Agenda item

This report outlines the responsibility of the Health and Wellbeing Board to publish a Pharmaceutical Needs Assessment (PNA) for Hammersmith and Fulham.  The report also describes the purpose and requirements for the PNA and outlines local arrangements to produce the PNA.    

Councillor Lukey welcomed Colin Brodie, Public Health Knowledge Manager, who presented a report that outlined the responsibility of the Board to publish a Pharmaceutical Needs Assessment (PNA) for Hammersmith and Fulham.  It was explained that the PNA was essentially a statement of need for pharmaceutical services in the Borough and was most recently submitted in 2015.  When a provider offered pharmacy services in an area, it was required to apply to NHS England and demonstrate that it responded to the level of need in the area, as set out in the PNA, in order to be included on a pharmaceutical list for that area.  The PNA was required to be refreshed every three years and the 2013 regulations also set a legal requirement for the Board to undertake consultation.  The updated PNA would need to be in place for 2018

Additionally, it was explained that this was useful evidence for local commissioning.  The work by colleagues on the Online JSNA had helped source a map of local pharmacies and it was noted that the update of the PNA would be included in the JSNA work programme.  Section 7 of the report set out further issues for the Board to consider, noting in particular, the role of pharmacies. The convenient location of pharmacies had long been recognised as an important feature of local high streets, and further, understanding the role of community pharmacies was helpful in offering context for the JHWB Strategy and the STP, to shape strategy and to prioritise.

The update of the PNA was being undertaken during a time when the financial challenges for community pharmacies were difficult but the impact of the October 2016 decision by the Department of Health to reduce funding in 2016/17 and 2017/18 for NHS contractors providing services under the contract, was not yet known, although it was likely that there might be some pharmacy closures.  A further challenge to the PNA assessment was the access to data held by a number of organisations which included PH England, NHS England and local CCGs, for which access would have to be requested. 

Keith Mallinson reported Healthwatch concerns regarding the issue of funding for community pharmacies, highlighting the point that appropriate provision should be in place prior to any decision was made to reduce funding.  Councillor Lukey observed that the update to the PNA provided a good opportunity to highlight the work of community pharmacies and the range of pharmaceutical businesses that existed.  There were many examples of good practice, and Councillor Lukey commented on the campaigns to support the retention of good, local pharmacies, which conducted home visits and took a personal approach, offering practical, confidential advice and support. 

Colin Brodie confirmed that the specific requirements of the scope of the PNA

were precise but it would be possible to look at trying to capture examples of good practice.  Stuart Lines suggested that community pharmacies be considered as an item at the next Board meeting on 20^th March.  Janet Cree, Managing Director, H&F CCG added that the while the requirement and scope of the PNA was formulaic, there was value around how to interpret the data, particularly in the context of work, for example, undertaken on immunisation, uptake of the flu vaccine and the management of unused medicine.  She affirmed that it was important for the CCGs to support this area of work, acknowledging the role of pharmacies in several practices, interfacing with national initiatives.  It was also noted that the commissioning of community pharmacies was within the remit of NHS England, but there was a partial element of it which lay within the commissioning services. 

Ian Lawry, with reference to the earlier discussion, commented that this could be added to the basic requirements of the Young Adults JSNA.  Young adults not wanting to attend GP surgeries, might be more willing to go to local, community pharmacies, and he suggested that this be included as part of the local mapping exercise of local pharmacies.  Colin Brodie explained that as part of the PNA, a survey of pharmaceutical businesses was undertaken.  One question that they were asked was about what other services they might be interested in providing, so there was scope in exploring this further to gain insight into potential interest.  There was a requirement to produce a specific document that contained a wealth of information, which would indicate and inform, local need, that community pharmacies could support. 

Councillor Fennimore referred to the report of the Poverty and Worklessness Commission and the 10 recommendations that it set out, some of which related to health.  She suggested that a link to the report be usefully shared.  Councillor Vaughan, reiterating previous drafting points, asked that officers consider the way in which the PNA was structured and the need to ensure clear explanations, avoiding technical jargon where possible.  He observed that this was a opportunity to highlight good practice in community pharmacies and how they supported the needs of residents.  He added that a qualitative analysis of data from the survey would also provide evidence to demonstrate how pharmacies supported initiatives such as immunisation uptake and identify likely future developments, noting the role of the NHS in this process. 

Colin Brodie concurred that they had previously struggled to obtain data, noting that the NHS were under resourced in supporting the process.  The production of data was timely and rich with information, to sufficiently inform the report, but additional information about, for example, local regeneration and developments was also helpful, in order to better identify the future need for pharmacies in these areas.  Councillor Lukey agreed that more data should be collected to better inform the PNA.  Janet Cree cautioned that this was technical work and expressed concern about the Board’s expectations in requesting something that was broader.  While the CCG indicated that they would happy to contribute to the work, there was a need to think through the scope of the requirement of need was and what fell outside the scope of the PNA.  With reference to section 6.3, page 105 of the report, members of the Board agreed that it might be helpful to produce two reports in parallel, one that was technical and met statutory requirements for producing the PNA, and a second document, which could be potentially an adaptation of the technical document, that contained greater detail. 

ACTION: Public Health / CCG

RESOLVED

1.        That the current Pharmaceutical Needs Assessment and Department of Health guidance on PNAs, be noted;

2.        That the arrangements for producing the PNA, as set out in the report and as discussed by the Board, be approved;

3.        That the Board’s discussion of role of community pharmacies to deliver local strategies and priorities, particularly the Joint Health and Wellbeing Strategy and the Sustainability and Transformation Plan, be noted; and

4.        That the Health and Wellbeing Board member organisations agreed to provide any data necessary to complete the PNA, where they were the source organisation.