Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 2015-18
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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
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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.
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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 needs that cannot be met by existing contractors, and that improvements and better access in the future would be best addressed in the first instance through working with existing contractors
It is increasingly recognised that community pharmacists and pharmacy services have an important role to play in supporting the transformation of primary care and have a fundamental and more substantive role to play in the developing Health and Social Care system. “Health on the High Street: rethinking the role of community pharmacy” places emphasis on the significant and increased role that community pharmacy has to play in ensuring a sustainable healthcare system. It also highlights the importance of integrating the role of community pharmacy with that of other elements of the health and public health system. Given this role it is felt that the focus moving forward should be on:
• Communication: o To work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. o To work with pharmacy contactors to improve awareness of available translation services. • Development of Services: o To work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods. o To work with local pharmacies to ensure that EEFO accreditation is achieved across Cornwall.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 2 January 2015 version no. 6
1. Introduction
1.1 What is a Pharmaceutical Needs Assessment (PNA)
1.1.1 A Pharmaceutical Needs Assessment (PNA) is a comprehensive assessment of the current and future pharmaceutical needs of the local population for community pharmacy, dispensing appliance contractors, and dispensing doctors in rural areas where relevant.
1.1.2 Any person (pharmacist, dispenser of appliances or a GP (normally in rural areas)) who wishes to provide NHS pharmaceutical services must apply to NHS England to be included on a pharmaceutical list. This process is known as the NHS market entry system and is overseen locally by the NHS South of England Regional Team (hereafter referred to as the Regional Team).
The Regional Team is responsible for commissioning pharmacies, GP services, dental services, and some aspects of optical services, as well as military and prison health. The PNA is used primarily to:
• make decisions regarding which NHS funded services need to be provided by local community pharmacies and other providers, • make decisions as to whether new pharmacies or services are needed, • inform decision-making about the relocation of existing premises in response to applications by businesses, including independent owners and large pharmacy companies, • inform the commissioning of locally enhanced services from pharmacies.
1.1.3 Providers of pharmaceutical services will use the PNA to inform their applications to provide pharmaceutical services, by demonstrating that they are able to meet a pharmaceutical need as set out in the local PNA. There are exceptions to this, such as applications for needs not foreseen in the PNA or to provide pharmaceutical services on a distance selling (internet or mail order only) basis. Decisions regarding provider applications are made by the Regional Team the decisions made by the Regional Team can be appealed with the Family Health Services Appeal Unit (FHSA). The FHSA will determine appeals against decisions in accordance with the NHS (Pharmaceutical Services) Regulations 2005, the NHS (Pharmaceutical Services) Regulations 2012 and the NHS (Pharmaceutical & Local Pharmaceutical Services) Regulations 2013 concerning the provision of NHS pharmaceutical services. Consequently, it is important to have an up-to-date and locally relevant PNA.
1.1.4 This PNA will serve several key purposes. In accordance with the NHS (Pharmaceutical Services and Local Pharmaceutical Services) Regulations 2013, it will 1:
• Be used by NHS England when making decisions on applications to open new pharmacies and dispensing appliance contractor premises; or applications from current pharmaceutical providers to change their existing regulatory requirements, • Help the HWB to work with providers to target services to the areas where they are needed and limit duplication of services in areas where provision is adequate,
1 Primary Care Commissioning ‘Pharmaceutical needs assessments.’ March 2013. Available at: http://www.pcc-cic.org.uk/ Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 3 January 2015 version no. 6 • Inform interested parties of the pharmaceutical needs in Cornwall and the Isles of Scilly and enable work to plan, develop and deliver pharmaceutical services for the population, • Inform commissioning decisions by local commissioning bodies including local authorities (public health services from community pharmacies), NHS England and Clinical Commissioning Groups (CCGs).
1.2 Legislative background
1.2.1 The Health Act 2009 required NHS Primary Care Trusts (PCTs) to publish their first PNA by 1 February 2011. However, the Health and Social Care Act 2012 abolished PCTs and gave local authorities responsibility for local population health improvement. Health and Wellbeing Boards (HWBs) were established to bring together local commissioners of health and social care, elected representatives and representatives of Healthwatch to agree an integrated way to improving local health and wellbeing.
1.2.2 The Health and Social Care Act 2012 2 transferred the statutory responsibility to develop and update PNAs from PCTs to HWBs from 1 April 2013. This means that the HWB’s for Cornwall and the Isles of Scilly, in conjunction with Cornwall Council and the Council for the Isles of Scilly, have a legal duty to ensure the production of a PNA for Cornwall and the Isles of Scilly. Responsibility for using PNAs as the basis for determining market entry to a pharmaceutical list transferred from PCTs to NHS England from 1 April 2013. HWBs must ensure that the NHS Commissioning Board (NHSCB) and the Regional Teams have access to their PNAs.
1.2.3 HWBs are required to publish their first PNA by 1 April 2015. The Board must publish a statement of its revised assessment within three years of its previous publication or sooner if changes to the need for pharmaceutical services are identified which are of significant extent.
1.3 Context for the Pharmaceutical Needs Assessment (PNA)
1.3.1 The Health and Social Care Act 2012 also amended the Local Government and Public Involvement in Health Act 2007 to introduce duties and powers for HWBs to produce Joint Strategic Needs Assessments (JSNAs). The aim of JSNAs is to improve the health and wellbeing of the local community and reduce inequalities for all ages. 3 They are a continuous process of strategic assessment for the health and wellbeing needs of the local population. The JSNA is used to determine what actions local authorities, the NHS and other partners need to take to meet health and social care needs and to improve health outcomes and address health inequalities. In light of this, the PNA should help inform and be informed by local JSNAs, as well as other plans for health and social care and locally relevant strategies. Current guidance outlines that, whilst PNAs are a separate statutory requirement and cannot be subsumed as part of these documents, they can be annexed to them.
1.3.2 In addition to undertaking PNAs and JSNAs though the HWB, local councils are responsible for commissioning certain public health services from community pharmacies. Community pharmacy provides insight into the public’s and patients’ needs and behaviours around a wider group of services and will help to contribute to the production of the JSNA. It is also an important investor in local communities, for example through employment and supporting neighbourhoods and high street economies. The HWB and the local council have a broader strategic role in supporting the development of community pharmacies with an increased role in public health and
2 http://www.legislation.gov.uk/ukpga/2012/7/contents/enacted 3 http://www.cornwall.gov.uk/jsna Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 4 January 2015 version no. 6 improving health and wellbeing. This is highlighted in the new Professional Standards for Public Health Practice for Pharmacy published by the Royal Pharmaceutical Society in March 2014. These standards provide a framework to support pharmacists and their teams in England and Wales to improve public health services, and shape future services and pharmacy roles to deliver quality patient care and improve health outcomes. A discussion of the future of pharmacy provision is provided in Section 8.
Minimum information that must be included in the PNA
1.3.3 The NHS (Pharmaceutical Services and Local Pharmaceutical Services) Regulations 2013 4 set out the legislative basis for producing and updating PNAs. This includes a list of minimum information that must be included in the PNA under Schedule 1 of the Regulations (Table 1) and requirements for appropriate consultation.
Table 1: SCHEDULE 1 – Information to be contained in PNAs
Necessary 1 A statement of the pharmaceutical services that the HWB has services: current identified as services that are provided: provision (a) in the area of the HWB and which are necessary to meet the need for pharmaceutical services in its area (b) outside the area of the HWB but which nevertheless contribute towards meeting the need for pharmaceutical services in its area (if the HWB has identified such services) Necessary 2 A statement of the pharmaceutical services that the HWB has services: gaps in identified (if it has) as services that are not provided in the area of provision the HWB but which the HWB is satisfied: (a) need to be provided (whether or not they are located in the area of the HWB) in order to meet a current need for pharmaceutical services, or pharmaceutical services of a specified type, in its area (b) will, in specified future circumstances, need to be provided (whether or not they are located in the area of the HWB) in order to meet a future need for pharmaceutical services, or pharmaceutical services of a specified type, in its area Other relevant 3 A statement of the pharmaceutical services that the HWB has services: current identified (if it has) as services that are provided: provision (a) in the area of the HWB and which, although they are not necessary to meet the need for pharmaceutical services in its area, nevertheless have secured improvements, or better access, to pharmaceutical services in its area (b) outside the area of the HWB and which, although they do not contribute towards meeting the need for pharmaceutical services in its area, nevertheless have secured improvements, or better access, to pharmaceutical services in its area (c) in or outside the area of the HWB and, whilst not being services of the types described in sub-paragraph (a) or (b), or paragraph 1, they nevertheless affect the assessment by the HWB of the need for pharmaceutical services in its area
4 http://www.legislation.gov.uk/uksi/2013/349/contents/made Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 5 January 2015 version no. 6 Improvements and 4 A statement of the pharmaceutical services that the HWB has better access: gaps identified (if it has) as services that are not provided in the area of in provision the HWB but which the HWB is satisfied: (a) would, if they were provided (whether or not they were located in the area of the HWB), secure improvements, or better access, to pharmaceutical services, or pharmaceutical services of a specified type, in its area (b) would, if in specified future circumstances they were provided (whether or not they were located in the area of the HWB), secure future improvements, or better access, to pharmaceutical services, or pharmaceutical services of a specified type, in its area Other NHS services 5 A statement of any NHS services provided or arranged by a local authority, the NHSCB, a CCG, an NHS trust or an NHS foundation trust to which the HWB has had regard in its assessment, which affect: (a) the need for pharmaceutical services, or pharmaceutical services of a specified type, in its area (b) or whether further provision of pharmaceutical services in its area would secure improvements, or better access, to pharmaceutical services, or pharmaceutical services of a specified type, in its area How the 6 An explanation of how the assessment has been carried out and, assessment was in particular: carried out (a) how it has determined what are the localities in its area; (b) how it has taken into account (where applicable) (i) the different needs of different localities in its area, and (ii) the different needs of people in its area who share a protected characteristic (c) a report on the consultation that it has undertaken Map of provision 7 A map that identifies the premises at which pharmaceutical services are provided in the area of the HWB Source: NHS Regulations 2013
1.3.4 In accordance with the above Regulations, it is not within the scope of the PNA to include all providers of pharmaceutical services but to focus on providers included in the pharmaceutical list and dispensing doctors who are listed separately. Pharmaceutical services provided by acute or community hospitals, or their subcontracting arrangements, such as Homecare medicines providers, are therefore excluded from this Needs Assessment. The ‘inclusion and exclusion criteria’ for mapping providers of pharmaceutical services are summarised below:
Providers of pharmaceutical services included in the PNA:
• Community pharmacies • Distance selling pharmacies • Dispensing doctors (dispensing GP practices) • Dispensing appliance contractors • Providers of pharmaceutical services excluded from the PNA: • Acute hospital pharmacy provision • Outpatient pharmacy units • Community hospital pharmacy provision • Homecare medicines providers
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 6 January 2015 version no. 6 2. Development Process
2.1 Introduction
2.1.1 This section outlines the process followed for the production of the PNA. This was largely dictated by current legislation regarding what should be included in a PNA (Table 1). The Department of Health has developed an Information Pack for Local Authority Health and Wellbeing Boards 5 to guide the PNA process. This has no statutory standing, nor does it constitute non-statutory guidance, but was used to support Cornwall and the Isles of Scilly to interpret and implement their duty with regard to this PNA.
2.2 Peninsula PNA Steering Group
2.2.1 The Peninsula PNA Steering Group was established to agree a consistent approach to producing the PNA in accordance with current legislation but with locally relevant format. Group membership consisted of:
• Dave Bearman, Chair, Devon, Cornwall and Isles of Scilly Pharmacy Local Professional Network • Sue Taylor, Chief Officer, Devon Local Pharmaceutical Committee • James Glanville, Assistant Contracts Manager, NHS England, South Region – South West • Janet Newport, Contracts Manager, NHS England, South Region – South West • Karen Acott, Executive Partner, Wallingbrook Health Group (dispensing practice representative) • Rob Nelder, Consultant in Public Health Intelligence, Plymouth City Council • Sarah Ogilvie, Specialty Registrar in Public Health, Plymouth City Council • Ian Tyson, Health Improvement and Quality Manager, Public Health, Torbay Council • Steven Brown, Assistant Director of Public Health, Devon County Council • Ian Tearle, Principal Public Health Specialist, Devon County Council • Kirsty Priestley, Senior Public Health Information Analyst, Devon County Council • Stuart Bourne, Acting Director of Public Health, Cornwall Council and Council of the Isles of Scilly • Phillip Yelling, Chief Officer, Cornwall and Isles of Scilly Local Pharmaceutical Committee
2.2.2 The Steering Group was established in March 2014 with a deadline of October 2014 for completion of the final draft prior to consultation. The group met at regular intervals throughout PNA development. Each stage was discussed and agreed by all Members of the Steering Group. A project plan and Gantt chart were drawn up to guide the process and establish individuals’ roles and contributions. The HWB’s for both Cornwall and the Isles of Scilly were kept informed of the process followed and the report’s progress through briefings.
2.3 Cornwall and the Isles of Scilly PNA Working Group
A time limited PNA Working Group was also established to take forward the operational work in Cornwall and the Isles of Scilly for 2014/15. The group
5 https://www.gov.uk/government/organisations/department-of-health Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 7 January 2015 version no. 6 established in March 2014 met monthly to review how best to progress the PNA locally. The Group included:
• Stuart Bourne, Acting Director of Public Health, Cornwall Council and Council of the Isles of Scilly • Phillip Yelling, Chief Officer, Cornwall and Isles of Scilly Local Pharmaceutical Committee • Rebecca Cohen, Advanced Information Analyst, Public Health, Cornwall Council • Linda Howarth, Advanced Information Analyst, Public Health, Cornwall Council • Paul Hughes, Senior Pharmaceutical Advisor, Prescribing and Medicines Optimisation Team, NHS Kernow Clinical Commissioning Group • Martin Priest, General Practitioner (GP), Petroc Group Practice, and Cornwall and Isles of Scilly Local Medical Committee Representative
3. Assessing Need: An overview of Cornwall
3.1 Introduction
Cornwall is a maritime area, set on the most south westerly tip of the South West peninsula, covering an area of 3,559 sq. km. It is the second largest local authority area in the South West region, and has the longest coastline of all English counties at 697 km. Cornwall itself has a distinctive peninsular form with a long indented coastline. The sea forms the northern, southern and western boundaries, with the River Tamar forming the eastern border with Devon.
It encompasses a diverse environment and rich economic and cultural history; the quality of which attracts residents, visitors and businesses alike. Cornwall is an area of many contrasts; with varied landscapes with remote rural, costal and environmentally sensitive areas, interspersed with villages and historic market towns; where affluence sit’s alongside some of the most disadvantaged areas in England.
Famous the world over for its ‘mining industrial heritage’ recognised through its world heritage status, Cornwall’s fame now stretches beyond its historic accolades to the influential role it now plays in environmental protection and technologies, the arts, alongside the growing role and reputation of its academic institutions.
Since 1 April 2009 Cornwall has had a single tier administration. Cornwall Council is a Unitary Council, meaning that the Council is responsible for all local services and functions within its area. The Council has 123 Councillors, working with and supported by 213 Parish Councils. There are also currently six parliamentary constituencies in Cornwall.
Cornwall has a dispersed settlement pattern with over 40% of the population living in settlements of less than 3,000 population. While Cornwall’s larger towns are small in a national context they are no less urban.
The larger settlements/conurbations are Camborne, Pool, Illogan and Redruth, Falmouth and Penryn, St Austell, Truro and Threemilestone, Newquay, Penzance and Saltash. These larger towns contain over 30% of the population.
Our settlement pattern fundamentally influences most of the characteristics and challenges and opportunities that Cornwall faces.
A map showing settlement patterns in Cornwall is set out in appendix 1.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 8 January 2015 version no. 6
• Cornwall’s settlements pattern is dispersed, with over 40% of people living in settlements of less than 3,000 population. The range and number of settlements provides strong challenges to service delivery and the understanding of communities’ needs and aspirations.
3.2 Population
Cornwall’s population has been growing steadily since the 1960’s. Current estimates (2013) suggest that Cornwall’s population stands at around 541,319 and it is estimated to reach 616,796 by 2030 6, an increase of 75,477 (13.9%). This growth is predicted to be driven by migration, largely due to more people moving in than out, but also importantly due to a decline in the number of people leaving Cornwall. The highest numbers of inward migrants are predominantly persons of working age which is contrary to common perceptions that people who move in to Cornwall are predominately retired or elderly.
Like the rest of the South West region, the population of Cornwall is not only gradually increasing but also changing demographically. In line with national trends Cornwall's population is getting older as average life expectancy continues to rise and it is projected that 1 in 4 will be aged 65+ by 2019. The most recent population estimates suggest that there are 125,448 people aged over 65 in Cornwall 7, which is just over 23% of the total population. There are higher proportions of older people on the south coast and in more affluent rural villages, such as the St Just in Roseland area, St Mawes, alongside some areas in or near town centres, which are closer to service points – Bude Poughill, the Wherrytown area in Penzance, Penponds in Camborne, and St Austell Bethel, Holmbush and Sandy Hill.
Conversely, Cornwall has fewer younger people than the UK average. Historically Cornwall has experienced high levels of outward migration of those between the ages of 16-29, which accounts in some part for the low figures. However, the expansion in
6 2012-based subnational population projections and Mid Year Population Estimates, Population Estimates Unit, ONS: Crown Copyright 2010. 7 2013 Mid-year Estimates, ONS Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 9 January 2015 version no. 6 the higher education infrastructure and better employment prospects has led to reductions of younger people leaving Cornwall and increasingly greater numbers of younger people moving to Cornwall. These trends are neither fixed or guaranteed, and are fragile.
Despite overall growth, population growth isn’t consistent across all areas of Cornwall. Many coastal communities have shown a population decline, linked, although not exclusively, with holiday homes. The most notable decline was in the Torpoint HMS Raleigh (LSOA) at -60% between 2001 and 2013, compared to the Saltash East Pill LSOA which doubled in this period.
Across Cornwall, about 1.8% of the population in 2011 described themselves as being of Mixed, Asian/Asian British, Black/Black British, Chinese or other ethnic group, compared to 4.6% on average across the Region and 14% across England and Wales.
Population Pyramids showing the changes in the age of Cornwall’s population between 1991 and 2011 are set out below.
• The population of Cornwall is not only gradually increasing but also changing demographically - in line with national trends Cornwall's population is getting older as average life expectancy continues to rise. • Fewer young people are leaving Cornwall - historically Cornwall has experienced high levels of outward migration of those between the ages of 16-29. However, the expansion in the higher education infrastructure and better employment prospects has led to reductions of younger people leaving Cornwall. These trends are neither fixed or guaranteed, and are fragile. • Contrary to popular belief, inward migration is predominately for economic
and lifestyle reasons, not retirement purposes - many of those moving to Cornwall are returners and there is every reason, and some evidence to believe this is still a strong trend.
3.3 Inequality and deprivation
Cornwall is an area of contrast, with concentrations of both visible wealth as well as significant visible and hidden poverty. Around 52,000 people (10% of the population of Cornwall) live in ‘deprived’ communities according to the national measure of
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 10 January 2015 version no. 6 deprivation; the Index of Multiple Deprivation 8. Many people living in these areas will experience issues associated with lower incomes, higher unemployment rates, ill health, child poverty, low qualifications, poorer housing conditions and higher crime rates.
A significant number of these deprived communities are in town areas, however, not all deprived people live in deprived areas. There are likely to be a number of people experiencing issues associated with deprivation in rural areas who are not identified through national measures as the rural nature of Cornwall, along with its dispersed population, make areas of need and ‘hot-spots’ difficult to identify.
The effects of deprivation are often cumulative and intergenerational. Those who are in persistent poverty i.e. poor for a long time, are most at risk of social exclusion.
People living in a deprived area have a life expectancy of up to 8 years shorter than affluent areas in Cornwall. The 2010 Marmot Review ‘Fair Society Healthy Lives’, highlighted that people living in deprived areas are also more likely to suffer from illnesses like chronic obstructive pulmonary disorder, heart disease and suffer from mental health problems such as anxiety and depression.
Cornwall as a whole is not particularly deprived; ranking 110 out of 326 local authorities 9. However, there are wide geographic variations between areas; Pengegon in Camborne is within the 2% most deprived areas in England and Latchbrook South (Saltash) is at the other end of the spectrum at 94%.
8 defined as the 20% most deprived areas in England 9 based on rank of average score, where 1 is most deprived Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 11 January 2015 version no. 6 • There are pockets of deprivation but Cornwall as a whole is not deprived - Cornwall as a whole is not deprived but there are areas where there are very high levels of deprivation and this has not changed for some years. There is a relationship between living in a disadvantaged area and worse outcomes across a range of issues
including education, crime and health. • Life expectancy is lower in deprived areas and the gap is increasing - the gap or difference between the life expectancy of the most and least deprived areas is increasing in Cornwall and Isles of Scilly, with life expectancy increasing fastest in the least deprived groups.
3.4 Transport and infrastructure
Cornwall is a peripheral area, which has a dispersed settlement pattern. These factors, combined with Cornwall’s coastline, highlight issues of accessibility which present challenges in delivering and maintaining the transport infrastructure to ensure transport options are available to our residents, businesses and visitors.
Transport facilities and access to services play an important role in quality of life and the functioning of communities and the local economy. Rural accessibility issues do occur in parts of Cornwall and studies show that limited access to transport, particularly in rural areas, can lead to isolation, social exclusion and severely restrict people’s quality of life and life chances. The dispersed settlement pattern of Cornwall presents challenges for the provision of appropriate transport infrastructure, the viability and accessibility of local services, and employment opportunities.
Cornwall has over 7,500 classified roads and 189 km of trunk roads, namely the two main spinal routes which provide links to the rest of England in Cornwall, the A38 which enters at Saltash passing through Liskeard and ending at Bodmin and the A30, Cornwall's main road which enters Cornwall at Launceston and ends at Land's End. These are supported by a significant network of roads which link the trunk road network with the main towns and settlements, however, a high percentage of these roads are lower classification or unclassified roads.
The proportion of Cornwall’s households without access to a car or van is relatively low, mainly due to high levels of car and van ownership which reflects Cornwall’s rural nature where conventional public transport is often not viable. Between 1970 and 2008 traffic growth in Cornwall has reflected the national trend of continuous growth. However, Traffic growth is not evenly distributed over the county’s road network and is concentrated on our major roads. There are also strong seasonal variations in traffic volumes within the road network; influenced by holiday and day visitors.
Cornwall’s only major civilian airport, Newquay Cornwall Airport, is owned by the Council and provides links with both domestic and European destinations and to the Isles of Scilly. In 2010 over 285,000 passengers flew from Newquay making it the 4th busiest airport in the South West Region.
Mainline train services run through the centre of Cornwall, supported by five branch lines. The number of passengers using branch line services across Cornwall have nearly doubled between 2009/10 and 2012/13. Convergence funding has helped to improve the Truro to Falmouth line providing extra capacity to meet growing travel demands and, during the same period, saw traffic rise by 37.8 percent (third-highest growth in England). However, the rail network west of Exeter has seen little investment in infrastructure improvements and currently suffers from low line speeds and capacity limitations due to signalling and gauge restrictions, which impact on both passenger services and freight movements.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 12 January 2015 version no. 6 As a maritime area, Cornwall also has a number of year-round ferry links providing vital links between coastal towns as well as strategically important ferry links such as the Torpoint ferry and Isles of Scilly sea ferry.
Cornwall’s scenic landscape and coastline make it popular for walkers, cyclists and equestrians alike. The rights of way network in Cornwall totals 4,388 km with an additional 491 km of coastal path.
The installation of a superfast broadband network across Cornwall is the largest ever build of a superfast broadband infrastructure in a rural area anywhere in the world 10 ; presenting numerous opportunities, such as encouraging start-ups and facilitating business growth and homeworking.
• Cornwall’s geographical shape and position make infrastructure delivery challenging - dispersed settlement patterns, coastal inlets and the long peninsula form present challenges for the provision of appropriate transport infrastructure, the viability and accessibility of local services, and employment opportunities. • Superfast broadband opens employment and new market opportunities - reliable internet access is vital for business and education, and will help to promote social inclusion and ensure the sustainability of our rural communities. 11 • Car ownership in Cornwall is not a sign of wealth – high proportions of car ownership reflects Cornwall’s rural nature where conventional public transport is often not viable. Over 60% of cars in Cornwall are over 6 years old 19 reflecting the fact that for many the car is an expensive necessity rather than a luxury.
10 www.superfastcornwall.org 11 DVLA, Licensed Vehicles by year of registration, 2010 Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 13 January 2015 version no. 6 3.5 Public Health England’s Profile for Cornwall 2014
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 14 January 2015 version no. 6 3.6 Child Health Profile for Cornwall 2014
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 15 January 2015 version no. 6 4. Assessing Need: An overview of the Isles of Scilly
4.1 Introduction
The Isles of Scilly comprise over 200 granite islands scattered across 200 km², set out in the Atlantic some 45 km south-west of Land’s End. Five islands are permanently inhabited (St Mary’s, St Agnes, St Martin’s, Tresco and Bryher) and each of these has their own unique character and distinct identity. The occupied islands cover a total area of just over 14 km².12
Scilly has a resident population of just over 2,200 people, approximately 360 of which are aged 18 or under. Scilly has a rich cultural history that, over time, has seen the island gain their fair share of exposure both locally and nationally and at times even internationally.
The Council for the Isles of Scilly is an independent unitary authority and oversees the administration of services, however, due to efficiencies a number of services are delivered jointly with Cornwall Council, NHS Kernow and health trusts.
The Council has 21 Councillors, thirteen from St Mary's and two from each of the remaining islands of St Martins, St Agnes, Tresco and Bryher. Scilly is also represented by the St Ives parliamentary constituency.
4.2 Population
The Islands support a resident population of around 2,200. The population of the Islands declined in the 1980s but has been slowly increasing since then, with nearly all of the growth being on St Mary’s. It is estimated that 1,700 live on St Mary’s, 175 on Tresco, 135 on St Martin’s and 170 on Bryher and St Agnes.
Whilst the resident population growth may have been slow, every year the Islands are visited by over 100,000 tourists, which include day visitors and those who stay for a longer holiday period. It is estimated that between 70 and 85 percent of the islands’ economy is tourism related.
As with its mainland neighbour (Cornwall), Scilly has an aging population with the percentage of those aged 65+ exceeding the average for England and Wales. The proportion of older working aged people, i.e. 45-64 is also in excess of the national average. Conversely, the number of children and young people (0-19) on the Isles of Scilly are fewer than proportions across England and Wales (17% compared to 24%). A contributing factor to this is access to further and higher education provision i.e. 16+, which is only available on the mainland. The impact can be seen on the chart below where the 2.5% of the population is aged 15-19 on Scilly compared to 6.3% across England and Wales.
12 Natural England: National Character: Area Profile 158 Isles of Scilly, publications.naturalengland.org.uk/file/6631520605306880 Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 16 January 2015 version no. 6 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 10 5 0 5 10 Percentage of total population
England & Wales Female % IoS Female % England & Wales Male % IoS Male %
Across the Isles of Scilly, about 1.2% of the population in 2011 described themselves as being of Mixed, Asian/Asian British, Black/Black British, Chinese or other ethnic group, compared to 4.6% on average across the Region and 14% across England and Wales.
• The population of the Isles of Scilly is not only gradually increasing but also changing demographically - in line with national trends the population is getting older as average life expectancy continues to rise. • The proportion of young people is low - a contributing factor to this is access to further and higher education provision i.e. 16+, which is only available on the mainland. • Tourism plays a key role on the Isles of Scilly - every year the Islands are visited by over 100,000 tourists and it is estimated that between 70 and 85 percent of the islands ’ economy is tourism related
4.3 Inequality and deprivation
Deprivation is frequently measured in England by the Index of Multiple Deprivation (IMD). This combines income, employment, education, barriers to housing and services, crime, living environment, and health and disability into a measure that compares one geographical area with another. However, this approach was primarily developed with urban centred deprivation in mind and, as such, does not provide a clear picture of rural deprivation where deprivation is more scattered and, therefore, does not provide a true reflection of the challenges faced on the Isles of Scilly.
