All Health and Wellbeing Boards have a statutory responsibility to publish and keep up to date a Pharmaceutical Needs Assessment (PNA). The PNA is updated every three years, with the last report being published in 2022. The development of the PNA in Surrey is delegated to the PNA Steering Group. The paper outlines the findings of the draft Surrey PNA 2025 and the recommendations which are being presented for sign off.
Agenda item for HWB and Surrey Heartlands ICP.
Minutes:
Speakers:
Dr Louis Hall, Public Health Consultant
Linda Honey, Director of Pharmacy, NHS Surrey Heartlands
Yinka Kuye, Community Pharmacy Clinical Lead, NHS Frimley
Julia Powell, CEO, Community Pharmacy Surrey and Sussex (Local Pharmaceutical Committee)
Key points raised during the discussion:
1. The Public Health Consultant noted that the Health and Wellbeing Board was required to sign off the Pharmaceutical Needs Assessment (PNA), which had been developed by the PNA steering group.
1. The PNA guided assessment of pharmaceutical market entries and to identify gaps in pharmaceutical need.
2. The PNA was informed by quantitative data, including socioeconomic and health, and qualitative data, from residents’ views.
3. The Public Health Consultant emphasised there had been flexible assessment across Surrey, rather than applying metrics uniformly.
4. Resident surveys showed little demand for out-of-hours access.
5. Data highlighted that greatest need matched key neighbourhoods identified in the Health and Wellbeing Strategy. Access to pharmacies was prioritised in those areas.
6. The Pharmaceutical Needs Assessment method developed would be used to ensure sufficient pharmacy provision over the 3 years of the PNA.
1. Although 98% of pharmacies had signed up to the Pharmacy First service, most were unable to deliver it due to public unawareness or seeking support elsewhere.
2. The CEO of Community Pharmacy Surrey and Sussex explained that pharmacies were funded from a fixed global NHS sum. Increasing the number of pharmacies would dilute funding and lead to closures.
3. The global sum allowed pharmacies to dispense prescriptions with margins made from buying medications at a lower rate than NHS reimbursement. The global sum had remained flat for 5 years.
4. Prescription charges were returned to the Government.
5. Pharmacy closures were more likely in deprived areas as those in wealthier areas could offer additional private services. NHS funding accounted for 95% to 99% of many pharmacies’ business.
6. A Board member noted the PNA remained high level and could not consider specific local needs like community cohesion.
7. Travel time was reviewed across Surrey to identify gaps, with walking distance an optional consideration in the national guidance.
8. The PNA flexibly considered access to car travel depending on urban or rural setting. The Vice-Chair (Health and Care) noted consideration for neighbourhoods less likely to have car travel access.
9. All areas had access to a pharmacy within 30 minutes’ walk, most were within 5 minutes’ drive.
10. The Steering Group had considered areas and populations with higher barriers to pharmacy access that were otherwise not identified by geography. These coincided with key neighbourhoods.
11. The Public Health Consultant considered that those experiencing higher barriers of access to pharmacies possibly also had similar difficulties accessing other services. Such consideration was beyond the remit of the PNA but relevant for the System to consider.
12. In response to a Board member’s question, the Public Health Consultant noted the 111 service could support urgent prescription needs.
13. It was noted that unpaid cares were significantly more likely to be in key neighbourhoods.
Resolved:
The Health and Wellbeing Board and Surrey Heartlands Integrated Care Partnership:
1. To agree the findings and the recommendations of the Surrey PNA 2025 and to sign off the report.
2. To agree to support the recommendations of the Surrey PNA 2025:
a. Pharmacies should be further supported to offer those services identified in the PNA as non-essential commissioned services, for example, Pharmacy First, to further strengthen the community-led approach to service delivery.
b. Key neighbourhoods should be a priority in the planning and delivery of advanced, enhanced and locally commissioned services by both commissioners and pharmacies.
Actions/further information to be provided:
None.
Supporting documents: