Agenda item

The provision of NHS pharmacy services is a controlled market. If someone wants to provide NHS pharmaceutical services, they are required to apply to the NHS to be included on a pharmaceutical list and must prove they are able to meet a pharmaceutical need.

The National Health Service England (Pharmaceutical Services and Local Pharmaceutical Services) Regulations 2013 (SI 2013 No. 349) set out the system for market entry. Under these Regulations, Health and Wellbeing Boards are responsible for publishing a Pharmaceutical Needs Assessment (PNA). The PNA tells us what pharmaceutical services are currently available and where we are likely to need changes in the future because of demographic or other changes.

NHS England (the national body responsible for commissioning pharmaceutical services) relies on PNAs to inform decision making, specifically regarding whether existing pharmaceutical services meet local need. NHS England also uses the PNA to assess applications from applicants who want to modify existing services or deliver new pharmaceutical services within Medway.

This paper presents the Health and Wellbeing Board with the draft PNA that will go out for a 60-day consultation.

Discussion:

The Deputy Director of Public Health (DDPH) presented the draft Pharmaceutical Needs Assessment (PNA) that would go out for a 60-day consultation.  He explained that under the National Health Service England (Pharmaceutical Services and Local Pharmaceutical Services) Regulations 2013 (SI 2013 No. 349), Health and Wellbeing Boards were responsible for publishing a PNA which stated what pharmaceutical services were currently available and where future changes were needed because of demographic or other changes.

NHS England (the national body responsible for commissioning pharmaceutical services) relied on PNAs to inform decision-making, specifically regarding whether existing pharmaceutical services met local needs. NHS England also used the PNA to assess applications from applicants who wanted to modify existing services or deliver new pharmaceutical services within Medway.

The following issues were discussed:

Collection and delivery services – on the question of delivery charges, the DDPH advised that delivery of medicines was not currently a commissioned service provided by pharmacies. However, most pharmacies delivered dispensed medicines free of charge while some might charge for this service and members of the public might change to other pharmacies in the same area. DDPH added that people could find a nearby pharmacy using their postcode via the NHS website (https://www.nhs.uk/service-search/pharmacy/find-a-pharmacy).

There was a suggestion for the authority to investigate what could be done to enable free delivery of dispensed medicines to all Medway residents. The DPH responded that the pharmaceutical services were commissioned by the NHS England and local authorities had no control over delivery charges. However, Medway residents might voice their needs for free delivery during the 60-day consultation. 

Supervised consumption of opioid substitutes – the Board noted that substances such as heroin, opium and morphine were known as ‘opioids’ which could change a person’s mood or behaviour. Addressing concerns of opioid dependence and abuse, the DPH clarified that supervised consumption of opioid substitutes by community pharmacies was part of the organised treatment plan.  He reassured that as the pharmacist supervised the patient’s consumption of the opioid substitute in the pharmacy, the risk of illegal diversion or consumption by anybody other than the patient was hence minimised.

Out of area providers of pharmaceutical services – Board members noted that 92% of the prescriptions issued by prescribers were dispensed “in area” of Medway while the remaining were dispensed outside of Medway, for example, by a pharmacy in Kent or distance-selling pharmacies. The DDPH added that in the last 3 years, an average of 5% of the prescriptions dispensed by community pharmacies in the area were prescribed by GP practices out of the area.

60-day consultation – on whether the consultation document and its summary, if any, would be accessible to all and provided in different languages, the DPH said that the authority upheld access equity and would accommodate the needs of specific communities and facilitate their involvement in the process. The DDPH undertook to make the consultation documents accessible to different communities in the future. 

Decisions:

The Health and Wellbeing Board agreed to

a)       the draft Pharmaceutical Needs Assessment for consultation; and

b)       delegate authority to the DPH, in consultation with the Chairman of the Health and Wellbeing Board, to finalise and sign off the updated version for consultation given the Board had requested amendments to the PNA.