The IMD does, however, highlight two domains of deprivation which rank highly on the Isles of Scilly, namely Access to Services where Scilly ranks 43 out of 32,482 and Living Environment where Scilly features highly for housing conditions (mainly due to lack of access to mains gas). Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 17 January 2015 version no. 6
Living on the Islands also incurs additional costs in travel and the extra freight charge incurred on imports. There is no shortage of evidence indicating that residents generally have a below average income and above average cost of living expenses 13 .
The cost of living means money doesn’t go as far on Scilly as it does on the mainland, £100 spent in the local co-op will purchase far less than the same amount spent on similar products in a mainland supermarket. Likewise the cost of building can be in excess of 50% more expensive on Scilly.
• The peripheral nature of the Islands has a cost - living on the Islands incurs
additional costs in travel and the extra freight charge incurred on day to day imports
such as food.
• There are pockets of deprivation but the Isles of Scilly as a whole is not
deprived - residents generally have a below average income and above average cost of living expenses. Access to services and housing conditions i.e. insulation, lack of mains gas and fuel poverty are however, cited nationally as key components of deprivation on Scilly.
4.4 Transport and infrastructure
The isolated nature of the Isles of Scilly means that transport links to the mainland are significant in bringing resources and tourists to the islands. The islands are linked to the mainland by air and sea services, and boat services provide inter-island connections.
By sea, the Isles of Scilly Steamship Company provides a passenger and cargo service from Penzance to St Mary's (journey time to the islands: 2 hours 45 minutes). The A30 main road link and main rail lines also run to Penzance, providing important access via the ferry link to the rest of the country for the export of island produce and import of resources.
Air access to the islands is via St. Mary's Airport. Fixed-wing aircraft services, operated by Isles of Scilly Skybus, connect to Land's End (journey time: 15 minutes), Newquay and Exeter.
St. Mary's is the only island with a significant road network; in 2005 there were 619 registered vehicles on the island. The island also has taxis and a community bus service. On St Mary's you can hire electric powered golf cart type buggies for use on the island's metalled road network.
• The location and topography make infrastructure delivery challenging - good transport links (inter-island and mainland) are important for residents and visitors to get to services. Furthermore reliable transport links are vital to ensure that pharmaceutical supplies and continuity of supply for medicines is critical for a number of people who rely on specific medicines to keep them well. It should be noted that all transport is both expensive and limited in availability by weather.
13 Isles of Scilly CYP Plan, 2011-15 Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 18 January 2015 version no. 6 4.5 Views on Pharmacy provision on the Isles of Scilly
Healthwatch Isles of Scilly undertook a community survey in October 2013. Of the 935 surveys sent out 193 were returned, giving a response rate of just over 20%. The following commentary was given in relation to pharmacy provision on the Islands:
• The majority rated the service as excellent to good and works well. Comments included ‘well organised’, ‘helpful’, ‘obliging and prompt’. • Staff were described as friendly, efficient and helpful, and people appreciate the pharmacists advice. • A number of people liked the new pharmacy premises, describing it as an improvement, but others still think the Health Centre location is inconvenient, i.e. for off islanders, for collecting prescriptions, or for visitors needing travel sickness medicines. • There were adverse comments about opening hours, in particular closing at lunchtime. • Dispensing of prescriptions - some people thought this works well, but more said that processing of repeat prescriptions takes too long, or that they would prefer to collect and pay for a three month supply of ongoing medication rather than one month at a time. • The majority of residents on the Isles of Scilly are positive about pharmacy provision – most rated the service as excellent or good but the location is considered inconvenient by some who feel it should be located more centrally in the Town.
4.6 Public Health England’s Profiles 2014
4.6.1 The small population often means that Scilly doesn’t fit comfortably into national data sets and so it is not possible to produce comparable profile data to that provided for Cornwall.
5. Groups with Protected Characteristics
5.1 Introduction
5.1.1 The PNA regulations require that the needs of people who share a protected characteristic (as defined by the Equality Act 2010) are taken into account when making the assessment. This section details how the needs of these populations have been taken into account in forming the assessment.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 19 January 2015 version no. 6 5.2 Groups
Protected Characteristic How pharmacy can support the specific population Age
Young People: Younger people, have different abilities to Across Cornwall and the Isles of Scilly there metabolise and eliminate medicines from are estimated to be over 146,000 young their bodies. Advice can be given to parents people aged between 0-24 (2012). on the optimal way to use the medicine or appliance and provide explanations on the variety of ways available to deliver medicines.
Pharmacies also play a key role in providing information and access or referral to specialist services relating to
• Smoking • Obesity • Drug/Alcohol • Sexual health incl. c-card scheme • Mental health
Working Age: In people of working age, pharmacies can Working aged is defined as those between play a role in supporting people to change 16-64 years of age. In Cornwall and the Isles their behaviours. For example, pharmacies of Scilly there are estimated to be offering smoking cessation and other health approximately 327,000 people falling within promotion campaigns targeted at this age these age groups. group widen access, especially around working hours. In addition, screening can also help diagnose people earlier and introduce medication or other management at an earlier stage.
Access around working hours requires a coordinated approach by pharmacies to offer pharmacy services at times and locations convenient to the working age population.
Older people: Age has an influence on which medicine and The population structure of Cornwall and the method of delivery is prescribed. Older Isles of Scilly is rather older than the England people have a higher prevalence of illness and Wales average. In 2012 it was estimated and take many medicines. The medicines that there were in excess of 122,000 people management of older people is complicated aged 65+. Other things being equal, the by multiple disease, complex medication demand for pharmacy services is likely to be regimes and the aging process affecting the higher as illness generally increases with age. body’s capacity to metabolise and eliminate medicines from it.
Community pharmacies can support people to live independently by supporting optimisation of use of medicines, support with ordering, re-ordering medicines, home delivery to the housebound and appropriate provision of multi-compartment compliance aids and other interventions such as reminder charts to help people to take their medicines.
Supporting independence by offering: • Supply of daily living aids Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 20 January 2015 version no. 6 Protected Characteristic How pharmacy can support the specific population • Identifying emerging problems with people’s health • Signposting to additional support and resources
Pharmacy staff provide broader advice when appropriate to the patient or carer on medicine, for example, its possible side effects and significant interactions with other substances. The safe use of medicines for children and older people is one where pharmacies play an essential role. Disability
When patients are managing their own • The pharmacy contract includes funding medication but need some support, for reasonable adjustments to the pharmacists and dispensing doctors must packaging or instructions that will support comply with the Equality Act 2010. Where them in self-care. The first step should the patient is assessed as having a long term be a review to ensure that the number of physical or mental impairment that affects medications and doses are reduced to a their ability to carry out every day activities, minimum. If further support is needed, such as managing their medication. then compliance aids might include multi- compartment compliance aids, large print There is no gold standard disability data labels, easy to open containers, source and no single definitive measure of medication reminder alarms/charts, eye disability or chronic illnesses. Estimates of dropper or inhaler aids. disability prevalence and chronic illness vary • Each pharmacy should have a robust between surveys according to the definitions system for assessment and auxiliary aid of disability that are used and the motives of supply that adheres to clinical governance the collector. principles.
The 2011 Census identified that 21.4% or 113,715 people in Cornwall and 14% or 300 people in the Isles of Scilly identified their health as limiting their day to day activities a little or a lot.
Gender Though pharmacy services target both men • EHC for women. and women, there are some services that are • Men are less likely to use health services gender specific. in general, so opportunistic screening, health promotion and public health In Cornwall and the Isles of Scilly there is a interventions should be used to their full slightly higher proportion of females at potential. 51.5% than men at 48.4%. • Community pharmacy is a socially inclusive healthcare service providing a convenient and less formal environment for those who do not choose to access other kinds of health service. Race There are well documented links between • Language can be a barrier to delivering ethnic origin and health, where people from effective advice on medicines, health different ethnic communities have higher promotion and public health interventions. levels of illness for some diseases compared • Community pharmacy is a socially to the general population. In addition, inclusive healthcare service providing a differences in cultural background, language convenient and less formal environment skills and residence time in the new country for those who cannot easily access or do may impact on the access and utilisation of not choose to access other kinds of health health care services. Cornwall and the Isles service. Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 21 January 2015 version no. 6 Protected Characteristic How pharmacy can support the specific population of Scilly are largely white and people in minority groups are often not present in sufficient numbers to form coherent groups. This can result in an unknown demand for services and potentially unmet need.
Religion Across Cornwall and the Isles of Scilly nearly • Pharmacies can provide advice to specific 60% of people stated their religion as religious groups on medicines derived Christian in the 2011 Census, with 30% from animal sources and during periods of stating they had no religious beliefs. 0.3% fasting. stated their religion as Buddhist and 0.1% respectively as Hindu or Jewish.
Pregnancy and maternity In Cornwall and the Isles of Scilly in 2013/14 • Pharmacies can provide advice to there were over 4,500 live births. pregnant mothers on medicines and self- care. They have the expertise on advising which medicines are safe for use in pregnancy and during breast feeding. • Pharmacies are ideally placed to offer antenatal advice and health promotion to newly pregnant women, including helping pregnant women to quit smoking. Sexual orientation There are no accurate statistics available No specific needs are identified. regarding the profile of the lesbian, gay, bisexual and transgender (LGBT) population in either Cornwall or the Isles of Scilly or Britain as a whole. Sexuality is not incorporated into the census or most other official statistics. Nationally it has been estimated that 6-7% of the population is lesbian, gay or bisexual (LGBT). Gender reassignment Pharmacies have an integral role to play for Provision of necessary medicines and advice people undergoing gender reassignment, as on adherence and side effects. most treatments involve medical treatment. Ensuring patients have access to their medications without significant delay is also important.
Studies suggest that approximately one in 30,000 men and one in 100,000 women seek gender reassignment surgery. Marriage and civil partnership Figures from the 2011 Census indicate that of No specific needs are identified. the 272,000 people living as a couple in Cornwall and the Isles of Scilly, 79.5% were married, 19.3% co-habiting and 1.1% in a civil partnership.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 22 January 2015 version no. 6 In addition to these groups there are two further groups identified locally for the purposes of this PNA:
Protected Characteristic How pharmacy can support the specific population Gypsy and Travellers Gypsies and Travellers have significantly • Can access pharmaceutical services poorer health status and significantly more without registering as opposed to using GP self-reported symptoms of ill-health than services. other UK-residents including, English • Provision of over the counter medications, speaking ethnic minorities and economically advice and signposting to other services disadvantaged white UK residents. Health made available as a walk in service problems amongst Gypsies and Travellers without the need for an appointment. are between two and five times more common than the settled community.
According to the 2011 Census, 635 people in Cornwall and the Isles of Scilly identified themselves as being of gypsy or Irish traveller ethnicity; this is 0.1% of the population. Homeless Homeless people have a significantly lower • Can access pharmaceutical services life expectancy compared with the rest of the without registering as opposed to using GP population and experience poorer health services. generally, with particular issues around social • Provision of over the counter medications, isolation, poor access to services, mental advice and signposting to other services health and substance misuse. made available as a walk in service without the need for an appointment.
6. Assessing need: Cornwall and the Isles of Scilly localities
6.1 Introduction
6.1.1 According to the Regulations (2013), the PNA should have regard to the different needs of the different localities, as well as within localities, within the HWB area.
6.2 Rationale for localities
6.2.1 For the purposes of the PNA, there is a requirement to divide the geographical area of Cornwall and the Isles of Scilly into distinct localities for the purposes of identifying local health needs and assessing service provision.
6.2.2 In Cornwall, we have 19 established localities called community networks areas (CNAs). These are based around groupings of parishes and electoral divisions. The 19 community network areas are: Bodmin; Bude; Caradon; Camborne, Pool and Redruth; Camelford; China Clay area; Cornwall Gateway; Falmouth and Penryn; Hayle and St Ives; Helston and the Lizard; Launceston; Liskeard and Looe; Newquay and St Columb; West Penwith, St Agnes and Perranporth; St Austell; St Blazey, Fowey and Lostwithiel; Truro and Roseland; Wadebridge and Padstow
6.2.3 The main advantage of using the CNAs as the PNA Localities was that individual health and social profiles were available. This data allowed comprehensive benchmarking against comparable populations for a variety of health and social markers.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 23 January 2015 version no. 6 6.2.4 Given the challenges of securing small area data it was decided that the Isles of Scilly would, as far as possible, be treated as its own locality.
7. The current provision of pharmaceutical services
7.1 Introduction
7.1.1 The following section defines pharmaceutical services and commissioning arrangements, outlines providers of pharmaceutical services in Cornwall and the Isles of Scilly, and presents the findings of the audit of community pharmacies.
7.2 Defining NHS Pharmaceutical Services and commissioning arrangements
7.2.1 The NHS England Regional Teams commission all services in the NHS Community Pharmacy Contractual Framework (CPCF). 14 For Cornwall and the Isles of Scilly, this is overseen by the South of England Regional Team – South West.15 The CPCF is a regulatory framework based on the Terms of Service set out in the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 and the Pharmaceutical Services (Advanced and Enhanced Services) (England) Directions 2013. The Regional Team is responsible for managing and performance monitoring the CPCF. The CPCF defines three different types of NHS Pharmaceutical Services that are commissioned by the Regional Team – Essential, Advanced and Enhanced services. These are explained in turn below. Other commissioners cannot commission these three services from community pharmacies: they may choose to commission some local services from community pharmacies, but they would be classified as ‘Locally Commissioned Services’ rather than Enhanced services.
14 http://psnc.org.uk/services-commissioning/locally-commissioned-services/which-commissioner/ 15 http://devonlpc.org/nhs-england/area-team-of-devon-cornwall-and-isle-of-scilly/ Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 24 January 2015 version no. 6 ESSENTIAL SERVICES
Legal arrangements: Set out in Part 2, Schedule 4 of the Regulations
Commissioning arrangements: Pharmacy owners (contractors) must provide essential services. They are commissioned by NHS England.
Explanation/examples:
• Dispensing – the safe supply of medicines or appliances. Advice is given to the patient about the medicines being dispensed and how to use them. • Repeat dispensing – the management of repeat medication for up to one year, in partnership with the patient and prescriber. • Disposal of unwanted medicines – pharmacies accept unwanted medicines from individuals. The medicines are then safely disposed of. • Promotion of Healthy Lifestyles (Public health) - opportunistic one to one advice is given on healthy lifestyle topics, such as stopping smoking, to certain patient groups who present prescriptions for dispensing. Pharmacies will also get involved in six local campaigns a year, organised by NHS England. • Signposting patients to other healthcare providers - pharmacists and staff will refer patients to other healthcare professionals or care providers when appropriate. • Support for self-care – the provision of advice and support by pharmacy staff to enable people to derive maximum benefit from caring for themselves or their families. The main focus is on self-limiting illness, but support for people with long- term conditions is also a feature of the service. • Clinical governance – pharmacies must have a system of clinical governance to support the provision of excellent care.
For more information: http://psnc.org.uk/services-commissioning/essential-services/
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 25 January 2015 version no. 6 ADVANCED SERVICES
Legal arrangements: Set out in the Directions.
Commissioning arrangements: Pharmacy contractors can choose whether they wish to provide advanced services. They can be provided by all contractors once accreditation requirements have been met. They are commissioned by NHS England.
Explanation/examples: There are four Advanced Services within the NHS Community Pharmacy Contractual Framework (CPCF):
1. The Medicines Use Review (MUR) and Prescription Intervention Service consists of accredited pharmacists undertaking structured adherence-centred reviews with patients on multiple medicines, particularly those receiving medicines for long term conditions.
2. Appliance Use Review (AUR) can be carried out by a pharmacist or a specialist nurse in the pharmacy or at the patient’s home. AURs should improve the patient’s knowledge and use of any ‘specified appliance’. The service can be provided by pharmacies that normally provide the specified appliances in the normal course of their business. There are a number of conditions that must be satisfied first.
3. Stoma Appliance Customisation (SAC) involves the customisation of a quantity of more than one stoma appliance, based on the patient’s measurements or a template. The aim of the service is to ensure proper use and comfortable fitting of the stoma appliance and to improve the duration of usage, thereby reducing waste. The stoma appliances that can be customised are listed in Part IXC of the Drug Tariff. The service can be provided by pharmacies that normally provide stoma appliances in the normal course of their business. There are a number of conditions that must be satisfied first.
4. The New Medicine Service (NMS) provides support for people with long-term conditions newly prescribed a medicine to help improve medicines adherence; it is initially focused on particular patient groups and conditions. Since its introduction in October 2011, more than 90% of community pharmacies in England have provided it to their patients. Initial funding for the service was agreed until March 2013, and since then funding has been extended pending a decision on the long-term future of the service.
For more information: http://psnc.org.uk/services-commissioning/advanced-services/
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 26 January 2015 version no. 6 ENHANCED SERVICES
Legal arrangements: Set out in the Directions.
Commissioning arrangements: Enhanced services are commissioned by NHS England. Other commissioners can commission some Enhanced services from community pharmacies, but they are classified as ‘locally commissioned services’ (see below).
Explanation/examples: Only those services that are listed within the Directions may be referred to as Enhanced services. If NHS England wishes to commission a service not listed within the Directions then it falls outside the definition of ‘pharmaceutical services’. The commissioning of the following Enhanced services which were listed in the Pharmaceutical Services (Advanced and Enhanced Services) (England) Directions 2012 transferred from PCTs to local authorities with effect from 1 April 2013:
• Needle and syringe exchange • Screening services such as chlamydia screening • Stop smoking • Supervised administration service • Emergency hormonal contraception services through patient group directions
Where such services are commissioned by local authorities they no longer fall within the definition of pharmaceutical services as set out in legislation and are, therefore, called ‘locally commissioned services’. However, the 2013 directions do make provision for NHS England to commission the above services from pharmacy contractors where asked to do so by a local authority. Where this is the case, they are treated as enhanced services and fall within the definition of pharmaceutical services. Currently there are no such Enhanced Services being commissioned in Cornwall by NHS England:
• Anticoagulation monitoring • Care home service • Disease specific medicines management service • Gluten free food supply service • Independent prescribing service • Home delivery service • Language access service • Medication review service • Medicines assessment and compliance support • Minor ailment service • On demand availability of specialist drugs • Out of hours service • Patient group direction service (not related to public health services) • Prescriber support service • Schools service • Supplementary prescribing service
For more information: http://psnc.org.uk/services-commissioning/locally-commissioned- services/
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 27 January 2015 version no. 6 LOCALLY COMMISSIONED SERVICES
Legal arrangements: These services are not part of ‘NHS Pharmaceutical Services’ as defined by the Regulations and, therefore, cannot be described as Enhanced services. The correct description of these services is ‘locally commissioned services’.
Commissioning arrangements: Since April 2013 a number of commissioners have had a role in commissioning services from community pharmacies. Organisations most likely to do so are Clinical Commissioning Groups (CCGs) and Local Authorities (LAs), although as outlined previously there are some grey areas which may result in local variation. Detailed information about contracting arrangements can be found at: http://psnc.org.uk/services-commissioning/locally-commissioned-services/which- commissioner/
The following public health services provided by community pharmacies are commissioned by Cornwall Council in identified areas:
• Needle and syringe programme • EHC and contraceptive services • Stop smoking • Health checks
Local authorities will use their own contracts or the standard public health contract to commission services from community pharmacies. There are a small number of circumstances where a public health service is commissioned by another organisation, e.g. NHS England commissions’ vaccination services from GPs, community pharmacies and other providers. There may also be circumstances where Clinical Commissioning Groups may wish to be involved in commissioning a public health service, due to the impact the service may have on the development or management of long term conditions. This may involve co-commissioning a service, which is likely to happen on a more regular basis as a result of the full introduction of the Better Care Fund in 2015/16.
Clinical Commissioning Groups may wish to commission services such as minor ailments services, palliative care schemes, MUR+ and other medicines optimisation services.
The following services provided by community pharmacies are commissioned by NHS Kernow in identified areas:
• Minor ailments • Emergency supply • Gluten Free service • Domiciliary Visits (pilot)
CCGs have to use the NHS Standard Contract to commission services from community pharmacies. For more information: http://psnc.org.uk/services-commissioning/locally-commissioned- services/
7.3 Providers of pharmaceutical services in Cornwall and the Isles of Scilly
7.3.1 As highlighted above in Section 7, there are a number of different providers of pharmaceutical services across Cornwall and the Isles of Scilly, including:
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 28 January 2015 version no. 6 • Community pharmacies* • GP dispensing practices (relevant to rural areas)* • Dispensing Appliance Contractors* • Minor Injury Units • Out-of-Hours Service • Acute Trust Pharmacy • Homecare Companies • Community Health Service Pharmacists • Distance selling pharmacies*
Those providers that have been starred (*) are within the scope of this PNA and are, therefore, described in more detail below.
7.3.2 Distance Selling Pharmacies
Distance selling pharmacies (sometimes referred to as Internet or online pharmacies) provide pharmaceutical services to a broad population. Patients can order medicines online and have them delivered to them directly via the mail or shipping companies. Distance selling pharmacies also support medicines use and public health initiatives through websites and other communication routes. The National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 detail a number of conditions for distance selling pharmacies in addition to the regulations governing all pharmacies. As compliance with the conditions is a pre-requisite for all distance selling pharmacies to remain on the pharmaceutical list, breach of the conditions could lead to removal from the Pharmaceutical List by NHS England. Distance selling pharmacies must allow for the uninterrupted provision of Essential services during the opening hours of the pharmacy to anyone in England who requests the service. In addition, nothing in any written or oral communication (such as a practice leaflet or any publicity) can suggest, either expressly or impliedly, that services will only be available to persons in particular areas of England, or only particular categories of patients will (or will not) be provided for. See: http://psnc.org.uk/contract-it/market- entry-regulations/distance-selling-pharmacies/ .
There are currently no Distance Selling Pharmacies within Cornwall and the Isles of Scilly. There are, however, two in Plymouth, one at Estover and the other at Plympton. As these pharmacies provide services to a broad population both within and outside of the Plymouth boundaries, their impact on the pharmaceutical needs of the Cornwall and the Isles of Scilly population at the locality level is not clear. For this reason, they are only mentioned briefly in this report.
7.3.3 Dispensing doctors
NHS legislation provides that in certain rural areas classified as controlled localities general practitioners may apply to dispense NHS prescriptions. Dispensing doctors play a vital role in ensuring that people who live in rural areas have access to pharmaceutical services without having a lengthy journey to their nearest pharmacy. Permission is granted to GPs, providing there is no ‘prejudice’ to the existing medical or pharmaceutical services. Prejudice is defined as: being unable to comply with the medical or pharmaceutical terms of service. The provisions to allow GPs to dispense were introduced to provide patients access to dispensing services in rural communities not having reasonable access to a community pharmacy. Pharmacy applications in rural areas are also required to satisfy the prejudice test and, unlike GP dispensing applications, are subject to the additional market entry tests (i.e. in most cases judged against the PNA). See: http://psnc.org.uk/contract-it/market-entry- regulations/rural-issues/
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 29 January 2015 version no. 6
The rurality of parts of Cornwall and the Isles of Scilly has led to relatively high numbers of dispensing GP practices. Dispensing GP practices make a valuable contribution to dispensing services although they do not offer the full range of pharmaceutical services offered at community pharmacies.
There were 36 dispensing GP practices within Cornwall and the Isles of Scilly as of 31/10/2014. The names of the dispensing GP surgeries within Cornwall and the Isles of Scilly are listed in Appendix 3 and their locations shown in the maps within appendix 4. Out of 562,154 people registered with a GP in Cornwall and the Isles of Scilly, 347,125 people (62%) were registered with a dispensing GP practice (July 2014) 16 .
7.3.4 Dispensing Appliance Contractors
Dispensing Appliance Contractors (DACs) specialise in supplying stoma and continence appliances. Pharmacists may regularly dispense appliances in the course of their business, or they may dispense such prescriptions infrequently, or they may have taken a decision not to dispense them at all. All pharmacy contractors choosing to dispense appliances in the normal course of their business are required to comply with Essential services requirements.
A number of contractors were identified during the development of this PNA, most of which are national companies covering a wide geographical area. DACs are unable to supply medicines or provide the range of pharmaceutical services offered by community pharmacy. They are, however, used by patients in Cornwall and the Isles of Scilly due to their convenience.
7.3.5 Community pharmacies
A community pharmacy provides pharmaceutical services to people in a local area or community. Every day approximately 1.6 million people visit a pharmacy in England. Community pharmacists are easily accessible with around 11,400 community pharmacies in England located where people live, shop and work. The latest information shows that 99% of the population – even those living in the most deprived areas – can get to a pharmacy within 20 minutes by car and 96% by walking or using public transport. Many are open long hours when other healthcare professionals are unavailable.
There are several different types and sizes of community pharmacies, ranging from the large chains with shops on every High Street or in edge of town supermarkets, to small individually owned pharmacies in small communities, in the suburbs and often in deprived areas or rural settings.
In recent years, community pharmacists have been developing clinical services in addition to the traditional dispensing role to allow better integration and team working with the rest of the NHS. Community pharmacy is consequently a socially inclusive healthcare service providing a convenient and less formal environment for those who cannot easily access or do not choose to access other kinds of health service. Most pharmacies now have a private consultation area specifically for confidential or sensitive discussions. See: http://psnc.org.uk/psncs-work/about-community- pharmacy/ .
16 Only certain patients are eligible to receive dispensing services from a dispensing doctor. Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 30 January 2015 version no. 6 Under current contractual arrangements, community pharmacies are required to open for at least forty hours per week. This constitutes a pharmacy’s core hours. 100-hour pharmacies are required to open for at least one hundred hours per week.
Extended hours are operated, either through individual core hour’s extensions, especially through the summer months, or through the provision of established rota services in line with local GP opening hours and/or locally identified need.
Community pharmacies wishing to amend or reduce their core or extended hours are required to apply to the PCT in writing giving three months’ notice. Requests will then be reviewed and consideration given to the impact of the change of the provision of local pharmaceutical services.
Delivery services are offered by the majority of community pharmacies and dispensing practices for the benefit of their patients. Most arrangements are free of charge and none are compulsory or contractual. Because of this, they are often limited to elderly or housebound individuals. Delivery services are very much an advantage in terms of access to pharmaceutical services that has developed in Cornwall. Deliveries are conducted by dedicated drivers that are sometimes shared between branches, taxis, or members of staff during, or after work.
Patients are always advised to check with their local pharmacy or GP dispensary for up-to-date information on their delivery services as arrangements stated in the PNA can often change, or be withdrawn without notice. Inclusion of delivery service information within this document within a Locality is no guarantee that a patient is automatically eligible. The decision to offer a delivery service remains the decision of the contractor.
In Cornwall and the Isles of Scilly, a large proportion of pharmaceutical services are provided by community pharmacies. Consequently, the remainder of this section focuses on presenting the findings of the audit of community pharmacists.
7.4 Community pharmacy in Cornwall and the Isles of Scilly – Audit
7.4.1 Introduction
An online audit of pharmacies was conducted between 27 June 2014 and 27 August 2014. This investigated the facilities and services offered by pharmacies in Cornwall and the Isles of Scilly (CIoS) and collected data regarding pharmacy opening hours. The following section summaries the findings of this audit.
To help align service provision to need, and identify any gaps in current provision, the data have been presented by community network area (see Section 6). There are 19 Community Network Areas (CNAs) within Cornwall plus the Isles of Scilly. The following provides an overall summary of the responses. Detailed responses for each of the 19 community network areas and the Isles of Scilly are set out in the adequacy assessment section (7.5) where a summary is provided for each area.
