Cornwall and Isles of Scilly Pharmaceutical Needs Assessment 2018-21 Current Document Status Version Approving body Health and Wellbeing Board 4.0 Date of formal approval (if Date 26 April 2018 01/04/2018 applicable) Review date Responsible officer Rebecca Cohen www.cornwall.gov.uk/pharmacy Location Version History Date Version Author/Editor Comments 19/04/2017 1.0 Draft Rebecca Cohen First draft pre consultation. 03/11/2017 2.0 Draft Linda Howarth Data updates. 30/11/2017 3.0 Draft Rebecca Cohen Second draft pre consultation. 10/01/2018 3.1 Draft Rebecca Cohen Final draft pre consultation. Final incorporating consultation responses and 28/03/2018 4.0 Final Rebecca Cohen changes. Comprehensive Impact Assessment Record Date Type of Stage/level Summary of Completed by Impact assessment completed actions taken Assessment conducted (where decisions made review date applicable) Insert Date Initial / Full Not Yet Complete NFA Insert officer name Insert date Document retention Document retention period E.g. 5 years in hard and electronic copies. Cornwall and Isles of Scilly Pharmaceutical Needs Assessment April 2018 Contents Acknowledgments 1 Executive Summary 2 1. Introduction 9 1.1 Purpose of a Pharmaceutical Needs Assessment (PNA) ............................................................. 9 1.2 Health and Wellbeing Board Duties in respect of the PNA ......................................................... 10 1.3 The Scope of this PNA: Contactors and Services ..................................................................... 12 1.3.9 Changes to the existing provision of pharmaceutical services .................................................. 23 2. How the assessment was undertaken 24 2.1 Cornwall and the Isles of Scilly PNA Working Group ................................................................ 24 2.2 PNA Localities .................................................................................................................... 24 2.3 Other sources of information ................................................................................................ 24 2.4 Equality impact assessment ................................................................................................. 24 3. Consultation 25 4. Cornwall and the Isles of Scilly localities 26 4.1 Introduction ....................................................................................................................... 26 4.2 Rationale for localities ......................................................................................................... 26 5. An overview of Cornwall and Isles of Scilly 27 5.1 Cornwall ............................................................................................................................ 27 5.3 Population ......................................................................................................................... 28 5.4 Inequality and deprivation ................................................................................................... 32 5.4.1 Inequality and deprivation in Cornwall ................................................................................... 32 5.4.2 Inequality and deprivation on the Isles of Scilly ...................................................................... 34 5.5 Transport and infrastructure ................................................................................................ 35 5.5.1 Transport and infrastructure in Cornwall ................................................................................ 35 5.5.2 Transport and infrastructure on the Isles of Scilly ................................................................... 36 5.6 General Health Needs .......................................................................................................... 38 5.6.1 Public Health England’s Profile for Cornwall and Isles of Scilly 2017 ........................................... 38 5.6.2 Child Health Profile for Cornwall and Isles of Scilly 2017 .......................................................... 39 5.6.3 Sexual Health..................................................................................................................... 35 5.6.4 Mental Health ..................................................................................................................... 36 5.6.5 Drugs ................................................................................................................................ 37 5.6.6 Alcohol .............................................................................................................................. 38 5.6.7 Tobacco ............................................................................................................................. 39 5.6.8 Healthy Eating.................................................................................................................... 40 5.6.7 Physical Activity ................................................................................................................. 41 5.6.7 Healthy Children ................................................................................................................. 42 5.6.8 Community Network Health Profiles ...................................................................................... 43 7. Groups with Protected Characteristics 43 8. Health Needs that can be met by pharmaceutical services 47 9. Provision of pharmaceutical services 48 9.1 Introduction ....................................................................................................................... 48 9.2 Necessary Services ............................................................................................................. 48 Cornwall and Isles of Scilly Pharmaceutical Needs Assessment April 2018 9.3 Current Provision of Necessary Services ................................................................................ 49 9.4 Community pharmacy in Cornwall and the Isles of Scilly .......................................................... 51 10. Other relevant services 58 11. Future needs of pharmaceutical services 61 11.1 Introduction ....................................................................................................................... 61 11.2 Known future needs in Cornwall and the Isles of Scilly ............................................................ 61 11.3 Transformation of Health System .......................................................................................... 61 11.4 Essential Small Pharmacy Local Pharmaceutical Services (ESPLPS) ........................................... 61 11.5 The role of the PNA in enabling ‘the future’ ............................................................................ 62 12. Locality Summary and Adequacy Assessment 63 13. Conclusions 78 Appendix 1: Glossary 80 Appendix 2: Legislation relating to PNAs 83 Appendix 3: Pharmacy Access Scheme – Eligible Pharmacies 91 Appendix 4: Cornwall & Isles of Scilly Pharmacy List 92 Appendix 5: Dispensing Practices (GPs) 94 Appendix 6: All Practices (GPs): dispensing and non-dispensing 94 Appendix 7: Locality Profiles and Maps 96 Appendix 8: Consultation Feedback 97 Appendix 9: Equality Impact Assessment 117 Cornwall and Isles of Scilly Pharmaceutical Needs Assessment April 2018 Acknowledgments The development of this Pharmaceutical Needs Assessment (PNA) was overseen by the Cornwall PNA Steering Group with contributions from: NHS England, South, South West and Public Health England Local Knowledge and Intelligence Service Cornwall and Isles of Scilly Draft Pharmaceutical Needs Assessment 1 April 2018 Executive Summary The Pharmaceutical Needs Assessment (PNA) is a document that outlines services and ensures that pharmaceutical services across Cornwall and the Isles of Scilly both meet the needs of the population and that they are in the correct locations to adequately support residents. The two health and wellbeing boards (HWBs) for Cornwall and the Isles of Scilly have a statutory responsibility to publish and keep the PNA up to date. This PNA describes the needs of Cornwall and the Isles of Scilly residents for pharmacy services. This PNA includes information on: • pharmacies across Cornwall and the Isles of Scilly and the services they currently provide • maps of providers of pharmaceutical services across the Cornwall and the Isles of Scilly area • pharmaceutical contractors in neighbouring HWB areas • potential gaps in provision and likely future needs for the population of Cornwall and the Isles of Scilly Decisions on whether to open new pharmacies are made by NHS England – NHS England, South, South West. When making the decision NHS England is required to refer to the local PNA. As these decisions may be appealed or challenged via the NHS Litigation Appeals process, it is important that PNAs, both in their content and in the process of their construction, comply with regulations and that mechanisms are established to keep the PNA up-to-date. In accordance with these regulations, the PNA will be updated every three years. Context The PNA for the Cornwall and the Isles of Scilly area is undertaken in the context of the needs of the local population. The health and wellbeing needs of the local population are described in the Cornwall and the Isles of Scilly joint strategic needs assessments (JSNAs). For the purposes of this PNA, Cornwall and the Isles of Scilly have been divided into twenty distinct areas. 19 of these areas are termed Community Network