Making the Most of Your Local Pharmacy
Wigan Borough
Pharmaceutical Needs Assessment
2018
Page Contents Executive Summary 1 1. Introduction 4 1.1 What is a Pharmaceutical Needs Assessment (PNA)? 4 1.2 Why is Wigan Borough Health and Wellbeing Board producing a PNA? 4 1.3 How will the PNA be used? 4 2. Wigan Borough Profile 4 2.1 Geography 4 2.2 Population 8 2.3 Health 16 2.4 Factors affecting health 25 2.5 Conclusion 33 3. Pharmacy Services 34 3.1 Background 34 3.2 Who can provide pharmacy services? 34 4. Pharmacy Contractors 34 4.1 Definition 34 4.2 Essential Services 35 4.3 Advanced Services 36 4.4 Enhanced Services 38 4.5 Locally Commissioned Services (Commissioned by the Local Authority) 38 4.6 Locally Commissioned Services (Commissioned by the Clinical Commissioning Group) 41 4.7 Non-NHS Pharmaceutical Services 43 5. Appliance Contractors 44 5.1 Definition 44 5.2 Essential Services 44 5.3 Advanced Services 45 6. Current Pharmacy Service Provision 45 7. Analysis of Pharmacy Services by Service Delivery Footprint (SDF) 48 7.1 Why SDF level analysis 48 7.2 Services not included in the SDF level analysis 48 7.3 SDF 1 - Wigan North 48 7.4 SDF 2 - Tyldesley and Atherton 50 7.5 SDF 3 - Ince, Hindley, Abram, Platt Bridge 51 7.6 SDF 4 - Leigh 52 7.7 SDF 5 - Lowton and Golborne 54 7.8 SDF 6 - Wigan Central 55 7.9 SDF 7 - South Wigan and Ashton North 56 8. Pharmacy Services Response to Local Health Issues 58 8.1 How current pharmacy services help meet the health needs of the Wigan Borough 58 Population 8.2 How future pharmacy services could be developed to further meet the health needs of 61 the Wigan Borough Population 9. Future Needs 63 10. Conclusion 63
Appendix Appendix 1 – Pharmaceutical Needs Assessment Process Appendix 2 – Pharmacies in Wigan Borough Appendix 3 – General Practices in Wigan Borough Appendix 4 – Pharmacy Services – Essential and Advanced Services Appendix 5 – Pharmacy Services – Locally Commissioned Services Appendix 6 – Pharmacy Access Appendix 7 – Pharmacy and General Practice Opening Hours Appendix 8 – Service Delivery Footprint Maps – Pharmacy and General Practice Location Appendix 9 – Patient Satisfaction Survey Appendix 10 – Wigan Borough Health Profile 2017 (Public Health England)
Executive Summary
This document provides an assessment of the need for pharmaceutical services in Wigan Borough. It follows and updates the position of the Pharmaceutical Needs Assessment published in March 2015. The purpose of the document is to inform future planning and commissioning decisions in respect of future public services and, in particular, pharmaceutical services within the Borough.
Context
The key change in the population of Wigan Borough is in respect of its age structure. There has been a steady increase in the 85+ population in Wigan Borough as life expectancy has increased. The size of the 65 – 84 population remained fairly static until around 2005 when it started to increase reflecting the higher birth rates during the Second World War and the post-war period. Projections provided by the Office of National statistics indicate that the size of the under-65 population in Wigan Borough will remain fairly static. However, the 65+ population will continue to increase in size with the 85+ population projected to double during the next 15 years. However, care is needed in interpreting projections as they become less accurate the longer one looks into the future. That being said, there will be significantly more older people in Wigan Borough in the future and local pharmacies will need to adapt their services to the changing needs of the population that result from this.
Inequality in health due to different levels of deprivation continues to be an issue within the Borough. This is reflected in differences in life expectancy. Latest data shows life expectancy at birth in Wigan Borough is 77.7 years for men and 81.2 years for women (2013 – 2015). However, while life expectancy has steadily increased, life expectancy is 12.2 years lower for men and 9.8 years lower for women in the most deprived areas of the Borough than in the least deprived areas.
Current Pharmacy Service
At present, there are 70 pharmacies in Wigan Borough. Two pharmacies have closed since the draft Pharmaceutical Needs Assessment for consultation was published in October 2017. This equates to an average of 22 pharmacies per 100,000 population with the national average being 21 pharmacies per 100,000 population in England1. People can also access pharmacies outside the border of Wigan Borough, for example people may access a pharmacy near where they work as well as 321 internet pharmacies nationally1. Within the Borough, 98% of general practices have a pharmacy within 1km and 75% have one within 300 metres.
All pharmacies are required to provide all Essential Services, thus provision is excellent across the Borough. Pharmacy service provision in the Borough covers a wide range of opening hours including six ‘100 hour’ pharmacies that provide access for around 14 to 15 hours each day. All pharmacies provide a Prescription Collection Service and 65 (93%) provide a Prescription Delivery Service. In general, wheelchair access to pharmacy services is good.
1 NHS Digital, General Pharmaceutical Services England 2007/08 to 2016/17 Page | 1
Addressing Local Health Need
As well as providing prescription medication to treat and, where possible, prevent the development of diseases such as heart disease, lung disease and diabetes, pharmacies provide other services that include:
Medicines Use Reviews
New Medicines Service
Minor Ailment Service to address some of the issues concerning primary care capacity
Access to free Emergency Hormonal Contraception
Chlamydia Screening
Condom (C-card) Scheme allowing young people to obtain free condoms from participating pharmacies and other outlets
Stop Smoking Service with access to nicotine replacement products
Supervised Methadone and Buprenorphine Consumption Service
Needle Exchange Scheme
Seasonal Influenza Vaccination
‘Brief Interventions’ to at-risk patients to help raise awareness that small changes to their lifestyle can have a significant, positive impact on their health
Services that are not yet provided by local pharmacies but could be considered by commissioners include:
The offer of NHS Health Checks
The provision of aspects of the weight management pathway
‘Brief interventions’ in respect of alcohol use
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Conclusion
Health in Wigan Borough continues to improve as reflected by increasing life expectancy. However, inequality in health remains. Although the prevalence of smoking has dropped considerably, equal access to preventive services and health services in general, including pharmacies, needs to be assured for all residents across the Borough.
In future years, there will be an increasing number of older people within the Borough. There are many positives resulting from this including benefits to their families (e.g. assisting with childcare), benefits to the economy with some working longer, and benefits to local communities through community engagement, volunteering, etc. However, there will be more people living with long term conditions and, in some cases, multiple conditions. Community pharmacies already provide a service to older residents locally. There is an opportunity for pharmacies to continue to adapt to the growing needs of older people within the Borough by further improving access particularly for those who are becoming less mobile.
Overall, access to pharmacy services is excellent. In the case of Locally Commissioned Services there are areas in the Borough where provision of some services could be improved. This should be addressed, in the first instance, by existing pharmacy contractors. There is also scope to improve public awareness of the many pharmacy services available and encourage people to use pharmacies as the first port of call for the management of minor ailments. By improving public knowledge of services available and developing current and future services, Wigan Council and Wigan Borough Clinical Commissioning Group (CCG) will continue to support the development of community pharmacy services in line with the direction set by the government, the health needs of our population and the changes that will occur as a result of Devolution Manchester.
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1. Introduction
1.1. What is a Pharmaceutical Needs Assessment?
1.1.1. The Pharmaceutical Needs Assessment (PNA) is a health needs assessment specifically identifying how pharmacy services are helping to meet the health needs of the population and how they could help in the future.
1.1.2. The process and requirements of the PNA are given in Appendix 1.
1.2. Why is Wigan Borough Health and Wellbeing Board producing a PNA?
1.2.1. The Health and Social Care Act 2012 transferred responsibility for the development and updating of the PNA to Health and Wellbeing Boards.
1.3. How will the PNA be used?
1.3.1. In order for the Health and Wellbeing Board to better harness and fully utilise the extensive skills within community pharmacies, the way in which decisions about commissioned pharmacy services are made has been reformed. This has been achieved by placing PNAs at the centre of Health and Wellbeing Board decision making, ensuring pharmaceutical services are more responsive to local need and commissioned through an integrated local plan.
1.3.2. This document provides an update to the Pharmaceutical Needs Assessment published by Wigan Council in March 2015. The production of this PNA has been led by Wigan Council (Public Health) with a significant contribution from Wigan Borough Clinical Commissioning Group (Medicines Management).
2. Wigan Borough Profile
2.1. Geography
2.1.1. Wigan Borough is located in the North West of England, between Manchester, Liverpool and Preston and is part of Greater Manchester. It is one of the largest Metropolitan Boroughs in England and borders Bolton, Chorley, Salford, St Helens, Warrington and West Lancashire. The Borough is made up of a number of towns and districts, the largest of which is Wigan (See Figure 1).
2.1.2. Historically, Wigan Borough was a mining area and the towns developed reflecting the workforce demands of that industry. Although with development the towns have merged in places there remains a considerable area of green space within the Borough. Wigan Borough Clinical Commissioning Group covers the same geographical area as Wigan Council.
2.1.3. Wigan Borough is now divided into seven Service Delivery Footprints with the aim to deliver integrated health and social care services within each of these areas (see Figure 2).
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Standish
Shevington Aspull
Wigan Orrell Pemberton Hindley Atherton
Billinge Platt Bridge Tyldesley
Bryn Astley Leigh Ashton-in Makerfield
Golborne Lowton
Contains Ordnance Survey data © Crown copyright and database right 2010 Figure 1. Wigan Borough
Figure 2. Service Delivery Footprints in Wigan Borough
2.1.4. Figures 3 and 4 show the locations of pharmacies and general practices. Page | 5
Figure 3. Wigan Borough pharmacy locations by Service Delivery Footprint (See Appendix 2 for pharmacy codes) Page | 6
Figure 4. Wigan Borough general practice locations by Service Delivery Footprint (See Appendix 3 for general practice codes) Page | 7
2.2. Population
2.2.1. Age/sex distribution and future trend in population size Figure 5 shows the age/sex distribution of the population of Wigan Borough using the Office of National Statistics (ONS) mid-2015 population estimates. Overlying this is the ONS 2025 population projection (2014-based). As of 2015, the population of Wigan Borough was 322,022.
2.2.2. Above the age of 55, the population of most of the age groups are projected to increase in size. Below the age of 55, the population of most of the age groups are projected to remain fairly static or shrink in size. This is a clear indication of the ageing of the population of Wigan Borough.
Figure 5. Wigan Borough population by age and sex (2015) with projection (2025)
2.2.3. Therefore, Wigan Borough is undergoing a significant population shift. Figures 6 and 7 provide the context around this. From 1991 to 2005, the Wigan Borough population remained stable. The 0 – 84 age group, despite some change in the size of its constituent age groups, remained a similar size throughout that period. Only the 85+ age group showed a steady increase in size. This was due to the improved health of the population that gave rise to a steady increase in life expectancy with more people living beyond age 85. Life expectancy at birth in Wigan Borough now stands at 77.7 years for men and 81.2 years for women (2013 – 2015). An increase in the size of the 65 – 84 population only started around 2005, probably reflecting the increase in birth rate during World War II. This merged with the effect of the early post war baby boom in around 2010. Beyond 2015, the under 65 population is projected to remain static. However, the 65+ population is projected to continue to rise with the 85+ population accelerating in growth reflecting the wartime increase in birth rate and the post war baby boom. Following this the rate in the rise in the size of this age group levels off.
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2.2.4. Caution is needed in regard to population projections as errors accumulate the further one projects into the future. Present projections suggest that the Wigan Borough 85+ population could double in the next 15 years. However, if the Office of National Statistics has been over optimistic regarding the rate of increase in life expectancy the doubling in size of the 85+ population may take longer.
Figure 6. Estimates and projections of the Wigan Borough population aged 65 - 84
Figure 7. Estimates and projections of the Wigan Borough population aged 85+
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2.2.5. Whatever the growth rate of the 65+ population of Wigan Borough turns out to be, it will have a significant effect on the local health and social care system. More people will be living with a long term health condition and more people will be living with multiple health conditions. Therefore, demand for health and social care services will increase. Community pharmacies will have to adapt to this both in terms of meeting the increase in demand for pharmacy services and ameliorating the demand for other health and social care services within the Borough.
2.2.6. Ethnicity Figure 8 shows the distribution of ethnic groups (excluding White British) within Wigan Borough compared with England as a whole. It should be noted that this is based on data from the 2011 census. There is no recent data. Although Wigan Borough is active in accepting refugees and other migrants, it is unlikely that this has greatly changed the ethnic mix of the population since the last census. The population of Wigan Borough is predominantly White British (95.5%) as compared to England (79.8%) where the proportion is smaller. Wigan Borough has had an increase in migrants, refugees and asylum seekers in recent years. Although the numbers are small compared to the size of the total population and some only stay for a short period of time, it is important that they are not ignored as some will have specific health needs that need to be addressed. In addition, it is important that individuals with infectious diseases such as tuberculosis are identified quickly in order that they can be treated and to protect the public health.
Figure 8. Ethnic mix of the Wigan Borough population excluding White British (2011)
2.2.7. Population density Figure 9 shows the population density per square kilometre within Wigan Borough by Local Super Output Area (LSOA) and thus shows the main population centres in the Borough. Service Delivery Footprints are also shown.
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Source: Office of National Statistics
Figure 9. Wigan Borough population density per square kilometre by LSOA with Service Delivery Footprints Page | 11
2.2.8. Deprivation Figure 10 shows the proportion of the Wigan Borough LSOAs within each deprivation quintile where ‘1’ represents LSOAs that are among the 20% most deprived in England and ‘5’ represents LSOAs that are among the 20% least deprived in England. Wigan Borough is compared with England as a whole where, by definition, each quintile contains 20% of the LSOAs.
Figure 10. Distribution of deprivation in Wigan Borough
2.2.9. Wigan Borough has a higher proportion of LSOAs that are within the 20% most deprived in England compared to England as a whole, and a concomitant reduction in LSOAs in the three least deprived quintiles. Figure 11 shows the same information as Figure 10 but presented as a map.
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Source: Index of Multiple Deprivation 2015 Figure 11. Distribution of deprivation in Wigan Borough by LSOA deprivation quintile Page | 13
2.2.10. Homelessness Homelessness is associated with severe poverty and is a social determinant of health. Homelessness is linked to adverse health, education and social outcomes, particularly for children. To be deemed statutorily homeless, a household must have become unintentionally homeless and must be considered to be in priority need. As such, statutorily homeless households contain some of the most vulnerable members of the community. Figure 12 shows the estimated proportion of households in temporary accommodation per 1,000 households for Wigan Borough and England. Wigan Borough has consistently had a far smaller proportion of households in temporary accommodation compared to England as a whole.
2.2.11. Figure 13 shows the eligible number of homeless people not in priority need as a proportion of the total number of households. Most people in this category are single. For the years 2014/15 and 2015/16 Wigan Borough had a similar proportion to England as a whole. A significant number of homeless people (including travellers) do not access health and social care services and many will have some degree of mental health problem and/or substance misuse.
2.2.12. The Homeless and Vulnerable Persons Team, provided by Bridgewater Community Healthcare NHS Trust in Wigan Borough, encourages and empowers homeless and vulnerable people to gain control of their own health and determine their own lives and futures. The service provides healthcare, support and advice for homeless people, migrants, asylum seekers, refugees and travellers.
Figure 12. Statutory homelessness - households in temporary accommodation
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Figure 13. Statutory homelessness - Eligible homeless people not in priority need
2.2.13. Migration Figure 14 shows the net internal migration in respect of Wigan Borough for the year ending 2015. Internal migration is defined as residential moves between different Local Authorities in the UK. The greatest net outflow occurred in the age group 15 – 19. This probably reflects the move of young people to colleges or universities outside Wigan Borough in order to continue their education. However, the greatest net inflow occurred within the subsequent age groups 20 – 24 and 25 – 29. This may reflect the return of individuals to the Borough following their higher education. For females this inflow mainly occurred when aged 20 – 24, whereas for males this is spread over 20 – 29. Care needs to be given to interpreting this difference between males and females. One possibility is that males may be more likely to extend their higher education beyond degree level, though across the UK more females than males study for a degree, or they are more likely to spend more time outside the Borough (e.g. they have found work elsewhere).
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Figure 14. Net internal migration, Wigan Borough year ending 2015
2.2.14. Wigan Borough net migration (internal and long term international) has been around +360 per year during the three year period year ending June 2013 to year ending June 2015. During that period, the population of Wigan Borough rose by around 1,120 per year. Therefore, net migration contributed to just under a third of the population increase each year during that time. Falling mortality rates with the concomitant rise in life expectancy accounts for most of the year-on-year rise in the population of Wigan Borough.
2.3. Health
2.3.1. The population changes taking place in Wigan Borough and elsewhere including the ageing of the population give rise to a number of challenges for the health and social care system. Greater Manchester devolution of health and social care funding provides an opportunity to develop health and social care services that meet the needs of local people in the face of population changes.
2.3.2. The main focus of devolution of health and social care is:
Preventing people getting ill, helping people find employment, and helping people to remain independent.
Joining up health and social care services, to reduce gaps in the system and make services work better together, facilitated by the development of Integrated Care Organisations (ICOs).
Providing better community-based care near people’s homes.
Providing better care and support for people with mental health problems.
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2.3.3. Wigan Council recognises that health and wellbeing requires a partnership with local people and communities as set out in the Deal for Health and Wellness (Figure 15).
Figure 15. Deal for Health and Wellness
2.3.4. The Deal for Health and Wellness is part of a wider Deal with residents and communities that Wigan Council has been promoting since 2010. It is an informal agreement between the Council and everyone who lives or works here to work together to create a better Borough. The aim is to work with people and communities, recognising the many skills, talents and assets that are available in this Borough. Further information is available at the link below:
www.wigan.gov.uk/Council/The-Deal
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2.3.5. Mortality Figure 16 shows the trend in all-age mortality for males for both Wigan Borough and England. In both cases the trend is down though mortality remains higher for Wigan Borough. However, there is an indication that the difference in mortality is narrowing.
Figure 16. Trend in mortality for males in Wigan Borough compared to England
Figure 17 shows the trend in all-age mortality for females for both Wigan Borough and England. As above, the trend is down though mortality remains higher for Wigan Borough. The narrowing of the gap between Wigan Borough and England is not quite so clear cut but this may be masked by year-on-year variation.
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Figure 17. Trend in mortality for females in Wigan Borough compared to England
2.3.6. During the three year period 2013 to 2015 there were just over 3,000 deaths in Wigan Borough per year. Figures 18 and 19 show the main causes of death for people aged less than 75 in the Borough, and by males and females respectively. Cardiovascular disease, cancer and respiratory disease account for the bulk of deaths under age 75. Liver disease and accidents cause a significant proportion of deaths in males under the age of 75 with a smaller proportion of females affected. Dementia as an underlying cause of death features only as a small proportion of deaths in people under the age of 75.
2.3.7. Figures 20 and 21 show the main causes of death for people aged 75 and over in the Borough. While cardiovascular disease and cancer still account for a significant proportion of deaths, both dementia and respiratory disease account for a larger proportion of deaths compared to people aged under 75.
2.3.8. With an ageing population (Section 2.2) it is highly likely that the number of people with dementia and respiratory disease in Wigan Borough will increase. Therefore, both the need for pharmaceutical services and the ability to access pharmaceutical services are issues that need to be considered for these two groups of people.
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Figure 18. Cause of death in males under the age of 75 in Wigan Borough (2013 – 15)
Figure 19. Cause of death in females under the age of 75 in Wigan Borough (2013 – 15)
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Figure 20. Cause of death in males aged 75 and over in Wigan Borough (2013 – 15)
Figure 21. Cause of death in females aged 75 and over in Wigan Borough (2013 – 15)
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2.3.9. Long term conditions Table 1 shows the number of Wigan Borough patients on GP disease registers during the year 2015/16 together with the prevalence of each condition, as reported as part of the Quality Outcome Framework.
Wigan Borough Clinical England Commissioning Group
Long Term Condition Number Prevalence Prevalence
Atrial Fibrillation 6,379 2.0% 1.7% Coronary Heart Disease 13,681 4.2% 3.2%
Heart Failure 3,321 1.0% 0.8% Hypertension 51,605 16.0% 13.8%
DISEASE Peripheral Arterial Disease 2,579 0.8% 0.6% Stroke or Transient Ischaemic
CARDIOVASCULAR 6,215 1.9% 1.7% Attacks
Asthma 21,549 6.7% 5.9%
Chronic Obstructive Pulmonary DISEASE 7,879 2.4% 1.9%
Disease RESPIRATORY
Epilepsy (18+) 2,391 0.9% 0.8%
DISEASE Dementia 2,396 0.7% 0.8% NEUROLOGICAL
Depression (18+) 23,468 9.1% 8.3%
HEALTH Mental Illness 2,607 0.8% 0.9% (Excludes depression)
CONDITIONS Learning Disabilities 1,701 0.5% 0.5% MENTAL MENTAL
Cancer 7,891 2.4% 2.4%
Chronic Kidney Disease (18+) 13,252 5.1% 4.1% Diabetes Mellitus(17+) 18,670 7.1% 6.6% Obesity (18+) 31,057 12.1% 9.5%
Osteoporosis (50+) 423 0.4% 0.3%
CONDITIONS Palliative Care 930 0.3% 0.3%
OTHERLONG TERM Rheumatoid Arthritis (16+) 2,098 0.8% 0.7% Table 1. Prevalence of long term conditions (Source: Quality and Outcomes Framework 2015-16)
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2.3.10. The recorded prevalence from general practice based registers should be treated with caution, as many factors can affect reported prevalence. These factors apply more to some conditions rather than others, for instance, recognition and labelling of diabetes where there is a clear clinical definition is more accurate than for depression. However, recorded prevalence of a condition does not necessarily reflect actual prevalence, though there is evidence in Wigan Borough that there is good case ascertainment and recording in general practice registers. This may not be reflected elsewhere. Therefore, any comparison with England as a whole also has to be treated with caution as a higher recorded prevalence of a condition in Wigan Borough may just be a reflection of higher case ascertainment compared to England rather than an actual higher prevalence.
2.3.11. However, the information in Table 1 is still of value as it provides an indication of the burden of long term conditions in the population. This is important in the face of an ageing population. It is likely that despite falling incidence and mortality rates for key diseases such as coronary heart disease and stroke, particularly in the under 75 population, that there will be an increase in number of people within the Borough who will be suffering a long term condition. This is simply due to the increase in the number of older people, particularly in the 85+ population where conditions such as dementia are common.
