Agenda item

The Surrey Health and Wellbeing Board (HWB) has a statutory responsibility to deliver a Pharmaceutical Needs Assessment (PNA) every three years. The PNA was delayed from 2020 to 2021 due to resources being diverted to the Covid-19 pandemic. The full Surrey PNA was last published in March 2018.  This is regularly supplemented by the PNA Steering Group which reviews changes to the local population and local services annually to ensure that no substantive changes to the Pharmaceutical Needs Assessment are required. The attached report provides a supplementary statement to the 2021 Pharmaceutical Needs Assessment which reports no substantive changes are required to the findings of the 2018 Pharmaceutical Needs Assessment.

Witnesses:

Dr Naheed Rana - Consultant in Public Health (SCC)

Key points raised in the discussion:

1.    The Consultant in Public Health (SCC) noted that:

·         The Pharmaceutical Needs Assessment (PNA) determined the local need for pharmaceutical services and was used to inform decisions on whether to allow new pharmaceutical services to be introduced in a given area based on need through the market entry process.

·         The PNA helped inform other activities with ICP colleagues around primary care, long term care management and urgent emergency care provision.

·         The Health and Wellbeing Board had a statutory responsibility to deliver the PNA every three years with the last full PNA published in March 2018. The publication of the next PNA was delayed from 2021 to 2022 due to Covid-19.

·         Annually the PNA Steering Group reviewed changes to the local population and local services in order to advise whether there were substantive changes to be made to the PNA; if not a Supplementary Statement was produced.

·         The PNA Steering Group met and agreed the 2021 Supplementary Statement, noting that:

-     there were a large number of housing developments planned in Surrey in the coming decade, namely in Epsom and Ewell, Guildford, and Mole Valley.

-     interventions under Covid-19 and national lockdown caused significant disruption to community pharmacies, slightly mitigated through an increase in telephone and online consultations as well as an amendment to scheduled pick-ups.

-     it concluded that no new pharmacies or pharmaceutical services were required at present, and that an in-depth needs assessment into the impact on health inequalities for those more vulnerable populations, service access and housing developments would be undertaken in the 2022 PNA for approval by the Health and Wellbeing Board - drafts would be circulated to Board members.

2.    The Deputy Chairman asked about the process around the objective needs assessments for more pharmacies, noting that Surrey was down by about twelve pharmacies per 100,000 population, particularly as Covid-19 would have changed the way pharmacies faced the public, and asked whether footfall for pharmacy access had increased as a result of primary care becoming more digital. She also asked whether Surrey would develop an objective needs assessment or whether that was happening nationally.

-       In response, the Consultant in Public Health (SCC) explained that although national guidance allowed a delay in publishing the next PNA, Surrey had already started the work on an in-depth needs assessment.

-       The Consultant in Public Health (SCC) explained that the benchmark was that there should be one pharmacy per 100,000 population, however that excluded the online and telephone consultations and the other online provisions in place and an analysis was underway by NHS colleagues to capture the change in accessibility, noting digital exclusion.

-       The Consultant in Public Health (SCC) explained that at present additional pharmacies were not required, however it was vital to complete the in-depth needs assessment swiftly through the PNA Steering Group, with key partners and following national guidance, welcoming Board member input.

-       The Deputy Chairman added that she would be happy to get involved and welcomed the in-depth needs assessment, as the 100,000 population benchmark was one dimensional; pharmacy provision must look at deprivation, transport links and social isolation.

3. A Board member recalled the past discussion at the Board on the 2018 PNA around online pharmacies and what impact those might have on local services since the new Community Pharmacy Contract. He asked whether there had been any significant negative impacts from the online roll out and lessons learnt.

-       In response, the Consultant in Public Health (SCC) explained that when ascertaining the impact of online pharmacies, there was a good record of the Surrey based ones, that nationally NHS colleagues were undertaking that analysis and the in-depth needs assessment would take that into account.  

4. A Board member asked whether the 2021 census information would be included in the in-depth needs assessment and whether assumptions were received based on Borough and District Council interpretations of people living in houses of multiple occupancy or unofficial dwellings, regarding an unrecorded population and possible additional provision based on that.

-       In response, the Consultant in Public Health (SCC) explained that the issue had been noted in previous PNAs and Supplementary Statements and that as part of addressing health inequalities it was vital to capture all populations including hard to reach communities to accurately assess pharmacy provision; which was not about a benchmark but was about meeting the needs of residents. Reviewing transport links, maps around transport distance and deprivation would be included in the 2022 PNA.

RESOLVED:

1.    The Board approved the 2021 Pharmaceutical Needs Assessment Supplementary Statement, on the advice of the Pharmaceutical Needs Assessment Steering Group.

2.    The Board would publish the approved Supplementary Statement on surreyi.gov.uk and surreycc.gov.uk by 31 March 2021.

Actions/further information to be provided:

1.    Drafts of the 2022 PNA will be shared with Board members in due course.

2.    The Deputy Chairman will liaise with the Consultant in Public Health (SCC) regarding the in-depth needs assessment for the 2022 PNA.