A Report on Feedback from Engagement Activities With

A report on feedback from engagement activities with residents of Horn Park estate about the use of primary care services and The Source A report prepared by Picker Institute Europe on behalf of NHS Greenwich Clinical Commissioning Group (Greenwich CCG)

Date: September 2016 www.pickereurope.org

Picker Institute Europe

Picker Institute Europe is an international charity dedicated to ensuring the highest quality health and social care for all, always. We are here to:

Influence policy and practice so that health and social care systems are always centred around people’s needs and preferences.

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Empower those working in health and social care to improve experiences by effectively measuring, and acting upon, people’s feedback.

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Contents

Background 1 The Source 2 Context 2 Engagement Activities 2 Methods 3 Results 4 Questionnaire Results 4 Respondent Demographic Profile 4 GP Surgeries 6 Views on GPs 7 The Source 9 Usage of the Source 9 Views on the Source 13 Transport and accessibility 16 Alternatives to the Source 17 Closing comments 18 Answering questions 19 Appendix 1: Survey Frequency Tables 20

Executive Summary Background The Source is a nurse led, ‘drop-in’ facility located on Horn Park Estate offering free confidential health care advice and services to people who live in or are registered with a GP in the Royal Borough of Greenwich. Due to financial constraints, Greenwich CCG is obliged to consider withdrawing funding for this service and therefore have sought to engage with a variety of stakeholders and the public to assess how such a closure might impact. This report provides an overview of the issues and themes raised to help inform the CCG’s decision making process.

Engagement activities Local partners and stakeholders (including NHS England and Royal Borough of Greenwich) were consulted, as were The Health Overview and Scrutiny Committee (HOSC). In addition, three public engagement sessions were held at the Horn Park Community Centre. Dedicated “Have Your Say” spaces at the Source, The Dutch (local Pub) and the Horn Park Community Centre were provided and an online and paper survey (designed and implemented by NHS Greenwich CCG) was administered (112 responses). In addition, there was a dedicated website page with information about The Source and engagement opportunities. Summary Overall, the Source is a highly valued service. Respondents speak favourably about the quality of the service, the range of services offered, the ease of getting an appointment and the importance of relieving the burden from GPs and local hospitals. There is no GP surgery on the estate and therefore The Source is felt to be invaluable to some. However, there are those who do not use it and this could be due to location, accessibility issues or simply lack of need. Results from all engagement activities highlighted the following positives about the service:

o Range and quality of services offered o Convenience and ease of getting an appointment o Friendliness and approachability of staff o Valuable resource for oversubscribed GP surgeries (GPs themselves refer patients to the Source also) o Continuity of care

There were some issues raised over the geographical location, because the estate is not well sourced in terms of public transport. This was both a positive and a negative: good for those on the estate but cited as a possible reason the Source is not accessed by those from outside the estate.

Concern was raised over the threatened closure that local needs would not be met, particularly around health prevention and self-management, and that existing GP surgeries would be even more pressurised as a result, without the Source to refer people to.

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Background

This report analyses and consolidates feedback from a number of engagement activities that took place in the Horn Park area about the use of primary care services and The Source.

The Source

The Source is a nurse led, walk in facility located on Horn Park Estate offering free confidential health care advice and services to people who live in or are registered with a GP in the Royal Borough of Greenwich. The service operates by drop-in, whereby no appointment is required.

The Source is popular with local residents who believe that the Horn Park Estate is geographically isolated with poor transport links. Services at the Source include:

Wound dressings

Sexual Health and contraception

Smoking cessation

Weight management

Childhood and influenza vaccinations

Healthy living and general health and wellbeing advice Context

NHS Greenwich Clinical Commissioning Group (Greenwich CCG) is currently facing a challenging financial position and obliged to significantly reduce its costs in order to return the organisation to financial balance by March 2017. This situation has required some difficult decisions including the Greenwich CCG not being in the position to fund services that fall outside its delegated authority. The services offered at The Source fall within the Primary Care contract managed by NHS England and outside the remit of Greenwich CCG. Engagement Activities

Following the proposal to withdraw funding for services at the Source, Greenwich Clinical Commissioning (CCG) has engaged with the following:

Local partners and stakeholders (including NHS England and Royal Borough of Greenwich) on July 20th who confirmed that they would be unable to fund current services at the Source.