2.3.12. In addition to the larger number of people with a long term condition, there will also be more people with multiple conditions. This is another reflection of an ageing population that needs to be taken into account in planning the future provision of local pharmaceutical services.
2.3.13. Sexual Health and Teenage pregnancies Table 2 shows the diagnosis rate of the major sexually transmitted diseases, comparing Wigan Borough and England as a whole. The picture is encouraging. Wigan Borough has lower diagnosis rates for syphilis, gonorrhoea, chlamydia, genital herpes and HIV. This probably reflects a lower incidence of these diseases compared to England. However, the Borough has higher diagnosis rates for genital warts. In regard to chlamydia, the aim is to detect cases in the 15 to 24 age group in order to reduce future complications such as infertility in women. Chlamydia detection rates for this age group are higher than for England as a whole but less than the Public Health England recommended minimum detection rate of 2,300 per 100,000 per year. That Wigan Borough does not achieve this detection rate probably reflects the lower proportion of people aged 15 to 24 screened for chlamydia.
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Wigan Year England Borough Syphilis diagnosis rate per 2015 4.1 9.3 100,000 per year Gonorrhoea diagnosis rate per 2015 28.4 70.7 100,000 per year Chlamydia diagnosis rate per 2015 304 361 100,000 per year Chlamydia detection rate per 100,000 aged 15 to 24 per 2015 1,914 1,887 year % screened for chlamydia 2015 21.6% 22.5% aged 15 to 24 Genital warts diagnosis rate 2015 129.3 118.9 per 100,000 per year Genital herpes diagnosis rate 2015 48.9 57.6 per 100,000 per year Prevalence of diagnosed HIV infection per 1,000 aged 15 to 2015 1.13 2.26 59 New HIV diagnosis rate per 2015 4.1 12.1 100,000 per year aged 15+ Table 2. Sexual health in Wigan Borough compared to England (Source: Sexual and Reproductive Health Profile for Wigan Borough 2017, PHE)
2.3.14. Table 3 shows the under-18 conception and birth rates in Wigan Borough compared to England. Under-18 conception and birth rates continue to fall in Wigan Borough. However, rates remain higher than England as a whole though the gap is narrowing.
Wigan Year England Borough Under 18s conception rate per 2014 31.6 22.8 1,000 per year Under 18s birth rate per 1,000 2014 7.1 6.7 per year Table 3. Under 18 conception and birth rates compared to England (Source: Sexual and Reproductive Health Profile for Wigan Borough 2017, PHE)
2.3.15. Health Inequalities Female life expectancy in the Borough is 81.2 years, 1.9 years less than England (Source: Office of National Statistics 2013 – 2015). Male life expectancy is 77.7 years, 1.8 years less than England. Life expectancy in Wigan Borough and England continues to increase but there is evidence that the rate of increase is slowing.
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2.3.16. Deprivation has a considerable impact on life expectancy. Despite the increase in life expectancy overall, the gap in life expectancy between areas of high deprivation and areas of low deprivation remains. During the three year period 2013 and 2015 life expectancy was 12.2 years lower for men and 9.8 lower for women in the most deprived areas in Wigan Borough compared to the least deprived areas. (Source: Public Health England). The gap for men has increased though there is evidence of a slight fall for women.
2.3.17. While there are historical reasons for the level of variation in life expectancy within the Borough (e.g. differential prevalence of smoking), efforts continue to reduce this level of health inequality. This includes providing better access to services that help people improve their health e.g. stopping smoking, losing excess weight, increasing physical activity, support with alcohol problems, as well as support with general wellbeing via HealthyRoutes2. In addition, action is being taken to address some of the wider determinants of health such as school readiness, unemployment and fuel poverty.
2.4. Factors affecting health
2.4.1. Smoking Smoking remains the most significant contributing factor in regard to ill health, health inequality across the Borough, and reduced life expectancy particularly in respect of cancer (especially lung cancer), coronary heart disease and respiratory disease. Reducing smoking prevalence across the Borough, therefore, remains a key priority.
2.4.2. The prevalence of smoking in adults in Wigan Borough continues to fall. Between 2012 and 2016 smoking prevalence in Wigan Borough fell from 22.7% to 17.7%, a proportionate fall of 22.0%.
2.4.3. The prevalence of smoking in adults in routine and manual occupations in Wigan Borough fell from 31.9% in 2012 to 26.3% in 2016, a proportionate fall of 17.6%. Table 4 shows the prevalence of smoking in Wigan Borough for 2016 compared to England as a whole. While overall smoking prevalence in Wigan Borough remains higher than England, smoking prevalence in adults with routine and manual occupations has fallen to a level similar to England. However, it should be noted that this information is derived from a survey of a sample of the population (Annual Population Survey). Therefore, these results for smoking prevalence are subject to potentially high year-on-year variation.
Wigan England Borough Smoking prevalence - Overall 17.7% 15.5%
Smoking prevalence - Routine and manual 26.3% 26.5% Table 4. Smoking prevalence (2016) (Annual Population Survey)
2 www.wigan.gov.uk/Resident/Health-Social-Care/Healthy-Routes Page | 25
2.4.4. Smoking in pregnancy can have adverse health effects on the unborn child including increasing the risk of low birth weight and premature birth. Table 5 shows smoking status at time of delivery in Wigan Borough compared to England as a whole. Since 2010/11 the proportion of women smoking at the time of delivery has fallen from 19.9% (736 women) to 14.8% (495 women), a proportionate fall of 25.6% (see Figure 22). However, the proportion of women smoking at the time of delivery in Wigan Borough remains higher than England as a whole.
Wigan Borough England Number % % Proportion of women who 495 14.8% 10.6% smoke at time of delivery Table 5. Smoking status at time of delivery (2015/16) (Source: Public Health Outcomes Framework)
Figure 22. Trend in proportion of women smoking at time of delivery In Wigan Borough compared to England (Source: Public Health Outcomes Framework)
2.4.5. Alcohol Excessive alcohol consumption can have a serious effect on an individual’s health. Binge drinking can cause acute liver damage, respiratory depression and even death. Long term excessive alcohol use can be more insidious with people thinking that their health is fine until their liver fails as a result of liver damage including cirrhosis of the liver. Excessive alcohol use has also been linked to an increased risk in respect of a number of cancers including breast cancer and oesophageal cancer.
2.4.6. As well as the effects of alcohol on the individual, excessive alcohol use can have serious effects on families and society. For example, domestic violence and crime in an area can have a significant alcohol component.
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2.4.7. Figures 23 and 24 show the trend in alcohol-specific mortality and hospital admission rates respectively for Wigan Borough and England as a whole. In both cases, the rates for Wigan Borough for both males and females are higher than England.
Figure 23. Trend in alcohol-specific mortality in Wigan Borough and England
Figure 24. Trend in alcohol-specific admissions in Wigan Borough and England
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2.4.8. Care must be taken in interpreting the rise in alcohol-specific mortality from 2009 – 11 to 2012 – 14. Deaths that can be specifically attributed to alcohol are generally due to over consumption lasting years or even decades. For this reason, any improvement in alcohol-specific mortality rates as a result of effective preventive measures can take time before they manifest.
2.4.9. With regard to alcohol-specific hospital admission rates for Wigan Borough these are also higher than England as a whole. However, there is some more favourable news. Alcohol admission rates for the under-18s have been falling (see Figure 25). However, this may be levelling off. It should be noted that unlike all-age admission rates, females aged under 18 have higher alcohol-specific admission rates than males.
Figure 25. Trend in under-18 alcohol-specific admissions in Wigan Borough and England
2.4.10. Drug use The use of recreational drugs can have a severe impact on health and sometimes cause death. Injecting drug users risk infection with blood born viruses (e.g. hepatitis B, hepatitis C, HIV, etc.) as well as adverse effects of the drugs, additional substances with which the drugs are cut, and any contaminants (e.g. anthrax).
2.4.11. Even drugs such as cannabis and the new psychoactive substances can have considerable adverse health effects. Cannabis has been linked to increased risk of mental disorders such as depression and psychosis as well as being associated with poor concentration and reduced ability to organise and use information.3
3 www.rcpsych.ac.uk/healthadvice/problemsdisorders/cannabis.aspx Page | 28
2.4.12. More recently there has been an increase in the use of ‘Spice’ that is essentially a collective term for preparations that contain chopped up herbs possibly with the addition of tobacco that have been sprayed with synthetic cannabinoids. For this reason Spice is sometimes called synthetic cannabis or synthetic marijuana. However, the synthetic cannabinoids used in Spice are very much more powerful than tetrahydrocannabinol (THC), the active ingredient in cannabis. Therefore cannabis and Spice are very different and should not be confused. Some versions of Spice are deadly and can kill. All versions can have severe physical and psychoactive effects. The use of Spice has increased in prisons as well as within the homeless population in major cities such as Manchester. It is likely to become a major public health issue in the UK.
2.4.13. Figures 26 and 27 show the trend in mortality due to drug misuse for Wigan Borough compared to England as a whole for males and females respectively.
Figure 26. Mortality due to drug misuse in males in Wigan Borough compared to England.
2.4.14. During the last ten years males have had a consistently higher mortality rate for drug misuse in Wigan compared to England as a whole. Up until 2011-13 the female mortality rate for drug misuse in Wigan reflected England as a whole. Since then there has been a rise in mortality that has diverged from England.
2.4.15. For the three year period 2014 – 2016, there were a total of 61 deaths due to drug misuse in Wigan Borough. 41 were in males and 20 in females. This compares with the period 2004 – 2006 where 28 deaths were due to drug misuse (23 male, 3 female). The proportion of people dying from drug misuse in Wigan Borough that were female has increased from 1 in 4 prior to 2010 – 2012 to 1 in 3 during 2014 – 2016.
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Figure 27. Mortality due to drug misuse in females in Wigan Borough compared to England.
2.4.16. Drug use impacts on the immediate household, including children if the individual’s lifestyle becomes chaotic. It can also fuel crime. Therefore, drug use can give rise to considerable health and social consequences that costs society as a whole.
2.4.17. The estimated prevalence of opiate and/or crack cocaine use in Wigan Borough during 2011/12 was 8.9 per 1,000 people aged 15 to 64 (Source: Public Health England). There is no more recent data. This compares with 8.4 per 1,000 people within England as a whole during the same period.
2.4.18. Table 6 shows both the number and proportion of drug users that left drug treatment successfully and did not re-present for treatment within six months within Wigan Borough compared to England. Clearly, non-opiate users experience a much higher level of success than opiate users. However, Wigan Borough has proportionately had a greater level of success with opiate drug users compared to England as a whole.
Wigan Borough England Number % % Opiate drug users that left drug treatment successfully who did not re-present to 91 8.4% 6.7% treatment within 6 months Non-opiate drug users that left treatment successfully who do not re-present to 193 36.4% 37.3% treatment within 6 months Table 6. Successful treatment of drug users (Source: Public health Outcomes Framework – 2015 data)
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2.4.19. Excess weight Excess weight (overweight and obesity) can have significant implications for health, social care, the economy and educational attainment. Having excess weight increases the risk of developing a range of serious diseases, including heart disease, type II diabetes and has been linked to a number of cancers. Table 7 shows the estimate of the prevalence of excess weight in adults in Wigan Borough compared to England as a whole.
Time period Wigan Borough England
2012 – 2014 68.1% 64.6%
2013 – 2015 69.4% 64.8% Table 7. Excess weight in adults (Source: Active People Survey, Sport England)
2.4.20. Therefore, just over two-thirds of adults in Wigan Borough are estimated to have excess weight, around 5% higher than England as a whole. Figure 28 shows Wigan Borough in comparison with its nearest statistical neighbours (i.e. have similar demographic, deprivation and other characteristics) as defined by the Chartered Institute of Public Finance and Accountancy (CIPFA). Wigan Borough is in the middle of the distribution.
Figure 28. Proportion of adults with excess weight (2013 – 2015)
2.4.21. Figures 29 and 30 show the same information but for children aged 4 to 5 years old and children aged 10 to 11 years old respectively. The difference between Wigan Borough and England is less than for adults. However, there is a need to continue to explore ways to reduce excess weight in children in order to reduce the likelihood of this translating into excess weight in adults in the future.
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Figure 29. Proportion of children aged 4 - 5 with excess weight (2015/16)
Figure 30. Proportion of children aged 10 - 11 with excess weight (2015/16)
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2.4.22. Physical activity Good levels of physical activity reduce the risk of excess weight and the diseases that arise as a result of this. In addition, there is evidence that physical activity is good for health and wellbeing in its own right. For example, a good level of physical activity benefits an individual’s mental health. Figure 31 shows an increase in the proportion for physically active adults in Wigan Borough as estimated by the Active People Survey (Sport England)4. However, this remains below England as a whole.
Figure 31. Proportion of physically active adults in Wigan Borough and England
2.5. Conclusion
2.5.1. While on average health is improving within Wigan Borough as evidenced by increasing life expectancy there remains considerable inequality in health experience within the Borough. Some of this may derive from the mining/industrial heritage of the area. Some may be as a result of high historical smoking prevalence. The good news is that smoking prevalence has reduced. However, excess weight and lack of exercise remain issues in Wigan Borough.
2.5.2. Looking forward, it is the changing population structure that will provide one of the biggest challenges to the local health and social care system, including pharmacy services. With people living longer there will be more people with long term conditions and more people suffering multiple health problems. Community pharmacies already have an important role in providing local services to help people maintain their health. This role will become even more important as the population ages and people are restricted in their movement either through physical infirmity or reduced mental capacity due to dementia. Pharmacies will, therefore, need to adapt to ensure that their services remain accessible.
4 www.sportengland.org/research/about-our-research/active-people-survey Page | 33
3. Pharmacy Services
3.1. Background
3.1.1. Community pharmacies (also known as retail pharmacies or chemists) play an important role in the UK’s healthcare system. They form an extensive network of outlets that allow the majority of people to have their prescriptions dispensed conveniently. In addition, they provide other essential services to the community including the sale of non-prescription medicines and healthcare products, provide professional advice on the safe and responsible use of medicines, and provide lifestyle advice and information on other services available5. As the population continues to age and as health expectations continue to rise, the role of community pharmacies will continue to grow in supporting the nation’s health.
3.2. Who can Provide Pharmacy Services?
3.2.1. For the purposes of the Pharmaceutical Needs Assessment (PNA) pharmaceutical services are defined as:
“All the pharmaceutical services that may be provided by Pharmacies, Appliance Contractors, Local Pharmaceutical Service Schemes and Dispensing Doctors6.”
3.2.2. Within Wigan Borough there are no dispensing doctors or Local Pharmaceutical Service Schemes. There were 111 appliance contractors in contract at 31 March 2017 in England, all of whom were actively dispensing in the year7. There are no appliance contractors located in Wigan Borough but due to the nature of their business, appliance contractors will generally deliver devices to patients over a large geographical area rather than supplying a service to their local population. Therefore, these appliance contractors together with the pharmacies in the Borough meet the needs of our residents requiring appliances.
4. Pharmacy Contractors
4.1. Definition
4.1.1. The Community Pharmacy Contractual Framework defines the services that pharmacies offer. These are divided into three categories:
1. Essential Services 2. Advanced Services 3. Enhanced Services
4.1.2. In addition, both the Local Authority and Clinical Commissioning Group (CCG) can commission pharmacy services. These services will be referred to as Locally Commissioned Services within this document.
5 The control of entry regulations and retail Pharmacy services in the UK. A report of an OFT market investigation. January 2003 6 http://www.legislation.gov.uk/uksi/2013/349/part/2/made 7 NHS Digital, General Pharmaceutical Services England 2007/08 to 2016/17 Page | 34
4.2. Essential Services
4.2.1. These are services which all pharmacy contractors must provide at all times. They are:
4.2.2. Dispensing Service All pharmacy contractors dispense prescriptions. In addition to dispensing prescriptions this service requires contractors to have an ‘owings’ procedure, to provide waiting times, to check for evidence of exemption from prescription charges, and provide patients with advice as necessary in the following areas:
Prescribing interventions Patient counselling with prescriptions e.g. advice on side effects, interactions, how to take medication Safe storage advice Waste disposal advice
4.2.3. Repeat Dispensing This service makes additional requirements to those for dispensing services, allowing pharmacies to supply medication using a repeatable prescription for up to one year without the need for the patient to visit the doctor. The pharmacy must ascertain the patient's need for a repeat supply and communicate any clinically significant issues to the prescriber.
4.2.4. Disposal of Unwanted Medication All pharmacy contractors must accept returned medication from households if the NHS England Local Area Team has made arrangements to collect this waste. This service requires contractors to store this medication appropriately, separate waste as required by the Environment Agency and Waste Collection Contractor, ensure that staff handling waste medication are aware of the risks, and have appropriate protective and spillage equipment available. This service is in operation in Wigan Borough.
4.2.5. Promotion of Healthy Lifestyles The pharmacy contract requires prescription linked interventions. This means that where patients present prescriptions indicating they are at risk of coronary heart disease (CHD), have diabetes, smoke or are overweight, the pharmacist or their staff will provide opportunistic lifestyle advice with the aim of increasing the patients’ knowledge and understanding of health issues relevant to them when appropriate. Pharmacies should provide written advice and referral to other sources of information as necessary. There is provision in the pharmacy contract under this service for NHS England to require pharmacy contractors to take part in up to six public health campaigns per year.
4.2.6. Signposting This service requires pharmacies to refer patients to other services to obtain advice, treatment or support whilst ensuring the appropriate use of health and social services. Referral may be verbal or written if required.
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4.2.7. Support for Self-care This service requires pharmacies to provide advice and support to people caring for themselves or their families including dealing with referrals from NHS 111. This may be by the provision of lifestyle advice, advice regarding the management of a medical condition, advice on the treatment options available to people or advice on the appropriate selection and use of those medications patients can purchase without a prescription.
4.2.8. Clinical Governance Clinical Governance arrangements are separated into six areas in the community pharmacy contract as follows:
Patient and public involvement programme Clinical audit programme Risk management programme Clinical effectiveness programme Staffing and staff management programme Use of information programme Premises standards
4.2.9. These requirements detail a wide range of procedures and policies the pharmacy must have in place to protect patients and the public and to comply with a range of legislation.
4.3. Advanced Services
4.3.1. Pharmacy contractors can choose whether or not to offer Advanced Services to their patients. They include the following:
4.3.2. Medicines Use Review (MUR) This service aims to help patients to improve the way their medication is taken (medication adherence). This includes establishing the use, understanding and patient experience of taking the medication and then identifying, discussing and resolving poor or ineffective medication use by the patient.
4.3.3. The review may identify side effects or drug interactions affecting compliance, improve the clinical and cost effectiveness of prescribed medication and reduce wastage of medication. Service provision is capped and pharmacies can only claim payment for 400 Medicines Use Reviews per year. Pharmacies must ensure that 70% of their reviews are carried out with patients in one or more of the agreed target groups to ensure support for patients with long term conditions.
4.3.4. Target groups are: Patients taking high risk medicines Patients recently discharged from hospital that had changes made to their medicines while they were in hospital. Ideally patients discharged from hospital will receive an MUR within four weeks of discharge but in certain circumstances the MUR can take place within eight weeks of discharge Patients with respiratory disease Patients at risk of, or diagnosed with, cardiovascular disease and regularly being prescribed at least four medicines Page | 36
4.3.5. New Medicines Service This service provides support to people who are newly prescribed a medicine to manage a long-term condition and aims to help them to take the medication appropriately. The service is restricted to patients prescribed specific medications for the management of asthma and chronic obstructive pulmonary disease (COPD), type II diabetes, antiplatelet/anticoagulant therapy and hypertension.
4.3.6. Flu vaccination This Advanced Service has been commissioned annually since September 2015. It allows community pharmacies to administer a seasonal influenza (flu) vaccination to eligible patients aged over 18 years, in accordance with a Patient Group Direction (PGD) provided by NHS England. The service runs from 1 September to 31 March each year and aims to support the population uptake of flu vaccine in at-risk groups by improving access and convenience for patients.
4.3.7. Vaccinations are provided by a suitably trained pharmacist and in addition to minimum requirements specified for the pharmacy premises, there are requirements that the pharmacy must maintain appropriate records and notify the patient’s GP practice that a vaccination has been administered.
4.3.8. NHS Urgent Medicine Supply Advanced Service (NUMSAS) This Advanced Service is intended to be run as a national pilot from 1st December 2016 to 31st March 2018 with a review point to consider progress in September 2017. The aim of the service is to reduce the burden on urgent and emergency care services of handling urgent medication requests, whilst ensuring patients have access to the medicines or appliances they need.
4.3.9. Pharmacies providing this service are able to supply a repeat medicine at NHS expense, following a referral from NHS 111 if they are satisfied that there is an immediate need for it to be supplied and that it is impracticable in the circumstances for the patient to obtain a prescription without undue delay. The service commenced in Greater Manchester in July 2017. At the time of writing three pharmacies within Wigan Borough are providing this service.
4.3.10. Appliance Use Review This service is a review of patients’ appliances with the underlying purpose of improving the patient’s knowledge and use of the appliances they are using. This service is only available to patients prescribed specific appliances e.g. stoma appliances.
4.3.11. Reviews must be conducted by a suitably trained pharmacist or a specialist nurse working on behalf of the dispensing appliance contractor or pharmacy contractor and can take place within the pharmacy or at the patient’s home. Service provision is capped based on the number of appliances dispensed by the contractor.
4.3.12. Stoma Appliance Customisation Stoma Appliance Customisation refers to the process of modifying multiple identical parts for use with a stoma appliance to the same specification, where the modification is based on the patient’s measurements or record of those measurements and, if applicable, a template. This is a highly specialised service and there are a variety of requirements that must be followed when providing the service. Page | 37
4.3.13. Provision of Advanced Services in Wigan Borough:
62 (89%) pharmacies in Wigan Borough currently provide Medicines Use Reviews (MURs). This provides the opportunity for 24,400 reviews to be completed per year (400 per pharmacy). Data provided by NHS England showed that 12,701 MURs were delivered in the first 6 months of 2016/17.
62 (89%) pharmacies in the Wigan Borough currently provide the New Medicines Service. Data on the number carried out is not currently available.
9 (13%) pharmacies provide Appliance Use Reviews (AURs). This service is also provided by appliance contractors to patients within Wigan Borough. Data on the number carried out is not currently available.
12 (17%) pharmacies provide Stoma Appliance Customisation. This service is also provided by appliance contractors to patients within Wigan Borough. Data on the number carried out is not currently available.
53 (76%) pharmacies provided the Flu Vaccination service during 2016/17, administering a total of 4,119 flu vaccines.
