be particularly rapid – in the main towns – there is no evidence that existing pharmaceutical provision could not serve the increase in the period of the PNA. .