Local GP practices near The Source who gave assurances that practices would accommodate the additional demand from Horn Park estate should The Source no longer be available

The Health Overview and Scrutiny Committee (HOSC)

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In addition to the above, the communications and engagement team organised the following:

Three Public engagement sessions at the Horn Park Community Centre (24th August, 7th and 13th September)

Dedicated “Have Your Say” spaces at the Source, The Dutch (local Pub) and the Horn Park Community Centre

An online survey available until 19th September (designed and implemented by NHS Greenwich CCG)

Website page with information about The Source and engagement opportunities Methods

This report provides an overview of issues and themes raised from the engagement data as well as responses to specific questions in the questionnaires.

The purpose of the report is to help inform the CCG’s decision around the future of the Source and also to help the CCG understand areas for further development that may assist the commissioning of future improvements to local healthcare services for patients.

All fieldwork, survey development and implementation was conducted by NHS Greenwich CCG. Feedback from the different sources was submitted to the Picker Institute – these comprised:

 Data file with 52 results from on-line survey  60 additional paper versions (scanned) of the questionnaire  Qualitative feedback from open ended questions on both online and paper surveys  Qualitative feedback from interviews/discussions conducted by NHS Greenwich CCG staff members  Qualitative feedback received via email and other sources

Existing data from the on-line version of the survey were checked and cleaned, and then merged with the data that had been gathered from the paper questionnaires. Charts and tables were created and an overview of the quantitative findings produced, including respondent profile and characteristics. These results were then presented alongside the qualitative data in order to produce an overall picture of the usage of primary care services in the area, including the Source.

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Results

Questionnaire Results The survey questionnaire, designed and administered by NHS Greenwich CCG, was administered via an on-line survey, and a paper survey, handed out at a number of events and locations around the Horn Park Estate.

The questionnaire yielded a total of 112 responses, 54% (n=60) of which were paper returns and 46% (n=52) were completed online. The data from both methods was combined and results analysed together.

Table: Survey Responses by Methodology

Frequency/ Percent number Online Survey 52 46.4% Paper Survey 60 53.6% Total 112 100%

Respondent Demographic Profile The demographics of survey respondents are displayed in the below table. More females (76%; n=73) than males (24%; n=23) responded to the survey, and almost a third (32%; n=30) of respondents were aged 65 and above. Over a quarter of respondents (27%; n=30) had a long-term health condition, other than those specified in the questionnaire. Table: Demographic characteristics of respondents

Respondent characteristic Frequency/number Percent

Gender Male 23 24% Female 73 76%

Age 18 – 24 years 11 12% 25 – 44 years 28 29% 45 – 54 years 17 18% 55 – 64 years 10 10% 65 – 74 years 16 17% 75 years and above 14 15%

Ethnicity Black African or Caribbean 3 3% Mixed 3 3% Other 3 3% Prefer not to say 4 4%

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White (British, Irish, Other) 83 87%

Long-term conditions Physical Impairment 18 16% Sensory Impairment 11 10% Learning disability 4 4% Mental health condition 12 11% Other long-term health condition 30 27% Prefer not to say 12 11%

The majority of responses to the survey (92%; n=97) were made in a personal capacity, with only 3% (n=3) of responses being provided from a carers’ perspective. A further six percent of responses (n=6) were made as a representative of a group.

Q1. I am providing a response…

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GP Surgeries

Horn Park estate does not have its’ own GP surgery, so residents register at a number of different surgeries in the area. From the quantitative survey, 94% (n=103) of respondents said that they were registered with a GP Surgery. 6% (n=7) are not currently registered. Of those who were registered, 39% (n=25) were with Eltham Medical Practice, followed by both Sherard Road Medical Centre (22%; n=14) and Eltham Palace Surgery (22%; n=14).

Q2. Are you registered with a GP Surgery?

Q2a. What surgery are you registered with? (coded)

Surgery Frequency Percent

Baring Road Medical Clinic 2 3.1 Burnt Ash Surgery 2 3.1 Eltham Medical Practice 25 39.1 Eltham Palace Surgery 14 21.9 Eltham Park Surgery 1 1.6 Henley Cross Medical Centre 3 4.7 Nightingale Surgery 3 4.7 Sherard Road Medical Centre 14 21.9 Total 64 100.0 Missing 48

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Views on GPs Residents fed back their views on GPs in a number of ways – the overall feeling seemed to be that GPs were oversubscribed and difficult to access in terms of both gaining appointments as well as geographically.

