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Making the Most of Your Local Pharmacy

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Making the Most of Your Local Pharmacy 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 Page | 2 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. Page | 3 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.
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