7.4.2 Overview of pharmacies in Cornwall and the Isles of Scilly
Overall, there are 104 pharmacies in Cornwall and the Isles of Scilly (CIoS) serving an estimated population of 537,900. Of these 104 pharmacies 2 are non-NHS and were, therefore, not invited to complete the pharmaceutical questionnaire. Two of the 104 pharmacies have only recently opened in Penzance (January 14 th 2015) and Torpoint
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 31 January 2015 version no. 6 (19 th January 2015), these are also not invited to complete the pharmaceutical questionnaire as at the time of circulation, both were not yet operational. In total 100 pharmacies completed the questionnaire in CIoS (a response rate of 100%).
Figure 1 below shows the providers of these pharmacies, of which there were 46 Boots Chemists, 7 supermarket in-store pharmacies and 28 independent pharmacies.
Providers 50 Group Total 45 Asda 2 40 Boots 46 35 Day Lewis 11 30 Lloyds 5 25 Other 28 20 Sainsbury’s 1 15 Superdrug 3 10 Tesco 4 5 Grand 0 Total 100
Figure 1 : Providers
7.4.3 Opening Hours
The pharmacies were asked what their weekly core hours were, the most common core opening hours between Monday and Friday was 9:00am to 5:30pm, between 9:00am and 5:30pm on Saturday and between 10:00am and 4:00pm on Sundays. Almost 80% of pharmacies were closed on Sunday’s, with 5 community network areas/28 towns having no pharmacy available. In the majority of community network areas there was a pharmacist open during lunchtime hours.
7.4.4 Consultation Facilities
A number of questions were asked about the facilities provided, the consultation areas should meet the standard set out in the contractual framework to offer advanced services. 92% provide an onsite consultation area, the majority of which (89%) are in an enclosed area. Of the pharmacies providing this facility only 77% have wheelchair access. Only one pharmacy had an off-site consultation room approved by the NHS, whilst the results were equal between those who were willing to undertake consultations in a patient’s home/other suitable site and those not offering the service.
7.4.5 Information Technology
A section of the questionnaire was dedicated to Information Technology with pharmacies asked whether their computer system is Electronic Prescription Service (EPS) R2 enabled. 95% already had EPS R2 with 1 coming on line within the next 12 months and the remainder having no definite plans. 96% have email, 62% have websites, 63% have unrestricted internet access and less than 35% use NHS mail.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 32 January 2015 version no. 6 As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats. Whilst 3% responded they could not open or view using any of these file formats, the following percentages were able to:
MS Word 82% MS Excel 83% MS Access 29% PDF 92%
7.4.6 Transport access
Figure 2 below shows the proportion of different transport options available less than 3 minutes of the pharmacy premises. Of these pharmacies, 73% are served by buses and only 1 is located within 3 minutes of a train station. In total 84% of providers could offer parking within 3 minutes, whilst only 27% offered onsite parking.
Pharmacy Transport Links (within 3 minute walk away)
100% 90% 80% 73% 70% 60% 50% 38% 40% 27% 30% 19% 20% 10% 1% 0% Parking : Parking : Parking : Other Train Bus Onsite Council (street, private, etc.)
Figure 2 : Transport access within 3 minutes of the pharmacy
7.4.7 Essential Services (appliances)
The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings. 92% offered all three services, with 1 pharmacy offering everything except stoma appliances, 2 offered everything except stoma and incontinence appliances and two only offering just dressings.
7.4.8 Advanced Services
Pharmacies were asked to provide details of the advanced services provided. Whilst the Medicines Use Review service (MUR) and New Medicine Service (NMS) are provided by most respondents, the Appliance Use Review service (AUR) and Stoma Appliance Customisation service (SAC) are provided by very few respondents.
Yes No Soon MUR 89% 7% 3% NMS 86% 8% 5% AUR 7% 86% 6% SACS 6% 89% 5%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 33 January 2015 version no. 6 7.4.9 Commissioned Services
A section of the questionnaire was dedicated totally to Commissioned Services, where pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services.
Willing to provide if Currently Willing & able commissioned Currently Providing to provide if (need Left Blank Providing (need Private commissioned facilities training) Service adjustment) Emergency Hormonal 75% 11% 5% 2% 1% 5% Contraception Service Gluten Free Food Supply 76% 10% 6% 2% 1% 6% Service Minor Ailments Scheme 87% 5% 2% 3% 0% 3% Needle & Syringe 28% 28% 22% 1% 1% 20% Exchange Service Palliative Care Scheme 23% 23% 27% 2% 1% 28%
Alcohol 27% 18% 29% 7% 0% 24%
NRT Voucher service 79% 7% 7% 0% 1% 6%
Supervised Administration 74% 9% 5% 2% 0% 11%
The number offering an emergency hormonal contraception service was over 70%, rising to 95% once those pharmacies who stated they would be either willing and able to provide if commissioned, trained or adjustments were made to their facilities were added. The gluten free food supply was another service with a high percentage at just over 75% and again pharmacies without these facilities were willing to provide once commissioned or trained. Over 85% of pharmacies stated they already provided a minor ailments scheme, rising to over 97% once those either, willing and able to provide if commissioned, trained or adjustments were made to their facilities were added. At present there are only 28% of pharmacies offering a needle and syringe exchange service with 20% unwilling or unable to provide this service.
7.4.10 Minor Ailments Scheme
Patient only medicines supplied under Patient Group Directions (PGD) are:
• Fusidic Acid 1% eye drops (Fucithalmic) • Chloramphenicol 0.5% eye drops • Fusidic Acid 2% cream (Fucidin) • Trimethoprim 200mg tablets • Nystatin Oral Suspension (Nystan) • Timodine Cream
EHC • levonorgestrel (Levonelle)
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 34 January 2015 version no. 6 7.4.11 Collection and Delivery services
Pharmacies were asked if they provided any collection and delivery services. 95% collected prescriptions from surgeries for patients. Dispensed medicines were delivered free of charge by 83% of pharmacies, 9% of these would deliver to any patients, whilst almost 25% would only deliver to the housebound, elderly, care homes, those with no access, etc. The majority of those pharmacies stating they would deliver were happy to deliver anything from the immediate surrounding area up to 10 miles radius.
7.4.12 Languages
One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked:
• What languages other than English are spoken in the pharmacy:
Afrikaans Norwegian Arabic Polish Czech Portuguese Dutch Punjabi French Romanian German Slovak Hebrew Spanish Hindu Swedish Hungarian Urdu Italian
• What languages other than English are spoken by the community your pharmacy serves:
Cantonese Polish Chinese Portuguese Czech Punjabi German Russian Hindu Slovak Hungarian Urdu
Not all languages spoken in the community were spoken in the pharmacies within their area. Some pharmacies, however, had access to translation services or used a mobile phone app.
7.5 Adequacy Assessment
Detailed summaries are set out below for each of the 19 community network areas and the Isles of Scilly.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 35 January 2015 version no. 6 Bodmin Community Network Area: Summary
Overview of the geography The Bodmin Locality is situated in North Cornwall and is made up of seven parishes; Blisland, Bodmin, Cardinham, Helland, Lanhydrock, Lanivet, and Withiel.
The Locality’s main urban area is Bodmin town outside of which the area is largely rural, dominated by Bodmin Moor.
Summary Issues
• Bodmin Community Network has 19,575 residents; 3.7% of Cornwall’s total population. The workday population is 21,974 so 2,399 (net) people commute into the network to work. • The Bodmin area generally experiences higher levels of deprivation than on average across Cornwall. In Bodmin town, there are two LSOAs that are among the most deprived 10% in England. • 18% of the population does not have access to a car. • Although the pharmacies are multi-lingual, Hungarian appears to be the only language spoken in the community not covered.
A socio-economic profile for the Bodmin CNA can be downloaded from: www.cornwall.gov.uk/pharmacy .
A summary health profile for the Bodmin CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 2 practices and branch surgeries operated by other practices in St Breward (Camelford Health Centre – Garrod and Nash) and Blisland (Port Isaac). Number of Dispensing GP Surgeries 2 Carnewater Practice The Hlth Ctr, Dennison Rd Bodmin PL31 2LB Stillmoor House Bell Lane Bodmin PL31 2JJ Number of Pharmacies 4 Asda Stores Ltd Launceston Road Bodmin PL31 2AR Boots 5405 34 Fore St. Bodmin PL31 2HL Boots 5560 Unit 5, Bell Lane Bodmin PL31 2JL Day Lewis Plc 17 Dennison Road Bodmin PL31 2LL Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 4 19,575 4,894 0.2
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 36 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 4 of which fall under the Bodmin Community Network Area. Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Bodmin Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Tuesday to Friday there is a pharmacy available between 7:00am and 11:00pm, Mondays from 8:00am, Saturdays from 8:00am until 10:00pm then between 10:00am and 4:00pm on Sundays.
Bodmin
Bodmin
Bodmin
Bodmin
Bodmin
Bodmin
Bodmin Sun Sat Fri Thur Wed Tue Mon
6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. All the pharmacies provide onsite consultation, in an enclosed area with wheelchair access. Only 1 pharmacy states they are willing to undertake consultations in a patient’s home/other suitable site whilst the remaining 3 did not offer the service. Hand Washing Facilities are available in all pharmacies, 3 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology, all pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. All have email, 2 have websites, 3 have unrestricted internet access and 1 has NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 100% MS Excel 100% MS Access 75% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves:
Spoken in the Pharmacy Spoken by the Community Czech Romanian Czech Romanian Polish Russian Hungarian Russian Portuguese Slovak Polish Slovak Portuguese
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 37 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. All 4 pharmacies had some form of parking and 3 had bus stops within 3 minutes. There is no accessibility by train to Bodmin pharmacies.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery Services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients, with 3 delivering dispensed medicines free of charge. 1 would deliver only to the housebound, whilst the remainder did not specify. None of the pharmacies charged for delivery, nor did they restrict the area they would deliver to.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings 75% offered all services the remaining 25% offered dressings & stoma.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 38 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or
CCG services. Service Currently Currently Currently Currently Providing Providing if provide Left Blank Left Blank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to & able Willing Providing Private Private Providing Willing to provide provide Willing to provide Willing to Anticoag Monitoring 0 2 1 0 0 1 Anti viral distribution 0 2 1 0 0 1 Care Home Service 2 1 0 0 0 1 Chlamydia Treatment 0 2 1 0 0 1 Contraceptive Service 2 0 1 0 1 1 Allergies 0 2 1 0 0 1 Alzheimers/dementia 0 2 1 0 0 1 Asthma 1 1 1 0 1 1 CHD 0 2 1 0 0 1 Depression 0 2 1 0 0 1 Diabetes Type I 0 2 1 0 1 1 Diabetes Type II 0 2 1 0 1 1 Epilepsy 0 2 1 0 0 1 Heart failure 0 2 1 0 0 1 Hypertension 0 2 1 0 1 1 Parkinsons disease 0 2 1 0 0 1 Emergency Hormonal Contraception Service 3 1 0 0 1 0 Gluten Free Food Supply Service 1 2 0 0 0 1 Independent Prescribing Service 0 2 1 0 1 1 Language Access Service 0 1 2 0 0 1 Medication Review Service 1 1 1 0 0 1 Medicines Management Support Service 0 1 2 0 0 1 DomMAR Carer's Charts 1 1 1 0 0 1 Minor Ailments Scheme 3 1 0 0 0 0 MUR Plus/Medicines Optimisation Service 0 1 2 0 0 1 Needle &Syringe Exchange Service 1 1 1 0 0 1 Obesity Management (Adults & Children) 0 1 2 0 0 1 Directly Observed Therapy 0 1 2 0 0 1 Out of hours service 0 1 2 0 0 1 Palliative Care Scheme 2 1 0 0 0 1 Phlebotomy Service 0 1 1 0 0 2 Prescriber support service 0 1 1 0 0 2 Schools Service 0 1 1 0 0 2 Alcohol 3 1 0 0 0 0 Chlamydia 0 1 2 0 0 1 Cholesterol 1 0 1 0 2 1 Diabetes 2 0 0 0 2 1 Gonorrhoea 0 1 2 0 0 1 H.pylori 0 1 2 0 0 1 HbA 1C 0 1 2 0 0 1 Hepatitis A 0 1 2 0 0 1 HIV 0 1 2 0 0 1 Seasonal flu vac 4 0 0 0 1 0 Childhood vac 0 1 2 0 0 1 HPV 0 1 2 0 0 1 Hep B vacc 0 1 2 0 0 1 Travel vaccines 0 1 2 0 1 1 Sharps Disposal service 0 1 2 0 0 1 NRT Vouch 1 2 0 0 0 1 Smoke cess counc 0 1 1 0 0 2 Supervised Administration 4 0 0 0 0 0 Supplementary Prescribing 0 1 2 0 0 1 NHS Healthcheck 0 1 2 0 0 1 Emergency Supply Svs/**URM Scheme 3 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 39 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings (2011 no usual Housing completed since commitments Census) residents (2011 Allocation 2014- 2010 (yet to be built) Census) 30 8,277 6.2% 280 646 3,200
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 490 additional dwellings will be built in this Community Network Area. Over 410 of these will be within the Bodmin town area.
Identified gaps in service provision
• 3 pharmacies do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods. • Ensure that all 100 hour pharmacies are providing EHC, EPS and Minor Ailments.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 40 January 2015 version no. 6 Bude Community Network Area: Summary
Overview of the geography The Bude Locality is situated in North Cornwall and is made up of eleven parishes; Bude- Stratton, Jacobstow, Kilkhampton, Launcells, Marhamchurch, Morwenstow, North Tamerton, Poundstock, St Gennys, Week St. Mary, and Whitstone. The Locality borders with Devon in the east, and the Camelford, and Launceston Localities in the south.
Summary Issues
• Bude Community Network has 16,879 residents; 3.2% of Cornwall’s total population. The workday population is 16,314 so 565 people (net) commute out of the network area to work. • 15.2% of households do not have access to a car. • Life expectancy is generally higher than the Cornwall average. • Bude is a well-established holiday resort and, as such, experiences a significant tourist influx during the summer months. • Few languages other than English are spoken in the pharmacies, however, with the combination of holidaymakers and migrant seasonal staff there are probably some shortfalls. • No access to a pharmacy for the working population except for lunchtimes and weekends.
A socio-economic profile for the Bude CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Bude CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 2 practices. Number of Dispensing GP Surgeries 0 Number of pharmacies 4 Boots 5427 20 Belle Vue Bude EX23 8JL Lloyds 9 Belle Vue Bude EX23 8JL Dudley Taylor 26 Belle Vue Bude EX23 8JS Lloyds Medical Centre, Hospital Road, Stratton Stratton EX23 9BP Population per pharmacy
Number of Population Population per Rate (per pharmacies (2012) pharmacy 1000 Pop.) 4 16,879 4,220 0.2
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 41 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 4 of which fall under the Bude Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were. Within Bude Community Network there is a pharmacy open Monday to Saturday between 9:00am and 5:30pm including lunchtimes (figure 1). There is one pharmacy open on Sundays between 10:00am and 4:00am.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. All the pharmacies provide onsite consultation, in an enclosed area with wheelchair access. Only 1 pharmacy was willing to undertake consultations in a patient’s home/other suitable site whilst the remaining 3 did not offer the service. Hand Washing Facilities within the consultation area were available in only 1 pharmacy, 2 provided facilities close by with 1 providing no facilities.
Information Technology A section of the questionnaire was dedicated to Information Technology 3 pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled and 1 within the next 12 months. 4 have email, 1 has a website, 3 have unrestricted internet access and 1 has NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 100% MS Excel 100% MS Access 50% PDF 75%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves:
Spoken in the Pharmacy Spoken by the Community Arabic French (little)
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 42 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. Only 2 pharmacies had some form of parking within 3 minutes, the remainder on average only 4 minutes away. All 4 had bus stops within 3 minutes, however, there is no accessibility by train to Bude pharmacies.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. 2 would only deliver to the housebound, whilst the remainder did not specify. Only one of the pharmacies charged for delivery, 2 pharmacies did have restrictions on delivery areas (1 within a 10 mile radius and the other to only Bude, Marhamchurch, Poundstock, Kilkhampton, Widemouth, Week St Mary).
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings 100% offered all services.
Advanced Services
Yes No Soon MUR 75% 25% 0% NMS 75% 25% 0% AUR 0% 100% 0% SACS 50% 50% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 43 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or
CCG services. Service Currently Currently Currently Currently Providing Providing if provide Left Blank Left Blank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to & able Willing Providing Private Private Providing Willing to provide provide Willing to provide Willing to Anticoag Monitoring 0 2 2 1 0 0 Anti viral distribution 0 2 2 1 0 0 Care Home Service 1 2 0 1 0 0 Chlamydia Treatment 0 2 2 1 0 0 Contraceptive Service 0 2 2 1 0 0 Allergies 0 2 1 1 0 0 Alzheimers/dementia 0 2 2 1 0 0 Asthma 0 2 1 1 0 0 CHD 0 2 2 1 0 0 Depression 0 2 2 1 0 0 Diabetes Type I 0 2 2 1 0 0 Diabetes Type II 0 2 2 1 0 0 Epilepsy 0 2 2 1 0 0 Heart failure 0 2 2 1 0 0 Hypertension 0 2 2 1 0 0 Parkinsons disease 0 2 2 1 0 0 Emergency Hormonal Contraception Service 2 1 0 1 0 0 Gluten Free Food Supply Service 2 1 0 1 0 0 Independent Prescribing Service 0 2 1 0 0 2 Language Access Service 0 2 0 0 0 2 Medication Review Service 1 1 0 1 0 1 Medicines Management Support Service 0 2 1 1 0 1 DomMAR Carer's Charts 1 1 0 0 0 2 Minor Ailments Scheme 2 1 0 1 0 0 MUR Plus/Medicines Optimisation Service 1 2 0 0 0 1 Needle &Syringe Exchange Service 1 2 0 0 0 1 Obesity Management (Adults & Children) 0 2 2 0 0 1 Directly Observed Therapy 1 1 1 0 0 1 Out of hours service 0 2 0 0 0 2 Palliative Care Scheme 1 2 1 0 0 1 Phlebotomy Service 0 2 1 0 0 2 Prescriber support service 0 2 1 0 0 2 Schools Service 0 2 1 0 0 2 Alcohol 0 2 2 1 0 0 Chlamydia 0 2 2 1 0 0 Cholesterol 0 2 2 1 0 0 Diabetes 1 1 2 1 0 0 Gonorrhoea 0 2 1 0 0 2 H.pylori 0 2 2 0 0 1 HbA 1C 0 2 1 0 0 2 Hepatitis A 0 2 1 0 0 2 HIV 0 2 1 0 0 2 Seasonal flu vac 0 2 1 0 0 1 Childhood vac 0 2 1 0 0 1 HPV 0 2 1 0 0 1 Hep B vacc 0 2 1 0 0 1 Travel vaccines 0 2 1 0 0 1 Sharps Disposal service 1 2 0 1 0 1 NRT Vouch 3 1 0 0 0 0 Smoke cess counc 0 2 1 0 0 1 Supervised Administration 0 2 2 0 0 1 Supplementary Prescribing 0 0 0 0 0 2 NHS Healthcheck 0 2 2 0 0 0 Emergency Supply Svs/**URM Scheme 2 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 44 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2010 (yet to be built) Census) 2014-30 7,268 14.0% 192 558 1,500 Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 370 additional dwellings will be built in this Community Network area. Over 230 of these will be within the Bude/Stratton town area and 48 within the Parish of Killkhampton.
Identified gaps in service provision
• 2 pharmacies do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 45 January 2015 version no. 6 Camelford Community Network Area: Summary
Overview of the geography The Camelford Locality is situated in North Cornwall and made up of eighteen parishes; Advent, Camelford, Davidstow, Forrabury and Minister, Lesnewth, Michaelstow, Otterham, St Breward, St Clether, St Juliot, St Teath, Tintagel, Tremaine, Treneglos, Tresmeer, Trevalga, Warbstow, and Warbstow (DET).
The main Locality town is Camelford.
Summary Issues
• Camelford Community Network has 12,341 residents; 2.3% of Cornwall’s total population. The workday population is 10,961 so 1,380 people (net) commute out of the network area to work. • 11.1% of households do not have access to a car. • Tintagel and Boscastle on the north coast are popular tourist destinations and experience a significant influx of visitors during the summer months. • Tintagel has a Sunday pharmacy during the summer months from 10:00am – 4:00pm but is closed on Sundays for the rest of the year. • No pharmacies open on Sundays, nearest in Launceston and Wadebridge a 20/25 minute drive away. • The pharmacy in Camelford does not have wheelchair access to the consultation room, the one in Tintagel does. • Polish was the only other language spoken in the pharmacies, as a tourist destination there are probably many overseas visitors speaking numerous languages.
A socio-economic profile for the Camelford CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Camelford CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 3 practices with branch surgeries in Tintagel, and Delabloe and further branch surgeries operated by another practice in St Teath and Delabole (Port Isaac). Number of Dispensing GP Surgeries 3 Bottreaux Surgery Boscastle PL35 0BG Tintagel Medical Centre Bossinney Road Tintagel PL34 0AE Number of Pharmacies 2 Boots 5322 25 Market Square Camelford PL32 9PD Boots 5341 Bath House, Fore St. Tintagel PL34 0DA Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 2 12,341 6,170 0.2
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 46 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 2 of which fall under the Camelford Community Network Area.
Opening Hours
x Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Camelford Community Network there is a pharmacy open 6 days per week including lunchtimes (figure 1). Monday to Saturday there is a pharmacy available between 9:00am and 6:00pm. The only Sunday openings are during the summer months in Tintagel, the remainder of the year the nearest pharmacies are 20/25 minutes away in Launceston and Wadebridge.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. Both pharmacies provide onsite consultation, in an enclosed area 1 with wheelchair access. Both were also willing to undertake consultations in a patient’s home/other suitable. Hand washing facilities were available at both pharmacies within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology and both pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. Both have email and unrestricted internet access, 1 has NHS mail but no website. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 50% MS Excel 50% MS Access 0% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves. Polish was spoken in one of the pharmacies but neither referenced any other language within the community.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 47 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. The pharmacy in Tintagel has parking in the immediate vicinity. Camelford pharmacy has parking approximately 3 minutes away and a bus service within 3 minutes. There is no access to a pharmacy by rail.
Pharmacy Transport links (within 3 minute walk) 100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. Both pharmacies collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. Neither pharmacy stated who they would deliver to, they do not charge for delivery, nor did they state the area they would deliver to. Pharmaceutical Opening Hours Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings 100% offered all services.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 48 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or
CCG services. Service Currently Currently Currently Currently Providing Providing if provide Left Blank Left Blank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to & able Willing Providing Private Private Providing Willing to provide provide Willing to provide Willing to Anticoag Monitoring 0 0 1 0 0 1 Anti viral distribution 0 0 1 0 0 1 Care Home Service 0 0 1 0 0 1 Chlamydia Treatment 0 0 1 0 0 1 Contraceptive Service 0 0 1 0 0 1 Allergies 0 0 1 0 0 1 Alzheimers/dementia 0 0 1 0 0 1 Asthma 0 0 1 0 0 1 CHD 0 0 1 0 0 1 Depression 0 0 1 0 0 1 Diabetes Type I 0 0 1 0 0 1 Diabetes Type II 0 0 1 0 0 1 Epilepsy 0 0 1 0 0 1 Heart failure 0 0 1 0 0 1 Hypertension 0 0 1 0 0 1 Parkinsons disease 0 0 1 0 0 1 Emergency Hormonal Contraception Service 2 0 0 0 0 0 Gluten Free Food Supply Service 1 0 1 0 0 0 Independent Prescribing Service 0 0 1 0 0 1 Language Access Service 0 0 1 0 0 1 Medication Review Service 0 0 1 0 0 1 Medicines Management Support Service 0 0 1 0 0 1 DomMAR Carer's Charts 0 0 1 0 0 1 Minor Ailments Scheme 2 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 0 0 1 0 0 1 Needle &Syringe Exchange Service 0 0 1 0 0 1 Obesity Management (Adults & Children) 0 0 1 0 0 1 Directly Observed Therapy 0 0 1 0 0 1 Out of hours service 0 0 1 0 0 1 Palliative Care Scheme 0 0 1 0 0 1 Phlebotomy Service 0 0 1 0 0 1 Prescriber support service 0 0 1 0 0 1 Schools Service 0 0 1 0 0 1 Alcohol 0 0 1 0 0 1 Chlamydia 0 0 1 0 0 1 Cholesterol 0 0 1 0 0 1 Diabetes 0 0 1 0 0 1 Gonorrhoea 0 0 1 0 0 1 H.pylori 0 0 1 0 0 1 HbA 1C 0 0 1 0 0 1 Hepatitis A 0 0 1 0 0 1 HIV 0 0 1 0 0 1 Seasonal flu vac 0 0 1 0 0 1 Childhood vac 0 0 1 0 0 1 HPV 0 0 1 0 0 1 Hep B vacc 0 0 1 0 0 1 Travel vaccines 0 0 1 0 0 1 Sharps Disposal service 0 0 1 0 0 1 NRT Vouch 2 0 0 0 0 0 Smoke cess counc 0 0 1 0 0 1 Supervised Administration 1 0 0 0 0 1 Supplementary Prescribing 0 0 1 0 0 1 NHS Healthcheck 0 0 1 0 0 1 Emergency Supply Svs/**URM Scheme 2 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 49 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2010 (yet to be built) Census) 2014-30 6,200 17.5% 224 217 1,200
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 189 additional dwellings will be built in this Community Network area. 59 of these will be within the Tintagel town area and 23 within the Parish of St Breward and 28 within the Camelford town area.
Identified gaps in service provision
• There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 50 January 2015 version no. 6 Caradon Community Network Area: Summary
Overview of the geography The Caradon Locality is situated in East Cornwall and is made up of eight parishes; Callington, Calstock, Linkinhorne, Pillaton, South Hill, St Dominick, St Ive, and St Mellion.
The Locality borders with Devon in the east, the Launceston Locality on the north, the Liskeard and Looe Locality in the southwest, and the Cornwall Gateway Locality in the south east.
Summary Issues
• Caradon Community Network has 17,764 residents; 3.3% of Cornwall’s total population. The workday population is 16,074 so 1,690 people (net) commute out of the network area to work. • 11.6% of households do not have access to a car. • No pharmacies are open within the community network area on Sunday as there has been no evidence of need. However, Sunday provision is available a 20 minute drive away. • The pharmacy in Callington does not provide wheelchair access owing to the listed building status and steps which are not possible to ramp.