Appointments

Some of the responses appear to suggest a general frustration in getting an appointment with the GP, with difficulty getting through on the phone and some having to wait weeks to be seen. “Although I have an excellent GP, it is often difficult to get an immediate appointment.”

“it’s difficult to access my GP, there is a phone back service at 4pm, there is a 3 week wait for an appointment”.

“we are unable to access our GP on the day (for appointments)…it’s difficult to get in contact with anyone”

Another respondent appeared to be satisfied that she was able to get an appointment, although had to call at specific times: “To get an on the day appointment you need to ring at 8.15 or 2.15 and you do get an appointment.”

GP surgeries in the locality seem to be oversubscribed and sometimes short staffed leading to long waits. “A lot of people here are elderly and have no access to their GP's on a regular basis and with too many patients on GP's book the waits are excessive without even factoring in accessibility issue”

Attitude of staff

Whilst some respondents seemed happy with their GPs, and with the service they received once they were able to see them, staff attitude appeared to be a concern to some respondents: “I've practically given up on my GP surgery who seem to employ the rudest staff they can find, and the stress of dealing with them was too much.”

Some of the views given noted that GP’s can be unfriendly and disengaged with difficult receptionists: “GP atmosphere is cold, not friendly, doctors don't sound enthusiastic.”

“All doctors new and don't tell you. Receptionist (GP) insists on being told everything about [you].

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Lack of nurses

Some respondents noted difficulties in getting to see the nurse at their GP surgery as she is “never available” which was supported by the views of others who noted that there aren’t enough nurses at GP practices.

To support this, from the survey it can be seen that 79% (n=85) of respondents have needed to see the practice nurse at their GP surgery in the last 12 months but of those respondents, 58% (n=48) have found it difficult to get an appointment with a practice nurse. Only 12% (n=10) found it easy and 10% (n=8) found it very easy. [NB please note this question does not establish how long they had to wait for their appointment with the nurse]

Q3. Have you needed to see the practice nurse at your GP surgery in the last 12 months?

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Q3a. How easy was it to get an appointment with your practice nurse? (answered by those who have seen a nurse within the last 12 months)

The Source

Usage of the Source 84% (n=91) of respondents said they have used The Source and of those, 53% (n=48) have used it 0-5 times in the last 12 months and 47% (n=43) have used it over 5 times in the last 12 months. Full responses to this question are displayed in the graph below.

Q4. Have you ever used The Source?

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Q4a. If yes, how many times in the last 12 months? (answered by those who have used The Source previously)

80% (n=78) of respondents care for someone who has used The Source. Of those respondents, 55% (n=41) say that the person they care for has used The Source between 0- 5 times and 45% (n=33) say they have used it over 5 times within the last 12 months. Full responses to this question are displayed in the graph below.

Q5. Has someone you care for ever used The Source?

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Q5a. If yes, how many times in the last 12 months? (Answered by those who care for someone that has used The Source)

Survey respondents were asked to rank how important a series of services were for Horn Park Estate. The services were:

Wound dressings

General advice

Sexual health and contraception

Smoking cessation

Weight management

Other

General advice was viewed as the most important service with over three quarters of respondents (76%; n=71) rating this as ‘5’ – most important. This was closely followed by ‘other’ services where 73% (n=49) perceived these ‘other’ services to be ‘very important’. [NB Unfortunately this question did not have a freetext box for respondents to specify exactly which services were most important].

The least important services were weight management and smoking cessation, with the greatest proportion of respondents stating these services were the least important to them (14% for weight management and 19% for smoking cessation). However, this may have been because they did not have a need for this particular service.

Full responses to this question are displayed in the graph below.

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Q7a-e. On a scale of 1 (least important) to 5 (very important), please help us prioritise the following services for Horn Park Estate

An average ranking was calculated for each service. This demonstrated that the most important service to respondents, with a mean ranking of 4.61, was ‘General advice’, and the least important services were smoking cessation with a mean ranking of 3.66, and weight management with a mean of 3.77 [NB as there was not a ‘not applicable’ option this may be because it was something that the respondent did not need]

Table: Mean ranking for Q7a-e. ‘On a scale of 1 (least important) to 5 (very important), please help us prioritise the following services for Horn Park Estate’

Number of Mean ranking responses

General advice 94 4.61 Other 67 4.58 Wound dressings 93 4.23 Sexual health and contraception 80 4.05

Weight management 84 3.67 Smoking cessation 80 3.66

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Variety of services

The qualitative feedback given also mentions the many reasons that people come to the Source – these include: Sexual Health issues including smear tests and contraception

Minor injuries

‘Straightforward’ prescriptions and some antibiotics

Day to day management of long-term conditions (e.g. asthma/ diabetes)

Vaccinations including baby vaccines

Minor injuries (including insect bites etc.)

