Agenda item

Purpose: To provide details of recent and planned changes to pharmaceutical services in West Berkshire and advise the Health and Wellbeing Board on the implications for the West Berkshire Pharmaceutical Needs Assessment.

April Peberdy presented the report on Changes to Pharmaceutical Services (Agenda Item 10).

The unforeseen benefits application for a new pharmacy in Newbury Town Centre had been discussed by Newbury Town Council. The assertion that there was no gap in provision was challenged – while the south of the town was well served by pharmacies, coverage in other parts was thin and some wards had no pharmacies (e.g., Newbury Clay Hill). It was noted that pharmacies were supposed to have a key role in supporting GPs, but patients would be put off by long queues. There was strong support for the new application.

The Board noted that Newbury had lost Lloyds Pharmacies in Sainsbury’s and Bartholomew Street as well as Superdrug in Northbrook Street. While a gap may not be present in statutory terms, there was felt to be a gap in practice, with long queues in Boots highlighted.

It was suggested that West Berkshire Council should do everything it could to support the application (e.g., planning permission).

Healthwatch reported a significant number of patient complaints about pharmacies - an additional pharmacy would help to address some of the issues that had been raised.

It was highlighted that there were plans to push even more services onto pharmacies from 2024, but they were struggling to deliver the existing range of services and to make time to have detailed conversations with patients. An additional pharmacy would help to improve capacity.

It was noted that the sites being considered for the new pharmacy would be close to town centre car parks, which would help to improve access.

The Board noted that there had been 21 pharmacies in West Berkshire when the Pharmaceutical Needs Assessment (PNA) had been undertaken. Since then, five pharmacies had closed and others had reduced their hours, which together had a cumulative impact. The assertion that there was no gap in provision was challenged. It was suggested that the Board should think strategically and consider future needs, taking account of new homes being built in the area.

It was highlighted that access to services was a key part of the ICB’s Primary Care Strategy. Community pharmacies had a key role to play in supporting GPs in relation to seven minor ailments, and improving access to GP appointments was reliant upon this additional support.

It was suggested that factors other than distance / travel time needed to be taken into account when determining whether gaps in provision had occurred, including the services that they were expected to provide.

The Board was advised that the Boots pharmacy in Thatcham regularly had long queues that extended out of the door. There were just two other pharmacies in Thatcham, neither of which were in the town centre. It was also suggested that residents from Newbury Clay Hill ward tended to go to Thatcham for prescriptions. Concerns were expressed about the impacts of the closure on the remaining pharmacies, and it was suggested that a gap would be created in Thatcham as a result of the closure.

Concerns were raised about closures pushing people towards online pharmacies, which would take business away from local pharmacies.  Also, long queues would discourage people from buying cosmetics and toiletries in pharmacies. These factors could affect the financial viability of local pharmacies.

Officers advised that assessments had been undertaken with regard to criteria set out in legislation and government guidance. Based on these criteria, no gaps in provision had been judged to have occurred as a result of the changes.

The point was made that there was a five year strategic plan for the Buckinghamshire, Oxfordshire and Berkshire West system. The Board was encouraged to think strategically about population need and how they could be best served to live and thrive. It was noted that 300 Boots pharmacies were scheduled to close by April 2024. The Board was asked what would happen if one of the Boots pharmacies in Newbury was to close.

It was noted that the Local Pharmaceutical Committee had been consulted about dispensing volumes and adequacy of provision, which had informed the decision around whether or to declare a gap in pharmaceutical services.

It was suggested that the report’s recommendations could be aligned with the emerging Primary Care Strategy and the model of community pharmacy that this was likely to outline. Furthermore, it was suggested that in addition to the statutory position through the PNA, the Board should also consider whether there was the capacity and resilience within the pharmacy network to take forward that model.

The Board was advised that Healthwatch would be conducting a piece of work around pharmacies in the New Year.

It was noted that there had been a request to the previous Chairman of the Health and Wellbeing Board to write to NHS England to voice the Board’s concerns about pharmacy services, but it was unclear as to whether that had been actioned.

It was suggested that the government guidance should be challenged, since it was not fit for purpose and did not reflect what was happening on the High Street.

In addition to the recommendations set out in the report, it was proposed to write in support of the unforeseen benefits application and to write to Primary Care Support England to express concerns about the guidance for PNAs, and the additional pressures being placed on remaining pharmacies as a result of closures, which would make it more difficult to implement the Pharmacy First Service.

RESOLVED:

(a)       To note the changes to pharmaceutical services in West Berkshire;

(b)       To note that the changes have been assessed as not creating a significant gap in the provision of pharmaceutical services in West Berkshire;

(c)        To agree that there is no requirement to update the Pharmaceutical Needs Assessment or publish a supplementary statement;

(d)       That the Chairman write to Primary Care Support England on behalf of the Health and Wellbeing Board in support of the unforeseen benefits application, and also to express concerns about the guidance for PNAs, and the additional pressures being placed on remaining pharmacies as a result of closures, which would make it more difficult to implement the Pharmacy First Service.