A socio-economic profile for the Caradon CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Caradon CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 2 practices with a branch surgery in Gunnislake. Number of Dispensing GP Surgeries 2 Pensilva Health Centre School Road Pensilva PL14 5RP Tamar Valley Health Centre Haye Road Callington PL17 7AW Gunnislake Health Centre The Orchard Gunnislake PL18 9JZ Number of Pharmacies 2 Lloyds 17-18 Fore St. Callington PL17 7AE Gunnislake Health Centre, The Gunnislake Pharmacy Gunnislake PL18 9JZ Orchard Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 2 17,764 8,882 0.1
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 51 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 2 of which fall under the Callington (Caradon) Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun: x
Pharmacies were asked what their weekly core hours were, within Callington (Caradon) Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Friday there is a pharmacy available between 8:30am and 6:30pm, Saturdays from 8:45am until 5:00pm. Neither pharmacy operates Sunday opening hours due to no evidence of need. The nearest pharmacies available on Sunday within a 20 minute drive of the community network area are in Launceston, Plymouth or Liskeard who are open alternate Sundays
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. Both pharmacies provide onsite consultation, in an enclosed area 1 with wheelchair access. Only 1 pharmacy was willing to undertake consultations in a patient’s home/other suitable site whilst the other did not offer the service. Both pharmacies offered hand washing within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology 1 pharmacy confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled and the other within 12 months. Both have email and a website, 1 has unrestricted internet access, 1 has NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 50% MS Excel 100% MS Access 50% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves. Neither listed any languages, however, 1 stated they had access to translator services.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 52 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. Both pharmacies have council parking and a bus service within 3 minutes. The pharmacy at Gunnislake is approximately 15 minutes to the nearest railway station.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. Both pharmacies collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. 1 stated they delivered to the housebound but others if needed, whilst the other did not specify. None of the pharmacies charged for delivery, nor did they restrict the area they would deliver to.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings. The pharmacy at Callington offered all services, whilst the pharmacy at Gunnislake offered stoma through an agency.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 53 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or
CCG services. Service Currently Currently Currently Currently Providing Providing if provide Left Blank Left Blank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to & able Willing Providing Private Private Providing Willing to provide provide Willing to provide Willing to Anticoag Monitoring 0 1 1 0 0 0 Anti viral distribution 0 1 1 0 0 0 Care Home Service 0 1 1 0 0 0 Chlamydia Treatment 0 1 1 0 0 0 Contraceptive Service 0 1 1 0 0 0 Allergies 0 1 1 0 0 0 Alzheimers/dementia 0 0 2 0 0 0 Asthma 0 1 1 0 0 0 CHD 0 1 1 0 0 0 Depression 0 1 1 0 0 0 Diabetes Type I 0 0 2 0 0 0 Diabetes Type II 0 1 1 0 0 0 Epilepsy 0 1 1 0 0 0 Heart failure 0 1 1 0 0 0 Hypertension 0 1 1 0 0 0 Parkinsons disease 0 0 2 0 0 0 Emergency Hormonal Contraception Service 1 0 1 0 0 0 Gluten Free Food Supply Service 1 0 1 0 0 0 Independent Prescribing Service 1 0 0 0 0 1 Language Access Service 1 0 0 0 0 1 Medication Review Service 2 0 0 0 0 0 Medicines Management Support Service 0 1 0 0 0 1 DomMAR Carer's Charts 1 0 1 0 0 0 Minor Ailments Scheme 2 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 0 1 0 0 0 1 Needle &Syringe Exchange Service 0 1 1 0 0 0 Obesity Management (Adults & Children) 0 0 1 0 0 1 Directly Observed Therapy 0 0 1 0 0 1 Out of hours service 0 0 1 0 0 1 Palliative Care Scheme 0 0 1 0 1 0 Phlebotomy Service 0 0 1 0 0 1 Prescriber support service 0 1 0 0 0 1 Schools Service 0 0 1 0 0 1 Alcohol 1 1 0 0 0 0 Chlamydia 0 0 1 0 0 1 Cholesterol 0 1 0 0 0 1 Diabetes 0 1 0 0 1 0 Gonorrhoea 0 0 1 0 0 1 H.pylori 0 0 1 0 0 1 HbA 1C 0 1 0 0 0 1 Hepatitis A 0 0 1 0 0 1 HIV 0 0 1 0 0 1 Seasonal flu vac 0 1 0 0 1 1 Childhood vac 0 0 1 0 0 1 HPV 0 0 1 0 0 1 Hep B vacc 0 0 1 0 0 1 Travel vaccines 0 1 0 0 0 1 Sharps Disposal service 1 0 0 0 0 1 NRT Vouch 1 1 0 0 0 0 Smoke cess counc 0 1 0 0 0 1 Supervised Administration 1 0 1 0 0 0 Supplementary Prescribing 1 0 0 0 0 1 NHS Healthcheck 0 1 0 0 0 1 Emergency Supply Svs/**URM Scheme 1 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 54 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2014- 2010 (yet to be built) Census) 30 8,331 5.6% 222 302 1,000
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 178 additional dwellings will be built in this Community Network area. Over 100 of these will be within the Parish of Calstock and 29 in the town area of Callington.
Identified Gaps in Service Provision
• The pharmacy in Gunnislake will have EEFO accreditation by the end of July 2015. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Partially Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 55 January 2015 version no. 6 China Clay Community Network Area: Summary
Overview of the geography The China Clay Locality is made up of five parishes; Roche, St Dennis, St Enoder, St Stephen-in-Brannel, and Treverbyn.
Summary Issues
• China Clay Community Network has 25,938 residents; 4.9% of Cornwall’s total population. The workday population is 22,100 so 3,838 people (net) commute out of the network area to work. • 11.8% of households do not have access to a car. • Both pharmacies are closed between 1:00pm and 2:00pm lunchtime. • The pharmacy in St Dennis closes at 12:00 on Saturday. • No pharmacy available on Sundays. • Neither pharmacy within the community network has wheelchair access to the consultation room. • No Polish, Lithuanian, etc. spoken in the pharmacies this could be problematic with the number of migrant workers in the area.
A socio-economic profile for the China Clay CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the China Clay CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 2 practices with branch surgeries in St Columb, St Dennis and Bugle and a further branch surgeries operated by other practices in Somercourt (Probus), St Columb Road and Foxhole. Number of Dispensing GP Surgeries 2 Brannel Surgery 58 Rectory Rd St Stephen PL26 7RL Clays Area Health Centre Victoria Road Roche PL26 8JF St Columb Road Surgery Chy-Wella Parka Road TR9 6PG St Dennis Surgery Fore Street St Dennis PL26 8AD Bugle Surgery Roche Road Bugle PL26 8PP Number of Pharmacies 2 Bann's 79 Fore St. St Dennis PL26 8AB Roche Pharmacy 1 Victoria Road Roche PL26 8JF Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 2 25,938 12,969 0.07
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 56 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 2 of which fall under the China Clay Community Network Area.
Opening Hours
x Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within the China Clay Community Network there is a pharmacy open 6 days per week excluding lunchtimes (figure 1). Monday to Friday there is a pharmacy available between 8:30am and 6:30pm, Saturdays from 9:00am until 5:00pm, closed between 1:00pm and 2:00pm daily. There is no pharmacy open on Sunday, however, due to the proximity of St Austell there is a pharmacy available within approximately 15 minute drive.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. Both pharmacies provide onsite consultation, in an enclosed area, with hand washing facilities within the consultation area, but without wheelchair access. Both are willing to undertake consultations in a patient’s home/other suitable site.
Information Technology A section of the questionnaire was dedicated to Information Technology and both pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. Both have email and unrestricted internet access, 1 has a website and 1 has NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 100% MS Excel 100% MS Access 100% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves. Neither listed any languages within the community, however, Hindi, Urdu and Punjabi is spoken in the pharmacy.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 57 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. Only one pharmacy has onsite parking but both have a bus service within 3 minutes. The Roche pharmacy is approximately a 3 minute drive from the nearest railway station.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. Both pharmacies collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. 1 stated they delivered to those meeting criteria under DDA whilst the other would deliver to all patients. 1 pharmacy charged for delivery, the 1 delivering for free would only deliver to Roche, Bugle, St Austell, Luxulyan, and St Dennis or within a 7 mile radius.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 58 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or
CCG services. Service Currently Currently Currently Currently Providing Providing if provide Left Blank Left Blank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to & able Willing Providing Private Private Providing Willing to provide provide Willing to provide Willing to Anticoag Monitoring 0 1 1 0 0 0 Anti viral distribution 0 2 0 0 0 0 Care Home Service 0 1 0 0 0 1 Chlamydia Treatment 0 2 0 0 0 0 Contraceptive Service 1 1 0 0 0 0 Allergies 0 1 0 0 0 1 Alzheimers/dementia 0 1 0 0 0 1 Asthma 0 1 1 0 0 0 CHD 0 1 1 0 0 0 Depression 0 1 0 0 0 1 Diabetes Type I 0 1 1 0 0 0 Diabetes Type II 0 1 1 0 0 0 Epilepsy 0 1 0 0 0 1 Heart failure 0 1 0 0 0 1 Hypertension 0 1 0 0 0 1 Parkinsons disease 0 1 1 0 0 0 Emergency Hormonal Contraception Service 1 1 0 0 0 0 Gluten Free Food Supply Service 2 0 0 0 0 0 Independent Prescribing Service 0 0 1 0 0 1 Language Access Service 0 1 0 0 0 1 Medication Review Service 1 0 0 0 0 1 Medicines Management Support Service 0 1 0 0 0 1 DomMAR Carer's Charts 0 1 0 0 0 1 Minor Ailments Scheme 2 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 1 0 0 0 0 1 Needle &Syringe Exchange Service 0 2 0 0 0 0 Obesity Management (Adults & Children) 0 1 1 0 0 0 Directly Observed Therapy 1 0 1 0 0 0 Out of hours service 1 1 0 0 0 0 Palliative Care Scheme 2 0 0 0 0 0 Phlebotomy Service 0 1 0 0 0 1 Prescriber support service 0 1 0 0 0 1 Schools Service 0 1 0 0 0 1 Alcohol 1 1 0 0 0 0 Chlamydia 0 2 0 0 0 0 Cholesterol 0 1 0 0 0 1 Diabetes 1 0 0 0 1 0 Gonorrhoea 0 2 0 0 0 0 H.pylori 0 2 0 0 0 0 HbA 1C 0 2 0 0 0 0 Hepatitis 0 1 1 0 0 0 HIV 0 1 1 0 0 0 Seasonal flu vac 0 2 0 0 0 0 Childhood vac 0 1 0 0 0 1 HPV 0 1 0 0 0 1 Hep B vacc 0 1 0 0 0 1 Travel vaccines 0 1 0 0 0 1 Sharps Disposal service 0 2 0 0 0 0 NRT Vouch 2 0 0 0 0 0 Smoke cess counc 1 0 1 0 0 0 Supervised Administration 2 0 0 0 0 0 Supplementary Prescribing 0 1 1 0 0 1 NHS Healthcheck 0 1 1 1 0 0 Emergency Supply Svs/**URM Scheme 2 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 59 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2010 (yet to be built) Census) 2014-30 9,399 5.9 685 512 3,200
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 442 additional dwellings will be built in this Community Network area. Over 200 of these will be within the Parish of St Enoder (key settlements: Summercourt, Fraddon and Indian Queens).
Identified gaps in service provision
• The pharmacy in Roche does not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 60 January 2015 version no. 6 Cornwall Gateway Community Network Area: Summary
Overview of the geography The Cornwall Gateway Locality is made up of twelve parishes; Antony, Botus Fleming, Landrake with St Erney, Landulph, Make-with- Rame, Millbrook, Millbrook (DET), Saltash, Sheviock, St Germans, St John, and Torpoint.
The Locality borders with Plymouth extending from Rame Head on the south coast to the Landulph parish in the north.
Summary Issues
• Cornwall Gateway Community Network has 32,750 residents; 6.2% of Cornwall’s total population. The workday population is 27,852 so 4,898 people (net) commute out of the network to work. A large proportion of the working population of the CNA commute to Plymouth every day. • 16.7% of households do not have access to a car. • 3.4% of people in the Cornwall Gateway Community Network live in a highly deprived area (in the top 20% most deprived in England). • No pharmacy in Torpoint operates Sunday opening hours.
A socio-economic profile for the Cornwall Gateway CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Cornwall Gateway CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 5 practices with 3 branch surgeries; 2 in Torpoint and 1 in Cawsand. Number of Dispensing GP Surgeries 1 Quay Lane Surgery Old Quay Lane, St. Germans Saltash PL12 5LH Number of Pharmacies 8 Boots 5556 16 Fore St. Torpoint PL11 2AD Boots 5559 1 York Rd. Torpoint PL11 2LG Millbrook Pharmacy The old Blacksmith Shop, The Parade Millbrook PL10 1AX Lloyds 19 Fore St. Saltash PL12 6AF Lloyds 139 Callington Rd, Burraton Saltash PL12 6EB Saltash Pharmacy 6 Regal House, Fore Street Saltash PL12 6JR Boots 5399 124 Fore St. Saltash PL12 6JW Lloyds Pharmacy Trevol Business Centre, Trevol Road Torpoint PL11 2TB Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 8 32,750 4,094 0.2
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 61 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 7of which fall under the Saltash & Torpoint (Cornwall Gateway) Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Saltash & Torpoint (Cornwall Gateway) Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Friday there is a pharmacy available between 7:00am and 11:00pm, Saturdays from 7:00am until 10:00pm. There is only 1 pharmacy open on Sundays, this is between 11:00am and 4:00pm in Saltash. There is no pharmacy open in Torpoint on a Sunday and the nearest is 15-20 minute drive away in Saltash or Plymouth.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. All pharmacies provide onsite consultation, in an enclosed area with wheelchair access. 3 pharmacies are willing to undertake consultations in a patient’s home/other suitable site. All pharmacies offered hand washing facilities 6 within the consultation area.
Information Technolog y A section of the questionnaire was dedicated to Information Technology 6 pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. All pharmacies have email, 5 have websites, 4 have unrestricted internet access, and 1 has NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 86% MS Excel 57% MS Access 0% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves.
Spoken in the Pharmacy Spoken by the Community German Polish Hindu Spanish Urdu
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 62 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. Although there appears to be a lack of parking within the immediate vicinity, with only 1 pharmacy having onsite parking and, on average, parking can be up to 10 minutes away, all pharmacies do have either parking or a bus service within 3 minutes. The nearest pharmacy to a railway station in Saltash is approximately 4 minute away, there is no access in Torpoint.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All the pharmacies within Saltash & Torpoint (Cornwall Gateway) Community Network collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. 1 stated they delivered to the housebound, 1 to all patients, whilst the others did not specify. None of the pharmacies charged for delivery, 2 did restrict delivery to the following areas: • Most areas of Rame Peninsula-Cremyll, Cawsand, Kingsand, Freathy, Portwrinkle, Crafthole, Antony, Torpoint • Saltash and Surrounding
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 86% 14% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 63 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 0 6 0 0 1 Anti viral distribution 0 3 3 0 0 1 Care Home Service 2 0 3 0 0 2 Chlamydia Treatment 0 1 5 0 0 1 Contraceptive Service 1 1 4 0 0 1 Allergies 0 1 4 0 1 2 Alzheimers/dementia 0 0 5 0 0 2 Asthma 0 2 3 0 0 2 CHD 0 1 4 0 0 2 Depression 0 0 5 0 0 2 Diabetes Type I 0 0 5 0 0 2 Diabetes Type II 0 1 4 0 1 2 Epilepsy 0 0 5 0 0 2 Heart failure 0 0 5 0 0 2 Hypertension 0 3 3 0 2 1 Parkinsons disease 0 0 5 0 0 2 Emergency Hormonal Contraception Service 4 1 2 0 0 0 Gluten Free Food Supply Service 6 0 1 0 0 0 Independent Prescribing Service 0 0 5 0 0 2 Language Access Service 0 0 4 0 0 3 Medication Review Service 4 0 2 0 0 1 Medicines Management Support Service 1 0 4 0 0 2 DomMAR Carer's Charts 2 1 2 0 0 3 Minor Ailments Scheme 4 0 2 0 0 1 MUR Plus/Medicines Optimisation Service 0 1 4 0 0 2 Needle &Syringe Exchange Service 2 1 2 0 0 2 Obesity Management (Adults & Children) 0 1 4 0 1 2 Directly Observed Therapy 1 0 4 0 0 2 Out of hours service 2 1 2 0 0 2 Palliative Care Scheme 1 3 2 0 0 2 Phlebotomy Service 0 0 4 0 0 3 Prescriber support service 0 1 4 0 0 2 Schools Service 0 0 5 0 0 2 Alcohol 2 0 3 0 0 2 Chlamydia 0 2 4 0 0 1 Cholesterol 0 0 4 1 0 2 Diabetes 0 1 4 0 1 1 Gonorrhoea 0 0 5 0 0 2 H.pylori 0 0 5 0 0 2 HbA 1C 0 0 5 0 0 2 Hepatitis A 0 0 5 0 0 2 HIV 0 0 5 0 0 2 Seasonal flu vac 2 0 4 0 2 1 Childhood vac 1 0 4 0 1 2 HPV 0 0 5 0 0 2 Hep B vacc 0 0 5 0 0 2 Travel vaccines 0 0 5 0 0 2 Sharps Disposal service 0 1 2 0 1 3 NRT Vouch 2 2 2 0 0 1 Smoke cess counc 0 0 6 0 0 1 Supervised Administration 5 0 1 0 0 1 Supplementary Prescribing 0 0 5 0 0 2 NHS Healthcheck 0 0 4 0 0 3 Emergency Supply Svs/**URM Scheme 5 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 64 January 2015 version no. 6 Future Development
Local Plan Dwellings with no Dwellings Current Dwellings Housing usual residents completed since commitments (2011 Census) Allocation (2011 Census) 2010 (yet to be built) 2014-30 15,263 6.4% 200 104 1,700
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 85 additional dwellings will be built in this Community Network area. Over 30 of these will be within the Saltash town area and 9 in Torpoint.
Identified gaps in service provision
• There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 65 January 2015 version no. 6 Camborne, Pool and Redruth Community Network Area: Summary
Overview of the geography The Camborne, Pool, and Redruth Locality is situated in West Cornwall and is made up of ten parishes; Camborne, Carharrack, Carn Brea, Gwennap, Illogan, Lanner, Portreath, Redruth, St Day, and Stithians.
Summary Issues
• Camborne, Pool and Redruth Community Network has 58,891 residents; 11.1% of Cornwall’s total population. The workday population is 56,537 so 2,354 people (net) commute out of the network to work. • 18.6% of households do not have access to a car. • 23.9% of people in the Camborne, Pool and Redruth Community Network live in a highly deprived area (in the top 20% most deprived in England). • Pharmacies are multi-lingual but no-one able to speak Polish which is spoken in the community. • 1 pharmacy in Redruth does not have wheelchair access to the consultation room and 1 does not provide this facility at all.
A socio-economic profile for the Camborne, Pool and Redruth CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Camborne, Pool and Redruth CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 9 practices with branch surgeries in St Day and Lanner and a further branch surgery operated by another practice in Stithians (Penryn). Number of Dispensing GP Surgeries 2 Harris Memorial Surgery Robartes Terrace Illogan TR16 4RX Homecroft Surgery Voguebeloth Illogan TR16 4ET Number of Pharmacies 12 Boots 5377 2 Trelawarren St. Camborne TR14 8AA Day Lewis 21 Trelawarren St. Camborne TR14 8AD Boots 5320 10 Commercial Sq. Camborne TR14 8JY Boots 5342 Fore St, Troon TR14 9EF Boots 5337 Manor Surgery, Forth Noweth, Chapel St. Redruth TR15 1AU Green Lane 12 Green Lane Redruth TR15 1JT Superdrug 72 Fore St, Redruth TR15 2AF Boots 5335 84 Fore St. Redruth TR15 2BL Bastion's 16 Chapel St. Redruth TR15 2DB Boots 5426 Pool Health Centre, Station Road Pool Pool TR15 3DU Tesco Instore Pharmacy Station Road, Carn Brea Industrial Estate Redruth TR15 3QJ Boots 5336 Paynters Lane Illogan TR16 4SS Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 66 January 2015 version no. 6 Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 12 58,891 4,908 0.2
Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 12 of which fall under the Camborne and Redruth Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Camborne and Redruth Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Friday there is a pharmacy available until 10:30pm, opening at 8:00am on Monday and 6:30am the other four days. Saturday opening hours are from 6:30am until 10:00pm. There is a pharmacy in Redruth open between 10:00am and 4:00pm on Sundays. No pharmacies are open in Camborne, Troon or Illogan on Sunday, the nearest is a short drive away in Redruth.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. 11 pharmacies provide onsite consultation, in an enclosed area 10 with wheelchair access. 5 pharmacies were willing to undertake consultations in a patient’s home/other suitable site whilst the other 7 did not offer the service. 9 pharmacies offered hand washing within the consultation, 2 adjacent to the area whilst 1 did not offer this service.
Information Technology A section of the questionnaire was dedicated to Information Technology all 12 pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. All pharmacies have email, 8 have websites, 7 have unrestricted internet access, and none of the pharmacies has NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 91.67% MS Excel 91.67% MS Access 41.67% PDF 100%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 67 January 2015 version no. 6 Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves:
Spoken in the Pharmacy Spoken by the Community Arabic Hungarian Polish Dutch Urdu French
Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. Although there appears to be a lack of parking within the immediate vicinity, with only 1 pharmacy having onsite parking and, on average, parking can be up to 9 minutes away, all pharmacies do have either parking or a bus service within 3 minutes. The nearest pharmacy to a railway station is 3 minutes away.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients and 11 delivered dispensed medicines free of charge. 3 stated they delivered to the housebound, 2 delivered to all patients and the remaining 7 did not specify. Only 1 pharmacy charged for delivery and 5 pharmacies stated the areas they would deliver to: • Camborne, Redruth, Hayle & Praze • Carharrack, St Day, Lanner, Carnkie, Pool, Illogan, Porteath, Redruth, Camborne • Camborne, Redruth, Pool • 5-6 miles of pharmacy • Troon/Camborne area
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 91.67% 8.33% 0% NMS 91.67% 8.33% 0% AUR 8.33% 83.33% 8.33% SACS 0% 91.67% 8.33%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 68 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 4 4 0 0 4 Anti viral distribution 0 5 4 0 0 3 Care Home Service 3 3 1 0 0 5 Chlamydia Treatment 0 4 6 1 0 2 Contraceptive Service 1 3 5 0 0 3 Allergies 0 4 4 1 0 4 Alzheimers/dementia 0 4 4 1 0 4 Asthma 0 4 4 1 0 4 CHD 0 4 4 1 0 4 Depression 0 4 4 1 0 4 Diabetes Type I 0 4 4 1 0 4 Diabetes Type II 0 4 4 1 0 4 Epilepsy 0 4 4 1 0 4 Heart failure 0 4 4 1 0 4 Hypertension 0 4 4 1 0 4 Parkinsons disease 0 4 4 1 0 4 Emergency Hormonal Contraception Service 9 0 1 0 0 2 Gluten Free Food Supply Service 8 1 1 0 1 1 Independent Prescribing Service 0 1 4 1 0 6 Language Access Service 0 3 4 0 0 5 Medication Review Service 4 3 2 0 0 3 Medicines Management Support Service 0 3 4 0 0 5 DomMAR Carer's Charts 1 1 2 1 0 7 Minor Ailments Scheme 11 0 0 1 0 0 MUR Plus/Medicines Optimisation Service 0 3 5 0 0 4 Needle &Syringe Exchange Service 3 5 2 0 0 2 Obesity Management (Adults & Children) 0 3 4 0 0 5 Directly Observed Therapy 1 2 2 0 0 7 Out of hours service 2 2 0 1 1 6 Palliative Care Scheme 1 3 4 0 0 4 Phlebotomy Service 0 2 3 2 0 6 Prescriber support service 0 2 2 1 0 8 Schools Service 0 2 3 1 0 7 Alcohol 5 2 1 1 0 4 Chlamydia 0 4 3 1 0 5 Cholesterol 1 3 4 1 0 4 Diabetes 2 1 4 1 1 4 Gonorrhoea 0 2 4 1 0 6 H.pylori 0 3 4 1 0 5 HbA 1C 0 3 4 1 0 5 Hepatitis 1 3 3 1 0 5 HIV 0 3 4 1 0 5 Seasonal flu vac 2 1 7 2 1 1 Childhood vac 0 2 8 2 0 2 HPV 0 2 8 2 0 2 Hep B vacc 0 1 8 2 0 3 Travel vaccines 0 2 7 1 0 3 Sharps Disposal service 3 2 3 2 0 3 NRT Vouch 12 0 0 0 0 0 Smoke cess counc 2 3 3 1 0 4 Supervised Administration 9 0 0 1 0 2 Supplementary Prescribing 0 3 4 1 0 5 NHS Healthcheck 0 3 4 2 0 5` Emergency Supply Svs/**URM Scheme 11 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 69 January 2015 version no. 6 Future Development
Local Plan Dwellings with no Dwellings Current Dwellings Housing usual residents completed since commitments (2011 Census) Allocation (2011 Census) 2010 (yet to be built) 2014-30 26,858 5.2 911 3,587 5,300
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 2,990 additional dwellings will be built in this Community Network area. Over 1,000 of these will be within the Camborne town area, 1,180 within the Redruth town area and 660 within the Parish of Carn Brea (development new housing in Pool).
Identified gaps in service provision
• 4 pharmacies in Redruth, the pharmacy in Illogan and the 1 in Troon do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 70 January 2015 version no. 6 Falmouth and Penryn Community Network Area: Summary
Overview of the geography The Falmouth and Penryn Locality is made up of nine parishes; Budock, Constantine, Falmouth, Mabe, Mawnan, Mylor, Penryn, Perranarworthal, and St Gluvias.
Summary Issues
• Falmouth and Penryn Community Network has 42,986 residents; 8.1% of Cornwall’s total population. The workday population is 41,645 so 1,341 people (net) commute out of the network area to work. • 20% of households do not have access to a car. • 15.1% of people in the Falmouth and Penryn Community Network live in a highly deprived area (in the top 20% most deprived in England). • There is a large student population. • The area has a high seasonal tourist influx and additional public transport is available during the summer months. • Chinese and Hindu spoken in the community but no-one in the pharmacies conversant in these languages. • No Sunday opening at either pharmacy in Penryn. • 1 pharmacy in Falmouth does not have wheelchair access to the consultation room.
A socio-economic profile for the Falmouth & Penryn CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Falmouth & Penryn CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 4 practices with 4 branch surgeries in Mawnan Smith, Mylor Bridge, Flushing and Penryn and a further branch surgery operated by another practice in Constantine. Number of Dispensing GP Surgeries 2 Penryn Surgery Saracen Way Penryn TR10 8HX Trescobeas Surgery Trescobeas Road Falmouth TR11 2UN Mylor Bridge Lemon Hill Mylor Bridge TR11 5ND Constantine Surgery Bowling Green Constantine TR11 5AP Number of Pharmacies 7 Hendra's@ Penryn Ltd 56 Market St. Penryn TR10 8BH Hendra's@ Penryn Ltd The Penryn surgery, Saracen Way Penryn TR10 8HX Day Lewis Pharmacy Falmouth Health Centre, Trevaylor Road Falmouth TR11 2LH Boots 5323 Trescobeas Surgery, Trescobeas Rd Falmouth TR11 2UN Boots 396 47-49 Market St. Falmouth TR11 3AB
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 71 January 2015 version no. 6 Superdrug 55 Market St. Falmouth TR11 3AT Day Lewis 115 Killigrew St. Falmouth TR11 3PU Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 7 42,986 6,141 0.2
Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 7 of which fall under the Falmouth & Penryn Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Falmouth & Penryn Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Friday there is a pharmacy available between 7:00am and midnight, Saturdays from 9:00am until 6:00pm then between 10:00am and 4.30pm on Sundays. Pharmaceutical services are available in Falmouth on Sundays but not in Penryn.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. All Falmouth & Penryn Community Network pharmacies provide onsite consultation, 6 in an enclosed area with wheelchair access. 3 of the pharmacies were willing to undertake consultations in a patient’s home/other suitable site whilst the other 4 did not offer the service. 6 pharmacies offered hand washing facilities, 3 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology all pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. All pharmacies have email, 3 have websites, 4 have unrestricted internet access, 0 use NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats – MS Word 71.43% MS Excel 100% MS Access 0% PDF 71.43%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 72 January 2015 version no. 6 Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves:
Spoken in the Pharmacy Spoken by the Community Italian Swedish Chinese Polish Polish Hindu Spanish Italian
Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. Not all the pharmacies have parking nearby though there is parking on average within 5 minutes, 4 have a nearby bus service within 3 minutes. The nearest pharmacy to a railway station is 9 minutes away.
