Agenda item

8.1           Dr Ashlee Mulimba and Nicola Ashton provided an update on the consultation currently being produced as part of the pharmaceutical needs assessment (PNA), exploring the local provision of community based pharmaceutical services delivered by trusted providers.  This was a statutory requirement to be completed by 1 October 2022 and to be agreed by the Board.  The intention was to work with pharmacies as a collective group, integral to the healthcare system, less peripheral and key providers.  Dr Mulimba outlined the work of Health Dialogues on undertaking the H&F PNA. Health and Wellbeing Boards were required to conduct a PNA to evaluate the pharmaceutical needs of the borough and review how these were currently being fulfilled by local pharmacies. 

8.2           The PNA would determine whether there were any gaps in provision and evaluate this through gathering data and engaging with residents who use pharmacy services.  Dr Mulimba reported that service user survey would be undertaken between 1 July to 31 August 2022.  This included a targeted list of local organisations ensuring that a diverse range of views could be canvassed.  This also included the use of multiple H&F media communication channels, newsletters, and a citizen’s panel.  The initial response had been welcomingly diverse with a broad range of responses from the community and 85 community pharmacies, which was very positive.  Dr Mulimba described the extensive range of local pharmacies, location and accessibility of existing sites which offered residents great choice.  In the context of childhood immunisation and vaccination Dr Mulimba welcomed the suggestion of making community-based pharmacies more integral and supported health interventions that could help improve take up. 

8.3           Speaking in the context of the move to borough-based partnerships Dr James Cavanagh commented that it was important for pharmacists and pharmacies to have a community role supporting residents and asked how providers could be encouraged to work collectively.  Dr Mulimba responded that the lead pharmacist had been part of the PNA process but acknowledged that the role of pharmacists generally could be more strategic.  How to nurture a more strategic and collective group was recognised by Councillor Ben Coleman as being a pivotal issue given that pharmacies had such potential to play a preventative role with regards to public health interventions and to achieve some uniformity of service delivery. Councillor Rowbottom suggested that a “point” person could be identified from each pharmacy, like GPs.

ACTION: The Board and borough-based partnership to explore how pharmacists could strategically and collectively help develop an integrated provision of local pharmaceutical services

8.4           Councillor Natalia Perez asked about the number of pharmacies located in the north of the borough and whether there was sufficient and equitable distribution of sites across the borough, and if these were accessible.  She also asked about the delivery of medication the experience of this during the pandemic.  Carleen Duffy enquired about the morning after pill and if this could be delivered at home.  Councillor Alexandra Sanderson commented on the decrease in the number of independent prescribers in recent years and asked what could be done to improve support and help alleviate the pressure on GPs, recognising that there could be more services that could feasibly be delivered through pharmacies.  This would become more important given the cost-of-living increases and the challenges around managing costs.  Sarah Lumgair asked if there was a map showing the location of 24-hour pharmacies in the borough (provided in the report, page 21).

8.5           In terms of the morning after pill local offer, Nicola Ashton explained that H&F was one of the very few boroughs that offered the emergency hormonal contraceptive pill free in some local pharmacies.  A key point was how the number of pharmacies that offered this could be increased.  This provision was an outcome of H&F public health funding and the contractual arrangements between GPs and pharmacies.  There was also a free contraception e-service provided by the Pan-London sexual health service which could be posted. Dr Mulimba clarified that there was not a “24-hour” pharmacy service as such but that there was 100 hours of contractual service offered where some pharmacies were accessible 24 hours, one located in the south of the borough, and 6 located within a mile of the borough boundary, with varied opening hours.  Phillipa Johnson added that the role of the pharmacist had changed and that there was an ongoing discussion within the borough-based partnership about this.  The most recent initiative was a lucrative offer for pharmacists to work in GP practices so there was a subsequent drain on community pharmacies and placing greater pressure on retail pharmacies.  There was a need for innovative collaboration on new schemes to support discharges, new regulations regarding medication changes that permitted follow up and review in the community.

8.6           Councillor Coleman commented that there was a need to make a case for stronger integration of pharmacists at ICS level, to reach out to pharmacists and improve how they were utilised, identifying, and removing potential barriers in the context of the PNA. 

8.7           Councillor Perez asked about how these were linked to the consultation. For example, it was important to consider how pharmacy services within the existing health infrastructure could support a new development, potentially through section 106 funding, especially in regeneration areas.  Nicola Ashton responded that it was unclear whether a planning case for more pharmacists could be made but this could be further explored. There had been positive comments from the consultation that residents really valued their pharmacies. The five key draft recommendations revolved around the sexual health offer, support for people living with mental health issues, promotion of cancer screening services, childhood immunisations and how the borough worked with NHS England on configuring and funding the local pharmacy offer, which was not within the borough’s control.  This would need to be considered within the borough-based partnership, working with key stakeholders to garner improvements.  Lisa Redfern was keen to support a dynamic approach and suggested inviting pharmacists to the next meeting of the Board and to incorporate their views into the borough-based partnership work, representing a whole systems approach.  It was noted that the final PNA would be considered at the next meeting of the Board on 21 September.

RESOLVED

That the update report was noted.