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Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 2015-18

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Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 2015-18 Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 2015-18 Current Document Status Version Approving body Health and Wellbeing Board 6.0 Date of formal approval (if Date 08 May 2015 applicable) Review date 01 April 2016 Responsible officer Rebecca Cohen Insert web address where document can be accessed. Location Version History Date Version Author/Editor Comments 31 October 2014 1.0 Draft Rebecca Cohen First draft pre consultation. Draft sent to Cornwall HAWBB and the Isles of November 2014 2.0 Rebecca Cohen Scilly HAWBB prior to consultation. Draft completed for consultation. January 2015 3.0 Rebecca Cohen Rebecca Cohen/Linda March 2015 4.0/5.0 Howarth Minor changes to wording. Final version following consultation and Rebecca Cohen/Linda April 2015 6.0 approval from Cornwall Health and Wellbeing Howarth Board. Comprehensive Impact Assessment Record Date Type of Stage/level Summary of Completed Impact assessment completed actions by Assessment conducted (where taken review date applicable) decisions made Insert Date Initial / Full Complete NFA Insert officer Insert date name Document retention Document retention period E.g. 5 years in hard and electronic copies. Cornwall and Isles of Scilly Pharmaceutical Needs Assessment January 2015 version no. 6 CONTENTS Acknowledgments .......................................................................................... 1 Executive Summary ........................................................................................ 1 1. Introduction 3 1.1 What is a Pharmaceutical Needs Assessment (PNA) 3 1.2 Legislative background 4 1.3 Context for the Pharmaceutical Needs Assessment (PNA) 4 2. Development Process 7 2.1 Introduction 7 2.2 Peninsula PNA Steering Group 7 2.3 Cornwall PNA Steering Group 7 3. Assessing Need: An overview of Cornwall 8 3.1 Introduction 8 3.2 Population 9 3.3 Inequality and deprivation 10 3.4 Transport and infrastructure 12 3.5 Public Health England’s Profile for Cornwall 2014 15 3.6 Child Health Profile for Cornwall 2014 16 4. Assessing need: An overview of the Isles of Scilly 17 4.1 Introduction 17 4.2 Population 17 4.3 Inequality and deprivation 18 4.4 Transport and infrastructure 19 4.5 Views on pharmacy provision on the Isles of Scilly 20 4.6 Public Health England’s Profiles 2014 20 Cornwall and Isles of Scilly Pharmaceutical Needs Assessment January 2015 version no. 6 5. Groups with Protected Characteristics 20 5.1 Introduction 20 5.2 Groups 21 6. Assessing need: Localities 24 6.1 Introduction 24 6.2 Rationale for localities 24 7. The current provision of pharmaceutical services 25 7.1 Introduction 25 7.2 Defining NHS Pharmaceutical Services and commissioning arrangements 29 7.3 Providers of pharmaceutical services in Cornwall and the Isles of Scilly 32 7.4 Community pharmacy in Cornwall and the Isles of Scilly 32 Community Network Area Summaries: Bodmin 36 Bude 41 Camelford 46 Caradon 51 China Clay 56 Cornwall Gateway 61 Camborne, Pool and Redruth 66 Falmouth and Penry 71 Hayle and St Ives 76 Helston and Lizard 81 Liskeard and Looe 86 Launceston 91 Newquay and St Columb 96 West Penwith 101 St Agnes and Perranporth 106 St Austell and Mevagissey 111 St Blazey, Fowey and Lostwithiel 116 Truro and Roseland 121 Wadebridge and Padstow 126 Isles of Scilly 131 8. Future needs of pharmaceutical services 13 4 8.1 Introduction 13 4 8.2 Known future needs in Cornwall & the Isles of Scilly 13 4 8.3 The Changing Director of Pharmaceutical Provision Locally 13 4 8.4 Transformation of Primary Care 13 5 8.5 Rural Pharmaceutical Service Provision (Dispensing Doctors) 13 6 Cornwall and Isles of Scilly Pharmaceutical Needs Assessment January 2015 version no. 6 8.6 The role of the PNA in enabling ‘the future’ 13 6 9. Consultation 13 6 10. Conclusions 13 7 Appendices 1. Glossary 2. List of Community Pharmacies in Cornwall (August 2014) 3. List of Dispensing Practices (GPs) October 2014 4. Maps 5. Consultation Feedback Cornwall and Isles of Scilly Pharmaceutical Needs Assessment January 2015 version no. 6 Acknowledgments The development of this Pharmaceutical Needs Assessment (PNA) was overseen by the Peninsula PNA Steering Group (see 2.2 for Members). The author of this report would like to thank Members of the Steering Group for their considerable input and support throughout the process. Special thanks go to Sarah Ogilvie (Specialty Registrar in Public Health, Plymouth City Council) who oversaw the PNA process across the Peninsula in conjunction with the PNA Steering Group and Ian Tyson (Public Health, Torbay Council) and Kevin Noble (PharmOutcomes) for setting up and administering the pharmacy questionnaire via PharmOutcomes. The author