Pharmacy Transport links (within 3 minute walk)
100%
80%
60%
40%
20%
0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. 6 pharmacies collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. 3 stated they delivered to the housebound, 1 to all patients, whilst the others did not specify. None of the pharmacies charged for delivery, though 5 of them only delivered to the following areas:
• Falmouth, Penryn, Mawnan Smith, Mabe, Mylor Bridge, Flushing • Approx. 3 mile radius of Falmouth • 3 stated : local Falmouth/Penryn
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 85.71% 0% 14.29% AUR 0% 85.71% 14.29% SACS 0% 85.71% 14.29%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 73 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 0 4 1 0 2 Anti viral distribution 0 1 3 1 0 2 Care Home Service 1 3 2 0 0 2 Chlamydia Treatment 0 0 5 0 0 2 Contraceptive Service 0 0 5 0 0 2 Allergies 0 0 5 0 0 2 Alzheimers/dementia 0 0 5 0 0 2 Asthma 0 0 5 0 0 2 CHD 0 0 5 0 0 2 Depression 0 0 5 0 0 2 Diabetes Type I 0 0 5 0 0 2 Diabetes Type II 0 0 5 0 0 2 Epilepsy 0 0 5 0 0 2 Heart failure 0 0 5 0 0 2 Hypertension 0 0 5 0 0 2 Parkinsons disease 0 0 5 0 0 2 Emergency Hormonal Contraception Service 6 0 0 0 0 1 Gluten Free Food Supply Service 6 1 0 0 0 0 Independent Prescribing Service 0 0 4 0 0 3 Language Access Service 0 0 3 0 0 4 Medication Review Service 4 0 2 0 0 1 Medicines Management Support Service 0 1 3 0 0 3 DomMAR Carer's Charts 1 2 2 0 0 2 Minor Ailments Scheme 6 0 0 0 0 1 MUR Plus/Medicines Optimisation Service 0 1 3 0 0 3 Needle &Syringe Exchange Service 2 2 1 0 0 2 Obesity Management (Adults & Children) 0 2 3 0 0 2 Directly Observed Therapy 0 1 2 0 0 4 Out of hours service 1 0 1 1 0 4 Palliative Care Scheme 2 1 2 0 0 3 Phlebotomy Service 0 1 2 0 0 4 Prescriber support service 0 1 2 0 0 4 Schools Service 0 1 2 0 0 4 Alcohol 2 0 3 0 0 2 Chlamydia 0 1 3 0 0 3 Cholesterol 0 2 2 0 0 3 Diabetes 0 2 2 0 1 3 Gonorrhoea 0 1 2 0 0 4 H.pylori 0 1 2 0 0 4 HbA 1C 0 1 2 0 0 4 Hepatitis 0 1 1 1 0 4 HIV 0 1 1 1 0 4 Seasonal flu vac 3 0 1 0 1 2 Childhood vac 0 1 1 1 0 4 HPV 0 1 1 1 0 4 Hep B vacc 0 1 1 1 0 4 Travel vaccines 0 1 2 0 0 4 Sharps Disposal service 1 2 1 0 0 3 NRT Vouch 6 0 1 0 0 0 Smoke cess counc 1 0 4 0 0 2 Supervised Administration 4 1 0 0 0 2 Supplementary Prescribing 0 1 2 0 0 4 NHS Healthcheck 0 1 3 0 0 3 Emergency Supply Svs/**URM Scheme 6 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 74 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2010 (yet to be built) Census) 2014-30 20,693 9.4% 623 978 3,100
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 920 additional dwellings will be built in this Community Network area. Over 650 of these will be within the Falmouth/ Penryn town areas (470+ and 170+ respectively). There is also likely to be over 100 additional dwellings within the Parish of Mylor and over 95 within the Parish of Mabe.
Identified gaps in service provision
• 3 pharmacies do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 75 January 2015 version no. 6 Hayle & St Ives Community Network Area: Summary
Overview of the geography The Hayle and St Ives Locality is made up of five parishes; Gwinear-Gwithian, Hayle, St Erth, St Ives and Towednack.
Summary Issues
• Hayle and St Ives Community Network has 25,837 residents; 4.9% of Cornwall’s total population. The workday population is 24,834 so 1,003 people (net) commute out of the network area to work. • 20.4% of households do not have access to a car. • 8.1% of people in the Hayle and St Ives Community Network live in a highly deprived area (in the top 20% most deprived in England). • The area has a high seasonal tourist influx and additional public transport is available during the summer months. • Some languages spoken in the pharmacies, however, with the combination of holidaymakers and migrant seasonal staff there are probably some shortfalls. • 1 of the pharmacies in St Ives does not have wheelchair access. • No pharmacy available in Carbis Bay on Sundays.
A socio-economic profile for the Hayle & St Ives CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Hayle & St Ives CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 2 practices and a branch surgery operated by another practice in Connor Downs (Praze). Number of Dispensing GP Surgeries 1 Connor Downs Surgery Turnpike Road Connor Downs TR27 5DT Number of pharmacies 8 Leddra's 7 Fore St. St Ives TR26 1AB Boots 5340 Old Stennack School, Stennack St Ives TR26 1RU Boots UK Limited 3 High Street St Ives TR26 1RS Carbis Bay Pharmacy Units 1-2, Trevose House Carbis Bay TR26 2FZ Boots 5326 1-2 Penpol Terrace, Foundry Square Hayle TR27 4BQ Boots 5325 44-46 Fore Street, Copperhouse Hayle TR27 4DY Bodriggy Pharmacy 60 Queensway Hayle TR27 4PB Unit E, Marsh Lane, West Cornwall Shopping Boots 6442 Hayle TR27 4PN Park
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 76 January 2015 version no. 6 Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 8 25,837 3,230 0.3
Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 8 of which fall under the Hayle & St Ives Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Hayle & St Ives Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Saturday there is a pharmacy available between 7:00am and midnight and between 9:00am and 9:00pm on Sundays. The pharmacy in Carbis Bay is not open on Sundays and the nearest is in St Ives a short distance away.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. 8 pharmacies provide onsite consultation, in an enclosed area 1 with no wheelchair access. 6 pharmacies were willing to undertake consultations in a patient’s home/other suitable site whilst the other 3 did not offer the service. Hand washing facilities were provided at all the pharmacies 6 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology all pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. 7 pharmacies have email, 6 have websites, 6 have unrestricted internet access and 2 have NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 87.5% MS Excel 100% MS Access 37.5% PDF 87.5%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves. Although none of the pharmacies have listed languages spoken within the community, the combination of holidaymakers and migrant seasonal staff indicates otherwise. Spoken in the Pharmacy Spoken by the Community Arabic Portuguese Dutch Spanish
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 77 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. All pharmacies have parking within a 4 minute walk, 4 have onsite parking and 6 a bus service within 3 minutes. The nearest pharmacy to a railway station is 3 minutes away.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients and 6 delivered dispensed medicines free of charge (2 did not respond). 2 stated they delivered to the housebound 2 specified all patients, whilst the others did not specify. 5 pharmacies did not charge for delivery, and only 3 specified the area they would deliver to: • Hayle • Carbis Bay, St Ives, Halestown, Lelant, Hayle • Surgery catchment area (Stennack, St Ives)
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 7 offered all services whilst 1 of the pharmacies in St Ives only supplies dressings.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 12.5% 75% 12.5% SACS 12.5% 75% 12.5%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 78 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 5 2 0 0 2 Anti viral distribution 0 4 4 0 0 1 Care Home Service 1 5 2 0 0 2 Chlamydia Treatment 0 4 3 0 0 2 Contraceptive Service 0 5 3 0 0 1 Allergies 0 5 2 0 0 2 Alzheimers/dementia 0 5 2 0 0 2 Asthma 0 5 2 0 0 2 CHD 0 5 2 0 0 2 Depression 0 5 2 0 0 2 Diabetes Type I 0 5 2 0 0 2 Diabetes Type II 0 5 2 0 0 2 Epilepsy 0 5 2 0 0 2 Heart failure 0 5 2 0 0 2 Hypertension 0 5 2 0 0 2 Parkinsons disease 0 5 2 0 0 2 Emergency Hormonal Contraception Service 6 3 0 0 0 0 Gluten Free Food Supply Service 7 1 0 0 0 1 Independent Prescribing Service 0 3 4 0 0 2 Language Access Service 0 4 3 0 0 2 Medication Review Service 2 5 2 0 0 0 Medicines Management Support Service 0 5 2 0 0 2 DomMAR Carer's Charts 3 3 1 0 0 2 Minor Ailments Scheme 9 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 2 3 2 0 0 2 Needle &Syringe Exchange Service 2 5 2 0 0 0 Obesity Management (Adults & Children) 0 5 3 0 0 1 Directly Observed Therapy 0 3 3 1 0 2 Out of hours service 0 5 0 1 1 2 Palliative Care Scheme 0 4 3 0 0 2 Phlebotomy Service 0 3 3 1 0 2 Prescriber support service 0 5 2 1 0 2 Schools Service 0 4 2 1 0 2 Alcohol 0 5 2 1 0 2 Chlamydia 0 5 2 1 0 2 Cholesterol 0 5 2 1 0 2 Diabetes 1 4 2 1 0 2 Gonorrhoea 0 5 2 1 0 2 H.pylori 0 5 2 1 0 2 HbA 1C 0 5 2 1 0 2 Hepatitis 0 5 2 1 0 2 HIV 0 5 2 1 0 2 Seasonal flu vac 0 4 1 1 3 1 Childhood vac 0 4 2 1 0 2 HPV 0 4 2 1 0 2 Hep B vacc 0 4 2 1 1 2 Travel vaccines 0 4 1 1 0 3 Sharps Disposal service 0 5 1 1 0 2 NRT Vouch 9 0 0 0 0 0 Smoke cess counc 0 5 2 0 0 2 Supervised Administration 8 0 0 0 0 1 Supplementary Prescribing 0 3 4 0 0 2 NHS Healthcheck 0 3 3 1 0 3 Emergency Supply Svs/**URM Scheme 9 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 79 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2010 (yet to be built) Census) 2014-30 13,289 16.7% 568 1,404 2,750 Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 1,030 additional dwellings will be built in this Community Network area. Over 300 of these will be within the Hayle town area and a further 380 in the surrounding area, 320 in the St Ives/ Carbis bay area.
Identified gaps in service provision
• 4 pharmacies (1 in Carbis Bay, 2 in St Ives and 1 in Hayle) do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods. • Ensure that all 100 hour pharmacies are providing EHC, EPS and Minor Ailments. In Hayle, Bodriggy is not providing EHC and so are required to address this by July 2015.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 80 January 2015 version no. 6 Helston and Lizard Community Network Area: Summary
Overview of the geography The Helston and The Lizard Locality is made up of eighteen parishes; Breage, Crowan, Cury, Germoe, Grade-Ruan, Gunwalloe, Gweek, Helston, Landewednack, Manaccan, Mawgan-in- Meneage, Mullion, Porthleven, Sithney, St Anthony-in-Meneage, St Keverne, St Martin-in- Meneage, and Wendron.
Summary Issues
• Helston and the Lizard Community Network has 32,847 residents; 6.2% of Cornwall’s total population. The workday population is 31,283 so 1,564 people (net) commute out of the network area to work. • 12.8% of households do not have access to a car. • 6.2% of people in the Helston and the Lizard Community Network live in a deprived area. • The area has a seasonal tourist influx, particularly across the Lizard and the town of Porthleven. • Polish and Italian are spoken in the community but not covered in any of the pharmacies. • No Sunday pharmacy available in Mullion and Porthleven. • The pharmacy at Mullion does not have wheelchair access to the consultation room.
A socio-economic profile for the Helston and the Lizard CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Helston and the Lizard CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 5 practices with 3 branch surgeries in Porthleven, Ruan Minor and The Lizard. Number of Dispensing GP Surgeries 6 Helston Medical Centre Trelawney Road Helston TR13 8AU Mullion Health Centre The Health Centre Mullion TR12 7DQ Praze-An-Beeble Surgery School Rd Praze-An-Beeble TR14 0LB St Keverne Health Centre Polventon Parc St. Keverne TR12 6PB Lizard Surgery The Green Lizard TR12 7NZ Ruan Minor Surgery Grebe Place Ruan Minor TR12 7JW Number of Pharmacies 5 Boots 5606 Churchtown Mullion TR12 7BY Halls Pharmacy Trelawney Road Helston TR13 8AU Tesco Clodgey Lane. Helston TR13 8PJ Boots 415 38 Meneage St. Helston TR13 8QY Boots 5327 Fore St. Porthleven TR13 9HJ Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 5 32,847 6,569 0.2
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 81 January 2015 version no. 6
Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 5 of which fall under Helston and The Lizard Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Helston and The Lizard Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Saturday there is a pharmacy available between 8:00am and 8:00pm and Sundays between 10:00am and 4:00pm. The pharmacies in Mullion and Porthleven are closed on Sundays except for the summer months, however, there is a supermarket in-store pharmacy in Helston available all year round.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. 4 pharmacies provide onsite consultation, in an enclosed area with wheelchair access. Only 1 pharmacy was willing to undertake consultations in a patient’s home/other suitable site whilst the others did not offer the service. 3 pharmacies offered hand washing facilities, 2 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology and all the pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. 4 pharmacies have email, 4 have websites, 3 have unrestricted internet access, and 1 has NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 80% MS Excel 80% MS Access 40% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves.
Spoken in the Pharmacy Spoken by the Community French Polish Hindi Italian Romanian
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 82 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. 4 pharmacies have onsite parking, 3 have nearby council parking and all pharmacies are accessible by bus within 3 minutes. There is no pharmacy with train access.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All 5 pharmacies collected prescriptions from surgeries, however, only 1 delivered dispensed medicines free of charge to the housebound.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 80% 20% 0% NMS 80% 20% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 83 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 1 2 1 0 1 Anti viral distribution 0 2 2 0 0 1 Care Home Service 1 1 2 1 0 0 Chlamydia Treatment 0 1 3 1 0 0 Contraceptive Service 0 2 3 0 0 0 Allergies 0 1 4 0 0 0 Alzheimers/dementia 0 1 4 0 0 0 Asthma 0 1 4 0 0 0 CHD 0 1 4 0 0 0 Depression 0 1 4 0 0 0 Diabetes Type I 0 1 4 0 0 0 Diabetes Type II 0 1 4 0 0 0 Epilepsy 0 1 4 0 0 0 Heart failure 0 1 4 0 0 0 Hypertension 0 1 4 0 0 0 Parkinsons disease 0 1 4 0 0 0 Emergency Hormonal Contraception Service 5 0 0 0 0 0 Gluten Free Food Supply Service 4 1 0 0 0 0 Independent Prescribing Service 0 0 2 0 0 3 Language Access Service 0 0 2 0 0 3 Medication Review Service 3 1 1 0 0 0 Medicines Management Support Service 0 1 3 0 0 1 DomMAR Carer's Charts 0 1 2 0 0 2 Minor Ailments Scheme 5 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 0 1 4 0 0 0 Needle &Syringe Exchange Service 1 0 2 0 0 2 Obesity Management (Adults & Children) 0 1 4 0 0 0 Directly Observed Therapy 0 0 1 1 0 3 Out of hours service 2 0 0 1 0 2 Palliative Care Scheme 2 1 1 0 0 1 Phlebotomy Service 0 1 1 1 0 2 Prescriber support service 0 1 3 0 0 1 Schools Service 0 1 2 0 0 2 Alcohol 1 1 2 0 0 1 Chlamydia 0 1 2 1 0 1 Cholesterol 0 1 2 0 1 1 Diabetes 0 1 2 0 1 1 Gonorrhoea 0 1 2 1 0 1 H.pylori 0 1 2 1 0 1 HbA 1C 0 1 2 1 0 1 Hepatitis 0 1 2 1 0 1 HIV 0 1 1 1 0 2 Seasonal flu vac 0 1 2 1 1 0 Childhood vac 0 1 2 1 0 1 HPV 0 1 2 1 0 1 Hep B vacc 0 1 2 1 0 1 Travel vaccines 0 1 2 1 0 1 Sharps Disposal service 0 1 2 1 0 1 NRT Vouch 4 0 1 0 0 0 Smoke cess counc 0 1 3 0 0 1 Supervised Administration 3 2 0 0 0 0 Supplementary Prescribing 0 1 2 0 0 2 NHS Healthcheck 0 1 1 1 0 2 Emergency Supply Svs/**URM Scheme 5 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 84 January 2015 version no. 6 Future Development
Local Plan Dwellings with no Dwellings Current Dwellings Housing usual residents completed since commitments (2011 Census) Allocation (2011 Census) 2010 (yet to be built) 2014-30 16,027 12.0% 479 731 2,000
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 642 additional dwellings will be built in this Community Network area. Over 240 of these will be within the Helston town area and 60 within the Town of Porthleven.
Identified gaps in service provision
• 2 pharmacies (1 in Porthleven and 1 in Helston) do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 85 January 2015 version no. 6 Launceston Community Network Area: Summary
Overview of the geography The Launceston Locality is made up of sixteen parishes; Altarnun, Boyton, Egloskerry, Lanest, Launceston, Lawhitton Rural, Lewannick, Lezant, North Hill, North Petherwin, South Petherwin, St Stephens By Launceston Rural, St Thomas and the Apostle Rural, Stokeclimsland, Trewen, and Werrington.
The Locality borders with Devon to the east.
Summary Issues
• Launceston Community Network has 18,682 residents 3.5% of Cornwall’s total population. The workday population is 19,132 so 450 people (net) commute into the network to work. • 13.6% of households do not have access to a car. • Polish and Czech are spoken in the community but not within the pharmacy. Only one pharmacy stated they had access to translation services.
A socio-economic profile for the Launceston CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Launceston CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 1 practice and a branch surgery operated by another practice in Lewannick (Carnewater). Number of Dispensing GP Surgeries 1 Launceston Medical Centre Landlake Road Launceston PL15 9HH Number of Pharmacies 3 Day Lewis Plc 9 Broad Street Launceston PL15 8AA Boots 5546 28 Broad St. Launceston PL15 8AE Tesco Instore Pharmacy Tavistock Road Launceston PL15 9AG Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 3 18,682 6,227 0.2
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 86 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 3 of which fall under the Launceston Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Launceston Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Saturday there is a pharmacy available between 8:30am and 7:00pm. The supermarket in-store pharmacy is open on Sundays between 10:00am and 4:00pm.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. All the pharmacies provide onsite consultation, in an enclosed area with wheelchair access. 2 pharmacies are willing to undertake consultations in a patient’s home/other suitable site. All pharmacies offered hand washing facilities, 2 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology and all the pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. All pharmacies have email, unrestricted internet access and use NHS mail and 2 have websites. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 100% MS Excel 66% MS Access 33% PDF 66%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves. 1 of the pharmacies stated they had access to phone translation services.
Spoken in the Pharmacy Spoken by the Community Polish Czech
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 87 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. Parking is available within 3 minutes and 1 pharmacy has onsite parking, 1 has a nearby bus service. There is no pharmacy within range of a railway station.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients and 2 delivered dispensed medicines free of charge. 1 stated they delivered to the housebound within a 10 mile radius, whilst the other did not specify. 2 of the pharmacies did not charge for delivery.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings. 2 pharmacies offered all services, whilst the supermarket in-store pharmacy at Launceston offered all apart from stoma and incontinence appliances.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 88 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Currently Currently Providing Providing if provide Left Blank Left Blank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to & able Willing Providing Private Private Providing Willing to provide provide Willing to provide Willing to Anticoag Monitoring 0 0 2 0 0 1 Anti viral distribution 1 0 1 0 0 1 Care Home Service 1 0 1 0 0 1 Chlamydia Treatment 0 0 2 0 0 1 Contraceptive Service 1 0 1 0 0 1 Allergies 0 1 1 0 0 1 Alzheimers/dementia 0 1 1 0 0 1 Asthma 0 1 1 0 0 1 CHD 0 0 2 0 0 1 Depression 0 0 2 0 0 1 Diabetes Type I 0 1 1 0 0 1 Diabetes Type II 0 1 1 0 0 1 Epilepsy 0 0 2 0 0 1 Heart failure 0 1 1 0 0 1 Hypertension 0 1 1 0 0 1 Parkinsons disease 0 0 2 0 0 1 Emergency Hormonal Contraception Service 2 1 0 0 0 0 Gluten Free Food Supply Service 3 0 0 0 0 0 Home Delivery Service 1 0 0 0 1 1 Independent Prescribing Service 0 0 2 0 0 1 Language Access Service 1 0 0 0 0 2 Medication Review Service 2 0 1 0 0 0 Medicines Management Support Service 0 1 1 0 0 1 DomMAR Carer's Charts 1 0 1 0 0 1 Minor Ailments Scheme 3 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 0 0 2 0 0 1 Needle &Syringe Exchange Service 1 1 1 0 0 0 Obesity Management (Adults & Children) 0 1 2 0 0 1 Directly Observed Therapy 0 1 1 0 0 2 Out of hours service 1 1 0 0 0 1 Palliative Care Scheme 1 1 0 0 0 1 Phlebotomy Service 0 0 2 0 0 1 Prescriber support service 0 0 2 0 0 1 Schools Service 0 0 2 0 0 1 Alcohol 2 0 0 0 0 1 Chlamydia 0 1 1 0 0 2 Cholesterol 2 1 1 0 0 0 Diabetes 3 1 1 0 0 0 Gonorrhoea 0 0 1 0 0 2 H.pylori 0 0 1 0 0 2 HbA 1C 0 0 1 0 0 2 Hepatitis 0 0 1 0 0 2 HIV 0 0 1 0 0 2 Seasonal flu vac 2 0 0 0 1 0 Childhood vac 0 1 0 0 0 2 HPV 0 1 0 0 0 2 Hep B vacc 0 1 0 0 0 2 Travel vaccines 0 1 0 0 0 2 Sharps Disposal service 0 1 0 0 0 2 NRT Vouch 3 0 0 0 0 0 Smoke cess counc 2 0 0 1 0 0 Supervised Administration 3 0 0 0 0 0 Supplementary Prescribing 0 0 2 0 0 1 NHS Healthcheck 0 0 2 0 0 1 Emergency Supply Svs/**URM Scheme 3 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 89 January 2015 version no. 6 Future Development
Local Plan Dwellings with no Dwellings Current Dwellings Housing usual residents completed since commitments (2011 Census) Allocation (2011 Census) 2010 (yet to be built) 2014-30 8,698 7.2% 437 656 1,900
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 790 additional dwellings will be built in this Community Network area. Over 380 of these will be within the Launceston town area with a further 270 in the surrounding area.
Identified gaps in service provision
• 2 pharmacies do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 90 January 2015 version no. 6 Liskeard and Looe Community Network Area: Summary
Overview of the geography The Liskeard and Looe Locality is made up of eighteen parishes; Deviock, Dobwells and Trewidland, Duloe, Lanreath, Lansallos, Lanteglos, Liskeard, Looe, Menheniot, Morvah, Pelynt, Quethiock, St Cleer, St Keyne, St Martinby-Looe, St Neot, St Pinnock and Warleggan.
The Locality extends from Bodmin Moor in the north to Looe on the south coast.
Summary Issues
• Liskeard and Looe Community Network has 31,043 residents; 5.8% of Cornwall’s total population. The workday population is 29,288 so 1,755 people (net) commute out of the network to work. • 16.7% of households do not have access to a car. • 9.1% of people in the Liskeard and Looe Community Network live in a deprived area. • Popular tourist destinations of Looe and Polperro see a seasonal influx of visitors. • 1 pharmacy in Liskeard and 1 in Looe do not have wheelchair access to the consultation room.
A socio-economic profile for the Liskeard and Looe CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Liskeard and Looe CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 3 and branch surgeries in Polperro, Pelynt and a branch surgery operated by another practice in Downderry. Number of Dispensing GP Surgeries 4 Oak Tree Surgery Clemo Road Liskeard PL14 3XA Pelynt Health Centre Summer Lane Pelynt PL13 2JW Rosedean Surgery 8 Dean Street Liskeard PL14 4AQ The Looe Health Centre Station Road Looe PL13 1HA Number of Pharmacies 5 Day Lewis 4 Pike St. Liskeard PL14 3JE Boots 445 21-22 Baytree Hill Liskeard PL14 4BG Boots 2088 Coach House Arcade, Fore Street Looe PL13 1DT Looe 65 Fore Street Looe PL13 1DT Robert's Pharmacy The Coombes Polperro PL13 2RG Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 5 31,043 6,235 0.2
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 91 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 5 of which fall under the Liskeard and Looe Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Liskeard & Looe Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Saturday there is a pharmacy available between 8:30am and 6:00pm. 2 pharmacies in Looe are open between 9:00am and 5:00pm on Sundays. Liskeard pharmacies operate on a rota system and are open extra hours between 5:30pm and 6:00pm Monday to Friday and 5:00pm-6:00pm on Sundays. The pharmacy in Polperro is closed Sundays.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. All 5 pharmacies provide onsite consultation, in an enclosed area 3 with wheelchair access. 3 pharmacies were willing to undertake consultations in a patient’s home/other suitable site. All pharmacies offered hand washing facilities, 3 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology and all the pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. All pharmacies have email and websites, 3 have unrestricted internet access and 2 have NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 100% MS Excel 80% MS Access 20% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves.
Spoken in the Pharmacy Spoken by the Community French German Polish
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 92 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. 3 pharmacies have nearby parking and 2 a bus service within 3 minutes, on average there is parking within 5 minutes, none have onsite parking. The nearest pharmacy to a railway station is 6 minutes away. There is no access to a railway station in Polperro.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients and 4 delivered dispensed medicines free of charge. 4 pharmacies did not charge for delivery and only 1 stated they would deliver within a roughly 5 mile area.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings. 4 pharmacies offered all services whilst 1 pharmacy in Looe offered all excluding stoma and incontinence appliances.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 93 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 1 4 0 0 0 Anti viral distribution 1 2 2 0 0 0 Care Home Service 1 3 1 0 0 0 Chlamydia Treatment 0 2 3 0 0 0 Contraceptive Service 1 0 4 0 0 0 Allergies 0 2 3 0 0 0 Alzheimers/dementia 0 2 3 0 0 0 Asthma 0 2 3 0 0 0 CHD 0 2 3 0 0 0 Depression 0 1 4 0 0 0 Diabetes Type I 0 2 3 0 0 0 Diabetes Type II 0 2 3 0 0 0 Epilepsy 0 1 4 0 0 0 Heart failure 0 2 3 0 0 0 Hypertension 0 2 3 0 0 0 Parkinsons disease 0 1 3 0 0 1 Emergency Hormonal Contraception Service 4 1 0 0 0 0 Gluten Free Food Supply Service 4 1 0 0 0 0 Independent Prescribing Service 0 2 3 0 0 0 Language Access Service 0 3 2 0 0 0 Medication Review Service 3 1 1 0 0 0 Medicines Management Support Service 0 3 2 0 0 0 DomMAR Carer's Charts 1 1 3 0 0 0 Minor Ailments Scheme 5 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 2 2 1 0 0 0 Needle &Syringe Exchange Service 2 2 1 0 0 0 Obesity Management (Adults & Children) 0 2 3 0 0 0 Directly Observed Therapy 1 2 2 0 0 0 Out of hours service 1 2 1 0 0 1 Palliative Care Scheme 0 3 2 0 0 0 Phlebotomy Service 0 1 3 1 0 0 Prescriber support service 0 2 3 0 0 0 Schools Service 0 2 3 0 0 0 Alcohol 1 2 2 0 0 0 Chlamydia 0 2 3 0 0 0 Cholesterol 0 2 3 0 0 0 Diabetes 0 2 3 0 0 0 Gonorrhoea 0 1 4 0 0 0 H.pylori 0 1 4 0 0 0 HbA 1C 0 1 4 0 0 0 Hepatitis 0 1 4 0 0 0 HIV 0 1 4 0 0 0 Seasonal flu vac 2 1 1 1 1 0 Childhood vac 0 1 3 1 0 0 HPV 0 1 3 1 0 0 Hep B vacc 0 1 3 1 0 0 Travel vaccines 0 1 3 1 0 0 Sharps Disposal service 3 0 1 1 0 0 NRT Vouch 3 2 0 0 0 0 Smoke cess counc 1 1 3 0 0 0 Supervised Administration 5 0 0 0 0 0 Supplementary Prescribing 0 1 4 0 0 0 NHS Healthcheck 0 1 4 0 0 0 Emergency Supply Svs/**URM Scheme 5 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 94 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2010 (yet to be built) Census) 2014-30 16,305 12.0% 451 1,107 2,650
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 1,060 additional dwellings will be built in this Community Network area. Over 610 of these will be within the Liskeard town area with a further 170 in the town of Looe.
