Knowsley Pharmaceutical Needs Assessment 2018-2021 FOREWORD Knowsley's Health and Wellbeing Board has responsibility for the ongoing review, development and publication of the Pharmaceutical Needs Assessment (a responsibility transferred to it from the now abolished Knowsley Primary Care Trust). This is a statutory document, by virtue of the National Health Services (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013. Its content has to be taken into account by those responsible for the approval of pharmacy contract applications (at NHS England) as well as those commissioning all other health services for our local population. From a Primary Care perspective this includes Clinical Commissioning Groups and Local Authorities looking to commission and develop local services from General Practice, Dental, Optometry and Pharmacy Contractors. As such we are very happy to present our second formal Pharmaceutical Needs Assessment 2018–2021 which outlines the Pharmaceutical Services available to our population. This document provides information around current services being commissioned and proposals for future changes and developments. This document will be used by NHS England to make decisions on applications for new contracts and changes to existing contracts, assist Knowsley Council and Knowsley Clinical Commissioning Group when reviewing our commissioning strategies, upon which we base our decisions. It is recognised that our Community Pharmacy colleagues have a key role to play in helping us develop and deliver the best possible Pharmaceutical Services for our population. We commend this report to you and we look forward to your continuing involvement as this document is regularly reviewed and updated. Signed Anthony Leo, Steve Coffey Director of Commissioning Independent Chair NHS England – North (Cheshire and Knowsley Health and Wellbeing Merseyside) Board Knowsley Pharmaceutical Needs Assessment, 2018 2 | P a g e READER INFORMATION Title Knowsley Pharmaceutical Needs Assessment, 2018 - 2021 Team Public Health Author Lisa McGurgan – Specialist Public Health Analyst Contributors Knowsley Pharmaceutical Needs Assessment Steering Group Knowsley Pharmaceutical Needs Assessment Steering Group Richard Holford – Public Health Specialist Reviewers Matthew Ashton – Assistant Executive Director - Public Health and Wellbeing Circulated Knowsley Health and Wellbeing Board to Release April 2018 Date Annual review with supplementary statements as necessary with a Review Date formal review by April 2021 Status Final Purpose To assess the needs for pharmaceutical services in Knowsley The Pharmaceutical Needs Assessment (PNA) is a primary tool for NHS England and local commissioners to support the decision making process for pharmacy applications and to ensure that commissioning Description intentions for services that could be delivered via community pharmacies, in addition to other providers, are incorporated into local planning cycles. Superseded NHS Knowsley Pharmaceutical Needs Assessment (2015) Documents Lisa McGurgan – Specialist Public Health Analyst Contact [email protected] Knowsley Pharmaceutical Needs Assessment, 2018 3 | P a g e KNOWSLEY PHARMACEUTICAL NEEDS ASSESSMENT STEERING GROUP MEMBERS Anthony Leo Director of Commissioning, NHS England – North (Cheshire and (Chair) Merseyside) Jackie Jasper Contracts Manager, NHS England Lisa McGurgan Specialist Public Health Analyst, Knowsley MBC ACKNOWLEDGEMENTS Janette Rawlinson for her ongoing support and promotion of the patient surveys Cheshire and Merseyside colleagues for helping to put together the Merseyside framework and support throughout the development of the PNA Public Health and CCG colleagues for providing information for section 7 Pharmacies for providing information on the services they provide Patients for responding to the patient pharmacy survey Healthwatch for engagement and distributing of patient survey Health and Wellbeing Board for distribution of patient survey Villages Housing for distribution of patient survey Halton Local Authority for updating the literature search Knowsley Pharmaceutical Needs Assessment, 2018 4 | P a g e TABLE OF CONTENTS FOREWORD ............................................................................................................. 2 TABLE OF CONTENTS ............................................................................................ 5 EXECUTIVE SUMMARY .......................................................................................... 7 1. INTRODUCTION AND PURPOSE ............................................................... 11 2. SCOPE AND METHODOLOGY ................................................................... 12 2.1 Scope of the Pharmaceutical Needs Assessment ............................... 12 2.2 Methodology and Data Analysis .......................................................... 12 2.3 Consultation ......................................................................................... 14 2.4 Pharmaceutical Needs Assessment Review Process.......................... 14 2.5 How to use the Pharmaceutical Needs Assessment ........................... 15 3. NATIONAL PHARMACEUTICAL CONTRACT OVERVIEW ....................... 17 3.1 Essential Services and Clinical Governance ....................................... 17 3.2 Advanced Services .............................................................................. 18 3.3 Enhanced Services .............................................................................. 22 3.4 Healthy Living Pharmacies .................................................................. 22 3.5 Locally Commissioned Services .......................................................... 24 3.6 Pharmacy Survey ................................................................................ 25 3.7 Funding the Pharmacy Contract .......................................................... 26 4. OVERVIEW OF CURRENT PROVIDERS OF PHARMACEUTICAL SERVICES ................................................................................................... 28 4.1 Community Pharmacy Contractors ...................................................... 28 4.2 Dispensing Doctors .............................................................................. 28 4.3 Appliance Contractors ......................................................................... 28 4.4 Local Pharmaceutical Services (LPS) .................................................. 29 4.5 Acute Hospital Pharmacy Services ...................................................... 29 4.6 Mental Health Pharmacy Services ....................................................... 29 4.7 Bordering Services / Neighbouring Providers ...................................... 29 4.8 Quality Standards for Pharmaceutical Service Providers: Community Pharmacy Contract Monitoring ............................................................ 30 5. PHARMACY PREMISES ............................................................................. 31 5.1 Pharmacy Locations ............................................................................ 31 5.2 Pharmacy Opening Hours ................................................................... 34 5.3 Distance Selling Pharmacies ............................................................... 39 5.4 Residents’ Survey Summary ............................................................... 39 5.5 Pharmacy Survey Summary ................................................................ 43 5.6 Prescribing ........................................................................................... 45 5.7 Neighbouring Local Authorities Provision ............................................ 45 Knowsley Pharmaceutical Needs Assessment, 2018 5 | P a g e 6. POPULATION AND HEALTH PROFILE OF KNOWSLEY .......................... 48 6.1 Location ............................................................................................... 48 6.2 Deprivation .......................................................................................... 49 6.3 Population Structure and Projections................................................... 51 6.4 Life Expectancy ................................................................................... 53 6.5 All Age, All Cause, Mortality ................................................................ 55 7. PHARMACY ACTIVITY THAT SUPPORTS LOCAL PRIORITIES .............. 59 7.1 Tobacco Control .................................................................................. 59 7.2 Alcohol ................................................................................................. 63 7.3 Planned Care ....................................................................................... 65 7.4 Unplanned/Urgent Care ....................................................................... 69 7.5 Supporting and Identifying People with Long Term Conditions ........... 74 7.6 Cancers ............................................................................................... 78 7.7 Sexual Health ...................................................................................... 79 7.8 Mental Health ...................................................................................... 86 7.9 Substance Misuse ............................................................................... 89 7.10 Older People ........................................................................................ 94 7.11 Palliative Care ....................................................................................