Pharmaceutical Needs Assessment

31st January 2011 PHARMACEUTICAL NEEDS ASSESSMENT

Welcome ...... 1 1 What are pharmaceutical services? ...... 2 2 What is a pharmacy needs assessment? ...... 2 3 What is the pharmacy needs assessment for? ...... 3 4 Executive summary...... 4 5 The population: General overview...... 4 5 1. Age ...... 5 5 .2 Life expectancy ...... 5 5 .3 Ethnicity ...... 5 5 4. Deprivation ...... 5 6 Health profile of Leeds ...... 6 6 1. Causes of ill health ...... 6 6 1. 1. Alcohol ...... 6 6 1. .2 Drugs ...... 6 6 1. .3 Smoking ...... 7 6 1. 4. Sexual health ...... 7 6 1. 5. Obesity ...... 8 6 .2 Long term health conditions ...... 8 6 .2 1. Diabetes ...... 8 6 .2 .2 Chronic obstructive pulmonary disease ...... 9 6 .2 .3 Coronary heart disease ...... 9 6 .2 4. Mental health ...... 9 6 .3 Mortality ...... 10 6 .3 1. infant mortality ...... 12 6 .3 .2 circulatory disease mortality ...... 12 6 .3 .3 cancer mortality...... 12 6 .3 4. Chronic obstructive pulmonary disease mortality...... 13 7 Health service provision in Leeds ...... 13 7 1. Acute and tertiary services ...... 13 7 .2 Primary care services ...... 13 7 .3 Other primary care services ...... 14 7 4. NHS Leeds community healthcare services ...... 14 7 5. Drug and alcohol treatment services ...... 15 8 Current pharmaceutical provision in Leeds ...... 15 9 Ward summary and profiles ...... 22 10 Current summary of identified pharmaceutical need ...... 23 11 Further possible pharmaceutical services in Leeds ...... 86 12 Conclusions ...... 89 13 Acknowledgments ...... 89 PNA development group ...... x Medical director /executive sponsor ...... x 12 References ...... 90 13 Appendices ...... 91 14 Glossary of terms/abbreviation ...... 113 Welcome

NHS Leeds is the organisation responsible for ensuring that the city’s health services meet the needs of local people. With a budget of over £1 billion NHS Leeds is one of the largest primary care trusts in the UK. NHS Leeds is an ambitious organisation committed to adding years to life and life to years for the people of Leeds . We have a clear and well recognised vision: “To improve health and wellbeing, reduce inequalities and transform health services for the people of Leeds by working with others and being a leading edge organisation ”. Leeds is the third largest city in the UK with a population of approximately 800,000 made up of people from a diverse range of communities, cultures and ethnicities . The resident population continues to grow, with plans to expand city centre housing, and reflects the increasing levels of wealth in some parts of the city . Whilst there has been improvement in the health of the population as a whole, there has been little change in the areas of the city that experience the worst health . About one in five people in Leeds live in neighbourhoods that are amongst the 10 percent most deprived in the country . This means that residents in these areas live an average of eight to ten years less than those in wealthier areas . This Pharmaceutical Needs Assessment (PNA) uses data based on the 33 electoral wards of Leeds, which vary in size from small, densely populated inner city areas to more rural parts of the city . Generally around 20,000 people live in each of the ward areas . For some specific health data the needs assessment focuses in further to neighbourhood levels known as super output areas . In this assessment, an overview of the has been provided along with individual breakdowns of each ward and a small description of the population characteristics, the key health issues and the current service provision .

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1 What are pharmaceutical 2 What is a Pharmaceutical services? Needs Assessment (PNA)? A full range of pharmaceutical services are provided Under the NHS Act 2006, all primary care trusts in by community pharmacies . Some elements of are required to produce a pharmaceutical pharmaceutical services are provided through other needs assessment (PNA) . The current Government’s mechanisms such as GP practices in rural areas or pharmacy White Paper “Pharmacy in England: sexual health clinics . Building on Strengths-delivering the future” also There are three categories of pharmaceutical expects all primary care trusts to have undertaken services . These are: this assessment and to use it as a framework for commissioning pharmacy services . Essential services which include dispensing, repeat dispensing, disposal of unwanted medicines, NHS Leeds, working in conjunction with partner support for self care, signposting, public health and organisations like the Leeds Local Pharmaceutical clinical governance . Committee, has developed this PNA using information from a wide range of sources . It tells Advanced services which include medicines us what pharmaceutical services are currently use review, prescription intervention, stoma available in the city and where we are likely to need customisation and appliance use review . these services in the future because of changes to Enhanced services which are services needed in the health or geographical location of the Leeds specific areas of the city to improve the health population . of people in that area . These can include stop Using this assessment, NHS Leeds will be able to smoking services, chlamydia testing and minor make sure that any future pharmaceutical services ailments schemes . that are commissioned for Leeds over the next few Essential and advanced services can be provided years will be based on the information provided by community pharmacies or dispensing appliance in this document . The technical term for this is contractors (who deal with dressings, catheter and “supporting the control of entry and pharmacy other appliances but not medicines) . Enhanced application process ”. It means that anyone wishing services under the NHS (pharmaceutical Services) to open a new pharmacy in Leeds in the future Regulations 2005 can only be supplied by will have to apply based on their plans to meet the community pharmacies, but similar services are needs of local people, which are identified in this often provided by GP practices . document . The PNA provides clarity and direction about which enhanced and advanced services should be commissioned from pharmacy applications granted under the exempt categories . The PNA is also used to inform the decision-making process of the NHS Leeds Pharmacy Applications Panel . This group reviews and approves pharmacy applications, as appropriate, which are received by NHS Leeds . The PNA was developed in line with national guidance . The process adopted by NHS Leeds is outlined in Appendix 1 .

2 3 What is this Pharmacy The preparation and consultation of PNA has taken account of the JSNA and five year strategic plan . Needs Assessment for? Part of the work undertaken to develop the JSNA has been used in order to prevent duplication This Pharmacy Needs Assessment (PNA): of work and multiple consultations with health • identifies any gaps in current pharmaceutical groups, patients and the public . The publication of services provided in Leeds and will ensure that this PNA in Leeds will inform subsequent revisions services commissioned in the near future meet of the Leeds JSNA . these needs; and The second objective is to ensure this PNA enables • contributes to reducing health inequalities in NHS Leeds to: Leeds by ensuring the right pharmaceutical • make appropriate decisions regarding services are in the right place to meet health applications for NHS pharmacy contracts in the needs . PCT boundary; This PNA will contribute to ensuring pharmaceutical • commission appropriate and accessible services services are of better quality; that they are more to help meet the health needs of the local effective in improving people’s health; and that population; they provide better value for money for the NHS • clearly identify and address any local gaps in and the taxpayer . pharmaceutical services; In line with the findings of the PNA our next • stipulate the range of services required from new objectives as a commissioning organisation will be “exempt” pharmacy applications (e g. . 100-hour to; pharmacies) should this clause remain in future Firstly ensure that any pharmaceutical revised regulations; commissioning takes into account the following: • contribute to the reduction of health inequalities; • the pharmaceutical needs of the local population • contribute to closer working relationships with due regard to the health needs and between different groups of independent wellbeing of the population as outlined in the contractors and healthcare professionals; and Leeds Joint Services Needs Assessment (JSNA);1 • make appropriate commissioning decisions in • current priorities, local and national targets; relation to Essential Small Pharmacies Local • appropriate national and local guidance, Pharmaceutical Scheme (ESPSLPS) . including relevant PNA guidance; • the opinions of local people sought via consultation; • the existing pharmaceutical services provided and commissioned locally; • the opportunities available via the community pharmacy contractual framework and the pharmacy “Control of Entry” rules 2005 and as amended; • the opportunities available to commission services via GP-led commissioning; • the community development agenda and joint working with the local authority and; 1 Implementing the Joint Strategic Needs Assessment • the environment of local pharmacies (2008) available online : http://www leeds. nhs. uk/. and pharmacists, and the full range of Downloads/Public%20Health/Implementing%20 pharmaceutical services they may provide; the%20Leeds%20Joint%20Strategic%20Needs%20 Assessment%20Framework%202009 pdf.

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4 Executive Summary 5 The Leeds population This PNA document outlines the current services General overview available, an overview of the local health profile Leeds has an approximate population of 800,000 . highlighting future needs, details of current This figure is taken from the GP practice registers community pharmacy services provided in Leeds in April 2010 so does not include people who and the pharmaceutical needs identified . It is were not registered with a GP practice at this time . also designed to lead to improved outcomes and However, it gives us a good idea of the numbers of reductions in health inequalities . people living in the city . The PNA was developed in line with national Most of the data used to inform this PNA is broken guidance . It includes comments from patients, the down into the 33 wards in the public and current pharmaceutical and healthcare area . These are: providers who were consulted on the development • Adel and Wharfedale of this document during 2010 . • The PNA will be used as a tool in commissioning • Ardsley and Robin Hood decisions for new pharmacy services, where the • Armley clinical resource within community pharmacy can • Beeston and Holbeck be used to maximum effect in meeting the health • Bramley and Stanningley needs of the Leeds population . • Burmantofts and Richmond Hill The PNA should be read in conjunction with the • Calverley and Farsley Joint Strategic Needs Assessment (2009) although, • Chapel Allerton where possible, the most recent available data has • City and Hunslet been used to give the most accurate picture of the city’s health to date . • Crossgates and Whinmoor • Farnley and Wortley There are few areas of the city without access to • Garforth and Swillington pharmaceutical services within one mile of where people live or work . • and • Guiseley and Rawdon The range of services provided is good . However, • it would be beneficial if pharmacies provided additional services, including harm reduction • Headingley interventions for people misusing drugs and alcohol • Horsforth as well as smoking cessation services especially in • Hyde Park and Woodhouse the most deprived wards . • Killingbeck and There is potential for pharmacy to have a much • Kippax and Methley greater role in reducing health inequalities, • Kirkstall particularly in case finding patients with diabetes, • Middleton Park respiratory conditions and those at high risk of • Moortown developing cardiovascular disease . • Morley North A summary of health needs and how community • Morley South pharmacies could contribute to meeting these • and Yeadon needs is identified throughout the document . • Pudsey Pharmaceutical provision across the city seven days • Rothwell a week is good . However, the need for extended • hours pharmaceutical provision should be reviewed • Temple Newsam regularly and only the hours and services needed • Weetwood should be commissioned . • See Appendix 2 for Ward map

4 5.1 Age • Men in Harewood live an average of ten years According to information from the Office of longer than men from the City and Hunslet National Statistics, the population of Leeds is likely ward . to increase to by 9 .2 percent to a population of (Public Health Annual Report 20093) . 878,700 by 20182 . The national inequalities target for primary care Around 86 percent of the Leeds population are trusts in England aims to increase the average life currently under 65 years of age . Within this: expectancy at birth to 78 6. years for men and • Almost six percent are aged under five years old . to 82 5. years for women . The aim is to reduce health inequalities, which will be measured by • 26 percent are aged 15-29 years old . This is a this life expectancy and by the number of deaths significantly higher proportion of people in this in children under one year old (known as infant age range compared to a national average of mortality) . nearly 20 percent and is contributed to by a significant student population . An estimated 5.3 Ethnicity 200,000 students study in the city and many The 2001 census for Leeds recorded that 78,000 move away during the holiday periods leading to people living in the city at that time were from a transient (or “shifting”) population . black or minority ethnic (BME) communities . This Nearly 15 percent of people currently living in Leeds represents 10 .8 percent of the resident population . are over 65 which is slightly below both national The BME population is also expected to rise by and local averages . The 2001 census showed that 55 percent by 2030 . Work done by Leeds School over a third of people in Leeds aged over 65 were of Geography anticipates that there will be an living alone and over three quarters of these were increase in the number of people coming to Leeds alone and without their own transport . from eastern Europe because of the expansion of By 2018, it is anticipated that the number of people the European Union . aged 65 and over could increase by almost 12 People from BME groups live in all areas of the percent from 112,358 to 126,800 . It is expected city but there are three main wards where these that the older population will be healthier than communities are more concentrated . These are: similar groups in the past . However there will • Gipton and Harehills; also be more people with physical disabilities and • Chapel Allerton; and mental health problems which are age-related such as dementia, which affects 20 percent of people • Hyde Park and Woodhouse . aged over 80 . In these three wards, the BME communities account for between 30-40 percent of the 5.2 Life expectancy population, whereas in 18 other wards in the On average, people in Leeds live to the age of 79 city, which is slightly more than half, the BME and generally women live longer to an average age population makes up less than five percent . The of 81, compared to 77 years for men . There is a Pakistani community is the largest BME community steady increase in life expectancy for both men and in the city (15,000 people) with over one quarter of women in the city . There are some key differences this population living in Gipton and Harehills . in life expectancy which are directly linked to levels of deprivation . For example: 5.4 Deprivation in Leeds • People in the affluent area of Harewood live an Super output areas (SOAs) are sub-ward average of 83 1. years compared to people living geographical areas that have been created in the deprived area of City and Hunslet who live nationally, specifically for the production of small to an average age of 73 6. years . area statistics . England has 32,482 SOAs with 476 in Leeds (Measuring the Gap 2009: Tackling Health • Women in the affluent area of Wharfedale live Inequalities 2007) . an average 9 6. years longer than women from the City and Hunslet ward .

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Leeds has some of the country’s most deprived health conditions like circulatory and respiratory areas and around 150,000 people in Leeds live conditions, and causes of ill-health . in the worst 10 percent of super output areas nationally . This includes one quarter of the city’s 6.1 Causes of ill-health children and 18 percent of its older population . To gain a good understanding of the health of Living in these areas has a significant impact on the the Leeds population, it is important to explain health and wellbeing of residents there . In Leeds the issues which contribute to ill-health within the there is a difference in life expectancy of over 10 city . These are complex and include factors such years between the most and least affluent areas of as poverty, employment and housing, access to the city . services and also people’s individual behaviours in The Scholebrooks and Scott Hall Road area of the relation to their health and wellbeing . The detail city is the most deprived with Gipton and Harehills below summarises the health-related behaviour being the only ward where all of its lower SOAs are data available for Leeds . ranked in the top 10 percent of deprived SOAs in the country . 6.1.1 Alcohol A map of these areas of deprivation is provided in 155,000 adults in Leeds are estimated to drink appendix 3 three . It is broken down into lower layer above safe drinking levels which have been agreed SOAs which consist of around 1500 people per nationally by the Department of Health . They state area . that men should not drink more than 3-4 units daily and women should have no more than 2-3 units 2 Sub-National Population Projections 2008- per day on a regular basis . 2033 ONS, available online : http://www leeds. . gov uk/files/Internet2007/2010/24/revised%20. It is estimated that out of a population of 500,000 population%20analysis%20for%202008%20vrf(1) . people aged 16-64 in Leeds there are: pdf • 100,000 hazardous drinkers - when a person 3 NHS Leeds (2009) . The Annual Report of the drinks over the recommended weekly limit; Director of Public Health in Leeds 2009: Making • 30,000 harmful drinkers - when a person drinks a difference – people and places available over the recommended weekly amount and has online at: http://www leeds. nhs. uk/Downloads/. experienced health problems directly related to Public%20Health/Public%20Health%20Annual%20 alcohol; and Report%202009 pdf. • 25,000 dependent drinkers-when a person feels that they are unable to function without alcohol 6 Health profile for Leeds and the consumption of alcohol becomes an important part of their lives . Understanding the health of the local population is Around 75,000 people are classed as binge a very important step in determining where future drinkers . These are people who regularly drink pharmaceutical services will be needed and how large amounts of alcohol with the intention of they will be used to improve the health of local getting drunk . This group will overlap with the people . hazardous and harmful groups explained above . In 2009, NHS Leeds and Leeds City Council 4 produced a Joint Strategic Needs Assessment 4 Leeds PCT and Leeds City Council (2009) . Joint (JSNA) for the city . This identifies the current health Strategic Needs Assessment-Information Pack issues experienced by people in Leeds and what version 4 1. available online at: Supporting Data | their future health, social care and wellbeing needs Leeds Strategic Plan | Leeds Initiative http://www . are likely to be in the next few years . This data leedsinitiative org/lsp/page. .aspx?id=10238 provides an important profile that has been used 5 Egerton S . (2009) . Alcohol Screening and Brief to inform this assessment and provide a clearer interventions in Primary care in Leeds: a research understanding of pharmaceutical needs in different study . NHS Leeds . parts of the city . 6 CACI http://www caci. co. uk/About_caci. .aspx Most of the data used comes from the JSNA although, where possible, the most recent available 7 CACI weekly spend data for Leeds pub 2010 data has been used to give the most accurate available online at: InstantAtlas™ Report http:// picture of the city’s health to date . www cio. leeds. nhs. uk/mapping/JSNA/Atlases/PNA/. atlas html. The information is broken down by mortality (death rates), number of people with long-term 6 Binge drinking rates are particularly high in the Research undertaken by Glasgow University, on north west of the city, which could be a reflection behalf of the Home Office 8, estimated that Leeds of the high proportion of students living in this part has 6,347 problem drug users (opiate or crack of the city . (Egerton, 2009) 5 cocaine users) . National Treatment Agency figures Residents of the City and Hunslet ward spend the calculated around 3,165 were considered to be most on alcohol each week compared to the rest in effective treatment in the city (in contact with of Leeds (CACI 6 alcohol weekly spend data 2010 7) . treatment agencies for a period of 12 weeks or The more affluent wards in the outer north east more) during 2008/09 . and north west also have a high weekly spend for Problem drug users who seek help from the NHS alcohol . can be offered replacement drugs to help them to There is no direct link in the data between the reduce or break their habit of using illegal drugs amount spent on alcohol and the numbers of like heroin . These kinds of legal replacement drugs people being admitted to hospital with alcohol- are usually called methadone and buprenorphine related illness or injury . City and Hunslet ward and are prescribed by a doctor or drug treatment is the only ward where alcohol spending and service . alcohol-related hospital admissions (1874 .8 hospital To give an understanding of the areas where drug admissions per 100,000 people) are both high . use is higher in Leeds, data showing where these Other wards with high rates of alcohol-related prescriptions for replacement drugs have been hospital admissions are Burmantofts and Richmond given have been mapped against postcode areas Hill (1821 9. hospital admissions per 100,000 for the city . people) and Hyde Park and Woodhouse (1766 6). . The map indicates that the wards where there are Wards with the lowest rates of admissions are the highest levels of methadone and buprenorphine Harewood (622 .2), Horsforth (667 6),. Kippax and dispensing are in line with the most deprived Methley (697 4). . The map in Appendix four shows wards . The majority are located in the inner south alcohol related hospital admissions by ward . and inner east areas such as: In 2004, the number of deaths related to alcohol Beeston and Holbeck; across the and Humber region rose • City and Hunslet; by more than 46 percent; the largest rise in the • Middleton Park; country . Alcohol-related death rates are 45 percent higher in deprived areas of the region . Data on • Burmantofts; alcohol-related deaths is not available by city or at • Gipton and Harehills; ward level . • Killingbeck and Seacroft; Community pharmacy has a role to play in • Chapel Allerton; signposting patients to services which can help • Kirkstall; and address alcohol misuse and possibly have a role in • Bramley and Stanningley . the future in providing brief interventions around alcohol misuse . Although the mapping data is taken from pharmacy postcodes and patients may not always 6.1.2 Drugs use their local pharmacy, data looking at referral For the purposes of this PNA the term “problem drug user” refers to the consumption or use of 8 Hay, G ,. Gannon, M ,. Macdougall, J ,. Millar, T ,. heroin, and crack cocaine . It does not include Eastwood, C ,. Mckeganey, N . (2004/05) Estimates people who only use other types of drug such of the prevalence of opiate use and/or crack as powder cocaine, amphetamines, ecstasy, cocaine use (2004/05) hallucinogens or cannabis . Region . The Centre for Drug Misuse Research, University of Glasgow

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patterns for young people into drug treatment related admissions are Bramley and Stanningley services also mirrors this pattern with referrals (2234 hospital admissions per 100,000 people), highest in inner city, east, south and west of the City and Hunslet (2040 6),. and Killingbeck and city (JSNA 2009) Seacroft (1997 .8) . These are wards with high Community pharmacy has a crucial harm reduction numbers of smokers . The wards with the lowest role in signposting patients to appropriate drug rates of admissions are Roundhay (969 5),. misuse services, offering needle exchange services Alwoodley (1005 6),. and Headingley (1015 6). . and supporting treatment services by supervising 6.1.4 Sexual Health consumption of opiate substitute drugs where prescribed . A sexual health needs assessment for Leeds was published in December 2008 10 . The 6.1.3 Smoking assessment outlined a number of conclusions and People in inner east, inner south and inner west recommendations for Leeds . Leeds are more likely to smoke than in the rest of The assessment outlined the following: the city . People in the north east of Leeds are the • Teenage pregnancy rates for Leeds are above least likely to smoke . national averages and remain at 1998 levels . The ASH (Action on Smoking and Health) website There are large variations in teenage conception contains the most up to date ward level data; rates across the Leeds, with the most deprived however this should be used with caution as wards having the highest rates . they refer to the pre-2004 wards . The lowest • Complicated infection rates for chlamydia are estimated smoking level of 18 percent is seen in well above the regional average for females Wetherby and the highest (46 percent) in Seacroft . and there has been a sharp increase from 2005 . Other wards with 40 percent or higher smoking Numbers of 15-24yr olds screened for Chlamydia prevalence are: in Leeds is currently above the national average . • Hunslet at 44 percent; • There has been an increasing trend in Hepatitis • Burmantofts at 44 percent; C infection rates since 2001 with a recent sharp • Richmond Hill at 43 percent; rise from 2005 that mirrors the national picture . • City and Holbeck at 41 percent; and • Rates of new HIV with CD4 counts under 200 (ie needing treatment), are higher in east and • University - now Hyde Park and Woodhouse 9 - north east Leeds . The biggest increases in HIV at 40 percent . prevalence in Leeds have been among the Black The CACI 2010 tobacco weekly spend data African population . In particular, HIV prevalence confirms that residents of City and Hunslet ward among Black African females has increased in spend the most on tobacco, compared to the rest recent years . To a large extent, these increases of the city . in prevalence reflect recent immigration from The data shows a direct link between smoking regions of Africa with extremely high rates of rates and deaths from smoking in the city . The HIV . wards with the highest numbers of people dying Recommendations were also made regarding from smoking-related illness are also the areas access to contraception services and the C-Card where higher numbers of people smoke . These scheme . Details are included in section eight of this include City and Hunslet ward and Burmantofts and document . Richmond Hill . Middleton Park has slightly lower levels of smoking prevalence (38 percent) but the second highest smoking-related mortality in the 9 Link to pre 2004 LCC ward information www leeds. . city . gov uk/page. .aspx?pageidentifier=bb6d342a-2ba8- A similar geographical trend emerges when 4eb5-8e4e-c4cb07e3062f comparing smoking-related hospital admissions . 10 Yorkshire and Humber Public Health Observatory The wards with the highest rates of smoking - and York Health Economics Consortium (2008) . Leeds PCT - Sexual Health Needs Assessment

8 6.1.5 Obesity admissions to hospital from these conditions has Obesity affects people of all ages, ethnicities and also been included . social backgrounds . Obesity is another way of Cancer data is not available at ward level and describing people who are very overweight and is therefore cancer has not been included as a long- caused by a lack of physical activity combined with term health condition . unhealthy eating and drinking patterns . The prevalence data on long-term conditions Data on the number of people recorded as included in this PNA has been taken from overweight or obese in Leeds is not routinely information provided in the GP practices disease collected and therefore the information that is register audits and hospital admissions data is available does not provide a full picture of obesity taken from the JSNA data set 11. It directly relates levels in the city . to age standardised rates for 2005-07 . For the According to the disease register audit data (April purposes of this document the most recent data 2009) that is available for Leeds, the highest that is available where aggregated up to ward level levels of obesity for the city are in the postcode is used NHS Leeds continues to refresh it’s data as areas covering Middleton, Hunslet, Burmantofts, new information is available . Richmond Hill, Harehills, Seacroft, Garforth and The national census asks people to state whether Swillington . There are also high rates of obesity on they feel they have a limiting long-term illness . the outskirts of the city in the Kippax and Methley This is loosely described as “any long-term illness, areas and some bordering Wakefield (WF10) health problem or disability which limits their postcode areas . daily activities or the work they can do, including The obesity rates taken from 08/09 National Child problems that are due to old age” . Measurement Programme (NCMP) for the city In the 2001 census, over 128,000 people said they for 08-09 are as follows: Reception 10 .3% Year 6 considered themselves to have a limiting long-term 20 9%. . Rates in deprived Leeds are slightly higher illness . This is 18 percent of the total population than the Leeds average . of Leeds . Of these 57,732 (45 percent) were of In 2003, nearly a quarter of men in Yorkshire and working age . the Humber (24 6. percent) were estimated to be 6.2.1 Diabetes obese; the highest prevalence of any region in Diabetes is a condition where the amount of England . The region also has the highest obesity glucose in your blood is too high because the body prevalence among young adult males (aged 16–24) cannot use it properly . There are different types of any region in England (based on 2002 data) . of diabetes; Type 1, which is usually diagnosed Community pharmacy has a role in signposting in people under 40; Type 2 which can often be patients to weight management services and also caused by poor diet and lifestyle; and gestational to provide general dietary and exercise advice . diabetes which is a condition that can develop Community pharmacy may have a role in future during pregnancy . weight management services . The data available relates to the number of people 6.2 Long-term health conditions with diabetes . It is based on figures from the 2010 The World Health Organisation (WHO) defines (April) disease register audit, which is a list of GP- long-term conditions (also called chronic registered patients that have been diagnosed with conditions) as health problems that require ongoing the condition . management over a period of years or decades . This includes a wide range of health conditions . This section outlines the prevalence rates of the long-term conditions which have the biggest impact on life expectancy and may also place 11 Dataset for Hospital Admissions by ward Pub increased demand on community pharmacy 2009 for JSNA : available online at: services . Where available, information on http://www cio. leeds. nhs. uk/mapping/.

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The data for Leeds shows the average prevalence The areas of the city with the highest rates of CHD of diabetes is 3 74. percent . However, national are: evidence suggests that many more people may • Garforth and Swillington (5 17. percent) have the condition but haven’t been diagnosed . • Crossgates and Whinmoor (4 .88 percent); and Diabetes is therefore thought to affect just over five percent of the Leeds population . • Wetherby (4 .81percent) . The areas of Leeds with the highest rates of This appears to contradict the CHD mortality data diabetes are Garforth and Swillington (4 76. (2005-08) which indicated that City and Hunslet percent), Kippax and Methley (4 64. percent) Gipton ward experienced the highest rates . However and Harehills (4 5. percent) and Middleton (4 5. the Disease Register data reported it as the third percent) . lowest prevalence across the city (2 .37 percent) . One explanation for this may be that CHD remains Activities aimed at the prevention and reduction undetected for relatively higher numbers of people of obesity will help to combat the increase in the in this ward, therefore causing (premature) death prevalence of diabetes . Community pharmacy has a rather than presenting to, and subsequently role to play in signposting patients to such services . managed by, primary care . Community pharmacy may have a role to play to ensure medication compliance, offering advice and More people living in the most deprived areas of supporting self - management . Leeds are admitted to hospital as a result of a heart attack (myocardial infarction or “MI”) than people 6.2.2 Chronic obstructive pulmonary from more affluent parts of the city . disease (COPD) The wards with the highest rates of admissions to Chronic obstructive pulmonary disease (COPD) is hospital from a heart attack are City and Hunslet the term used for a number of long-term breathing (169 1. per 100,000 population), Gipton and conditions including chronic bronchitis and Harehills (166 1),. and Armley (153 .2) . The wards emphysema . with the lowest rates of admissions to hospital are The data available for COPD prevalence in Leeds Headingley (73 6),. Harewood (81 .8), and Adel and is based on information from the disease register Wharfedale (82 .2) . audit of April 2009 . According to this data, 1 67. 6.2.4 Mental health percent of people in Leeds have COPD . However, research from the Eastern Region Public Health Mental health is about how people think, feel and Observatory suggests that COPD is likely to affect behave . One in four people in the UK has a mental as much as 4 5. percent of the Leeds population . health problem at some point, which can affect their daily life, relationships or physical health . The areas of Leeds with the highest rates of COPD are; Burmantofts and Richmond Hill (LS9); A mental health needs assessment was Middleton and Hunslet (LS10); Beeston, Holbeck commissioned on behalf of the NHS and local and Cottingley (LS11); and Killingbeck and Seacroft authority in 2009 with involvement from local (LS14) . patient and service user groups . The aim of the assessment is to improve mental health services in 6.2.3 Coronary heart disease (CHD) Leeds . Data from the assessment was not available Coronary heart disease (CHD) is the term that at the time this PNA was developed but will be describes what happens when your heart’s blood included in any later versions of the document . supply is blocked or interrupted by a build-up of In the interim, this PNA uses data available from fatty substances in the coronary arteries . the national Mental Health Observatory12 which The latest data available for coronary heart disease publishes mental health needs indicators based on prevalence at ward level in Leeds is based on hospital and primary care data . information from the disease register audit of April 2009 . According to this data, 3 56. percent of people in Leeds have CHD .