There are also other services suggested by respondents that the public may benefit from if the Source could provide these in the future – these include blood tests, X rays and ECGs.

As one respondent noted, The Source is able to provide access to a variety of services by being nurse-led:

“The Source provides a nurse with numerous skills so that can provide lots of different services for patients. The nurses at the Source are also prescribers.”

“Nurses at the Source have more of the skills than the nurses at the GP”

Views on the Source One of the clear advantages of the Source, coming through from the qualitative feedback, is the ‘drop-in’ / walk-in centre nature of the clinic. Many benefits of this were listed, and included: Convenience/Flexibility

The Source’s walk-in service offers convenience for the local community – it is felt that it is a service available for all – from babies through to OAPs – with teenagers reporting them as approachable and friendly. “I believe closing this place will result in a rise in teenage pregnancies, they are the friendliest team I have dealt with while getting the contraception pill. I come all the way from Woolwich and know other people that travel from that far as its easier etc. than going to the doctors. I do hope the source stays open for a number of reasons as this does not only help teenagers, or people like me, they also do other services from babies to OAPs”

Working mothers in particular have reported the service as being important to them, as it offers flexibility around working and family life;

“I rely on The Sources' drop in service, as a working mother as there is no other such provision around for my children. I have no doubt that the health of

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the local community will be negatively affected by its’ closure, particularly in families where income needs warrant a ‘flexible health service provision”

“I have found the service to be invaluable in providing a means to ensure the health of my children….flexibly around my working life, where it was difficult to get doctors’ appointments”

It was also used regularly by some patients with long term conditions and carers.

“I suffered back problems in caring for my wife, I did not feel supported (by GP practice) but the staff at the Source were there”

Access and availability

Feedback suggests that the ability to get an ‘on the day’ appointment was one of the major strengths of the Source, something that is very hard to get at their GP surgeries. “I have used the source in the past when I have been unable to get a GP appointment. I have also used it when it's easier to 'walk in' there than to try to get a GP appointment (knowing that I'll have to wait a few weeks)”

This is echoed by another respondent who found it helpful not to have to make a pre- arranged appointment for her asthmatic son: “One of my sons has asthma and having The Source on the estate is a big help for me/ him - if he needs to see someone I can go straight in and not have to make an appointment at the GP's and wait a week.”

Relieves pressure on GPs and local hospitals

There was a strong feeling that, as well as being a valuable service for the local community, the services offered at the Source help to relieve pressures on oversubscribed GPs as well as local hospital resources, particularly when dealing with issues such as minor injuries: “This is an important first port of call before trying to get a GP's appointment or bothering the already overworked hospitals when it may not be required.”

“I have also had instances where there were no available doctor appointments for the children for other health needs and was able to rely on the Source for my children to be treated, avoiding trips to, and pressures on, hospital resources”.

“The Source is essential – not only does it ease pressure on already strained GPs it makes everyone’s lives that use it that little but more manageable”

Another respondent stated that “Keeping the service means less stress on hospitals”.

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It would seem that the Source also acts as a vital resource for GPs too, with a number of comments referring to the fact that the GPs themselves refer patients to the Source: “When you need to see a practice nurse quickly at my GP surgery, they just say – go to The Source” “Receptionists are the ones sending people to the Source”

“Other GP surgeries are sending people there for wound dressings”

“…within Sherard Road surgery there are posters up signposting people to attend the Source”.

Reliability and Efficiency

The Source appears to offer patients reliability (as one noted “we rely on the service”) and a quick and efficient service:

“The Source offers a lot of services and everyone who lives in or around Horn Park would rather come to the Source instead of their GP because the Source is reliable and sees you quickly.”

