Agenda item

Purpose: To present an overview on the pharmaceutical provisions in West Berkshire. Assessment of current provision and opportunities for improvement.

Julie Dandridge (Head of Pharmacy, Optometry and Dentistry, BOB ICB) presented the report on Community Pharmacy Provision across Buckinghamshire, Oxfordshire and Berkshire West (BOB).

During the presentation the following points were highlighted:

• There had been a change in community pharmacy provision recently due to Lloyds no longer operating in supermarkets and so there were new providers on the high street. There were fewer large chains, and more independent providers who were more likely to become part of the community.
• Previously the core role of pharmacies was to dispense prescriptions, however the services provided were expanding including Pharmacy First. There had been a shift to internet-based pharmacies delivering prescriptions to homes.
• It was explained that when a pharmacy reported a closure, the ICB worked closely with Community Pharmacy Thames Valley to see whether neighbouring pharmacies had the capacity to pick up the extra demand.
• During and after Covid there were many unplanned closures of pharmacies. In response to that, new regulations were brought in for pharmacies to have continuity plans and to notify the ICB if there was an unplanned closure. Since then, unplanned closures had reduced and only occurred in exceptional circumstances.
• There had been a reduction in pharmacy opening hours as the new regulations allowed for this. This benefitted pharmacies as they could be more financially viable.
• Community pharmacist numbers had been falling due to pharmacists moving to work in Primary Care Networks. Initiatives were being developed to provide incentives for new graduates to go into community pharmacy.
• The next steps highlighted were the progress of the BOB ICB draft primary care strategy, digital improvements and the use of the NHS App for patients to request repeat prescriptions.

David Dean (Chief Executive Officer, Community Pharmacy Thames Valley) confirmed that they worked closely with the ICB. They were also working more closely with GP practices to enable patients to get healthcare more quickly.

During the Committee’s discussion the following points were raised:

• It was shared that members of the public were concerned about accessibility to pharmacies and the need for more pharmacy provision. The ICB had received a number of new applications for pharmacies across Buckinghamshire, Oxfordshire and Berkshire West. However, there were clear regulations about what, how and when these applications could be approved. There were appeals processes and timelines to follow. It was a long, complex process and they worked closely with the West Berkshire Health and Wellbeing Board who identified gaps and were a consultee in the process.
• It was noted that the pharmacy provision in Thatcham had improved, despite reducing from four to two pharmacies recently. There was a better service and shorter waiting times. It was agreed that quality over quantity was important. Those that had left the market were because they were not financially viable and so it was important to protect the existing pharmacies for the future. This could be impeded by opening new pharmacies.
• It was highlighted that the Health and Wellbeing Board had raised concerns that in some areas of West Berkshire waiting times at pharmacies had increased. They had requested the ICB and Healthwatch to carry out a check on the resilience of pharmacies. The Health and Wellbeing Board had also looked at two new pharmacy applications in Newbury and Thatcham and they had written in support of those.
• It was clarified that the Health and Wellbeing Board was responsible for the Pharmaceutical Needs Assessment which looked at where there may be gaps in provision. It was a three-to-five-year cycle. The Health and Wellbeing Board could issue supplementary statements if a closure led to a gap in provision. This impacted on how the ICB looked at an application (as an identified need or as an unforeseen benefit) which determined the process. They were also a consultee on new applications.
• Concern was raised about a specific independent pharmacy being unable to access digital prescriptions from the local surgery. It was clarified that this should not be happening. Patients could choose where their prescription was sent digitally. It was also noted this would produce queues at the pharmacy as the medication could not be dispensed in advance. Community Pharmacy Thames Valley were working with pharmacies and the ICB to identify these pharmacies and drive improvements.

Action: Julie Dandridge to investigate and update Councillor Carter.   

• It was highlighted that there had been no change in government funding for ten years. Whilst efficiencies had been made, there was more pressure on pharmacies. Funding had reduced by 40% in real terms and was why there were less pharmacies today.
• A query was raised around whether there was the workforce available to provide the extra services provided through Pharmacy First. This would be additional for the existing pharmacist on site, but on occasions another pharmacist may be needed.
• It was advised that all pharmacies and pharmacists, including online pharmacies, were regulated by the General Pharmaceutical Council. 
• It was clarified that delivery of prescriptions were not part of the contract with the ICB. They were a service provided by some pharmacies. Patients could request an online pharmacy who would deliver.
• It was advised that there was an annual questionnaire which local pharmacies committed to getting their community to fill in. This provided feedback about the services. Community Pharmacy Thames Valley also worked closely with Healthwatch who would conduct surveys to find out community views.

RESOLVED to note the report.