10 The latest figures for Leeds (using the MINI2000 6.3 Mortality index based on 1998 data) show that five of the All age all cause mortality (AAACM) city’s most deprived wards are likely to have 20 All age all cause mortality is a substitute percent more people with severe mental illness measurement used to determine life expectancy, (requiring occasional hospital treatment) than based on the rate of mortality for all residents England as a whole . These wards (pre-2004 (both males and females) of all ages and from all boundaries) are City and Holbeck, Harehills, causes of death . If all age all cause mortality rates Burmantofts, Seacroft and Richmond Hill . improve, life expectancy will improve . The Observatory also uses an index called the Since 2000, the mortality rates in Leeds have Clinical Interview Schedule - Revised (CIS-R12) to fallen as they have regionally and nationally s but work out the number of people who are likely to be the national rate has fallen faster than the rate at higher risk of having a common mental illness . in Leeds . The mortality rate in deprived areas By this, it means people at more risk of conditions continues to be significantly higher and with little such as depression or anxiety but who are unlikely improvement compared to the Leeds and national to need admitting to hospital for treatment . averages . The trajectory for narrowing the gap The areas of Leeds where people are more likely between Leeds overall and deprived Leeds is of to be at risk of common mental illness are below . significant concern . The figure is the percent of local people in that area The table included with the ward profiles indicates who are at risk: the ward mortality rates within Leeds and • University now Hyde Park and Woodhouse highlights those wards with a higher than average 22 7. percent mortality . • Headingley 22 5. percent The main causes of the differences in death rates • City and Holbeck 20 .3 percent within Leeds are chronic lung disease, lung cancer • Kirkstall 20 percent and heart disease . There are some specific aspects • Chapel Allerton 19 .8 percent of mortality which are monitored separately including deaths; Generally speaking, the wards with lowest likelihood of severe mental illness also have a low • in babies under one year old (infant mortality); risk of common mental illness . The only exception • from cancer; is Headingley where a high proportion of people • from circulatory diseases; and are at risk of common illness but few are at risk of • from chronic obstructive pulmonary disease severe illness requiring hospital treatment . (COPD) . Dementia is classed as a severe and enduring Approximately 77 percent of the gap in life mental health condition and therefore some data expectancy is due to these long-term conditions on people admitted to hospital with dementia is (NHS Yorkshire and Humber 2007 13) . included . The wards with the highest numbers of people admitted to hospital for dementia treatment are: City and Hunslet (331 .3 admissions per 100,000 population); Armley (272 4);. and Hyde Park and Woodhouse (260 9). . The wards with the 12 Mental Health Observatory website (2010) . lowest rates of admissions are Adel and Wharfedale Downloaded on 31 August 2010 from : (76 5),. Weetwood (84 .8) and Alwoodley (90 4). . www nepho. org. uk/mho/mini. Pharmacy has a role in signposting to appropriate services and identifying poor or non-compliance 13 Yorkshire and Humber Strategic Health with medication . Authority (2007) . Reducing Health Inequalities in Yorkshire and the Humber: A Systematic Way Forward . Downloaded on 23 August 2010 http://www yorksandhumber. nhs. uk/document. . php?o=1069

11 PHARMACEUTICAL NEEDS ASSESSMENT

6.3.1 Infant Mortality better awareness of the symptoms of stroke among In Leeds, just over 50 babies under one-year old members of the public coupled with faster access to die each year . There are differences between the medication which reduces the effect of stroke and affluent and deprived parts of Leeds, with the improved stroke rehabilitation services . infant mortality rate in deprived areas being higher . The mortality rate for people under 75 years old from Beeston and Holbeck ward has significantly higher circulatory diseases is dramatically different in some rates of infant mortality (11 .3 deaths per 1000 of the deprived wards compared to some of the more births) than the rest of the city (5 9. deaths per affluent wards . The lowest rate is in the Adel and 1000) . There are seven wards that are significantly Wharfedale ward (51 deaths per 100,000 people) below the Leeds average and experience fewer and the highest rate is in the City and Hunslet ward baby deaths; most notably Kippax and Methley and (188 deaths per 100,000 people) . (NHS Leeds, 2009) . Harewood wards . Deaths of people under 75 years old from circulatory Nationally, infant mortality rates have shown a diseases in deprived areas of Leeds were consistently decrease meaning that overall there have been and significantly higher than Leeds regional and fewer preventable deaths in babies under one year national averages between 2003 and 2007 . CHD, old . The data available for Leeds shows that overall stroke and overall circulatory disease mortality are rates for infant mortality had been rising but that highest in the City and Hunslet ward . this rise had levelled off in the most recent years 6.3.3 Cancer mortality that data is available for (2004-2008) . The directly age standardised rate of cancer mortality The latest data also shows that there has been for the deprived areas of Leeds is significantly a clear downward trend of infant mortality in higher than the Leeds average from 2004 to the more deprived areas but that rates of infant 2007 . The average age at diagnosis is significantly mortality in the more affluent areas have levelled lower for people living in deprived parts of Leeds off . This indicates that the gap in infant mortality compared to the Leeds non-deprived population . between the deprived and non-deprived (see Stage at diagnosis shows trend of earlier stage at glossary) population of Leeds is beginning to presentation for non-deprived Leeds and later stage narrow . (JSNA, data set 2010) . for “deprived Leeds” . Surgery forms a significantly Infant mortality is contributed to by many different higher proportion of the therapies received for factors including smoking, co-sleeping (sharing Non-deprived Leeds than Deprived Leeds . However a bed or sofa), weight and other lifestyle factors . it should be borne in mind that treatment type also Pharmacy services can play an important part in relates to cancer site . For instance, C43: Malignant reducing these preventable deaths in young babies . melanoma of skin occurs more frequently in the non- They can support women to achieve a healthy deprived Leeds population than the deprived Leeds weight before getting pregnant; raise awareness population and this is treated almost exclusively with of the dangers of co-sleeping; help parents to stop surgery . In addition completeness of data on stage smoking; and help women access ante-natal care at diagnosis is dependent on treatment type (Wood, early .14 200915) . Survival rates are inversely related to level of deprivation . 6.3.2 Circulatory disease mortality The mortality rate for circulatory disease includes death from coronary heart disease, diabetes and stroke . It varies widely across the different wards of 14 NHS Leeds (2009) . The Annual Report of Leeds with some areas having many more deaths the Director of Public Health in Leeds 2009: from these conditions than others . This is largely Making a difference-people and places available due to lifestyle factors such as smoking, drinking online at: http://www leeds. nhs. uk/Downloads/. alcohol and poor diet . Public%20Health/Public%20Health%20Annual%20 Report%202009 pdf. Across Leeds, mortality rates from stroke have been falling in most wards since 2003 . This is due to 15 Wood, F . (2010) . Leeds Cancer Baseline data summary . NHS Leeds

12 There is a correlation between deprivation and 7 Health Service provision in emergency admission rate for all cancers and lung cance” and between deprivation and elective Leeds admission for lung cancer . NHS Leeds is committed to ensuring the healthcare Admission and mortality rates are significantly services are commissioned to meet the needs of higher than Leeds average for inner south, inner local people . Because Leeds is a major city with east and inner west areas . Generally the trend a diverse population, healthcare services are shows reducing rates for Leeds overall, with the commissioned from a wide range of providers . exception of mortality rates in inner west (Armley and Bramley & Stanningley wards) . Admission rates 7.1 Acute and tertiary services are lowest for outer north east and highest in inner Acute services are generally defined as short-term south . Mortality rates are also lowest for outer medical treatment, usually in a hospital, for patients north east . having an acute illness (including mental illness) or injury or recovering from surgery . 6.3.4 Chronic obstructive pulmonary disease (COPD) mortality Tertiary services are those available for people who need specialised care for an illness or injury that In Leeds, COPD is the fifth highest cause of hospital might not be available in all hospitals . People using admission and death in men and the seventh these services may need specialist investigation or highest in women (Yorkshire and the Humber treatment, for example in the case of rare cancers Public Health Observatory, 2010) . or other conditions . Deaths from COPD vary widely across Leeds . The Acute and specialist tertiary services are mainly inner south area of the city, which covers the City commissioned from: and Hunslet, Beeston and Holbeck, and Middleton Park wards, has significantly higher levels of deaths • Leeds Teaching Hospitals NHS Trust; from COPD than the rest of Leeds . This has been • Mid Yorkshire Hospitals NHS Trust; the case since 2003 and levels of COPD deaths in • Harrogate and District NHS Foundation Trust; this area continue to rise . • Independent sector hospitals which include Data from the quality and outcomes framework Nuffield, Spire and Eccleshill; Independent Sector (QoF), which is gathered from various sources Treatment Centre; and including GP clinical systems, shows that COPD is • Leeds Partnerships NHS Foundation Trust . more common in deprived areas affecting around Some of these services may be provided by the 2 1. percent of the local population in those areas . hospitals but could be delivered in community In Leeds as a whole, COPD affects around 1 7. settings, such as some of the specialist percent of people (NHS Leeds, 2009 16) . rehabilitation services or outpatient clinics . Smoking is the most common cause of COPD . Other causes include occupational exposure, 7.2 Primary care services passive smoking and other inherited factors . Primary care describes a range of services provided Community pharmacy may have a role to play to patients in the local community . in signposting to, or the provision of, smoking Some of these services are commissioned from GP cessation services . Community pharmacy also has practices and are described by the type of contract a role to play in identifying poor compliance with they are provided under: medications . General medical services (GMS) are the standard, nationally agreed contracts . All GP practices must 16 NHS Leeds (2009) . The Annual Report of the provide the core services from these contracts to Director of Public Health in Leeds 2009: Making their patients . There are others which they can a difference – people and places available choose to provide if they can prove they are able online at: http://www leeds. nhs. uk/Downloads/. to . Public%20Health/Public%20Health%20Annual%20 Report%202009 pdf.

13 PHARMACEUTICAL NEEDS ASSESSMENT

Personal medical services (PMS) are locally-agreed 7.3 Other primary care services contracts which GP practices can choose to sign There are other primary care services in Leeds up to provide additional services identified by NHS which are commissioned to support the varying Leeds as being required for specific local areas . health needs of the city, including dentistry, Where GP practices opt out of providing some optometry and minor illness services . services, NHS Leeds is responsible for finding Walk-in services alternative providers of these aspects of care . Leeds currently has two walk-in facilities; based at NHS Leeds uses Alternative provider medical Burmantofts Health Centre and The Light in the city services (APMS) contracts to commission services centre . tailored to specific local needs . APMS can be used to provide essential services, additional services NHS Leeds commissions a GP-led health centre at where GMS/PMS practices opt out, enhanced Burmantofts Health Centre, which is open seven services, out-of-hours services or any one element days a week from 8am to 8pm . A nurse-led walk or combination of these services . - in service is also commissioned from The Light in the city centre, which is open Monday to Friday GMS and PMS contracts are divided into core from 7am to 7pm . services and additional or enhanced services . In 2010, all Leeds practices were providing the core General dental services GMS and PMS contract services . For GP practices, NHS Leeds commissions general dental services core opening hours are 8am to 6 .30pm, Monday from 99 dental practices . In addition there are to Friday . In addition, some or most of the GP four providers of specialist orthodontic services . practices holding contracts in 2010 also provided There are currently 60 general dental Service (GDS) other services including: contract holders and 43 personal dental service Additional services (PDS) contract holders . • collection and submission of information on child General optometry services health; NHS Leeds holds 62 contracts for mandatory • contraceptive services; optometry services, 25 additional contracts and 29 both mandatory and additional contracts . • maternity medical services; • cervical screening; 7.4 NHS Leeds Community • childhood vaccinations and immunisations; and Healthcare services • vaccination and immunisations . The provider arm of NHS Leeds provides a variety of services across the city which include, amongst Enhanced services others, district and twilight nurses, health visiting • childhood vaccinations and immunisations; and primary care mental health workers . NHS • seasonal flu immunisation; Leeds Community Healthcare is also commissioned • smoking cessation; to provide the services listed below . • chlamydia testing and treatment; The contraception and sexual health (CaSH) • minor surgery; service is commissioned to provide specialist contraceptive and sexual health advice and support • dispensing services; in clinics located across the city . All methods of • NHS health checks (vascular risk assessment and contraception are offered including condoms, coils management); and and long-acting reversal contraception like the • extended hours of opening . implant . The service also provides counselling and A number of GP practices across the city participate onward referral to other services . The team gives in the shared care scheme to provide prescribing advice on menopausal symptoms and on sexual and care for people involved in substance misuse . difficulties, performs cervical smear tests and some limited testing for sexually transmitted infections . A specialist young people’s contraception service is open six days a week in the city centre .

14 • No Fixed Abode Team • Multiple Choice –offers structured day care and The No Fixed Abode (NFA) Team provide primary access to residential rehabilitation services; and care general medical services to the homeless • No fixed abode team- offers drug treatment in population of Leeds through a team including the community to the homeless . GPs, nurse practitioners, practice nurses, drug and alcohol practitioners, mental health support 8 Current pharmaceutical and support workers . They look after people who sleep rough, those staying in the city’s provision in Leeds hostels and those in insecure or temporary In Leeds there are currently 161 pharmacies working accommodation or who find it difficult to access within the national contract and two pharmacies services elsewhere . which hold a Essential Small Pharmacy Local • Prison services Pharmaceutical Contract (ESPLPS) . These are all Health services are provided in HMP Wealstun, shown on the map in appendix five . HMP Armley and Wetherby Young Offenders The Community Pharmacy Contractual Framework Institute (YOI) . These are not services specifically (2005) identifies a three tiered service which for Leeds residents but for the prison population includes essential, advanced and enhanced services . which can include people from all over the country . Essential services • Healthy Living Services These services, negotiated and funded at a national A range of services to support healthier living level are provided by all community pharmacies . choices are provided across the city including 1-1 They include dispensing, repeat dispensing, the and group smoking cessation clinics and weight disposal of medications, sign-posting to appropriate management and dietetic services . These clinics services, promoting healthy lifestyles, support for are held in health centres and outreach clinics self-care and clinical governance assurance . around the city and in public buildings such as Advanced services leisure centres . There are now three advanced services available for 7.5 Drug and alcohol treatment services community pharmacies to provide: The community drug service is commissioned on • medicines use reviews and prescription behalf of NHS Leeds by the Safer Leeds partnership intervention service (MURs); of which the organisation is a key partner . Drug • appliance use reviews (AURs); and and alcohol services provide structured alcohol • stoma customisation . treatment programmes including detox and In addition, dispensing appliance contractors (DACs) rehabilitation . Organisations providing these may also provide AURs and stoma customisation . services are: Individual pharmacists need to have undertaken • Addiction Dependency Solutions which provides extra training to accredit them to provide the MUR brief interventions, community support and service . MURs must be provided in a consultation treatment plans for alcohol users; room which should meet the criteria set out in • St Anne’s detox which provides residential detox the service specification for MURs and contractors and rehabilitation services; must complete a self-certification form to that • Leeds Addiction Unit which provides individual effect . MURs can only be conducted on patients packages of care for those experiencing who have given consent and used the pharmacy problems with alcohol and drug usage; and for a minimum of three months . The exception to • St Martin’s Healthcare (jointly working as Leeds this criteria is where a prescription intervention Community Drugs Partnership with Barca and St highlights that a more detailed examination of the Anne’s and DISC) providing treatment, structured patient’s medication is necessary, leading to the support, and harm reduction in the community; need for an MUR .

15 PHARMACEUTICAL NEEDS ASSESSMENT

Currently there are no specific training • Baskind Pharmacy, Rutland Lodge, LS7 - requirements to carry out AURs . However, they Chapel Allerton ward should be conducted in a consultation room where • Asda Pharmacy Morley, LS26 - both the opportunity for private conversations and Morley South ward visual privacy have been taken into account . This • Pudsey Pharmacy, Chapeltown Road, LS28 - applies to both community pharmacies and DACs Pudsey ward providing this service . • Asda Pharmacy Killingbeck, LS14 - Currently there are no specific training Killingbeck & Seacroft ward requirements to carry out stoma customisation . The service should be provided from a clearly • Boots Pharmacy Colton, LS15 - designated private area which is suitable for the Temple Newsam ward volume of customisation being undertaken at any • Tesco Pharmacy . Garforth, LS25 - given time . This criteria applies to both community Garforth & Swillington ward pharmacies and dispensing appliance contractors . • Boots Pharmacy Kirkstall, LS5 - Kirkstall ward Enhanced services • Al-Shafa Pharmacy, Dewsbury Road, These services are commissioned locally and for City and Hunslet ward some services extra accreditation may be required . They are commissioned by NHS Leeds on an An audit of ePACT data over 12 months (7/09-6/10) individual pharmacy basis . These services are: shows that almost a quarter (23 percent) of Out of Hours prescriptions are dispensed by Leeds 100hr • minor ailment schemes; pharmacy . • smoking cessation schemes; • supervised administration methadone and Essential Small Pharmacies Scheme Local buprenorphine; Pharmaceutical Services (ESPSLPS) • needle and syringe exchange schemes; Not all areas that have a need for pharmaceutical services can financially sustain a pharmacy . • pharmaceutical advice to care homes (PAtCH); The ESPLPS scheme was introduced in 2006 to • emergency hormonal contraception; ensure that pharmacy services in these areas are • palliative care; maintained . This is a contract that is held directly • medical administration of record scheme; and with the PCT in whose area the pharmacy is sited . • chlamydia testing . These pharmacies should be monitored on an annual basis to ensure that the pharmacy still meets 100 hour pharmacies the following criteria (taken from drug tariff): There are currently nine pharmacies in Leeds • The pharmacy dispenses fewer than 28,536 which hold contracts to deliver pharmaceutical prescriptions (this figure can vary and is always services for a minimum of 100 hours or more per stipulated in the drug tariff); week . This enables the public to access pharmacy • The pharmacy is more than one kilometre by the services outside of normal contractual hours . These nearest practicable route available to the public pharmacies provide all the essential services, along on foot from the next nearest pharmacy or is less with a range of enhanced services as determined than one kilometre but previously qualified as a by NHS Leeds depending on perceived patient need special consideration case and the circumstances in the area . (see Appendix six) of the pharmacy remain unchanged; The current 100 hour pharmacies in Leeds are: • If the pharmacy has, in the year immediately • Oakwood Pharmacy Pharmacy, preceding that year, dispensed fewer than Roundhay Road, LS8 - Roundhay ward 6000 prescriptions, the authority certifies in • Lloyds Pharmacy, Old Crown Cinema, writing at the beginning of that year that the Tong Road, LS12 - Armley ward pharmacy is essential to the proper provision of pharmaceutical services and the contractor shall be entitled to ESPS payments . 16 NHS Leeds currently has two ESPSLPS pharmacies . Dispensing doctors These are: Limited pharmacy services are offered directly from • Whinmoor Pharmacy, LS14 some GP practices . These are referred to dispensing • Pool Pharmacy, LS21 doctors and are situated in rural areas where there ESPSLPS contracts are due to expire on 31 March is no other pharmacy provision . Dispensing doctors 2013 . provide a dispensing service to their patients who live in the rural area . Distance selling (internet) pharmacies The current dispensing doctor practices in the A distance selling pharmacy is a registered Leeds area are: pharmacy that provides essential services over the • Dr Swaby and Partners, Scholes internet . They were introduced in April 2005 as one • Dr Porter and Partners, Barwick in Elmet of four categories of applications that were exempt from the control of entry system (regulation 13, • Dr Porter and Partners, Aberford NHS (Pharmaceutical Services) Regulations 2005, as • Dr Davies and Partners, Aberford amended) . • Dr Batra and Partners, Monk Fryston It is a condition of their inclusion on a primary care • Dr Lightfoot and Partners, Collingham trusts pharmaceutical list that they do not offer • Dr Lightfoot and Partners, Thorner to provide essential services face-to-face on their • Dr Nicholls and Partners, Bramham premises . Their premises may not be on the same site or in the same building as the premises of a • Dr Knight and Partners, Harewood provider of primary medical services with a patient Controlled localities list . A controlled locality is an area which has been NHS Leeds currently has one distance selling determined, either by a primary care trust or on pharmacy on its pharmaceutical list . This is: appeal to the NHS Litigation Authority, to be • Pharmacy2U, LS14 ‘rural in character’ . Each case must be judged on Dispensing appliance contractors (DACs) individual circumstances and will depend upon a variety of factors . The following criteria should be As well as medicines, GPs can prescribe a range of considered: dressings and appliances . These can be dispensed • number and variety of amenities/facilities/ by pharmacies and dispensing doctors, but they services available to the population, can also be dispensed by dispensing appliance contractors • transport services (bus,rail)/ quality of roads; Appliance contractors dispense: • planning applications pending ; • dressings • population density; • incontinence appliances • open countryside; • stoma appliances • number of schools ; • other appliances (catheters and trusses) • populations statistics ; The large majority of dispensing appliance • council definition ; contractors specialise in the supply of stoma • number of churches/religious buildings; appliances, including colostomy, urostomy • environmental factors such as land use and ileostomy bags and associated materials . (agricultural); The services provided by dispensing appliance • size and patterns of settlements/density of contractors are often valued by patients who housing/type of housing; welcome, for example, home deliveries and personalised services . • street light spacing; and • employment (agricultural);

17 PHARMACEUTICAL NEEDS ASSESSMENT

NHS Leeds currently has two controlled localities, Just four out - of - area pharmacies were identified shown in the maps in Appendix seven and eight . as dispensing in excess of 400 items to our area all of which are on the borders of the city as would be Reserved locations expected . A reserved location is one within a controlled Further breakdown of ePACT data for out - of - locality where the patient population, on all of the hours dispensing showed just one % of pharmacies patient lists, within 1 6km. of the proposed location outside the Leeds area dispense to prescriptions or the actual premises is less than 2750 . NHS Leeds from Local Care Direct Leeds primary out of hours currently has one reserved location in Bramham, provider . Wetherby ward . Availability of pharmacy services in Hospital pharmacy providers Leeds Some pharmaceutical services are provided by There are 161 pharmacies plus nine dispensing secondary care, usually based in a hospital . These practices in the city (accurate at July 2010) with are very specific services relating to prescribing an average of 4732 people per pharmacy across of medicines within a hospital setting and are for the city . This is based on GP practice register both inpatients and outpatients . When patients population figures for April 2010 . are discharged from hospital they get their The ward with the lowest population per pharmacy medication dispensed from the hospital pharmacy is City and Hunslet . This reflects the higher number prior to discharge . Also patients that attend as an of pharmacies in the city centre which serve outpatient may get certain medication dispensed the commuter population as well as residents . from the hospital pharmacy . The average figure of 4,732 for Leeds compares The current hospital sites in Leeds providing such with national figures which vary between 2564 services are: per pharmacy for a primary care trust in central • Leeds General Infirmary; London, to 6666 for rural Herefordshire . • St James’s Hospital-two pharmacies; Appendix nine shows the distribution of • Chapel Allerton Hospital; pharmacies across the city . The rural Harewood • Wharfedale Hospital; and Wetherby wards are served by nine dispensing practices . One of these is outside the • Leeds Partnership NHS Foundation Trust; Leeds boundary but is a second site of a Leeds • Spire Roundhay; based practice so comes under NHS Leeds as • Nuffield Hospital, Leeds and; commissioners . Controlled locality maps are • Spire Methley Park included in appendix seven and eight for the dispensing practices . Prison pharmacy services The prisons in Leeds provide pharmacy services Pharmacy opening times in Leeds for offenders . These services include dispensing Saturday and Sunday medicines and supervised consumption of The 33 wards across the city all have pharmacies methadone and buprenorphine . open Saturday morning and 27 wards have a pharmacy open all day Saturday . 24 wards have Out of Area Providers pharmacies open before 9 on Saturday morning . To identify where pharmaceutical services out of Wards that do not have pharmacies open all day on area are contributing to access and improvements Saturdays all border wards which do have longer within Leeds, Electronic Prescribing and Cost opening hours Tabulation (EPACT) data was analysed . Where 17 wards have Sunday opening and these are pharmacies dispensed in excess of 400 items in spread around the city from inner to outer areas a 12 month period prescribed by Leeds providers with 4 in the city centre . these pharmacies have been identified in the area summaries as providing a significant service .

18 Late opening Minor ailments: 28 wards have a pharmacy open after 6pm 28 This enhanced service is targeted at, and benefits, wards until 6 .30pm 17 until 7pm 16 until 8pm deprived areas where the population may not 11 until 9pm and eight after 9pm . Of these, two have the financial resources or knowledge to pharmacies in the city are open until midnight self-medicate or buy over the counter medicines . Monday to Friday . (See ward profiles for detailed Studies undertaken for the Proprietary Association opening times) . of Great Britain (PAGB 17) in 2006-07 examined The table in appendix 10 shows the range of the minor ailment workload in general practice opening times available in each of the wards . and concluded that 18% of GP’s time was taken with minor ailments . Research also concluded that 100 hour pharmacies community pharmacy could manage an estimated 100 hour pharmacies offer extended opening in the 8 percent of adult attendances to inner city hospital following wards: accident and emergency departments . • Roundhay The current MA schemes are particularly pertinent • Kirkstall to deprived wards and where there may be a high • Killingbeck and Seacroft number of the population aged under five . In • Garforth Leeds, although they were targeted primarily in the more deprived wards, they are spread widely • Temple Newsam across the city . There is quite a wide variance in • Pudsey terms of how much the schemes are used around • Armley . the city . This varies from 3166 consultations from For most of the enhanced services of emergency a pharmacy in the Middleton Park ward in 2009- hormonal contraception, needle exchange, minor 2010, to just eight consultations in a Wetherby ailments and palliative care, the extended opening pharmacy for the same period . There are currently times offered by pharmacies are essential to 55 community pharmacies providing this service . providing a comprehensive service around the city . Palliative care Access This service is aimed at the supply of specialist Community pharmacy provide a service to any palliative care drugs, the demand for which may member of the community regardless of whether be urgent and/or unpredictable . The pharmacy they are registered with a GP or resident within the contractor stocks a locally agreed list of specialist city . Under the Equality Act 2010 (which replaces palliative care drugs and makes a commitment to older disability discrimination law), pharmacies also ensure that users of this service have prompt access have an obligation to make reasonable adjustments to these medicines . The pharmacy also provides to help disabled individuals access their goods, information and advice to the user, carer and facilities and services . clinician . They may also refer to specialist centres, From the feedback received from pharmacies, 78 support groups or other health and social care percent of pharmacies stated that they had car professionals where appropriate . parking available for their site and 37 percent were This scheme was established to improve access fully Disability Discrimination Act (DDA) compliant . for people to specialist medicines when they are A further 57 percent were partially compliant . required . It ensures prompt access and continuity of Providers and enhanced services supply and support to people, carers and clinicians by providing them with up to date information and Currently enhanced service provision is advice, and referral where appropriate . The scheme commissioned across the city for the following is provided by 64 pharmacies across the city . services: The table in appendix 11 breaks down the community pharmacies and dispensing GP practices by ward, and identifies where there is currently an enhanced service commissioned by NHS Leeds .

19 PHARMACEUTICAL NEEDS ASSESSMENT

Pharmaceutical advice to care homes (PAtCH): maintain some patient independence . The scheme The pharmaceutical advice to care homes also reduces dispensing into medication compliance (PAtCH) service was established in response to aids, thereby increasing safety and reducing the Commission for Social Care Inspection report unnecessary risk . ‘Handle with Care’ published in February 2006 . The MAR chart scheme is currently provided by 22 The report highlighted the risk of medication pharmacies . It is intended that the scheme will roll errors faced by patients in residential care and out across the city, as staff in social care become the contribution primary care trusts can make to trained up to prompt or administer medication . ensuring patient safety . Sexual health - emergency hormonal The Department of Health alert-“The use of contraception (EHC) and chlamydia medicines in care homes for older people” requires PCTs to work with primary medical care EHC contractors, providers of pharmaceutical services NHS Leeds, jointly with Leeds City Council, and social care partners to’’ (2010) - 001: currently has a target of reducing teenage 0“review the safety of local…dispensing, conceptions which are higher than national administration, and monitoring arrangements in averages, and which have not reduced in the city, the provision of medication to older people in despite an increase in sexual health provision . care homes and establish a plan for effective joint The EHC pharmacy enhanced scheme is part of working …including auditing on-going progress” . wider strategy to provide emergency hormonal contraception to key areas of the city and NHS Leeds, in partnership with the local authority, complement existing services such as CaSH clinics has established a quality care homes scheme and C-card scheme and contraception implant and to support the contracting of funded nursing inter uterine contraceptive device (IUCD) provided care placements . The PAtCH service forms the by some GP practices . backbone of the primary care trusts response to its obligations to ensure the safe use of medication The recent sexual health needs assessment for in care homes . PAtCH is currently provided by 24 Leeds found that the most deprived wards had the pharmacies across Leeds . highest teenage conception rates . EHC is currently provided by 35 pharmacies spread across Leeds . Medication administration record scheme These are focussed on the more deprived wards (MARS) and those with a larger population aged between The MAR chart scheme was developed in order 15 and 24 . for community pharmacies to help support The C-card scheme providing free contraception domiciliary care workers, by preparing a medication to young people in Leeds aged between 15 and administration record (MAR) sheet . The pharmacy 24 is widely available . It is provided in a variety of produces a MAR chart for a patient which includes places such as pharmacies, schools, health centres, all the medication that is currently required to libraries, young people’s clubs and centres . be administered to the patient . The MAR chart scheme helps to support patients with long-term Chlamydia screening conditions, who otherwise may require residential The prevalence of chlamydia in the population of care . The scheme helps to support self-care and Leeds is currently around 7 5. percent; the national prevalence is 8 percent . Chlamydia screening is offered from a variety of places, including GPs, pharmacies, CASH clinics, colleges, prisons and youth projects . Chlamydia screening is currently available from 45 pharmacies across the city and complements the 17 Proprietry Association of Great Britian, Driving wider screening programme for Leeds . As with the self-care agenda, 2008 available online: all services the cost effectiveness of providing http://www pagb. co. uk/information/PDFs/. the chlamydia screening service in pharmacy AndyTismanarticle pdf.

