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Leicester Pharmaceutical Needs Assessment

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Leicester Pharmaceutical Needs Assessment Leicester Pharmaceutical Needs Assessment Approved by the Leicester Health and Wellbeing Board March 2015 Version 2.0 April 2015 0 Review date: March 2018 CONTENTS EXECUTIVE SUMMARY ………………………………………………………………………………………………………. 6 INTRODUCTION AND BACKGROUND…………………………………………………………………………………. 11 1. Population profile of Leicester……………………………………………………………………………………. 17 1.1 Age…………………………………………………………..……………………………………..…………..….. 17 1.2 Deprivation……………………………………………………………………………………..…………….... 18 1.3 Ethnicity……………………………………………………………………….…………………………………. 19 1.4 Languages……………………………………………………………………….……………….………..……. 21 1.5 Religion………………………….…………………………………………………………………..…………… 22 1.6 Socio-economic background……………………………………………………………………..…….. 23 1.7 Housing, health and wellbeing……………………………..…………………………………….…… 25 1.8 Care homes / sheltered accommodation…………………………………………..…….………. 25 1.9 Students…………………………………………………………………………………………..………...…… 28 1.10 Statutory homelessness………………………………………………………………………….….……. 28 1.11 Transient populations…………………………………………………………………………….……….. 29 2. Local Health needs………………………………………………………………………………………………………. 30 2.1 Life expectancy at birth……………………………………………………………………………………. 30 2.2 Main causes of death……………………………………………………………………………………… 32 2.3 Coronary heart disease, stroke and cancer mortality……………………………………… 33 2.4 Smoking-related deaths and smoking cessation……………………………………………… 34 2.5 Chronic obstructive pulmonary disease………………………………………………………….. 36 2.6 Diabetes………………………………………………………………………………………………………….. 37 2.7 Sexual ill health………………………………………………………………………………………………. 39 2.8 Mental health………………………………………………………………………………………………….. 40 2.9 Oral health………………………………………………………………………………………………………. 42 2.10 Obesity…………………………………………………………………………………………………………….. 42 2.11 Drug misuse…………………………………………………………………………………………………….. 43 2.12 Accident and emergency attendances…………………………………………………………….. 44 3. Local health needs by wards in Leicester……………………………………………………………………. 46 3.1 Abbey……………………………………………………………………………………………………………….. 46 3.2 Aylestone………………………………………………………………………………………………………….. 46 3.3 Beaumont Leys…………………………………………………………………………………………………. 47 3.4 Belgrave…………………………………………………………………………………………………………… 47 3.5 Braunstone Park and Rowley Fields………………………………………………………………….. 47 3.6 Castle……………………………………………………………………………………………………………….. 48 1 3.7 Charnwood………………………………………………………………………………………………………. 48 3.8 Coleman………………………………………………………………………………………………………….. 49 3.9 Evington…………………………………………………………………………………………………………… 49 3.10 Eyres Monsell………………………………………………………………………………………………….. 49 3.11 Fosse……………………………………………………………………………………………………………….. 50 3.12 Freemen………………………………………………………………………………………………………….. 50 3.13 Humberstone and Hamilton……………………………………………………………………………. 50 3.14 Knighton………………………………………………………………………………………………………….. 51 3.15 Latimer……………………………………………………………………………………………………………. 51 3.16 New Parks……………………………………………………………………………………………………….. 51 3.17 Rushey Mead…………………………………………………………………………………………………… 52 3.18 Spinney Hills……………………………………………………………………………………………………. 52 3.19 Stoneygate………………………………………………………………………………………………………. 52 3.20 Thurncourt………………………………………………………………………………………………………. 53 3.21 Westcotes……………………………………………………………………………………………………….. 53 3.22 Western Park…………………………………………………………………………………………….…….. 54 4. Location and Access to pharmacies………………………………………………………….….………..……. 55 4.1 Pharmacies in Leicester…………………………………………………………………………………… 55 4.2 Types of pharmacies……………………………………………………………………………………….. 55 4.3 Walk times to pharmacies……………………………………………………………………………….. 59 4.4 Public transport travel times to pharmacies…………………………………………………… 60 4.5 Drive times to pharmacies………………………………………………………………………………. 61 4.6 Pharmacy opening times…………………………………………………………………………………. 64 5. Current Pharmacy Provision and Services………..…………………………………………….…….……… 67 5.1 Community pharmacy contractual framework…………………………………………………. 67 5.2 Provision of pharmacy services…………….…..……………………………………………………… 67 5.2.1 Essential services………………………………………………………………………………. 67 5.2.2 Advanced services…………………….………………………………………………………. 68 5.2.3 Community based services……………………………………………………………….. 70 5.3 Provision of pharmacy services in Leicester…………………………………………………….. 71 5.4 Delivery of pharmacy services in Leicester……………………………………………………... 73 5.4.1 Essential services………………………………………………………………………………. 73 5.4.2 Advanced services…………………………………………………………………………….. 75 5.4.2.1 Medicines Use Reviews………………………………………………………. 75 5.4.2.2 New Medicines Service………………………………………….…………… 77 5.4.2.3 Stoma Appliance Customisation…………………………….…………… 78 5.4.2.4 Appliance Use Reviews……………………………………….………………. 80 5.4.3 Community based services……………………………………………………………….. 82 5.4.3.1 Chlamydia screening……….……………..…………………………………… 82 5.4.3.2 Emergency hormonal contraception………….