would also like to thank members of the Cornwall PNA Steering Group for their considerable input and Linda Howarth (Information Analyst, Public Health, Cornwall Council) for analysing the pharmacy data and contributing significantly to the write-up of this section (Section 7). Executive Summary The production and publication of a PNA became a statutory requirement in the Health Act 2009. Following the abolition of Primary Care Trusts in 2013 this statutory responsibility was passed to Health and Wellbeing Boards (HWB) by virtue of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013, which came into force on 1st April 2013. Pharmaceutical services are provided across primary, secondary and community care settings. Pharmacy has much more to offer than the safe and effective dispensing of medicines. It is increasingly expanding its provision of additional clinical services, becoming a persuasive force in improving the health and wellbeing of individuals and communities, and reducing health inequalities. The PNA is a statement of needs for pharmaceutical service provision within the HWB area. This mapping of pharmaceutical services against local health needs will be used by NHS England in its determination as to whether to approve applications to join the pharmaceutical list under The National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 as well as applications to change existing services. It will enable local pharmaceutical service providers and commissioners to: • Understand the pharmaceutical needs of the population • Gain a clearer picture of pharmaceutical services currently provided • Make appropriate decisions on applications for NHS pharmacy contracts • Commission appropriate and accessible services from community pharmacy • Clearly identify and address any local gaps in pharmaceutical services • Target services to reduce health inequalities within local health communities For the purposes of this PNA Cornwall and the Isles of Scilly have been divided into twenty distinct areas. 19 of these areas are termed Community Network Areas (CAN) which are groupings of parishes and electoral divisions that have been developed as part of Cornwall’s ‘Localism’ agenda. The remaining area covers the Isles of Scilly. For each area, all providers of pharmaceutical services were identified. In the main, these are community pharmacies, and GP dispensing practices which provide valuable dispensing services in more rural areas of Cornwall and the Isles of Scilly. 24-hour access to urgent medicines is currently provided by the out of-hours service. Cornwall and Isles of Scilly Draft Pharmaceutical Needs Assessment 1 27 November 2014 version no. 4 The community network headline profiles and health profiles form the basis of the local priorities for pharmaceutical services. Where gaps in service provision have been identified, the document clearly states how the gap can be filled, mainly by working with existing providers to improve provision and quality of local service delivery. Pharmaceutical service provision within each area has been assessed for adequacy under locally-agreed criteria. A scoring system based on the level of access, service provision, reasonable choice, and future adequacy has been used to ensure a consistent approach. Taking into account the rural nature of Cornwall and the Isles of Scilly and the associated challenges that inherently exist, there is generally good provision and access to pharmaceutical services. • There are 104 pharmacies in Cornwall and the Isles of Scilly serving an estimated population of 540,100 (537k Cornwall and 2.2k Isles of Scilly). Of these, 2 are non- NHS pharmacies. • Over 85% of pharmacies surveyed delivered ‘Medicine Use Reviews’ (MURs) and New Medicines Service (NMS); part of the ‘Advanced Services’ offer. • ‘Locally Commissioned Services’ (i.e. services not commissioned by NHS England) are delivered by many pharmacies throughout Cornwall and the Isles of Scilly, and are largely in keeping with need. However, there are opportunities for all pharmacies to further develop provision to support improving population health and wellbeing. This will help ensure that the needs of specific areas are met in an accessible and cost- effective manner which further utilises the skills and expertise of community pharmacists. • The majority of services are delivered in the most densely populated areas of Cornwall and the Isles of Scilly. In the main, these are also the areas with highest levels of socio-economic deprivation and ill-health. Service delivery must continue to be in line with population growth and need. • The population of Cornwall and the Isles of Scilly is steadily increasing, and there is substantial housing development in some areas. The assessment made in this PNA concludes that there are no current pharmaceutical
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