20 will be under review and future commissioning Supervised consumption decisions may alter as a result of this . Treatment for Supervised consumption can help methadone chlamydia is available from GP practices and CASH and buprenorphine be more effective by clinics . making people take the same amount every Nicotine replacement therapy (NRT) day . Supervised consumption schemes have also Life-limiting long- term illness is currently a priority increased the number of treatment places available area for NHS Leeds . The trust currently has targets because doctors know that the methadone or for reducing mortality, reducing health inequalities buprenorphine they prescribe can’t be sold on and for reducing the number of the people who the illicit market . In Leeds currently the scheme is smoke . offered from 115 pharmacies which reflects the residency of those in treatment and the fact that The pharmacy enhanced service around smoking most pharmacies only have capacity to take a cessation fits neatly into all these categories . relatively small number of clients . Smoking - related illnesses, including COPD, are high on the causes of mortality and of hospital Leeds Pharmacy Monitoring Programme admissions . 18 percent of the population of The Leeds Pharmacy Monitoring Programme is Wetherby are smokers percent compared to 46% commissioned by St Martins Healthcare Services in the Killingbeck and Seacroft ward . Killingbeck Ltd to support the drug treatment services in the and Seacroft also has high self-reported life-limiting city and their clients . It is an initiative to involve illness rate at 22% compared to 18% for the city pharmacists more closely in the delivery of as a whole . As the health profile of Leeds has Leeds community drug services . The programme highlighted the health disparities across the city are is a remunerated service where pharmacists great . conduct short clinical reviews to stable clients The NHS Leeds stop smoking service currently has on Methadone or Buprenorphine substitute clinics across the city to help people stop smoking . prescriptions and currently has participating There are clinics for one to one and group support, pharmacists citywide . and advice and support is available in health centres, GP practices and hospitals, with a mixture of booked and no appointment needed slots . The pharmacy smoking enhanced services is set up to complement the NHS Leeds Smoking cessation service . Smoking cessation services in pharmacy, which includes issuing nicotine replacement vouchers and having smoking cessation advisors available, are delivered from 103 pharmacies across the city . The success of the entire smoking cessation scheme in Leeds, including in pharmacy, will be reviewed during 2010 as part of the review of healthy living services Needle exchange Needle exchange schemes are one of the main harm reduction measures that aim to curb the spread of blood-borne viruses such as HIV and Hepatitis C among injecting drug users (IDUs) . This scheme is currently provided by 16 pharmacies across Leeds .

21 PHARMACEUTICAL NEEDS ASSESSMENT

9 Stakeholder views Uptake of additional pharmaceutical services by respondents to the survey is 60 percent . Of those Patients and community pharmacy users using the services the most commonly used was prescription collection (41 percent) and medicine During the development of the PNA, NHS Leeds deliveries (28 percent), however these are not NHS sought the views and opinions of a range of commissioned services . Despite the sizeable uptake, stakeholders including patients, the public, GPs, the responses to the survey suggest that there are practice-based commissioning consortia and currently gaps in-or low awareness of-provision for community pharmacies . a number of additional services . A four week survey of patients, carers and the Participants were asked which additional services public across Leeds was carried out during June should be offered by community pharmacies . 2010 . The questionnaire was distributed to Healthy living checks were the most commonly members of NHS Leeds’ Patient, Carer and Public suggested service that should be offered, with Involvement Network, the Leeds LINk and through 44 percent of respondents saying they would like GP practices and community pharmacies . this option . Almost as popular were adult weight The questionnaire asked people to explain which management services (43 percent) . Whilst some services they currently use or would probably use additional services seem to be used heavily, the and what services they feel should be offered by a demand for a tailored health offering seems quite community pharmacy . high, reflecting the movement toward community Over 300 completed questionnaires were received . pharmacy as a first point of contact for health- Feedback from the survey revealed a high level of related issues . satisfaction with pharmacy services across Leeds with 17% of people using a pharmacy regularly Community pharmacists because of good customer service . (Appendix 12) In addition to the enhanced services already commissioned, current providers were asked Convenience also plays an important role in to indicate whether they would be interested people’s selection of pharmacies . Around 45 in providing further services which maybe percent of people said they have a regular commissioned by NHS Leeds . Of the 125 responses, pharmacy as it was either near their home or next 57 replied yes, four replied no, 46 did not answer, door to a GP practice . 11 said they would provide any new services, one Approximately 13 percent of people also felt that was not sure and one felt it was not applicable . there should be a pharmacy nearer to their home, Not all providers have been commissioned to although a proportion of these already have a deliver all enhanced services . Reasons for this pharmacy within a mile of their home . The survey include location in an area not identified as results suggest this is most commonly requested in greatest need . 40 respondents stated that they the LS17 and LS9 postcode areas . fell into this category but expressed a specific Overall, the survey shows a high level of interest in providing further services . Suggestions satisfaction with current opening hours, although included a existing enhanced services like EHC, 11 71. percent of people would like additional minor ailments, palliative care, smoking and opening times after 6pm on weekdays . Around pharmaceutical advice to care homes and new 11 percent of respondents to the survey also services such as vascular checks, anti-coagulant expressed a request for additional access on monitoring, weight management, and glucose Saturday mornings . monitoring .

22 10 Ward profiles and The indices of deprivation (IMD) measure deprivation for every lower layer super output area population and local authority in England and Wales . The index consists of seven domains which are all weighted; For the purpose of the PNA the 33 electoral income deprivation (22 5. percentage) employment wards of around 20,000 people were the more deprivation (22 5. percentage) health deprivation manageable in the sense of data interpretation and disability (13 5. percentage) education skills and a substantial amount of data has already been and training deprivation (13 5. percentage) barriers aggregated to this level for the purpose of the Joint to housing and services (9 .3 percentage) crime Service Needs Assessment (JSNA) . (9 .3 percentage) living environment deprivation Although for some health data it is more useful (9 .3 percentage)-(see Appendix 3) . The higher the to look at smaller areas such as neighbourhoods, deprivation within an area the higher the score will the wards give a good overview and manageable be . approach to mapping the needs of the local All pharmacy contractors information, including population . It may be necessary when identifying opening times, is correct from the Leeds Pharmacy gaps for services in wards that lower level Panel List complied by WYCSA ( information is referred to assess where the most Central Services Agency) Jan 2011 . Any services appropriate place for services within wards are . that are additional after this date are not included . For the individual ward profiles outlined in this NHS Choices Find NHS services in your area has section, the data sources already mentioned in an current directory of NHS services including Sections five (population) and six (health profile) pharmacies which includes opening times and have been applied to create the individual profiles . services offered which should be used as a live Population data used is taken from GP register directory . data for April 2010 which includes those patients registered with Leeds GPs and resident in Leeds wards . The morbidity and hospital admission data has been taken from the data compiled for the JSNA published in 2009 and aggregated to ward level . Data on prevalence is taken from GP practice audit data and opiate dependency on data collected from pharmacy dispensing data for opiate substitute prescriptions plus data from the JSNA . The data can be found on an interactive map at http://www cio. leeds. nhs. uk/mapping/JSNA/. Atlases/PNA/atlas html. . The full JSNA can be seen http://www leedsinitiative. org/JSNA/. . In addition, further data has been included from the 2001 census (Office for National Statistics) on ethnicity and Leeds Benefit Service data from Oct 2008 (including percentage of population in receipt of any council administered benefit including income support, housing, council tax, job seekers allowance, disability living allowance) taken from profiles created as part of the Leeds Strategic Plan 18.

18 http://www leedsinitiative. org/lsp/. page .aspx?id=10742

23 PHARMACEUTICAL NEEDS ASSESSMENT

Table showing population per ward based on 2010 GP register data .

NAME Under 5’s 5-14yrs 15-24yrs 25-64yrs Over 65’s. Total Pop Adel and Wharfedale 1093 2177 2206 11374 4338 21188 Alwoodley 1356 2619 2801 13146 4268 24190 Ardsley and Robin Hood 1443 2721 2687 12981 2750 22582 Armley 1847 2791 3680 15074 3078 26470 Beeston and Holbeck 1699 2676 3409 13501 2935 24220 Bramley and Stanningley 1560 2758 3066 12984 3041 23409 Burmantofts and Richmond 2184 2968 3915 14314 2855 26236 Calverley and Farsley 1483 2315 2480 13167 3646 23091 Chapel Allerton 1752 2966 4495 16188 2981 28382 City and Hunslet 1906 2351 9692 18089 2094 34132 Cross Gates and Whinmoor 1371 2414 2975 12313 4317 23390 Farnley and Wortley 1586 2770 3393 13873 3700 25322 Garforth and Swillington 940 2231 2465 10886 4263 20785 Gipton and Harehills 3008 4912 5010 16680 2554 32164 Guiseley and Rawdon 1379 2549 2490 12919 3719 23056 Harewood 914 2104 1872 9889 4209 18988 Headingley 255 386 12672 7714 954 21981 Horsforth 1191 2292 3145 12455 3986 23069 Hyde Park and Woodhouse 1179 1404 13949 16643 1258 34433 Killingbeck and Sea croft 1690 3347 3883 13297 3534 25751 Kippax and Methley 1296 2468 2406 11662 3560 21392 Kirkstall 1039 1832 5691 13086 2581 24229 Middleton Park 2092 3537 4068 14201 3450 27348 Moortown 1506 2512 2756 13432 3906 24112 Morley North 1397 2490 2561 13384 3762 23594 Morley South 1352 2348 2566 12877 3207 22350 Otley and Yeadon 1178 2371 2489 12637 4474 23149 Pudsey 1275 2548 2686 12524 3951 22984 Rothwell 1212 2301 2305 11288 3829 20935 Roundhay 1603 2927 2941 13903 3741 25115 Temple Newsam 1443 2731 3021 12221 3790 23206 Weetwood 1101 2010 5572 11812 3106 23601 Wetherby 929 1984 1885 10354 4521 19673 All Leeds Wards 47259 82810 131232 430868 112358 804527

The table opposite shows mortality for Leeds wards (2005-2007) three year aggregate directly age standardised rates per 100 000 persons . The rates show the incidences per 100 000 population that would occur if an area had the standard age profile, i e. . the same proportion of people in each age group as the population modifier . This allows dissimilar areas to be directly compared with each other, for example, an area which has mainly young people in it in a university town can be compared with an area containing mostly retired people . This also allows a small area to be compared with the rest of the city or region . Red - significantly higher than Leeds average Green - significantly below Leeds average White - not significant

24 Mortality (2005-2007) (3 Yr Aggregate Directly Age Standardised Rates per 100 000 persons)

Smoking Circulatory Wards All Causes COPD CHD Cancer Stroke Related Disease Leeds 601 5. 327 1. 33 .4 101 5. 184 5. 47 5. 193 .8 Leeds Deprived 787 .3 461 7. 55 9. 142 7. 231 .2 56 9. 255 .4 Adel and Wharfedale 386 .2 191 .2 8 .2 57 7. 137 37 .8 126 .8 Alwoodley 426 .8 225 9. 16 7. 74 6. 148 9. 30 .3 136 6. Ardsley and Robin Hood 560 .2 307 .2 42 90 .4 189 1. 32 172 9. Armley 761 7. 426 .4 33 5. 137 .2 234 5. 53 5. 236 9. Beeston and Holbeck 734 9. 400 .8 78 .8 106 9. 234 7. 33 .8 196 Bramley and Stanningley 684 1. 386 .8 43 114 251 .3 41 6. 207 .8 Burmantofts & Richmond Hill 759 .3 454 .4 53 .3 125 6. 227 7. 64 229 1. Calverley and Farsley 587 .3 319 7. 27 .8 105 6. 179 5. 39 5. 185 .2 Chapel Allerton 638 9. 361 6. 33 5. 121 .8 175 .8 61 .3 237 .2 City and Hunslet 986 567 7. 76 6. 178 1. 241 9. 83 .8 323 7. Cross Gates and Whinmoor 605 345 9. 26 .2 103 7. 209 7. 52 7. 193 7. Farnley and Wortley 648 9. 354 .8 33 9. 123 217 .4 41 5. 209 .8 Garforth and Swillington 526 .8 263 .8 26 5. 84 .3 154 .3 42 5. 172 5. Gipton and Harehills 696 .2 384 9. 51 121 1. 197 1. 50 234 .3 Guiseley and Rawdon 508 .4 245 .4 18 .8 81 7. 160 5. 44 .2 168 9. Harewood 415 6. 220 .3 20 .2 75 .4 151 .4 39 1. 138 .3 Headingley 623 .8 345 9. 26 .2 131 1. 146 9. 58 .4 223 9. Horsforth 489 .3 233 1. 20 1. 82 .8 147 .4 32 .4 163 9. Hyde Park and Woodhouse 762 6. 437 .8 71 5. 117 .4 196 6. 68 .8 240 1. Killingbeck and Seacroft 722 1. 411 5. 48 147 9. 222 7. 46 .2 248 Kippax and Methley 695 9. 374 5. 31 5. 95 206 .3 68 .2 208 .8 Kirkstall 639 6. 371 .2 31 5. 125 205 6. 50 6. 230 7. Middleton Park 784 462 .8 68 142 .3 220 6. 57 7. 252 .2 Moortown 550 9. 263 .4 20 1. 76 6. 148 6. 49 5. 181 .2 Morley North 598 6. 320 9. 27 .4 94 .4 192 .3 58 .2 199 5. Morley South 601 .2 349 44 9. 119 .2 194 9. 31 .2 191 5. Otley and Yeadon 515 6. 273 7. 31 .8 81 158 35 158 .2 Pudsey 603 1. 332 .4 34 .4 91 206 7. 45 171 .3 Rothwell 572 7. 306 .2 27 6. 100 1. 191 9. 37 .8 169 Roundhay 634 .2 334 25 9. 94 7. 169 .2 74 216 .3 Temple Newsam 638 9. 353 6. 24 .8 104 7. 177 .2 65 9. 218 .2 Weetwood 460 9. 241 .4 18 9. 89 9. 125 .4 33 6. 167 7. Wetherby 437 6. 227 7. 18 78 7. 145 6. 28 .3 147 5.

25 PHARMACEUTICAL NEEDS ASSESSMENT

Adel and Wharfedale ward The Adel and Wharfedale ward has a population of 21,188 . Located in the outer north west of the city, it is relatively affluent, stretches northwards from Holt Park and Cookridge and includes the villages and hamlets of Pool, , and Carlton . The ward has a relatively large elderly population; more than 25 percent of population is over the age of 60 . Less than eight percent of the population are identified as being from a black or minority ethnic community . Less than seven percent of the population in households in the ward receive council- administered benefits and less than six percent of children are in households which claim benefits . The index of multiple deprivation score for this ward is one of the lowest in the city at 9 .8 . Life expectancy in the ward is amongst the highest in the city . Women in this area live to an average age of 85 7. years, which is the highest for Leeds . Current services Four community pharmacies in the ward offer the following services:

Open Open Enhanced Monday to Open Sat all Day Services Friday morning Saturday Open Sunday

Your Local Boots Pharmacy Supervised 9am-1pm 9am-1pm 9am-1pm Unit 5 consumption, 2pm -6 .30pm 2pm-5pm Holt Park Shopping Centre NRT, PATCH Leeds LS16 7SR

Adel Pharmacy 8 .30am- 141 Long Causeway, Adel 12 .30pm, Leeds 4pm-6pm LS16 8EX (Closes Weds 12:30pm)

Stancliffe Pharmacy Palliative Care, 9am-12 .30pm, 9:00am- 4 The Parade PATCH 4pm-6 .30pm 12:30pm Breary Lane, Bramhope Leeds LS16 9AF

Pool Pharmacy NRT 9am-12 .30pm, 9am-12 .30pm Main Street 2pm-5 .30pm Pool-in-Wharfedale Leeds LS21 1LH

26 A recent application has been approved for a 100 hour pharmacy at Asda in Holt Park and we anticipate this will open in the near future . Four GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

GP Practice Site

Zoltowski, Highfield Surgery, - - - Holtdale Approach, LS16 7RX

Lund JA, The Health Centre, Mon morning - - Tredgold Crescent, Bramhope, LS16 9BR and evening, Wed morning

Rickards AF, The Surgery at Adel, At other - Yes 141 Lonq Causeway LS168EX branch

Kirkham J, Holt Park Medical Centre, At other - From Oct 2010 Holt Road, LS16 7QD branch

Holt Park Health Centre is located in this ward . It houses a range of services in the community including a stop smoking clinic, weight management clinic, dietetic and paediatric services . There is an NHS “10% Group” for diet and exercise run from the Holt Park Leisure Centre . There are a number of C-card pick-up points in this ward . Health profile of the ward The mortality rates for smoking-related illness, COPD, CHD, cancer, circulatory disease and ‘all age, all cause’ mortality are all significantly below those of Leeds average . The exception to this is stroke-related illness which is still below the Leeds average but not significantly so . There are low hospital admission rates in this ward for dementia, smoking-related illnesses and heart attack (myocardial infarction) . The life expectancy for the ward is one of the highest in the city . Potential need for services Due to the imminent opening of a 100 hour pharmacy within the ward, there are no gaps of pharmaceutical services .

27 PHARMACEUTICAL NEEDS ASSESSMENT

Alwoodley ward The Alwoodley ward has a population of 24,190 . Located in the north of the city, a substantial part of the ward is rural land, including the area of Eccup . The ward has a higher than average elderly population, and a substantial Jewish population of 20 percent . The BME community makes up around 15 percent of the local population . Around 11 4. percent of the Alwoodley population live in households that are claiming council administered benefits This includes 11 75. percent of the children living in Alwoodley . The index of multiple deprivation for this ward is relatively low at 14 5. however there are small pockets of relatively deprived populations on the border of this ward . Life expectancy is above the Leeds average . Current services Four community pharmacies in the ward offer the following services:

Open Late Enhanced Monday to Open Sat Open all day Services Friday morning Saturday Open Sunday

Living Care Pharmacy Minor 8 .30 am-5:00pm 49 Cranmer Bank Ailments, Moortown Supervised Leeds LS17 5JD Consumption, NRT, Palliative Care

Sainsburys Pharmacy Minor 8:00 am-9:00pm 8:00am- 9:00pm 8 00. am- Moor Allerton Centre Ailments, 9:00 pm Leeds LS17 5NY Supervised Consumption, NRT, Palliative Care, PATCH

Lloyds Pharmacy Ltd Minor 08 .45 am - 6 .30 9:00 am- 1 00. 2 The Avenue Ailments, pm pm Alwoodley NRT, (closes 6 00. pm Leeds LS17 7BE Supervised Tuesday) Consumption

Co-op Healthcare Ltd Supervised 8 15. am - 6 15pm. 139 Shadwell Lane Consumption, Leeds LS17 8AE Palliative Care

28 Four GP practices are located in this ward:

Extended NHS Health GP Practice Site Hours Smoking Checks

Fellerman SM At other - 24 The Avenue branch Leeds LS17 7BE

Hall GI Mon morning - Moorcroft Surgery 646 King Lane Leeds LS17 7AN

Potts RK Mon/Weds - Shadwell Medical Centre evenings 137 Shadwell Lane, LS17 8AE

Rickards AF Mon/Weds - The Surgery at Nursery Lane mornings 150 Nursery Lane Leeds LS17 7AQ

Health profile of the ward Mortality figures for this ward are significantly below the Leeds average for smoking- related illness, COPD, circulatory disease and ‘all age, all cause’ mortality . There are also low rates of hospital admissions for dementia and smoking-related illness . Potential need for services In this ward there is good access to pharmacy services seven days a week; during the day, including lunchtime, and on an evening . There is also a good spread of enhanced services .

29 PHARMACEUTICAL NEEDS ASSESSMENT

Ardsley and Robin Hood ward The Ardsley and Robin Hood ward has a population of 22,582 . Located in the far south of the city the ward borders the Wakefield area . Less than four percent of people living in Ardsley and Robin Hood are from BME backgrounds . The proportion of people in households who receive council administered benefits is 11 7. percent (12 .36 percent of children live in households on benefits) . The index of multiple deprivation for this ward is 17 .8 . Current services Three community pharmacies within the ward offer the following services:

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Rowlands Pharmacy Supervised 8 .30am-1:00pm, 8 .30am-12:00 Leigh View, Bradford Road Consumption, 1:20pm-6:00pm midday Tingley NRT Wakefield WF3 1RQ

Thorpe Pharmacy 10:00am-6:00pm 1 Oakley Street Thorpe Wakefield WF3 3DX

Carlton Lane Pharmacy Supervised 8:30am-6:00pm 2 Carlton Lane consumption, Lofthouse NRT, Palliative Wakefield WF3 3LJ Care

Analysis of EPACT data shows that residents in this ward make substantial use of Boots on Kirkgate in Wakefield . This service is commissioned by NHS Wakefield . Two GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Blakemore LT, - - From Oct 2011 Lofthouse Surgery, 2 Church Farm Close, Lofthouse, WF3 3SA

Elliot N, Mon, Tues, - From Oct 2011 Leigh View Medical Centre, Wed, Fri Bradford Road, Tingley, WF3 1RQ evenings

Health profile of the ward The mortality rates for stroke within the ward are significantly below the Leeds average, however they are around the Leeds average for all other causes . Potential need for services Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday . This ward also has limited access to enhanced services, and although not necessary, it may be desirable to consider the reallocation of services to ensure equity across all areas . 30 Armley ward The Armley ward has a population of 26,470, which makes it one of the largest wards in the city . Located in the inner west of the city, it is close to the city centre . The ward has a relatively high BME population, with 10 percent of people identified as being from a BME background . Around 23 42. percent of people in this area live in households who receive council administered benefits . 32 11. percent of children in this area live in households claiming benefits . The index of multiple deprivation for this ward is high at 38 6. . Current services Five community pharmacies in the ward offer the following services:

Enhanced Open all Day Services Open Late M-F Open Sat am Sat Open Sun

Lloyds Pharmacy Needle 7 00am-11:00pm. 8:00am-8:00pm 8:00am- 10:00am- Old Crown Cinema Site Exchange, 8:00pm 6:00pm 14-16 Tong Road Supervised Leeds Consumption, LS12 1HX NRT, Palliative Care

Cohens Chemist EHC, 8:45am-6:00pm New Building Chlamydia, Green Lane Supervised Leeds Conumption, LS12 1JZ NRT, Palliative Care, MARS

Your Local Boots Pharmacy Supervised 8:45am-1:30pm, 8:45am-1:30pm, 8:45am- 5-7 Town Street Consumption, 2:30pm-5:30pm 1:30pm, Leeds NRT, Palliative 2:30pm- LS12 1UG Care 5:30pm

Co-operative Pharmacy NRT 8:30am-6:00pm Station Road Armley Leeds LS12 3EY

Lloyds Pharmacy Supervised 8:30am-6:30pm 62 Armley Ridge Road Consumption, Leeds NRT LS12 3NP

31 PHARMACEUTICAL NEEDS ASSESSMENT

Four GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Addlestone RI, Mon morning - Yes Thornton Medical Centre, Mon/Tues 15 Green Lane, LS12 1JE evenings

Burkill AD, Mon morning - Yes Priory View Medical Centre, Thurs evenings 2a Green Lane, LS12 1HU

Lee PS, Tues/Wed - Yes Armley Medical Centre, morning, Thurs Armley Moor HC, evening 95 Town Street, LS12 3HD

Singh H, Mon evening - Yes The Highfield Medical Centre, Highfield Road, Bramley, LS13 2BL

Armley Moor Health Centre, St Mary’s Hospital and Thornton Medical Centre are all located in this ward . They provide a range of services in the community including stop smoking clinics, weight management clinics, warfarin clinics, diabetes, mental health, paediatric and dietetic services . There is also a contraception and sexual health (CASH) clinic at Armley Moor Health Centre and a number of C-card pick-up points . Health profile of the ward Mortality figures for Armley are significantly above the Leeds average for smoking, CHD, cancer, circulatory disease and ‘all age, all cause’ mortality with high prevalence of CHD and high hospital admissions for alcohol, dementia and heart attack . There are also high rates of attendance to the accident and emergency department for this ward . Potential need for services As already highlighted, this ward has a high rate of deprivation compared with the Leeds average . Currently there is no pharmaceutical provision of minor ailments service and therefore it may be desirable to look at the realignment of services to ensure equity across all areas of the city . If NHS Leeds agrees to commission NHS Health Checks from community pharmacies then population of this ward would benefit from accessing this service . Based on the high number of hospital admissions, the population of this ward would also benefit from alcohol brief interventions if they were to be commissioned for community pharmacies by NHS Leeds .

32 Beeston and Holbeck ward The Beeston and Holbeck ward is located in the inner south of the city . It has a population of 24,220 and around 10 percent of these people are from BME backgrounds . There is low life expectancy in this area and the index of multiple deprivation for this ward is relatively high at 38 .8 . The proportion of people in households who receive council administered benefits is 26 10. percent . 35 40. percent of children here are living in households that are claiming benefits . Current services Six community pharmacies in the ward offer the following services:

Open Open Enhanced Services Open Late M-F Open Sat am all day Sat Sun

Cottingley Pharmacy Supervised 9:00am-6:00pm 3 Cottingley Vale Consumption (closes 1:00pm Cottingley Wed) Leeds LS11 0JY

Living Care Pharmacy Minor Ailments, 9:00am-6:00pm 311 Dewsbury Road Supervised Leeds LS11 5LQ consumption, NRT, Palliative Care

Living Care Pharmacy Supervised 9 00am-6:00pm. 188 Old Lane consumption, NRT (closes 1:00pm Leeds Wed) LS11 8AG

Your Local Boots Pharmacy Minor Ailments, 8:15am-1:00pm, 9 00am-. 9 00am-. 132 Beeston Road Needle Exchange, 2:00pm-6:30pm 1:00pm 1:00pm, Leeds LS11 8BB Supervised 2:00pm- consumption, NRT, 5:00pm Palliative Care

The Co-operative NRT, Palliative Care 8:45am-5:45pm 8:45am- 8:45am- Pharmacy 4:45pm 4:45pm Beeston District Centre Town Street Leeds LS11 8PN

Cohens Chemist Minor Ailments, 9 00am-6:00pm. 5a Shafton Lane EHC, Chlamydia, (closes 1:00pm Holbeck Supervised Wed) Leeds consumption, NRT, LS11 9LY Palliative Care

There has been an application approved for an additional 100 hour pharmacy within this ward and it is anticipated this will open in the near future .

33 PHARMACEUTICAL NEEDS ASSESSMENT

Six GP practices are located in the ward:

Extended NHS Health Hours Smoking Checks

Berridge JM, - - Yes Beeston Village Surgery, Beeston District Centre, Town St, LS11 8PN

Bhandary LV, - Yes Yes 20A Shafton Lane, Holbeck, LS11 9RE

Iwantschak A, - Yes Yes Parkside Community Health Centre, 311 Dewsbury Road, Leeds LS11 5LQ

Iwantschak A, Mon evening Yes Yes Leeds City Medical Practice, 123 Cemetery Road, LS11 8LH

Pai HU, Wed morning - Yes Cottingley Community Centre, 115 Cottingley Approach, LS11 0HJ

City View Medical Practice, Mon /Thurs Yes Yes Beeston Hill Health Centre, evenings Beeston Hill, LS11 8BS

Beeston Village Medical Centre, Beeston Hill Health Centre and Parkside Health Centre are located in this ward . These provide a number of services in the community including stop smoking clinics, weight management clinics, community dental clinics, podiatry and diatetic services . There is also a contraception and sexual health (CaSH) clinic at Beeston Village Health Centre and an outreach CaSH service is available in Holbeck . The ward has a number of C-card pick-up points . Health profile for the ward The mortality rates for smoking-related illness, COPD, cancer and all age, all cause mortality are significantly above the Leeds average . There are high rates for alcohol- related hospital admissions and smoking-related illness . There is also a high prevalence for COPD and smoking-related illness . There is a higher than average rate of opiate dependence, along with high rates of teenage conceptions in parts of the ward . The ward also shows higher than average attendance at hospital accident and emergency departments . Potential need for services If NHS Leeds agrees to commission NHS Health Checks from community pharmacies the population of this ward would benefit for accessing the service . The population of this ward would also benefit from alcohol brief interventions if they were to be commissioned from community pharmacies by NHS Leeds . As already highlighted, the ward has a higher rate of teenage pregnancy than the national average . Currently, there is little pharmaceutical provision of emergency hormonal contraception (EHC) Monday to Saturday, and no provision on a Sunday which is potentially not enough to meet the identified needs .

34 Bramley and Stanningley ward The Bramley and Stanningley ward has a population of 23,409 and is located in the inner west of the city . Less than six percent of its population is from a BME background . The index of multiple deprivation for this ward is relatively high at 33 .2 . The proportion of people in households who receive council administered benefits is 21 .86 percent . 28 .84 percent of local children live in households that are claiming benefits) . Current services Five community pharmacies within the ward offer the following services:

Enhanced Open all Day Services Open M-F Open Sat am Sat Open Sun

Boots Chemist Ltd EHC, Chlamydia, 8 .30am-1:30pm, 8 .30am-1:30pm 8 .30am-1:30pm, 31-33 Bramley Centre Supervised 2:00pm-5:30pm 2:00pm-5:30pm Bramley LS13 2ET consumption, NRT

Co-op Pharmacy Supervised 9 00am-6:00pm. 9 00am-5:00pm. 9 00am-5:00pm. 35 Bramley Centre consumption, NRT, Bramley LS13 2ET MARS

Lloyds Pharmacy Supervised 8 .30am-6:30pm Bellmount Close consumption Bramley LS13 2UP

The Co-operative Supervised 9 00am-6:00pm. Pharmacy consumption, NRT 23 Nora Place Bramley LS13 3JE

Lloyds Pharmacy Supervised 9 00am-6:30pm. 283-285 Town Street consumption Bramley LS13 3JT

Two GP practices are located in the ward:

Extended NHS Health Hours Smoking Checks

Tolley JM, - - Yes Manor Park Surgery, Bell Mount Close, LS13 2UP

Lee AV, - - From Oct 2010 Glenlea Surgery, 701 Leeds and Bradford Road, Stanningley, Pudsey, LS28 6PE

35 PHARMACEUTICAL NEEDS ASSESSMENT

Bramley clinic is located in the ward . It provides a range of services in the community including a stop smoking clinic and dietetic services along with a Kickstart group for diabetic-related obesity and nutrition . There is a drug treatment and harm reduction service in this ward run by BARCA in association with Leeds Community Drugs Partnership which serves the west and north west of the city . Health profile of the ward The mortality rates for smoking-related illness, cancer and all age, all cause mortality are all significantly above those of the Leeds average . There is also a high prevalence of opiate dependence . The ward has the highest rates of hospital admissions for smoking- related illness in the city . Potential need for services Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday .

36 Burmantofts and Richmond Hill ward The Burmantofts and Richmond Hill ward has a population of 26,236 . Located in the inner east of the city and close to the city centre, it has large areas of non-residential, industrial land . The 2001 census data identified that 12 percent of the population is from a BME background compared to the Leeds average of 8 percent . The index of multiple deprivation for this ward is one of highest at 50 6. . The ward is also in the bottom six ranked wards in Leeds for life expectancy . The proportion of people in households who receive council administered benefits is high at 37 97. percent with over half of local children (52 16. percent) in households that are claiming benefits . Current services Seven community pharmacies within the ward offer the following services:

Open all Open Enhanced Services Open M-F Open Sat am Day Sat Sun

Lloyds Pharmacy Minor Ailments, 9 00am-6:30pm. 399 Harehills Lane Supervised LS9 6AP consumption

Lloyds Pharmacy Minor ailments, 9 00am-6:00pm. Shaftesbury Medical Centre supervised 480 Harehills Lane consumption, NRT, LS9 6DE Palliative Care

The Co-operative Pharmacy Minor Ailments, 9 00am-6:00pm. 9:00am-1:00pm 84-86 Lincoln Green Road supervised LS9 7SU consumption, NRT

Living Care Pharmacy Minor Ailments, 8 .30am-6:00pm 9a Upper Accommodation supervised (Closes 1:00pm Rd consumption, NR Tues) LS9 8RZ

Lloyds Pharmacy Minor Ailments, EHC, 8 .30am-6:00pm 78a Osmondthorpe Lane Chlamydia, Supervised LS9 9BL consumtion, NRT, Palliative Care

Cohens Chemist Minor Ailments, Needle 9 00am-6:00pm. 230 York Road Exchange, Supervised (Wed 5:30pm) LS9 9BP consumption

Living Care Pharmacy Minor Ailments, EHC, 8 00am-6:00pm. 5-7 East Park Road Chlamydia, NRT East End Park LS9 9JG

37 PHARMACEUTICAL NEEDS ASSESSMENT

Ten GP practices are located in this ward .

Extended NHS Health Hours Smoking Checks

Addlestone MB East Park Medical Centre, Mon morning - Yes 5-7 East Park Road, LS9 9JD Mon evening

Boonin AS, Bellbrooke Surgery, Mon /Wed - Yes Bellbrooke Avenue, LS9 6AU evenings

Chilvers McCrea at Lincoln Green, Tues/Wed - Yes Lincoln Green Medical Practice, evenings Burmantofts HC, LS9 7TA

Darbyshire PG, Shaftesbury MC, Mon/Wed - Yes 1st Floor, East Leeds HC, morning, Tues Osmondthorpe Lane, LS9 9EF evening,

Guckian DMF, Londesborough House Surgery, Thurs evening - Yes 1 East Park Parade, LS9 9NQ

Laybourn SM 143 Rookwood Avenue, LS9 0NL - - Yes

Proctor JJ, The Garden Surgery, 2nd Floor East Leeds HC, - Yes Yes Osmondthorpe Lane, LS9 9EF

Sooltan AR, 179 York Road, LS9 7RD Thurs evening - Yes

Srivastava SK, The Richmond Medical Centre, Wed evenings - Yes 15 Upper Accom . Road, LS9 8RZ

Shakespeare Community Practice, Burmantofts Health Mon-Sun - From Oct 2011 Centre, Cromwell Mount, LS9 7TA 8am-8pm

A GP-led service, known as Shakespeare There are high predicted rates of severe mental Community Practice, is available from Burmantofts illness, high opiate dependence, high rates of Health Centre and is open from 8am-8pm, 365 smoking-related illness and high obesity rates . days a year . Potential need for services There are a number of services provided in the community and based in the local Burmantofts and The neighbouring wards of Chapel Allerton, East Leeds health centres . Among these are stop Killingbeck and Seacroft all currently have 100 smoking, warfarin monitoring, diabetic and weight hour pharmacy provision . However none of the management clinics . There are contraception and community pharmacies within the Burmantofts and sexual health clinics at both centres and outreach Richmond Hill wards are open on either a Saturday services located at Richmond Hill . afternoon or Sunday . The Primary care mental health team offer services It maybe desirable, in order to improve access from East Leeds health centre . There are numerous to encourage existing providers to consider C-card pick-up points . A number of voluntary opening for an identified period to support organisations offer healthy living services in this services provided from the GP Led service within ward . Burmantofts Health Centre . St James’ University Hospital is located on the As already highlighted, this ward has a higher rate border of this ward and has an adult accident and of teenage pregnancy than the national average . emergency department . Currently, there is no pharmaceutical provision of emergency hormonal contraception (EHC) on a Health profile of the ward weekend which is potentially not enough to meet The mortality rates for smoking-related illness, the identified needs . COPD, cancer, and all age, all cause mortality are If NHS Leeds agrees to commission NHS health above the Leeds average . There are high hospital checks from community pharmacies the population admissions for alcohol-related illness in this ward . of this ward would benefit from this service . Parts of the ward have high teenage conception rates and high attendance at accident and emergency departments .

38 Calverley and Farsley ward The Calverley and Farsley ward has a population of 23,091 . It is located in the outer west of the city and borders Bradford . The ward has a BME population of around 10 percent . The Index of Multiple deprivation for this ward is one of lowest in the city at 14 . The proportion of people in households receiving council administered benefits is also low at 9 06percent. with 8 .84percent of children in households on benefits . Current services Five community pharmacies within the ward offer the following services:

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

Liptrots Farsley EHC, 8:45am-6:15pm 9:00am-4:00pm 9:00am- 38-42 Town Street Chlamydia, 4:00pm Farsley LS28 5LD supervised consumption, NRT, palliative care, MARS

Liptrots Calverley EHC, NRT, 8:45am-6:00pm 9:00am-12:30 100 Thornhill Street Palliative midday Calverley Care, MARS, Leeds LS28 5PD supervised consumption .

ASDA Pharmacy Supervised 9 00am-1:30pm,. 9:00am-1:30pm, 9 00am-. 11:00am- Owlcotes Centre consumption, 2:30pm-9:00pm 1:30pm, 1:30pm, Pudsey NRT 2:30pm- 2:00pm- Leeds LS28 6AN 9:00pm 5:00pm

The Co-op Pharmacy Supervised 8:30am-1:00pm, Sunfield Medical Centre consumption, 2:15pm-6:00pm Sunfield Place, Stanningley NRT Leeds LS28 6DR

Your Local Boots Pharmacy Supervised 9 00am-6:00pm. 9:00am-12:00 72 Galloway Lane Consumption, midday Pudsey PATCH Leeds LS28 8LE

There are a number of cross border pharmacies provided by Bradford district, which may be accessed by residents of this ward . Claricks Pharmacy in Greengates is substantially used by people registered at practices in the ward .

39 PHARMACEUTICAL NEEDS ASSESSMENT

Four GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Broom C, Sunfield Mon morning Yes From Oct 2010 Medical Centre, Thurs eves Sunfield Place, Stanningley, Pudsey, LS28 6DR

Lee AV - - From Oct 2010 Calverley Medical Centre, 43 Upper Carr Lane, Calverley, Pudsey, LS28 5PL

Lee AV, - - From Oct 2010 West Lodge Surgery, New Street, Farsley, Pudsey, LS28 5DL

Maddy PJ, Mon/Tues Yes From April 2011 Hillfoot Surgery, evenings 126 Owlcotes Road, Pudsey, Leeds LS28 7QR

Cringlebar Health Centre is located within the ward which houses child and adolescent mental health services (CAMHS) . There is also a C-card pick-up point in the ward . Farsley Health Centre on the border of this ward also houses a weight management clinic . However, from April 2011, CAMHS will relocate to Kirkstall . Health profile of the ward The mortality rates for all disease states are neither significantly above or below the Leeds average . Potential need for services This ward already has a good provision of pharmacy service, with access to pharmaceutical services available seven days a week .

40 Chapel Allerton ward The Chapel Allerton ward has a population of 28,382 . It is located in the inner north of the city, close to the city centre . The ward has the highest reported BME community in the city with 37 percent of the population in this group . The index of multiple deprivation for this ward is also one of the highest in the city at 42 .2 . The proportion of people in households receiving council administered benefits is relatively high at 27 .32 percent with 38 19. percent of children in households on benefits . Current services Six community pharmacies in the ward offer the following services:

Enhanced Services Open M-F Open Sat am Open all Day Sat Open Sun

Baskind Pharmacy EHC, Chlamydia, NRT, 8:00am-11:00pm 8:00am-11:00pm 8:00am-11:00pm 8:00am-6:00pm Rutland Lodge Palliative Care Scott Hall Road LS7 3DR

Lloyds Pharmacy Supervised 9:00am-6:00pm 9:00am-1:00pm Reginald Joint Service consumption, Palliative Centre Care 263 Chapeltown Road LS7 3DX

Cohens Chemist Minor Ailments, 8:30am-6:00pm Chapeltown Health Supervised Centre consumption, NRT, Spencer Place MARS LS7 4BB

Medichem Minor Ailments, EHC, 9:00am-1:00pm, 4-5 Newton Parade Chlamydia, Needle 2:15pm-6:15pm Chapeltown Road Exchange, Supervised Leeds consumption, NRT, LS7 4JA Palliative Care, MARS

Medichem Minor Ailments, EHC, 9:00am-6:00pm 9:00am-1:00pm 42 Harrogate Road Chlamydia, Supervised Leeds consumption, NRT, LS7 4LA PATCH, MARS

Baskinds Chemist Minor ailments, 9:00am-6:00pm 9:00am-1:00pm 6 Stainbeck Lane supervised Leeds consumption, PATCH, LS7 3QY MARS

41 PHARMACEUTICAL NEEDS ASSESSMENT

Eight GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Hunjin MS, Mon morning - Yes Newton Surgery, 305 Chapeltown Road, LS7 3JT

Hunter CM, Sat morning Yes Yes 178 Chapeltown Road, LS7 4HP

Lawrence SL, St Martins Practice, Tues / Thurs - Yes 319 Chapeltown Road, LS7 3JT evening

Lawrenson FJ, Tues/Wed Yes Yes Allerton Medical Centre, mornings, 6 Montreal Avenue, LS7 4LF Thurs evening

Manuel JB, - - Yes Chapeltown Health Centre, Spencer Place, LS7 4BB

One Medicare at Hilton Road, Mon evenings Yes Yes Hilton Road Surgery, 67 Hilton Road, LS8 4HA

Ottman SC, Tues morning - Yes Rutland Lodge Medical Centre, and Rutland Lodge, Scott Hall Road, LS7 3RA evening

Sharma S, Mon evening, Yes Yes Westfield Medical Centre, Sat morning 2 St Martins Terrace, Chapeltown Road, LS7 4JB

Chapeltown Health Centre is located in the Chapel Allerton ward . It provides a range of services in the community including stop smoking clinic, weight management clinic contraception and sexual health clinic (CASH) and community paediatric services . Also Scott Hall Leisure Centre and the West Indian Centre are located in the ward and provide stop smoking clinics and weight management clinics and support (including an NHS ’10 percent’ group for diet and exercise) . There are a number of C-card pick up points in the ward . In October 2010, Chapeltown Joint Service Centre (JSC) to be known as The Reginald Centre will open offering a range of health (currently at Chapeltown Health Centre) and council services under one roof . Dr Sharma’s practice will relocate to Chapeltown JSC . There is also an application pending for the relocation of a pharmacy into the JSC . There will also be a primary care mental health team, diabetes clinic, and a community dental service . Rutland Lodge Eye Clinic is also in this ward . Health profile of the ward The mortality rates for circulatory disease are significantly above those of the Leeds average . There are high predicted rates of mild anxiety and depression along with high opiate dependence . Potential need for services This ward already has a good provision of pharmacy services with access to pharmaceutical services available seven days a week .

42 City and Hunslet ward The City and Hunslet ward has a population of 34,132 . This is a significant increase from a population of 18,149 in 2001 . This ward is located in the centre and inner south of the city . As a result of an increase in population, the BME population of 24 percent in 2001 will probably be significantly changed . The Index of Multiple deprivation for this ward is one of highest in the city at 45 6. . The proportion of people in households receiving council administered benefits is relatively high at 33 09. percent . 47 02. percent of children live in households on benefits which is almost half of the children in the ward . The ward has the lowest life expectancy in the city . Current services 12 community pharmacies within the ward offer the following services:

Open Sat Open all Day Enhanced Services Open M-F am Sat Open Sun Boots NRT, Palliative Care, 6 00am-midnight. 8:00am- 8 00am. 9 00am. – City Station Concourse Chlamydia midnight -midnight midnight Leeds LS1 4DT Boots NRT, Palliaitve Care, 8:ooam-7 00pm. 8:00am- 8:00am- 11:00am- 19 Albion Arcade Chlamydia 7 00pm. 7 00pm. 5 00pm. Bond Street Centre Leeds, LS1 5ET Superdrug Stores NRT, 8 .30am-6:00pm 8 .30am- 8 .30am- 13 Kirkgate, Leeds LS1 6BY 6:00pm 6:00pm Boots EHC, Chlamydia, 7:45am-6 00pm. 7:45am- 7:45am- 10 .30am- 12-14 Kirkgate Market Ctr Needle Exchange, 6 00pm. 6 00pm. 4:30pm Vicar Lane LS1 7JH supervised consumption Boots Supervised 9:00am-7:00pm 9:00am- 9:00am- 10 .30am- Crown Point Retail Park consumption, NRT, 7:00pm 7:00pm 4:30pm Junction Street Palliative Care, Leeds LS10 1ET Chlamydia, MARS The Co-operative Pharmacy Supervised 8 .30am-6:00pm 9:00am- 17-18 Penny Hill Centre consumption, NRT 1:00pm Hunslet, Leeds LS10 2AP Lloyds Pharmacy EHC, Chlamydia, 8 .30am-6:00pm 9:00am- Unit 1, Fraternity House supervised 1:00pm 52 Church Street, Hunslet consumption Leeds, LS10 2AR Your Local Boots Pharmacy Minor Ailments, 9 00am-1:00pm,. 9:00am- 1 Moor Road supervised 2:00pm-6:00pm 1:00pm Hunslet Carr consumption, Leeds LS10 2JJ Living Care Pharmacy Minor Ailments, EHC, 9:00am-6:00pm 227 Dewsbury Road Chlamydia, Needle LS11 5HZ Exchange, Supervised consumption, NRT, PATCH Boots Supervised 8:00am-6:00pm 8:00am- 8 00am-. 49-51 The Merrion Centre consumption, NRT, 6:00pm 6:00pm Leeds LS2 8DB Palliative Care, Chlamydia

43 PHARMACEUTICAL NEEDS ASSESSMENT

Open Sat Open all Day Enhanced Services Open M-F am Sat Open Sun Superdrug Stores EHC, Chlamydia, 8:00am-5:30pm 8:00am- 8 00am-. 31-35 The Merrion supervised 5:30pm 5:30pm Centre Leeds LS2 8NG consumption, NRT Al-Shafa Pharmacy Palliative Care Mon/Tues 8am-9pm 9 00am-. 9 00am-. 12 midday-12 267 Dewsbury Road Wed 8am-midnight midnight midnight midnight Leeds LS11 5HZ Thurs midday-9pm Fri 7 .45am-1 15pm,. 1 .45pm-9 15pm.

Seven GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Ali SA, Wed morning - - Church Street Surgery, 57 Church Street, Hunslet, LS10 2PE

Iwantschak A, At other - Yes Crossland Surgery, branch 218A Dewsbury Road, Leeds LS11 6ER

Khan A, Mon morning - Yes Hunslet Health Centre, Thurs evening 24 Church Street, LS10 2PT

Manning SI, - Yes Yes 12 Oakley Terrace, Leeds LS11 5HT

Menon R, Mon evening - Yes The Arthington Medical Centre, 5 Moor Road, LS10 2JJ

Morris M, Tues evening - Yes The Whitfield Medical Practice, Thurs morning Hunslet Health Centre, 24 Church Street, LS10 2PT

One Medicare at The Light, Tues/Thurs Yes Yes The Balcony, Level 7, mornings The Light, The Headrow, LS1 8TL Tues/Thurs evenings Sat morning

44 A nurse-led service, known as the Headrow walk-in centre, is available from The Light in the city centre . The service is open from 7am-7pm, Monday to Friday . There are a number of community services available in the ward . At Citywise, there is a contraception and sexual health (CASH) service . Stop smoking clinics are available at Leeds General Infirmary and Hunslet Health Centre . There is a drug treatment and harm reduction service, including needle exchange, at St Anne’s and the Rapid Access Prescribing Centre based at Mabgate Mills . This ward also has Addiction Dependency Solutions (ADS), the citywide alcohol service and Leeds Addiction Unit . There is a homeless healthcare team offering a centralised health service for the cities homeless and hostel dwelling population . There are numerous C-card pick-up points for this ward . There are a number of services provided in this ward which are used by people who do not live in the ward . Health profile of the ward The mortality rates for all areas, including smoking related illness, COPD, CHD, cancer, circulatory disease, stroke and ‘all age, all cause’ mortality are significantly above those of the Leeds average . There is also high prevalence of COPD, obesity and opiate dependence, with prevalence for smoking related illness at 41 percent . There is a predicted high rate for both mild and severe depression . There are high rates of hospital admissions for alcohol, dementia and smoking related illness along with high accident and emergency attendance . Parts of the ward show high teenage conception rates . Potential need for services If NHS Leeds agrees to commission NHS Health Checks from community pharmacies the population of this ward would benefit from accessing this service . The population of this ward would also benefit from alcohol brief interventions if they were to be commissioned for community pharmacies by NHS Leeds .

45 PHARMACEUTICAL NEEDS ASSESSMENT

Cross Gates and Whinmoor ward The Crossgates and Whinmoor ward has a population of 23 .390 . Located in the outer east of the city, it is one of the larger wards however the population has been very static over the last decade . The ward has a relatively large elderly population with over 23 percent of population aged 60 and over . Less than five percent of the population are identified as from a BME group . The Index of Multiple deprivation for this ward is 24 6. . The proportion of people in households receiving of council administered benefits is relatively low at 15 14. percent with 18 02. percent of children in households on benefits . Current services Four community pharmacies within the ward offer the following services:

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

Whinmoor Pharmacy Minor 9 00am-1:00pm,. 46a White Laithe Aprroach Ailments, 2:30pm-6:00pm LS14 2EH Supervised (closes early Wed consumption, 1:00pm) NRT

Lloyds Pharmacy Minor 8:30am-6:15pm Windmill Hth Ctr Pharmacy Ailments, Mill Green View Needle LS14 5JS Exchange, Supervised consumption, NRT

The Co-operative Pharmacy Minor 9 00am-6:00pm. 37 Austhorpe Road Ailments, LS15 8BA Supervised consumption, NRT, Palliative Care

Co-op Pharmacy Minor 8:30am-6:00pm 9:00am-3:00pm 42 Austhorpe Road Ailments, EHC, LS15 8DX Chlamydia, Supervised Consumption, NRT

There is also a ‘distance selling’ pharmacy located in this ward . As face to face contact is not permitted from a distance selling pharmacy when providing essential services, it has not been included in the table . There are smoking cessation clinics at St Theresa’s Parish Centre .

46 Five GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Darbyshire PG, Sat morning - Yes Church View Surgery, 41 Austhorpe Road, Crossgates, LS15 8BA

Eastwood PG, Wed evening - Yes Ashfield Medical Centre, 15 Austhorpe Road, Cross Gates, LS15 8BA

Mossad MG, - - From Oct 2010 Whinmoor Surgery, White Laithe Approach, Whinmor, LS14 2EH

Saffer CM, Tues/Thurs Yes Yes Windmill Health Centre, morning, Wed Mill Green, LS14 5JS evening

Swaby MJ, Sat morning Yes Yes Manston Surgery, 72-76 Austhorpe Road, LS15 8DZ

Health profile of the ward The mortality rates for all disease states are neither above or below the Leeds average . There is a high prevalence of CHD compared with the Leeds average however mortality rates for CHD are not significantly high . Potential need for services Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday . However there are pharmacies open on a Sunday in the neighbouring ward of Killingbeck and Seacroft .

47 PHARMACEUTICAL NEEDS ASSESSMENT

Farnley and Wortley ward The Farnley and Wortley ward has a population of 25,322 and is located in the outer south west of the city . Less than five percent of the population is identified as being from a BME community . The index of multiple deprivation for this ward is 30 4. . The proportion of people in households receiving council administered benefits is relatively low at 18 43. percent with 23 55. percent of children in households on benefits . There is a permanent site for Gypsies and Travellers on the borders of this ward . Current services Three community pharmacies in the ward offer the following services:

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

Lloyds Pharmacy Supervised 9:00am-6:00pm 9:00am-2:00pm 106 Dixon Lane consumption, Lower Wortley NRT LS12 4AD

Lloyds Pharmacy Supervised 9:00am-7:00pm 9:00am-5:00pm 9:00am- 531 Tong Road consumption, 5:00pm LS12 5AT NRT, Palliative Care, MARS

Freemans Pharmacy Supervised 8:15am-6:15pm 9:00am-12:30 Wortley Beck Health Centre consumption, midday Lower Wortley PATCH LS12 5SG

Five GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Ellison C, Dixon Lane Medical Centre, - - Yes 102 Dixon Lane, Lower Wortley, LS12 4AD

Matharu SS, Beech Tree Medical Centre, Tues morning - Yes 178 Henconner Lane, LS13 4JH

Robinson ASA, Whitehall Surgery, Wed evening Yes Yes 1st Floor, Wortley Beck Health Centre, Ring Road, LS12 5SG

Robinson ASA, New Farnley Surgery, At other Yes Yes 6 West End, Leeds LS12 5DR branch

Shevlin PV, Hawthorn Surgery, 2nd Floor, Mon evening - Yes Wortley Beck Health Centre, Ring Road, LS12 5SG

Wortley Beck Health Centre is located in Wortley and provides stop smoking clinics and paediatric speech and language clinics . Health profile of the ward The mortality rates for all disease states are neither above or below the Leeds average . Parts of the ward have higher than average attendance at hospital accident and emergency departments . Potential need for services Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday,

48 Garforth and Swillington ward The Garforth and Swillington ward has a population of 20,785 and is in a semi-rural location in the outer south east of the city . The population is mainly focused on the centres of Garforth and Swillington . The ward has a very low identified BME population with less than three percent of the population from this group . It is one of the lower ranked wards on the index of multiple deprivation at 12 0. . The proportion of people in households receiving council administered benefits is one of the lowest in city at 9 48. percent with 8 .36 percent of children in households on benefits . Current services Five community pharmacies within the ward offer the following services:

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

Lloyds Pharmacy Minor 8 00am-6:00pm. 9:00am-5:00pm 9 00am-. 24-26 Main Street Ailments, EHC, 5:00pm Garforth Chlamydia, Leeds LS25 1AA Supervised Consumption, NRT

Cohens Chemist NRT, Palliative 8 .30am-6:30pm 9:00am-1:00pm Cohen's, 10 Main Street Care, Garforth Supervised Leeds LS25 1EZ consumption

Tesco Instore Pharmacy 8 00am-10:30pm. 6:00am- 6 00am-. 10:00am- Aberford Road 10:00pm 10:00pm 4:00pm Garforth LS25 2DX

Lloyds Pharmacy Supervised 8:15am-6:00pm, 9 Fairburn Drive consumption, (closes 1:15pm Garforth LS25 2AR NRT Wed)

Swillington Pharmacy Minor 9 00am-6:30pm. 9:00am-1:00pm Church Lane Ailments, Swillington LS26 8DY Needle Exchange, Supervised Consumption, NRT, Palliative Care

49 PHARMACEUTICAL NEEDS ASSESSMENT

Four GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Grange Medicare, Sat morning - From Oct 2011 Swillington Clinic, Hillcrest Close, Swillington, LS26 8DZ

Porter KG , Mon,/Tues Yes From Oct 2011 Garforth Medical Centre, evening, Tues Church Lane, morning, Garforth, LS25 1HB

Davis SM, Mon evening Yes From April 2011 Moorfield House Surgery, Thurs morning 1 Wakefield Road, Garforth, LS25 1AN

Batra BK, At other - From Oct 2011 3-5 Hazelwood Avenue, branch Garforth, Leeds LS25 2AW

A Kickstart Group for adult obesity and nutrition is run from the Garforth Miners Welfare Club and there is a dietetic clinic run from Garforth Clinic . Health profile of the ward The mortality rates for smoking related illness are significantly below the Leeds average and obesity rates are high for the ward . However the mortality rates for all other disease states are neither above nor below the Leeds average . There is a high prevalence for CHD . Potential need for services This ward already has a good provision of pharmacy services with access to pharmaceutical services available seven days a week .

50 Gipton and Harehills ward The Gipton and Harehills ward has a population of 32 164. . Located in the inner east of the city, it is one of the smaller geographical wards but with one of the largest populations in the city seeing with an increase in population of 8,000 over the last decade . The ward is one of the most densely populated areas in the city with a large proportion of back-to-back houses . It has a large young population with over 9 percent of the population being under the age of five . It also has the largest BME community at 40 percent including 25 percent from Asian or Asian British descent . This ward is the highest ranked on the index of deprivation at 53 9. –it is the only ward in the city that has all its lower super output areas (Appendix 3 ). fall into the top 10 percent rank of deprivation nationally . This ward also falls into the bottom six of the city for life expectancy . The proportion of people in households receiving council administered benefits is high at 37 .31 percent with 52 02. percent, more than half, of children in households on benefits . Current services Seven community pharmacies within the ward offer the following services:

Open all Day Enhanced Services Open M-F Open Sat am Sat Open Sun

Lloyds Pharmacy Minor Ailments, 9 00am-. 368 Oakwood Lane Needle Exchange, 6:00pm LS8 3LF Supervised Consumption, NRT, Palliative Care

Roundhay Pharmacy Minor Ailments, 9 00am-. 9:00am- 255-257 Roundhay Road EHC, Chlamydia, 6:00pm 1:00pm LS8 4HS Supervised Consumption, NRT, Palliative Care, PATCH

Lloyds Pharmacy Minor Ailments, 8:30am- 125 Harehills Road Supervised 6:00pm LS8 5BW consumption, EHC (closes 1:00pm Wed)

Sky Pharmacy Minor Ailments, 10:00am- 10:00am- 10:00am- 12:00midday- 35 Harehills Road EHC, Chlamydia, 8:00pm 6:00pm 6:00pm 6:00pm LS8 5HR Supervised Consumption, NRT,

Rzm Chemists Harehills Minor Ailments, 9 00am-. 176 Harehills Lane Supervised 6:30pm LS8 5JP consumption

Harehills Pharmacy Minor Ailments, 9 00am-. 9:00am- 9 00am-. 365 Harehills Lane Supervised 5:30pm 4:00pm 4:00pm LS9 6AX consumption, NRT

Your Local Boots Pharmacy Minor Ailments, 9 00am-. 9:00am- 9 00am-. 262-266 Harehills Lane Supervised 1:00pm, 1:00pm 1:00pm, LS9 7BD Consumption 2:00pm- 2:00pm- 6:30pm 5:00pm

51 PHARMACEUTICAL NEEDS ASSESSMENT

Five GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Chilvers McCrea at Harehills Corner, Mon evening - Yes 209 Roundhay Road, LS8 4HQ

Mansoor S, Mon evenings - Yes Conway Medical Centre, 51-53 Conway Place, LS8 5DE

Wong YFS, - - Yes Ashton View Medical Centre, 7 Ashton View, LS8 5BS

North Leeds Medical Practice , Wed,Thurs - Yes 2 Milan Street, evening LS8 5JW

Rai A, Tues evening - Yes 173 Roundhay Road, LS8 5AN

The Compton Centre, which is a joint service centre, is located in this ward . It houses primary care mental health services in the community . There are a number of C-card pick up points . St James University Hospital with adult accident and emergency department is located in this ward . There is an NHS run ‘10% group’ for diet and exercise based at Fearnville Leisure Centre on the border of this ward . Health profile of the ward The mortality rates for smoking related illness, COPD, circulatory disease and ‘all age, all cause’ mortality are significantly above those of the Leeds average . There is a high prevalence of diabetes . There are high predicted rates of severe mental illness, high opiate dependence and high obesity prevalence in the Harehills area . The ward has higher than average hospital admission rates for heart attack (MI) along with high attendance at accident and emergency . Potential need for services If NHS Leeds agrees to commission NHS Health Checks from community pharmacies the population of this ward would benefit from accessing this service .

52 Guiseley and Rawdon ward The Guiseley and Rawdon ward has a population of 23,056 . Located in the outer west of the city, it is relatively affluent with large areas of sparsely populated land . Less than 4 percent of the population are identified as being from the BME community . The proportion of people in households receiving council administered benefits is one of lowest for the city at 7 .23 percent with just 7 .31 percent of children in households on benefits . It is ranked one of the lowest in the city on the index of multiple deprivation at 9 . There are however small pockets of relatively deprived populations in areas of this ward . Current services Three community pharmacies in the ward offer the following services .