……………………….. 84 5.4.3.3 H-pylori testing………….………………………………………………………… 86 2 5.4.3.4 Minor ailments…………….………………………………………………………. 88 5.4.3.5 Palliative care……………….……………………………………………………… 90 5.4.3.6 Stop smoking services……………………………….…………………………… 92 5.4.3.7 Substance misuse…………………………………………………………….…….. 93 5.4.4 The wider role of community pharmacies…………………………………………. 98 5.4.4.1 Collection and delivery service…………………………………………….. 98 5.4.4.2 Monitored dosage systems………………………………………………….. 98 6. Projected future needs……………………………………………………………………………….……….……. 101 6.1 Population trends…………………………………………………………………………………………… 101 6.2 Growth in numbers of people with long term conditions……………………………….. 101 6.3 Housing growth……………………………………………………………………………………………… 102 6.4 Ward boundary changes………………………………………………………………….……………..104 7. Consultation……..………………………………………………………………………………………..…………..… 108 7.1 Requirements of the consultation.…………………………………………………………………. 108 7.2 Consultation in Leicester……………………………………………………………………………….. 108 7.3 Responses and results……………………………………………………………………………………. 109 7.3.1 Responses from the statutory consultees……………………………………………109 7.3.2 Responses from the public…………………….…………………………………………… 111 7.3.3 Responses from the targeted consultation events……………………………… 113 7.4 Consultation conclusions………………………………………………………………………………… 113 8. Analysis of gaps in services…………………………………………………………….………..……….………. 115 9. Conclusions and Recommendations………………………………………………………….………………. 120 10. Equality Impact Assessment………………………………………………………………………………….….. 123 GLOSSARY OF TERMS……………………………………………………………………………………………..………… 137 Appendix 1: Opening times for Leicester Pharmacies……………………………………………….… 138 Appendix 2: PNA Terms of Reference………………………………………………………………………… 145 Appendix 3: PNA Consultation Documents…………………………………………………………………. 145 LIST OF TABLES Table 1: Change in population from Census 2001 and Census 2011 by ethnic group….. 20 Table 2: Top 3 languages spoken in Leicester’s wards………………………………………. 21 Table 3: Religions in Leicester…………………………………………………………………………………….. 22 Table 4: Economic and health status in Leicester, East Midlands and England……………. 24 Table 5: Care homes per ward in Leicester…………………………………………………………………. 26 Table 6: Full-time students in Leicester by wards……………………………………………………….. 28 Table 7: Top 3 causes of cancer deaths in Leicester men and women, 2012…………….…. 34 Table 8: Levels of underweight, healthy weight, overweight and obesity……………………. 43 3 Table 9: Pharmacy types, GP Practices and registered populations in Leicester wards.. 56 Table 10: Leicester Households with no cars or vans…………………………………………………..… 63 Table 11: Pharmacy opening days by wards……………………………………………………………….... 65 Table 12: Essential pharmacy services………………………………………………………………………….. 67 Table 13: Advanced pharmacy services…………………………………………………………………………. 69 Table 14: Community based pharmacy services as at 31 March 2014…………………………… 70 Table 15: Service provision in Leicester pharmacies……………………………………………………… 72 Table 16: Prescription items and associated costs, 2013/14…………………………………………. 73 Table 17: Provision of Emergency Hormonal Contraception in Leicester pharmacies and teenage conception rates 2009-2011…………..………………………………..……………… 86 Table 18: Pharmacies providing minor ailment services per 10,000 ward population…. 90 Table 19: Estimated smoking prevalence and uptake of pharmacy Stop Smoking service in 2013/14…………………………………………………………………………………………………….. 94 Table 20: Needle exchange service uptake by ward…………………………………………………….. 97 Table 21: Estimates of numbers of over 65 year olds with long standing health conditions 2015-2030…………………………………………………………………………………………………… 102 Table 22: Projected housing completions by wards 2014/15 to 2023/24…………….…..... 103 LIST OF FIGURES Figure 1: Leicester population structure by 5 year age band, 2013………………………………. 17 Figure 2: Index of multiple deprivation by lower super output area, Leicester, 2010…… 18 Figure 3: Ethnic groups in Leicester and England…………………………………………………………. 19 Figure 4: Leicester’s population structure for White British and South Asian ethnic Groups ……………………………………...…………………………………………………………………. 20 Figure 5: Care homes in Leicester……………………………………………………………………………….. 27 Figure 6: Average life expectancy at birth for men in England and Leicester, 2011- 2013……………………………………………………………………………………………………………….. 31 Figure 7: Average life expectancy at birth for women in England and Leicester, 2011- 2013…………………………………………………………………………………………………….……….. 31 Figure 8: Main causes of death in Leicester, all ages, 2012………………………………………….. 32 Figure 9: Main causes of death in Leicester in under 75 year olds, 2012………………………. 32 Figure 10: Heart disease and stroke mortality rates in under 75 year olds, 2012 ……………. 33 Figure 11: Cancer mortality rates in under 75 year olds, 2010-2012………………………………. 34 Figure 12: Estimates of smoking
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