Identified gaps in service provision
• 3 pharmacies (1 in Liskeard, 1 in Looe and the pharmacy in Polperro) do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 95 January 2015 version no. 6 Newquay and St Columb Community Network Area: Summary
Overview of the geography The Newquay and St Columb Locality is made up of five parishes; Colan, Mawgan-in- Pydar, Newquay, St Columb, and St Wenn. It covers an area extending from the west coast to St Wenn on the border with the Bodmin Locality.
A non-controlled locality boundary exists around the town of Newquay.
Summary Issues
• Newquay and St Columb Community Network has 26,612 residents; 5% of Cornwall’s total population. The workday population is 25,758 so 854 people (net) commute out of the network to work. • 20.3% of households do not have access to a car. • 5.5% of people in the Newquay and St Columb Community Network live in a highly deprived area (in the top 20% most deprived in England). • In the summer months access to local pharmaceutical services can often be compromised due to the high tourist influx. • Numerous languages are spoken within the pharmacies though there may be a shortfall in view of large influx of holiday makers and seasonal staff, particularly through the summer months.
A socio-economic profile for the Newquay and St Columb CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Newquay and St Columb CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 2 practices and a branch surgery operated by another practice in St Columb Major. Number of Dispensing GP Surgeries 1 St Columb Major Surgery Trekenning Road St. Columb Major TR9 6RR Number of Pharmacies 6 (2 non-NHS) Kaye's (Non-NHS) East St. Newquay TR7 1BH Boots 391 15 Bank St. Newquay TR7 1DH Newquay Health Centre, St Drury's Pharmacy Newquay TR7 1RU Thomas Rd Narrowcliff Pharmacy Narrowcliff Newquay TR7 2QF Drury's (Non-NHS) Chester Road Newquay TR7 2RT Boots 5558 Union Sq. St Columb TR9 6AP Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 4 (excluding 2 26,612 6,653 0.1 Non-NHS)
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 96 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 6 of which fall under the Newquay Community Network Area. 4 pharmacies completed the questionnaire as 2 are non-NHS.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Newquay Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Friday there is a pharmacy available between 8:30am and 6:30pm, Saturdays from 9:00am until 5:30pm then between 10:30am and 4:30pm on Sundays. There are extended opening hours during the summer season.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. All pharmacies provide onsite consultation, in an enclosed area 3 with wheelchair access whilst the other pharmacy stated they have two consultation rooms and another has a specialist chair which is used by a physio and podiatrist. 3 pharmacies were willing to undertake consultations in a patient’s home/other suitable site whilst the other did not offer the service. All pharmacies offered hand washing 3 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology and all pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. All pharmacies have email and websites, 3 unrestricted internet access and 3 NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats, 1 pharmacy was unable to access any of these formats –
MS Word 75% MS Excel 75% MS Access 25% PDF 75%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves. There were no languages listed as spoken by the community despite there being a large influx of holiday makers and seasonal staff, particularly through the summer months.
Spoken in the Pharmacy Spoken by the Community Italian German Polish Spanish
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 97 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. 2 pharmacies have onsite parking, on average there is parking within 5 minutes and 2 have a nearby bus service. The nearest pharmacy to a railway station is 6 minutes away.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. 1 stated they delivered to the housebound whilst the other did not specify. None of the pharmacies charged for delivery, nor did they restrict the area they would deliver to.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 75% 25% 0% SACS 50% 50% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 98 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 2 2 0 0 0 Anti viral distribution 1 1 2 0 0 0 Care Home Service 4 0 0 0 0 0 Chlamydia Treatment 0 2 2 0 0 0 Contraceptive Service 0 2 2 0 0 0 Allergies 0 2 2 0 0 0 Alzheimers/dementia 0 2 2 0 0 0 Asthma 0 3 1 0 0 0 CHD 0 2 2 0 0 0 Depression 0 2 2 0 0 0 Diabetes Type I 0 2 2 0 0 0 Diabetes Type II 0 3 1 0 0 0 Epilepsy 0 2 2 0 0 0 Heart failure 0 2 2 0 0 0 Hypertension 0 2 2 0 0 0 Parkinsons disease 0 2 2 0 0 0 Emergency Hormonal Contraception Service 4 0 0 0 0 0 Gluten Free Food Supply Service 4 0 0 0 0 0 Independent Prescribing Service 0 1 3 0 0 0 Language Access Service 1 0 3 0 0 0 Medication Review Service 4 0 0 0 0 0 Medicines Management Support Service 0 2 2 0 0 0 DomMAR Carer's Charts 2 2 0 0 0 0 Minor Ailments Scheme 4 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 0 1 2 0 0 1 Needle &Syringe Exchange Service 2 2 0 0 0 0 Obesity Management (Adults & Children) 0 2 2 0 0 0 Directly Observed Therapy 0 2 2 0 0 0 Out of hours service 3 1 0 0 0 0 Palliative Care Scheme 3 1 0 0 0 0 Phlebotomy Service 0 2 2 0 0 0 Prescriber support service 0 2 2 0 0 0 Schools Service 0 2 2 0 0 0 Alcohol 1 1 2 0 0 0 Chlamydia 0 2 2 0 0 0 Cholesterol 1 1 2 0 0 0 Diabetes 1 1 2 0 0 0 Gonorrhoea 0 2 2 0 0 0 H.pylori 0 2 2 0 0 0 HbA 1C 0 2 2 0 0 0 Hepatitis 0 2 2 0 0 0 HIV 0 2 2 0 0 0 Seasonal flu vac 1 1 2 0 0 0 Childhood vac 0 2 2 0 0 0 HPV 0 2 2 0 0 0 Hep B vacc 0 2 2 0 0 0 Travel vaccines 0 2 2 0 0 0 Sharps Disposal service 2 2 0 0 0 0 NRT Vouch 3 1 0 0 0 0 Smoke cess counc 2 1 1 0 0 0 Supervised Administration 4 0 0 0 0 0 Supplementary Prescribing 0 2 2 0 0 0 NHS Healthcheck 0 2 2 0 0 0 Emergency Supply Svs/**URM Scheme 4 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 99 January 2015 version no. 6 Future Development
Local Plan Dwellings with no Dwellings Current Dwellings Housing usual residents completed since commitments (2011 Census) Allocation (2011 Census) 2010 (yet to be built) 2014-30 14,176 13.5% 743 2,738 4,150
Newquay faces significant growth on both its north-eastern and southern boundaries. This will impact on future pharmaceutical demands and, therefore, the provision of adequate services in the Newquay growth areas. This will call for close scrutiny and attention over the coming years.
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 2,300 additional dwellings will be built in this Community Network area. Over 2,100 of these will be within the Newquay town area.
The principle development in Newquay will be at Nansledan, to the East of Newquay sited between the existing areas of Tretherras and Porth. An urban extension, on a 218-hectare site, which will take around 40 years to build and will eventually comprise 4,000 dwellings.
Identified gaps in service provision
• 1 pharmacy does not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 100 January 2015 version no. 6 West Penwith Community Network Area: Summary
Overview of the geography The West Penwith Locality is made up of fifteen parishes; Ludgvan, Madron, Marazion, Morvah, Paul, Penzance, Perranuthnoe, Sancreed, Sennen, St Buryan, St Hilary, St Just, St Levan, St Michael’s Mount, and Zennor. The Locality extends from Land’s End in the far west to the Hayle and St Ives Locality in the north-east.
Summary Issues
• West Penwith Community Network has 38,752 residents; 7.3% of Cornwall’s total population. The workday population is 38,100 so 652 people (net) commute out of the network area to work. • 25.5% of households do not have access to a car. • 24.6% of people in the West Penwith Community Network live in a deprived area. • Penzance has a very high seasonal tourist influx. • There is no Sunday pharmacy available in Marazion, Newlyn and St Just. • The pharmacy at Marazion and 2 pharmacies in Penzance do not have wheelchair access to the consultation room. • Pharmacies are multi-lingual though there may be a shortfall in view of large influx of holiday makers and seasonal staff, particularly through the summer months. • Since completing the questionnaire another pharmacy has opened in Sainsbury’s, Penzance.
A socio-economic profile for the West Penwith CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the West Penwith CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 7 practices with 5 branch surgeries in St Buryan, Sennen, Polgigga, Pendeen, Newlyn. Number of Dispensing GP Surgeries 3 Cape Cornwall Surgery St. Just-In-Penwith Penzance TR19 7HX Marazion Surgery Gwallon Lane Marazion TR17 0HW Penalverne Surgery Penalverne Drive Penzance TR18 2RE Number of Pharmacies 10 Baden House The Square Marazion TR17 0AP Boots 389 100-102 Market Jew St. Penzance TR18 2LE Boots 5332 3 Stewarts Buildings, Morrab Rd. Penzance TR18 2QU Boots 5331 3 Alverton St. Penzance TR18 2QW Day Lewis Pharmacy 16 Holly Terrace, Heamoor Penzance TR18 3EL Sainsbury Eastern Green Penzance TR18 3FA Morrab 2 Morrab Road Penzance TR18 4EL Day Lewis 1-2 Alverton Terrace. Penzance TR18 4JH Newlyn Pharmacy 5 The Strand Newlyn TR18 5HH Ramsay Pharmacy 42 Fore St. St Just in Penwith TR19 7LJ
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 101 January 2015 version no. 6
Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 10 38,752 3,875 0.3
Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 9 of which fall under the Penzance, Marazion and St Just (West Penwith) Community Network Area. Since completion of the questionnaire a further pharmacy has opened in Sainsbury’s Penzance.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Penzance, Marazion and St Just (West Penwith) Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Saturday there is a pharmacy available between 7:00am and 10:00pm and between 9:00am and 9:00pm on Sundays. The pharmacies in Marazion, Newlyn and St Just do not operate Sunday opening hours, pharmacies are available in Hayle and Penzance a 10 minute drive away.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. 7 pharmacies provide onsite consultation, in an enclosed area 6 with wheelchair access. 3 pharmacies were willing to undertake consultations in a patient’s home/other suitable site whilst the others did not offer the service. 6 pharmacies offered hand washing facilities, 5 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology all pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. All pharmacies have email, 4 have websites, 6 have unrestricted internet access, and 4 have NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 77.78% MS Excel 77.78% MS Access 22.22% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves. One of the pharmacies uses a mobile phone app.
Spoken in the Pharmacy Spoken by the Community Arabic Italian Punjabi Urdu Portuguese Urdu Punjabi Spanish Bengali
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 102 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. There is no onsite parking at any of the pharmacies, on average there is parking within 4 minutes and a bus service within 3 minutes for 8 of the pharmacies. The nearest pharmacy to a railway station is 5 minutes away.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other (street, Train Bus private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. 2 stated they delivered to the housebound and 1 delivered to anyone. Only 1 pharmacy charged for delivery, some restricted delivery areas to the following:
• Marazion, Long rock, Goldsithney and Rosudgeon • Penzance, Goldsithney, Marazion, St Buryan, Lamorna, St Just, Hayle, Gurmoe, Ludgvan, Crowlas • Newlyn, Penzance, Mousehole, Paul, Lamorna and surrounding villages • Within a 10mile radius
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings. 8 pharmacies offered all services whilst the pharmacy in St Just in Penwith only offered dressings.
Advanced Services
Yes No Soon MUR 66.67% 22.22% 11.11% NMS 66.67% 22.22% 11.11% AUR 0% 88.89% 11.11% SACS 0% 88.89% 11.11%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 103 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Currently Currently Providing Providing if provide Left Blank Left Blank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to & able Willing Providing Private Private Providing Willing to provide provide Willing to provide Willing to Anticoag Monitoring 0 3 4 0 0 2 Anti viral distribution 2 3 2 0 0 2 Care Home Service 3 1 2 0 0 3 Chlamydia Treatment 0 3 4 0 0 2 Contraceptive Service 1 3 3 0 0 2 Allergies 0 4 2 0 0 3 Alzheimers/dementia 0 3 2 0 0 4 Asthma 0 4 2 0 0 3 CHD 0 4 2 0 0 3 Depression 0 3 2 0 0 4 Diabetes Type I 0 4 2 0 0 3 Diabetes Type II 0 3 2 0 0 4 Epilepsy 0 3 2 0 0 4 Heart failure 0 4 2 0 0 3 Hypertension 0 4 2 0 0 3 Parkinsons disease 0 3 2 0 0 4 Emergency Hormonal Contraception Service 3 4 0 0 0 2 Gluten Free Food Supply Service 7 1 0 0 0 1 Independent Prescribing Service 0 4 2 0 0 3 Language Access Service 0 3 3 0 0 3 Medication Review Service 3 3 1 0 0 2 Medicines Management Support Service 0 3 3 0 0 3 DomMAR Carer's Charts 1 1 4 0 0 3 Minor Ailments Scheme 7 1 0 0 0 1 MUR Plus/Medicines Optimisation Service 1 2 3 0 0 3 Needle &Syringe Exchange Service 3 3 1 0 0 2 Obesity Management (Adults & Children) 0 2 3 0 0 4 Directly Observed Therapy 0 2 4 0 0 3 Out of hours service 1 1 4 0 0 3 Palliative Care Scheme 1 2 3 0 0 3 Phlebotomy Service 0 2 3 0 0 4 Prescriber support service 0 2 3 0 0 4 Schools Service 0 1 3 0 0 5 Alcohol 1 1 4 0 0 3 Chlamydia 0 2 5 0 0 2 Cholesterol 0 2 5 0 0 2 Diabetes 0 2 5 0 0 2 Gonorrhoea 0 2 3 0 0 4 H.pylori 0 2 4 0 0 3 HbA 1C 0 1 4 0 0 4 Hepatitis 0 1 3 1 0 4 HIV 0 1 3 1 0 4 Seasonal flu vac 4 2 1 0 1 2 Childhood vac 0 2 5 0 0 2 HPV 0 2 5 0 0 2 Hep B vacc 0 1 5 0 1 2 Travel vaccines 0 2 5 0 1 2 Sharps Disposal service 2 1 4 0 0 2 NRT Vouch 5 3 0 0 0 1 Smoke cess counc 1 3 3 0 0 2 Supervised Administration 8 1 0 0 0 0 Supplementary Prescribing 0 3 2 0 0 4 NHS Healthcheck 0 2 3 0 0 4 Emergency Supply Svs/**URM Scheme 7 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 104 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2010 (yet to be built) Census) 2014-30 20,737 13.1% 434 831 2,250
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 620 additional dwellings will be built in this Community Network area. Over 380 of these will be within the Penzance town area and 100 within the Parish of Ludgvan.
Identified gaps in service provision
• 7 out of 10 pharmacies do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods. • Ensure that all 100 hour pharmacies are providing EHC, EPS and Minor Ailments. In Penzance, Morrab is not providing EHC and so are required to address this by July 2015.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 105 January 2015 version no. 6 St Agnes & Perranporth Community Network Area: Summary
Overview of the geography The St Agnes and Perranporth Locality is made up of six parishes; Crantock, Cubert, Perranzabuloe, St Agnes, St Allen, and St Newlyn East. The Locality borders with the Newquay and St Columb Locality in the north, and extends down to the Camborne, Pool, and Redruth Locality in the south.
Summary Issues • St Agnes and Perranporth Community Network has 17,163 residents; 3.2% of Cornwall’s total population. The workday population is 14,529 so 2,634 people (net) commute out the network to work. • 13.5% of households do not have access to a car. • As coastal resorts, Perranporth and St Agnes receive high tourist influxes during the summer months. • No Sunday pharmacy except in Perranporth during the summer months. • No languages listed as spoken in the pharmacies, may be a shortfall in view of influx of holiday makers and seasonal staff during the summer months.
A socio-economic profile for the St Agnes & Perranporth CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the St Agnes & Perranporth CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 2 practices and a branch surgery in Mount Hawke. Number of Dispensing GP Surgeries 2 Perranporth Surgery The Perranporth Surgery Perranporth TR6 0PS St. Agnes Surgery Pengarth Road St. Agnes TR5 0TN Mount Hawke Surgery Short Cross Road Mount Hawke TR4 8UE Number of Pharmacies 2 Boots 5334 2-3 Beach Rd. Perranporth TR6 0JL Boots 5211 55 Vicarage Rd. St Agnes TR5 0TH Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 2 17,163 8,582 0.1
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 106 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 2 of which fall under the St Agnes and Perranporth Community Network Area.
Opening Hours
x Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within St Agnes and Perranporth Community Network there is a pharmacy open 6 days per week including lunchtimes (figure 1). Monday to Friday there is a pharmacy available between 8.30am and 6:15pm, Saturdays from 9:00am until 5:30pm. There is a pharmacy available in Perranporth on Sundays during the summer season. Neither pharmacy operate Sunday opening times the remainder of the year, the nearest pharmacy 15 minutes away is Redruth from St Agnes and Newquay for Perranporth.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. Both pharmacies provide onsite consultation, in an enclosed area with wheelchair access. Only 1 pharmacy was willing to undertake consultations in a patient’s home/other suitable site. Hand Washing Facilities within the consultation area were available in only 1 pharmacy.
Information Technology A section of the questionnaire was dedicated to Information Technology all pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. Both pharmacies have email, 1 has a website, 1 has unrestricted internet access, 1 has NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 50% MS Excel 100% MS Access 0% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves, none were stated.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 107 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. All pharmacies have some form of parking, 1 onsite and 1 had a bus stop within 3 minutes. There is no accessibility by train to St Agnes and Perranporth pharmacies.
Pharmacy Transport links (within 3 minute walk) 100%
50%
0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. Both pharmacies collected prescriptions from surgeries for patients, with 1 delivering dispensed medicines free of charge. Neither pharmacy commented on where or who they would deliver to. None of the pharmacies charged for delivery.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 108 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Currently Currently Providing Providing if provide Left Blank Left Blank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to & able Willing Providing Private Private Providing Willing to provide provide Willing to provide Willing to Anticoag Monitoring 0 1 1 0 0 0 Anti viral distribution 0 1 1 0 0 0 Care Home Service 2 0 0 0 0 0 Chlamydia Treatment 0 1 1 0 0 0 Contraceptive Service 0 1 1 0 0 0 Allergies 0 1 1 0 0 0 Alzheimers/dementia 0 1 1 0 0 0 Asthma 0 1 1 0 0 0 CHD 0 1 1 0 0 0 Depression 0 1 1 0 0 0 Diabetes Type I 0 1 1 0 0 0 Diabetes Type II 0 1 1 0 0 0 Epilepsy 0 1 1 0 0 0 Heart failure 0 1 1 0 0 0 Hypertension 0 1 1 0 0 0 Parkinsons disease 0 1 1 0 0 0 Emergency Hormonal Contraception Service 2 0 0 0 0 0 Gluten Free Food Supply Service 1 0 0 0 0 1 Independent Prescribing Service 0 0 1 0 0 1 Language Access Service 0 0 0 0 0 2 Medication Review Service 1 0 1 0 0 0 Medicines Management Support Service 0 0 1 0 0 1 DomMAR Carer's Charts 0 0 1 0 0 1 Minor Ailments Scheme 2 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 1 1 0 0 0 0 Needle &Syringe Exchange Service 0 0 0 0 1 1 Obesity Management (Adults & Children) 0 1 1 0 0 0 Directly Observed Therapy 0 1 1 0 0 0 Out of hours service 0 0 0 1 0 1 Palliative Care Scheme 2 0 0 0 0 0 Phlebotomy Service 0 1 1 0 0 0 Prescriber support service 0 1 1 0 0 0 Schools Service 0 1 1 0 0 0 Alcohol 0 1 1 0 0 0 Chlamydia 0 1 1 0 0 0 Cholesterol 0 1 1 0 0 0 Diabetes 1 0 1 0 0 0 Gonorrhoea 0 1 1 0 0 0 H.pylori 0 1 1 0 0 0 HbA 1C 0 1 1 0 0 0 Hepatitis 0 1 1 0 0 0 HIV 0 1 1 0 0 0 Seasonal flu vac 0 1 1 0 0 0 Childhood vac 0 1 1 0 0 0 HPV 0 1 1 0 0 0 Hep B vacc 0 1 1 0 0 0 Travel vaccines 0 1 1 0 0 0 Sharps Disposal service 0 1 0 1 0 0 NRT Vouch 2 0 0 0 0 0 Smoke cess counc 1 0 1 0 0 0 Supervised Administration 2 0 0 0 0 0 Supplementary Prescribing 0 0 1 0 0 1 NHS Healthcheck 0 0 1 0 0 1 Emergency Supply Svs/**URM Scheme 2 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 109 January 2015 version no. 6 Future Development
Local Plan Dwellings with no Dwellings Current Dwellings Housing usual residents completed since commitments (2011 Census) Allocation (2011 Census) 2010 (yet to be built) 2014-30 8,670 14.6% 256 384 1,100
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 360 additional dwellings will be built in this Community Network area. Over 180 of these will be within the within the Parish of Perranzabuloe (Lisky Hill, Perranporth).
Identified gaps in service provision
• No pharmacy has an EEFO accreditation within the community network area. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 110 January 2015 version no. 6 St Austell & Mevagissey Community Network Area: Summary
Overview of the geography The St Austell Locality is made up of eight parishes; Mevagissey, St Ewe, St Goran, St Mewan, Pentewan Valley, St Austell, Carlyon, and St Austell Bay.
Summary Issues
• St Austell and Mevagissey Community Network has 30,975 residents; 5.8% of Cornwall’s total population. The workday population is 33,273 so 2,298 people (net) commute into the network area to work. • 18.8% of households do not have access to a car. • 14.5% of people in the St Austell and Mevagissey Community Network live in a highly deprived area (in the top 20% most deprived in England). • St Austell, Mevagissey and Gorran Haven are popular tourist destinations during the summer months. • Polish was listed as being spoken within the community network area, however, there did not appear to be any languages spoken in the pharmacies. • 1 of the pharmacies does not have a consultation room. • No pharmacy in Mevagissey on Sundays.
A socio-economic profile for the St Austell & Mevagissey CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the St Austell & Mevagissey CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 5 practices and a branch surgery in Gorran Haven. Number of Dispensing GP Surgeries 1 Mevagissey Surgery River Street Mevagissey PL26 6UE Number of Pharmacies 7 Day Lewis Wheal Northey Centre, I Wheal Northey St Austell PL25 3EF Boots Pharmacy 25 Polkyth Parade, Carlyon Road St Austell PL25 4LD Boots 5550 67 Victoria Rd, Mount Charles St Austell PL25 4QF Boots 375 29 Fore St. St Austell PL25 5EP Day Lewis 1-3 Victoria Place. St Austell PL25 5PE Asda Stores Ltd Cromwell Road St Austell PL25 4PR Boots 5497 3 Fore St. Mevagissey PL26 6UQ
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 111 January 2015 version no. 6 Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 7 30,975 4,425 0.2
Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 7 of which fall under the St Austell and Mevagissey Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within St Austell and Mevagissey Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday there is a pharmacy available between 8.00am and 11:00pm, Thursday to Friday from 7:00am till 11:00pm, Saturdays from 7:00am until 10:00pm then between 10:00am and 4:00pm on Sundays. The pharmacy in Mevagissey does not open on Sunday except for during the summer months, the nearest is in St Austell.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. 6 pharmacies provide onsite consultation, in an enclosed area with wheelchair access, 1 does not provide this facility. Only 1 pharmacy was unwilling to undertake consultations in a patient’s home/other suitable site. Hand Washing Facilities were available at all the pharmacies 5 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology and all pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. 6 pharmacies have email, 5 have websites, 3 have unrestricted internet access and 1 has NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 57% MS Excel 57% MS Access 0% PDF 86%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves, only Polish was reported within the community.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 112 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. 2 pharmacies have onsite parking and all pharmacies have parking on average within a 4 minute walk, 6 had a bus stop within 3 minutes. The nearest pharmacy to a train station in St Austell is 5 minutes.
Pharmacy Transport links (within 3 minute walk) 100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 3 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients and deliver dispensed medicines free of charge. 1 pharmacy stated they delivered to the housebound another to all patients, whilst the majority did not comment. Only 2 of the pharmacies charged for delivery, however, 3 stated they delivered only to St Austell and the surrounding villages.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 86% 0% 14% NMS 86% 0% 14% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 113 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 0 5 2 0 1 Anti viral distribution 0 0 5 2 0 1 Care Home Service 1 0 5 1 0 1 Chlamydia Treatment 0 0 6 1 0 0 Contraceptive Service 0 0 5 1 0 1 Allergies 0 0 7 0 0 0 Alzheimers/dementia 0 0 6 1 0 1 Asthma 0 0 7 1 0 0 CHD 0 0 6 1 0 1 Depression 0 0 6 1 0 1 Diabetes Type I 0 0 5 2 0 1 Diabetes Type II 0 0 5 1 0 1 Epilepsy 0 0 6 1 0 1 Heart failure 0 0 6 1 0 0 Hypertension 0 0 5 2 1 0 Parkinsons disease 0 0 5 2 0 1 Emergency Hormonal Contraception Service 6 1 0 0 0 0 Gluten Free Food Supply Service 7 0 0 0 0 0 Independent Prescribing Service 0 0 5 1 0 1 Language Access Service 0 0 5 1 0 1 Medication Review Service 2 0 3 1 0 1 Medicines Management Support Service 0 0 4 2 0 1 DomMAR Carer's Charts 0 0 4 2 0 1 Minor Ailments Scheme 6 1 0 0 0 0 MUR Plus/Medicines Optimisation Service 0 0 4 2 0 1 Needle &Syringe Exchange Service 2 1 4 0 0 0 Obesity Management (Adults & Children) 0 0 5 1 1 0 Directly Observed Therapy 0 0 5 1 0 1 Out of hours service 1 1 3 1 0 1 Palliative Care Scheme 2 0 3 0 0 2 Phlebotomy Service 0 0 5 2 0 1 Prescriber support service 0 0 5 1 0 1 Schools Service 0 0 4 3 0 1 Alcohol 1 0 5 2 0 0 Chlamydia 0 0 6 2 0 0 Cholesterol 0 0 6 2 0 0 Diabetes 0 0 5 2 0 1 Gonorrhoea 0 0 5 2 0 1 H.pylori 0 0 6 2 0 0 HbA 1C 0 0 5 2 0 1 Hepatitis 0 0 5 2 0 1 HIV 0 0 5 2 0 1 Seasonal flu vac 3 0 2 2 2 0 Childhood vac 0 0 4 3 0 1 HPV 0 0 4 3 0 1 Hep B vacc 0 0 4 3 0 1 Travel vaccines 0 0 3 2 0 2 Sharps Disposal service 0 0 4 2 0 1 NRT Vouch 5 0 2 0 0 0 Smoke cess counc 0 0 6 1 1 0 Supervised Administration 6 0 0 1 0 0 Supplementary Prescribing 0 0 4 2 0 1 NHS Healthcheck 0 0 5 1 0 1 Emergency Supply Svs/**URM Scheme 6 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 114 January 2015 version no. 6 Future Development
Local Plan Dwellings with no Dwellings Current Dwellings Housing usual residents completed since commitments (2011 Census) Allocation (2011 Census) 2010 (yet to be built) 2014-30 17,206 9.5% 894 1,740 2,300
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 760 additional dwellings will be built in this Community Network area. More than 720 of these will be within the St Austell town area.
Identified gaps in service provision
• 4 pharmacies (3 in St Austell and the pharmacy in Mevagissey) do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 115 January 2015 version no. 6 St Blazey, Fowey & Lostwithiel Community Network Area: Summary
Overview of the geography The St Blazey, Fowey, and Lostwithiel Locality is made up of eleven parishes; Boconnoc, Broadoak, Fowey, Lanlivery, Lostwithiel, Luxulyan, St Blaise, St Sampson, St Veep, St Winnow, and Tywardreath.