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

Your Local Boots Pharmacy NRT, Palliative 9:00am-6:30pm Rawdon Surgery Care, PATCH, 11 New Road Side, Rawdon MARS LS19 6DD

Boots MARS 8:45am-5:30pm 8:45am-5:30pm 8:45am- 64 Otley Road 5:30pm Guiseley LS20 8AH

Cohens Pharmacy Needle 9:00am-6:00pm 9:00am-12:00 26 Otley Road Exchange, midday Guiseley supervised LS20 8AH consumption, NRT, Palliative care, MARS

Three GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Sheard TS, Rawdon Surgery, Mon evening Yes From Oct 2011 11 New Road Side, Rawdon, LS19 6DD

Thompson AJ , Park Road Medical Centre, Wed evenings - From Oct 2011 44 Park Road, Guiseley, LS20 8AR

Guiseley and Yeadon Medical Practice, At other - From Oct 2011 10 Netherfield Road, Guiseley, LS20 9HE branch

AJ Thompson & Partners have another practice site in Menston . There are a number of c-card pick-up points for this area . There is an NHS run ’10 percent’ group for diet and exercise run from Aireborough Leisure Centre . Health profile of the ward The mortality rates for smoking related illness, COPD and ‘all age, all cause’ mortality are significantly below the Leeds average . Future need for services Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday,

53 PHARMACEUTICAL NEEDS ASSESSMENT

Harewood ward The Harewood ward has a population of 18,988 . Located in the outer north east, it is a large rural ward which stretches across a large area and includes the villages and hamlets of Bardsey, East Keswick, Collingham, Linton, Aberford, Shadwell, Barwick - in - Elmet and Harewood The ward has the highest life expectancy in the city at 81 .3 years . It has the lowest proportion of the population in households receiving council administered benefits at just 4 56. percent and children at 3 .34 percent . It has a BME population of less than 5percent . The ward also ranks the lowest on the index of multiple deprivation in the city at 8 4. . Current services One community pharmacy within the ward and seven GP dispensing practices offer the following services:

Enhanced Open Sat Open all Services Open M-F am Day Sat Open Sun

Village Pharmacy PATCH, 9:00am-1:00pm, 9:00am- 5 Hastings Court 2:00pm-6:00pm 12:30 Collingham, Wetherby LS22 5AW midday

Dr Porter & Partners* 8 .30am-12:00 Elmwood Surgery midday, 2:00pm- Barwick in Elmet LS15 4JX 5:00pm (Mon till 5:30pm, Tues 8:30am-12:00 midday )

Dr Porter & Partners* 8:30am-12:00 Jessamine Cottage midday Aberford LS25 3AA

Dr Davis & Taylor* 11:30am-12:30 The Surgery, 1 Church Terrace midday Aberford LS25 3BR

Dr Lightfoot* 8:10am -1:00pm Church View Surgery, School Lane 2:00pm-6:30pm Collingham LS22 5BQ

Dr Lightfoot* 8:20am-12:30 Main Street, midday Thorner LS14 3DX (Thurs only also 15:15pm-6:15pm)

Dr Knight* Mon, The Square, Wed,Thurs,Fri Harewood LS17 9LQ 8:30am-12:00 midday Tues : 3:30pm- 6:00pm

Dr Swaby* 8:00am-11:00pm 96 Main Street Scholes LS15 4DR

54 Seven GP dispensing practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Porter KG, Sat morning - From Oct 2011 Elmwood Surgery, Elmwood Lane, Barwick in Elmet LS15 4JX

Porter KG, At other - From Oct 2011 Jessamine Cottage, branch Main Street, Aberford, LS25 3AA

Davis, At other - From April 2011 The Surgery, branch 1 Church Terrace, Aberford, LS25 3BR

Lightfoot, - - From April 2011 The Surgery, Main Street, Thorner, LS14 3DX

Lightfoot, - - From April 2011 Church View Surgery, School Lane, Collingham, LS22 5BQ

Knight J, - - From Oct 2011 The Square, Harewood, LS17 9LQ

Swaby MJ, At other - Yes 96 Main Street, branch Scholes, LS15 4DR

Collingham pharmacy provides a C-card pick-up point . Health profile of the ward The mortality rates for smoking - related illness, COPD, circulatory disease and all age, all cause mortality are significantly below the Leeds average . Potential need for services. This ward is served primarily with dispensing practices due to its rural location who do not offer enhanced pharmaceutical services . There are a number of residents who are on drug treatment but no supervised consumption service however the issue of anonymity and confidentiality in a rural community may be a prime concern here . Clients may not want to use a pharmacy where they are known, and therefore the option of establishing a service in the one pharmacy in Collingham may not be a solution . Although not necessary, it may be desirable to look at options for delivering a supervised consumption service for these residents . The drug treatment service serving the north east of the city does report having clients in the Harewood ward who have to travel some distance for supervised consumption Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday .

55 PHARMACEUTICAL NEEDS ASSESSMENT

Headingley ward The Headingley ward has a population of 21,981 . Located in the inner north of the city, close to the city centre, it is densely populated with a transient population . The population is very unusual due to it being the main location for the city’s student population . More than 50 percent of the population falls into the 15-24 year age bracket and less than 5 percent of the population are over the age of 65 . It has a BME population of 20 percent and just 5 .28 percent of the population is in a household which receives council administered benefits . 8 62. percent of children live in a household which receives benefits, again largely due to the unusual make up of this ward . The ward scores 15 7. on the index of multiple deprivation . Current services Five community pharmacies within the ward offer the following services:

Open all Day Enhanced Services Open M-F Open Sat am Sat Open Sun

RW Pullan Minor Ailments, 9:00am- 9:00am-12:00 58 Brudenell Road EHC, Chlamydia, 1:00pm, midday LS6 1EG Needle Exchange, 2:00pm- Supervised 6:00pm Consumption, Palliative Care,

Cardigan Road Pharmacy EHC, Chlamydia, 9:00am- 136 Cardigan Road Supervised 6:00pm LS6 1LU consumption

Lloyds Pharmacy EHC, Chlamydia, 8:30am- 9:00am- 52 Otley Road Supervised 7:00pm 1:00pm LS6 2AL consumption (closes 6:30pm Fri)

Your Local Boots Pharmacy Supervised 8:30am- 8:30am- 8:30am- 35 Otley Road consumption, NRT, 2:00pm, 2:00pm, 2:00pm, LS6 3AA Palliative Care 3:00pm- 3:00pm- 3:00pm- 5:30pm 5:30pm 5:30pm

Co-operative Pharmacy Supervised 9:00am- 203 Kirkstall Lane consumption, MARS 6:30pm LS6 3EJ

56 Two GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Lawton SL, Mon evenings Yes Oct 2010 Kirkstall Medical Centre, 216 Kirkstall Lane, LS6 3DS

Samuel CA, Wed evenings Yes Yes Laurel Bank Surgery, 216B Kirkstall Lane, LS6 3DS

There are a number of C-card pick-up points for this ward . Health profile of the ward The mortality rates for cancer are significantly below the Leeds average, while for CHD rates are significantly above the Leeds average . There is low prevalence of life limiting long-term illness at only 10 percent . There is a high predicted prevalence of mild anxiety and depression . Potential need for services Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday .

57 PHARMACEUTICAL NEEDS ASSESSMENT

Horsforth ward The Horsforth ward has a population of 23,069 . Located in the west of the city, a significant proportion of the ward is green field . Less than 5 percent of the population in the ward are identified as being from the BME community . A low rate of its population, 7 .20 percent, lives in a household on council administered benefits . 7 .38 percent of children live in a household which receives benefits . It scores low on the index of deprivation at just 9 .8 percent . Current services Three community pharmacies within the ward offer the following services:

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

The Co-operative Pharmacy 9:00am-6:00pm 9:00am-5:00pm 9:00am- 74 Town Street 5:00pm Horsforth LS18 4AP

Mitchell Pharmacy Supervised 9:00am-6:00pm 9:00am-1:00pm 88 New Road Side consumption, Horsforth NRT, Palliative LS18 4QB Care, MARS

Lloyds Pharmacy Supervised 8:30am-7:00pm 8:30am-12:00 Primary Medical Centre consumption, M/Thurs midday Broadgate Lane, Horsforth NRT, Palliative 8:30am-6:30pm LS18 4SE Care, MARS (TueWF)

Two GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Edwards W, Mon evenings Yes From April 2011 Fieldhead, New Road Side, Horsforth, LS18 4JY

Bolton AJ, Mon/Thurs - From April 2011 The New Croft Surgery, evenings, Broadgate Lane, Horsforth LS18 4SE

Community services are delivered from Horsforth Health Centre and stop smoking clinics are held at New Croft Medical Centre . Health profile of the ward The mortality rates for smoking related illness, cancer and ‘’all age, all cause’’ mortality are significantly below the Leeds average . There are low hospital admissions for alcohol and smoking - related illness Potential need for services Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, providers are encouraged to consider opening for an identified period of time on a Sunday .

58 Hyde Park and Woodhouse ward The Hyde Park and Woodhouse ward has a population of 34,433 . Located in the inner north of the city, close to the city centre and taking in Leeds University campus . Comparing 2001 census data with 2010 GP register data the population of this ward has risen by over 10,000 since 2001 . Many of the population are from the transient student population and 40 percent of the population are in the 15-24 year old age group . The ward has a relatively large BME population with over 30 percent of the population being identified as from this group . The ward has high rates of children in households on council administered benefits at 39 59. percent; the figure for the all the population in this ward is 18 67. percent . It scores relatively high on the index of deprivation at 30 . Current services Four community pharmacies within the ward offer the following services:

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

Lloyds Pharmacy Minor 9 00am-6:00pm. 166 Woodhouse Lane Ailments, LS2 9HB Supervised consumption, NRT, MARS

Tylee Andrew Needle 9:00am-1:00pm, 9 00am-12:00. 25 Hyde Park Road Exchange, 2:15am-6:15pm midday LS6 1PY Supervised consumption, MARS

Your Local Boots Pharmacy Supervised 8 .45am-12:45 9:00am-12:00 1 Moseley Place consumption, midday, midday LS6 2RY NRT 2:00pm-6:30pm

Lloyds Pharmacy Supervised 9:00am-6:00pm 54 Oatland Lane consumption, LS7 1SP MARS

59 PHARMACEUTICAL NEEDS ASSESSMENT

Five GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Greenway J, Mon,Tues,Fri - Oct 2010 Leeds Student Medical Practice, mornings 4 Blenheim Court, Blenheim Walk, LS2 9AE

Kinghorn SH, At other Yes Yes Woodhouse Health Centre, branch Cambridge Road, LS6 2SF

O'Shea TS, Mon/Tues Yes Oct 2010 Hyde Park Surgery, evenings Woodsley Road, LS6 1SG

Patel TB, Mon/Tues/ Yes Yes Craven Road Medical Practice, Thurs eve’s , 60 Craven Road, LS6 2RX Sat morning

Ottman, At other Yes Yes 27 Carlton Gardens, branch Leeds LS27 1JL

Woodhouse Health Centre is located in the ward . It provides a range of services in the community including dietetics, muscular skeletal, and podiatry and paediatric clinics . Stop smoking clinics, dietetic and CASH services are available at Woodsley Road Health Centre . Lexicon House ,which provides out- of -hours medical and dental care, is based in this ward . The Community Mental Health Trust (CMHT) base is located in the ward . There are numerous C-card pick-up points in this ward and chlamydia screening is available at Woodhouse Community Centre for 13 to 19 year olds . Health profile of the ward The mortality rates for smoking related illness, COPD, stroke, circulatory disease and ‘‘all age, all cause’’ mortality are all significantly higher than the Leeds average . There is also high prevalence of hospital admissions for alcohol and dementia and high teenage conception rates . Potential need for services As already highlighted, this ward has a higher rate of teenage pregnancy than the national average . Currently, there is no pharmaceutical provision of emergency hormonal contraception (EHC) within the ward which is potentially not enough to meet the identified needs . None of the community pharmacies within the ward are open on either a Saturday afternoon or Sunday . It may be desirable, in order to improve access, to encourage providers to consider opening for an identified period of time however the neighbouring ward of City and Hunslet has adequate weekend provision . If NHS Leeds agrees to commission NHS Health Checks from community pharmacies the population of this ward would benefit from accessing this service . Within the ward there is currently no provision of the palliative care service and therefore to ensure equity across the city this is a service that could be commissioned from this ward .

60 Killingbeck and Seacroft The Killingbeck and Seacroft ward has a population of 25,751 . Located in the inner east of the city, it is one of the largest wards . It has a relatively small BME community at under 7 percent . This ward is one of the highest ranked wards in the city with an index of multiple deprivation score of 47 5. . The ward also falls into the bottom six of the city for life expectancy . The proportion of people in households who receive council administered benefits is high at 29 17. percent with 34 77. percent of children in households on benefits . Current services Eight community pharmacies within the ward offer the following services:

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

Assura Pharmacy Park Edge NRT, Palliative 8:30am-1:00pm, Park Edge Medical Centre Care 2:00pm-6:00pm Askett Drive LS14 1HX

Seacroft Pharmacy Minor Ailments, 9:00am-6:30pm 868 York Road Supervised LS14 6DX consumption, NRT

Your Local Boots Pharmacy Minor Ailments, 8:45am-6:00pm 9:00am-11:30am 91 Moresdale Lane Supervised LS14 6GG consumption, NRT, Palliative Care, Chlamydia

Tescos Instore Pharmacy Minor Ailments, 8:00am-8:00pm 8:00am-8:00pm 8:00am- 10:00am- York Road EHC, Chlamydia, 8:00pm 4:00pm Seacroft Supervised LS14 6LU Consumption

Lloyds Pharmacy Supervised 8:30am-18:15pm Grange Med Centre consumption, Seacroft Avenue NRT LS14 6NX

Your Local Boots Pharmacy Supervised 9:00am-1:00pm, 9:00am-1:00pm, 9:00am- 5 Hollin Park Parade consumption 2:00pm-6:15pm 1:00pm, LS8 3AS 2:00am- 5:00pm

Co-op Pharmacy Minor Ailments, 9:00am-6:00pm 120 Dib Lane Supervised LS8 3AY Consumption, NRT, Chlamydia

ASDA Pharmacy 7:00am-11:00pm 7:00am- 7:00am- 10:00am- Killingbeck Drive (Mon from 8am) 10:00pm 10:00pm 4:00pm LS14 6UF

61 PHARMACEUTICAL NEEDS ASSESSMENT

Seven GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Cohen AF, Mon,Tues Yes Yes The Chapeloak Practice, Wed,Thur,Fri 347 Oakwood Lane, LS8 3HA mornings

Green AL, - - Yes The Lodge, Grange Park Avenue, LS8 3BA

Houghton AM, Mon morning Yes Yes The Grange Medical Centre, 999 York Road, LS14 6NX

Pearson RE, - Yes Yes Foundry Lane Surgery, 95 Moresdale Lane, LS14 6GG

Eastwood PG, Wed morning - Yes The Grange Medical Centre, Seacroft Crescent, LS14 6NX

Muncer ZK, Wed evening Yes Yes Park Edge Practice, Asket Drive, LS14 1HX

Laybourn SM, - - Yes 846 York Road, LS14 6DX

Seacroft Clinic is located within the ward and provides community services including dietetic and paediatric clinics . Stop smoking clinics are provided at Seacroft Hospital and The Lodge Medical Centre . There is also a weight management clinic at Seacroft Hospital . There is a community drug treatment service, including a needle exchange, at Deacon House which is located in Seacroft, serving the north east of the city . There is a CASH outreach clinic in Seacroft . There is also an NHS run ‘‘10percent’’ group for diet and exercise run form Fearnville Leisure Centre on the border of this ward . Health profile of the ward The mortality rates for smoking - related illness, CHD, circulatory disease and ‘‘all age, all cause’’ mortality are significantly above the average for the city . There is a high prevalence of COPD, and high rates of opiate dependence . The ward has higher than average rates of hospital admissions for smoking related illness and has the highest smoking prevalence at 46 percent . There is also a high rate of alcohol related hospital admissions . The ward has high attendance rates at accident and emergency, high infant mortality and high teenage conception rates . It has high rates of self-reported life - limiting long term illness at 22 percent . Potential need for services As already highlighted, this ward has a higher rate of teenage pregnancy than the national average . Currently, there is only one provider of emergency hormonal contraception (EHC) within the ward which potentially not enough to meet the identified needs . If NHS Leeds agrees to commission NHS Health Checks from community pharmacies the population of this ward would benefit for accessing the service . The population of this ward would also benefit from alcohol brief interventions if they were to be commissioned for community pharmacies by NHS Leeds .

62 Kippax and Methley ward The Kippax and Methley ward has a population of 21,392 . Located in the outer east of the city, it is a semi - rural ward . The ward has the smallest BME community within the city at just 2 percent . The proportion of people in households receiving council administered benefits is low at 11 44. percent with 12 74. percent of children in households on benefits . The index of multiple deprivation score for the ward is 17 5. . Current services Four community pharmacies within the ward offer the following services:

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

Your Local Boots Pharmacy Supervised 9:00am-1:00pm, 9:00am-1:00pm, 56 High Street consumption, 2:00pm-6:00pm 2:00pm-5:00pm Kippax NRT, Palliative, LS25 7AB PATCH

Your Local Boots Pharmacy PATCH 8 .30am-6:30pm 9:00am-12:00 Gibson Lane Health Centre (Wed closes midday Kippax 5:30pm) LS25 7JN

Methley Pharmacy, 8 .30am-6:30pm 8 .30am-12:00 Pinfold Ln (closes 1:30pm midday Methley Tues) LS26 9AB

Lloyds Pharmacy Minor 9 00am-6:00pm. Nova Scotia Medical Centre Ailments, (closes 5:00pm 22a Leeds Rd, Allerton Supervised wed) Bywater consumption Castleford WF10 2DP

There are also a number of cross border pharmacies . Boots in Kirkgate Wakefield is used substantially by patients registered in practices in this ward . Four GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Malhotra A, Tues evening - Oct 2010 Radshan Medical Centre, 33-35 Butt Hill, Lippax, LS25 7JU

Pearlman AD, Sat morning Yes Oct 2011 Kippax Hall Surgery, 54 High Street, Kippax, LS25 7AB

Batra RK, Tues/Wed Yes Oct 2011 Gibson Lane Practice, evening, Sat Kippax Health Centre, morning Kippax, LS25 7JN

Pierechod BA, Mon evening Yes April 2011 Nova Scotia Medical Centre, Leeds Road, Allerton Bywater, Castleford, WF10 2DP

63 PHARMACEUTICAL NEEDS ASSESSMENT

Located in this ward is a branch surgery of Dunphy R H and Partners . Although within NHS Leeds area, this practice is commissioned by NHS York and North Yorkshire . Kippax Health Centre is located within the ward . It provides a range of services in the community including a weight management clinic, paediatric, podiatry and muscular skeletal clinics . There is a C-card pick-up for this ward . Health profile of the ward The mortality rates for ’‘all age, all cause’’ mortality are significantly above the Leeds average . The ward has high levels of obesity and low alcohol - related hospital admissions . Potential need for services Although not necessary, it may be desirable for existing providers to consider opening for an identified period of time on a Sunday . This could improve access to pharmaceutical services .

Kirkstall ward The Kirkstall ward has a population of 24,229 and is located in the west of the city . The proportion of the population in households receiving council administered benefit is relatively high at 19 48. percent . 12 74. percent of children live in households receiving benefits . Kirkstall has a relatively high index of multiple deprivation score of 29 7. . Current services Four community pharmacies in the ward offer the following services:

KIRKSTALL

PHARMACIES Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Co-operative Pharmacy Minor Ailments, 8:00am-1:00pm, 275 Burley Road Supervised 2:00pm-7:00pm LS4 2EL consumption, Palliative Care

Lloyds Pharmacy Supervised 9 00am-6:00pm. 69 Vesper Road consumption, LS5 3QT

Lloyds Pharmacy Minor Ailments, 9 00am-. 6 .30pm 9:00am-1:00pm 24 Kirkstall Lane EHC, Chlamydia, LS5 3BH supervised consumption, NRT, Palliative Care

Boots The Chemist Supervised 8 00am-midnight. 8:00am- 8 00am-. 10:30am- 2 Savins Mill Way consumption, 10:00pm 10:00pm 4:30pm Kirkstall Valley Retail Park NRT, Chlamydia LS5 3RP

64 Five GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Birkin AE, Mon-Fri Yes From Oct 2010 Burley Park Medical Centre, evenings 273 Burley Road, LS4 2EL

Geraghty PGM, Mon evenings - Yes 43 Vesper Road, LS5 3QT

Geraghty PGM, At other - Yes Kirkstall Clinic, branch 15 Morris Lane, LS5 3DB

Kirkham J, Mon evening Yes From Oct 2010 The Abbey Medical Centre, Norman Street, LS5 3JN

Ogden LM, Tues evening Yes Yes 60 Moor Grange View, LS16 5BJ Fri morning

Kirkstall clinic is located in the ward . It provides a range of services in the community including weight management clinic and paediatrics . Stop smoking clinics are provided at the West Park Centre . There is also an NHS run ’10% group’ for diet and exercise at Kirkstall Leisure Centre . Health profile of the ward The mortality rates for all diseases are neither above nor below the Leeds average . The ward has high prevalence of opiate dependence . Potential need for services This ward already has a good provision of pharmacy services, with access to pharmaceutical services available seven days a week

65 PHARMACEUTICAL NEEDS ASSESSMENT

Middleton Park ward The Middleton Park ward has a population of 27,348 . The ward is located in the inner south of the city . The ward has a relatively small BME community at less than 4 percent . It is in the bottom six of the city for life expectancy and has one of the highest scores on the index of multiple deprivation at 43 .8 . The proportion of the population in households on council administered benefit is high at 29 91. percent 38 46. percent of children live in households receiving benefits . Current services Four community pharmacies within the ward offer the following services:

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Belle Isle Pharmacy 9:00am-6:00pm 9:00am-1:00pm 219 Middleton Road

LS10 3HU

Allied (Middleton) Minor 8:30am-6:30pm Pharmacy Ailments, EHC, Lingwell Croft Surgery Chlamydia, 20 Shelldrake Drive Supervised, LS10 3NB consumption, NRT, Palliative Care

The Co-op Pharmacy NRT, 8:30am-6:00pm Middleton Park Health Ctr Chlamydia Middleton Park Avenue LS10 4HT

Your Local Boots Pharmacy Supervised 9:00am-12:15 9:00am-12:15 9:00am- Middleton Park Pharmacy consumption, midday, midday 12:15 8 Middleton Park Circus NRT, Palliative 1:00pm-6:00pm midday LS10 4LU Care, PATCH 1:00pm- 5:00pm

Two GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Crystal TL, Mon/Tues - Yes Lingwell Croft Surgery, evenings 16 Sheldrake Drive, Middleton, LS10 3NB

Grange Medicare, Tues/Thurs - - Middleton Park Surgery, evening, Sat Middelton Clinic, afternoon Middelton Park Avenue, LS10 4HT

66 Middleton Park Health Centre is located with the ward . It provides a range of services in the community including a stop smoking clinic . At St George’s Centre there is a minor injuries unit which is open from 8am until 10 .30pm, 365 days a year . Children’s clinics are also run from St George’s Centre . CASH outreach clinics are held in the ward and there are a number of C-care pick-up points . There is an NHS run ’10 % group for diet and exercise run from the John Charles Centre for sport in this ward . Health profile of the ward The mortality rates for smoking related illness, COPD, CHD, cancer, circulatory disease and ‘all age ‘’all cause’’ mortality are significantly higher than the Leeds average . There is a high prevalence of diabetes, CHD and COPD in the ward as well as high levels of obesity . There are high rates of opiate dependence within the ward . The teenage conception rate is considerably higher than the Leeds average and there are high levels of attendance at the hospitals’ accident and emergency departments . Potential need for services As already highlighted, this ward has a higher rate of teenage pregnancy than the national average . Currently, there is no pharmaceutical provision of emergency hormonal contraception (EHC) on a weekend which is potentially not enough to meet the identified needs . If NHS Leeds agrees to commission NHS Health Checks from community pharmacies the population of this ward would benefit from accessing this service . Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday .

67 PHARMACEUTICAL NEEDS ASSESSMENT

Moortown ward The Moortown ward has a population of 24,112 . Located in the north of the city, it has a significantly higher than average BME population at 22 percent . The proportion of the population in households receiving council administered benefit is low at 10 .82 percent . 10 14. percent of children live in households that receive benefits . The ward scores 14 9. on the index of multiple deprivation . Current services Three community pharmacies in the ward offer the following services:

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

King Lane Pharmacy Minor 9:00am-6 00pm. 79 King Lane Ailments, NRT, LS17 5AX Palliative Care

Lloyds Pharmacy Minor 9:00am-6 00pm. 9:00am-5 00pm. 9:00am- 9:30am-12:30 396 Harrogate Road Ailments, 5 00pm. pm LS17 6PY Supervised Consumption, Palliative Care

The Co-op Pharmacy 9:00am-6 00pm. 141 Street Lane LS8 1AA

Two GP practices are located in this ward:

Extended NHS Health GP Practice Site Hours Smoking Checks Fellerman SM, Tues/Wed - From Oct 2010 4a Green Road, LS6 4JP mornings

North Leeds Medical Practice, Mon and Thurs Yes Yes 355 Harrogate Road, LS17 6PZ eves

Health profile of the ward The mortality rates for smoking related illness are significantly below the Leeds average . All other mortality rates for diseases are neither above nor below the Leeds average . Potential need for services This ward already has a good provision of pharmacy services, with access to pharmaceutical services available seven days a week .

68 Morley North ward The Morley North ward has a population of 21,566 . Located in the outer south west of the city, much of the ward is green field . The identified population from BME groups is relatively small at under 4 percent . The proportion of the population in households on council administered benefit is low at 10 .80percent; 11 14. percent of children live in households receiving benefits . There is a permanent site for Gypsies and Travellers on the borders of this ward . The ward scores 16 .3 on the index of multiple deprivation . Current services Six community pharmacies within the ward offer the following services:

Enhanced Open all Services Open M-F Open Sat am Day Sat Open Sun

Co-op Pharmacy NRT, Palliative 8 .30am-1:00pm 9 00am-12. .30 176 Whitehall Road Care, 2:00pm-6:30pm Drighlington Supervised (Thurs close Bradford Consumption 5:00pm) BD11 1AU

Driglington Pharmacy 8 .30am-1:00pm, 151 King Street 2 00pm-6. 00pm. Drighlington BD11 1ES

Boots EHC, 10:00am-8:00pm 9:00am-7:00pm 9:00am- 11:00am- White Rose Centre Chlamydia, (Thurs-till 7:00pm 5:00pm LS11 8LL Supervised 9:00pm) consumption, NRT, Palliative Care

Sainsburys Pharmacy NRT, Palliative 9:00am-12:00 8:00am-12:00 8:00am- 11:00am- White Rose Centre Care, PATCH miday, midday 12:00 5:00pm LS11 8LS 1 00pm-10:00pm. midday, 1:00pm- 8:00pm

Co-op Pharmacy Supervised 8:45am - 9:00am-1:00pm 25 Finkle Lane Consumption, 12:45pm, Gildersome Palliative Care 2 00pm-6:30pm. LS27 7DX

Co-op Pharmacy Supervised 8:30am-12:30pm, 4 Laneside Terrace, Consumption, 1:30pm-5:30pm Elland Rd NRT, PATCH Churwell LS27 7PT

69 PHARMACEUTICAL NEEDS ASSESSMENT

Four GP practices are located in this ward:

Extended NHS Health GP Practice Site Hours Smoking Checks Gupta F, Sat mornings Yes From April 2011 Drighlington Medical Centre, Station Road, Drighlington, Bradford, BD11 1JU

Mehrotra PN, Tues and Thurs - From Oct 2011 Gildersome Health Centre, mornings inkle Lane, Gildersome, LS27 7HL

Adams RJ, - - From Oct 2011 Shenstone Surgery, Elland Road, Churwell, LS27 7PX

Adams RJ, - - From Oct 2011 Adwalton House Surgery, 1-3 Wakefield Road, Drighlington, BD11 1DH

Health profile of the ward The disease mortality rates for this ward are neither above nor below the Leeds average . Potential need for services This ward already has a good provision of pharmacy services with access to pharmaceutical services available seven days a week .

70 Morley South ward The Morley South ward has a population of 22,350 . The ward is located in the outer south west of the city . The identified population from BME groups is relatively small at under 5 percent . The proportion of the population in households on council administered benefit is relatively low at 14 .20 percent with 14 43. percent of children in households receiving benefits . The ward scores 20 7. on the index of multiple deprivation . Current services Six community pharmacies within the ward offer the following services:

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Your Local Boots Pharmacy EHC, 8:45am-1:30pm, 8:45am-1:30pm, 8:45am- 3 Windsor Court Chlamydia, 2:30 -5:30 2:30pm -5:30pm 1:30pm, Morley Supervised 2:30pm- LS27 9BG consumption, 5:30pm Palliative Care

Co-op Pharmacy EHC, 8:30am-5:30pm 8:30am-5:00pm 8:30am- 68 Queen Street Chlamydia, 5:00pm Morley Supervised LS27 9BP consumption, NRT, PATCH

Lloyds Pharmacy 8:00am-6:30pm Fountain Medical Centre (Fri-closes Little Fountain Street, 6:00pm) Morley LS27 9EN

Co-op Pharmacy Supervised 8:30am-1:00pm, South Queen Street Consumption, 2:00-6 .00pm . Morley PATCH (closes 5:00pm) LS27 9EW

Co-op Pharmacy Supervised 8:30am-6:30pm 2 Queensway Consumption, Morley Palliative Care, LS27 9NB PATCH

ASDA Pharmacy 8:00am-11:00pm 7:00am- 7:00am- 10:00am- Howley Park Road 10:00pm 10:00pm 4:00pm Morley LS27 OBP

71 PHARMACEUTICAL NEEDS ASSESSMENT

There are a number of cross border pharmacies which can be accessed by the residents of this ward . Boots, Long Causeway in Dewsbury is substantially used by patients registered at practices in this ward . Four GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Adams RJ, Windsor House Surgery, - Yes From Oct 2011 Corporation Street, Morley, LS27 9NB

Haque ME, Mon evening - From Oct 2010 Morely Health Centre, Corporation Street, Morley, LS27 9NB

Hicks CA, Wed evening Yes From April 2011 The Surgery, South Queen Street, Morley, LS27 9EW

Ledger SJ, Mon ,wed, Yes From April 2011 The Dekeyser Group Practice, thurs The Medical Centre, mornings, Fountain Street, LS27 9EN

Morley Health Centre is located with the ward . It provides a range of services in the community including stop smoking clinics, weight management clinics, dietetic and nutrition clinics and paediatric clinics . Health profile of the ward The disease mortality rates for this ward are neither above nor below the Leeds average . Potential need for services This ward already has a good provision of pharmacy services, with access to pharmaceutical services available seven days a week .