Similarly, another respondent commented:

“I rely on the source for all manner of regular assistance that going to my GP would take months”

“Access to a nurse as and when is needed to sort issues, perhaps minor, that may not require a GP”

Physical access

Some feedback suggested that the Source is easier to get to for older people and disabled people living on the estate: ”For older people and disabled people it is easier to attend directly because it’s close”.

Another said: “As a carer I find it was easier to get my mother to the Source in her wheelchair than taking her all the way to Eltham on and off buses as I do not drive”

However, there were some mentions of the Source not being fully accessible as it was not wheelchair and mobility scooter accessible and this precludes some people from using it. “I have never used the Source. Can’t get me and my scooter in there”

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Quality of service and consistency of staff

There were a number of especially positive comments around the quality of service – respondents felt that the staff were efficient, supportive and provided continuity of care:

“At my GP surgery you see new faces all the time, you can’t get to know them but at the Source you see the same staff and they are all very warm and helpful”. “I used the Source while visiting relatives and found the staff very efficient and courteous but also very professional in their manner” The Source are fabulous - excellent care, friendly and excellent staff and care

The staff also seemed to have more time to listen to patients and weren’t rushed:

“Has time to listen to you. Personal care of staff – The Source” “GP - only 10 minutes consultation. The Source - as long as it takes.

Many spoke very positively about the Source and it was even described by some as a ‘lifeline’:

“To close The Source down is wrong it is a lifeline to many people,”

“My son is disabled. The Source has been a lifeline in treating him and enabling less disruption in his life.”

In addition, there was even one suggestion that the Source has had an effect on quality of life: “I've never received such great medical care and advice in my life and this small clinic has made my life so much easier and less stressful”

Transport and accessibility

Horn Park is not served by its own GP surgery and it is referred to as ‘The forgotten estate’ by a few, indicating that they feel the estate is cut off. “It’s like we are the forgotten estate – very edge of the borough and cut off from the borough” “Used to have GP, pharmacy, midwife - now no services if Source is closed”.

46% (n=51) of survey respondents travel to their GP surgery by car, followed by 37% (n=41) who travel by bus. Getting to the surgery by taxi appears to be the least popular.

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Q2b. How do you currently get to your GP Surgery? (select ALL that apply)

Public transport links to and from the estate are fairly sparse which perhaps is a reason why some people are not using the Source from further afield. However, to those on the estate itself it is a really valuable resource. “Firmly believe healthcare should be accessible to those who are less able/ marginalised more than other estates” “This affects me and it takes 2 buses to get to my GP surgery in Eltham and then we have to walk to the surgery. Don't close The Source because what are we going to do?”

Alternatives to the Source With The Source threatened with closure, many are unsure of, or unconvinced by, the alternative options. “We want to know that alternative options are in place before the Source closes” Some mention using Eltham Community Hospital as a potential alternative, but this is not always satisfactory, and there is currently no walk in service. “I would use Eltham (community hospital) if it had a walk in service available”.

“Eltham community hospital has not lived up to our expectations, we thought it would be able to cover most things, If more services were available at Eltham it would be better” “Need alternative service such as ELH prior to closure.”

Some mentioned the need for a good quality pharmacist in the locality who could perhaps provide some of the services:

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“We need a good quality local pharmacist…I attended my pharmacist for a flu vaccine, it (the room) was not very clinical, I had a reaction afterwards and that has never happened before”

“We could do with a pharmacy on the estate as well but for the time being we need to focus on the Source and keeping it up and running”

37% (n=41) of survey respondents travel by car to get to their local pharmacy followed by getting the bus (32%; n=36). Currently only a quarter of respondents walk to their pharmacy, suggesting that perhaps a more local pharmacy was needed.

Q6a. How do you currently get to your local pharmacy? (select ALL that apply)

Closing comments

Overall, the Source is a much valued service by those who use it. Respondents speak highly about the quality of the service, the range of services offered, the ease of getting an appointment and the importance of relieving the burden from GPs and local hospitals. However, there are some who do not use it due to geographical location, accessibility issues or simply lack of need.

The threatened closure has prompted a number of strong comments around the needs of the community, and the feeling that local needs would no longer be met, in particular around health prevention and self-management.

“There is a need for local NHS provision to match local need”

“At a time when we are all being encouraged to take more responsibility for own wellbeing, it seems both short-sighted and counter-productive to remove such a valuable asset from an area where there is a high level of need”

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“A continuation of nurse led medical services and public health prevention services is essential for all in an area that is not served by a GP surgery - and in some ways this mix of medical/prevention is better than a GP surgery.”

