Meeting documents

To receive the report.

The Somerset Health and Wellbeing Board endorsed the draft PNA; commented on the provision of Sunday opening in Chard and Hepatitis C antibody testing; and delegated endorsement of the final draft of the report to the Chair of the Health and Wellbeing Board, assuming only minor changes from the consultation draft.

As a supplement to his report contained within the agenda, Pip Tucker, Service Manager-Public Health, made a presentation on the Pharmaceutical Needs Assessment 2022-25.  In explaining what the PNA is, it was noted that it is part of the ‘market entry system’ for pharmacies and that the Health and Wellbeing board is required to provide this independent, factual view (due for September 2022) because the NHSE has a conflict of interests.  From April 2023, pharmacy commissioning will be the responsibility of the Integrated Care Board.  The PNA does not review the quality of pharmacies regarding service or hours or assessment locational conditions.  The PNA was written by a working group delegated by the Health and Wellbeing Board in October 2021, which is made up of the principal stakeholders (medical and pharmaceutical committees, Healthwatch, NHS England, Public Health, etc).  The findings were also presented, with it noted that the steering group is consulting on two improvements (wider commissioning of Hepatitis C antibody testing and the commissioning of an existing pharmacy in Chard to provide Sunday opening); there were also findings outside the scope of the PNA, which noted a considerable reduction in opening hours currently (largely caused by staffing difficulties) that is affecting prompt service.

The Board then discussed the PNA.  It was enquired if alternative methods of dispensing medicines were being looked at, such as mobile pharmacies or online services; it was responded that 20% of provisions are now digital.  It was suggested that digital prescriptions could cause problems for those without access to online services and that as the population ages, people may lose their sight or the ability to use their hands even if they know how to go online, so it would not be fair to shut down pharmacies.  The response was that 80% of prescriptions are still delivered face-to-face and that the trend toward digital is in all sectors; it is positive because it frees up staff and pharmacist time.  However, it was agreed that pharmacies should not be closed, as pharmacists also provide advice.

It was observed that many pharmacies are now a part of chains and that there is a pattern emerging of certain meds no longer being available, so were these meds imported?  The answer was unknown, as the issue does not form part of the PNA, but there are supply chain issues across all sectors; another response advised that work is being carried out with NHS England to identify substitutes for these meds, and everyone is very grateful to the pharmacy community for this.

A Council Member with his business in Dorset noted that community pharmacies have had a 40% reduction in funding from the NHS, which has influenced a reduction in opening hours.  He opined that PNA’s across the country are generally conservative, almost complacent about the situation, and that access is not just about opening hours but also staff levels, which are all affected by funding shortages.  It was asked if there was adequate resilience in the sector to cope with this, if the PNA could help remedy it, and what will happen if the situation deteriorates before the next review in three years?  It was suggested that weekend openings don’t go far enough and could even lead to weekday closures, while more access is needed in some areas for those who can’t get delivery of meds.  The reply was that Somerset has a higher rate of online prescriptions compared to other counties, that any short-term pharmacy closures are an NHS matter, and that information on the requirements for Chard would be welcomed.

A concern was raised about the NHS promoting pharmacies to take the pressure off GP, as if this is going to happen, there needs to be better access to pharmacies.  It was replied that Primary Care encompasses pharmacies as well as GPs, so the PNA is crucial going forward, as during Covid a drop-off in GP visit was seen with pharmacies playing a key role.  A huge opportunity will arise with the move to local commissioning, and it is necessary to ensure that each group within Primary Care gets the attention that it needs.

The Director of Public Health pointed out that the PNA is a huge piece of work and that there is not a similar needs assessment for dentistry; it will be interesting to see where it all goes in the future.  This information may go to the ICS rather than the HWBB, although commissioning will be done by our system in future. 

The Somerset Health and Wellbeing Board endorsed the draft PNA; commented on the provision of Sunday opening in Chard and Hepatitis C antibody testing; and delegated endorsement of the final draft of the report to the Chair of the Health and Wellbeing Board, assuming only minor changes from the consultation draft.