Agenda item

The purpose of this paper is to present key aspects of the Surrey PNA 2022, including its recommendations, to the Board for final approval and to seek agreement to its publication no later than 1 October 2022. 

Witnesses:

Tom Bourne - Public Health Analyst Team Lead, Surrey County Council

Ruth Hutchinson - Director of Public Health, Surrey County Council

Key points raised in the discussion:

1.    The Public Health Analyst Team Lead (SCC) noted that:

·      Board members had sent through comments on the draft Pharmaceutical Needs Assessment (PNA) in advance following a four-week review period - which had been incorporated.

·      Every Health and Wellbeing Board nationally has a statutory responsibility to look at pharmaceutical need in their area and to publish and keep the PNA up to date.

·      The PNA is used for a range of legal and commissioning responsibilities and is updated every three years and there had been an extension to that three-year period because of the Covid-19 pandemic.

·      The national regulations set out the content and requirements of the PNA, the PNA was fully compliant with that and those regulations.

·      The Board delegated responsibility for the oversight and production of the PNA to the PNA Steering Group which had met regularly since last year.

·      Two positive aspects of the PNA drafting process in line with the process set out by the Department of Health and Social Care was that: the PNA Steering Group had gone beyond the minimum expectation of the regulations through carrying out extensive surveys with the public and providers, an extended version of the questionnaire was circulated to the targeted population groups and those in key neighbourhoods; there had also been a 60-day consultation with the public and the draft PNA had been circulated to the required organisations and it was shared additionally with the place-based leads and chief pharmacists, and was shared with neighbouring authorities.

·      Six quality concerns from members of the public outside the scope of the consultation had been received and were listed in the PNA and where possible those were sign-posted to a point of escalation. Those qualitative responses are aired at the Board meeting and are not verifiable. 

·      The PNA Steering Group recognised that for some groups service provision is not equal across all populations, but in making a PNA conclusion reference must be made to the regulations which asks for specific statements and the need to look at the full body of evidence; the conclusions being that there are no gaps in necessary services, there was no consistent identification of additional pharmaceutical services and the locally commissioned services provided an improvement to provision.

·      The Board is asked to approve the final draft of the Surrey PNA and for it to be published on the Surrey-i website shortly, the PNA would last three years from 1 October 2022 to 30 September 2025.

·      The PNA Steering Group would revisit the PNA annually and would publish a supplementary statement taking into account new housing developments, increases in population and feedback from providers.

2.    A Board member noted that it was a fantastic and comprehensive piece of work, she understood how it connected with her unlike the previous PNA and she wondered why the Board receives it for sign-off and not other bodies such as the Integrated Care Board for example which had taken delegated commissioning from the region for dentistry, optometry and pharmacy. That gives the ICB different accountabilities that she was not sure were reflected in the PNA and she wondered whether the Health and Social Care Act had missed that.

-       A substitute Board member referred to the draft PNA, Annex 1, page 15 which outlined that ICBs had taken on delegated responsibility for community pharmacies. She noted that it was appropriate that the PNA comes to the Board for sign-off because it is part of SCC’s responsibility as it hosts Public Health and undertakes the needs assessment, however she noted that there were many other forums where this information also needed to go.

3.    A Board member noted that Healthwatch Surrey was involved in the drafting process and she appreciated the amount of engagement that was carried out. She reflected that things had changed dramatically in the last four to six months and she felt uncomfortable reading a recommendation that says that pharmaceutical needs provision is meeting the needs of Surrey residents when it is now almost the number issue voiced by the public that they cannot get access to a pharmacist when they need it due to closed pharmacies. She recognised that it was an ongoing process and it would come back to the Board regularly, however noted the potential inequality being created as people with limited resources cannot necessarily travel further and wider to access the medicines that they need.

-       A Board member noted that she would like to have a conversation after the meeting with the Board member about the rise in the concerns about pharmacy provision, to understand how much that was due to people using pharmacies as an alternative to General Practice and actually the demand is rising beyond where it was or whether it was something different.

-       The Chairman noted that pressure on pharmacies would increase under new plans by the Health Secretary.

-       A substitute Board member noted that there is a difference between the PNA and whether the services that had been commissioned are functioning and working and the workforce pressures that they have and that relates to the commissioning side of pharmaceutical services. She acknowledged the concerns but noted that it does not mean that there was not a good spread of pharmacies in the right places, validating the conclusions in the PNA.

4.    The Chairman sought clarification on an additional comment from a member of the public and for that person to be responded to, in response a Board member noted that a member of public had made a comment however the PNA Steering Group was confident that the PNA addresses those comments. She reiterated that there is an annual process to update the PNA and so it is dynamic. She welcomed the offer for the Public Health team (SCC) to take the PNA to wherever it is appropriate for discussion, ensuring that it is used as a dynamic document. 

RESOLVED:

Health and Wellbeing Board members were provided a copy of the PNA for comment during the four-week period Friday 5 August 2022 to Friday 2 September 2022. All comments received were addressed and incorporated.

1.    In order to give final approval of the PNA for publication, the Board considered:

a.    Whether the process followed to produce the PNA (section 5 of the report) was robust and met related regulations?

b.    Whether the findings are appropriate to the evidence found?

2.    The Board approved the final draft of the Surrey PNA 2022 (Annex 1) including its Appendices (Annex 2) and agreed to its immediate publication.

Actions/further information to be provided:

1.    The Board member (Claire Fuller) and a Board member representing the Frimley ICS will follow up with the Board member (Kate Scribbins) on her comments about the rise in concerns by Surrey’s residents of not being able to get access to a pharmacist when they need it due to closed pharmacies.

2.    The Public Health Analyst Team Lead (SCC) or the Director of Public Health (SCC) will respond to that member of the public regarding their additional comment.