72 Otley and Yeadon ward The Otley and Yeadon ward has a population of 23,149 . Located in the outer north west of the city, there are large unpopulated areas which are green field or farmland . Otley is a small rural market town and Yeadon has a district town centre . The ward has a relatively large elderly population with more than 19 percent of the population aged 65 and over . The identified BME population is very low at less than 4percent . The proportion of the population in households on council administered benefit is relatively low at 11 .20 percent and 10 .23 percent of children live in households receiving benefits . The ward scores low at 13 7. on the index of multiple deprivation Current services Six community pharmacies in the ward offer the following services:

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Lloyds Pharmacy EHC, 8:30am-7:00pm Silver Lane Medical Practice Chlamydia, 1 Suffolk Court, Yeadon Supervised LS19 7JN consumption, Palliative Care, PATCH

Lloyds Pharmacy NRT, Palliative 8:30am-6:00pm 9:00am-5:00pm 9:00am- 39 High Street Care, 5:00pm Yeadon Chlamydia, LS19 7SP PATCH, MARS

The Co-operative Pharmacy NRT 8:30am -6:00pm 9:00am-5:00pm 9:00am- 29 High Street 5:00pm Yeadon LS19 7SP

Cohens Chemist NRT 8:30am-6:00pm 9:00am-11:00am 1 Bridge Street Otley LS21 1BQ

Your Local Boots Pharmacy Needle 9:00am-12:30 9:00am-12:30 9:00am- 10:00am- 28-32 Kirkgate Exchange, midday, midday 12:30 3:00pm Otley Supervised 1:30pm-5:30pm midday, LS21 3HJ Consumption, 1:30pm- NRT, 5:30pm

Lloyds Pharmacy Supervised 8:30am-6 00pm. 8:30am-5:30pm 8:30am- 35 Kirkgate Consumption, 5:30pm Otley Chlamydia LS21 3HN

There are a number of pharmacies close to the border of Otley in Burley in Wharfedale and Menston which also offer enhanced services .

73 PHARMACEUTICAL NEEDS ASSESSMENT

Six GP practices are located in this ward:

Extended NHS Health GP Practice Site Hours Smoking Checks Allen NJ, Tues/Thurs Yes From Oct 2011 Charles Street Surgery, morning Otley, LS21 1BJ

Lund JA , Mon morning and From Oct 2011 Bridge Street Medical Centre, evening, 3 Bridge Street, Wed morning Otley Ls21 1BQ

Guiseley and Yeadon Med Practice, Mon evening From Oct 2011 Yeadon Health Centre, South View Road, Yeadon, LS19 7PS

Thackur Practice, Wed evening Yes From April 2011 Silver Lane Surgery, 1 Suffolk Court, Silver Lane, Yeadon, LS19 7JN

Robson DJ, Wed morning From April 2011 Yeadon Tarn Medical Practice, Wed evening Suffolk Court, Silver Lane, Yeadon, LS19 7JN

Spencer P, Tues, Wed, Thurs, Yes From Oct 2011 Westgate Surgery, Fri mornings Westgate, Otley, LS21 3HD

Dr AJ Thompson and Partners also has a site (Menston Medical Centre) within the Wharfedale ward) which serves residents in this area . Otley clinic is located within the ward . It provides a range of services in the community including a weight management clinic, anti-coagulant clinic and paediatric clinic . Whafedale Hospital is located within Otley . There is a minor injuries unit located at the hospital which is open for 8am-11pm, 365 days of the year . A stop smoking clinic is also run from the hospital . Yeadon Health Centre is also located within the ward . It provides a range of services in the community including a stop smoking clinic, weight management clinic, dietetic and paediatric services . There are a number of C-card pick-up points for this ward . Health profile of the ward The mortality rates for ‘all age, all cause’ mortality are significantly below the Leeds average . The rate of hospital accident and emergency attendance for the ward as a whole is not significant, but there is high attendance within one pocket of the ward . Potential need for services Although there is pharmaceutical provision within the ward in Otley on a Sunday, it may be desirable that in order to improve access to pharmaceutical services in Yeadon, existing providers are encouraged to consider opening for an identified period of time on a Sunday . The nearest locally provided EHC service for those in Otley is Yeadon but this pharmacy is closed at weekends . Otley residents can access EHC in Burley in Wharfedale up to midday Saturday but after that time would need to access a service closer to . One option for NHS Leeds may be to establish an EHC service in a pharmacy in the ward which opens over the weekend .

74 Pudsey ward The Pudsey ward has a population of 22,984 . Located in the outer west of the city, it borders Bradford . The BME community makes up less than five percent of the population . The proportion of the population in households on council administered benefit is relatively low at 13 67. percent, with 14 .29 percent of children in households receiving benefits . The ward scores relatively low at 20 7. on the index of multiple deprivation . Current services Seven community pharmacies within the ward offer the following services:

PUDSEY

PHARMACIES Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Tyersal Pharmacy EHC, 9:00am-5:30pm 9:00am-12:00 6 Tyersal Road Chlamydia midday Tyersal NRT, BD4 8ET

The Co-operative Pharmacy Supervised 9:00am-6:00pm 9:00am-1:00pm 187a Swinnow Road Consumption, NRT LS13 4PJ

Lloyds Pharmacy PATCH 8:30am-6:30pm 8:30am-12:30 Robin Lane Medical Centre (till 19:00 Thurs) midday Pudsey LS28 7BR

Boots Supervised 9:00am-2:00pm, 8:30am-2:00pm, 8:30am- 11 Church Lane Consumption, 3:00pm-5:30pm 2:00pm, Pudsey NRT 3 00pm-. LS28 7LD 5:30pm

Church Lane Pharmacy 9:00am-6:00pm 9:00am-5:00pm 9:00am- 23 Church Lane 5:00pm Pudsey LS28 7LD

Lloyds Pharmacy Supervised 8:30am-6:30pm 9:00am-12:30 32 Church Lane Consumption, midday Pudsey NRT LS28 7RF

The Pudsey Pharmacy NRT, Palliative 8:00am-11:00pm 8:00am-11:00pm 8:00am- 9:00am- 46 Chapeltown Road Care 11:00pm 7:00pm Pudsey LS28 8BS

75 PHARMACEUTICAL NEEDS ASSESSMENT

There are a number of pharmacies on the border and over the border in the Bradford district of this ward which residents can access for services . Boots, Darley Street, Bradford is substantially used by residents registered at practices in this ward . Three GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Belderson L, Wed morning, Yes From April 2011 Robin Lane Medical Centre, Thurs evening Robin Lane, and Sat Pudsey, LS28 7DE morning

Paul AC, Tues evenings Yes From Oct 2010 The Gables, 231 Swinnow Road, Pudsey, LS28 9AP

Ross RJ, Tues and Wed - From April 2011 Pudsey Health Centre, mornings 18 Mulberry Steet, Pudsey, LS28 7XP

Pudsey Health Centre and Farsley Clinic are located in the ward . They provide a range of services in the community including stop smoking clinic, mental health clinic, dietetic and paediatric services . There are a number of C-card pick up points in the ward . Health profile of the ward The disease mortality rates for this ward are neither above nor below the Leeds average . Potential need for services This ward already has a good provision of pharmacy services, with access to pharmaceutical services available seven days a week .

76 Rothwell ward The Rothwell ward has a population of 20,935 . Located in the outer south east of the city it borders Wakefield . The ward has a relatively large elderly population with more than 22 percent of the population over the age of 60 . Less than four percent of the population are identified as from a BME group . The proportion of the population in households on council administered benefit is relatively low at 13 .27 percent and 16 .30 percent of children live in households receiving benefits . The ward scores relatively low at 17 .8 on the index of multiple deprivation . Current services Five community pharmacies within the ward offer the following services:

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Boots Needle 9:00am-12:30 9:00am-12:30 9:00am- 69/71 Commercial Street Exchange, NRT midday, midday, 12:30 pm, Rothwell 1:00pm-5:30pm 1:00pm- LS26 0AP 17:30pm

Garners Pharmacy NRT 9:00am-6:00pm 9:00am-1:00pm 49 Commercial Street Rothwell LS26 0AP

Naseem's Chemist 9:00am-6 .30pm 9:00am-1:00pm 53a Commercial St, Rothwell LS26 0QD

Boots NRT 9:00am-1:00pm, Rothwell HC, Stone Brig 2:00pm-6:00pm Lane Rothwell LS26 0UE

Boots Supervised 9:00am-1:00pm, 9 00am-12:00. 7 Quarry Hill COnsumption 2:00pm-6:00pm midday Oulton LS26 8RE

77 PHARMACEUTICAL NEEDS ASSESSMENT

Four GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Garrett CJJ, Tues morning Yes From April 2011 Marsh Street Surgery, 25A Marsh Street, Rothwell, LS26 0AG

Garrett CJJ, Mon evening, Yes From April 2011 Oulton Medical Centre, Fri morning Quarry Hill, Oulton, LS28 8SJ

Blakemore, - - From Oct 2011 The Manse Surgery, 4 Marsh Street, Rothwell, LS26 0AE

Grange Medicare, Mon,Wed - From April 2011 New Cross Surgery, evening Rothwell Health Centre, Sat morning Stone Brig Lane, and afternoon Rothwell, LS26 0UE

Rothwell Health Centre is located within the ward . It provides a range of services in the community including a stop smoking clinic . There are a number of c-card pick-up points for this area . Health profile of the ward The disease mortality rates for this ward are neither above nor below the Leeds average . Potential need for services Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday . Within the ward there is no current provision of the palliative care service, however it is available in neighbouring wards . Although not necessary, it may be desirable to consider the realignment of services to ensure provision within the ward .

78 Roundhay ward The Roundhay ward has a population of 25,115 and is located in the north of the city . The ward has a relatively large elderly population with over 14 percent of population being over the age of 65 . The BME community also make up a significant proportion of the population at 22 percent . The proportion of the population in households on council administered benefit is low at 9 98. percent (children in such households at 12 56. percent) . The ward scores relatively low at 14 7. on the index of multiple deprivation . Current services Four community pharmacies within the ward offer the enhanced services:

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Ma Manning Ltd Minor Ailments, 9:00am-1:00pm, 9:00am-1:00pm 97 Lidgett Lane EHC, Chlamydia, 2:15pm-6:00pm LS8 1QR Supervised Consumption, NRT, Palliative Care

Lloyds Pharmacy Minor Ailments, 8:30am-6:15pm Street Lane Practice Supervised 12 Devonshire Avenue Consumption, LS8 1AY NRT

Oakwood Pharmacy Minor Ailments, 10:00am- 10:00am- 643 Roundhay Road EHC, Chlamydia, 8:30am-midnight 6:00pm 6:00pm LS8 4BA NRT, Palliative Care

Tesco's Instore Pharmacy Minor Ailments, 8:00am-9:00pm 8:00am-9:00pm 8:00am- 10:00am- 361 Roundhay Road Supervised 9:00pm 4:00pm LS8 4BU Consumption, NRT, Palliative Care

Three GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Bew NM, Tues/Wed - From Oct 2010 The Street Lane Practice, evenings 12 Devonshire Avenue, LS8 1AY

Singh GP, Tues evenings - From Oct 2010 Oakwood Surgery, Gledhow Rise, LS8 4AA

Kinghorn SH, Wed - Yes Chandos Medical Centre, evenings 123 Lidgett Lane, LS8 1QR Health profile of the ward The disease mortality rates for this ward are neither above nor below the Leeds average . Smoking - related illness hospital admissions for the ward are the lowest in the city . Potential need for services This ward already has a good provision of pharmacy services, with access to pharmaceutical services available seven days a week .

79 PHARMACEUTICAL NEEDS ASSESSMENT

Temple Newsam ward The Temple Newsam ward has a population of 23,206 . Located in the inner east of the city, there are pockets of deprived areas . The ward has a relatively small BME population with less than five percent being identified as from this group . The proportion of the population in households on council administered benefit is 16 75. percent (children in such households 24 05. percent) . The ward scores relatively high at 27 6. on the index of multiple deprivation . Current services There are 6 pharmacies within this ward providing enhanced services .

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Boots Pharmacy Minor 8:30am-6:30pm 8:30am-12:30 204 Selby Road Ailments, midday Halton Supervised LS15 0LF Consumption, NRT, PATCH

Halton Pharmacy Minor 9:00am-6:00pm 9:00am-4:30pm 253 Selby Road Ailments, EHC, Halton Chlamydia, LS15 7JR Supervised Consumption, NRT, Pallliative Care

Ben Wilson Ltd 8:45am-6:00pm 9:00am-12:30 7 Austhorpe View (close 1:00pm midday Whitkirk Thurs) LS15 8NN

Sainsburys Pharmacy Minor 8:00am-9:00pm 8:00am-9:00pm 8:00am- 11:00am- Selby Road Ailments, 9:00pm 5:00pm Colton Supervised LS15 9JA Consumption, NRT, Pallliative Care, PATCH

Boots The Chemists Minor 7:00am-11:00pm 7:00am-9:00pm 7:00am- 10:30am- Unit 1, Colton Park Ailments, 9:00pm 4:30pm Style Way Supervised LS15 9JB Consumption, NRT, Pallliative Care,

Boots Ltd MinorAilments, 9:00am-6:00pm 9:00am-3:00pm 9:00am- 49 Selby Road Supervised 3:00pm LS9 0EW Consumption

80 Three GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Rose DM, - Yes From Oct 2010 The Family Doctors, 5 Austhorpe View LS15 8NN

Addlestone MB, At other - Yes Halton Clinic, branch 2A, Primrose Lane, LS15 7HR

Houghton AM, Mon evening, - Yes Colton Mill Medical Centre, Tues morning Stile Hill Way, LS15 9JH

Halton Clinic is located within the ward . It provides a range of services in the community including a stop smoking clinic, mental health and paediatric services . A weight management service is held at East Leeds Leisure Centre . There are C-card pick-up points for this ward . Health profile of the ward The mortality rates for this ward are not significantly above or below the Leeds average, however there are pockets of the ward which have high teenage conception rates along with high accident and emergency attendance . Potential need for services This ward already has a good provision of pharmacy services, with access to pharmaceutical services available seven days a week .

81 PHARMACEUTICAL NEEDS ASSESSMENT

Weetwood ward The Weetwood ward has a population of 23,601 and is located in the inner north west of the city . The ward stretches from Meanwood to Adel . The ward has a BME population on 12 percent with the proportion of the population in households on council administered benefit at a low 11 44. percent (children in such households 16 73. percent) . The ward scores relatively low at 17 on the index of multiple deprivation . Current services Four community pharmacies within the ward offer the following services:

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Lloyds Pharmacy Supervised 8:45am-6:00pm 9:00am-1 00pm. 195-197 Butcher Hill Consumption, Palliative Care LS16 5BQ

WA Hawkin & Sons Ltd Needle 9:00am-6:00pm 10:00am-12:00 78 Otley Old Road Exchange, midday LS16 6LQ Supervised Consumption, NRT, Palliative Care, MARS

Cohens Chemist EHC, , 9:00am-6:30pm 6 Tinshill Lane Chlamydia, (Mon, Tues, LS16 7AP Supervised Thurs, Fri) Consumption, 8:00am-6:30pm NRT, Palliative (Wed) Care, MARS

Lloyds Pharmacy Minor 8:15am-6 .30pm 9:00am-4:30pm 9:00am-4:30 569-571 Meanwood Road Ailments, EHC, LS6 4AY Chlamydia, Needle Exchange, Supervised Consumption, NRT, Palliative Care, MARS

82 Four GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Allman IG, Mon/Thurs Yes From Oct 2010 Burton Croft Surgery, evenings, 5 Burton Crescent, LS6 4DN Mon-Fri mornings,Sat mornings

Newbound AD, Mon,Wed,Thur Yes Yes Meanwood Health Centre, evenings, Tues, 548 Meanwood Road, LS6 4JN Thurs mornings

Bolton AJ, Mon evening Yes From April 6 Tinshill Lane, LS16 7AP Wed morning 2011

Patel TB, Mon, Tues, Thurs - Yes 8 Holly Bank, evenings Otley Road, LS6 4DJ

Meanwood Health Centre is located within the ward . It provides a range of services in the community including speech and language clinic . Stop smoking services are provided at the West Park Centre which borders with the Weetwood ward . Health profile of the ward The mortality rates for smoking related illness, COPD, cancer, stroke and all age, all cause mortality are all significantly below the Leeds average . Potential need for services Although not necessary, it maybe desirable that in order to improve access to pharmaceutical services, that existing providers are encouraged to consider opening for an identified period of time on a Sunday .

83 PHARMACEUTICAL NEEDS ASSESSMENT

Wetherby ward The Wetherby ward has a population of 19,673 which has stayed relatively static over the last 10 years . The ward incorporates the market town of Wetherby, and includes the rural hamlets of Linton, Walton, Thorp Arch, Bramham, Boston Spa and Clifford . The ward has a relatively large elderly population with over 22 percent of the population being over the age of 65 . Less than four percent of the population are identified as from a BME group . The ward has a smaller population of 15-24 year olds than most wards at under 10 percent . It has the lowest proportion of the population in households on council administered benefit at a low 716. percent (children in such households 5 .38 percent) . The ward scores amongst the lowest in the city at 8 7. on the Index of Multiple Deprivation . Current services Four community pharmacies and one GP dispensing practice within the ward offer the following services:

Enhanced Open all Services Open Late M-F Open Sat am Day Sat Open Sun

Boots Minor 8:45am-5:30pm 8:45am-5:30pm 8:45am- 10:00am- 1 Horsefair Centre Ailments, NRT 5:30pm 3:00pm Wetherby LS22 6FL

Boots Supervised 9:00am-1:00pm, 9:00am-1:00pm 59 St James Street Consumption, 2:00pm-6:30pm Wetherby Palliative Care LS22 6RS

Day Lewis Pharmacy Minor 8:30am-12:30 9:00am-1:00pm 3-5 Crossley Street Ailments, EHC, midday, Wetherby Chlamydia 10:30am-5:30pm LS22 6RT

Cohens Chemist Minor 9:00am-6:00pm 9:00am-1:00pm 190 High Street Ailments, EHC, Boston Spa Chlamydia, LS23 6BT Supervised Consumption, NRT, Palliative Care

Dr Nicholls* Mon 8:30am- Bramham MC, Clifford Rd 8:00pm Bramham MC Tues-Fri LS23 6RN 8:30am-6:00pm

84 There are a number of cross border pharmacies that residents in this ward may make use of in neighbouring Tadcaster . Four GP practices are located in this ward:

Extended NHS Health Hours Smoking Checks

Brady MD, Spa Surgery, - Yes From Oct 2011 205 High Street, Boston Spa, Wetherby, LS23 6PY

Knight J , - - From Oct 2011 Wetherby Surgery Wetherby Health Centre, Lane, Wetherby, LS22 6JS

Mate JD, - Yes From Oct 2011 Crossley Street Surgery, Crossley Street, Wetherby, LS22 6RT

Nicholls JAJ, Mon evening - From April 2011 Bramham Medical Centre, Clifford Road, Bramham, Wetherby, LS23 6RN * dispensing practice

Wetherby clinic is located within the ward . It provides a range of services in the community including a dietetic and paediatric service . There are a number of C-card pick-up points . Health profile of the ward The mortality rates for CHD are below the Leeds average . However practice data shows high prevalence of CHD compared with the Leeds average . There are low rates of smoking related mortality and all age all cause mortality and low smoking prevalence at 18 percent . Potential need for services This ward already has a good provision of pharmacy services, with access to pharmaceutical services available seven days a week .

85 PHARMACEUTICAL NEEDS ASSESSMENT

11. Citywide summary of Applications for new community identified pharmaceutical need pharmacy contracts Contractors can make an application to NHS Leeds for a new pharmacy . There is a pharmacy Pharmacy availability and access applications panel where these are considered citywide monthly on an individual basis . All applications As stated previously, there are currently 161 are processed by West Yorkshire Central Services pharmacies providing services across Leeds and Agency (WYCSA) . At any time there are normally a nine dispensing practices serving rural areas, giving number of applications for consideration . an average of 4,732 people per pharmacy . The Dispensing GP practices population per pharmacy, with the exception of Harewood which is largely served by dispensing There are nine dispensing practices in NHS Leeds . practices, generally reflects a pattern of lower The current controlled locality maps for these numbers per pharmacy in more deprived areas dispensing practices can be seen at Appendices which is where higher use might be expected . seven and eight . NHS Leeds considers it to be extremely unlikely that during the life of this PNA There is good access to pharmaceutical service document, substantive changes will take place provision across the city with pharmacies open in these areas that will determine additional GP late evening and weekends . All wards which dispensing practices will be required . are not open all day Saturday border the wards which do have longer opening hours . 17 of the 33 Dispensing appliance suppliers (DACs) Leeds wards have access to pharmacies open on a There is currently one remaining dispensing Sunday . These pharmacies are spread around the appliance contractor in Leeds . NHS Leeds considers city from inner to outer areas . that the appliance supplies from a dedicated DAC Feedback from the public and other stakeholders are more than adequately being met by this one at pre-engagement stage shows that 50 percent of provider . The trust cannot anticipate any change respondents used out of hours pharmacies . These over the next three years that would require are pharmacies that are open outside of normal additional DAC suppliers to be established in the working hours . ( 9am-6pm) . Although almost 50 NHS Leeds area . percent were happy with the current opening Minor ailment scheme times of the pharmacy they use, there is indication Currently there are a number of community that the public is looking for greater flexibility of pharmacies providing the minor ailment scheme opening hours . across the city . 100 hour pharmacies There are a number of wards with no minor ailment The 100 hour pharmacies have improved access schemes although need has not been identified during evenings and weekends for patients . in these areas . However there are two relatively NHS Leeds does not plan to see a reduction in deprived wards, currently without a minor ailment provision of pharmaceutical services during these scheme which would benefit from the service . extended hours or out-of - hour periods from any These are Armley, and Bramley and Stanningley contracted 100 hour pharmacy . They complement There is also quite a wide variance in terms of how the extended hour work done across primary care much the schemes are used around the city . This and fulfil an identified need at times when other suggests that there either may not be much need pharmacies are closed . for the service in some areas or that the service An audit of ePACT data over 12 months (7/09-6/10) needs promoting further to get better use . shows that almost a quarter (23 percent) of Sexual health Out of Hours prescriptions are dispensed by 100 The Sexual Health Needs Assessment 2008 states: hour pharmacies . “…there is little evidence of significant gaps in service provision or inequities in access to services across Leeds ”.

86 The main gaps identified are the absence of part of the Healthy Living Review taking place emergency hormonal contraception service in two between August 2010 and February 2011 . The wards . In Otley and Yeadon, there is a difficulty in success of stop smoking services, including success accessing other emergency hormonal contraception within pharmacies, will be part of this review services out of normal working hours in the city and further decisions regarding commissioning due to the distance . In Hyde Park and Woodhouse enhanced services will be made . ward there has been a recent significant increase in Pharmaceutical Advice to Care Homes population, with a larger than average 15-24 year This service is not particularly relevant to old population . geographical need . Provision will need to take Needle exchange and supervised consumption account of increases in care homes numbers and These services are currently commissioned by the areas across the city with an increasing elderly Safer Leeds Partnership rather than NHS Leeds population . Provision at present is adequate . but as they address a health need it is appropriate to include the services in this needs assessment . Pallative Care The prevalence of opiate users both in treatment As identified within the ward profiles, there is a and still injecting is generally matched to the more lack of palliative care drug provision in specified deprived wards of the city . areas . Work done through both stakeholder Needle exchange for current injectors is provided engagement and health pathway design has through pharmacies around the city and the city highlighted the need for consistent accessibility centre . This complements the needle exchange across NHS Leeds . This particularly applies to and outreach service provided by St Anne’s harm Rothwell, Bramley and Stanningley, Harewood, reduction service . There is a city centre pharmacy Hyde Park and Woodhouse wards . NHS Leeds will offering needle exchange which opens at undertake work to ensure that patients residing in weekends and there are pharmacies offering the these wards will have prompt access to prescribed service in the deprived wards around the city where palliative care drugs . opiate prevalence is high . Supervised consumption 9 Further possible is offered in all wards with the exception of Harewood . It has been established there may be a considerations for preference for clients to travel outside of the ward pharmaceutical services in the for reasons of confidentiality . NHS Leeds will liaise with drug treatment services on client demand in future this ward . NHS Leeds is keen to develop services to meet the Smoking cessation needs of its population . However it is likely that the financial impact of commissioning a new pharmacy The enhanced service provided by Leeds’ contract to meet a gap or need in enhanced service community pharmacies ensures advice on smoking provision will be greater than the benefit gained cessation is available in every ward in the city . The from the service . For this reason, it is likely that only exception is Harewood ward where all but one any new enhanced services would be offered to community pharmacy is actually a dispensing GP existing providers of pharmaceutical services first site, so stop smoking advice here is given by the GP before considering new applications . practice . In the more deprived wards there is a greater Weight management concentration of services . In Killingbeck and There is currently a comprehensive range of Seacroft, which has high smoking rates, there services around the city run by NHS Leeds are four community pharmacies providing stop Community HealthCare and other voluntary sector smoking services . organisations which encourage healthy diet and Currently there is a wide variance in use and exercise . The dietetics and weight management success of the service which will be reviewed as services provide groups and courses around the city

87 PHARMACEUTICAL NEEDS ASSESSMENT

with a focus on areas where obesity is particularly alcohol consumption in primary care settings . It an issue . may be that community pharmacy could have a It may be that NHS Leeds would wish in the future role to play in this in the future . to commission some form of pharmacy based Any proposed new service would need to ensure service to complement existing services . Any that it would be appropriate for that area and proposed new service would need to ensure that identify value for money and feasibility before it it would be appropriate for that area and identify could be considered . value for money before it could be considered . Reduction of teenage conception rates NHS Health Checks It is not yet proven or established that emergency The National Health Check is currently being hormonal contraception (EHC) or increased access rolled out across Leeds . Initially the target areas to contraception at a community pharmacy will are the most deprived wards within Leeds, where decrease unplanned teenage conceptions and NHS Leeds would expect to see the reduction in further work would need to be done to clarify the mortality and health inequalities . benefit of commissioning such a service . The model in Leeds is for the primary care record Minor ailment scheme to be the centre of this programme to ensure that it is systematic and integrated into people’s care . As NHS Leeds would aim to fill gaps identified by the programme is rolled out across Leeds it may be providing a scheme in these wards and addressing necessary to provide Health Checks in a variety of the variance in use by ensuring that commissioned different settings so that the wider population can schemes meet identified need within the ward . It access the service . Community pharmacies may be maybe necessary to re-focus any available funding good places to provide such checks for people who to address the gaps identified in the ward profiles . do not have easy access to GP services . Palliative care In 2008, a survey was commissioned by NHS Leeds As identified within the ward profiles, there is a to identify community pharmacies who were lack of palliative care drug provision in specified willing to provide cardiovascular (CVD) screening . A areas . Work done through both stakeholder gap analysis was also completed to identify barriers engagement and health pathway design has to providing such a service . The survey indicated highlighted the need for consistent accessibility which community pharmacies were keen and across NHS Leeds . This particularly applies to eligible (eg had a consultation room on site) but Rothwell, Bramley and Stanningley, Harewood, also identified barriers such as IT or internet access, Hyde Park and Woodhouse wards . NHS Leeds will equipment required and immunisation of staff . undertake work to ensure that patients residing in these wards will have prompt access to prescribed Alcohol brief interventions palliative care drugs . A sizeable proportion of people in the city of Leeds are estimated to drink above safe limits . Local authority developments 155,000 from a population of almost 800,000 In respect of developments with Leeds City Council is the estimated figure . There are also higher a number of proposed developments have recently alcohol-related deaths in deprived areas; the been withdrawn due to present government JSNA estimates that they are 45 percent higher in spending restraints . The remaining development deprived areas than non-deprived . Deaths linked to plan is for the regeneration of an area of the lower alcohol are rising the region . aire valley extending between Leeds city centre and There may be a role for community pharmacy in the M1 and beyond . This area is referred to as Aire signposting patients to services where alcohol is Valley Leeds . Although new housing, commercial identified as an issue . and business premises are planned for this area it is not expected to see completion during the lifetime Brief alcohol interventions, which are generally of this PNA therefore future pharmacy needs have classed as short discussions with professionals, not yet been identified in this document . have been shown to be effective in reducing

88 Conclusions Acknowledgement and thanks This Pharmacy Needs Assessment will drive the Thanks are extended to the Pharmacy Needs commissioning of pharmaceutical service locally Assessment project group for all their hard work and support NHS Leeds to manage applications and commitment to support the production of this which ensure the provision of appropriate document . pharmaceutical services . Further acknowledgement to Richard Dixon, During the development of the PNA, the Information Manager, who provided invaluable population of Leeds confirmed that: advice and guidance . • community pharmacy is a well used service which is highly valued by those who access it; • community pharmacies are well placed to provide services because they are accessible and well known to local people; • patients and health professionals not always aware of the full range of enhanced services commissioned by NHS Leeds to meet the identified needs . In conclusion, the pre-engagement consultation did not identify any specific gaps in provision which would require a new pharmacy contract to be commissioned . Therefore any new applications would not be meeting a need that could not be addressed through the existing contracts and the re-alignment of specific commissioned services . NHS Leeds is now committed to addressing the following areas which although not necessary would support the improvement of equitable services . These include: • Increased opening times, particularly over the lunchtime and weekend periods in specified wards which will address the need for responsive access to an equitable service; • Improved advertising and signposting which will increase patient’s awareness of the scope of services available . This will be done by working with existing pharmacy contractors to ensure the promotion of services through NHS Choices and other marketing literature; • Working with current pharmacy contract holders to increase the uptake of commissioned services to ensure appropriate use of resources . NHS Leeds will also consider the re-alignment of funds if this work identifies gaps in other areas; and • Greater alliance with GP commissioners which will support the increase focus on GP-led consortia .