Some acknowledged that the Source is currently underutilised and that the closure is to do with funding – however, some suggest alternatives to closure. These include expanding the range of services offered and investigating other funding options: “Appreciate it is a funding issue. The Source is underutilised. A number of GP practices 'rent out' rooms to charities who offer bereavement support etc. Also drug/ alcohol support many services could be put in to support the older people and families with small children. We do not have a sure start centre. There are pockets of funding available. Drug and alcohol services particularly through court orders for treatment - the organisations responsible would jump at the chance to provide local 'anonymous' services. It would be a good idea to employ someone for 6 months to investigate and put into place funding pots - they do still exist, just a bit more obscure” “The Source is a valuable service that could be increased with use of empty buildings next door which could be used for many usages. X-Ray, ECG because they are portable. Leg ulcer clinic, weight, bereavement. 10.5 day clinic would pay for itself over time many more things could be achieved. We need the Source, the Source needs us.”

Answering questions There are still many unanswered questions that the public have around the proposed closure of the source, many to do with funding: “What happens to the money GPs do not use?” “How much money will be saved if the Source is closed?”

“Where does our money go? We pay taxes but yet you take everything away from us and give to every other estates” “What is the cost absorbed by the GPs if taking on the source?”

There were also mixed reactions to the proposal that a GP surgery is put on the site of the Source – some felt that it wouldn’t make a difference, and there was concern that the same problems may occur around appointments and registration if it lost its’ walk-in nature. “If you are not with that Surgery and a branch is created there how we will be able to see them? It is the same thing over again with what will deal at our surgeries now.”

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Appendix 1: Survey Frequency Tables

Responses (number and percentage) to each survey question are displayed in the frequency tables below.

Q1. I am providing a response…

Frequency Percent A carer 3 2.8 As a representative of group 6 5.7 In personal capacity 97 91.5 Total 106 100.0 Missing 6

Q2. Are you registered with a GP Surgery?

Frequency Percent No 7 6.4 Yes 103 93.6 Total 110 100.0 Missing 2

Q2B_NEW QUESTION. Surgery

Frequency Percent Baring Road Medical Clinic 2 3.1 Burnt Ash Surgery 2 3.1 Eltham Medical Practice 25 39.1 Eltham Palace Surgery 14 21.9 Eltham Park Surgery 1 1.6 Henley Cross Medical Centre 3 4.7 Nightingale Surgery 3 4.7 Sherard Road Medical Centre 14 21.9 Total 64 100.0 Missing 48

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Q2b. How do you currently get to your GP Surgery? (select ALL that apply)

Frequency Percent By Car 51 46 By Bus 41 37 By Taxi/Cab 4 4 Walk 29 26 Total 112

Q3. Have you needed to see the practice nurse at your GP surgery in the last 12 months?

Frequency Percent No (n=23) 23 21.3 Yes (n=85) 85 78.7 Total 108 100.0 Missing 4

Q3a. How easy was it to get an appointment with your practice nurse? (answered by those who have seen a nurse within the last 12 months)

Frequency Percent Very easy (n=8) 8 9.6 Easy (n=10) 10 12.0 Okay (n=17) 17 20.5 Difficult ((n=48) 48 57.8 Total 83 100.0 Missing 2

Q4. Have you ever used The Source?

Frequency Percent Yes (n=91) 91 84.3 No (n=17) 17 15.7 Total 108 100.0 Missing 4

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Q4a. If yes, how many times in the last 12 months? (answered by those who have used The Source previously)

Frequency Percent 0-5 times (n=48) 48 52.7 Over 5 times (n=43) 43 47.3 Total 91 100.0 Missing 99 0

Q5. Has someone you care for ever used The Source?

