Agenda item

This report presents a proposed response from the Health and Wellbeing Board to NHS England’s proposal to conduct a “rurality review” in Peter’s Village, near Wouldham in Kent. This area is separated from Halling in Medway by the river Medway.

If the rurality review determines that the area is no longer rural in nature, it will no longer be a controlled locality and as such it will be possible for NHS England to allow a pharmacy to open in the area.

The NHS (Pharmaceutical Services and Local Pharmaceutical Services) Regulations 2013 state that residents within 1.6 Km (as the crow flies) of any pharmacy cannot be dispensed to by a dispensing GP practice. Therefore if a pharmacy opens in Peter’s Village it is likely that a large proportion of the patients registered at Halling Medical Centre will no longer be able to be dispensed to by the practice.

The proposed letter to NHS England argues that the area is still very much rural in nature.

Reason for Urgency 

This report has been added to the agenda, because the Chairman of the Committee has agreed that it should be considered at this meeting as a matter of urgency, as permitted under section 100B of the Local Government Act 1972. The report is considered urgent because the next meeting of the Board after 6 November takes place on 19 February 2019. Consideration at this meeting of the Board’s response to a letter received from NHS England would be outside the 30 day time limit, from the date of the letter, for a response to be provided. The report was not available at time of agenda dispatch as officers needed time to consider a draft response. The letter invites the Board to make a representation in relation to an application received by NHS England for a new community pharmacy in the St Peters, Wouldham area, which has prompted the need to review the rurality status of the area.

Discussion

The Board was advised that pharmaceutical regulations described areas as either being controlled or non-controlled localities. In non-controlled localities, a new pharmacy could open where NHS England agreed that this would be appropriate. A controlled locality was a rural area containing a dispensing GP practice. GP practices in these areas are able to dispense pharmaceuticals to patients who live more than 1.6km (1 mile) as the crow flies from their nearest pharmacy. The process of determining whether an area should be controlled was called a rurality review. NHS England undertook these on a periodic basis or when a particular need was identified.

A letter had been received from NHS England advising that a rurality review would be undertaken of the Peters Village development near Wouldham in Kent. This followed the receipt of an application to open a pharmacy in the area. Were NHS England to determine that the Peter’s village area was no longer a rural area it would determine that there area was no longer a controlled locality and the application for a new pharmacy to open would be approved. However, this would have the result that the existing dispensing GP practice in Halling in Medway would no longer be able to dispense to any of its patients who lived within 1.6km of the new pharmacy in Peters Village. In view of the large number of patients that would be affected, the result could be that it would become unsustainable for the practice in Halling to dispense to any patients.

The Board was asked to comment on whether it considered the Peters Village area to still be rural in nature and to agree an appropriate response for submission to NHS England. The draft response presented to the Board stated that the area should be considered rural.

Two Board Members said that it was clear that the Peters Village area should be considered to be rural and expressed their support for the draft letter. It was requested that consultation with local ward Councillors be added to the proposed delegation set out in the report to enable the Director of Public Health, to in consultation with the Board Chairman, to be able to respond to future similar requests.

It was noted that the exact location of the proposed pharmacy was not known and that, therefore, it could not yet be determined exactly which areas would be affected in the event that NHS England determined Peters Village not to be a rural area. Officers advised that the centre of the village had been used for their analysis and that it was considered likely that the new pharmacy would be located in this area.

Decision

The Board:

i)     Delegated authority to the Director of Public Health to, in consultation with the Chairman of the Health and Wellbeing Board and local ward Councilors, as appropriate, to respond to requests from NHS England regarding matters relating to rurality reviews and consolidation of pharmaceutical services.

ii)    Approved the proposed response to NHS England regarding the rurality review of Peter’s Village.