Summary Issues • St Blazey, Fowey and Lostwithiel Community Network has 19,270 residents; 3.6% of Cornwall’s total population. The workday population is 17,626 so 1,644 people (net) commute out of the network to work. • 16.1% of households do not have access to a car. • 8.3% of people in the St Blazey, Fowey and Lostwithiel Community Network live in a highly deprived area, (in the top 20% most deprived in England). • Fowey is a small cargo port and popular tourist destination during the summer months. • No pharmacy available in Lostwithiel, Fowey or Par on a Sunday. Fowey operates Sunday opening hours during the summer season. • The pharmacy at Lostwithiel has no wheelchair access to the consultation room, whilst at Fowey they are unsure if a wheelchair could fit and at Par there is no consultation room available.
A socio-economic profile for the St Blazey, Fowey & Lostwithiel CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the St Blazey, Fowey & Lostwithiel CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 3 practices with 2 branch surgeries in Par and Polruan. Number of Dispensing GP Surgeries 3 Fowey River Practice Rawlings Lane Fowey PL23 1DT Lostwithiel Surgery North Street Lostwithiel PL22 0EF Polruan Surgery The Quay Polruan PL23 1PA Number of Pharmacies 5 Mountchase 13 Fore St. Lostwithiel PL22 0BW Boots 5625 16-18 Fore St Fowey PL23 1AQ Boots 5329 29 Eastcliff Rd. Par PL24 2AQ Boots 5330 4 Fernlea Villas, Middleway St Blazey PL24 2JG Middleway Pharmacy Middleway Surgery St Blazey PL24 2JL Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 5 19,270 3,854 0.3
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 116 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 5 of which fall under the St Blazey, Fowey & Lostwithiel Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within St Blazey, Fowey & Lostwithiel Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Saturday there is a pharmacy available between 7.00am and 10:00pm. There is only 1 pharmacy operating Sunday hours within the community network, between 9:00am and 9:00pm in St Blazey. Fowey operate Sunday hours during the summer season only. The nearest pharmacy on a Sunday to Lostwithiel, Fowey and Par is a short distance away in St Blazey.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. 4 pharmacies provide onsite consultation, in an enclosed area 2 with wheelchair access, 1 without wheelchair access and another stated they have a small consultation area which may not fit a wheelchair. 3 pharmacies were willing to undertake consultations in a patient’s home/other suitable site. Hand Washing Facilities were available at 4 of the pharmacies 2 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology and 4 pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled and 1 would be within 12 months. All pharmacies have email, 3 websites, 3 unrestricted internet access and 2 have NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats –
MS Word 100% MS Excel 100% MS Access 80% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves.
Spoken in the Pharmacy Spoken by the Community French Punjabi Spanish Urdu
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 117 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. 2 pharmacies have onsite parking and all pharmacies have parking on average within a 7 minute walk, 4 had a bus stop within 3 minutes. The nearest pharmacy to a train station is 6 minutes.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other (street, Train Bus private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. 4 pharmacies collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. 1 pharmacy stated they delivered to a small number of patients within the vicinity. 3 pharmacies did not charge for delivery whilst 2 did not comment.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 80% 20% 0% NMS 80% 20% 0% AUR 0% 100% 0% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 118 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 1 1 2 0 1 Anti viral distribution 0 1 2 1 0 1 Care Home Service 0 2 1 0 0 2 Chlamydia Treatment 0 2 1 1 0 1 Contraceptive Service 1 1 1 1 0 1 Allergies 0 2 1 1 0 1 Alzheimers/dementia 0 2 1 1 0 1 Asthma 0 2 0 1 0 2 CHD 0 2 1 1 0 1 Depression 0 2 1 1 0 1 Diabetes Type I 0 2 1 1 0 1 Diabetes Type II 0 2 1 1 0 1 Epilepsy 0 1 2 1 0 1 Heart failure 0 2 1 1 0 1 Hypertension 0 2 1 1 0 1 Parkinsons disease 0 1 2 1 0 1 Emergency Hormonal Contraception Service 2 2 0 1 0 0 Gluten Free Food Supply Service 5 0 0 0 0 0 Independent Prescribing Service 0 0 2 0 0 3 Language Access Service 0 0 2 0 0 3 Medication Review Service 3 0 1 1 0 0 Medicines Management Support Service 0 0 2 0 0 3 DomMAR Carer's Charts 0 0 2 0 0 3 Minor Ailments Scheme 4 0 0 1 0 0 MUR Plus/Medicines Optimisation Service 0 1 2 1 0 1 Needle &Syringe Exchange Service 0 1 1 0 0 3 Obesity Management (Adults & Children) 0 0 2 0 0 3 Directly Observed Therapy 0 1 2 0 0 2 Out of hours service 3 0 0 0 0 2 Palliative Care Scheme 1 1 1 0 0 2 Phlebotomy Service 0 1 1 1 0 2 Prescriber support service 0 1 2 0 0 2 Schools Service 0 0 2 0 0 3 Alcohol 3 0 0 0 0 2 Chlamydia 0 1 2 0 0 2 Cholesterol 0 1 1 1 0 2 Diabetes 0 1 1 1 0 2 Gonorrhoea 0 1 2 0 0 2 H.pylori 0 1 2 0 0 2 HbA 1C 0 1 1 1 0 2 Hepatitis 0 1 1 1 0 2 HIV 0 1 1 1 0 2 Seasonal flu vac 0 2 0 1 0 2 Childhood vac 0 1 1 0 0 3 HPV 0 1 1 0 0 3 Hep B vacc 0 1 1 0 0 3 Travel vaccines 0 1 1 0 0 3 Sharps Disposal service 0 1 0 0 0 4 NRT Vouch 4 1 0 0 0 0 Smoke cess counc 0 3 0 1 0 1 Supervised Administration 3 1 0 0 0 1 Supplementary Prescribing 0 1 1 0 0 3 NHS Healthcheck 0 1 1 0 0 3 Emergency Supply Svs/**URM Scheme 4 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 119 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2010 (yet to be built) Census) 2014-30 8,784 12.9% 221 347 1,300 Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 320 additional dwellings will be built in this Community Network area. Over 120 of these will be within the Fowey and a further 88 in town of St Blazey.
Identified gaps in service provision
• 2 pharmacies (the 1 in Fowey and 1 in Par) do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods. • Ensure that all 100 hour pharmacies are providing EHC, EPS and Minor Ailments. In Middleway pharmacy is not providing EHC and so is required to address this by July 2015.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 120 January 2015 version no. 6 Truro and Roseland Community Network Area: Summary
Overview of the geography The Truro and Roseland Locality is made up of nineteen parishes; Chacewater, Cuby, Feock, Gerrans, Grampound with Creed, Kea, Kenwyn, Ladock, Philleigh, Probus, Ruanlanihorne, St Clement, St Erme, St Just-in-Roseland, St Michael Caerhays, St Michael Penkevil, Tregoney, Truro, and Veryan.
Although the area around Truro city is largely urban and subject to a noncontrolled locality boundary, the Roseland Peninsula is sparsely populated.
Summary Issues
• Truro and Roseland Community Network has 43,883 residents; 8.2% of Cornwall’s total population. The workday population is 56,040 so 12,157 people (net) commute into the network area to work. • 17.4% of households do not have access to a car. • 7.2% of people in the Truro and Roseland Community Network live in a highly deprived area (in the top 20% most deprived in England). • 1 pharmacy is unable to open any of the common files (Microsoft, Adobe, etc.). • Polish and Cantonese spoken within the community but not in any pharmacy. • There is no pharmacy open in St Mawes on a Saturday or Sunday. The pharmacy in Threemilestone is closed on Sunday. • 3 of the pharmacies, the 1 at St Mawes, 1 at Threemilestone and 1 in Truro do not have wheelchair access to the onsite consultation room. • St Mawes is an essential small pharmacy.
A socio-economic profile for the Truro and Roseland CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Truro and Roseland CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 6 practices with four branch surgeries and 3 additional branch surgeries operated by other practices in St Ewe, St Mawes and Tregony. Number of Dispensing GP Surgeries 6 Carnon Downs Surgery Bissoe Road Carnon Downs TR3 6JD Chacewater Health Centre The Health Centre Chacewater TR4 8QS Probus Surgery Tregony Road Probus TR2 4JZ Portscatho Surgery Gerrans Hill Portscatho TR2 5EE Devoran Surgery Quay Road Devoran TR3 6PW Grampound Surgery Mill Lane Grampound TR2 4RU Number of Pharmacies 8 Boots 317 94 Pyder St. Truro TR1 2BD Boots THP Truro Health Park, Infirmary Hill Truro TR1 2JA Superdrug 13 Boscawen St. Truro TR1 2QU Tesco Garras Wharf Truro TR1 2TN AJ Reed's The Globe, Frances St. Truro TR1 3DP Sainsbury's Pharmacy Treyew Road Truro TR1 3XL Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 121 January 2015 version no. 6 St Mawes 12 Kings Rd. St Mawes TR2 5DH Victoria Pengelly Way Threemilestone TR3 6DP Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 8 43,883 5,485 0.2
Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 8 of which fall under the Truro and Roseland Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Truro and Roseland Community Network there is a pharmacy open 7 days per week including lunchtimes (figure 1). Monday to Friday there is a pharmacy available between 7.00am and 11:00pm, Saturdays between 7:00am and 10:00pm. In Truro there is a pharmacy available between 10:30am and 4:30pm on Sundays. The pharmacy in St Mawes closes at 2:00pm on Wednesdays and is closed Saturday and Sunday, the nearest pharmacy during those times is approximately 25 minute drive away in Truro. The pharmacy at Threemilestone closes at 12:30pm on Saturdays and is closed on Sunday, the nearest pharmacy is a short distance in Truro.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. All pharmacies provide onsite consultation, 7 in an enclosed area 5 with wheelchair access. 3 pharmacies were willing to undertake consultations in a patient’s home/other suitable site. Hand Washing Facilities were available at all of the pharmacies 6 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology and 7 pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled and 1 would be within 12 months. All pharmacies have email, 4 have websites, 4 have unrestricted internet access and 5 have NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats, 1 was unable to –
MS Word 75% MS Excel 63% MS Access 13% PDF 50%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 122 January 2015 version no. 6 Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves.
Spoken in the Pharmacy Spoken by the Community French Romanian Polish Cantonese
Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. 3 pharmacies have onsite parking and all pharmacies have parking on average within a 4 minute walk, 5 had a bus stop within 3 minutes. The nearest pharmacy to a train station is 8 minutes.
Pharmacy Transport links (within 3 minute walk)
100%
80%
60%
40%
20%
0% Parking : Onsite Parking : Council Parking : Other Train Bus (street, private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. 6 pharmacies collected prescriptions from surgeries for patients and 5 delivered dispensed medicines free of charge. 3 pharmacies delivered to the housebound, 1 of which stated patients must have difficulty attending in person and be within the TR1 postcode, 1 would deliver to any patient whilst the others did not comment. None of the pharmacies charged for delivery, although some restricted delivery to their immediate area, 1 was prepared to deliver to mid and east Cornwall.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings. 7 pharmacies offered all services, whilst the supermarket in-store pharmacy in Truro offered leg bags and dressings.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 88% 13% 0% AUR 25% 75% 0% SACS 13% 88% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 123 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 0 5 3 0 1 Anti viral distribution 0 2 2 2 1 2 Care Home Service 1 2 3 1 0 2 Chlamydia Treatment 0 1 3 2 0 3 Contraceptive Service 1 1 5 2 0 0 Allergies 0 2 5 2 0 1 Alzheimers/dementia 0 2 4 2 0 2 Asthma 0 2 5 2 1 0 CHD 0 2 4 2 0 2 Depression 0 2 4 2 0 2 Diabetes Type I 0 2 5 2 0 1 Diabetes Type II 0 2 6 2 0 0 Epilepsy 0 2 2 2 0 4 Heart failure 0 2 5 2 0 1 Hypertension 0 2 5 2 1 0 Parkinsons disease 0 2 4 2 0 2 Emergency Hormonal Contraception Service 8 0 0 0 0 0 Gluten Free Food Supply Service 6 0 1 1 0 1 Independent Prescribing Service 1 0 3 2 0 3 Language Access Service 0 0 3 2 0 4 Medication Review Service 2 2 2 2 0 2 Medicines Management Support Service 0 1 4 2 0 3 DomMAR Carer's Charts 1 2 2 1 0 3 Minor Ailments Scheme 8 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 0 2 3 2 0 3 Needle &Syringe Exchange Service 2 2 1 1 0 2 Obesity Management (Adults & Children) 0 3 4 2 0 1 Directly Observed Therapy 0 1 2 2 0 4 Out of hours service 2 0 1 2 0 3 Palliative Care Scheme 0 1 2 2 0 4 Phlebotomy Service 0 0 4 2 0 3 Prescriber support service 0 1 3 2 0 3 Schools Service 0 1 3 2 0 3 Alcohol 3 0 1 2 0 3 Chlamydia 1 2 2 2 0 3 Cholesterol 1 1 1 2 1 3 Diabetes 1 0 1 2 2 3 Gonorrhoea 0 2 3 2 0 3 H.pylori 0 2 3 2 0 3 HbA 1C 1 1 3 1 0 4 Hepatitis 0 2 3 1 0 4 HIV 0 2 1 1 0 5 Seasonal flu vac 3 1 0 1 3 1 Childhood vac 0 2 2 2 0 3 HPV 0 1 2 1 0 4 Hep B vacc 0 2 2 2 0 3 Travel vaccines 0 2 2 2 0 3 Sharps Disposal service 2 1 1 3 0 2 NRT Vouch 5 1 0 0 0 2 Smoke cess counc 0 3 3 2 0 2 Supervised Administration 4 2 1 0 0 1 Supplementary Prescribing 0 1 2 1 0 4 NHS Healthcheck 0 1 3 2 0 3 Emergency Supply Svs/**URM Scheme 8 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 124 January 2015 version no. 6 Future Development
Local Plan Dwellings with no Dwellings Current Dwellings Housing usual residents completed since commitments (2011 Census) Allocation (2011 Census) 2010 (yet to be built) 2014-30 20,738 9.2% 728 2,545 3,900
Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 2,900 additional dwellings will be built in this Community Network area. Over 2,200 of these will be within the Truro town area. Major developments include Langarth in Threemilestone (1,800 dwellings), Old Richard Lander School site, Truro (220) and the Truro Eastern District, adjoining the new park and ride site (97).
Identified gaps in service provision
• 4 pharmacies do not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V
Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 125 January 2015 version no. 6 Wadebridge & Padstow Community Network Area: Summary
Overview of the geography The Wadebridge and Padstow Locality is situated on the north coast of Cornwall and is made up of fourteen parishes; Egloshayle, Padstow, St Breock, St Endellion, St Ervan, St Evel, St Issey, St Kew, St Mabyn, St Merryn, St Minver Highlands, St Minver Lowlands, St Tudy, and Wadebridge.
Apart from Wadebridge which is subject to a non- controlled locality boundary, the area is largely rural and sparsely populated.
Summary Issues • Wadebridge and Padstow Community Network has 20,085 residents; 3.8% of Cornwall’s total population. The workday population is 20,244 so 159 people (net) commute into the network area to work. • 15% of households do not have access to a car. • The coastal town of Padstow receives the vast majority of the tourist influx during the summer months. • No pharmacy is open in Padstow on Sunday except during the summer months.
A socio-economic profile for the Wadebridge & Padstow CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
A summary health profile for the Wadebridge & Padstow CNA can be downloaded from: www.cornwall.gov.uk/pharmacy
Number of GP Surgeries 3 practices with 4 branch surgeries and an additional branch surgery operated by other practice in Polzeath. Number of Dispensing GP Surgeries 2 Padstow Medical Centre Boyd Avenue Padstow PL28 8ER St Merryn Surgery St Merryn Padstow PL28 8NP Bridge Medical Centre Harbour Road Wadebridge PL27 7AH Port Isaac Practice Hillson Close Port Isaac PL29 3TR St Kew Surgery St Kew Service Area St Kew PL30 3ED Rock Surgery Rock St Minver PL27 6PW Wadebridge and Camel Practice Brooklyn Wadebridge PL27 7BS Number of Pharmacies 3 Boots 5328 8/10 Market Street Padstow PL28 8AL Boots 5343 4 New Court House, The Platt Wadebridge PL27 7AG Day Lewis Jubilee Road Wadebridge PL27 7AT Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 3 20,085 6,695 0.1
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 126 January 2015 version no. 6 Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 3 of which fall under the Wadebridge & Padstow Community Network Area.
Opening Hours
Mon – Fri: Sat: Sun:
Pharmacies were asked what their weekly core hours were, within Wadebridge & Padstow Community Network there is a pharmacy open 7 days per week excluding 15 minutes on Saturday lunchtime (figure 1). A pharmacy in Bodmin is available during that time. Monday to Saturday there is a pharmacy available between 8:30am and 6:00pm. One pharmacy in Wadebridge is closed Saturday and Sunday, the other is open between 10:00am and 4:00pm on Sundays. The pharmacy in Padstow only operates Sunday opening hours during the Summer season, the nearest pharmacy is in Wadebridge.
Figure 1 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. All pharmacies provide onsite consultation, in an enclosed area with wheelchair access. 2 pharmacies were willing to undertake consultations in a patient’s home/other suitable site. Hand Washing Facilities were available at all of the pharmacies 2 within the consultation area.
Information Technology A section of the questionnaire was dedicated to Information Technology and all pharmacies confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. All pharmacies have email, 2 have websites, 2 have unrestricted internet access and all have NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats, 1 was unable to –
MS Word 66% MS Excel 100% MS Access 66% PDF 100%
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves.
Spoken in the Pharmacy Spoken by the Community Afrikaans Hebrew German (tourists) Danish Norwegian French Romanian German Swedish
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 127 January 2015 version no. 6 Transport access Figure 2 below shows the proportion of different transport options available within 3 minutes of the pharmacies premises. All pharmacies have nearby and 1 has onsite parking, 1 has a bus stop within 3 minutes. There is no pharmacy close to a train station.
Pharmacy Transport links (within 3 minute walk)
100% 80% 60% 40% 20% 0% Parking : Onsite Parking : Council Parking : Other (street, Train Bus private, etc.)
Figure 2 : Transport links
Collection and Delivery services Pharmacies were asked if they provided any collection and delivery services. All pharmacies collected prescriptions from surgeries for patients and delivered dispensed medicines free of charge. 1 pharmacy delivered to the housebound, 1 to any patient whilst the other did not comment. None of the pharmacies charged for delivery.
Essential Services (appliances) The pharmacies were asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, 100% offered all services.
Advanced Services
Yes No Soon MUR 100% 0% 0% NMS 100% 0% 0% AUR 33% 66% 0% SACS 33% 66% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 128 January 2015 version no. 6 Pharmacy Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. Service Service Currently Currently Providing Providing if provide Left Blank LeftBlank adjustment) adjustment) commissioned commissioned (need facilities facilities (need (need training) training) (need if commissioned if commissioned if commissioned Willing & able to able Willing & Providing Private Private Providing Willing to provide to Willing provide to Willing Anticoag Monitoring 0 0 3 0 0 0 Anti viral distribution 0 1 2 0 0 0 Care Home Service 1 0 2 0 0 0 Chlamydia Treatment 0 0 3 0 0 0 Contraceptive Service 1 0 2 0 0 0 Allergies 0 0 3 0 0 0 Alzheimers/dementia 0 0 3 0 0 0 Asthma 1 0 2 0 0 0 CHD 0 0 3 0 0 0 Depression 0 0 3 0 0 0 Diabetes Type I 0 0 3 0 0 0 Diabetes Type II 0 0 3 0 0 0 Epilepsy 0 0 3 0 0 0 Heart failure 0 0 3 0 0 0 Hypertension 1 0 2 0 0 0 Parkinsons disease 0 0 3 0 0 0 Emergency Hormonal Contraception Service 3 0 0 0 0 0 Gluten Free Food Supply Service 1 1 1 0 0 0 Independent Prescribing Service 1 0 2 0 0 0 Language Access Service 2 0 1 0 0 0 Medication Review Service 3 0 0 0 0 0 Medicines Management Support Service 1 0 2 0 0 0 DomMAR Carer's Charts 1 0 2 0 0 0 Minor Ailments Scheme 3 0 0 0 0 0 MUR Plus/Medicines Optimisation Service 1 0 2 0 0 0 Needle &Syringe Exchange Service 2 0 1 0 0 0 Obesity Management (Adults & Children) 0 0 3 0 0 0 Directly Observed Therapy 0 0 3 0 0 0 Out of hours service 0 0 2 1 0 0 Palliative Care Scheme 2 0 1 0 0 0 Phlebotomy Service 0 0 3 0 0 0 Prescriber support service 0 0 3 0 0 0 Schools Service 0 0 3 0 0 0 Alcohol 2 0 1 0 0 0 Chlamydia 0 0 3 0 0 0 Cholesterol 1 0 2 0 0 0 Diabetes 2 0 1 0 0 0 Gonorrhoea 0 0 2 1 0 0 H.pylori 0 0 3 0 0 0 HbA 1C 0 0 3 0 0 0 Hepatitis 0 0 3 0 0 0 HIV 0 0 3 0 0 0 Seasonal flu vac 2 0 1 0 0 0 Childhood vac 0 0 3 0 0 0 HPV 0 0 3 0 0 0 Hep B vacc 0 0 3 0 0 0 Travel vaccines 0 0 3 0 0 0 Sharps Disposal service 2 1 0 0 0 0 NRT Vouch 3 0 0 0 0 0 Smoke cess counc 0 1 2 0 1 0 Supervised Administration 3 0 0 0 0 0 Supplementary Prescribing 0 0 3 0 0 0 NHS Healthcheck 0 0 3 0 0 0 Emergency Supply Svs/**URM Scheme 3 0 0 0 0 0 *Without further investigation it cannot be ascertained whether the respondents leaving blank responses are unwilling, unsure or unable to provide these services or a suitable response. **Urgent Repeat Medicines Scheme Commissioned services provided within the community network area Services which can be commissioned but not provided within this community network area
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 129 January 2015 version no. 6 Future Development
Dwellings with Local Plan Dwellings Current Dwellings no usual Housing completed since commitments (2011 Census) residents (2011 Allocation 2010 (yet to be built) Census) 2014-30 12,376 30.1% 391 503 2,000 Based on the sites with planning permission which have not started or are currently under construction, it is anticipated that within the next 5 years, over 410 additional dwellings will be built in this Community Network area. Over 190 of these will be within the Wadebridge town area and 150 within the Parish of Padstow.
Identified gaps in service provision
• The pharmacy in Padstow does not have EEFO accreditation. • There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Adequate Adequacy Assessment
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 130 January 2015 version no. 6 Isles of Scilly: Summary
Overview of the geography The Isles of Scilly lies 45 km (28 mi) off mainland Cornwall (Land's End) and are made up of five inhabited Islands and hundreds of uninhabited islets, rocks and reefs. The 5 main islands are St Mary's, Tresco, St Martin's, St Agnes and Bryher.
Summary Issues
• 49.7% of households do not have access to a car. • No pharmacy available lunchtimes, after 12 noon on Saturday or all day Sunday. • Language could be an issue given the influx of international visitors during the summer months. • Pharmacy provides only a few commissioned services and intends to provide advanced services in the immediate future.
A summary health profile for the Isles of Scilly can be downloaded from: www.cornwall.gov.uk/pharmacy
1 but branch surgeries run on Bryher, Tresco, St Martins Number of GP Surgeries and St Agnes. Number of Dispensing GPs 1 The Health Centre King Edward Lane St Mary’s TR21 0HE Number of pharmacies 1 The Health Centre King Edward Lane St Mary’s TR21 0HE Population per pharmacy
Number of Population Population per Rate (per pharmacies pharmacy 1000 Pop.) 1 2,300 2,300 2.3
Current Pharmaceutical Provision In total 100 pharmacies completed the questionnaire in Cornwall and the Isles of Scilly, 1 of which is on the Isles of Scilly.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 131 January 2015 version no. 6 Opening Hours The pharmacy on the Isles of Scilly is open 6 days per week (figure 2). Opening hours are Monday to Friday 9:00am till 5:30pm closing lunchtimes between 1:00pm and 2:00pm, Saturdays from 9:30am until 12:00 noon. The pharmacy is closed Sundays.
Figure 2 : Opening hours
Consultation Facilities Consultation areas should meet the standards in the contractual framework to offer advanced services. The pharmacy provides onsite consultation, in an enclosed area with wheelchair access and hand washing facilities close to the consultation area. Consultations in a patient’s home/other suitable site are not available.
Information Technology A section of the questionnaire was dedicated to Information Technology and the pharmacy confirmed their computer system is Electronic Prescription Service (EPS) R2 enabled. They do not have email, or a website, do not have unrestricted internet access and do not use NHS mail. As information is often distributed to pharmacies as email attachments or via websites, they were asked if they could indicate whether or not they were able to open or view certain common file formats – they use MS Word, MS Excel and PDF but not MS Access.
Languages One potential barrier to accessing services at a pharmacy can be language. To help the local authority better understand any access issues caused by language, pharmacies were asked to list the languages (other than English) spoken in the pharmacy or by the community the pharmacy serves – no languages were listed.
Transport access The pharmacy has onsite parking. There is no train service on the Isles of Scilly and there is an irregular bus service which operates more frequently in the summer months.
Collection and Delivery services The pharmacy does not provide any collection and delivery services.
Essential Services (appliances) The pharmacy was asked to give details of the essential services they provide, if they dispensed stoma appliances, incontinence appliances and dressings, which they stated they do.
Advanced Services
Yes No Soon MUR 0% 0% 100% NMS 0% 0% 100% AUR 0% 0% 100% SACS 0% 100% 0%
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 132 January 2015 version no. 6 Commissioned Services Pharmacies were asked to record which local services they currently delivered or would like to deliver. These could be Enhanced Services, commissioned by the NHS England Regional Team, Public Health Services commissioned by a Local Authority or CCG services. They currently deliver the Gluten free food supply and Electronic Prescription Services. The pharmacy stated they would be willing and able to provide – medication review service, medicines management support service, minor ailments scheme and MUR plus/medicines optimisation service. They further stated they would be willing to provide if commissioned but they needed training – care home service, allergies, asthma, diabetes type I, diabetes type II and emergency hormonal contraception service. Future Development There is no open market housing development on the islands and occupancy restrictions apply to any new dwellings.
Due to limits placed on development by shortage of available land, as well as landscape designations, there will not be any large scale development on the Isles of Scilly in the foreseeable future. There is, however, acute pressure to provide housing for local key workers. The Isles of Scilly Local Growth Plan 17 identifies that provision should be made for between 90 and 120 new homes on Scilly over the next 10 years.
Identified gaps in service provision
• There is potential to expand NHS Health check to community pharmacy in 2015/16. This will be dependent on data sharing collaboration with GP Services. (Information Governance Level 2). • Need to work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. • Pharmacies need to ensure awareness of available translation services with all staff. • Ongoing work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods.
Assessment Score Partially Adequate
Partially Inadequate Adequate Adequate Level of Access V Level of Reasonable Choice V Current level of pharmaceutical Services
provided V Ability to meet future need V
17 Housing Growth Plan: Part of the Strategic Plan for the Isles of Scilly, May 2014 Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 133 January 2015 version no. 6 8. Future needs of pharmaceutical services
8.1 Introduction
This section identifies known future needs for pharmaceutical services in Cornwall and outlines what is known about the future direction of pharmacy which may impact on current service provision across Cornwall, the Isles of Scilly and the wider Peninsula.
8.2 Known future needs in Cornwall and the Isles of Scilly
Population growth is difficult to control or plan for, as there are so many factors which influence the levels, locations and characteristics of growth. Changes to the distribution and structure of the population will impact on the labour market, the housing market and demand for service. However, these elements can also be drivers for growth. Changes to the population, housing market etc. therefore, need to be reviewed annually.