89 PHARMACEUTICAL NEEDS ASSESSMENT

References 11 Summary of the Results of the National Child Measurement Programme 2008-09 NHS Leeds 1 Implementing the Joint Strategic Needs : available online: http://www leeds. nhs. uk/. Assessment (2008 available online : http:// Downloads/Public%20Health/National%20 www leeds. nhs. uk/Downloads/Public%20. Child%20Measurement%20Programme%20 Health/Implementing%20the%20 -%20Leeds%20Results%202008%20-%20 Leeds%20Joint%20Strategic%20Needs%20 2009 pdf. Assessment%20Framework%202009 pdf. 12 Dataset for Hospital Admissions by ward Pub 2 Sub-National Population Projections 2008-2033 2009 for JSNA : available online at: http://www . ONS, available online : http://www leeds. gov. . cio leeds. nhs. uk/mapping/. uk/files/Internet2007/2010/24/revised%20 13 Mental Health Observatory website (2010) . population%20analysis%20for%202008%20 Downloaded on 31 August 2010 from http:// vrf(1) pdf. www nepho. org. uk/mho/mini. 3 NHS Leeds (2009) . The Annual Report of the 14 Yorkshire and Humber Strategic Health Director of Public Health in Leeds 2009: Making Authority (2007) . Reducing Health Inequalities a difference-people and places available online in Yorkshire and the Humber: A Systematic at: http://www leeds. nhs. uk/Downloads/. Way Forward . Downloaded on 23 August 2010 Public%20Health/Public%20Health%20 http://www yorksandhumber. nhs. uk/document. . Annual%20Report%202009 pdf. php?o=1069 4 Leeds PCT and Leeds City Council (2007) . Joint 15 Department of Health (2007) . Implementation Strategic Needs Assessment-Information Pack Plan for Reducing Health Inequalities in Infant version 4 1. available online at: Supporting Mortality: a Good Practice Guide Data | Leeds Strategic Plan | Leeds Initiative 16 Wood, F . (2010) . Leeds Cancer Baseline data http://www leedsinitiative. org/lsp/page. . summary . NHS Leeds aspx?id=10238 17 NHS Leeds (2009) . The Annual Report of the 5 S . (2009) . Alcohol Screening and Brief Director of Public Health in Leeds 2009: Making interventions in Primary care in Leeds: a a difference-people and places available online research study . NHS Leeds . at: http://www leeds. nhs. uk/Downloads/. 6 CACI http://www caci. co. uk/About_caci. .aspx Public%20Health/Public%20Health%20 7 CACI weekly spend data for Leeds pub 2010 Annual%20Report%202009 pdf. available online at: InstantAtlas™ Report http:// 18 Proprietary Association of Great Britain, Driving www cio. leeds. nhs. uk/mapping/JSNA/Atlases/. the self-care agenda, 2008 available online: PNA/atlas html. http://www pagb. co. uk/information/PDFs/. 8 G ,. Gannon, M ,. Macdougall, J ,. Millar, T ,. AndyTismanarticle pdf. Eastwood, C ,. Mckeganey, N . (2004/05) 19 http://www leedsinitiative. org/lsp/page. . Estimates of the prevalence of opiate use aspx?id=10742 and/or crack cocaine use (2004/05) Yorkshire and the Region . The Centre for Drug Misuse Research, University of Glasgow 9 Link to pre 2004 LCC ward information : http://www leeds. gov. uk/page. . aspx?pageidentifier=bb6d342a-2ba8-4eb5- 8e4e-c4cb07e3062f 10 Yorkshire and Humber Public Health Observatory and York Health Economics Consortium (2008) . Leeds PCT - Sexual Health Needs Assessment

90 Appendix 1

How the PNA was developed • It was agreed that the most suitable method of dividing the geographical area was by ward; A PNA project group was developed to develop • Baseline data for current community pharmacy a draft PNA for the population of NHS Leeds services was collated; by September 2010; and to undertake required • Provision of services from other providers that consultation with stakeholders and publish a supported the indentified health needs were finalised PNA by 1 February 2011 . agreed to be incorporated into the PNA; Core membership included; • A patient questionnaire was developed and • Head of Strategic Support and Development distributed to the public via local network groups (Chair) and through community pharmacies as part of • NHS Leeds Local Pharmaceutical Committee the pre-engagement process; (LPC) representative • Community pharmacy views on services offered • Communications Lead and their future aspirations were also sought • Pharmacy Contracts Lead using a questionnaire agreed and supported by the LPC; • Public Health Manager • Further information obtained included: opening • Patient and Public Involvement (PPI) Lead hours of community pharmacies ; • Project Lead • After assessing local needs and current provision • Project Support and gaps in service were identified; Regular meetings have been held and formal • Communication plan and consultation process minutes recorded decisions of the group . Terms agreed; of reference were signed off by the Executive • First draft was distributed to the project group Management Team (EMT) . They were: and board sponsor for comments which were • A timeline to identify the process was agreed then incorporated into the document; and shared with stakeholders; • Draft finalised for consultation, published on • An assessment of local health needs and the NHS Leeds website and distributed to inequalities which could be influenced or stakeholders; and supported by local pharmaceutical service • Consultation period 4th October to 31st provision was undertaken by reviewing the JSNA December 2010 2009;

91 PHARMACEUTICAL NEEDS ASSESSMENT Appendix 2 Leeds Metropolitan Discrict Ward Boundaries Adam Taylor Adam ServiceLeeds Information NHS Leeds Care Primary Trust, WestNorth House. 1000332643.License Number Wetherby Kippax and Methley and Kippax Garforth Based upon the 2005the Based 1:250 upon 000 Scale map, Survey of on permission the Ordnance with of Majesty'sof controller the Her behalf Stationer y Office, (c)Copyright. Crown NHS Leeds Information ServiceLeeds NHS and Swillington and Cross Gates Harewood and Whinmoor and Temple Newsam Temple Rothwell Killingbeck and Seacroftand Gipton Roundhay and and Harehills and Burmantofts Richmond Hill Richmond Hunslet City and Chapel Allerton Alwoodley Middleton Park Middleton Moortown and Ardsley and Robin Hood Robin and Ardsley Hyde Park Hyde Woodhouse ries Beeston and Holbeck and Headingley Weetwood Armley Kirkstall Adel Adel Morley Morley South Farnley and Wharfedale and and Wortleyand Morley Morley North Bramley and Stanningley and Horsforth Pudsey Otley and Yeadon and Calverley and Farsley and Guiseley and Rawdon Guiseley and

92 Appendix 2: Leeds Metropolitan District 2: WardMetropolitan Leeds Appendix Bounda Wards Appendix 3

Index of multiple deprivation with ward overlay Taylor Adam ServiceLeeds Information NHS Leeds Care Primary Trust, WestNorth House. 1000332643.License Number Adam Taylor Adam ServiceLeeds Information NHS Leeds Care Primary Trust, WestNorth House. 1000332643.License Number Based upon the 2005the Based 1:250 upon 000 Scale map, Survey of on permission the Ordnance with of Majesty'sof controller the Her behalf Stationer y Office, (c)Copyright. Crown NHS Leeds Information ServiceLeeds NHS Based upon the 2005the Based 1:250 upon 000 Scale map, Survey of on permission the Ordnance with of Majesty'sof controller the Her behalf Stationer y Office, (c)Copyright. Crown NHS Leeds Information ServiceLeeds NHS rd overlay overlay rd rd overlay overlay rd 9.5 to 151.7 to (92) 9.5 (101) 45.4 45.4 to 73.7 (93) 24.7 to 45.4 (98) 15 to 24.7 (92) Appendix 3 : Index of Multiple deprivation with Wa with deprivation of Multiple 3 : Index Appendix Wards IMD score 2007 IMD score by LSOA

93 9.5 to 151.7 to (92) 9.5 (101) 45.4 45.4 to 73.7 (93) 24.7 to 45.4 (98) 15 to 24.7 (92) Appendix 3 : Index of Multiple deprivation with Wa with deprivation of Multiple 3 : Index Appendix Wards IMD score 2007 IMD score by LSOA PHARMACEUTICAL NEEDS ASSESSMENT

Appendix 4 Taylor Adam ServiceLeeds Information NHS Leeds Care Primary Trust, WestNorth House. 1000332643.License Number Alcohol related admissions map for Leeds 2005-2007 Adam Taylor Adam ServiceLeeds Information NHS Leeds Care Primary Trust, WestNorth House. 1000332643.License Number Based upon the 2005the Based 1:250 upon 000 Scale map, Survey of on permission the Ordnance with of Majesty'sof controller the Her behalf Stationer y Office, (c)Copyright. Crown NHS Leeds Information ServiceLeeds NHS Based upon the 2005the Based 1:250 upon 000 Scale map, Survey of on permission the Ordnance with of Majesty'sof controller the Her behalf Stationer y Office, (c)Copyright. Crown NHS Leeds Information ServiceLeeds NHS ap for Leeds 2005-2007 for Leeds ap ap for Leeds 2005-2007 for Leeds ap 861 to 1,155 (7) 1,155 to 861 to 742 (7) 861 to 622 (7) 742 1,461 to 1,875 (6) 1,875 to 1,461 (6) 1,461 to 1,155 Wards Appendix 4 : hospital Alcohol admissionsrelated Appendix m Alcohol related hospitalAlcohol related admissions Ward per

94 861 to 1,155 (7) 1,155 to 861 to 742 (7) 861 to 622 (7) 742 1,461 to 1,875 (6) 1,875 to 1,461 (6) 1,461 to 1,155 Wards Appendix 4 : hospital Alcohol admissionsrelated Appendix m Alcohol related hospitalAlcohol related admissions Ward per Appendix 5 Pharmacies and Dispensing Practices 7.116 Dr Dr Batra, Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Monk Dr Dr Batra, Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Monk Dr Dr Batra, Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Monk Dr Dr Batra, Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Monk Dr Dr Batra, Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Monk Dr Dr Batra, Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Monk Dr Dr Batra, Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Dr Batra,Monk Fryston Monk 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 Pharmacies GP Dispenser Ward Boundaries District Leeds 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 174 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 46 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 192 Key kilometers 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 133 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 117 0 Dr Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Dr Porter, Aberford Dr Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Porter, Aberford Dr Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Davies, Dr Aberford Davies, Dr Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, Dr Aberford Davies, 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 53 53 53 53 53 53 53 42 42 42 42 42 42 42 53 53 53 53 53 53 53 42 42 42 42 42 42 42 53 53 53 53 53 53 53 42 42 42 42 42 42 42 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 159 Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham 10 10 10 10 10 10 10 Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham 10 10 10 10 10 10 10 Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Bramham Dr BramhamNicholls, Dr Nicholls, Dr BramhamNicholls, Bramham Bramham 10 10 10 10 10 10 10 Dr Dr Nicholls, Bramham Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Bramham Dr BramhamNicholls, Dr Nicholls, Dr BramhamNicholls, Bramham Bramham Dr Dr Nicholls, Bramham Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham 10 10 10 10 10 10 10 Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham 10 10 10 10 10 10 10 Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham 63 63 63 63 63 63 63 10 10 10 10 10 10 10 Dr Dr Nicholls, Dr Nicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Dr BramhamNicholls, Bramham Bramham 63 63 63 63 63 63 63 10 10 10 10 10 10 10 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 63 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 243 216 216 216 216 216 216 216 243 243 243 243 243 243 243 216 216 216 216 216 216 216 243 243 243 243 243 243 243 216 216 216 216 216 216 216 243 243 243 243 243 243 243 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 216 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 283 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 268 164 164 164 164 164 164 164 164 164 164 164 164 164 164 164 164 164 164 164 164 164 126 126 126 126 126 126 126 164 164 164 164 164 164 164 126 126 126 126 126 126 126 164 164 164 164 164 164 164 126 126 126 126 126 126 126 164 164 164 164 164 164 164 126 126 126 126 126 126 126 164 164 164 164 164 164 164 126 126 126 126 126 126 126 126 126 126 126 126 126 126 126 126 126 126 126 126 126 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 33 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 220 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 72 288 288 288 288 288 288 288 72 72 72 72 72 72 72 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 288 Dr Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Dr Porter, Barwick 114 114 114 114 114 114 114 Dr Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick 114 114 114 114 114 114 114 Dr Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick 114 114 114 114 114 114 114 Dr Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick Dr Porter, Barwick 114 114 114 114 114 114 114 114 114 114 114 114 114 114 114 114 114 114 114 114 114 172 172 172 172 172 172 172 114 114 114 114 114 114 114 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 172 Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Collingham Collingham Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Collingham Collingham Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Collingham Collingham Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Collingham Collingham Dr Lightfoot,Collingham Dr Lightfoot, Dr Lightfoot,Collingham Collingham Collingham Dr Dr Lightfoot, Collingham Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Collingham Collingham Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Collingham Collingham Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Dr Lightfoot,Collingham Collingham Collingham 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 257 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 219 Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Thorner Thorner Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Thorner Thorner Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Thorner Thorner Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Thorner Thorner Dr Lightfoot,Thorner Dr Lightfoot, Dr Lightfoot,Thorner Thorner Thorner Dr Dr Lightfoot, Thorner Dr Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Thorner Thorner Dr Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Thorner Thorner Dr Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Dr Lightfoot, Dr Lightfoot, Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Dr Lightfoot,Thorner Thorner Thorner Dr Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Swaby, Dr Scholes Swaby, Dr Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, Dr Scholes Swaby, 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 205 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 36 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 242 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 275 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 233 225 225 225 225 225 225 225 233 233 233 233 233 233 233 225 225 225 225 225 225 225 233 233 233 233 233 233 233 225 225 225 225 225 225 225 233 233 233 233 233 233 233 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 225 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 144 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 208 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 258 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 183 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 287 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 273 83 83 83 83 83 83 83 273 273 273 273 273 273 273 83 83 83 83 83 83 83 273 273 273 273 273 273 273 83 83 83 83 83 83 83 273 273 273 273 273 273 273 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 83 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 39 39 39 39 39 39 39 39 39 39 39 39 39 39 177 177 177 177 177 177 177 39 39 39 39 39 39 39 177 177 177 177 177 177 177 39 39 39 39 39 39 39 177 177 177 177 177 177 177 39 39 39 39 39 39 39 177 177 177 177 177 177 177 39 39 39 39 39 39 39 177 177 177 177 177 177 177 39 39 39 39 39 39 39 177 177 177 177 177 177 177 177 177 177 177 177 177 177 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 274 274 274 274 274 274 274 12 12 12 12 12 12 12 274 274 274 274 274 274 274 12 12 12 12 12 12 12 274 274 274 274 274 274 274 12 12 12 12 12 12 12 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 274 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 266 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 247 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 155 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 48 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 271 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 134 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 154 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 223 223 223 223 223 223 223 223 223 223 223 223 223 223 223 223 223 223 223 223 223 84 84 84 84 84 84 84 223 223 223 223 223 223 223 84 84 84 84 84 84 84 223 223 223 223 223 223 223 84 84 84 84 84 84 84 223 223 223 223 223 223 223 84 84 84 84 84 84 84 223 223 223 223 223 223 223 84 84 84 84 84 84 84 84 84 84 84 84 84 84 84 84 84 84 84 84 84 Dr Dr Knight, Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Harewood Dr Dr Knight, Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Harewood Dr Dr Knight, Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Harewood 204 204 204 204 204 204 204 59 59 59 59 59 59 59 Dr Dr Knight, Dr Knight,Harewood Dr Knight,Harewood Harewood Dr Knight, Dr Knight,Harewood Dr Knight,Harewood Harewood Dr Dr Knight, Harewood 204 204 204 204 204 204 204 59 59 59 59 59 59 59 Dr Dr Knight, Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Harewood 204 204 204 204 204 204 204 59 59 59 59 59 59 59 Dr Dr Knight, Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Harewood 204 204 204 204 204 204 204 59 59 59 59 59 59 59 Dr Dr Knight, Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Dr Knight,Harewood Harewood 204 204 204 204 204 204 204 59 59 59 59 59 59 59 204 204 204 204 204 204 204 59 59 59 59 59 59 59 204 204 204 204 204 204 204 59 59 59 59 59 59 59 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 157 6 6 6 6 6 6 6 157 157 157 157 157 157 157 6 6 6 6 6 6 6 157 157 157 157 157 157 157 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 97 97 97 97 97 97 97 139 139 139 139 139 139 139 97 97 97 97 97 97 97 139 139 139 139 139 139 139 97 97 97 97 97 97 97 139 139 139 139 139 139 139 97 97 97 97 97 97 97 139 139 139 139 139 139 139 97 97 97 97 97 97 97 139 139 139 139 139 139 139 97 97 97 97 97 97 97 139 139 139 139 139 139 139 97 97 97 97 97 97 97 139 139 139 139 139 139 139 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 189 240 240 240 240 240 240 240 189 189 189 189 189 189 189 240 240 240 240 240 240 240 189 189 189 189 189 189 189 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 240 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 165 213 213 213 213 213 213 213 213 213 213 213 213 213 213 17 17 17 17 17 17 17 115 115 115 115 115 115 115 213 213 213 213 213 213 213 96 96 96 96 96 96 96 17 17 17 17 17 17 17 115 115 115 115 115 115 115 213 213 213 213 213 213 213 96 96 96 96 96 96 96 17 17 17 17 17 17 17 115 115 115 115 115 115 115 213 213 213 213 213 213 213 96 96 96 96 96 96 96 17 17 17 17 17 17 17 115 115 115 115 115 115 115 213 213 213 213 213 213 213 96 96 96 96 96 96 96 17 17 17 17 17 17 17 115 115 115 115 115 115 115 213 213 213 213 213 213 213 96 96 96 96 96 96 96 17 17 17 17 17 17 17 115 115 115 115 115 115 115 96 96 96 96 96 96 96 17 17 17 17 17 17 17 115 115 115 115 115 115 115 96 96 96 96 96 96 96 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 249 249 249 249 249 249 249 67 67 67 67 67 67 67 249 249 249 249 249 249 249 249 249 249 249 249 249 249 250 250 250 250 250 250 250 249 249 249 249 249 249 249 250 250 250 250 250 250 250 249 249 249 249 249 249 249 250 250 250 250 250 250 250 249 249 249 249 249 249 249 250 250 250 250 250 250 250 249 249 249 249 249 249 249 250 250 250 250 250 250 250 250 250 250 250 250 250 250 250 250 250 250 250 250 250 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 295 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 265 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2 2 2 2 169 169 169 169 169 169 169 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 218 31 31 31 31 31 31 31 31 31 31 31 31 31 31 15 15 15 15 15 15 15 31 31 31 31 31 31 31 15 15 15 15 15 15 15 31 31 31 31 31 31 31 15 15 15 15 15 15 15 31 31 31 31 31 31 31 15 15 15 15 15 15 15 31 31 31 31 31 31 31 15 15 15 15 15 15 15 31 31 31 31 31 31 31 38 38 38 38 38 38 38 15 15 15 15 15 15 15 38 38 38 38 38 38 38 15 15 15 15 15 15 15 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 38 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 130 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 91 91 91 91 91 91 91 98 98 98 98 98 98 98 91 91 91 91 91 91 91 98 98 98 98 98 98 98 91 91 91 91 91 91 91 98 98 98 98 98 98 98 91 91 91 91 91 91 91 98 98 98 98 98 98 98 91 91 91 91 91 91 91 91 91 91 91 91 91 91 91 91 91 91 91 91 91 291 291 291 291 291 291 291 281 281 281 281 281 281 281 40 40 40 40 40 40 40 291 291 291 291 291 291 291 281 281 281 281 281 281 281 40 40 40 40 40 40 40 291 291 291 291 291 291 291 281 281 281 281 281 281 281 40 40 40 229 229 229 229 229 229 229 40 40 40 40 291 291 291 291 291 291 291 281 281 281 281 281 281 281 40 229 229 229 229 229 40 40 40 40 40 40 229 229 291 291 291 291 291 291 291 281 281 281 281 281 281 281 282 282 282 282 282 282 282 40 40 40 40 40 40 40 229 229 229 229 229 229 229 291 291 291 291 291 291 291 281 281 281 281 281 281 281 282 282 282 282 282 282 282 229 40 40 40 40 40 40 40 229 229 229 229 229 229 291 291 291 291 291 291 291 281 281 281 281 281 281 281 282 282 282 282 282 282 282 95 95 95 95 95 95 95 40 40 40 40 40 40 40 229 229 229 229 229 229 229 282 282 282 282 282 282 282 95 95 95 95 95 95 95 229 229 229 229 229 229 229 282 282 282 282 282 282 282 95 95 95 95 229 229 229 229 229 229 229 95 95 95 282 282 282 282 282 282 282 95 95 95 95 95 95 95 282 282 282 282 282 282 282 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 30 30 30 30 30 30 30 30 30 30 30 30 30 30 217 217 217 217 217 217 217 30 30 30 30 30 30 30 217 217 217 217 217 217 217 30 30 30 30 30 30 30 217 217 217 217 217 217 217 30 30 30 30 30 30 30 217 217 217 217 217 217 217 30 30 30 30 30 30 30 217 217 217 217 217 217 217 30 30 30 30 30 30 30 217 217 217 217 217 217 217 217 217 217 217 217 217 217 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 206 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 161 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 278 100 100 100 100 100 100 100 194 194 194 194 194 194 194 100 100 100 100 100 100 100 194 194 194 194 194 194 194 100 100 100 100 100 100 100 194 194 194 194 194 194 194 100 100 100 100 100 100 100 194 194 194 194 194 194 194 100 100 100 100 100 100 100 194 194 194 194 194 194 194 100 100 100 100 100 100 100 194 194 194 194 194 194 194 100 100 100 100 100 100 100 194 194 194 194 194 194 194 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 62 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 163 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 107 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 203 232 232 232 232 232 232 232 232 232 232 232 232 232 232 256 256 256 256 256 256 256 232 232 232 232 232 232 232 256 256 256 256 256 256 256 232 232 232 232 232 232 232 256 256 256 256 256 256 256 232 232 232 232 232 232 232 256 256 256 256 256 256 256 232 232 232 232 232 232 232 256 256 256 256 256 256 256 232 232 232 232 232 232 232 256 256 256 256 256 256 256 256 256 256 256 256 256 256 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 207 103 103 103 103 103 103 103 103 103 103 103 207 207 207 207 207 207 207 103 103 103 103 103 103 103 103 103 103 207 207 207 207 207 207 207 103 103 103 103 103 103 103 47 47 47 47 47 47 47 103 103 103 103 103 103 103 47 47 47 47 47 47 47 103 103 103 103 103 103 103 47 47 47 47 47 47 47 103 103 103 103 103 103 103 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 47 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 23 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 58 234 234 234 234 234 234 234 234 234 234 234 234 234 234 4 4 4 4 4 4 4 234 234 234 234 234 234 234 4 4 4 4 4 4 4 234 234 234 234 234 234 234 4 4 4 4 4 4 4 234 234 234 234 234 234 234 4 4 4 4 4 4 4 234 234 234 234 234 234 234 4 4 4 4 4 4 4 234 234 234 234 234 234 234 4 4 4 4 4 4 4 4 4 4 4 4 4 4 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 109 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 239 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 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Solutions from Dotted Eyes from Solutions Mapping Digital 2008 (c)Copyright Crown reserved.rights All 100019918Licence Number Dixon Richard Officers Chief Information Department ServicesInformation Leeds NHS WestNorth House.

95 PHARMACEUTICAL NEEDS ASSESSMENT Appendix 6 Pharmaceutical services that could be requested from pharmacies established under the four exemption categories

The four exempt categories are: • One-stop centre; • 100hr a week pharmacy; • Retail park >15,000sqm; • Wholly mail order or internet

NHS Leeds could ask providers who fit into the exempt categories above to provide any combination of the following direct enhanced services: • Anticoagulant monitoring services • Care home medicines management service • Care home staff training • Disease Specific medicines management service • Clinical Medication review • Home delivery • Medicines assessment and compliance support • Medication administration records (MARs) scheme • Minor Ailments Scheme • Out of hours dispensing service • Palliative Care Service • Prescriber support services (audits,repeat prescribing administration) • Substance misuse services ( supervised consumption and / or needle exchange • Installment /supervision dispensing service for mental health patients, long term Tuberculosis patients and or drug misuse patients • Supplementary Prescribing • Patient Group Direction service • Language Access Services/Patient Advocacy • Sexual Health Service • EHC supply • Chlamydia screening • Smoking cessation Service (NRT) • Symptomatic Screening Services • Full Clinical Medication Review • Not dispensed scheme • Specials monitoring service

96 Appendix 7 Postcodes contained within a 1.6km buffer area around Barwick Controlled Locality Based upon the 2006 Landranger 2006 the upon Based of permission the with map, Scale 000 1:50 controller the of behalf on Survey Ordnance Crown (c) Office, Stationery Majesty's Her of Copyright. Dixon, Richard Department, Officer's Information Chief Trust, Care Primary Leeds West North House. 1000332643. Number License Postcodes contained within 1.6Km areabuffer Postcodes within PostcodesBuffer within Point Centre 1.6 Km Buffer PostcodesOther Key

97 PHARMACEUTICAL NEEDS ASSESSMENT Appendix 8 Bramham Controlled Locality Based upon the 2006 Landranger 2006 the upon Based of Scale map, permission the 000 with 1:50 Survey behalf Ordnance on of controllerthe Stationery Office,of Majesty's Her (c) Crown Copyright. Dixon,Richard Chief Information Officer's Department, Primary Trust, Care Leeds WestNorth House. 1000332643. Number License Postcodes in Buffer Postcodes Practices Key B86048 B86048 B86048 B86048 B86048 B86048 B86048 B86048 B86048 B86034 B86034 B86034 B86034 B86034 B86034 B86034 B86034 B86034 B86673 B86673 B86673 B86673 B86673 B86673 B86673 B86673 B86673 B86625 B86625 B86625 B86625 B86625 B86625 B86625 B86625 B86625 B86033 B86033 B86033 B86033 B86033 B86033 B86033 B86033 B86033 B86048 B86048 B86048 B86048 B86048 B86048 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86010 B86670 B86670 B86670 B86670 B86670 B86670 B86670 B86670 B86670

98 Appendix 9

Table showing population per pharmacy for each ward based on 2010 GP practice population data (includes dispensing practices).

2010 Pharmacy and Population per pharmacy/ Ward Population Dispensing Practices dispensing practice Adel and Wharfedale 21188 4 5297 Alwoodley 24190 4 6048 Ardsley and Robin Hood 22582 3 7527 Armley 26470 5 5294 Beeston and Holbeck 24220 6 4037 Bramley and Stanningley 23409 5 4682 Burmantofts and Richmond Hill 26236 7 3748 Calverley and Farsley 23091 5 4618 Chapel Allerton 28382 6 4730 City and Hunslet 34132 12 3103 Cross Gates and Whinmoor 23390 4 5848 Farnley and Wortley 25322 3 8441 Garforth and Swillington 20785 5 4157 Gipton and Harehills 32164 7 4595 Guiseley and Rawdon 23056 3 7685 Harewood 18988 8 2601 Headingley 21981 5 4396 Horsforth 23069 3 7690 Hyde Park and Woodhouse 34433 4 8608 Killingbeck and Seacroft 25751 8 3219 Kippax and Methley 21392 4 5348 Kirkstall 24229 4 6057 Middleton Park 27348 4 6837 Moortown 24112 3 8037 Morley North 23594 6 3932 Morley South 22350 6 3725 Otley and Yeadon 23149 6 3858 Pudsey 22984 7 3283 Rothwell 20935 5 4187 Roundhay 25115 4 6279 Temple Newsam 23206 6 3868 Weetwood 23601 4 5900 Wetherby 19673 5 3935 Total 804,527 171

99 PHARMACEUTICAL NEEDS ASSESSMENT Appendix 9

Table showing population change in wards over last decade using 2001 census figures and April 2010 practice registration figures.

Total Total Ward Persons Groups 2010 2001 All Ages All Ages NAME Under 5 5-14 yrs 15-24 yrs 25-64 yrs Over 65 2010 2001 Difference Adel and Wharfedale 1093 2177 2206 11374 4338 21188 19,904 1,284 Alwoodley 1356 2619 2801 13146 4268 24190 22,630 1,560 Ardsley and Robin Hood 1443 2721 2687 12981 2750 22582 19856 2,726 Armley 1847 2791 3680 15074 3078 26470 24958 1,512 Beeston and Holbeck 1699 2676 3409 13501 2935 24220 21791 2,429 Bramley and Stanningley 1560 2758 3066 12984 3041 23409 21681 1,728 Burmantofts and Richmond Hill 2184 2968 3915 14314 2855 26236 22148 4,088 Calverley and Farsley 1483 2315 2480 13167 3646 23091 21921 1,170 Chapel Allerton 1752 2966 4495 16188 2981 28382 20599 7,783 City and Hunslet 1906 2351 9692 18089 2094 34132 18010 16,122 Cross Gates and Whinmoor 1371 2414 2975 12313 4317 23390 22987 403 Farnley and Wortley 1586 2770 3393 13873 3700 25322 23184 2,138 Garforth and Swillington 940 2231 2465 10886 4263 20785 20524 261 Gipton and Harehills 3008 4912 5010 16680 2554 32164 24906 7,258 Guiseley and Rawdon 1379 2549 2490 12919 3719 23056 21330 1,726 Harewood 914 2104 1872 9889 4209 18988 18,213 775 Headingley 255 386 12672 7714 954 21981 19835 2,146 Horsforth 1191 2292 3145 12455 3986 23069 21562 1,507 Hyde Park and Woodhouse 1179 1404 13949 16643 1258 34433 22220 12,213 Killingbeck and Seacroft 1690 3347 3883 13297 3534 25751 24,580 1,171 Kippax and Methley 1296 2468 2406 11662 3560 21392 20267 1,125 Kirkstall 1039 1832 5691 13086 2581 24229 21051 3,178 Middleton Park 2092 3537 4068 14201 3450 27348 25477 1,871 Moortown 1506 2512 2756 13432 3906 24112 22239 1,873 Morley North 1397 2490 2561 13384 3762 23594 21426 2,168 Morley South 1352 2348 2566 12877 3207 22350 20,603 1,747 Otley and Yeadon 1178 2371 2489 12637 4474 23149 23036 113 Pudsey 1275 2548 2686 12524 3951 22984 22,473 511 Rothwell 1212 2301 2305 11288 3829 20935 20113 822 Roundhay 1603 2927 2941 13903 3741 25115 22403 2,712 Temple Newsam 1443 2731 3021 12221 3790 23206 21748 1,458 Weetwood 1101 2010 5572 11812 3106 23601 21830 1,771 Wetherby 929 1984 1885 10354 4521 19673 19,897 -224 Leeds 47259 82810 131232 430868 112358 804527 715,402 89125

100 Appendix 10

Table showing range of opening times for pharmacy by ward - July 2010

Wards Weekday Sat Sun Adel and Wharfedale 8:30-18:30 9:00-18:30 Alwoodley 8:00-21:00 8:00-21:00 10:00-16:00 Ardsley and Robin Hood 8:30-18:00 8:00-12:00 Armley 7:00-23:00 8:00-20:00 10:00-18:00 Beeston and Holbeck 8:15:-18:30 8:45-16:45 Bramley and Stanningley 08:30-18:30 8:30-17:30 Burmantofts and Richmond Hill 8:00-18:30 9:00-13:00 Calverley and Farsley 8:30-21:00 9:00-21:00 11:00-17:00 Chapel Allerton 8:00-23:00 8:00-23:00 8:00-18:00 City and Hunslet 6:00-midnight 6:00-midnight 9:00-midnight Cross Gates and Whinmoor 8:30-18:00 9:00-15:00 Farnley and Wortley 8:15-19:00 9:00-17:00 Garforth and Swillington 8:00-22:30 6:00-22:00 10:00-16:00 Gipton and Harehills 8:30-20:00 9:00-18:00 12:00-18:00 Guiseley and Rawdon 8:45-18:30 8:45-17:30 Harewood 8:10-18:30 9:00-12:30 Headingley 8:30-19:00 8:30-17:30 Horsforth 8:30-18:30 8:30-17:00 Hyde Park and Woodhouse 8:45-18:30 9:00-12:00 Killingbeck and Seacroft 7:00-23:00 7:00-22:00 10:00-16:00 Kippax and Methley 8:30-18:30 8:30-17:00 Kirkstall 8:00-midnight 8:00-22:00 10:30-16:30 Middleton Park 8:30-18:00 9:00-17:00 Moortown 9:00-18:00 9:00-17:00 9:30-12:30 Morley North 8:30-22:00 08:00-20:00 11:00-17:00 Morley South 8:00-23:00 7:00-22:00 10:00-16:00 Otley and Yeadon 8:30-19:00 8:30-17:30 10:30-15:00 Pudsey 8:00-23:00 8:00-23:00 9:00-19:00 Rothwell 9:00-18:30 9:00-17:30 Roundhay 8:00-midnight 8:00-midnight 10:00-18:00 Temple Newsam 8:00-23:00 8:00-21:00 10:30-17:00 Weetwood 8:15-18:30 9:00-16:30 Wetherby 8:30-18:30 8:45-17:30 10:00-15:00

101

PHARMACEUTICAL NEEDS ASSESSMENT MARS

Y PATCH

Y Y Y Chalmydia

Y Y Palliative Care Palliative

Y Y Y Y Y Y Y Y Y Y Y Y

Therapy

Nicotine Replacement Replacement Nicotine y

Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Supervised Consumption Supervised

Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Needle Exchange Needle

Y Y

Contraception

Emergency Hormonal Hormonal Emergency Y Y Minor Ailments Minor

Y Y Y Y Y Y LS16 7SR LS16 8EX LS16 9AF LS16 1LH LS21 5JD LS17 5NY LS17 7BE LS17 8AE LS17 WF3 1RQ WF3 3DX WF3 3LJ 1HX LS12 1JZ LS12 1UG LS12 3EY LS12 3NP LS12 0JY LS11 5LQ LS11 8AG LS11 8BB LS11 8PN LS11 9LY LS11 Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Wakefield Wakefield Wakefield Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Holt Park Shopping Centre Adel Breary Lane, Bramhope Pool-in-Wharfedale Moortown Alwoodley Tingley Thorpe Lofthouse Road Tong 14-16 Green Lane Armley Cottingley Street Town Holbeck Address Unit 5 Long Causeway 141 4 The Parade Main Street Cranmer49 Bank Moor Allerton Centre 2 The Avenue Shadwell Lane139 Leigh View, Bradford Road 1 Oakley Street 2 Carlton Lane Old Crown Cinema Site New Building Street Town 5-7 Station Road Armley62 Ridge Road 3 Cottingley Vale Dewsbury Road 311 Old188 Lane Beeston Road132 Beeston District Centre 5a Shafton Lane Pharmacy Name Boots Pharmacy Adel Pharmacy Stancliffe Pharmacy Pool Pharmacy Living Care Pharmacy Sainsburys Pharmacy Lloyds Pharmacy The Co-Op Pharmacy Rowlands Pharmacy Thorpe Pharmacy Carlton Lane Pharmacy Lloyds Pharmacy Cohens Chemist Boots The Chemists The Co-Operative Pharmacy Lloyds Pharmacy Ltd Cottingley Pharmacy Living Care Pharmacy Living Care Pharmacy Boots Uk Limited The Co-Operative Pharmacy Cohens Chemist Ward Adel & Wharfedale Alwoodley Ardsley & Robin Hood Armley Beeston and Holbeck Appendix 11 Appendix

102 103 PHARMACEUTICAL NEEDS ASSESSMENT

Y Y Y Y Y Y Y

Y Y Y

Y Y Y Y Y Y Y

Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Y Y

Y Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y Y Y LS13 2ET LS13 2ET LS13 2UP LS13 3JE LS13 3JT LS13 LS9 6AP LS9 6DE LS9 7SU LS9 8RZ LS9 9BL LS9 9BP LS9 9JG LS28 5LD LS28 5PD LS28 6AN LS28 6DR LS28 8LE LS7 3DR LS7 3DX LS7 4BB LS7 4JA LS7 4LA LS7 3QY Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Bramley Bramley Bramley Bramley Bramley 480 Harehills Lane East End Park Farsley Calverley Pudsey SunfieldStanningley Place, Pudsey Scott Hall Road Spencer Place Chapeltown Road 31-33 Bramley Centre 31-33 Bramley35 Centre Bellmount Close 23 Nora Place Street Town 283-285 399 Harehills Lane Shaftesbury Medical Centre 84-86 Lincoln Green Road 9a Upper Accommodation Rd 78a Osmondthorpe Lane Road 230 York East Park Road5-7 Street38-42 Town Thornhill100 Street Owlcotes Centre Sunfield Medical Centre Galloway72 Lane Rutland Lodge Chapeltown263 Road Chapeltown Health Centre 4-5 Newton Parade Harrogate42 Road 6 Stainbeck Lane Boots The Chemist Co-Op Pharmacy Lloyds Pharmacy Co-Op Pharmacy Lloyds Pharmacy Ltd Lloyds Pharmacy Lloyds Pharmacy Co-Op Pharmacy Living Care Pharmacy Lloyds Pharmacy Cohens Chemist Living Care Pharmacy Liptrots Farsley Liptrots Calverley ASDA Pharmacy The Co-operative Pharmacy Boots The Chemist Baskind Pharmacy Lloyds Pharmacy Cohens Chemist Medichem Pharmacy Medichem Pharmacy Baskinds Chemist Bramley & Stanningley Burmantofts & Richmond Hill Calverley & Farsley Chapel Allerton

102 103

PHARMACEUTICAL NEEDS ASSESSMENT MARS

y

Y PATCH

Y Y Chalmydia

Y Y Y Y Y Y Y Y Y Palliative Care Palliative

Y Y Y Y Y Y Y

Therapy

Nicotine Replacement Replacement Nicotine Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Consumption

Supervised Supervised y

Y Y Y Y Y Y Y Y Y Y Y Y Y Y Needle Exchange Needle

Y Y Y

Contraception

Emergency Hormonal Hormonal Emergency Y Y Y Y Y Minor Ailments Minor

Y Y Y Y Y Y LS10 2JJ LS10 LS1 7JH LS1 LS1 5ETLS1 LS14 5JS LS14 LS1 6BY LS1 LS2 8DB LS12 5AT LS12 LS14 2EH LS14 LS12 5SG LS12 LS14 1PQ LS14 LS10 2AP LS10 LS2 8NG LS15 8BA LS15 LS10 2AR LS10 LS12 4AD LS12 POST-CODE LS1 4DT LS1 1ET LS10 5HZ LS11 5HZ LS11 8DX LS15 Address 3 Address Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Address 2 Address Bond Street Centre Vicar Lane Junction Street Hunslet Church52 Street, Hunslet Hunslet Carr Coal Road Mill Green View Lower Wortley Lower Wortley Address 1 City Station Concourse Albion19 Arcade Kirkgate 13 Kirkgate Market 12-14 Ctr Crown Point Retail Park Penny Hill Centre 17-18 FraternityUnit 1, House 1 Moor Road Dewsbury227 Road The Merrion49-51 Centre The Merrion 31-35 Centre Dewsbury267 Road 1 Hawthorn Park 46a White Laithe Aprroach Windmill Hth Centre Austhorpe37 Road Austhorpe42 Road Dixon106 Lane Road Tong 531 Wortley Beck HC PHARMACY NAME Boots Boots Superdrug Pharmacy Boots Boots Co-Op Pharmacy Lloyds Pharmacy Local BootsYour Pharmacy Living Care Pharmacy Boots Superdrug Pharmacy Al-Shafa Pharmacy Pharmacy2U Ltd Whinmoor Pharmacy Lloyds Pharmacy The Co-Operative Pharmacy The Co-Op Pharmacy Lloyds Pharmacy Lloyds Pharmacy Freemans Pharmacy Ward City & Hunslet Crossgates & Whinmoor Farnley & Wortley

104 105 PHARMACEUTICAL NEEDS ASSESSMENT

Y Y Y

Y Y Y

Y Y Y

Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y Y Y

Y Y Y

Y Y Y Y

Y Y Y Y Y Y Y Y Y LS8 5JP LS8 3LF LS8 4HS LS25 1EZ LS9 6AX LS25 3BR LS15 4DR LS15 LS14 3DX LS14 LS25 2DX LS25 2AR LS8 5BW LS19 6DD LS19 LS22 5BQ LS25 3AA LS20 8AH LS20 8AH LS22 5AW LS25 1AA LS26 8DY LS8 5HR LS9 7BD 4JX LS15 9LQ LS17 Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Garforth Garforth Garforth Garforth Swillington New Road Side, 11 Rawdon Guiseley Guiseley Collingham, Wetherby Barwick in Elmet Aberford Aberford Collingham Thorner Harewood Scholes 24-26 Main Street 24-26 Main Cohen's, 10 Street Aberford Road 9 Fairburn Drive Church Lane 368 Oakwood Lane Roundhay 255-257 Road Harehills Road125 Harehills35 Road Harehills Lane176 Harehills365 Lane Harehills Lane 262-266 Rawdon Surgery 64 Otley Road Otley 26 Road 5 Hastings Court Elmwood Surgery Jessamine Cottage The Surgery, 1 Church Terrace Church View Surgery, School Lane Main Street, The Square, 96 Main Street Lloyds Pharmacy Cohens Chemist PharmacyTesco Lloyds Pharmacy Swillington Pharmacy Lloyds Pharmacy Roundhay Pharmacy Lloyds Pharmacy Sky Pharmacy Rzm Chemists Harehills Harehills Pharmacy Local BootsYour Pharmacy Local BootsYour Pharmacy Local BootsYour Pharmacy Cohens Pharmacy Village Pharmacy Dr Porter & Partners* Dr Porter & Partners* Dr Davis & Taylor* Dr Lightfoot* Dr Lightfoot* Dr Knight* Dr Swaby* Garforth & Swillington Gipton & Harehills Guiseley & Rawdon Harewood

104 105

PHARMACEUTICAL NEEDS ASSESSMENT MARS

Y Y Y Y Y Y PATCH

Y Y Chalmydia

Y Y Y Y Y Y Palliative Care Palliative

Y Y Y Y Y Y Y

Therapy

Nicotine Replacement Replacement Nicotine Y Y Y Y Y Y Y Y Y Y Y

Consumption

Supervised Supervised Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Needle Exchange Needle

Y Y

Contraception

Emergency Hormonal Hormonal Emergency Y Y Y Y Minor Ailments Minor

Y Y Y Y Y Y Y LS6 1EG LS6 1LU LS6 2AL LS6 3AA LS6 3EJ 4AP LS18 4QB LS18 4SE LS18 LS2 9HB LS6 1PY LS6 2RY LS7 1SP 1HX LS14 6DX LS14 6GG LS14 6LU LS14 6NX LS14 LS8 3AS LS8 3AY 6UF LS14 LS25 7AB LS25 7JN LS26 9AB 2DP WF10 Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Castleford Horsforth Horsforth Broadgate Lane, Horsforth Askett Drive Seacroft Seacroft Avenue Leeds Kippax Kippax Methley Leeds22a Rd, Allerton Bywater Address 58 Brudenell Road Cardigan136 Road Otley52 Road Otley35 Road Kirkstall203 Lane Street Town 74 88 New Road Side The Primary Medical Centre Woodhouse166 Lane Hyde25 Park Road 1 Moseley Place 54 Oatland Lane Park Edge Medical Centre Road868 York Moresdale91 Lane Road York Seacroft Grange Med Ctr 5 Hollin Park Parade Dib Lane 120 Killingbeck Drive 56 High Street Gibson Lane Health Centre Pinfold Ln Nova Scotia Medical Centre W Pullan . PHARMACY NAME R Cardigan Road Pharmacy Lloyds Pharmacy Local BootsYour Pharmacy The Co-Op Pharmacy The Co-Op Pharmacy D L Mitchell Pharmacy Lloyds Pharmacy Lloyds Pharmacy AndrewTylee Local BootsYour Pharmacy Lloyds Pharmacy Assura Pharmacy Park Edge Seacroft Pharmacy Local BootsYour Pharmacy InstoreTesco Pharmacy Lloyds Pharmacy Local BootsYour Pharmacy Co-Op Pharmacy ASDA Pharmacy Local BootsYour Pharmacy Local BootsYour Pharmacy Methley Pharmacy Lloyds Pharmacy WARD Headingley Horsforth Hyde Park & Woodhouse Killingbeck & Seacroft Kippax & Methley

106 107 PHARMACEUTICAL NEEDS ASSESSMENT

Y Y Y Y Y Y

Y Y Y Y Y Y Y y

Y Y Y Y Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y Y Y y

Y Y Y Y Y Y Y Y Y Y Y Y Y

Y Y Y Y Y

Y Y Y Y Y LS4 2EL LS5 3QT LS5 3BH LS5 3RP 3HU LS10 3NB LS10 4HT LS10 4LU LS10 5AX LS17 6PY LS17 LS8 1AA 1AU BD11 1ES BD11 8LL LS11 8LS LS11 LS27 7DX LS27 7PT LS27 9BG LS27 9BP LS27 9EN LS27 9EW LS27 9NB LS27 OBP Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Bradford Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Kirkstall Valley Retail Park Shelldrake20 Drive Middleton Park Avenue 8 Middleton Park Circus Drighlington Drighlington Gildersome Churwell Morley Morley Little Fountain Street, Morley Morley Morley Morley 275 Burley275 Road Vesper69 Road Kirkstall24 Lane 2 Savins Mill Way Middleton Road 219 Lingwell Croft Surgery Middleton Park Health Ctr Middleton Park Pharmacy King79 Lane 396 Harrogate Road Street Lane 141 Whitehall Road 176 King Street 151 White Rose Centre White Rose Centre Finkle25 Lane 4 Laneside Elland Terrace, Rd 3 Windsor Court 68 Queen Street Fountain Medical Centre South Queen Street 2 Queensway Howley Park Road The Cooperative Pharmacy Lloyds Pharmacy Lloyds Pharmacy Local BootsYour Pharmacy Belle Isle Pharmacy Allied Middleton Pharmacy The Cooperative Pharmacy Local BootsYour Pharmacy Kings Lane Pharmacy Lloyds Pharmacy The Cooperative Pharmacy The Cooperative Pharmacy Drighlington Pharmacy Local BootsYour Pharmacy Sainsburys Pharmacy The Cooperative Pharmacy The Cooperative Pharmacy Local BootsYour Pharmacy The Cooperative Pharmacy Lloyds Pharmacy The Cooperative Pharmacy The Cooperative Pharmacy ASDA Pharmacy Kirkstall Middleton Park Moortown Morley North Morley South

106 107

PHARMACEUTICAL NEEDS ASSESSMENT MARS

Y PATCH

Y Y Y Chalmydia

Y Y Y Y Y Y Palliative Care Palliative

Y Y Y Y Y Y

Therapy

Nicotine Replacement Replacement Nicotine Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Consumption

Supervised Supervised Y Y Y Y Y Y Y Y Y Y Needle Exchange Needle

Y Y

Contraception

Emergency Hormonal Hormonal Emergency y

Y Y Y Minor Ailments Minor

Y Y Y Y POST-CODE 7JN LS19 7SP LS19 7SP LS19 1BQ LS21 3HJLS21 3HNLS21 BD4 8ET 4PJ LS13 LS28 7BR LS28 7LD LS28 7LD LS28 7RF LS28 8BS LS26 0AP LS26 0AP LS26 0QD LS26 0UE LS26 8RE LS8 1QR LS8 1AY LS8 4BA LS8 4BU Address 3 Address Leeds Leeds Leeds Leeds Leeds Leeds Bradford Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Address2 1 Suffolk Court, Yeadon Yeadon Yeadon Otley Otley Otley Pudsey Pudsey Pudsey Pudsey Pudsey Rothwell Rothwell Rothwell Rothwell Oulton Devonshire Avenue12 Address1 Silver Lane Medical Practice High39 Street High29 Street , 1 Bridge Street Kirkgate 28-32 Kirkgate35 6 Tyersal Road Swinnow Road 187a Robin Lane Medical Centre Church Lane 11 23 Church Lane Church32 Lane 46 Chapeltown Road 69/71 Commercial Street Commercial49 Street Commercial53a St Rothwell HC, Brig Stone Lane 7 Quarry Hill Lidgett97 Lane Street Lane Practice 643 Roundhay Road Roundhay Road361 PHARMACY NAME Lloyds Pharmacy Lloyds Pharmacy The Co-Operative Pharmacy PharmacyCohen's Local BootsYour Pharmacy Lloyds Pharmacy Tyersal Pharmacy The Co-Operative Pharmacy Lloyds Pharmacy Local BootsYour Pharmacy Church Lane Pharmacy Lloyds Pharmacy The Pudsey Pharmacy Local BootsYour Pharmacy Garners Pharmacy Naseem's Chemist Local BootsYour Pharmacy Local BootsYour Pharmacy Ma Manning Pharmacy Lloyds Pharmacy Oakwood Pharmacy Instore PharmacyTesco's WARD Otley & Yeadon Pudsey Rothwell Roundhay

108 109 PHARMACEUTICAL NEEDS ASSESSMENT

Y Y Y

Y Y

Y Y Y Y Y

Y Y Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y Y Y

Y Y

Y Y Y Y Y

Y Y Y Y Y Y Y Y Y LS15 7JR LS15 LS15 9JA LS15 LS6 4AY LS22 6FL LS16 6LQ LS16 LS22 6RT LS23 6BT LS16 5BQ LS16 LS9 0EW LS23 6RN LS15 8NN LS15 LS15 0LF LS15 9JB LS15 7AP LS16 LS22 6RS Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Leeds Halton Halton Whitkirk Colton Style Way Wetherby Wetherby Wetherby Boston Spa Bramham MC 204 Selby Road Selby253 Road 7 Austhorpe View Selby Road ColtonUnit Park 1, Selby49 Road Butcher Hill 195-197 Otley78 Old Road 6 Tinshill Lane Meanwood569-571 Road 1 Horsefair Centre James St Street59 3-5 Crossley Street High190 Street Bramham MC, Clifford Rd Your Local BootsYour Pharmacy Halton Pharmacy Ben Wilson Ltd Sainsburys Pharmacy Local BootsYour Pharmacy Local BootsYour Pharmacy Lloyds Pharmacy HawkinWA & Sons Cohens Chemist Lloyds Pharmacy Local BootsYour Pharmacy Local BootsYour Pharmacy Day Lewis Pharmacy Cohens Chemist Dr Nichols* (dispensing practice) Temple Temple Newsam Weetwood Wetherby * denotes the* denotes dispensing practices

108 109 PHARMACEUTICAL NEEDS ASSESSMENT Appendix 12 Pre Engagement Process The pre-engagement ran for a period for four weeks and during this time views were sought from stakeholders and the general public . They were asked their views on current pharmacy services and how they would like to see future services within Leeds developed . Along with all the information that NHS Leeds has regarding demographics and pharmacy services currently provided, the information collected helped NHS Leeds to identify where there are gaps in service and the potential need for additional pharmacy essential and enhanced services . Public events As part of the process, six events were held across Leeds where NHS Leeds staff spoke to the public regarding pharmacy services and asked to complete a questionnaire . These events were held in health centres across Leeds in the following venues .

Date Venue Times

7th June 2010 Yeadon Health Centre 0830-1200

7th June 2010 Headrow Walk In Centre 1000-1300

10th June 2010 Chapeltown Health Centre 1400-1700

15th June 2010 Hunslet Health Centre 0830-1200

22nd June 2010 Armley Moor Health Centre 0900-1200

24th June 2010 East Leeds Health Centre 0830-1200

25th June 2010 Wetherby Health Centre 1400-1700

NHS Leeds staff were present at the event to answer questions about current and future provision . Attendees were also asked to complete the questionnaire . Pre engagement questionnaire The questionnaire was sent out to a wide variety of stakeholders across the city . 303 completed questionnaires were received from a wide range of stakeholders . Of the 303 responses: • 71 .33 percent were from patients; • 3 41. percent were from a health or social care worker; • 2 05. percent were from carers; and • 11 60. percent were from local residents .

The responses indicated that the public visit pharmacies with the following frequency: • 6 .27 percent visit a pharmacy more than once a week; • 6 .27 percent visit a pharmacy weekly; • 12 54. percent visit a pharmacy once a fortnight; • 35 .31 percent% visit a pharmacy monthly; • 25 41. percent visit a pharmacy every few months; and • 14 19. percent visit a pharmacy less often; • 80 74percent. of people normally use the same pharmacy .

110 Of the pharmacies that are used: People use pharmacies for a variety of services: • 70 .20 percent of people use a pharmacy within • 40 45. percent use the pharmacy for prescription one mile of their home; dispensing; • 23 51. percent of people use a pharmacy • 1 95. percent use the pharmacy for photo between 1 and 3 miles of their home; and developing; • 4 97. percent of people use a pharmacy between • 21 92. percent use the pharmacy to buy over the 4 and 7 miles of their home . counter medicines; • 12 41. percent use the pharmacy to buy Of the 303 responses, 12 .85 percent of people felt toiletries; there should be a pharmacy closer to their home . This appears to be in areas LS19, LS17, LS12, LS16, • 10 .32 percent use the pharmacy for health LS18, LS11, LS21, WF3, LS7, LS15, LS9 . Although advice; these respondents felt there should be a pharmacy • 2 51. percent use the pharmacy for additional closer to their home, a number of them have a services; pharmacy within one mile of their home address . • 9 90. percent use the pharmacy for non From the responses, patients use pharmacies for a prescription medicines only available through variety of reason . These include: pharmacies; and • 26 92. percent because the pharmacy is close to • 0 .28 percent use the pharmacy for other home; reasons . These include products available for • 9 07. percent because of ease of parking; purchasing, dossette box provision and other service provision . • 4 .32 percent because it is near to work; • 17 15. percent because of the good customer Respondents were asked about the opening service; times of the pharmacies within Leeds, and if they • 2 .23 percent because the pharmacy is in a would liken to see any additional opening hours of supermarket; pharmacies . • 9 48. percent because the pharmacy is on a high • 8 03. percent weekdays before 9am; street or in a shopping area; • 11 71. percent weekdays after 6pm; • 5 02. percent because products are reasonably • 11 71. percent Saturday mornings; priced; • 1 .34 . percent Saturday afternoons; • 17 .85 percent because the pharmacy is next to a • 5 02. percent Sunday mornings; GP practice; • 1 .34 percent Sunday afternoons; • 0 56. percent because the pharmacy is internet • 8 70. percent late night; and based; • 48 16. percent are satisfied with normal opening • 7 .39 percent because of the range of services times available; and • 47 49. percent of respondents have used a • 0 .28 . percent because of other reasons . These pharmacy outside of normal opening hours include because the pharmacy is efficient, (before 9am or after 6pm . services that are offered, helpful staff and opening hours .

111 PHARMACEUTICAL NEEDS ASSESSMENT Appendix 13 Consultation Process

Pharmaceutical Needs Assessment Consultation Between 4 October and 31 December, NHS Leeds held a consultation to seek views and comments from stakeholders and the general public about the draft Pharmaceutical Needs Assessment (PNA) Consultees were asked if the PNA fulfilled its stated purpose and if it had been developed following the correct process . Two separate questionnaires were developed and distributed . The first questionnaire was developed for statutory stakeholders, including all providers of primary and secondary health care, Local Medical Council (LMC), Local Pharmaceutical Council (LPC), neighbouring primary care trusts, Scrutiny Board (Health) and Leeds Involvement Network (LINk) . The second questionnaire was for the general public and distributed to members of the NHS Leeds Patient, Public and Carer Involvement Network, involvement groups from local Practice Based Commissioning Consortia, voluntary sector organisations with an interest in the health agenda and to the over 300 respondents to our pre-engagement survey around the use of community pharmacies and their services . Stakeholder and public events As part of the consultation process, six open events were held across the city . NHS Leeds staff gave presentations, outlined what the process was all about and explained how the questionnaires were distributed . Those who attended had an opportunity to ask questions and to complete a questionnaire . These events were held across Leeds in the following venues:

Date Venue Times

20 October 2010 Wetherby Health Centre 1 00pm. - 3 00pm.

27 October 2010 Yeadon Health Centre 10 00am. - 12noon

5 November 2010 Kippax Health Centre 2 .30pm - 4 .30pm

12 November 2010 Armley Moor Health Centre 10 00am. - 12 noon

10 November 2010 Shine, Harehills Road 5 .30pm -7 .30pm

15 November 2010 Beeston Hill Health Centre 11 00am. - 1 00pm.

Responses 37 replies were received from the general public and one of the recurring themes was access to pharmacy services . Some people highlighted the need for better access to services on an evening and weekend . Others highlighted the need for pharmaceutical services to be extended within existing pharmacies . People commented that staffing would need to be adequate to provide these services . Further comments included better advertising of services provided in pharmacies, especially in GP practices as some people are unaware of the full range of services offered . The document was discussed at the Leeds Involvement Network (LINk) meeting and was minuted as a brilliant document and an example of really good practice . 15 replies were received from professional stakeholders . Several responses identified some inaccuracies with the data regarding current pharmaceutical services Feedback was also received from Leeds Scrutiny Board (Health) who asked for it to be formally acknowledged that the PNA was a well written, easy to read, very clear document . The Board appreciated that was split in relevant sections and contained information from a wide variety of sources which was interpreted well . 112 Glossary / Abbreviations APMS Alternative provider medical services APMS can be used to provide essential services, additional services where GMS/PMS practices opt out, enhanced services, out-of-hours services or any one element or combination of these services AUR Appliance use review BME Black and minority ethnic groups CACI The UK branch of an International corporation offering marketing solutions and information - is a wholly owned subsidiary of CACI International Incorporated . www caci. . co uk/About_caci. .aspx CaSH Contraceptive and Sexual Health C-card Condom-card CHD Coronary heart disease Community pharmacy contract The community pharmacy contract is made up of three service levels; essential services, advanced services and enhanced services Control of entry Regulatory framework for assessment and approval or rejection of pharmacy applications . COPD Chronic obstructive pulmonary disease Deprived/non-deprived When referring to deprived Leeds these are the specific poorer areas that are within England’s 10 percent most deprived LSOAs see map (appendix three) . Non-deprived is the remaining 80 percent of Leeds . Directed services The enhanced services that a PCT can require applicants applying through the exemption route to provide as part of their terms of service Directly Age Standardised Rates These are rates that are adjusted to account for differences in the age structure of different populations . Doing this means we can exclude differences in age structure when investigating the underlying causes of causes of different rates . DAC Dispensing appliance contractors Dispensing GP General Practitioner that is able to dispense medicines for some patients in rural areas for whom a pharmacy is not readily available EHC Emergency hormonal contraception or the morning after pill .

113 ePACT An electronic data system which allows prescribers and prescribing advisors to access large volumes of prescribing data . Exempt categories One stop centres, one hundred hours a week, retail park 15,000sqm, wholly mail order and internet only, pharmacies Extended hours Opening hours beyond normal working day: for GP before 8 .30am and after 6 .30pm GDS General dental services . GMS General Medical Services . General medical services . (GMS) are the standard, nationally agreed contracts . All GP practices must provide the core services from these contracts to their patients . Harm Reduction Harm reduction programmes aim to reduce the negative consequences of drug use, by reducing the harm self-inflicted by the user through unsafe practices and the harm inflicted upon communities . Indices of Deprivation The indices measures deprivation for every lower layer Super Output Area and local authority area in England . There are separate indices for each of the seven types of deprivation: income; employment; health and disability; education skills and training; barriers to housing and services; crime; and living environment deprivation . This allows all the lower layer Super Output Areas in the country to be ranked according to how deprived they are in relation to one another JSNA Joint Strategic Needs Assessment . This identifies the current health issues experienced by people in Leeds and what their future health, social care and wellbeing needs are likely to be in the next few years . MUR Medicine use reviews NHS Health Checks A new national scheme aiming to prevent the onset of health problems such as heart disease, stroke, type 2 diabetes and kidney disease by offering a check up to people between the ages of 40 and 74 who do not already these conditions . ONS Office of National Statistics Pharmacy panel under the National Health Service (Pharmaceutical Services) Regulations 2005, the PCT has an obligation to consider and approve a wide range of issues in relation to the provision of community pharmacy services, including the location of community pharmacies, opening hours and new contract requests . The Pharmacy Panel holds this responsibility on behalf of the PCT PDS Personal dental services PMS Personal medical services (PMS) are locally-agreed contracts which GP practices can choose to sign up to provide additional services identified by NHS Leeds is being required for specific local areas . Where GP practices opt out of providing some services, NHS Leeds is responsible for finding alternative providers of these aspects of care . Prevalence This refers to the proportion of the population who have a disease at a point in time . It is calculated by dividing the total number of people with the disease by the total number of people at risk, and usually expressed by a percentage or rates per 100,000 of the population . Quality & Outcomes Framework The framework known as (QoF) which identifies patients with specific diseases, records their status and pays practices accordingly Super output areas Super output area is the definition of an area by similar population numbers, to allow collection and comparison of statistical data to a greater level of detail MSOA’s are approximately (see Section 5 4).

115 PHARMACEUTICAL NEEDS ASSESSMENT

116 117 PHARMACEUTICAL NEEDS ASSESSMENT

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