Agenda item

Purpose: To set out a proposed process for assessing the impacts of notified changes to pharmaceutical services in West Berkshire and for keeping the Pharmaceutical Needs Assessment under review.

April Peberdy (Interim Service Director – Communities and Wellbeing) presented the item on the Pharmaceutical Needs Assessment (PNA) Decision Making Process (Agenda Item 10).

It was noted that the recent notifications of proposed closures in the Sainsbury’s superstores at Calcot and Newbury had been a trigger for the Board to review its processes. It was recognised that the Board needed to respond in an agile manner between meetings.

Members noted that updating the PNA or publishing a supplementary statement would not address issues created by pharmacies closing and asked how concerns could be escalated. It was explained that the Board merely had a duty to assess the implication of any proposed changes to provision and had no powers beyond this. An updated PNA or supplementary statement was useful in highlighting gaps, but it was up to providers if they wanted to enter the market. It was confirmed that the PNA and any supplementary statements would be published on the West Berkshire Observatory website.

It was noted that the Health Scrutiny Committee had a role in questioning the NHS about the operation of pharmacies and had done so at the last meeting. Also, it was acknowledged that pharmacies were mostly private businesses and an appropriate response needed to be agreed by the NHS system.

It was proposed that all Board members should be notified of proposed changes to pharmacy services.

It was highlighted that recent temporary closures had resulted in long queues at other pharmacies in the areas, and that there was a need to communicate with patients and GPs.

It was recognised that pharmacies played a key role in the preventative approach to health care.

One of the proposed closured was in an area of relative deprivation where it was considered important to have a pharmacy present within the community in order to make access as easy as possible.

A question was asked about provision of pharmacies in new developments.

Concern was expressed that other pharmacies may be on the verge of closing.

Members were reminded that this item was related to the process for assessing the impact of changes rather than the planned closures, which would be discussed as part of Item 11.

There was a query about whether the PNA process took account of online pharmacies. It was recognised that while these offered benefits in terms of reliable supply of medicines and avoiding the need to queue, community pharmacists did much more than dispense medicines. Also, they were unable to provide same day supply of medicines.

Action: April Peberdy to confirm if the PNA took account of online pharmacy options.

It was noted that the proposal was for local ward councillors only to be consulted if a gap was identified. However, it was suggested that they should be consulted on all changes, since they had the local intelligence to help identify issues that may contribute to gaps in provision being declared. They could also disseminate messages to local residents.

It was suggested that a review was needed to get a better understanding of the current and future situations with respect to pharmacy provision in West Berkshire.

A point was made about the potential for strengthening primary care through extended hours health centres with in-house pharmacies.

Members observed that many family-owned pharmacies had been bought out by large pharmacy providers who were now disengaging.

It was noted that Healthwatch had been unaware of the proposed closures until the story broke in the local newspaper. This reinforced the importance of all Board Members being informed when notifications of planned closures were received.

It was highlighted that patients were increasingly being told to visit their pharmacist as an alternative to visiting their GP, but were experiencing long queues. Patients were also experiencing problems in getting repeat prescriptions.

A question was asked about the proportion of independent pharmacies vs independent pharmacies and whether all were privately owned.

Action: April Peberdy to provide further detail on the breakdown of pharmacy ownership in West Berkshire.

A number of amendments were proposed to the Pharmaceutical Needs Assessment Terms of Reference.

·         3.3.2 to move up to 3.2 and become: ‘Details of proposals shall be circulated to the Health and Wellbeing Board and local ward members so they can provide relevant comments for consideration by the Sub-Committee’.

·         3.3.1 to be amended: delete ‘and / or’.

·         3.3.2 to be amended: ‘where a Gap is anticipated, consultation with the Local Pharmaceutical Committee in order to understand the likely impacts on other pharmacies’.

The proposal was seconded and an indicative vote was taken of all Members include those attending remotely prior to the formal vote by Members in the room.

RESOLVED that:

(a)       notifications of changes to pharmaceutical services in West Berkshire should be shared with all members of the Health and Wellbeing Board and local ward councillors;

(b)       decisions about the appropriate response to notifications of changes to pharmaceutical services be delegated to a Sub-Committee of the Health and Wellbeing Board, consisting of the Chairman and Vice Chairman of the Health and Wellbeing Board, the Director of Public Health for Berkshire West, and a senior Public Health Officer;

(c)       the Sub-Committee shall consult the Local Pharmaceutical Committee (Pharmacy Thames Valley) if a gap in provision is identified in order to understand the likely impact on other pharmacies;

(d)       all decisions of the Sub-Committee will be reported back to the Health and Wellbeing Board at the next public meeting and the Berkshire West Shared Public Health Team will publish any supplementary statements or updated PNA on the Berkshire Public Health Observatory website as required;

(e)       the proposed terms of reference for the Pharmaceutical Needs Assessment Sub-Committee be approved subject to the following amendments:

·         3.3.2 to move up to 3.2 and become:

o   ‘Details of proposed changes shall be circulated to the Health and Wellbeing Board and local ward members so they can provide relevant comments for consideration by the Sub-Committee’;

·         3.3.1 to be amended:

o   delete ‘and / or’;

·         3.3.2 to be amended to:

o   ‘where a Gap is anticipated, consultation with the Local Pharmaceutical Committee in order to understand the likely impacts of the closure(s) on other pharmacies’.