3 pharmacies currently provide the NHS Urgent Medicine Supply Advanced Service (NUMSAS). No data is currently available on the uptake of this service.
4.4. Enhanced Services
4.4.1. Enhanced Services are services that the Local NHS England Area Team commission from pharmacies to meet the needs of our population.
4.4.2. The Greater Manchester Local Area Team does not currently commission any pharmacy Enhanced Services within the Borough.
4.5. Locally Commissioned Services (Commissioned by the Local Authority8)
4.5.1. Chlamydia Screening At the time of writing, 9 community pharmacies in Wigan Borough provide free kits for testing for chlamydia and gonorrhoea for people under the age of 25.
4.5.2. All GPs and family planning clinics currently provide this service. It is also provided by a variety of other service providers such as the Shine Centre, Brook, Leigh Walk-in Centre and college nurses. Provision via college nurses has not been mapped in service provision data as the service is restricted to pupils at the college making it difficult to interpret service provision at a local level.
4.5.3. The C-Card Scheme The C-Card Scheme allows young people aged 13 to 25 to confidentially access condoms and sexual health advice at locations and times that are suited to them.
8 Wigan Council Page | 38
4.5.4. The C-Card Scheme aims to provide young people with support, guidance and accurate information so that they are able to make better informed, safe and responsible decisions about their sexual health and practice. The service is provided in a variety of settings including:
Schools Colleges Youth agencies Health settings The youth offending team Drug and alcohol services Pharmacies
4.5.5. At the time of writing, 7 pharmacies are providing this service. The expansion of this service through pharmacies will be explored as part of the wider sexual health service review which is currently being carried out within Wigan Borough.
4.5.6. Emergency Hormonal Contraception Community pharmacies are able sell Emergency Hormonal Contraception (EHC). The Locally Commissioned EHC Service allows pharmacies to provide free EHC to women, whatever their age via a Patient Group Direction (PGD) and to discuss ongoing contraception, signposting to other services as required. At the time of writing, 63 (90%) community pharmacies in Wigan Borough provide this service. Data shows that 2,418 EHC consultations were carried out during 2014/15 (more recent data is currently unavailable) and EHC was issued in 98% of these consultations.
4.5.7. All GPs and family planning clinics currently provide this service and it is also provided by a variety of other service providers such as the Shine Centre, Brook, Leigh Walk-in Centre and school and college nurses. Provision via nurses has not been mapped in service provision data as the service is restricted to pupils at the college or school making it difficult to interpret service provision geographically.
4.5.8. A comprehensive review of sexual health services is currently being carried out within Wigan Borough which is looking at how services can be brought closer to people in their communities. As pharmacies provide key access to sexual health services in the community, it is envisaged that the future sexual health service model will further improve access to sexual health advice, contraception and, testing and treatment of sexually transmitted infections via pharmacies, where safe and appropriate to do so.
4.5.9. Healthy Living Pharmacies Healthy Living Pharmacies (HLPs) are a nationally recognised concept enabling pharmacies to help reduce health inequalities within the local community, by delivering high quality health and well-being services, promoting health and providing proactive health advice. The services provided as part of the Healthy Living Pharmacies program are tailored to local health needs.
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4.5.10. Pharmacies are required to have fulfilled a number of criteria to become accredited as a HLP including having suitable premises and team members who are skilled in promoting health and wellbeing and effective leadership.
4.5.11. At the time of writing, 68 pharmacies in Wigan Borough have completed the Greater Manchester HLP accreditation scheme. Recently, changes to the National Community Pharmacy Contract have introduced a Quality Payment, part of which requires pharmacies to achieve HLP level 1 status. Pharmacies who were not previously accredited can become accredited through the Royal Society of Public Health. All pharmacies within Wigan Borough are currently being supported to achieve HLP status.
4.5.12. Stop Smoking Service Community Pharmacy Stop Smoking Services are commissioned by City Health Care Partnership CIC (CHCP) on behalf of Wigan Council.
4.5.13. There are currently two levels of Stop Smoking Services provided via pharmacies within Wigan Borough:
Level 1 Support - Provision of Nicotine Replacement Therapy (NRT) either against a paper voucher issued by Wigan's Healthy Routes Team or electronic voucher issued via CHCP's Healthy Routes digital portfolio (Quit Buddy and Quit Online).
Level 2 Support - Provision of one-to-one behavioural support and advice, treatment with NRT and on-going support.
4.5.14. Both levels of the Stop Smoking Service offer 12 weeks support and are free of charge to those people entitled to free prescriptions. For those paying prescription charges a prescription charge is paid each time Nicotine Replacement Therapy (NRT) is supplied on the scheme (max. 7 charges).
4.5.15. In addition to the pharmacy provision, GPs provide stop smoking support and there are also a wide variety of intermediate advisers trained to provide counselling for this service across the Borough e.g. stop smoking service advisers, health improvement workers, health visitors and midwives. This provides access to the necessary counselling at a variety of clinics, one-to-one sessions and in people’s homes.
4.5.16. At the time of writing, 69 (99%) pharmacies provide the level 1 service and 19 (27%) pharmacies also provide level 2 support.
4.5.17. Supervised Consumption of Methadone and Buprenorphine Supervised consumption services are commissioned by the Drug and Alcohol Service for Adults and Young People on behalf of Wigan Council.
4.5.18. The guidelines on the treatment of opioid dependence recommend that all clients prescribed substitute medication (methadone or buprenorphine are used in Wigan Borough) for treatment of addiction should be supervised consuming their daily dose in the pharmacy for the first three months of treatment.
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4.5.19. At the time of writing, 40 (57%) pharmacies in Wigan Borough offer the Supervised Consumption Service, giving service users a range of locations where they can obtain their medication.
4.5.20. Needle Exchange Scheme Needle exchange services are commissioned by the Drug and Alcohol Service for Adults and Young People on behalf of Wigan Council.
4.5.21. The Needle Exchange Scheme aims to reduce the impact of illicit drug use by allowing injecting drug users to obtain clean needles and syringes and return used ones for safe disposal and destruction. Pharmacies provide advice to help improve the lives of those accessing the service including referral to health and social care professionals and specialist drug and alcohol treatment services where appropriate. In addition, pharmacies provide support and advice on safe practice to the user, including advice on sexual health and sexually transmitted infections (STIs), HIV and Hepatitis C transmission, and Hepatitis B immunisation. This scheme ensures that there is safe disposal of used equipment protecting the health of all people in the Borough.
4.5.22. The need for the Needle Exchange Scheme is difficult to predict and tends to be estimated based on where injecting drug users live. However, there are other clients who require this service such as steroid users and those injecting tanning solutions.
4.5.23. At the time of writing, 24 (34%) pharmacies offer this service.
4.6. Locally Commissioned Services (Commissioned by the Clinical Commissioning Group9)
4.6.1. Minor Ailment Scheme The Minor Ailment Scheme is a service that allows patients to consult a community pharmacist rather than the GP for a defined list of minor ailments. Community pharmacists already advise patients on a wide range of minor ailments and either recommend and sell treatment or refer to another healthcare professional. This service allows patients who are exempt from NHS prescription charges to receive treatment from an agreed local formulary free of charge from the pharmacy. At the time of writing, this scheme is provided by 68 (97%) pharmacies within Wigan Borough.
4.6.2. Monitored Dosage System (MDS) Scheme Monitored Dosage Systems are a type of compliance aid that can help patients who are struggling with their medication. Medication is blister packed with the aim of simplifying medication taking for the patient and so improving compliance. All pharmacies offer this service to patients who fall within the Disability Discrimination Act (DDA) as part of their Essential Services. This scheme allows pharmacies to provide this service to patients who are not classed as meeting DDA criteria.
9 Wigan Borough Clinical Commissioning Group Page | 41
4.6.3. MDS are associated with several risks. Therefore, a careful assessment of the risks versus the benefits of MDS must be completed before this type of system is recommended. At the time of writing, 40 (57%) pharmacies provide the CCG scheme.
4.6.4. The scheme is currently undergoing a review during the financial year 2017/18 and future plans for this service are to incorporate recent guidance from the Pharmaceutical Services Negotiating Committee and Royal Pharmaceutical Society Guidance on the appropriate assessment of patients under the Equality Act and appropriate use of MDS. This may lead to a change in service provision but will be in line with national guidance.
4.6.5. Palliative Care Scheme The Palliative Care Scheme ensures that people in the Borough have access to medications regularly required at the end of life over an extended range of hours. At the time of writing the Palliative Care Scheme is offered by 8 (11%) pharmacies distributed across the Borough. The service is only commissioned from pharmacies that are open at least:
Monday – Friday: 09:00 hours – 22:00 hours Saturday: 09:00 hours – 20:00 hours Sunday: Any 6 hour period
4.6.6. This level of service provision is considered sufficient across the Borough as it is specifically designed to provide access to medication outside normal pharmacy opening hours.
4.6.7. It is not possible to quantify the use of this service as the scheme ensures access to and availability of medications rather than number of prescriptions dispensed and pharmacies are not required to keep a record of activity.
4.6.8. Out-of-Hours Pharmacy Service In addition to traditional pharmacy services the CCG commissions an Out-of- Hours Pharmacy Service. The Out-of-Hours Pharmacy Service operates from 10pm until 8am seven days a week and is provided by a number of pharmacists on a rota basis. This service, accessed via the out-of-hours GP service, ensures that patients requiring urgent treatment out-of-hours can obtain their prescription.
4.6.9. The Out-of-Hours Pharmacy Service also holds stock to respond to meningitis or influenza outbreaks.
4.6.10. Analysis of the Out-of-Hours Pharmacy Service usage data has shown that there were approximately 35 callouts over a 12 month period for 54 prescriptions and a total of 101 items of medication.
4.6.11. The Out-of-Hours Pharmacy Service along with the extended opening hours of many pharmacies ensures all patients within Wigan Borough are able to access pharmacy services at all times. This service has been in operation for over 10 years and has been found to work very effectively. If required it is possible to extend the hours of operation of this service e.g. during influenza outbreaks.
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4.6.12. Bank Holiday Pharmacy Service A Bank Holiday Pharmacy Service is in operation to ensure there is access to pharmacy services at Easter, Christmas and New Year. A rota system is in operation from 10:00am until 10:00pm on the following days:
Easter Sunday Christmas Day New Year’s Day
4.6.13. The rota is divided into four sessions and the pharmacies providing the service are distributed across Wigan Borough to ensure that there is a pharmacy open in a variety of areas at some point throughout the day.
4.6.14. Pharmacies who apply to provide the service are chosen on the basis of their geographical location, ability to provide the Minor Ailments Scheme, and ability to ensure access to the palliative care medications (see Section 4.6.5).
4.6.15. Although there are not normally additional rota slots on other Bank Holidays due to pharmacies within supermarkets and shopping centres being open on these days, there is provision to expand the service to ensure access to pharmacy services for additional hours. For example, during the Christmas and New Year period 2017/18, an additional session was commissioned between 7:00pm and 10:00pm on 26/12/18 to ensure access to pharmacy services for a 12 hour period on this day.
4.7. Non-NHS Pharmaceutical Services
4.7.1. Pharmacies offer a range of additional services such as blood pressure testing, diabetes checks, weight loss advice and support. These services are not included in this PNA as they fall outside of the pharmacy contract and, therefore, the Local Authority does not have full details of the services on offer or the cost to the patient.
4.7.2. Pharmacies providing these services have developed them individually and there is not necessarily any continuity in service provision across contractors. They are, however, services that patients across the Borough may access and find valuable. They help to identify patients with long-term conditions who can then be referred to the appropriate service and may be contributing towards meeting the health needs of the Borough.
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5. Appliance Contractors
5.1. Definition
5.1.1. Appliance contractors are a specific sub-set of NHS pharmacy contractors. They provide services to people who need appliances such as stoma and incontinence care aids, trusses, hosiery, surgical stockings and dressings. They range from small sole-trader businesses to larger companies. They do not supply medicines. It should be noted that pharmacy contractors are also able to dispense prescriptions for appliances. All community pharmacy contractors choosing to dispense appliances in the normal course of their business and appliance contractors are required to comply with the following Essential Services requirements.
5.2. Essential Services
5.2.1. Minimising Waste and Repeat Dispensing Patients should be appropriately advised on the importance of only requesting items they actually need. This obligation exists for both repeatable and standard prescriptions. Pharmacies and appliance contractors should also advise patients about appropriate ordering and use of appliances and the importance of minimising waste. The intention is to ensure that stock-piling of appliances is avoided, and that the appliance is used correctly (for example, discarded at suitable intervals, rather than disposed of too frequently).
5.2.2. Similarly when asked to dispense a batch issue for an appliance, it should be established whether the ‘manner of utilisation’ has changed, such that a review is appropriate.
5.2.3. A Home Delivery Service and Supply of Supplementary Items There is a requirement to offer home delivery for all qualifying items in the Drug Tariff. It is the patient's choice whether they collect their appliance from the pharmacy/appliance contractor or have it delivered. A reasonable supply of appropriate supplementary items such as wipes and disposal bags for qualifying items should be supplied with the appliances.
5.2.4. Provision of Appropriate Clinical Advice Pharmacy and appliance contractors must provide appropriate advice to patients about any stoma or incontinence appliance provided to them in order to enable them to use, store and dispose of the appliance appropriately. They must also ensure that a patient may consult, if they wish, someone to obtain expert clinical advice regarding the appliance being dispensed or, where the pharmacist believes it appropriate to do so, to refer the patient to the prescriber or to offer the patient an Appliance Use Review (AUR).
5.2.5. Where an AUR is required, but the pharmacist is not able to provide the AUR service, the patient must be given the contact details of at least two pharmacies or suppliers of appliances who are able to arrange for the service to be provided.
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5.2.6. Signposting If a pharmacy or appliance contractor cannot dispense the item prescribed or cannot provide the required Stoma Appliance Customisation, there is a requirement, with the patient’s consent, to refer the prescription form or repeatable prescription to another pharmacy or appliance contractor.
5.2.7. If the patient does not consent to referral, then contact details for at least two other contractors who may be able to dispense the required item or provide the specific service should be provided.
5.2.8. Emergency Supply A prescriber may request an emergency supply of a medicine or an appliance, provided that they supply a prescription within 72 hours (or transmit an electronic prescription). This is the same provision that applies to the emergency supply of Prescription Only Medicines.
5.3. Advanced Services
5.3.1. Appliance contractors are able to provide Appliance Use Reviews and Stoma Customisation as detailed in Sections 4.3.10 and 4.3.12 respectively.
6. Current Pharmacy Service Provision
6.1.1. There are currently 70 pharmacies in the Wigan Borough. The NHS Digital report, “General Pharmaceutical Services in England 2007/08 to 2016/17,” found that on 31 March 2017 there were 21 pharmacies per 100,000 population in England10. Based on a Wigan Borough population of just over 322,000, Wigan Borough currently has 22 pharmacies per 100,000 population. Whilst it cannot be stated that Wigan Borough has the correct number of pharmacies per head, as there is no national definition of the number of people an individual pharmacy should serve, the Borough is at the national average. This would suggest that this level of service meets the current need for our patients.
6.1.2. The Wigan Borough population can also access any community pharmacy outside of the Borough, for example it may be better for a person to use a pharmacy near where they work rather than where they live. People can access Essential and Advanced Services from these pharmacies although access to Enhanced and Locally Commissioned Services may not be available. Where there are pharmacies outside the Borough but near our boundaries these have been identified in the PNA analysis at Service Delivery Footprint (SDF) level.
6.1.3. There are also 321 Internet pharmacies nationally which can be accessed by any person in the Borough. This secures further access to the Essential Pharmacy Services securing better access for the population. The Office of Fair Trading report on pharmacy services published in 2003 found that the UK was well served geographically by pharmacies. Most people lived within a short distance of a community pharmacy. 79% of people in Great Britain had a community pharmacy within one kilometre of their home and 47% had a pharmacy within 500 metres. In general, for at least half of cases, prescriptions were picked up following a visit to a GP from a pharmacy near the surgery.
10 NHS Digital, General Pharmaceutical Services England 2007/08 to 2016/17 Page | 45
6.1.4. Around 98% of general practices in the UK had a community pharmacy within one kilometre and around 75% had one within a short walk of 300 metres11.
6.1.5. In Wigan Borough, 98% of general practices (including branch surgeries) have a pharmacy within 1km and 75% have one within 300 metres reflecting the situation above12. With data currently available we are unable to calculate the percentage of our population with a pharmacy within 1km of their home. However, Figure 32 shows the location of each pharmacy in the Borough with a 1km radius around each. This appears to cover the majority of residential areas.
6.1.6. Good access takes many forms. It includes having a pharmacy within easy reach (usually from the doctor’s surgery or from the home), having convenient opening hours and after-hours services, access to valued services such as Collection and Delivery Services, and private consultation areas.
6.1.7. In Wigan Borough, there is pharmacy service provision over a wide range of opening hours (this is discussed in more detail at the level of the individual Service Delivery Footprints) and an out-of-hour’s service. There are six ‘100 hour’ pharmacies which are contractually obliged to open for at least 100 hours each week, thereby guaranteeing access for around 14 or 15 hours each day.
6.1.8. All pharmacies within the Borough provide a Prescription Collection Service and 65 (93%) provide a Prescription Delivery Service. 69 (99%) pharmacies have a consultation area providing a private place for patients to discuss issues with pharmacy staff.
6.1.9. A patient satisfaction survey was carried out at all 72 pharmacies in Wigan Borough during May and June 2017 (See appendix 9). Two of these pharmacies closed in January 2018. This found that 99.3% of patients who had responded to the question “How would you rate the service you received today” gave the answer “excellent” or “good”. When asked if they were satisfied with the opening hours of their regular pharmacy or the one they had used that day, 97.3% of responders were satisfied. The patient satisfaction survey shows that the majority of responders are satisfied with the access to pharmacy services across the Borough and the quality of the service received.
6.1.10. The patient satisfaction survey also asked how regularly the individual completing the survey visited a pharmacy. The majority of people surveyed visited a pharmacy at least once every three months with the largest proportion of people visiting a pharmacy monthly.
6.1.11. While most people surveyed were attending the pharmacy to collect a prescription it was clear from the responses that pharmacies were being visited for a wide diversity of reasons and to access a number of services.
11 The control of entry regulations and retail Pharmacy services in the UK. A report of an OFT market investigation. January 2003 12 Note, there was an error in the 2015 Pharmaceutical Needs Assessment where it was stated that 94% of general practices had a pharmacy within 300 metres Page | 46
Figure 32. Map showing pharmacies in Wigan Borough each with a 1 kilometre radius buffer (August 2017) Page | 47
7. Analysis of Pharmacy Services by Service Delivery Footprint (SDF)
7.1. Why SDF level analysis
7.1.1. Provision of pharmacy services has been evaluated at SDF level.
7.1.2. The development of health and social care in the community within Wigan is based on SDFs and is aligned to the Wigan Locality Plan, the NHS Five Year Forward View and Devolution Manchester.
7.1.3. SDFs are geographical areas based around GP practices with a population of 30,000 - 50,000 people. They are the building block of primary care service delivery. Within the SDF, community services wrap around the GP practices to improve patient outcomes.
7.1.4. As pharmacies are a provider of community services they are key component of the SDF.
7.2. Services not included in the SDF level analysis
7.2.1. Provision of Appliance Use Reviews and Stoma Appliance Customisation by pharmacies within Wigan Borough has not been included in the SDF analysis. These are relatively specialised services with low activity expected. Information on the availability of these services from appliance contractors is unavailable at the time of writing and, therefore, we are unable to assess if service provision is sufficient to meet the needs of our population.
7.2.2. Provision of the NHS Urgent Medicine Supply Advanced Service (NUMSAS) has not been included in the analysis at SDF level as this pilot service has recently been commissioned with only three pharmacies currently providing the service. As this is a pilot service there is currently no data available on the service level required to meet demand and, therefore, we are unable to assess if service provision is sufficient to meet the needs of our population.
7.3. SDF 1 - Wigan North
7.3.1. There are 9 pharmacies in this SDF.
7.3.2. Accessibility Pharmacy services are well distributed throughout the SDF around the main areas of population. The pharmacies in this SDF provide the necessary level of service both to meet need and secure better access. There is a good choice of service provider.
7.3.3. All pharmacies in the SDF are accessible in a wheelchair and one has Hearing Loop. All have parking either on site or nearby and all are readily accessible by public transport. All pharmacies in the SDF provide a prescription collection service and all are able to deliver prescriptions to patients homes securing access to essential services for those patients less able to travel to the pharmacy.
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7.3.4. Pharmacy opening hours provide excellent coverage in this SDF ensuring pharmacy service provision 7 days a week from early in the morning to late at night. Pharmacy services are available at all times when GP practices within the SDF are open.
7.3.5. Essential and Advanced Service Provision All pharmacies are required to provide all essential services, thus provision is excellent across the locality. In addition, all except one pharmacy are able to dispense appliances and there is good access to services for measuring and fitting trusses across the SDF. All pharmacies in the locality have a consultation room available allowing patient access to a private consultation if required. All except three pharmacies provide Medicines Use Review (MUR), and all except one provide the New Medicines Service (NMS). Six pharmacies provide the Flu Vaccination Service in addition to GP practices within the SDF. This gives patients excellent choice and access to services at times convenient to them.
7.3.6. Locally Commissioned Service Provision There is excellent availability of the Minor Ailment Scheme and Level 1 Stop Smoking Service with all pharmacies in the SDF providing these services. In addition, three pharmacies in the SDF are able to provide Level 2 face-to-face behavioural stop smoking support. All except two pharmacies provide the Monitored Dosage System service supporting patients to take their medication and all pharmacies are accredited as Healthy Living Pharmacies. This level of service ensures that patients have a choice of service provider and greater access to these services particularly in the evenings and at weekends.
7.3.7. All pharmacies provide the Emergency Hormonal Contraception service. This service is also provided by all GPs and a number of other providers including Brook (under 25’s only) and the Shine Centre. This provides an excellent level of service provision and choice of provider at all times in the locality. Currently there is no access to chlamydia screening through pharmacies within the SDF. There is, however, access to chlamydia screening through all GPs and from the other sexual health services in the SDF and it is likely that the current review of sexual health services within the Borough will explore the potential expansion of this service through pharmacies within the SDF.
7.3.8. Supervised consumption is offered by all except four pharmacies within the SDF. These are well distributed but currently there is no provision of this service in the areas of Aspull and Shevington. The needle exchange scheme is provided by two pharmacies within the SDF. There is no provision of this service in the areas of Aspull, Shevington and Standish. Although this may reflect a lower need for the service in these areas, as stated in the description of this service, it is difficult to establish need for needle exchange and, therefore, the Drug and Alcohol Service for Adults and Young People may wish to review service provision in this area.
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7.4. SDF 2 - Tyldesley and Atherton
7.4.1. There are 8 pharmacies in this SDF.
7.4.2. Accessibility Pharmacy services are well distributed throughout the SDF around the main areas of population although there is a cluster of pharmacies in the town of Tyldesley in a very small area. There are also two pharmacies just over the border in a neighbouring CCG providing further access to Essential and Advanced Services. The pharmacies in this SDF provide the necessary level of service both to meet need and secure better access. There is a good choice of service provider.
7.4.3. All pharmacies except one in the SDF are accessible in a wheelchair and five have Hearing Loop. All have parking either on site or nearby and all are readily accessible by public transport. All pharmacies in the SDF provide a prescription collection service with all able to deliver prescriptions to patients homes securing access to essential services for those patients less able to travel to the pharmacy.
7.4.4. Pharmacy opening hours provide excellent coverage in this SDF ensuring pharmacy service provision 7 days a week from early in the morning to late at night. Pharmacy services are available at all times when GP practices within the SDF are open.
7.4.5. Essential and Advanced Service Provision All pharmacies are required to provide all essential services, thus provision is excellent across the SDF. In addition, all pharmacies except one are able to dispense appliances and there is good access to services for measuring and fitting trusses across the SDF. All pharmacies in the SDF have a consultation room available allowing patient access to a private consultation if required. All except one pharmacy provide Medicines Use Review, and all provide the New Medicines Service. Six pharmacies provide the Flu Vaccination Service in addition to GP practices within the SDF. This gives patients excellent choice and access to services at times convenient to them.
7.4.6. Locally Commissioned Service Provision There is excellent availability of the Minor Ailment Scheme with only one pharmacy not providing this service. All pharmacies provide a Level 1 Stop Smoking Service and in addition, one pharmacy in the SDF is able to provide Level 2 face-to-face behavioural stop smoking support. All except two pharmacies provide the Monitored Dosage System service supporting patients to take their medication and all except one pharmacy are accredited as Healthy Living Pharmacies. This level of service ensures that patients have a choice of service provider and greater access to these services particularly in the evenings and at weekends.
7.4.7. All pharmacies provide the Emergency Hormonal Contraception Service. This service is also provided by all GPs. This provides an excellent level of service provision and choice of provider at all times in the locality. Pharmacy provision ensures the service is available 7 days a week and in the evenings. There is access to chlamydia screening through all GPs and two pharmacies. It is likely that the current review of sexual health services within the Borough will explore the potential expansion of this service through pharmacies within the SDF. Page | 50
7.4.8. Supervised consumption is offered by all except two of the pharmacies in the SDF. These are well distributed to ensure there is availability in Atherton, Tyldesley and Astley. Only three pharmacies do not provide the needle exchange service and provision is good in all areas except Astley, where there is currently no service provision via pharmacies. Although this may reflect a lower need for the service in these areas, as stated in the description of this service, it is difficult to establish need for needle exchange and, therefore, the Drug and Alcohol Service for Adults and Young People may wish to review service provision in this area.
7.5. SDF 3 - Ince, Hindley, Abram and Platt Bridge
7.5.1. There are 11 pharmacies in this SDF.
7.5.2. Accessibility Pharmacy services are well distributed throughout the SDF around the main areas of population. The pharmacies in this SDF provide the necessary level of service both to meet need and secure better access. There is a good choice of service provider.
7.5.3. All pharmacies except three in the SDF are accessible in a wheel chair and six have Hearing Loop. All have parking either on site or nearby and all except one pharmacy are readily accessible by public transport. All pharmacies in the SDF provide a prescription collection service with all able to deliver prescriptions to patients homes securing access to essential services for those patients less able to travel to the pharmacy.
7.5.4. Pharmacy opening hours provide excellent coverage in this SDF ensuring pharmacy service provision 7 days a week. On weekdays, pharmacies are open from early in the morning to late at night and services are available at all times when GP practices within the SDF are open. There are no pharmacies open after 6pm on Saturdays and there is one pharmacy open for 4 hours on Sundays. People within this SDF can access pharmacy services in neighbouring SDFs outside of these times.
7.5.5. Essential and Advanced Service Provision All pharmacies are required to provide all essential services, thus provision is excellent across the SDF. In addition, all pharmacies are able to dispense appliances and there is good access to services for measuring and fitting trusses across the SDF. All except one pharmacy in the SDF have a consultation room available allowing patient access to a private consultation room if required. All except two pharmacies provide Medicines Use Review, and six pharmacies provide the New Medicines Service. Seven pharmacies provide the Flu Vaccination Service in addition to GP practices within the SDF. This gives patients good choice and access to services at times convenient to them.
7.5.6. Locally Commissioned Service Provision There is excellent availability of the Minor Ailment Scheme with only one pharmacy not providing this service. All except one pharmacy provide the Level 1 Stop Smoking Service and in addition, just under half of the pharmacies are able to provide Level 2 face-to-face behavioural stop smoking support.
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7.5.7. The Monitored Dosage System service supporting patients to take their medication is provided by eight pharmacies and all except one pharmacy are accredited as Healthy Living Pharmacies. This level of service ensures that patients have a choice of service provider and greater access to these services particularly in the evenings and at weekends.
7.5.8. All except two pharmacies provide the Emergency Hormonal Contraception Service. This service is also provided by all GPs. This provides an excellent level of service provision and choice of provider at all times in the SDF. Pharmacy provision ensures the service is available 7 days a week and in the evenings. Currently there is no access to chlamydia screening through pharmacies within the SDF. There is however access to chlamydia screening through all GPs and from the other sexual health services in the SDF and it is likely that the current review of sexual health services within the Borough will explore the potential expansion if this service through pharmacies within the SDF.
7.5.9. Supervised Consumption is offered by seven pharmacies in the SDF. These are distributed across the locality but currently there is no provision of this service in the Platt Bridge area. There are four pharmacies providing Needle Exchange which are located in Hindley and Abram. There is no service provision in Ince and Platt Bridge. Although this may reflect a lower need for the service in these areas, as stated in the description of this service, it is difficult to establish need for needle exchange, therefore, the Drug and Alcohol Service for Adults and Young People may wish to review service provision in this area.
7.6. SDF 4 - Leigh
7.6.1. There are 12 pharmacies in this SDF.
7.6.2. Accessibility Pharmacy services are well distributed throughout the SDF around the main areas of population and around the town of Leigh. The pharmacies in this SDF provide the necessary level of service both to meet need and secure better access. There is a good choice of service provider.
7.6.3. All pharmacies except one in the SDF are accessible in a wheel chair and half of the pharmacies have Hearing Loop. All pharmacies have parking either on site or nearby and all except two pharmacies are readily accessible by public transport. All pharmacies in the SDF provide a prescription collection service and all except one are able to deliver prescriptions to patients’ homes securing access to essential services for those patients less able to travel to the pharmacy.
7.6.4. Pharmacy opening hours provide excellent coverage in this SDF ensuring pharmacy service provision six days a week from early in the morning to late at night. Pharmacy services are available at all times when GP practices within the SDF are open. Pharmacies are open for six hours on Sundays. People within this SDF can access pharmacy services in neighbouring SDFs outside of these times.
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7.6.5. Essential and Advanced Service Provision All pharmacies are required to provide all essential services, thus provision is excellent across the SDF. In addition, all except three pharmacies are able to dispense appliances and there is good access to services for measuring and fitting trusses across the SDF, with half of the pharmacies offering this service. All pharmacies in the locality have a consultation room available allowing patient access to a private consultation if required. All pharmacies provide Medicines Use Review, and the New Medicines Service. All except one pharmacy provide the Flu Vaccination Service in addition to GP practices within the SDF. This gives patients excellent choice and access to services at times convenient to them.
7.6.6. Locally Commissioned Service Provision There is excellent availability of the Minor Ailment Scheme with all pharmacies in the SDF providing this service. All pharmacies provide the Level 1 Stop Smoking Service and in addition, three pharmacies are able to provide Level 2 face-to-face behavioural stop smoking support. This level of service ensures that patients have a choice of service provider and greater access to these services particularly in the evenings and at weekends.
7.6.7. The Monitored Dosage System service supporting patients to take their medication is provided by just under half of the pharmacies in the SDF which is a lower level of service provision than other SDFs. However one pharmacy provides this service to a large number of patients which may account for this. All pharmacies are accredited as Healthy Living Pharmacies.
7.6.8. All pharmacies in the SDF provide the Emergency Hormonal Contraception Service. This service is also provided by all GPs and a number of other providers including Brook (under 25’s only), and Leigh Walk-in Centre. This provides an excellent level of service provision and choice of provider at all times in the SDF. There is access to chlamydia screening through all GPs and from the other sexual health services in the SDF. In addition to this, three pharmacies provide the service ensuring there is a choice of provider into the evenings and at the weekends. Again this is a good level of service provision and choice of provider for young people in the SDF.
7.6.9. Supervised consumption is offered by half of the pharmacies in the SDF. These are distributed across the SDF. Provision of the needle exchange scheme by pharmacies is good in the SDF and is provided by half of the pharmacies which are distributed well throughout the town with additional provision via the substance misuse team. As stated in the description of this service, it is difficult to establish need for needle exchange and, therefore, the Drug and Alcohol Service for Adults and Young People may wish to review if service provision is adequate in this area.
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7.7. SDF 5 - Lowton and Golborne
7.7.1. There are 10 pharmacies in this SDF.
7.7.2. Accessibility Pharmacy services are fairly well distributed throughout the SDF around the town centre’s although there is a cluster of pharmacies in the town centre of Golborne in a very small area. The pharmacies in this SDF provide the necessary level of service both to meet need and secure better access. There is a good choice of service provider.
7.7.3. All pharmacies in the SDF are accessible in a wheelchair and all except two have Hearing Loop. All pharmacies except one have parking either on site or nearby and all are readily accessible by public transport. All pharmacies in the SDF provide a prescription collection service and all except one pharmacy are able to deliver prescriptions to patients’ homes securing access to essential services for those patients less able to travel to the pharmacy.
7.7.4. Pharmacy opening hours provide excellent coverage in this SDF ensuring pharmacy service provision 7 days a week from early in the morning to late at night. Pharmacy services are available at all times when GP practices within the SDF are open.
7.7.5. Essential and Advanced Service Provision All pharmacies are required to provide all essential services, thus provision is excellent across the SDF. In addition, all except one pharmacy are able to dispense appliances. Although only three pharmacies in the SDF are able to measure and fit trusses this is a sufficient level of service provision as the need for this service is relatively low. All pharmacies in the SDF have a consultation room available allowing patient access to a private consultation if required. All except one pharmacy provide Medicines Use Review, and all except one pharmacy provide the New Medicines Service. Over half of the pharmacies provide the Flu Vaccination Service in addition to GP practices within the SDF. This gives patients good choice and access to services at times convenient to them.
7.7.6. Locally Commissioned Service Provision There is excellent availability of the Minor Ailment Scheme with all pharmacies in the SDF providing this service. All pharmacies provide the Level 1 Stop Smoking Service and in addition, three pharmacies are able to provide Level 2 face-to-face behavioural stop smoking support. The Monitored Dosage System service supporting patients to take their medication is provided by four pharmacies and all pharmacies are accredited as Healthy Living Pharmacies. This level of service ensures that patients have a choice of service provider and greater access to these services particularly in the evenings and at weekends.
7.7.7. All pharmacies except one provide the Emergency Hormonal Contraception Service. This service is also provided by all GPs. This provides an excellent level of service provision and choice of provider at all times in the SDF. Pharmacy provision ensures the service is available 7 days a week and in the evenings.
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7.7.8. Currently there is no access to chlamydia screening through pharmacies within the SDF. There is however access to chlamydia screening through all GPs and from the other sexual health services in the SDF and it is likely that the current review of sexual health services within the Borough will explore the potential expansion if this service through pharmacies within the SDF.
7.7.9. Supervised Consumption is offered by four pharmacies in the SDF. There is only one pharmacy providing needle exchange. Although this may reflect a lower need for the service in this SDF, as stated in the description of this service, it is difficult to establish need for needle exchange and, therefore, the Drug and Alcohol Service for Adults and Young People may wish to review if service provision is adequate in this area.
7.8. SDF 6 - Wigan Central
7.8.1. There are 14 pharmacies in this SDF.
7.8.2. Accessibility Pharmacy Services are well distributed throughout the SDF around the main areas of population and in the town centre. The pharmacies in this locality provide the necessary level of service both to meet need and secure better access. There is a good choice of service provider.
7.8.3. All pharmacies in the SDF are accessible in a wheel chair and all except three have Hearing Loop. All pharmacies have parking either on site or nearby and all except one pharmacy are readily accessible by public transport. All pharmacies in the SDF provide a prescription collection service and all except three are able to deliver prescriptions to patients' homes securing access to essential services for those patients less able to travel to the pharmacy.
7.8.4. Pharmacy opening hours provide excellent coverage in this SDF ensuring pharmacy service provision six days a week from early in the morning to late at night. Pharmacy services are available at all times when GP practices within the SDF are open. Pharmacies are open for 6 hours on Sundays. People within this SDF can access pharmacy services in neighbouring SDFs outside of these times.
7.8.5. Essential and Advanced Service Provision All pharmacies are required to provide all essential services, thus provision is excellent across the SDF. In addition, all pharmacies are able to dispense appliances and all except three pharmacies provide access to services for measuring and fitting trusses. All pharmacies in the locality have a consultation room available allowing patient access to a private consultation if required. All pharmacies provide Medicines Use Review, and all except one pharmacy provide the New Medicines Service. All except two pharmacies provide the Flu Vaccination Service in addition to GP practices within the SDF. This gives patients excellent choice and access to services at times convenient to them.
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7.8.6. Locally Commissioned Service Provision There is excellent availability of the Minor Ailment Scheme with all pharmacies in the SDF providing this service. All pharmacies provide the Level 1 Stop Smoking Service and in addition, two pharmacies are able to provide Level 2 face-to-face behavioural stop smoking support. This level of service ensures that patients have a choice of service provider and greater access to these services particularly in the evenings and at weekends.
7.8.7. The Monitored Dosage System service supporting patients to take their medication is provided by just under half of the pharmacies in the SDF. All pharmacies are accredited as Healthy Living Pharmacies.
7.8.8. All pharmacies except three in the SDF provide the Emergency Hormonal Contraception service. This service is also provided by all GPs and a number of other providers including Brook (under 25’s only), the Shine Centre and Sullivan Way clinic. This provides an excellent level of service provision and choice of provider at all times in the SDF. There is access to chlamydia screening through all GPs and from the other sexual health services in the SDF. In addition to this, three pharmacies provide the service ensuring there is a choice of provider into the evenings and at the weekends. Again this is a good level of service provision and choice of provider for young people in the SDF.
7.8.9. Supervised consumption is offered by all except four of the pharmacies in the SDF. These are distributed across the SDF. Provision of the needle exchange scheme by pharmacies is good in the SDF and is provided by five of the pharmacies which are distributed well throughout the town centre with additional provision via the substance misuse team. There is, however, no service provision in Pemberton. Although this may reflect a lower need for the service in these areas, as stated in the description of this service, it is difficult to establish need for needle exchange and, therefore, the Drug and Alcohol Service for Adults and Young People may wish to review service provision in this area.
7.9. SDF 7 - South Wigan and Ashton North
7.9.1. There are 6 pharmacies in this SDF.
7.9.2. Accessibility Pharmacy services are well distributed, particularly throughout the north and east of the SDF. The pharmacies in this SDF provide the necessary level of service both to meet need and secure better access. There is a good choice of service provider.
7.9.3. All pharmacies except one in the SDF are accessible in a wheel chair and two of the pharmacies have Hearing Loop. All pharmacies have parking either on site or nearby and all are readily accessible by public transport. All pharmacies in the SDF provide a prescription collection service and all are able to deliver prescriptions to patients homes securing access to essential services for those patients less able to travel to the pharmacy.
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7.9.4. Pharmacy opening hours provide good coverage in this SDF. Pharmacies are open 6 days a week. There is currently no late night pharmacy service in this SDF meaning that there is a small time period each day when GP services are available but there is no pharmacy service. There is also no Sunday service provision. People within this SDF can access pharmacy services in neighbouring SDFs at these times.
7.9.5. Essential and Advanced Service Provision All pharmacies are required to provide all essential services, thus provision is excellent across the SDF. In addition, all pharmacies are able to dispense appliances and there is good access to services for measuring and fitting trusses across the SDF, with all except two of the pharmacies offering this service. All pharmacies in the locality have a consultation room available allowing patient access to a private consultation if required. All except one pharmacy provide Medicines Use Review and all provide the New Medicines Service. All except two pharmacies provide the Flu Vaccination Service in addition to GP practices within the SDF. This gives patients excellent choice and access to services at times convenient to them.
7.9.6. Locally Commissioned Service Provision There is excellent availability of the Minor Ailment Scheme with all pharmacies in the SDF providing this service. All pharmacies provide the Level 1 Stop Smoking Service and in addition, two pharmacies are able to provide Level 2 face-to-face behavioural stop smoking support. This level of service ensures that patients have a choice of service provider and greater access to these services particularly in the evenings and at weekends.
7.9.7. The Monitored Dosage System service supporting patients to take their medication is provided by all except two pharmacies in the SDF. All pharmacies are accredited as Healthy Living pharmacies.
7.9.8. All except one pharmacy in the SDF provide the Emergency Hormonal Contraception service. This service is also provided by all GPs. This provides a good level of service provision and choice of provider at all times in the SDF. There is access to chlamydia screening through all GPs and from the other sexual health services in the SDF. In addition to this one pharmacy provides the service ensuring there is a choice of provider for young people in the SDF.
7.9.9. Supervised Consumption is offered by two pharmacies in the SDF. There is only one pharmacy providing needle exchange. There is no provision in Orrell, Winstanley or Hawkley Hall. Although this may reflect a lower need for the service in these areas, as stated in the description of this service, it is difficult to establish need for needle exchange and, therefore, the Drug and Alcohol Service for Adults and Young People may wish to review service provision in this area.
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8. Pharmacy Services Response to Local Health Issues
8.1. How Current Pharmacy Services Help Meet the Health Needs of Our Population
8.1.1. The key health issues affecting people in Wigan Borough are described in Section 2. Modern lifestyle issues such as obesity, alcohol use, smoking and lack of exercise are creating new demands on the NHS. Pharmacies play an important role in addressing these issues.
8.1.2. Pharmacies provide patients with prescribed medications to treat or prevent the development of many of these conditions/diseases. They provide advice and support on the use of these medications, how to get the most benefit from them, how to avoid or reduce side effects, etc., all of which encourage patients to take the medication prescribed for them. Pharmacies provide lifestyle advice to patients and specifically target those who present prescriptions indicating they have coronary heart disease, diabetes, smoke or are overweight. The provision of ‘brief interventions’ to these patients can help raise awareness that small changes to lifestyle can have a significant, positive impact on health. For those patients struggling to manage the medications they are prescribed, the pharmacy Monitored Dosage System Scheme which simplifies their medication and ensures it is taken correctly supports the management of the underlying condition(s).
8.1.3. Healthy Living Pharmacies proactively provide lifestyle advice to improve the health of those visiting the pharmacy. Through this service pharmacies are able to provide advice to the population not currently accessing medical services regularly. They can provide advice to reduce the individual’s risk e.g. weight management advice, smoking cessation, advice on the consumption of alcohol and signpost to the services available across the Borough.
8.1.4. The pharmacy Stop Smoking Service provides people within the Borough with access to nicotine replacement products, support and practical advice to help them stop smoking at the cost of a prescription charge (that is free for many people). Stopping smoking is one of the biggest changes a person can make to improve their health. Among other things it reduces the risk of lung cancer, cardiovascular disease and chronic obstructive airways disease. Pharmacies began to provide the current Level 2 Stop Smoking Service in February 2017. During the first 6 months of this service, 35 patients have been supported with behavioural support to stop smoking via pharmacies. This is in addition to the provision of nicotine replacement therapy to patients referred by City Health Care Partnership CIC (CHCP) Stop Smoking Advisors. CHCP are currently working closely with pharmacy providers to support them in identifying and supporting more patients via the Level 2 Stop Smoking Service.
8.1.5. All pharmacies can sell Emergency Hormonal Contraception and in Wigan Borough they can also provide it free of charge to women of any age. This has significantly improved access to Emergency Hormonal Contraception and most importantly has ensured its availability at times when other service providers are not available such as evenings, weekends and Bank Holidays.
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8.1.6. In the financial year 2014/15, (more recent data is not yet available) pharmacies provided 2,418 Emergency Hormonal Contraception consultations, resulting in the provision of EHC on 2,375 occasions. This has contributed to the reduction in unwanted pregnancies.
8.1.7. Within the Borough, there is a need to improve access to sexual health services for young people especially chlamydia screening. The initiation of a pharmacy chlamydia screening service was hoped to help meet this need, however the level of activity by pharmacies appears low. This may be due to a lack of uptake from potential service users or a lack of confidence by pharmacy staff to undertake opportunistic interventions.
8.1.8. As discussed earlier, a comprehensive review of sexual health services is currently being carried out within Wigan Borough which is looking at how services can be brought closer to people in their communities. As pharmacies provide key access to sexual health services in the community, it is envisaged that the future sexual health service model will further develop the chlamydia screening service to improve access to sexual health advice, and the testing of STIs via pharmacies, where safe and appropriate to do so.
8.1.9. The pharmacy Minor Ailment Scheme helps to address some of the issues around primary care capacity. As demand for Primary Care Services increases due to rising public expectations, lifestyle factors and health needs resulting from an ageing population, general practice workload increases. It is estimated that that 3% of all A&E consultations and 5.5% of GP consultations for common ailments could be managed in community pharmacies. This equates to over 650,000 visits to A&E and over 18 million GP consultations every year13. Research has shown that treating common ailments such as coughs and sore throats in community pharmacies rather than in A&E or in GP surgeries provides patients with equally good treatment and could save the NHS up to £2 billion per year.13,14
8.1.10. Pharmacies provided 40,967 Minor Ailment Scheme consultations during the financial year 2016/17. Of these consultations just under 37,500 patients would have used their GP, 279 would have used A&E, with the remainder accessing other services had the Minor Ailment Scheme not been available. This demonstrates that the scheme reduces GP workload and reduces unnecessary A&E attendances. The scheme needs further promotion to appropriate target groups and healthcare professionals should be encouraged to refer patients to the scheme.
8.1.11. The Supervised Consumption Service is meeting the health needs of those people in the early stages of opioid replacement therapy, helping stabilise lives that may otherwise be chaotic. The Drug and Alcohol Service for Adults and Young People which is at present undergoing a review of service will consider if there are areas within the Borough where currently the need is not being met.
13 Pharmacy Research UK. MINA Study. Community Pharmacy Management of Minor Illness. January 2014 14 Pharmaceutical Services Negotiating Committee. Five Point Forward Plan for Community Pharmacy. September 2015 http://psnc.org.uk/wp-content/uploads/2015/08/5-Point-Plan-Flyer.pdf Page | 59
8.1.12. The Needle Exchange Scheme is available from just over one third of the pharmacies in the Borough ensuring clean injecting equipment is available to those who require it along with advice to help improve the lives of these people including referral to treatment services. This scheme also ensures that there is safe disposal of used equipment and, therefore, protects the health of all residents in the Borough.
8.1.13. The need for the Needle Exchange Scheme is difficult to predict and tends to be estimated based on where known injecting drug (opiate) users live but there is an overall opinion that the current level of service provision may not be sufficient to meet the needs of the Borough. As part of the Drug and Alcohol Service Review, The Drug and Alcohol Service for Adults and Young People will need to develop this service further. This will mean addressing pharmacy concerns in terms of providing this service as well as securing additional funding for the service.
8.1.14. There should be a planned approach in extending service provision ensuring those areas with an identified need for the service are targeted whilst acknowledging that we may not be fully aware of the requirement for this service. There are other clients who require this service such as steroid users and those injecting tanning solutions. This type of user presents a different sort of need and may require access to the service in areas with previously low requirements for the scheme. At present, service provision is based largely on pharmacies willing to provide the service as opposed to targeting areas where the service is required. As funding is limited this approach will need to be modified. Ideally, there should be provision of this service in all areas within each Service Delivery Footprint.
8.1.15. An ageing population in the Borough means that more people are living with long- term conditions. This means there are many people in the Borough who would benefit from Medicines Use Review (MUR) and the New Medicines Service (NMS). Whilst the majority of pharmacies are offering these services work is needed to ensure that the appropriate groups of patients are being targeted. Developing these services would ensure more patients on long-term medication would benefit. Targeting MURs or providing clinical MURs could help to address health needs in the Borough for people suffering from cardiovascular disease and respiratory disease. Currently work is ongoing within Greater Manchester to increase the number of referrals to pharmacies for these services from both Primary and Secondary Care.
8.1.16. Clinical MURs differ from standard MURs in that they are aimed at ensuring patients are on the optimum treatment for their condition rather than focusing on patient education and solving patient problems which is the aim of standard MURs. MURs could be targeted at patients prescribed inhalers ensuring they are being used appropriately and so reduce COPD exacerbations and help patients with other respiratory diseases manage their condition. They could be aimed at improving the management of long-term conditions. The New Medicines Service provides additional support when patients are initiated on new medication for asthma and COPD, type II diabetes, antiplatelet/anticoagulant therapy or hypertension helping to meet the needs of patients with COPD and cardiovascular disease.
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8.1.17. Appropriately co-ordinating and targeting the public health campaigns the Greater Manchester Local Area Team runs through community pharmacies could help to tackle many of the health needs of our residents. Wigan Council will continue to work with the NHS England Greater Manchester Local Area Team on this service.
8.1.18. Due to the increasing age of the population within Wigan, long term conditions associated with older age such as dementia will become more common, especially in the over 85 population. Pharmacies have responded to this by ensuring staff are ‘dementia-friendly’ trained and during the financial year 2016/17, Wigan Council ran several training sessions to support this. Training was opened to pharmacy delivery drivers as these are key members of the pharmacy team who are often the main contact between vulnerable, older residents and the pharmacy. The Dementia Friends initiative is about giving people an understanding of dementia and the small things that could make a difference to people living with dementia in their community. It has been developed by the Alzheimer’s Society, and is supported by Public Health England (PHE).
8.1.19. For all Locally Commissioned Services there is a need to raise the public’s awareness of these services and which pharmacies provide them. This is something that needs to be addressed across the Borough. Both the public and healthcare professionals require this information. Wigan Council and Wigan Borough CCG will need to develop a communications strategy to ensure there is a consistent approach across the Borough to ensure all patient groups receive this information.
8.2. How future Pharmacy Services could be developed to further meet the health needs of the Wigan Borough Population
8.2.1. Pharmacies will always have an important role in ensuring the safe and effective use of medicines but there needs to be development in pharmacy services to enable the NHS to get the most out of the clinical skills of the pharmacist with an increased emphasis on the contribution pharmacies can make to health improvement and public health. Pharmacy services should be developed further to enable pharmacies to play a greater role in meeting the health needs of the population.
8.2.2. The following services are not currently commissioned locally but are services that Wigan Council and Wigan Borough CCG would consider commissioning through pharmacies if funding became available. These are services which meet current identified health needs or are nationally commissioned services. It should be noted that there are a large variety of Enhanced Services that community pharmacies can provide. Any decisions to develop pharmacy services should be based on health needs and patient and public opinion at the time of commissioning. It may be that at this time a different service may be more appropriate. Should any pharmacy Enhanced Services or Locally Commissioned Service be commissioned we believe that the current number and distribution of pharmacies within the Borough would ensure a suitable level of service provision to meet the needs of the population.
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8.2.3. In terms of reducing cardiovascular disease, pharmacies could offer NHS Health Checks if the appropriate infrastructures were put in place and they were able to out-compete alternative providers. Some people may feel more comfortable by going to a pharmacy to receive a Health Check in comparison to requiring an appointment with their GP. It would also ensure that the service was available to any residents not registered with a GP and would allow the service to be provided in the evenings and at weekends which may be more convenient for working people.
8.2.4. ‘Lose Weight Feel Great’ is the current provider of services in the weight management pathway. Community pharmacies could tender to provide aspects of this service as part of the ‘any willing provider’ arrangements when services are commissioned. Pharmacies are already seen by the public as a source of weight loss advice and products to facilitate weight loss. Wigan Council would only commission an appropriate evidence based service for patients. Some patients may prefer the more private one-to-one approach that would be available through pharmacies and may also prefer the hours a pharmacy can offer e.g. lunch times, in the evenings or at weekends.
8.2.5. Reducing alcohol related harm is a difficult challenge. Many people who need to reduce their drinking do not access services until harm has actually occurred. Young people do not routinely visit their GPs and so do not receive this advice from their GP. People who are healthy use pharmacies for Over-the-Counter products and non-medical products. Provision of ‘brief interventions’ could ensure that alcohol advice is provided to these patients. Alcohol interventions could be provided to people using other services such as the Condom Card Scheme or Stop Smoking Service. Any pharmacy service would need to be part of the overall Wigan Borough Alcohol Strategy.
8.2.6. There is a need to improve communication across the primary/secondary care interface, particularly with regards to medication. Better communication between hospital and community pharmacies may help to meet this need improving patient care and reducing re-admissions following discharge from hospital. Work is already underway at a Greater Manchester level to improve the communication of information in relation to discharge medication across the interface.
8.2.7. Electronic prescribing has developed significantly over the past few years. All GP practices and all pharmacies in Wigan Borough are currently operating Electronic Transfer of Prescriptions (ETP) release 2 compliant systems and as more prescriptions are processed by this means, this should make it easier for patients to get their prescription medication with fewer visits to the GP practice and reduce GP and pharmacy workload thus improving NHS capacity. Wigan Borough CCG will continue to support GP practices and pharmacies with their development of this service.
8.2.8. Repeat dispensing allows GPs to issue repeatable prescriptions to patients allowing them to obtain up to a year’s prescription without the need for further GP consultation or issue of further prescriptions. This service would make obtaining prescription medication significantly simpler for those patients who require regularly monthly medication and who are stable on this medication. It is not suitable for people whose medication changes frequently.
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8.2.9. This service will require the CCG to work with pharmacies and GPs to ensure appropriate procedures are put in place and that the service is offered to appropriate patient groups. The CCG has recently issued guidance to support GP practices who wish to pursue this facility.
9. Future Needs
9.1.1. At the time of writing there are no future developments planned during the lifetime of this PNA that are likely to affect the pharmaceutical or health needs of the Borough.
10. Conclusion
10.1.1. There are 70 pharmacies across Wigan Borough providing pharmaceutical services over a wide range of hours seven days a week. In general, pharmacy opening hours match the GP opening hours. On occasions where pharmacy opening hours do not mirror the local GP opening hours there is pharmacy service provision in a nearby SDF at those times. In relation to ‘100 hour’ pharmacy contractors, we have considered the current provision from these pharmacies and the potential for these contractors to apply to reduce their hours in the future based on the PNA. We have concluded that our current ‘100 hour’ contractors perform an important role in opening up access in the early morning, evening and at weekends and would not want to see this decrease or increase15.
10.1.2. Taking into account the availability and variety of services available through pharmacies in Wigan Borough, in general provision of Locally Commissioned Services across the Borough is excellent although there are areas and services where provision could be improved. This should be addressed, in the first instance, by existing pharmacy contractors providing these services.
10.1.3. There is scope to improve awareness of many pharmacy services and we need to ensure that people living in the Borough are aware of what is on offer from pharmacies and encourage them to use pharmacies as the first port of call for the management of Minor Ailments for example. We need to promote the Locally Commissioned Services on offer through pharmacies more effectively and ensure the people who could benefit most from these services are aware of them. It is important to work with existing providers to ensure that the highest standards of quality and the optimum range of services are delivered.
10.1.4. By improving the knowledge of our residents and development of current and future services Wigan Council and Wigan Borough CCG will continue to support the development of community pharmacy services in line with the direction set by the Wigan Locality Plan, the NHS Five Year Forward View, Devolution Manchester, and the health needs of our population.
15 These contractors are not currently able to reduce their hours under present national arrangements. If this were to be allowed in the future, locally we would not want to see these pharmacies reduce their hours as this service ensures provision over extended hours when other primary care services may not be available. Page | 63
Appendix 1 – Pharmaceutical Needs Assessment Process
Co-ordination
The production of this PNA was co-ordinated by a small working group:
Wigan Council Consultant in Public Health Two Senior Public Health Analysts
Wigan Borough Commissioning Group Senior Assistant Director of Medicines Management Acting Assistant Director of Medicines Management
Profile of Wigan Borough including population and health needs
The majority of data analysis was carried out by a Public Health Analyst with assistance of a consultant in public health. The following data sources were used:
Office of National Statistics Mid-2015 Population Estimates and 2014-based population projections (www.ons.gov.uk) English Indices of Deprivation www.gov.uk/government/statistics/english-indices-of- deprivation-2015 Primary Care Mortality Database NHS Digital (indicators.ic.nhs.uk) Public Health Profiles (fingertips.phe.org.uk) Local Alcohol Profiles for England (http://fingertips.phe.org.uk/profile/local-alcohol- profiles)
Pharmacy Service Provision
All pharmacy contractors have been contacted to provide up to date information on the services they provide with the help of the commissioners of the individual pharmacy services and via the consultation process. Pharmacy data has been analysed by Wigan Borough Clinical Commissioning Group Medicines Management staff.
Patients Satisfaction Survey
A patient satisfaction survey was carried out at all local pharmacies during May/June 2017 (see Appendix 9).
Stakeholder Engagement
Primarily, stakeholder engagement is via the 60 day public consultation on this Pharmaceutical Needs Assessment.
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Summary of requirements of the PNA
The PNA must relate to: The provision of pharmaceutical services by community pharmacies and dispensing appliance contractors The provision of local pharmaceutical services under a Local Pharmacy Scheme (LPS) The dispensing of drugs and appliances by a person on a dispensing doctors list, but not other NHS services that may be provided by a dispensing doctor
Commissioners must have regard, as far as is practicable, to: The Joint Strategic Needs Assessment (JSNA) The different needs of members of different groups in its area – age, disability, gender, reassignment of gender, race, religion or belief, or sexual orientation Demography of the area Benefits of reasonable choice with regard to pharmaceutical services Different needs of different localities Pharmaceutical services provided in neighbouring Local Authorities which affect need or access Dispensing services or other NHS services which affect need or access to pharmaceutical services Likely future needs – changes in population or risks to the health and wellbeing of the population
The PNA must include the following: Necessary services: current provision – a statement of the pharmaceutical services that the Local Authority has identified that are provided which are necessary to meet the need for pharmaceutical services in its area Necessary services: gaps in provision – a statement of the pharmaceutical services that the Local Authority has identified (if it has) as services that are not provided in the area but which the Local Authority is satisfied need to be provided either immediately or in specified future circumstances Other relevant services: current provision – a statement of the pharmaceutical services that the Local Authority has identified (if it has) as services, which although they are not necessary to meet the need for pharmaceutical services, nevertheless have secured improvements to or better access to pharmaceutical services Improvements and better access: gaps in provision – a statement of the pharmaceutical services that the Local Authority has identified (if it has) as services that are not provided but which would secure improvements to or better access to services either immediately or in specified future circumstances Dispensing services: a statement of any dispensing services to which the Local Authority has had regard in its assessment which affect the need for current or future pharmaceutical services Other NHS services: a statement of any NHS services which affect the need for current or future pharmaceutical services An explanation of how the assessment has been carried out Map of provision: a map that identifies the premises at which pharmaceutical services and dispensing services are provided in the area of the Local Authority
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Regulations
The PNA for Wigan Borough has been developed in accordance with NHS Pharmaceutical Services Regulations and associated guidance produced by the Department of Health. The full regulations and guidance can be found at the following links:
Regulations: www.legislation.gov.uk/uksi/2013/349/part/2/made
Guidance: http://www.gov.uk/government/publications/pharmaceutical-needs-assessments- information-pack
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Appendix 2 – Pharmacies in Wigan Borough
Contractor Pharmacy Address Town Postcode Code Contractor Name FGN59 Abram Pharmacy 358 Warrington Road, Abram Wigan WN2 5XA
53 Woodnook Road FLK57 Appley Bridge Pharmacy Wigan WN6 9JR Appley Bridge
FKH90 Asda Pharmacy Adsa Superstore, Soho Street Wigan WN5 0XA
Asda Superstore, FHL39 Asda Pharmacy Leigh WN7 5RZ Atherleigh Way
FQL08 Asda Pharmacy Edge Green Lane Golborne WA3 3SP Bestway National Chemists FY111 216 Ormskirk Road, Newtown Wigan WN5 9ED Ltd FPT79 Blundell's Pharmacy Ltd Leigh Stadium, LSV, Sale Way Leigh WN7 4JY
FYQ21 Boots 22-23 Grand Arcade Wigan WN1 1BH
FMF32 Boots the Chemist 82 Market Street Atherton M46 0DP
Unit 8a, The Gerard Centre, FAT70 Boots the Chemist Wigan WN4 9AN Ashton in Makerfield
FRG44 Boots the Chemist Robin Park, 37 Loire Drive Wigan WN5 0UH
FJK23 Boots the Chemist 29/31 Bradshawgate Leigh WN7 4NB
FRE68 Bradshaw Street Pharmacy Bradshaw Street, Orrell Wigan WN5 0AB
FRF02 Cohens Chemist Ormerod House, Nelson Street Atherton M46 0LE
FDH71 Cohens Chemist 259c Orrell Road Wigan WN5 8NB FGM90 Cohens Chemist 47a High Street, Standish Wigan WN6 0HA FHH13 Cohens Chemist 36a Braithwaite Ave Lowton WA3 2HY
FDH26 Davina Pharmacy Ltd 155 Elliott Street Tyldesley M29 8FL FGW20 Day Lewis Pharmacy 38b Gathurst Lane, Shevington Wigan WN6 8HW FCV17 Elliott Street Pharmacy 177 Elliott Street Tyldesley M29 8DR
FM634 England Pharmacy 280 Gidlow Lane Wigan WN6 7PG
George Wilson (Pemberton) Pemberton Health Centre FQP74 Wigan WN5 9QX Ltd Sherwood Drive
FDP26 Golborne Late Night Chemist 98 High Street Golborne WA3 3DA
Gorgemead Ltd (Cohens FHL05 Wigan WN6 0HF Chemist) 42 High Street
FMH96 Hawkley Pharmacy 54 Carr Lane, Hawkley Hall Wigan WN3 5ND
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Contractor Pharmacy Address Town Postcode Code Contractor Name
Hindley Health Centre FXV58 17 Liverpool Road, Hindley Wigan WN2 3HQ Pharmacy
FA200 Hollowood Chemists 7 Ince Green Lane, Ince Wigan WN2 2AR 760 Atherton Road FGL99 Hollowood Chemists Wigan WN2 4SB Hindley Green
FXM89 Hollowood Chemists 4 Moorside, Aspull Wigan WN2 1XW FPC22 Hollowood Chemists 11 Mesnes St Wigan WN1 1QP
Unit 3, 19 Borsdane Avenue FDG06 I Borsdane Pharmacy Wigan WN2 3QN Hindley
109 Wigan Road FLP99 J Morris Pharmacy Wigan WN4 9BH Ashton in Makerfield
612 Liverpool Road FVX03 Liverpool Road Pharmacy Wigan WN2 5BB Platt Bridge
FEA28 Lloyds Pharmacy 234 Scholes Wigan WN1 3NH FCW22 Lloyds Pharmacy 91a Mesnes Street Wigan WN1 1QJ Sainsburys Supermarket FGN21 Lloyds Pharmacy Wigan WN3 6XE Worthington Way
FTF35 Lloyds Pharmacy 23 Church Street Atherton M46 9DE FW814 Lloyds Pharmacy 147-149 Elliott Street Tyldesley M29 8FL
FQ045 Manor Pharmacy Chandler House, Poolstock Ln Wigan WN3 5HL
FJD69 Manor Pharmacy 12 The Centre, Higher Folds Leigh WN7 2XT FM484 Manor Pharmacy 8 Worsley Mesnes Drive Wigan WN3 5TE FFH39 Manor Pharmacy Boston House, Frog Lane Wigan WN6 7LB FQF30 Manor Pharmacy 4 Gathurst Lane, Shevington Wigan WN6 8HA FLX23 Manor Pharmacy 90-92 Manchester Road Leigh WN7 2LD FLL04 New Springs Pharmacy 21 Wigan Road, New Springs Wigan WN2 1DH
FAL71 Platt Bridge HC Pharmacy Rivington Ave, Platt Bridge Wigan WN2 5NG
FA756 Rowlands Pharmacy 5 Oaklands Road Lowton WA3 2LA
FEY33 Rowlands Pharmacy 52 Marsh Green Wigan WN5 0PU
Ashton Medical Centre FJR77 Rowlands Pharmacy Wigan WN4 9SU 120 Wigan Road
391 Manchester Road FVM22 Rowlands Pharmacy Astley M29 7BY Tyldesley FK754 Rowlands Pharmacy Leigh WN7 5HQ 475 Wigan Road Sainsburys Supermarket FXG57 Rowlands Pharmacy Leigh WN7 5SJ Parsonage Retail Park
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Contractor Pharmacy Address Town Postcode Code Contractor Name
Shevington Community Houghton Lane FX694 Wigan WN6 8ET Pharmacy Shevington
FW187 Standish Pharmacy 15 Preston Road, Standish Wigan WN6 0HR FGM80 Tesco Pharmacy Central Park Way Wigan WN1 1XF FXW22 Tesco Pharmacy Spinning Jenny way Leigh WN7 4PE
Claire House, Phoenix Way FJG67 Tims and Parker Wigan WN3 4NW Ince
FNH71 Tims and Parker 76 Bradshawgate Leigh WN7 4NP FKK46 Tims and Parker 11 College Street Leigh WN7 2RB FPE00 Tims and Parker Derby Street Leigh WN7 2PD
Leigh Health Centre FYQ60 Tims and Parker Leigh WN7 1HR The Avenue
FKX71 Trayners Chemist 108 Market Street, Hindley Wigan WN2 3AY FHG83 Well Pharmacy 56 Church Street, Orrell Wigan WN5 8TQ FJ016 Well Pharmacy 1 Coldalhurst Lane, Tyldesley Astley M29 7BS FLA12 Well Pharmacy 62 High Street Golborne WA3 3BH FR006 Well Pharmacy 97-99 High Street Golborne WA3 3BU
Hindley Medical Centre FY680 Well Pharmacy Wigan WN2 2QG 109 Ladies Lane
FG017 Your Local Boots Pharmacy 254-256 Wigan Road, Bryn Wigan WN4 0AR
765 Ormskirk Road FMR35 Your Local Boots Pharmacy Wigan WN5 8AT Pemberton
91 Holmes House Avenue FRW39 Your local Boots Pharmacy Wigan WN3 6JA Winstanley
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Appendix 3 – General Practices in Wigan Borough
Surgery Address 1 Address 2 Address 4 Address 5 Postcode Code P92006 Dr Ahmad & Alexandra House Surgery, Platt Bridge Wigan WN2 5NG Partners Rivington Avenue Y02378 Dr Alistair Ashton Ashton Clinic, Queens Ashton-in- Wigan WN4 8LB Road Makerfield P92605 Dr Anderson & Boothstown Medical Boothstown Manchester M28 1BZ Partner Centre, 239 Mosley Common Road P92012 Dr Anis & Partner Golborne Health Centre, Golborne Wigan WA3 3GS Kidglove Rd P92034 Dr Ashworth & Bryn Cross Surgery, 246 Bryn Ashton-in- WN4 0AR Partners Wigan Road Makerfield P92626 Dr Atrey Meadow View Surgery, Nelson Atherton M46 0LE Ormerod House Street P92033 Dr C P Khatri The Surgery High Street Tyldesley M29 8AL P92634 Dr Ellis & Kreppel Mesnes View Surgery Mesnes Wigan WN1 1ST View Y00050 Dr Gupta Bridgewater Medical Leigh WN7 2PE Centre, Henry Street P92633 Dr Hati Kakoty Beefold lane Surgery Beefold Atherton M46 0BD Lane P92042 Dr K K Chan Seven Brooks Medical 21 Church Atherton M46 9DE Centre Street P92646 Dr K Khatri The Surgery, 10 Higher Astley Tyldesley M29 7HG Green Lane P92026 Dr M K Patel, Longshoot Health Centre Scholes Wigan WN1 3NH Kamath & Partners P92630 Dr M Pal & The Surgery, Morden Ashton-in- Wigan WN4 9PT Partners Avenue Makerfield P92648 Dr Mahadevappa Slag Lane Medical Centre 216 Slag Warrington WA3 2EZ Lane, Lowton P92607 Dr Martin/Dr Grasmere Surgery, Leigh The Leigh WN7 1HR Lewis & Dr Health Centre Avenue Saravannan P92623 Dr Maung Leigh Health Centre The Leigh WN7 1HR Avenue P92024 Dr Mohan Kumar Chandler House, Worsley Poolstock Wigan WN3 5HL Mesnes Health Centre, Lane P92003 Dr Mughal & The Dicconson Practice, Frog Lane Wigan WN6 7LB Partners Wigan HC P92017 Dr Munro & The Surgery, Houghton Shevington Wigan WN6 8ET Partners Lane P92647 Dr Ollerton Hawkley Brook, Chandler Poolstock Wigan WN3 5HL House, Worsley Mesnes Lane HC P92008 Dr P Smith & Bradshaw Medical Centre, Orrell Wigan WN5 0AB Partners Bradshaw St P92041 Dr Pitalia & Ashton Med Centre, 120 Ashton-in- Wigan WN4 9SU Partner Wigan Rd Makerfield P92619 Dr S N Sharma Ormerod House, Atherton Nelson Atherton M46 0LE HC Street Page | 1
Surgery Address 1 Address 2 Address 4 Address 5 Postcode Code P92038 Dr Saxena Winstanley Medical Centre, Winstanley Wigan WN3 6JN Holmes House Avenue P92030 Dr Seabrook The Surgery, 1 Wigan WN1 2AZ Wrightington Street P92028 Dr Shah Elliott Street Surgery, 145 Leigh Tyldesley M29 8FL Elliott Street P92639 Dr Shahbazi & Golborne Health Centre, Golborne Wigan WA3 3GS Partner Kidglove Rd P92020 Dr Sivakumar & The Surgery, 1 Coldhurst Astley Tyldesley M29 7BS Partner Lane P92011 Dr Smith & Sullivan Way Surgery Sullivan Wigan WN1 3TB Partners Way P92029 Dr Trivedi & The Surgery, 429 Abram Wigan WN2 5XB Partner Warrington Road P92004 Dr Tun & Partners The Health Centre, 17 Hindley Wigan WN2 3HQ Liverpool Road P92031 Dr Ullah Platt Bridge Health Centre, Platt Bridge Wigan WN2 5NG Rivington Avenue P92001 Dr Vallabhaneni & Medicentre, 185 Wigan Ashton-in- Wigan WN4 9SL Partners Road Makerfield P92635 Dr Vasanth & Ormerod House, Atherton Nelson Atherton M46 0LE Partner HC Street P92007 Dr Wong & Old Henry Street Health Henry Leigh WN7 2PG Partners Centre Street P92651 Dr Xavier The Surgery, 208c Newton Lowton Warrington WA3 2AQ Road P92005 Dr Zaman & Chandler House, Worsley Poolstock Wigan WN3 5HL Partner Mesnes HC Lane P92615 Esa Surgery Ltd Leigh Health Centre The Leigh WN7 1HR Avenue P92602 Foxleigh Surgery Bridgewater MC Henry Leigh WN7 2PE Street P92616 Ince Surgery Ince Community Clinic Manchester Wigan WN2 2DA Road, Ince Y02274 Intrahealth Platt Platt Bridge Health Centre, Platt Bridge Wigan WN2 5NG Bridge Rivington Avenue Y02321 Intrahealth Tyldesley Health Centre, Tyldesley Tyldesley M29 8AX Tyldesley Poplar Street P92035 Lilford Park Leigh Health Centre, The Leigh WN7 1HR Surgery Avenue P92620 Lower Ince Claire House, Lower Ince Phoenix Wigan WN3 Surgery Health Centre Way 4NW P92642 Marus Bridge Chandler House, Worsley Poolstock Wigan WN3 5HL Practice Mesnes HC Lane P92621 Premier Health Bridgewater Medical Centre Henry Leigh WN7 2PE Team Street P92653 Shakespere Chandler House, Worsley Poolstock Wigan WN3 5HL Surgery Mesnes HC Lane P92002 Braithwaite Road 36 Braithwaite Road Lowton Warrington WA3 2HY Surgery P92010 Beech Hill 278 Gidlow Lane Beech Hill Wigan WN6 7PD Medical Centre P92014 Standish Medical 49 High Street Standish Wigan WN6 0HD Practice P92015 Aspull Surgery Haigh Road Aspull Wigan WN2 1XH
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Surgery Address 1 Address 2 Address 4 Address 5 Postcode Code P92016 Pennygate MC 109 Ladies Lane Hindley Wigan WN2 2QG P92019 Pemberton Pemberton PCRC Sherwood Wigan WN5 9QX Surgery Drive P92021 Newtown Medical Pemberton PCRC Sherwood Wigan WN5 9QX Centre Drive P92023 Brookmill Medical College Street Leigh WN7 2RB Centre P92637 Astley General 391 Manchester Road Astley Tyldesley M29 7BY Practice P92652 7 Brooks Medical 21 Church Street Atherton M46 9DE Centre Y02322 Leigh Family Bridgewater MC Henry Leigh WN7 2PE Practice Street Y02885 Intrahealth Marsh Harrow Road Marsh Wigan WN5 0QL Green Green Y02886 Intrahealth LSV Leigh Sports Village Sale Way Leigh WN7 4JY Y02887 Intrahealth Family Leigh Sports Village Sale Way Leigh WN7 4JY Practice
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Appendix 4 – Pharmacy Services - Essential and Advanced Services
Service Delivery Footprint 1 (Wigan North)
ESSENTIAL SERVICES ADVANCED SERVICES Consultation Medicines New Appliance Stoma Essential Influenza Code Pharmacy Appliances Trusses Room Use Medicines Use Appliance Services Vaccination Available Review Service Review Customisation Appley Bridge Pharmacy, FLK57 53 Woodnook Road YES Cohens Chemist, FGM90 47a High Street YES Day Lewis Pharmacy, FGW20 38b Gathurst Lane YES Gorgemead Ltd (Cohens Chemist), 42 FHL05 High Street YES Hollowood Chemists, FXM89 4 Moorside YES Manor Pharmacy, FQF30 4 Gathurst Lane YES New Springs Pharmacy, FLL04 21 Wigan Road YES Shevington Community Pharmacy, Houghton FX694 Lane YES Standish Pharmacy, FW187 15 Preston Road YES
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Service Delivery Footprint 2 (Tyldesley and Atherton)
ESSENTIAL SERVICES ADVANCED SERVICES Consultation Medicines New Appliance Stoma Essential Influenza Code Pharmacy Appliances Trusses Room Use Medicines Use Appliance Services Vaccination Available Review Service Review Customisation
Boots the Chemist, FMF32 82 Market Street YES Cohens Chemist, FRF02 Ormerod House, YES Davina Pharmacy Ltd, FDH26 155 Elliott Street YES Elliott Street Pharmacy, FCV17 177 Elliott Street YES Lloyds Pharmacy, FTF35 23 Church Street YES Lloyds Pharmacy, FW814 147-149 Elliott Street YES Rowlands Pharmacy, FVM22 391 Manchester Road YES Well Pharmacy, FJ016 1 Coldalhurst Lane YES
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Service Delivery Footprint 3 (Ince, Hindley, Abram, Platt Bridge)
ESSENTIAL SERVICES ADVANCED SERVICES Consultation Medicines New Appliance Stoma Essential Influenza Code Pharmacy Appliances Trusses Room Use Medicines Use Appliance Services Vaccination Available Review Service Review Customisation
Abram Pharmacy, FGN59 358 Warrington Road YES Hindley Health Centre Pharmacy, 17 Liverpool FXV58 Road YES Hollowood Chemists, FA200 7 Ince Green Lane YES Hollowood Chemists, FGL99 760 Atherton Road YES I Borsdane Pharmacy, Unit 3, 19 Borsdane FDG06 Avenue YES Liverpool Road Pharmacy, FVX03 612 Liverpool Road Lloyds Pharmacy, FEA28 234 Scholes YES Platt Bridge Health Centre Pharmacy, FAL71 Rivington Ave YES Tims and Parker, Claire FJG67 House, Phoenix Way YES Trayners Chemist, FKX71 108 Market Street YES Well Pharmacy, FY680 Hindley Medical Centre YES
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Service Delivery Footprint 4 (Leigh)
ESSENTIAL SERVICES ADVANCED SERVICES Consultation Medicines New Appliance Stoma Essential Influenza Code Pharmacy Appliances Trusses Room Use Medicines Use Appliance Services Vaccination Available Review Service Review Customisation
Asda Pharmacy, FHL39 Asda Superstore YES Blundell's Pharmacy FPT79 Ltd, Leigh Stadium YES Boots the Chemist, FJK23 29/31 Bradshawgate YES Manor Pharmacy, FJD69 12 The Centre YES Manor Pharmacy, FLX23 90-92 Manchester Road YES Rowlands Pharmacy, FK754 475 Wigan Road YES Rowlands Pharmacy, FXG57 Sainsburys Supermarket YES Tesco Pharmacy, FXW22 Spinning Jenny way YES Tims and Parker, FNH71 76 Bradshawgate YES Tims and Parker, FKK46 11 College Street YES Tims and Parker, FPE00 Derby Street YES Tims and Parker, FYQ60 Leigh Health Centre YES
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Service Delivery Footprint 5 (Lowton and Golborne)
ESSENTIAL SERVICES ADVANCED SERVICES Consultation Medicines New Appliance Stoma Essential Influenza Code Pharmacy Appliances Trusses Room Use Medicines Use Appliance Services Vaccination Available Review Service Review Customisation
Asda Pharmacy, FQL08 Edge Green Lane YES Boots the Chemist, Unit FAT70 8a, The Gerard Centre YES Cohens Chemist, FHH13 36a Braithwaite Ave YES Golborne Late Night FDP26 Chemist, 98 High Street YES J Morris Pharmacy, FLP99 109 Wigan Road YES Rowlands Pharmacy, FA756 5 Oaklands Road YES Rowlands Pharmacy, FJR77 Ashton Medical Centre YES Well Pharmacy, FLA12 62 High Street YES Well Pharmacy, FR006 97-99 High Street YES Your Local Boots Pharmacy, FG017 254-256 Wigan Road YES
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Service Delivery Footprint 6 (Wigan Central)
ESSENTIAL SERVICES ADVANCED SERVICES Consultation Medicines New Appliance Stoma Essential Influenza Code Pharmacy Appliances Trusses Room Use Medicines Use Appliance Services Vaccination Available Review Service Review Customisation
Asda Pharmacy, FKH90 Adsa Superstore YES Bestway National Ltd, FY111 216 Ormskirk Road YES Boots, FYQ21 22-23 Grand Arcade YES Boots the Chemist, FRG44 Robin Park YES Bradhsaw Street FRE68 Pharmacy, Bradshaw St YES England Pharmacy, FM634 280 Gidlow Lane YES George Wilson Ltd, Pemberton HC FQP74 Pharmacy YES Hollowood Chemists, FPC22 11 Mesnes St YES Lloyds Pharmacy, FCW22 91a Mesnes Street YES Lloyds Pharmacy, FGN21 Sainsburys Supermarket YES Manor Pharmacy, FFH39 Boston House YES
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Service Delivery Footprint 6 (Wigan Central) Cont.
ESSENTIAL SERVICES ADVANCED SERVICES Consultation Medicines New Appliance Stoma Essential Influenza Code Pharmacy Appliances Trusses Room Use Medicines Use Appliance Services Vaccination Available Review Service Review Customisation
Rowlands Pharmacy, FEY33 52 Marsh Green YES Tesco Pharmacy, FGM80 Central Park Way YES Your Local Boots Pharmacy, FMR35 765 Ormskirk Road YES
Service Delivery Footprint 7 (South Wigan and Ashton North)
ESSENTIAL SERVICES ADVANCED SERVICES
Consultation Medicines New Appliance Stoma Essential Influenza Code Pharmacy Appliances Trusses Room Use Medicines Use Appliance Services Vaccination Available Review Service Review Customisation
Cohens Chemist, FDH71 259c Orrell Road YES Hawkley Pharmacy, FMH96 54 Carr Lane YES Manor Pharmacy, FQ045 Chandler House YES Manor Pharmacy, FM484 8 Worsley Mesnes Drive YES Well Pharmacy, FHG83 56 Church Street YES Your local Boots Pharmacy, 91 Holmes FRW39 House Avenue YES Page | 7
Appendix 5 - Pharmacy Services - Locally Commissioned Services
Service Delivery Footprint 1 (Wigan North)
Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Appley Bridge Pharmacy, 53 Woodnook FLK57 Road Cohens Chemist, FGM90 47a High Street Day Lewis Pharmacy, 38b Gathurst FGW20 Lane Gorgemead Ltd (Cohens Chemist), 42 FHL05 High Street Hollowood Chemists, FXM89 4 Moorside Manor Pharmacy, FQF30 4 Gathurst Lane New Springs Pharmacy, FLL04 21 Wigan Road Shevington Community Pharmacy, FX694 Houghton Lane
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Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Standish Pharmacy, 15 Preston FW187 Road
Service Delivery Footprint 2 (Tyldesley and Atherton)
Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Boots the Chemist, FMF32 82 Market Street Cohens Chemist, FRF02 Ormerod House, Davina Pharmacy Ltd, FDH26 155 Elliott Street Elliott Street Pharmacy, FCV17 177 Elliott Street Lloyds Pharmacy, 23 Church FTF35 Street Lloyds Pharmacy, 147-149 Elliott FW814 Street Rowlands Pharmacy, 391 Manchester FVM22 Road
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Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Well Pharmacy, 1 Coldalhurst FJ016 Lane
Service Delivery Footprint 3 (Ince, Hindley, Abram, Platt Bridge)
Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Abram Pharmacy, 358 Warrington FGN59 Road Hindley Health Centre Pharmacy, 17 FXV58 Liverpool Rd Hollowood Chemists, 7 Ince Green FA200 Lane Hollowood Chemists, 760 Atherton FGL99 Road Borsdane Pharmacy, Unit 3, 19 Borsdane FDG06 Avenue Liverpool Road Pharmacy, 612 FVX03 Liverpool Road
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Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Lloyds Pharmacy, FEA28 234 Scholes Platt Bridge Health Centre Pharmacy, FAL71 Rivington Ave Tims and Parker, Claire House, FJG67 Phoenix Way Trayners Chemist, 108 Market FKX71 Street Well Pharmacy, Hindley Medical FY680 Centre
Service Delivery Footprint 4 (Leigh)
Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Asda Pharmacy, Asda FHL39 Superstore Blundell's Pharmacy Ltd, FPT79 Leigh Stadium Boots the Chemist, 29/31 FJK23 Bradshawgate
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Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Manor Pharmacy, FJD69 12 The Centre Manor Pharmacy, 90-92 Manchester FLX23 Road Rowlands Pharmacy, 475 Wigan FK754 Road Rowlands Pharmacy, Sainsburys FXG57 Supermarket Tesco Pharmacy, Spinning Jenny FXW22 way Tims and Parker, 76 FNH71 Bradshawgate Tims and Parker, 11 College FKK46 Street Tims and Parker, FPE00 Derby Street Tims and Parker, Leigh Health FYQ60 Centre
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Service Delivery Footprint 5 (Lowton and Golborne)
Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Asda Pharmacy, Edge Green FQL08 Lane Boots the Chemist, Unit 8a, The Gerard FAT70 Centre Cohens Chemist, 36a Braithwaite FHH13 Ave Golborne Late Night Chemist, FDP26 98 High Street J Morris Pharmacy, 109 Wigan FLP99 Road Rowlands Pharmacy, 5 Oaklands FA756 Road Rowlands Pharmacy, Ashton Medical FJR77 Centre Well Pharmacy, FLA12 62 High Street Well Pharmacy, 97-99 High FR006 Street
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Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Your Local Boots Pharmacy, 254- 256 Wigan FG017 Road
Service Delivery Footprint 6 (Wigan Central)
Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Asda Pharmacy, Adsa FKH90 Superstore Bestway National Chemists Ltd, 216 Ormskirk FY111 Road Boots, 22-23 FYQ21 Grand Arcade Boots the Chemist, FRG44 Robin Park Bradhsaw Street Pharmacy, FRE68 Bradshaw Street England Pharmacy, 280 Gidlow FM634 Lane
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Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II George Wilson (Pemberton) Ltd, Pemberton Health Centre FQP74 Pharmacy Hollowood Chemists, FPC22 11 Mesnes St Lloyds Pharmacy, 91a Mesnes FCW22 Street Lloyds Pharmacy, Sainsburys FGN21 Supermarket Manor Pharmacy, FFH39 Boston House Rowlands Pharmacy, FEY33 52 Marsh Green Tesco Pharmacy, Central Park FGM80 Way Your Local Boots Pharmacy, 765 FMR35 Ormskirk Road
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Service Delivery Footprint 7 (South Wigan and Ashton North)
Stop Stop Emergency Monitored Minor Palliative Healthy Chlamydia Needle Smoking Smoking Supervised Code Pharmacy Hormonal Dosage Ailment Care Living Screening Exchange Service Service Consumption Contraception System Scheme Scheme Pharmacy Level I Level II Cohens Chemist, 259c Orrell FDH71 Road Hawkley Pharmacy, FMH96 54 Carr Lane Manor Pharmacy, FQ045 Chandler House Manor Pharmacy, 8 Worsley FM484 Mesnes Drive Well Pharmacy, 56 Church FHG83 Street Your local Boots Pharmacy, 91 Holmes House FRW39 Avenue
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Appendix 6 - Pharmacy Access
Service Delivery Footprint 1 (Wigan North)
Train Station Wheelchair Hearing Parking within Bus Stop within Prescription Prescription Code Pharmacy within 500 Access Loop 100 Metres 100 Metres Collection Delivery Metres Appley Bridge Pharmacy, FLK57 53 Woodnook Road Cohens Chemist, FGM90 47a High Street Day Lewis Pharmacy, FGW20 38b Gathurst Lane Gorgemead Ltd (Cohens FHL05 Chemist), 42 High Street Hollowood Chemists, FXM89 4 Moorside Manor Pharmacy, FQF30 4 Gathurst Lane New Springs Pharmacy, 21 FLL04 Wigan Road Shevington Community FX694 Pharmacy, Houghton Lane Standish Pharmacy, FW187 15 Preston Road
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Service Delivery Footprint 2 (Tyldesley and Atherton)
Train Station Wheelchair Hearing Parking within Bus Stop within Prescription Prescription Code Pharmacy within 500 Access Loop 100 Metres 100 Metres Collection Delivery Metres Boots the Chemist, FMF32 82 Market Street Cohens Chemist, FRF02 Ormerod House, Davina Pharmacy Ltd, FDH26 155 Elliott Street Elliott Street Pharmacy, FCV17 177 Elliott Street Lloyds Pharmacy, FTF35 23 Church Street Lloyds Pharmacy, FW814 147-149 Elliott Street Rowlands Pharmacy, FVM22 391 Manchester Road Well Pharmacy, FJ016 1 Coldalhurst Lane
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Service Delivery Footprint 3 (Ince, Hindley, Abram, Platt Bridge)
Train Station Wheelchair Hearing Parking within Bus Stop within Prescription Prescription Code Pharmacy within 500 Access Loop 100 Metres 100 Metres Collection Delivery Metres Abram Pharmacy, FGN59 358 Warrington Road Hindley Health Centre Pharmacy, 17 Liverpool FXV58 Road Hollowood Chemists, FA200 7 Ince Green Lane Hollowood Chemists, FGL99 760 Atherton Road I Borsdane Pharmacy, Unit FDG06 3, 19 Borsdane Avenue Liverpool Road Pharmacy, FVX03 612 Liverpool Road Lloyds Pharmacy, FEA28 234 Scholes Platt Bridge Health Centre FAL71 Pharmacy, Rivington Ave Tims and Parker, FJG67 Claire House, Phoenix Way Trayners Chemist, FKX71 108 Market Street Well Pharmacy, FY680 Hindley Medical Centre
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Service Delivery Footprint 4 (Leigh)
Train Station Wheelchair Hearing Parking within Bus Stop within Prescription Prescription Code Pharmacy within 500 Access Loop 100 Metres 100 Metres Collection Delivery Metres Asda Pharmacy, FHL39 Asda Superstore Blundell's Pharmacy Ltd, FPT79 Leigh Stadium Boots the Chemist, FJK23 29/31 Bradshawgate Manor Pharmacy, FJD69 12 The Centre Manor Pharmacy, FLX23 90-92 Manchester Road Rowlands Pharmacy, FK754 475 Wigan Road Rowlands Pharmacy, FXG57 Sainsburys Supermarket Tesco Pharmacy, FXW22 Spinning Jenny way Tims and Parker, FNH71 76 Bradshawgate Tims and Parker, FKK46 11 College Street Tims and Parker, FPE00 Derby Street Tims and Parker, FYQ60 Leigh Health Centre
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Service Delivery Footprint 5 (Lowton and Golborne)
Train Station Wheelchair Hearing Parking within Bus Stop within Prescription Prescription Code Pharmacy within 500 Access Loop 100 Metres 100 Metres Collection Delivery Metres Asda Pharmacy, FQL08 Edge Green Lane Boots the Chemist, Unit 8a, FAT70 The Gerard Centre Cohens Chemist, FHH13 36a Braithwaite Ave Golborne Late Night FDP26 Chemist, 98 High Street J Morris Pharmacy, FLP99 109 Wigan Road Rowlands Pharmacy, FA756 5 Oaklands Road Rowlands Pharmacy, FJR77 Ashton Medical Centre Well Pharmacy, FLA12 62 High Street Well Pharmacy, FR006 97-99 High Street Your Local Boots Pharmacy, 254-256 Wigan FG017 Road
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Service Delivery Footprint 6 (Wigan Central)
Train Station Wheelchair Hearing Parking within Bus Stop within Prescription Prescription Code Pharmacy within 500 Access Loop 100 Metres 100 Metres Collection Delivery Metres Asda Pharmacy, FKH90 Adsa Superstore Bestway National Chemists FY111 Ltd, 216 Ormskirk Road
FYQ21 Boots, 22-23 Grand Arcade Boots the Chemist, FRG44 Robin Park Bradhsaw Street Pharmacy, Bradshaw FRE68 Street England Pharmacy, FM634 280 Gidlow Lane George Wilson (Pemberton) Ltd, Pemberton Health Centre FQP74 Pharmacy Hollowood Chemists, FPC22 11 Mesnes St Lloyds Pharmacy, FCW22 91a Mesnes Street Lloyds Pharmacy, FGN21 Sainsburys Supermarket Manor Pharmacy, FFH39 Boston House Rowlands Pharmacy, FEY33 52 Marsh Green Tesco Pharmacy, FGM80 Central Park Way
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Train Station Wheelchair Hearing Parking within Bus Stop within Prescription Prescription Code Pharmacy within 500 Access Loop 100 Metres 100 Metres Collection Delivery Metres Your Local Boots Pharmacy, 765 Ormskirk FMR35 Road
Service Delivery Footprint 7 (South Wigan and Ashton North)