Frequency Percent No (n=20) 20 20.4 Yes (n=78) 78 79.6 Total 98 100.0 Missing 14

Q5a. If yes, how many times in the last 12 months? (Answered by those who care for someone that has used The Source)

Frequency Percent 0-5 times 41 55.4 Over 5 times 33 44.6 Total 74 100.0 Missing 4

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Q2B_Q6. Which local pharmacy do you use to obtain repeat prescriptions and over the counter medicines? (CODED from freetext)

Frequency Percent Baring Road 1 1.3 Boots 19 24.7 Chemcare Pharmacy 1 1.3 Co-op 2 2.6 Courd Yard 1 1.3 Court Road 1 1.3 Dickinsons 2 2.6 Eltham 5 6.5 Gokal Chemist 2 2.6 Greenwich 2 2.6 Grove Park Pharmacy 1 1.3 Lee Pharmacy 7 9.1 Mangal Pharmacy 5 6.5 Newmarket Pharmacy 6 7.8 Sainsburys 10 13.0 Well Pharmacy 12 15.6 Total 77 100.0 Missing 35

Q6a. How do you currently get to your local pharmacy? (select ALL that apply)

Frequency Percent By Car 41 36.6 By Bus 36 32.1 By Taxi/Cab 1 .9 Walk 28 25.0 Total 106

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Q7_a. On a scale of 1 (least important) to 5 (most important) please help us to prioritise the following services for Horn Park estate. WOUND DRESSINGS

Frequency Percent 1 4 4.3 2 6 6.5 3 13 14.0 4 12 12.9 5 58 62.4 Total 93 100.0 Missing 19

Q7_b. On a scale of 1 (least important) to 5 (most important) please help us to prioritise the following services for Horn Park estate. GENERAL ADVICE

Frequency Percent 1 0 0.0 2 2 2.1 3 10 10.6 4 11 11.7 5 71 75.5 Total 94 100.0 Missing 18

Q7_c. On a scale of 1 (least important) to 5 (most important) please help us to prioritise the following services for Horn Park estate. SEXUAL HEALTH AND CONTRACEPTION

Frequency Percent 1 8 10.0 2 2 2.5 3 12 15.0 4 14 17.5 5 44 55.0 Total 80 100.0 Missing 32

P3116 | Greenwich The Source | LT BH | 290916| v3.0 Protect

Q7_d. On a scale of 1 (least important) to 5 (most important) please help us to prioritise the following services for Horn Park estate. SMOKING CESSATION

Frequency Percent 1 15 18.8 2 4 5.0 3 10 12.5 4 15 18.8 5 36 45.0 Total 80 100.0 Missing 32

Q7_e. On a scale of 1 (least important) to 5 (most important) please help us to prioritise the following services for Horn Park estate. WEIGHT MANAGEMENT

Frequency Percent 1 12 14.3 2 7 8.3 3 17 20.2 4 9 10.7 5 39 46.4 Total 84 100.0 Missing 28

Q7_f. On a scale of 1 (least important) to 5 (most important) please help us to prioritise the following services for Horn Park estate. OTHER

Frequency Percent 1 0 0.0 2 1 1.5 3 8 11.9 4 9 13.4 5 49 73.1 Total 67 100.0 Missing 45

P3116 | Greenwich The Source | LT BH | 290916| v3.0 Protect

Q9. To which of the following age groups do you belong?

Frequency Percent 18-24 11 11.5 25-44 28 29.2 45-54 17 17.7 55-64 10 10.4 65-74 16 16.7 75+ 14 14.6 Total 96 100.0 Missing 16

Q10. How would you describe your ethnicity?

Frequency Percent Black African or Caribbean 3 3.1 Mixed 3 3.1 Other 3 3.1 Prefer not to say 4 4.2 White (British, Irish, Other) 83 86.5 Total 96 100.0 Missing 16

Q11a. Do you consider yourself to have any of the following conditions? (select ALL that apply)

Frequency Percent Physical Impairment 18 16.1 Sensory Impairment 11 9.8 Learning disability 4 3.6 Mental health condition 12 10.7 Other long-term health condition 30 26.8 Prefer not to say 12 10.7

Q12. Gender

Frequency Percent Female 73 76.0 Male 23 24.0 Total 96 100.0 Missing 16

P3116 | Greenwich The Source | LT BH | 290916| v3.0 Protect

Respondent demographics Q9. To which of the following age groups do you belong?

Q10. How would you describe your ethnicity?

P3116 | Greenwich The Source | LT BH | 290916| v3.0 Protect

Q11a. Do you consider yourself to have any of the following conditions? (select ALL that apply)

Q12. Gender

P3116 | Greenwich The Source | LT BH | 290916| v3.0 Protect

Q6. Which local pharmacy do you use to obtain repeat prescriptions and over the counter medicines? (CODED from freetext)

P3116 | Greenwich The Source | LT BH | 290916| v3.0 Protect