Pharmaceutical Needs Assessment 2015 Havering Health and Wellbeing Board Havering PNA Contents Contents .............................................................................................................. 1 Executive summary.................................................................................................. 6 Section 1: Introduction .......................................................................................... 15 1.1 Background ..................................................................................................... 15 1.2 Purpose of the PNA ........................................................................................ 16 1.3 Scope of the PNA ........................................................................................... 16 1.3.1 Pharmacy contractors ............................................................................... 17 1.3.2 Dispensing appliance contractors ............................................................. 19 1.3.3 Local pharmaceutical service providers .................................................... 19 1.3.4 Dispensing GP practices........................................................................... 20 1.3.5 Other providers of pharmaceutical services in neighbouring HWB areas . 20 1.3.6 Other services and providers in the Havering HWB area ......................... 20 1.4 Process for developing the PNA ..................................................................... 22 1.5 Localities for the purpose of the PNA .............................................................. 25 Section 2: Context for the PNA ............................................................................. 27 2.1 Joint Strategic Needs Assessment ................................................................. 27 2.2 Joint Health and Wellbeing Strategy ............................................................... 27 2.3 Population characteristics ............................................................................... 27 2.3.1 Overview ................................................................................................... 27 2.3.2 Age ........................................................................................................... 28 2.3.3 Predicted population growth ..................................................................... 30 2.3.4 Life expectancy.......................................................................................... 32 2.3.5 Specific populations .................................................................................. 33 2.3.5.1 Ethnicity .............................................................................................. 33 2.3.5.2 Children and young people ................................................................. 37 2.3.5.3 Children in care .................................................................................. 39 2.3.5.4 Older people ....................................................................................... 41 2.3.5.5 Prison populations .............................................................................. 44 2.3.5.6 Less-abled populations ....................................................................... 45 2.3.5.7 Breastfeeding ..................................................................................... 53 2.3.5.8 Homeless populations ........................................................................ 55 1 Havering PNA 2.3.5.9 Short term migrant populations........................................................... 57 2.3.5.10 Traveller population .......................................................................... 58 2.3.6 Deprivation................................................................................................ 60 2.3.7 Causes of ill health ................................................................................... 61 2.3.7.1 Premature mortality ............................................................................ 63 2.3.7.2 Cardiovascular disease ...................................................................... 65 2.3.7.3 Cancers .............................................................................................. 65 2.3.7.4 Respiratory diseases .......................................................................... 66 2.3.7.5 Liver disease ...................................................................................... 67 2.3.7.6 Depression and mental health ............................................................ 68 2.3.7.7 Diabetes ............................................................................................. 69 2.3.7.8 Chronic obstructive pulmonary disease .............................................. 71 2.3.7.9 Accidental injuries............................................................................... 73 2.3.7.10 Asthma ............................................................................................. 74 2.3.7.11 Obesity ............................................................................................. 75 2.3.7.12 Palliative care ................................................................................... 81 2.3.8 Lifestyle issues ......................................................................................... 82 2.3.8.1 Drug and alcohol misuse .................................................................... 82 2.3.8.2 Alcohol and related disease ............................................................... 83 2.3.8.3 Sexual health and teenage pregnancy ............................................... 84 2.3.8.4 Smoking ............................................................................................. 92 2.3.8.5 Oral health .......................................................................................... 95 Section 3: NHS pharmaceutical services provision; currently commissioned. 96 3.1 Community pharmacies .................................................................................. 96 3.1.1 Choice of community pharmacies ............................................................. 98 3.1.2 Intensity of current community pharmacy providers .................................. 98 3.1.3 Weekend and evening provision ............................................................... 99 3.2 Dispensing appliance contractors ................................................................. 100 3.3 Distance-selling pharmacies ......................................................................... 100 3.4 Access to community pharmacies ................................................................. 100 3.4.1 Routine daytime access to community pharmacies ................................ 101 3.4.2 Routine weekday evening access to community pharmacies ................. 102 3.4.3 Routine Saturday daytime access to community pharmacies ................. 105 2 Havering PNA 3.4.4 Routine Sunday daytime access to community pharmacies ................... 108 3.4.5 Routine bank holiday access to community pharmacies ........................ 110 3.5 Advanced service provision from community pharmacies ............................. 110 3.6 Enhanced service provision .......................................................................... 111 3.7 Pharmaceutical service provision provided from outside the Havering HWB area .................................................................................................................. 112 Section 4: Other services which may impact on pharmaceutical services provision .......................................................................................... 113 4.1 Local authority commissioned services provided by community pharmacies in Havering ...................................................................................................... 113 4.2 Clinical commissioning group commissioned services .................................. 113 4.3 Other services provided from community pharmacies .................................. 113 4.4 Collection and delivery services .................................................................... 114 4.5 Language services ........................................................................................ 114 4.6 Services for less-abled people ...................................................................... 114 4.8 GP Access Hubs ........................................................................................... 115 4.9 Demographics and social traffic .................................................................... 115 Section 5: Findings from the public survey ....................................................... 116 Section 6: Analysis of health needs and service provision ............................. 119 6.1 Service provision and health needs .............................................................. 119 6.2 Essential services ......................................................................................... 119 6.3 Advanced services ........................................................................................ 121 6.4 Enhanced services ........................................................................................ 122 6.5 Locally commissioned services ..................................................................... 123 6.5.1 Emergency hormonal contraception ....................................................... 123 6.5.2 Chlamydia screening and treatment ......................................................