Current trends indicate a growing population (see section 3) meaning that the overall demand for pharmaceutical services will continue to grow, particularly for services relating to the older age groups. For example, it is predicted that it is projected that 1 in 4 will be aged 65+ by 2019.
8.3 The changing direction of pharmaceutical provision locally
Pharmacies are well placed to deliver healthcare services to their local communities and it is expected that the role they play will continue to evolve over the coming years. Whilst the core activity of community pharmacies is commissioned by NHS England, they also provide a key role for local authorities and Clinical Commissioning Groups, particularly in relation to improving the public’s health and wellbeing. Community pharmacies are a key public health resource and offer potential opportunities to promote health and wellbeing as recommended by the Local Government Association (LGA). (Ref: Local Government Association (2013) “Community Pharmacy: Local Government’s new public health role’ available at http://www.local.gov.uk/documents/10180/11463/community+Pharmacy+-)
The LGA report recommends that local commissioners consider the Healthy Living Pharmacy model (HLP) and how it could be used to help improve health and reduce inequalities. Cornwall and the Isles of Scilly are exploring the role of healthy living champions in pharmacies to drive public health messages.
Community pharmacy has a number of strengths and offers significant opportunities for future provision of pharmaceutical services:
1) Pharmacists are the third largest health profession and community pharmacy is the gateway to health for 1.6 million patients nationally each day.
2) A core component of the current pharmaceutical service is to support the public to stay well, live healthier lives and to ‘self-care’. This role is even more critical in terms of reaching those who do not normally access NHS services. Through this role, pharmacies can help to improve the health of the local population and reduce health inequalities.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 134 January 2015 version no. 6 3) Pharmacists have a central role in management of long-term conditions. Pharmacists currently carry out Medicines Use Reviews (MURs) and provide the New Medicine Service (NMS) to patients newly prescribed certain medicines. These services support patients helping them getting the most out of their medicines.
4) Pharmacy’s accessibility in terms of location and long opening hours is seen as a significant benefit to the public. Patients greatly value the fact that they do not need an appointment to see a pharmacist and this also ensures good access to the supply of medicines. The public also values the range of provider models; based in communities, on the high street, in supermarkets, in shopping centres, in health centres and online. This accessibility ensures that pharmacy is well-placed to provide a signposting and referral role to health and social care which is part of the core contract.
The role of community pharmacy in the NHS transformational agenda was highlighted in NHS England’s Call to Action for Community Pharmacists published in 2013. NHS England aims for community pharmacy are to:
• develop the role of the pharmacy team to provide personalised care, • play an even stronger role at the heart of more integrated out-of-hospital services, • provide a greater role in healthy living advice, improving health and reducing health inequalities, • deliver excellent patient experience which helps people to get the most from their medicines.
It is recognised that a contractual framework which better supports these aims is required and greater contractual alignment with other sectors to drive collaboration is needed.
In the South West, the Local Pharmacy Networks are exploring new ways of working. This includes exploring the possible role pharmacists could have in:
• urgent care - both in local pharmacies and in Emergency Departments • providing vaccination services • medication review • near patient testing services • minor injury and ailment services • long term condition management
The location of provision for these services could, in many instances, be the community pharmacy but it is anticipated that pharmacists and pharmacy staff will also support provision in the community and in practice.
8.4 Transformation of primary care
It is increasingly recognised that community pharmacists and pharmacy services have an important role to play in supporting the transformation of primary care and have a fundamental and more substantive role to play in the developing Health and Social Care system. “Health on the High Street: rethinking the role of community pharmacy” places emphasis on the significant and increased role that community pharmacy has to play in ensuring a sustainable healthcare system. It also highlights the importance of integrating the role of community pharmacy with that of other elements of the health and public health system.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 135 January 2015 version no. 6 8.5 Rural pharmaceutical services provision (dispensing doctors)
Rural pharmaceutical provision is essential in large areas of Cornwall and the Isles of Scilly. In rural settings much of the provision of medicines is provided through dispensing doctors. The reduction of inequalities and disparity in the provision of services is an area of focus for the developing health system and greater alignment of pharmaceutical provision is sought ensuring the quality of provision.
The Dispensing Service Quality Scheme (DSQS) has developed standards ensuring some requirements of the core community pharmacy contract are present in dispensing practices. This also includes the Dispensing Review of the Use of Medicines (DRUMs) which reviews a proportion of patients for their concordance with prescribed medicines regimes. However, some key services, such as NMS, are not provided through the dispensing doctor setting. It is acknowledged that to create changes in such provision this would require changes to national contracts.
8.6 The role of the PNA in enabling ‘the future’
The future vision for pharmaceutical services is based on underlying system changes that are predicted to emerge in primary care over the next few years. The PNA, as written today, cannot reflect a need that is yet to materialise; however it is not intended to be a static document but should be continually updated to reflect change. Historically this has primarily meant changes to populations and infrastructure. However, the rapid change in primary care provision envisaged over the next few years, in addition to changes to future pharmacy provision as highlighted in NHS England’s Call to Action, will need to be reflected in future PNAs and, if appropriate, drive a commissioning response when required.
9. Consultation
9.1 The NHS (Pharmaceutical Services and Local Pharmaceutical Services) Regulations 2013 set out the requirements for consultation and PNA approval. Prior to publishing the PNA, the HWB’s for Cornwall and the Isles of Scilly consulted with the following persons regarding the contents of the assessment:
• Cornwall and Isles of Scilly Local Pharmaceutical Committee • Cornwall and Isles of Scilly Local Medical Committee • Persons on the pharmaceutical list and any dispensing doctors practices • Any Local Pharmaceutical Service (LPS) chemist in Cornwall and the Isles of Scilly with whom NHS England has made arrangements for the provision of local pharmaceutical services • Cornwall Healthwatch • Isles of Scilly Healthwatch • Royal Cornwall Hospitals NHS Trust • NHS England Regional Team • Devon Health and Wellbeing Board • Plymouth Health and Wellbeing Board
9.2 The consultation period ran from 06 February until 06 April 2015. In accordance with NHS Regulations the above persons were consulted at least once during this period. Persons being consulted were either emailed directly or directed to the following website containing the draft PNA and consultation feedback form. Hard copies were available upon request. The findings of the consultation are presented in Appendix 5.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 136 January 2015 version no. 6 10. Conclusions
10.1 It is increasingly recognised that community pharmacists and pharmacy services have an important role to play in supporting the transformation of primary care and have a fundamental and more substantive role to play in the developing Health and Social Care system. “Health on the High Street: rethinking the role of community pharmacy” places emphasis on the significant and increased role that community pharmacy has to play in ensuring a sustainable healthcare system. It also highlights the importance of integrating the role of community pharmacy with that of other elements of the health and public health system. Given this role it is felt that the focus moving forward should be on:
• Communication: o To work with pharmacy contactors to improve advertising of available pharmacy services and opening hours. o To work with pharmacy contactors to improve awareness of available translation services.
• Development of Services: o To work with local pharmacies to explore the potential offered to reduce health inequalities, through a range of commissioning methods. o To work with local pharmacies to ensure that EEFO accreditation is achieved across Cornwall.
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 137 January 2015 version no. 6 Appendix 1
Glossary
AUR Appliance Use Review C-Card Free condom card scheme for anyone aged 13 to 24 CCG Clinical Commissioning Group CIoS Cornwall and Isles of Scilly CNA Community Network Area: An area based around a collection of parishes and electoral divisions CPCF Community Pharmacy Contractual Framework DAC Dispensing Appliance Contractor DRUM Dispensing Review of Use of Medicines DSQS Dispensing Services Quality Scheme EEFO Any service that has been EEFO-approved has been validated as meeting the EEFO Quality Standards and is therefore providing a ’young person friendly’ service EPS Electronic Prescription Service GP General Practitioner HLP Healthy Living Pharmacy HWB Health & Wellbeing Board JSNA Joint Strategic Needs Assessment LGA Local Government Association LPS Local Pharmaceutical Service LSOA Lower Super Output Area MAS Minor Ailment Scheme: A locally accredited community pharmacy service to supply a number of prescription-only medicines to treat several minor ailments MUR Medicines Use Review: A non-clinical review conducted by a community pharmacist looking primarily at medicines usage NHS National Health Service NHSCB National Health Service Commissioning Board NMS New Medicine Service PCT Primary Care Trust PGD Patient Group Directions PNA Pharmaceutical Needs Assessment SAC Stoma Appliance Customisation
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 138 January 2015 version no. 6 Appendix 2
Cornwall & Isles of Scilly Pharmacy list
Bodmin Asda Stores Ltd Launceston Road Bodmin PL31 2AR Boots 5405 34 Fore St. Bodmin PL31 2HL Boots 5560 Unit 5, Bell Lane Bodmin PL31 2JL Day Lewis Plc 17 Dennison Road Bodmin PL31 2LL Bude Boots 5427 20 Belle Vue Bude EX23 8JL Lloyds 9 Belle Vue Bude EX23 8JL Dudley Taylor 26 Belle Vue Bude EX23 8JS Lloyds Medical Centre, Hospital Road, Stratton Stratton EX23 9BP Callington (Caradon) Lloyds 17-18 Fore St. Callington PL17 7AE Gunnislake Pharmacy Gunnislake Health Centre, The Orchard Gunnislake PL18 9JZ Camborne & Redruth Boots 5377 2 Trelawarren St. Camborne TR14 8AA Day Lewis 21 Trelawarren St. Camborne TR14 8AD Boots 5320 10 Commercial Sq. Camborne TR14 8JY Boots 5342 Fore St, Troon TR14 9EF Boots 5337 Manor Surgery, Forth Noweth, Chapel St. Redruth TR15 1AU Green Lane 12 Green Lane Redruth TR15 1JT Superdrug 72 Fore St, Redruth TR15 2AF Boots 5335 84 Fore St. Redruth TR15 2BL Bastion's 16 Chapel St. Redruth TR15 2DB Boots 5426 Pool Health Centre, Station Road Pool Pool TR15 3DU Tesco Instore Station Road, Carn Brea Industrial Estate Redruth TR15 3QJ Pharmacy Boots 5336 Paynters Lane Illogan TR16 4SS Camelford Boots 5322 25 Market Square Camelford PL32 9PD Boots 5341 Bath House, Fore St. Tintagel PL34 0DA China Clay Bann's 79 Fore St. St Dennis PL26 8AB Roche Pharmacy 1 Victoria Road Roche PL26 8JF Falmouth & Penryn Hendra's@ Penryn Ltd 56Market St. Penryn TR10 8BH Hendra's@ Penryn Ltd The Penryn surgery, Saracen Way Penryn TR10 8HX Day Lewis Pharmacy Falmouth Health Centre, Trevaylor Road Falmouth TR11 2LH Boots 5323 Trescobeas Surgery, Trescobeas Road Falmouth TR11 2UN Boots 396 47-49 Market St. Falmouth TR11 3AB Superdrug 55 Market St. Falmouth TR11 3AT Day Lewis 115 Killigrew St. Falmouth TR11 3PU Hayle & St Ives Leddra's 7 Fore St. St Ives TR26 1AB Boots 5340 Old Stennack School, Stennack St Ives TR26 1RU Boots UK Limited 3 High Street St Ives TR26 1RS Carbis Bay Pharmacy Units 1-2 Carbis Bay TR26 2FZ Boots 5326 1-2 Penpol Terrace, Foundry Square Hayle TR27 4BQ Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 139 January 2015 version no. 6 Boots 5325 44-46 Fore Street, Copperhouse Hayle TR27 4DY Bodriggy Pharmacy 60 Queensway Hayle TR27 4PB Unit E, Marsh Lane, West Cornwall Boots 6442 Hayle TR27 4PN Shopping Park Helston & The Lizard Boots 5606 Churchtown Mullion TR12 7BY Halls Pharmacy Trelawney Road Helston TR13 8AU Tesco Clodgey Lane. Helston TR13 8PJ Boots 415 38 Meneage St. Helston TR13 8QY Boots 5327 Fore St. Porthleven TR13 9HJ Isles of Scilly Health Centre, King Edward Lane, St Isles of Scilly Pharmacy Isles of Scilly TR21 0HE Marys Launceston Day Lewis Plc 9 Broad Street Launceston PL15 8AA Boots 5546 28 Broad St. Launceston PL15 8AE Tesco Instore Tavistock Road Launceston PL15 9AG Pharmacy Liskeard & Looe Day Lewis 4 Pike St. Liskeard PL14 3JE Boots 445 21-22 Baytree Hill Liskeard PL14 4BG Boots 2088 Coach House Arcade, Fore Street Looe PL13 1DT Looe 65 Fore Street Looe PL13 1DT Robert's Pharmacy The Coombes Polperro PL13 2RG Newquay Kaye's (non-NHS) East St. Newquay TR7 1BH Boots 391 15 Bank St. Newquay TR7 1DH Drury's Pharmacy Newquay Health Centre, St Thomas' Rd Newquay TR7 1RU Narrowcliff Pharmacy Narrowcliff Newquay TR7 2QF Drury's (non-NHS) Chester Road Newquay TR7 2RT Boots 5558 Union Sq. St Columb TR9 6AP Penzance, Marazion & St Just (West Penwith) Baden House The Square Marazion TR17 0AP Boots 389 100-102 Market Jew St. Penzance TR18 2LE Boots 5332 3 Stewarts Buildings, Morrab Rd. Penzance TR18 2QU Boots 5331 3 Alverton St. Penzance TR18 2QW Day Lewis Pharmacy 16 Holly Terrace, Heamoor Penzance TR18 3EL Sainsbury Eastern Green Penzance TR18 3FA Morrab 2 Morrab Road Penzance TR18 4EL Day Lewis 1-2 Alverton Terrace. Penzance TR18 4JH Newlyn Pharmacy 5 The Strand Newlyn TR18 5HH Ramsay Pharmacy 42 Fore St. St Just in Penwith TR19 7LJ Saltash & Torpoint (Cornwall Gateway) Boots 5556 16 Fore St. Torpoint PL11 2AD Boots 5559 1 York Rd. Torpoint PL11 2LG Millbrook Pharmacy The Old Blacksmith's Shop, The Parade Milbrook PL10 1AX Lloyds 19 Fore St. Saltash PL12 6AF Lloyds 139 Callington Rd, Burraton Saltash PL12 6EB Saltash Pharmacy 6 Regal House, Fore Street Saltash PL12 6JR Boots 5399 124 Fore St. Saltash PL12 6JW Lloyds Pharmacy Trevol Business Centre, Trevol Road Torpoint PL11 2TB
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 140 January 2015 version no. 6 St Agnes & Perranporth Boots 5334 2-3 Beach Rd. Perranporth TR6 0JL Boots 5211 55 Vicarage Rd. St Agnes TR5 0TH St Austell & Mevagissey Day Lewis Wheal Northey Centre, I Wheal Northey St Austell PL25 3EF Boots Pharmacy 25 Polkyth Parade, Carlyon Road St Austell PL25 4LD Boots 5550 67 Victoria Rd, Mount Charles St Austell PL25 4QF Boots 375 29 Fore St. St Austell PL25 5EP Day Lewis 1-3 Victoria Place. St Austell PL25 5PE Asda Stores Ltd Cromwell Road St Austell PL25 4PR Boots 5497 3 Fore St. Mevagissey PL26 6UQ St Blazey, Fowey & Lostwithiel Mountchase 13 Fore St. Lostwithiel PL22 0BW Boots 5625 16-18 Fore St Fowey PL23 1AQ Boots 5329 29 Eastcliff Rd. Par PL24 2AQ Boots 5330 4 Fernlea Villas, Middleway St Blazey PL24 2JG Middleway Pharmacy Middleway Surgery St Blazey PL24 2JL Truro & Roseland Boots 317 94 Pyder St. Truro TR1 2BD Boots THP Truro Health Park, Infirmary Hill Truro TR1 2JA Superdrug 13 Boscawen St. Truro TR1 2QU Tesco Garras Wharf Truro TR1 2TN AJ Reed's The Globe, Frances St. Truro TR1 3DP Sainsbury's Pharmacy Treyew Road Truro TR1 3XL St Mawes 12 Kings Rd. St Mawes TR2 5DH Victoria Pengelly Way Threemilestone TR3 6DP Wadebridge & Padstow Boots 5328 8/10 Market Street Padstow PL28 8AL Boots 5343 4 New Court House, The Platt Wadebridge PL27 7AG Day Lewis Jubilee Road Wadebridge PL27 7AT
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 141 January 2015 version no. 6
Appendix 3
Dispensing Practices (GPs) October 2014
Bodmin Carnewater Practice The Health Centre, Dennison Rd Bodmin PL31 2LB Stillmoor House Bell Lane Bodmin PL31 2JJ St Breward Medical Centre Brookside, St Breward Bodmin PL30 4LN Callington (Caradon) Pensilva Health Centre The Health Centre, School Road Pensilva PL14 5RP Callington Health Centre The Health Centre, Haye Road Callington PL17 7AW Gunnislake Health Centre The Orchard Gunnislake PL18 9JZ Camborne & Redruth Harris Memorial Surgery Robartes Terrace Illogan TR16 4RX Homecroft Surgery Voguebeloth Illogan TR16 4ET Camelford Bottreaux Surgery Boscastle PL35 0BG Tintagel Medical Centre Bossinney Road Tintagel PL34 0AE China Clay Brannel Surgery 58 Rectory Rd St Stephen PL26 7RL The Clays Practice Victoria Road Roche PL26 8JF Bugle Surgery Roche Road Bugle PL26 8PP St Columb Road Surgery Chy-Wella, Parka Road St Columb TR9 6PG Falmouth & Penryn Penryn Surgery Saracen Way Penryn TR10 8HX Trescobeas Surgery Trescobeas Road Falmouth TR11 2UN Constantine Surgery Bowling Green Constantine TR11 5AP Mylor Bridge Surgery Lemon Hill Falmouth TR11 5ND Hayle & St Ives Connor Downs Surgery Turnpike Road Connor Downs TR27 5DT Helston & The Lizard Helston Medical Centre Trelawney Road Helston TR13 8AU Mullion Health Centre The Health Centre Mullion TR12 7DQ Praze-An-Beeble Surgery School Rd Praze-An-Beeble TR14 0LB St Keverne Health Centre The Health Centre St. Keverne TR12 6PB Ruan Minor Surgery Grebe Place Ruan Minor TR12 7JW Lizard Surgery The Green The Lizard TR12 7NZ Isles of Scilly St Mary's Health Centre Health Centre, King Edward Lane St Marys TR21 0HE Launceston Launceston Medical Centre Landlake Road Launceston PL15 9HH Liskeard & Looe Oak Tree Surgery Clemo Road Liskeard PL14 3XA Old Bridge Surgery Station Road East Looe PL13 1HA Rosedean Surgery 8 Dean Street Liskeard PL14 4AQ Pelynt Health Centre Summer Lane Pelynt PL13 2JW Newquay Petroc Group Practice The Surgery Trekenning Road St.Columb Major TR9 6RR Penzance, Marazion & St Just (West Penwith) Cape Cornwall Surgery St.Just-In-Penwith Penzance TR19 7HX Marazion Surgery Gwallon Lane Marazion TR17 0HW Penalverne Surgery Penalverne Drive Penzance TR18 2RE Saltash & Torpoint (Cornwall Gateway) Quay Lane Surgery Old Quay Lane St.Germans PL12 5LH St Agnes & Perranporth Perranporth Surgery The Perranporth Surgery Perranporth TR6 0PS St.Agnes Surgery Pengarth Road St.Agnes TR5 0TN
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 142 January 2015 version no. 6 Mount Hawke Surgery Short Cross Road Mount Hawke TR4 8UE St Austell & Mevagissey Mevagissey Surgery The Surgery River Street Mevagissey PL26 6UE St Blazey, Fowey & Lostwithiel Fowey River Practice The Surgery Rawlings Lane Fowey PL23 1DT Polruan Surgery The Quay Polruan PL23 1PA Lostwithiel Surgery North Street Lostwithiel PL22 0EF Truro & Roseland Carnon Downs Surgery The Surgery Bissoe Road Carnon Downs TR3 6JD Chacewater Health Centre The Health Centre Chacewater TR4 8QS Probus Surgery The Surgery Tregony Road Probus TR2 4JZ Roseland Surgeries The Surgery Gerrans Hill Portscatho TR2 5EE Grampound Surgery Mill Lane Grampound TR2 4RU Devoran Surgery Quay Road Devoran TR3 6PW Wadebridge & Padstow Port Isaac Surgery The Surgery Hillson Close Port Issac PL29 3TR Wadebridge & Camel Estuary Estuary Practice, Brooklyn Wadebridge PL27 7BS Practice Padstow Medical Centre Boyd Avenue Padstow PL28 8ER St Merryn Surgery St Merryn Padstow PL28 8NP St. Kew St Kew Surgery St Kew Service Area PL30 3ED Highway Bridge Medical Centre Harbour Road Wadebridge PL27 7AH Rock Surgery Rock St Minver PL27 6PW
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 143 January 2015 version no. 6 Appendix 4
Maps
All maps are available at:
www.cornwall.gov.uk/pharmacy
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 144 January 2015 version no. 6
Appendix 5
Consultation Feedback
A total of 6 responses were submitted throughout the consultation period and the following summarises these responses and actions taken in response to the comments made:
Area Comments Action/Changes
N/A No comments received. Bodmin Pg. 45 - Adequacy Assessment table change Current level of pharmaceutical services provided from partial to Agreed and amended adequate (the absent of provision of local services would not equate to being partially adequate)
Pg. 45 - With the Network Area Summaries there is no narrative to explain why there are inadequate gradings in Agreed and amended Bude Bude. We do not believe these are inadequate. Pages 51-55: Caradon It is noted that no pharmacy is open on a Sunday, however the PNA does not state why this is important i.e. Amended P51 currently we seen no evidence of need.
The Pharmacy Services section, Gunnislake pharmacy currently provides the following services which are not noted in the PNA: 1. Domiciliary MAR Carer's Charts are provided to patients/carers where a disability assessment identifies if Amended P54 they are need.
2. Emergency supply of medicines (the Emergency Supply Svs/URM Scheme). Amended P54
3. From the 13th of April 2015 Gunnislake pharmacy will be providing the alcohol IBA service. Not inc. as outside of assessment period. 4. The Palliative Care Scheme is not commissioned in this area; however the pharmacy does hold emergency Amended P54 medicines for use with end of life patients. Not inc. as outside of 5. Gunnislake pharmacy will be EEFO accredited by the end of July 2015 assessment period.
We believe the future services for pharmacy should include services with low uptake locally such as the listed health Inc. in conclusions. checks, and the healthy living pharmacy model which has been rolled out across other areas to help reduce inequalities.
The PNA notes an adequacy score of partially adequate for level of access, as this no evidence that there is a need on Amended P55 Sunday this in our opinion should be adequate.
The PNA notes an adequacy score of partially adequate for current services, we believe as all commissioned services Amended P55 are provided where there has been need identified by the commissioner this should read adequate.
The PNA notes an adequacy score of partially adequate for future need; however the PNA does not state how this Amended P55 conclusion is drawn.
Cornwall and Isles of Scilly Draft Pharmaceutical Needs Assessment 145 27 November 2014 version no. 4
Pg. 55 - Caradon - all boxes deemed to be adequate. All except level of services have been amended to adequate.
Pg. 55 - With the Network Area Summaries there is no narrative to explain why there are inadequate gradings in All except level of Caradon. We do not believe these are inadequate. services have been amended to adequate.
Pg. 51 - With the comment about wheel chair access in Callington, we believe that you cannot actually get wheel Retained but amended chairs into the shop. It is a listed building and the access is down steps, which are not possible to ramp. text.
Pg. 70 - Camborne Pool - all boxes assessed as Adequate Agreed and amended
Camborne and Redruth Agreed and amended Pg. 50 - Adequacy Assessment all boxes should be Adequate (rate per 1000 population is low and choice is high) because of the with the exception of level of access which is correctly assigned as partial. number of population
Camelford per pharmacy. Agreed and amended Pg. 60 - Level of access should be partially adequate China Clay Pg. 75 - Falmouth - all boxes assessed as Adequate Agreed and amended Falmouth and Penryn Pg. 80 - Hayle & St Ives - all boxes assessed as Adequate Agreed and amended
Hayle and St Ives Agreed and amended Pg. 85 - Helston - all boxes assessed as Adequate Helston and the Lizard N/A No comments received. Isles of Scilly Pg. 90 Launceston - all boxes assessed as adequate Agreed and amended
Launceston N/A No comments received. Liskeard and Looe Future Needs Pages 134/136 . Page 134, Line 2 : please add a new sentence as follows: Added slightly Newquay amended text to “Newquay in particular faces extraordinary growth on both its north-eastern and southern boundaries. The pg.100 burgeoning population will have a significant and material impact on future pharmaceutical demands and, therefore, the provision of adequate services in the Newquay growth areas, in particular, calls for close scrutiny and attention.”
N/A No comments received. Penzance, Marazion and St Just (West Penwith) Pg. 65 - Cornwall Gateway - all boxes should be Adequate Agreed and amended
Saltash and Torpoint (Cornwall Gateway) Agreed all except level Pg. 110 - With the Network Area Summaries there is no narrative to explain why there are inadequate gradings in of access have been St. Agnes. We do not believe these are inadequate. St Agnes and Perranporth amended. This Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 146 January 2015 version no. 6 remains partially adequate due the number of patients per pharmacy.
N/A No comments received. St Austell and Mevagissey N/A No comments received. St Blazey, Fowey and Lostwithiel N/A No comments received. Truro and Roseland N/A No comments received. Wadebridge and Padstow Page 2 – change paragraph beginning, Cornwall and the Isles of Scilly to: Agreed and amended General – relating parts of the Assessment other The population of Cornwall and the Isles of Scilly is steadily increasing, and there is substantial housing development than the Network Assessments. in some areas.
Pg. 3 - Sentence beginning, Decisions regarding provider applications: Agreed and amended Decisions regarding provider applications are made by the Area Team the decisions made by the Area Team can be appealed with the Family Health Services Appeal Unit (FHSA). The FHSA will determine appeals against decisions in accordance with the NHS (Pharmaceutical Services) Regulations 2005, the NHS (Pharmaceutical Services) Regulations 2012 and the NHS (Pharmaceutical & Local Pharmaceutical Services) Regulations 2013 concerning the provision of NHS pharmaceutical services.
Pg. 29 – Remove text regarding services they NHS England may commission and replace with: Agreed and amended Currently there are no such Enhanced Services being commissioned in Cornwall by NHS England.
Pg. 3 - 2nd bullet point - not sure what EPS is. I think it should be Emergency Supply Scheme. Agreed and amended
Pg. 3 - 1.1.2 Should we now refer to Area Team by new title? Agreed and amended
Pg. 17 - 2nd paragraph would be more consistent with 5th paragraph if stated population as just under 2,200. Agreed and amended
Pg. 22 - Not sure in top box what is meant by Reablement services and Falls assessment. These are not commissioned services. The last line talks about Pregnancy testing services. Most Pharmacies do not carry out tests Agreed and removed only sell home testing kits.
Pg. 28 - Do we actually want to say what locally enhanced services are commissioned in Cornwall? May want to add Health Checks to council services, although is only a few locations. Also CCG services of Minor ailments, Emergency Agreed and amended supply, Gluten Free service and piloting of Domiciliary Visits.
Pg. 32 - The line about hand washing is vague and should be removed. All pharmacies have hand washing facilities. Agreed and amended Pg. 34 - The table is hard to understand, the services except palliative care are commissioned, so it is tricky to understand willing and able to provide if commissioned. Appreciate this came from the questionnaire. Accept but part of the Pg. 138 - Some gaps in glossary definitions. consultation so retained. Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 147 January 2015 version no. 6 Pg. 139-141 - Putting in the Boots store numbers does not seem to mean much to the General Public. Agreed and amended Pg. 140 - Under Newquay does not say that Kaye’s, East Street is non NHS like it does Drury’s Chester Road. Agreed, but useful for mapping etc. Agreed and amended
Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 148 January 2015 version no. 6