Train Station Wheelchair Hearing Parking within Bus Stop within Prescription Prescription Code Pharmacy within 500 Access Loop 100 Metres 100 Metres Collection Delivery Metres Cohens Chemist, 259c FDH71 Orrell Road Hawkley Pharmacy, 54 FMH96 Carr Lane Manor Pharmacy, Chandler FQ045 House Manor Pharmacy, 8 FM484 Worsley Mesnes Drive Well Pharmacy, 56 Church FHG83 Street Your local Boots Pharmacy, FRW39 91 Holmes House Avenue
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Appendix 7 - Pharmacy and General Practice Opening Hours
Service Delivery Footprint 1 (Wigan North)
Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Appley Bridge Pharmacy FLK57 08:45 - 18:00 08:45 - 18:00 08:45 - 17:00 08:45 - 18:00 08:45 - 18:00 08:45 - 12:45 CLOSED 53 Woodnook Road Aspull Surgery P92015 08:30 - 12:30 08:30 - 12:30 08:30 - 13:00 08:30 - 12:30 08:30 - 12:30 CLOSED CLOSED Haigh Road Beech Hill Medical Centre P92010 14:00 - 18:30 14:00 - 18:30 CLOSED 14:00 - 18:30 14:00 - 18:30 CLOSED CLOSED 278 Gidlow Lane Cohens Chemist FGM90 08:15 - 18:30 08:15 - 18:30 08:15 - 17:00 08:15 - 18:30 08:15 - 18:30 CLOSED CLOSED 47a High Street Day Lewis Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FGW20 CLOSED CLOSED 38b Gathurst Lane 14:00 - 18:30 14:00 - 18:30 14:00 - 17:30 14:00 - 18:30 14:00 - 18:30 Dr Munro & Partners P92017 08:30 - 18:30 08:30 - 18:30 08:30 - 17:00 08:30 - 18:30 08:30 - 18:30 CLOSED CLOSED Houghton Lane Dr S N Sharma P92619 13:30 - 18:30 13:30 - 18:30 13:30 - 18:30 13:30 - 18:30 13:30 - 18:30 CLOSED CLOSED Atherton Health Centre Gorgemead Ltd (Cohens FHL05 Chemist) 09:00 - 17:00 09:00 - 17:00 09:00 - 17:00 09:00 - 17:00 09:00 - 17:00 CLOSED CLOSED 42 High Street Hollowood Chemists 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FXM89 09:00 - 13:00 09:00 - 13:00 CLOSED 4 Moorside 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 Manor Pharmacy FQF30 09:00 - 18:00 09:00 - 18:00 09:00 - 17:00 09:00 - 18:00 09:00 - 18:00 09:00 - 13:00 CLOSED 4 Gathurst Lane New Springs Pharmacy 21 Wigan Road FLL04 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 13:00 CLOSED
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Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Shevington Community FX694 Pharmacy 07:00 -22:00 07:00 - 22:00 07:00 - 22:00 07:00 - 22:00 07:00 - 22:00 07:00 - 22:00 10:00 - 20:00 Houghton Lane Standish Medical Practice P92014 08:20 - 18:30 08:20 - 18:30 08:20 - 16:30 08:20 - 20:00 08:20 - 18:30 CLOSED CLOSED 49 High Street Standish Pharmacy FW187 09:00 -17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 13:00 CLOSED 15 Preston Road
Service Delivery Footprint 2 (Tyldesley and Atherton)
Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday 7 Brooks Medical Centre P92652 08:00 - 18:30 08:00 - 18:30 08:00 - 20:00 08:00 - 18:30 08:00 - 18:30 08:00 - 12:00 CLOSED 21 Church Street Astley General Practice P92637 07:30 - 18:30 08:00 - 18:30 08:00 - 13:00 07:00 - 18:30 08:00 - 18:30 CLOSED CLOSED 391 Manchester Road Boots the Chemist FMF32 08:30 - 18:00 08:30 - 18:00 08:30 - 18:00 08:30 - 18:00 08:30 - 18:00 08:30 - 17:00 CLOSED 82 Market Street Cohens Chemist FRF02 09:00 - 18:30 09:00 - 18:30 09:00 - 13:00 09:00 - 18:30 09:00 - 18:30 10:00 - 12:00 CLOSED Ormerod House, Davina Pharmacy Ltd FDH26 08:30 - 18:30 08:30 - 18:30 08:30 - 18:30 08:30 - 18:30 08:30 - 18:30 09:00 - 13:00 CLOSED 155 Elliott Street Dr Anderson & Partner P92605 08:00 - 18:00 08:00 - 18:00 08:00 - 13:00 08:00 - 18:00 08:00 - 18:00 CLOSED CLOSED Boothstown Medical Centre Dr Atrey P92626 Meadow View Surgery 08:00 - 18:00 08:00 - 13:00 08:00 - 13:00 08:00 - 13:00 08:00 - 13:00 CLOSED CLOSED
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Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Dr C P Khatri P92033 14.00- 18:30 15.15 - 18:30 CLOSED 14.00 -20:00 14.00 - 18:30 CLOSED CLOSED The Surgery Dr Hati Kakoty P92633 08:00 - 20:00 08:00 - 18:30 08:00 - 18:30 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED Beefold lane Surgery Dr K K Chan P92042 08:00 - 12:00 08:00 - 12:00 08:00 - 13:00 08:00 - 12:00 08:00 - 12:00 CLOSED CLOSED Seven Brooks Medical Centre Dr K Khatri P92646 13:00 - 18:30 13:00 - 18:30 CLOSED 13:00 - 18:30 13:00 - 18:30 CLOSED CLOSED The Surgery Dr Shah P92028 08:00 - 18:30 08:00 - 20:30 08:00 - 13:00 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED Elliott Street Surgery Dr Sivakumar & Partner P92020 08:00 - 18:30 07:00 - 18:30 07:00 - 18:30 08:00 - 18:30 07:00 - 18:30 CLOSED CLOSED The Surgery Dr Vasanth & Partner P92635 08:00 - 18:30 08:00 - 18:30 08:00 - 13:00 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED Ormerod House Elliott Street Pharmacy FCV17 08:00 - 22:30 08:00 - 22:30 08:00 - 22:30 08:00 - 22:30 08:00 - 22:30 08:00 - 22:30 09:30 - 22:30 177 Elliott Street Intrahealth Tyldesley Y02321 CLOSED CLOSED CLOSED 18:30 - 19:30 CLOSED CLOSED CLOSED Tyldesley Health Centre Lloyds Pharmacy FTF35 08:15 - 18:15 08:15 - 18:15 08:15 - 18:15 08:15 - 18:15 08:15 - 18:15 CLOSED CLOSED 23 Church Street Lloyds Pharmacy FW814 08:30 - 18:00 08:30 - 18:00 08:30 - 18:00 08:30 - 18:00 08:30 - 18:00 09:00 - 13:00 CLOSED 147-149 Elliott Street Rowlands Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FVM22 391 Manchester Road 09:00 - 13:00 CLOSED 13:20 - 18:30 13:20 - 18:30 13:20 - 17:00 13:20 - 18:30 13:20 - 18:30
Well Pharmacy FJ016 08:30 - 18:45 08:30 - 18:45 08:30 - 12:30 08:30 - 18:45 08:30 - 18:45 CLOSED CLOSED 1 Coldalhurst Lane
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Service Delivery Footprint 3 (Ince, Hindley, Abram, Platt Bridge)
Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Abram Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FGN59 CLOSED CLOSED 358 Warrington Road 14:15 - 18:15 14:15 - 18:15 14:15 - 18:15 14:15 - 18:15 14:15 - 18:15 Dr Ahmad & Partners P92006 08:00 - 18:00 08:00 - 18:00 08:00 - 18:00 08:30 - 20.15 08:00 - 18:00 CLOSED CLOSED Alexandra House Surgery Dr Tun & Partners P92004 CLOSED 18:30 - 20:00 CLOSED CLOSED CLOSED CLOSED CLOSED The Health Centre Dr Ullah P92031 08:30 - 18:00 07:00 - 18:00 08:00 - 13:00 07:00 - 18:00 08:30 - 18:00 CLOSED CLOSED Platt Bridge Health Centre Hindley Health Centre FXV58 Pharmacy 08:30 - 19:00 08:30 - 19:00 08:30 - 17:00 08:30 - 19:00 08:30 - 19:00 09:00 - 11:00 CLOSED 17 Liverpool Road Hollowood Chemists 09:00 - 13:15 09:00 - 13:15 09:00 - 13:15 09:00 - 13:15 09:00 - 13:15 FA200 09:00 - 13:00 CLOSED 7 Ince Green Lane 14:15 - 18:00 14:15 - 18:00 14:15 - 18:00 14:15 - 18:00 14:15 - 18:00 Hollowood Chemists 09:00 - 14:00 09:00 - 14:00 09:00 - 14:00 09:00 - 14:00 FGL99 09:00 - 17:00 CLOSED CLOSED 760 Atherton Road 15:00 - 18:00 15:00 - 18:00 15:00 - 18:00 15:00 - 18:00 I Borsdane Pharmacy FDG06 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 13:00 CLOSED Unit 3, 19 Borsdane Avenue Ince Surgery P92616 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 CLOSED CLOSED Ince Community Clinic Intrahealth Platt Bridge Y02274 13:00 - 18:30 13:00 - 18:30 13:00 - 18:30 13:00 - 18:30 15:30 - 8:30 CLOSED CLOSED Platt Bridge Health Centre Liverpool Road Pharmacy FVX03 612 Liverpool Road 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 CLOSED CLOSED
Lloyds Pharmacy FEA28 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 CLOSED CLOSED 234 Scholes Lower Ince Surgery P92620 Claire House 18:30 - 20:00 CLOSED CLOSED 18:30 - 20:00 CLOSED CLOSED CLOSED
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Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Pennygate Medical Centre P92016 13:30 - 18:00 13:30 - 18:00 CLOSED 13:30 - 18:00 13:30 - 18:00 CLOSED CLOSED 109 Ladies Lane Platt Bridge Health Centre 08:30 - 13:30 08:30 - 13:30 08:30 - 13:30 08:30 - 13:30 08:30 - 13:30 FAL71 Pharmacy 09:00 - 12:30 CLOSED 14:30 - 18:30 14:30 - 18:30 14:30 - 17:00 14:30 - 18:30 14:30 - 18:30 Rivington Ave Tims and Parker FJG67 09:00 - 21:00 09:00 - 21:00 09:00 - 21:00 09:00 - 21:00 09:00 - 21:00 09:00 - 18:00 10:00 - 14:00 Claire House, Phoenix Way Trayners Chemist FKX71 08:00 - 18:00 08:00 - 18:00 08:00 - 16:00 08:00 - 18:00 08:00 - 18:00 08:00 - 14:00 CLOSED 108 Market Street Well Pharmacy FY680 08:30 - 18:30 08:30 - 18:30 08:30 - 18:30 08:30 - 18:30 08:30 - 18:30 09:30 - 11:30 CLOSED Hindley Medical Centre
Service Delivery Footprint 4 (Leigh)
Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Asda Pharmacy FHL39 08:00 - 23:00 07:00 - 23:00 07:00 - 23:00 07:00 - 23:00 07:00 - 23:00 07:00 - 22:00 10:00 - 16:00 Asda Superstore Blundell's Pharmacy Ltd 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FPT79 CLOSED CLOSED Leigh Stadium 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 Boots the Chemist FJK23 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 CLOSED 29/31 Bradshawgate Brookmill Medical Centre P92023 College Street 08:00 - 18:30 08:00 - 20:00 08:00 - 17:00 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED
Dr Gupta Y00050 08:00 - 18:00 08:00 - 18:00 08:00 - 13:00 08:00 - 18:00 08:00 - 18:00 CLOSED CLOSED Bridgewater Medical Centre Dr Maung P92623 08:00 - 18:30 08:00 - 20:00 08:00 - 13:00 08:00 - 20:00 08:00 - 18:30 CLOSED CLOSED Leigh Health Centre
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Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Dr Trivedi & Partner P92029 08:00 - 18:30 08:00 - 18:30 08:00 - 13:00 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED The Surgery Dr Wong & Partners P92007 08:00 - 13:00 08:00 - 13:00 08:00 - 13:00 08:00 - 13:00 08:00 - 13:00 CLOSED CLOSED Old Henry Street Health Centre Drs Martin, Lewis & Saravannan P92607 CLOSED CLOSED CLOSED 18:30 - 20:00 CLOSED CLOSED CLOSED Grasmere Surgery Esa Surgery Ltd P92615 08:30 - 18:00 08:30 - 18:00 08:30 - 13:00 08:30 - 18:00 08:30 - 18:00 09:40 - 11:40 CLOSED Leigh Health Centre Foxleigh Surgery P92602 CLOSED CLOSED 17:00 - 19:00 CLOSED CLOSED CLOSED CLOSED Bridgewater Medical Centre Intrahealth Family Practice Y02887 08:30 - 20:00 08:30 - 18:00 08:30 - 13:00 08:30 - 18:00 08:30 - 18:00 CLOSED CLOSED Leigh Sports Village Intrahealth LSV Y02886 08:00 - 18:30 07:00 - 18:30 07:00 - 18:30 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED Leigh Sports Village Leigh Family Practice Y02322 08:00 - 20:00 08:00 - 20:00 08:00 - 20:00 08:00 - 20:00 08:00 - 20:00 08:00 - 12:00 CLOSED Bridgewater Medical Centre Lilford Park Surgery P92035 08:00 - 18:30 08:00 - 18:30 08:00 - 18:30 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED Leigh Health Centre Manor Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FJD69 09:00 - 13:00 CLOSED 12 The Centre 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 Manor Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FLX23 09:00 - 13:00 CLOSED 90-92 Manchester Road 14:00 - 18:00 14:00 - 18:00 14:00 - 17:00 14:00 - 18:00 14:00 - 18:00 Premier Health Team P92621 08:00 - 12:00 08:00 - 12:00 08:00 - 13:00 08:00 - 12:00 08:00 - 12:00 CLOSED CLOSED Bridgewater Medical Centre Rowlands Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FK754 CLOSED CLOSED 475 Wigan Road 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 Rowlands Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FXG57 10:30 - 16:30 Sainsburys Supermarket 13:20 - 20:00 13:20 - 20:00 13:20 - 20:00 13:20 - 20:00 13:20 - 20:00 13:20 - 20:00 Tesco Pharmacy FXW22 08:00 - 22:30 06:30 - 22:30 06:30 - 22:30 06:30 - 22:30 06:30 - 22:30 06:30 - 22:00 11:00 - 17:00 Spinning Jenny way Page | 6
Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Tims and Parker 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FNH71 CLOSED 76 Bradshawgate 13:30 - 17:30 13:30 - 17:30 13:30 - 17:30 13:30 - 17:30 13:30 - 17:30 13:30 - 17:30 Tims and Parker 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FKK46 CLOSED CLOSED 11 College Street 13:30 - 17:45 13:30 - 17:45 13:30 - 17:45 13:30 - 17:45 13:30 - 17:45 Tims and Parker FPE00 09:00 - 18:00 09:00 - 18:00 09:00 - 17:30 09:00 - 18:00 09:00 - 18:00 CLOSED CLOSED Derby Street Tims and Parker FYQ60 08:45 - 20:00 08:45 - 20:00 08:45 - 20:00 08:45 - 20:00 08:45 - 20:00 09:00 - 12:00 11:00 - 14:00 Leigh Health Centre
Service Delivery Footprint 5 (Lowton and Golborne)
Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Asda Pharmacy FQL08 08:00 - 23:00 07:00 - 23:00 07:00 - 23:00 07:00 - 23:00 07:00 - 23:00 07:00 - 22:00 10:00 - 16:00 Edge Green Lane Boots the Chemist FAT70 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 CLOSED Unit 8a, The Gerard Centre Braithwaite Road Surgery P92002 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 CLOSED CLOSED Lowton Cohens Chemist FHH13 09:00 - 18:30 09:00 - 18:30 09:00 - 18:30 09:00 - 18:30 09:00 - 18:30 09:00 - 12:00 CLOSED 36a Braithwaite Ave Dr Anis & Partner P92012 08:15 - 20:00 08:15 - 18:00 08:15 - 15:00 08:15 - 18:00 08:15 - 18:00 9:00 - 12:00 CLOSED Kidglove Road Dr M Pal & Partners P92630 Morden Avenue 08:00 - 13:00 08:00 - 13:00 08:00 - 12:00 08:00 - 13:00 08:00 - 13:00 CLOSED CLOSED
Dr Mahadevappa P92648 14:00 - 18:30 14:00 - 18:30 CLOSED 14:00 - 18:30 14:00 - 18:30 CLOSED CLOSED 216 Slag Lane Dr Pitalia & Partner P92041 08:00 - 12:30 08:00 - 12:30 08:00 - 13:00 08:00 - 12:30 08:00 - 12:30 CLOSED CLOSED 120 Wigan Road Page | 7
Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Dr Seabrook P92030 13:00 - 20:00 13:00 - 20:00 13:00 - 18:30 13:00 - 20:00 13:00 - 18:30 CLOSED CLOSED 1 Wrightington Street Dr Shahbazi & Partner P92639 08:00 - 18:30 08:00 - 18:30 08:00 - 18:30 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED Kidglove Road Dr Xavier P92651 14:00 - 18:30 14:00 - 18:30 CLOSED 14:00 - 18:30 14:00 - 18:30 CLOSED CLOSED 208c Newton Road Golborne Late Night Chemist FDP26 07:00 - 22:00 07:00 - 22:00 07:00 - 22:00 07:00 - 22:00 07:00 - 22:00 07:00 - 22:00 08:00 - 18:00 98 High Street J Morris Pharmacy FLP99 09:00 - 18:30 09:00 - 18:30 09:00 - 18:30 09:00 - 18:30 09:00 - 18:30 09:00 - 13:00 CLOSED 109 Wigan Road Rowlands Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:15 09:00 - 13:00 09:00 - 13:00 FA756 CLOSED CLOSED 5 Oaklands Road 14:00 - 18:15 14:00 - 18:15 14:00 - 18:15 14:00 - 18:15 14:00 - 18:15 Rowlands Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FJR77 CLOSED CLOSED Ashton Medical Centre 13:20 - 18:30 13:20 - 18:30 13:20 - 18:30 13:20 - 18:30 13:20 - 18:30 Well Pharmacy FLA12 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 13:00 CLOSED 62 High Street Well Pharmacy FR006 09:00 -18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 CLOSED CLOSED 97-99 High Street Your Local Boots Pharmacy FG017 08:30 - 20:30 08:30 - 20:30 08:30 - 20:30 08:30 - 20:30 08:30 - 20:30 09:00 - 18:00 15:30 - 21:30 254-256 Wigan Road
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Service Delivery Footprint 6 (Wigan Central)
Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Asda Pharmacy FKH90 08:00 - 22:00 08:00 - 22:00 08:00 - 22:00 08:00 - 22:00 08:00 - 22:00 08:00 - 20:00 10:30 - 16:30 Adsa Superstore Bestway National Chemists Ltd FY111 09:00 - 18:00 09:00 - 18:00 09:00 - 17:30 09:00 - 18:00 09:00 - 18:00 09:00 - 13:00 CLOSED 216 Ormskirk Road Boots FYQ21 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 09:00 - 17:30 11:00 - 16:00 22-23 Grand Arcade Boots the Chemist FRG44 09:00 - 20:00 09:00 - 20:00 09:00 - 20:00 09:00 - 20:00 09:00 - 20:00 09:00 - 18:00 11:00 - 17:00 Robin Park Bradhsaw Street Pharmacy FRE68 08:30 - 18:15 08:30 - 18:15 08:00 - 16:30 08:30 - 18:15 08:30 - 18:15 09:00 - 12:00 CLOSED Bradshaw Street Dr Ellis & Kreppel P92634 09:00 - 20:30 09:00 - 18:30 08:00 - 13:00 09:00 - 18:30 09:00 - 18:30 CLOSED CLOSED Mesnes View Surgery Dr M K Patel & Partners P92026 08:00 - 18:30 08:00 - 20:00 07:00 - 18:00 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED Longshoot Health Centre Dr Mughal & Partners P92003 08:00 - 18:00 08:00 - 18:00 08:00 - 14:00 08:00 - 18:00 08:00 - 18:00 CLOSED CLOSED The Dicconson Practice Dr P Smith & Partners P92008 08:00 - 20:00 08:00 - 18:30 08:00 - 13:00 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED Bradshaw Medical Centre Dr Smith & Partners P92011 09:00 - 18:00 09:00 - 18:00 09:00 - 13:00 09:00 - 18:00 09:00 - 18:00 CLOSED CLOSED Sullivan Way Surgery England Pharmacy 08:15 - 13:00 08:15 - 13:00 08:15 - 13:00 08:15 - 13:00 08:15 - 13:00 FM634 08:30 - 13:00 CLOSED 280 Gidlow Lane 14:00 - 21:00 14:00 - 21:00 14:00 - 21:00 14:00 - 21:00 14:00 - 21:00 George Wilson (Pemberton) Ltd 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 FQP74 09:00 - 12:30 CLOSED Pemberton Health Centre 14:00 - 18:00 14:00 - 18:00 14:00 - 17:00 14:00 - 18:00 14:00 - 18:00 Pharmacy Hollowood Chemists FPC22 11 Mesnes St 09:00 - 18:00 09:00 - 18:00 09:00 - 17:00 09:00 - 18:00 09:00 - 18:00 09:00 - 13:00 CLOSED
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Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Intrahealth Marsh Green Y02885 08:30 - 18:00 08:30 - 20:00 08:30 - 17:00 08:30 - 18:00 08:30 - 18:00 CLOSED CLOSED Harrow Road Lloyds Pharmacy FCW22 91a Mesnes Street 08:30 - 18:00 08:30 - 18:00 08:30 - 18:00 08:30 - 18:00 08:30 - 18:00 CLOSED CLOSED
Lloyds Pharmacy FGN21 08:00 - 20:00 08:00 - 20:00 08:00 - 20:00 08:00 - 21:00 08:00 - 21:00 08:00 - 19:00 10:00 - 16:00 Sainsburys Supermarket Manor Pharmacy 08:30 - 12:30 08:30 - 12:30 08:30 - 13:00 08:30 - 12:30 08:30 - 12:30 FFH39 09:00 - 13:00 CLOSED Boston House 13:30 - 18:30 13:30 - 18:30 14:00 - 18:30 13:30 - 18:30 13:30 - 18:30 Newtown Medical Centre P92021 08:30 - 18:30 08:30 - 18:30 08:30 - 17:00 08:30 - 18:30 08:30 - 18:30 CLOSED CLOSED Pemberton PCRC Pemberton Surgery P92019 08:30 - 20:00 08:30 - 18:00 08:30 - 12:00 08:30 - 18:00 08:30 - 18:00 CLOSED CLOSED Pemberton PCRC Rowlands Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FEY33 09:00 - 13:00 CLOSED 52 Marsh Green 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 Tesco Pharmacy FGM80 08:00 - 22:00 08:00 - 22:00 08:00 - 22:00 08:00 - 22:00 08:00 - 22:00 08:00 - 20:00 10:00 - 16:00 Central Park Way Your Local Boots Pharmacy FMR35 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 18:00 09:00 - 17:30 CLOSED 765 Ormskirk Road
Service Delivery Footprint 7 (South Wigan and Ashton North)
Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Cohens Chemist FDH71 09:00 - 17:00 09:00 - 17:00 09:00 - 14:00 09:00 - 17:00 09:00 - 17:00 09:00 - 12:00 CLOSED 259c Orrell Road Dr Alistair Ashton Y02378 08:00 - 20:00 08:00 - 20:00 08:00 - 20:00 08:00 - 20:00 08:00 - 20:00 08:30 - 12:00 CLOSED Queens Road Dr Ashworth & Partners P92034 08:00 - 18:30 08:00 - 18:30 08:00 - 13:00 08:00 - 18:30 08:00 - 18:30 CLOSED CLOSED 246 Wigan Road
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Code GP Name/Pharmacy Name Monday Tuesday Wednesday Thursday Friday Saturday Sunday Dr Mohan Kumar P92024 08:30 - 18:30 08:30 - 19:30 08:00 - 13:00 08:30 - 18:30 08:30 - 18:30 CLOSED CLOSED Worsley Mesnes Health Centre Dr Ollerton P92647 Worsley Mesnes Health Centre 08:30 - 18:30 08:30 - 18:30 08:30 - 17:00 08:30 - 18:30 08:30 - 18:30 CLOSED CLOSED
Dr Saxena P92038 08:00 - 13:00 08:00 - 13:00 08:00 - 13:00 08:00 - 13:00 08:00 - 13:00 08:00 - 12:00 CLOSED Holmes House Avenue Dr Vallabhaneni & Partners P92001 08:30 - 18:30 08:30 - 18:30 08:30 - 13:00 08:30 - 18:30 08:30 - 18:30 CLOSED CLOSED 185 Wigan Road Dr Zaman & Partner P92005 18:30 - 19:15 CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED Worsley Mesnes Health Centre Hawkley Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FMH96 09:00 - 12:30 CLOSED 54 Carr Lane 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 Manor Pharmacy 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 08:30 - 13:00 FQ045 CLOSED CLOSED Chandler House 14:15 - 18:30 14:15 - 18:30 14:00 - 16:00 14:15 - 18:30 14:15 - 18:30 Manor Pharmacy 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 09:00 - 13:00 FM484 09:00 - 13:00 CLOSED 8 Worsley Mesnes Drive 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 14:00 - 18:00 Marus Bridge Practice P92642 08:30 - 18:00 08:30 - 18:00 08:30 - 13:00 08:30 - 18:00 08:30 - 18:00 CLOSED CLOSED Worsley Mesnes Health Centre Shakespere Surgery P92653 13:00 - 20:00 13:00 - 18:30 CLOSED 13:00 - 18:30 13:00 - 18:30 CLOSED CLOSED Worsley Mesnes Health Centre Well Pharmacy FHG83 08:30 - 19:00 08:30 - 18:00 08:30 - 18:00 08:30 - 19:00 08:30 - 16:00 CLOSED CLOSED 56 Church Street Your local Boots Pharmacy FRW39 09:00 - 18:00 09:00 - 18:00 09:00 - 17:30 09:00 - 18:00 09:00 - 18:00 09:00 - 17:30 CLOSED 91 Holmes House Avenue
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Appendix 8 – Service Delivery Footprint Maps (Pharmacy and General Practice Location)
Figure A1. Pharmacies (Brown) and general practices (Green) in Wigan North Service Delivery Footprint Page | 1
Figure A2. Pharmacies (Brown) and general practices (Green) in Wigan Central Service Delivery Footprint Page | 2
Figure A3. Pharmacies (Brown) and general practices (Green) in South Wigan and Ashton North Service Delivery Footprint Page | 3
Figure A4. Pharmacies (Brown) and general practices (Green) in Ince, Hindley, Abram and Platt Bridge Service Delivery Footprint
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Figure A5. Pharmacies (Brown) and general practices (Green) in Lowton and Golborne Service Delivery Footprint Page | 5
Figure A6. Pharmacies (Brown) and general practices (Green) in Leigh Service Delivery Footprint Page | 6
Figure A7. Pharmacies (Brown) and general practices (Green) in Tyldesley and Atherton Service Delivery Footprint
Appendix 9 – Pharmacy Patient Satisfaction Survey
Making the Most of Your Local Pharmacy
Wigan Borough
Pharmacy Patient Satisfaction Survey
May and June 2017
(Note: Two pharmacies have closed since this survey was completed)
Introduction
A patient satisfaction survey was carried out at all 72 pharmacies in Wigan Borough during May and June 2017. As this was carried out prior to the consultation on the draft Pharmaceutical Needs Assessment (PNA) the report on this survey is included within the appendix of the draft PNA. Each pharmacy was given 20 copies of the survey. The aim was that these were to be given to patients/customers to complete while attending the pharmacy. 451 responses were received (31.3% response rate). A copy of the survey is given in Appendix 1.
All responses are completely anonymous.
Key Findings – Service Satisfaction
How would you rate the service you received today?
99.3% of people responding to this question replied ‘Excellent’ or ‘Good’.
How would you rate the cleanliness and tidiness of the pharmacy?
99.3% of people responding to this question replied ‘Excellent’ or ‘Good’.
How would you rate the helpfulness of the staff today?
99.1% of people responding to this question replied ‘Excellent’ or ‘Good’.
How would you rate the time taken for staff to serve you?
98.4% of people responding to this question replied ‘Excellent’ or ‘Good’.
Are you satisfied with the opening hours of your regular pharmacy, or if you have no regular pharmacy, the one you used today?
97.3% of people responding to this question replied ‘Yes’.
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Survey Coverage
Within Wigan Borough there are seven Service Delivery Footprints (see Figure 1). These are areas where the aim is to provide more integrated local health and social care services. In turn, this should give rise to more coherent and efficient services to residents with a reduction in duplication particularly for people in receipt of multiple services. Pharmacies have an important role to play in this as they are often the first port of call for people seeking advice about their health.
Figure 1. Service Delivery Footprints (SDFs) in Wigan Borough
Table 1 shows the coverage of the survey by SDF in terms of the proportion of the questionnaires returned by SDF and the proportion of returned questionnaires by SDF.
% of questionnaires % of returned questionnaires SDF of Pharmacy returned by Service Delivery Footprint Wigan Central 41.3% 27.5% Wigan North 70.0% 24.8% Leigh 36.3% 19.3% Tyldesley and Atherton 20.6% 8.2% Ince, Hindley, Abram, Platt bridge 14.2% 7.5% Lowton and Golborne 17.2% 6.9% South Wigan and Ashton North 18.6% 5.8% WIGAN BOROUGH 31.3% 100.0% Table 1. Survey coverage by Service Delivery Footprint
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Overall 31.3% of questionnaires distributed to pharmacies were returned. However, at the SDF level the proportion of questionnaires returned ranges from 14.2% to 70.0%. In terms of the distribution of returned questionnaires by SDF, this ranges from 5.8% to 27.5% with 71.6% of returned questionnaires accounted for by three SDFs (Wigan Central, Wigan North, and Leigh). Therefore, there is considerable variation in survey representation across the Borough.
Survey Analysis
Gender and age group of people surveyed Figure 2 shows the breakdown of those surveyed by gender. Of those that responded to the question there were more females than males. 10% of those surveyed did not answer this question. Figure 3 shows the breakdown of those surveyed by age group. Most of those surveyed were aged 25+. 7% of those surveyed did not provide an answer to this question.
46 (10%)
Female Male 163 (36%) 242 (54%) Not answered
Figure 2. Gender of people surveyed
28 (6%) 4 (1%) 4 (1%)18 (4%)
Under 16 16 - 24 100 (22%) 25 - 44 147 (33%) 45 - 59 60+ 150 (33%) Prefer not to say Not Answered
Figure 3. Age group of people surveyed
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Figure 4 provides a breakdown by age group and gender. Of those that answered the questions on both age and gender a higher number of females were surveyed compared to males for all age groups. This gender difference was particularly pronounced between the ages of 16 – 44. This probably reflects young women’s need to access pharmacy services during pregnancy and in respect of their children. Prescription for oral contraception may also influence this.
80
70
60
50
40
30
20 Number of responders of Number 10
0 Under 16 16 - 24 25 - 44 45 - 59 60+ Prefer not Not Age Group to say Answered Female Male Not answered
Figure 4. Age group of people surveyed by gender
Ethnicity of people surveyed 89.4% of people surveyed gave their ethnicity as ‘White’. However, 7.5% of people either did not answer this question or answered ‘Prefer not to say’. Taking this into account, of those people surveyed who declared their ethnicity, 96.6% declared their ethnicity as ‘White’. This largely reflects the situation in Wigan Borough as a whole where in the 2011 Census over 95% of people responding in Wigan Borough declared their ethnicity as ‘White’. Of those who declared their ethnicity in this survey, 1.5% were ‘Asian or Asian British’, and 1.9% were either ‘Black or Black British’, ‘Chinese’, ‘Mixed’ or ‘Other’.
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Reasons for visiting a pharmacy on the day when surveyed Figure 5 shows the proportion of people surveyed by the number of reasons that they had for visiting a pharmacy that day. Most people (84.0%) had only a single reason for visiting a pharmacy on that day,
90%
80%
70%
60%
50% % % peopleof 40%
30%
20%
10%
0% 1 2 3 4 5 Not answered Number of reasons for attending
Figure 5. Number of reasons for visiting a pharmacy on the day when surveyed
Figure 6 shows the reasons people had to visit a pharmacy on the day that they were surveyed as a proportion of all the reasons given. The most common reason given (over 70%) was to collect a prescription.
Other Needle Exchange Supervised Methodone/Subutex Stop Smoking Scheme Medicines use Review Emergency Hormonal Contraception Minor Ailment Scheme Advice To buy other products To buy medication Prescription
0% 10% 20% 30% 40% 50% 60% 70% 80% % of reasons for attending pharmacy
Figure 6. Reasons for visiting a pharmacy as a proportion of all the reasons given
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Figure 7 provides the same information as Figure 6 but as a proportion of people surveyed. This excludes people that did not provide an answer to this question (see Figure 5). The majority of people surveyed were attending in order to collect a prescription (over 85%).
Other Needle Exchange Supervised Methodone/Subutex Stop Smoking Scheme Medicines use Review Emergency Hormonal Contraception Minor Ailment Scheme Advice To buy other products To buy medication Prescription
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% % of people attending by reason
Figure 7. Reasons for visiting a pharmacy as a proportion of people surveyed
Figure 8 shows the preference of people when choosing to visit a pharmacy. The majority of those surveyed preferred to visit the pharmacy they attended on the day they were surveyed.
6.0% 2.2% 8.6% This is the pharmacy I choose to visit if possible This is one of several pharmacies I use
83.1% This pharmacy was just convenient for me today Not answered
Figure 8. Preference of those surveyed in visiting a pharmacy
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Service Satisfaction Figure 9 shows the results of the key service satisfaction questions within the survey questionnaire. This includes the proportion of people who did not answer each question. Figure 10 shows the same results as Figure 9 but excludes people that did not answer the question, combines ‘Excellent or Good’ and ‘Poor or Very Poor’, and zooms in on the chart to highlight information.
How would you rate the time taken for staff to serve you?
How would you rate the helpfulness of staff today?
How would you rate the cleanliness and tidiness of the pharmacy?
How would you rate the service you received today?
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Proportion of people questioned Excellent Good Average Poor Very Poor Not answered
Figure 9. Results of key service satisfaction questions
How would you rate the time taken for staff to 98.4% serve you?
How would you rate the helpfulness of staff 99.1% today?
How would you rate the cleanliness and tidiness of 99.3% the pharmacy?
How would you rate the service you received 99.3% today?
95% 96% 97% 98% 99% 100% Proportion of people questioned Excellent or Good Average Poor or Very Poor
Figure 10. Results of key service satisfaction questions (excluding not answered questions)
Figure 11 shows the proportion of people satisfied with the opening hours of their regular pharmacy, or if they have no regular pharmacy, the one they used when they completed the survey questionnaire.
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Are you satisfied with the opening hours of your regular pharmacy, or, if you have no regular 97.3% pharmacy the one you used today? (Excludes not answered)
Are you satisfied with the opening hours of your regular pharmacy, or, if you have no regular 95.6% pharmacy the one you used today? (Includes not answered)
90% 91% 92% 93% 94% 95% 96% 97% 98% 99% 100% Proportion of people questioned Yes No Not answered
Figure 11. Satisfaction with opening hours
Taken as a whole, there appears to be a high level of satisfaction with the pharmacy service received by those who completed the survey questionnaire.
General pharmacy use Figure 12 shows how regularly the people surveyed visited a pharmacy. The majority of people surveyed visit a pharmacy at least once every three months with the largest proportion of people visiting a pharmacy monthly.
Not answered
Once a year or less
Twice a year
Every 3 months
Monthly
Weekly
Daily
0% 10% 20% 30% 40% 50% 60% Proportion of people surveyed
Figure 12. Frequency of pharmacy use by people surveyed
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Figure 13 shows the usual means of travel of people surveyed either to their regularly pharmacy, or if they do not have one, to the pharmacy they used when surveyed. The majority either walked to the pharmacy or travelled by car.
Not answered
Other
Car
Taxi
Public Transport
Cycle
Walk
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Proportion of people surveyed
Figure 13. Means of travel to a pharmacy
Figure 14 shows the travel times of those surveyed using their usual means of travel to a pharmacy. The majority were able to travel to a pharmacy within ten minutes with in excess of 90% travelling to a pharmacy within 20 minutes.
Not answered
more than 25 minutes
20 - 25 minutes
15 - 20 minutes
10 - 15 minutes
5 - 10 minutes
5 minutes or less
0% 5% 10% 15% 20% 25% 30% 35% 40% Proportion of people surveyed
Figure 14. Travel time to pharmacy
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Figure 15 shows the reasons that people used a pharmacy within the previous 12 months as a proportion of people that gave at least one reason. People ticked up to eight reasons given for the survey question ‘Have you used a pharmacy for any of the following in the last 12 months?’
Needle exchange Supervised methodone/subutex Medicines use review Prescription delivery service Blister pack/compliance aid Minor Ailment Scheme Emergency Hormonal Contraception Help to stop smoking Advice on where to go for other services Disposing of medicine you no longer need Advice on a more healthy lifestyle Advice on a long term health issue Advice on a current health problem
0% 10% 20% 30% 40% 50% 60% % of people attending by reason
Figure 15. Reasons for visiting a pharmacy within the previous 12 months as a proportion of people surveyed that provided at least one reason
However, 22% of those surveyed did not provide any answer to this question. This could be interpreted as they had not visited a pharmacy within the previous 12 months for any of the reasons listed or that they had not answered the question.
Finding a pharmacy closed during the previous 12 months 30% of the people surveyed found a pharmacy closed at least once during the previous 12 months. This ranged from 50% for those stating they visited a pharmacy daily to 26% visiting a pharmacy once a month. 30% of people visiting a pharmacy four times a year or less found a pharmacy closed at least once during the previous 12 months. People visiting a pharmacy very frequently are more likely to find it closed during a 12 month period. However, people visiting a pharmacy very infrequently may be visiting for an urgent reason (e.g. with an urgent antibiotic prescription) that may be outside usual hours. Figure 16 shows the number of people finding a pharmacy closed by weekday. The distribution is fairly balanced across the week with the highest number on Saturday.
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Can't remember
Bank Holiday
Sun
Sat
Fri
Thurs
Wed
Tues
Mon
0 5 10 15 20 25 30 35 40 Number of people finding a pharmacy closed by weekday
Figure 16. Number of days when pharmacy found closed by weekday
Figure 17 shows the number of people finding a pharmacy closed by time period during the day. The time periods where pharmacies were most frequently found to be closed were 9 am – 12 pm and 2 pm – 6 pm.
Can't remember
10pm - 6am
8pm - 10pm
6pm - 8pm
2pm - 6pm
12pm - 2pm
9am - 12pm
6am - 9am
0 5 10 15 20 25 30 35 40 45 Number of people finding a pharmacy closed by time period
Figure 17. Number of times when pharmacy found closed by time period
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Figure 18 shows the action taken by those finding a pharmacy closed. The majority waited for the pharmacy in question to open or used a different pharmacy. Indeed, if one excludes those who could not specify a time period, 91.5% of people did this. This suggests that most people visiting a pharmacy did so with the expectation that it would be open but that they either arrived a little early or the pharmacy opened a little late. Either way, people were happy to wait. Those that arrived after closing time were able to find another pharmacy. This probably explains the high numbers given for the two time periods above.
Can't remember
Went to hospital
Used NHS direct
Went to walk in centre
Used out of hours doctor
Went to doctor
Used a different pharmacy
Waited until pharmacy was open
0% 10% 20% 30% 40% 50% 60% Action taken when pharmacy found closed
Figure 18. Actions taken when pharmacy found closed
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Conclusion
This patient satisfaction survey provides an overview of patients and customers views of pharmacy services within Wigan Borough. As such it has several limitations. Firstly, it provides no specific information regarding individual pharmacies. Secondly, people surveyed were more likely to be people who attended pharmacies relatively frequently. Therefore, there is less information in regard to the occasional user as illustrated in Figure 12. Fourthly, since it was most convenient for people to complete the survey questionnaire while they were waiting for the dispensing of a prescription, there is likely to be an over representation of people attending a pharmacy to collect a prescription. This is certainly suggested in Figure 7 where around 85% of those surveyed (excluding those who did not provide an answer) did attend a pharmacy to collect a prescription. Finally, there is geographical variation in the number of responses provided by each pharmacy with the highest proportion of responses returned being provides by pharmacies within the Wigan North, Wigan Central and Leigh Service Delivery Footprints.
However, given the above limitations following can be stated:
1. In regard to the key service satisfaction questions, the majority of people were satisfied with the service that they received on the day they were surveyed with over 98% of people answering the questions given in Figure 10 as ‘Excellent’ or ‘Good’.
2. Over 97% of people answering the question were satisfied with the opening hours of their regular pharmacy or the one they used on the day surveyed (Figure 11).
3. Around 30% of people surveyed were faced with a closed pharmacy during the previous 12 months. However, over 90% either waited for the pharmacy to open or used a different pharmacy.
4. Most people surveyed either walked or used a car to travel to a pharmacy with over 90% having a travel time of no more than 20 minutes (Figure 14).
5. While most people surveyed were attending the pharmacy to collect a prescription it was clear that those surveyed used pharmacies for a wide diversity of reasons (Figures 7 and 15) including advice on a number of issues.
Local pharmacies provide a valuable service to the community as they can often provide advice and services that reduce the need to patients to seek other clinical services. In addition, when patients seek advice for what could be a serious condition pharmacy staff can advise patients to see their doctor or signpost them to another appropriate service. Despite its limitations, this survey does suggest that most people are very satisfied with the service they receive from local pharmacies.
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Appendix 1 Pharmaceutical Needs Assessment Public Questionnaire
Date Completed ______Time Completed ______
Why are you using the pharmacy today? Prescription To buy medication To buy other products Advice Minor Ailment Scheme Emergency Contraception (morning after pill) Stop Smoking Scheme Supervised Medicines Use Review Methadone/Subutex Needle Exchange Other Which of the following best describes how you use this pharmacy? This is the pharmacy I This is one of several This pharmacy was just
choose to visit if possible pharmacies I use convenient for me today How would you rate the service you received today? Excellent Good Average Poor Very poor Don’t know How would you rate the cleanliness and Tidiness of the pharmacy? Excellent Good Average Poor Very poor Don’t know How would you rate the helpfulness of the staff today? Excellent Good Average Poor Very poor Don’t know How would you rate the time taken for staff to serve you? Excellent Good Average Poor Very poor Don’t know How regularly do you visit a pharmacy (include any pharmacy you use not just the one you are using today)? Daily Weekly Monthly Every 3 months Twice a year Once a year or less How do you usually travel to your regular pharmacy, or, if you have no regular pharmacy the one you used today? Walk Cycle Public transport Taxi Car Other How long does it take you to get to the pharmacy by this method? 5 minutes or less 5-10 minutes 10-15 minutes 15-20 minutes 20-25 minutes More than 25 minutes Are you satisfied with the opening hours of your regular pharmacy, or, if you have no regular pharmacy the one you used today? Yes No
In the last 12 months have you wanted to use your regular pharmacy (or if you do not have a regular pharmacy the one most convenient to you) at a time when it was closed? Yes No If yes what day of the week was it? Tick all that apply Monday Tuesday Wednesday Thursday Friday Saturday Sunday Bank holiday Can’t remember If yes what time of the day was it? Tick all that apply Early morning 6am-9am Morning 9am-12pm Lunchtime 12pm-2pm Afternoon 2pm-6pm Evening 6pm-8pm Late evening 8pm-10pm Night 10pm-6am Can’t remember If yes what did you do? Tick all that apply Waited until pharmacy was Used a different Went to doctor open pharmacy Used out of hours doctor Went to walk in centre Used NHS direct Went to hospital Can’t remember Have you used a pharmacy for any of the following in the last 12 months? Tick all that apply Advice on a current health Advice on a long-term Advice on a more healthy problem health issue lifestyle Disposing of medicines you Advice on where to go Help to stop smoking no longer need for other services Emergency Contraception Blister pack/Compliance Minor Ailment Scheme (morning after pill) aid Prescription Delivery Medicines Use Review Supervised
Service Methadone/Subutex Needle Exchange Are you: Male Female Age: Under 16 16-24 25-44 45-59 60 or over Prefer not to say Ethnicity: White Asian or Asian British Black or Black British Chinese Mixed Other Prefer not to say What is your postcode?
Appendix 10 – Wigan Borough Health Profile 2017 (Public Health England)
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