Arena Point Merrion Way REF: SHA/22127 Leeds LS2 8PA Tel: 0203 928 2000 APPEAL AGAINST NHS COMMISSIONING BOARD Fax: 0207 821 0029 ("NHS ENGLAND") DECISION TO REFUSE AN Email: [email protected] APPLICATION BY MEDICSTAR (UK) LTD FOR A RELOCATION THAT DOES NOT RESULT IN A SIGNIFICANT CHANGE TO PHARMACEUTICAL SERVICES PROVISION UNDER REGULATION 24 FROM 344 MANCHESTER ROAD, WEST TIMPERLEY, ALTRINCHAM, WA14 5NH TO THE LIBRARY AT 405 STOCKPORT ROAD AND CAR PARK ON BAKER STREET, TIMPERLEY, ALTRINCHAM, WA15 7XR 1 Outcome 1.1 The Pharmacy Appeals Committee (“Committee”), appointed by NHS Resolution, quashes the decision of NHS England and redetermines the application. 1.2 The Committee determined that the application should be granted. NHS Resolution is the operating name of NHS Litigation Authority – we were established in 1995 as a Special Health Authority and are a not-for-profit part of the NHS. Our purpose is to provide expertise to the NHS on resolving concerns fairly, share learning for improvement and preserve resources for patient care. To find out how we use personal information, please read our privacy statement at www.nhsla.com/Pages/How-we-use-your-information-- -FHSAU.aspx Arena Point REF: SHA/22127 Merrion Way Leeds LS2 8PA APPEAL AGAINST NHS COMMISSIONING BOARD Tel: 0203 928 2000 ("NHS ENGLAND") DECISION TO REFUSE AN Fax: 0207 821 0029 APPLICATION BY MEDICSTAR (UK) LTD FOR A Email: [email protected] RELOCATION THAT DOES NOT RESULT IN A SIGNIFICANT CHANGE TO PHARMACEUTICAL SERVICES PROVISION UNDER REGULATION 24 FROM 344 MANCHESTER ROAD, WEST TIMPERLEY, ALTRINCHAM, WA14 5NH TO THE LIBRARY AT 405 STOCKPORT ROAD AND CAR PARK ON BAKER STREET, TIMPERLEY, ALTRINCHAM, WA15 7XR 1 A summary of the application, decision, appeal and representations and observations are attached at Annex A. 2 Preliminary Consideration and Site Visit 2.1 The Pharmacy Appeals Committee (“Committee”) appointed by NHS Resolution, had before it the papers considered by NHS England, together with a plan of the area showing existing pharmacies and doctors’ surgeries and the location of the proposed pharmacy. 2.2 It also had before it the responses to NHS Resolution’s own statutory consultations. 2.3 An oral hearing took place to determine the application. This took place at the offices of the Greater Manchester Health and Social Care Partnership, London Road, Manchester on 3rd December, 2019. 2.4 The Committee comprised of Mr A Tomlinson (chair), Mr P Bratley and Mr S Chappell. The Applicant was represented by Mr J Devlin accompanied by Mr G Chan and Ms S F Ghai. Well Pharmacy was represented by Ms E Griffiths- Mbarek accompanied by Mr A Edwards and Greater Manchester LPC was represented by Peter Marks. Lucy Reid from NHS Resolution accompanied the Committee on the site visit and observed the hearing. 2.5 Before the hearing started the Committee undertook a site visit. The following is a brief summary of the visit but further observations appear in section 5 below. 2.6 The Committee assembled in the centre of Timperley, a busy crossroads controlled by traffic lights. There are shops, cafes and a public house close to the crossroads including two pharmacies and a Sainsbury’s local store. Parking is available on a car park only a short distance from the crossing for which there is no charge although it is limited to a three hour stay. 1 2.7 The Committee walked along Stockport Road to the site of the proposed surgery and pharmacy on Baker Street. There was building work in progress with the site fenced off and signs advertising the construction of apartments. 2.8 The Committee then returned to the crossroads and walked along Park Road to the site of the Applicant’s pharmacy on Manchester Road close to the westerly end of Park Road. The walk took 35 minutes at a reasonable pace. It was not considered to be a pleasant walk with some narrow and uneven pavements, two gradients where the road crossed over railway lines and many side streets to be crossed. The road was busy with mainly light vehicles although there was some commercial traffic. 2.9 On Park Road the Committee observed the Park Medical Practice in a large converted dwellinghouse and also the Station Pharmacy in a small row of shops by the Timperley tram station. There is extensive and dense housing on both sides of Park Road, most of the houses being older detached and semi detached properties with private driveways. 2.10 A number of people were observed walking along the road, mainly to and from the centre of Timperley and the tram station. The Committee also noted a bus, service number 281, driving in an easterly direction towards the centre of Timperley. 2.11 The Applicant’s pharmacy was seen to be in a parade of shops on the busy A56, Manchester Road which is a dual carriageway. There is a forecourt in front of the shops and at the time of the visit there were a number of cars and other vehicles parked there although it was clear that access on to and off the forecourt was difficult, especially when, as at the time of the visit, traffic travelling south along the road was backed up and stationary along the length of the shops. 2.12 Other shops in the parade included many food takeaways including a Subway, a hair salon, a computer shop and a kitchen shop. The Pelican public house and a hotel are just to the north of the parade, served by their own car park with signs warning that non-customers should not park there. It was noted that parking was available on the residential streets behind the parade. A car hire depot, car sales garages and a funeral undertakers were amongst the businesses on the west side of Manchester Road. Pedestrian crossings were available for crossing the road although few pedestrians were seen, the nature of the shops suggesting that they attracted few regular visitors. 2.13 The Pelican pharmacy occupied a double fronted shop towards the northerly end of the parade. There were no customers in the pharmacy at the time of the visit and the Committee did not observe any customers visiting the pharmacy in the short time that they were close by. 3 A summary of the above observations was provided to those in attendance. They were invited to comment upon them or indicate if any of the observations appeared to be inaccurate. Such comments as were made appear in the next section. 4 Oral Hearing Submissions 4.1 Mr J Devlin (for the Applicant) 2 4.1.1 He undertook on behalf of his client that the pharmacy would offer the same services at the new location, including the core hours currently operated and that there would be no interruption in the services provided. 4.1.2 He clarified that the pharmacy would be based on the ground floor of the apartment block being constructed at Baker Street which was due to be completed in summer 2020. 4.1.3 This was the Applicant’s second application relating to the proposed move and he stressed that the previous decision and that of NHS England had been based on assumptions. 4.1.4 He also confirmed that the move would lead to no significant change in the arrangements for the provision of pharmaceutical services. NHS England had decided that there would be no such change and no evidence had been produced to the contrary. 4.1.5 The main change in the current application was the availability of 3 months data at pages 138-332. The data referred to the provision of all services, essential, advanced and commissioned. 4.1.6 Patient Groups had been simplified. The data showed that all patients started their journey to the pharmacy from home and all the 97 patients surveyed had signed to say that the pharmacy at the new location would be as easy to get to. 4.1.7 The pharmacy was dispensing 2,500 – 2,600 items per month which was the lowest figure amongst local pharmacies. 90% of items were delivered to patients amounting to 110 items per day. 4.1.8 Very few patients accessed the pharmacy premises. The pharmacy had a stable customer base and did not open at weekends or in the evenings. 4.1.9 There were two patients groups namely (1) patients who used the delivery service and (2) patients accessing the premises for any reason. Mr Chan produced the ledgers recording deliveries. There was a part time van driver who occasionally advised patients. 4.1.10 Patients who accessed the pharmacy did so on foot or by car. There was one cyclist and none used public transport according to the survey. 4.1.11 Those objecting to the application did not have access to the information available to the Applicant. 4.1.12 Boots had stated that the Applicant had failed to produce a proper definition of patient groups but only the Applicant was in a position to do so. Further the distance between the two sites nor the walk between the sites were key considerations. 4.1.13 Well Pharmacy in their objections had focussed on a wider range of patient groups such as those starting from a surgery but the Applicant received prescriptions from over 20 surgeries and all their patients started their journey from home. 3 4.1.14 The Park Medical Practice with a patient list of over 5,000 would be moving to the new premises in Baker Street. The Applicant received very few prescriptions from them at present.