Issue - meetings

8.1       The Board considered an update report on Pharmacy closures in East Sussex, which provided an update on the changes and the actions to be taken in regard to the pharmacy closures and the impact on the Pharmaceutical Needs Assessment (PNA).

8.2       Veronica Kirwan commented that Healthwatch had received some feedback on out of hours pharmacy services as part of its roadshow work, where the public did not know where to go to find out which pharmacies are open out of hours. This may be a communications issue and Healthwatch would be happy to work with the Public Health team to address this.

8.3       The Board RESOLVED to:

1). Approve the removal of the Supplementary Statement posted regarding Lloyds Pharmacy (in Sainsburys) St Leonards;

2) Agree that no supplementary statement will be required regarding Lloyds Pharmacy (in Sainsburys) Hampden Park; and

3) Approve the issue of a Supplementary Statement for Lloyds Pharmacy in Sainsburys in Newhaven. 

Report by the Director of Public Health.

39.1     The Board considered a report on Pharmacy provision in East Sussex following the notification by LloydsPharmacy that it was closing three 100 hour pharmacies located in Sainsbury’s supermarkets in St. Leonards on Sea, Newhaven, and Hampden Park in Eastbourne.

39.2     The Board commented that the closures would mean a substantial amount of out of hours access to pharmacies would be lost. Dr Stephen Pike also raised concerns about the loss of acute access to pharmacies (e.g. the Newhaven pharmacy provides medicines for end of life care) and commented that overall activity can mask individual patient need.

39.3     The Board asked if a reason had been given for the closures.

39.4     Darrell Gale, Director of Public Health responded that a reason had not been given by Lloyds for the closures, and this was a Lloyds decision rather than a decision by Sainsbury’s where the pharmacies are located. It may be a reflection of decisions being made by Lloyds about their pharmacy business, and it is understood that the future of Lloyds pharmacies located in Ringmer, Newick, Forest Row and Sidley are also under discussion.(Post meeting note: It has been clarified that LloydsPharmacy is reviewing its community pharmacy estate and is selectively selling some branches. There have been no notifications of any closures in East Sussex other than the three within Sainsbury’s).

39.5     Councillor O’Brien expressed concern about the closures as this would leave the Lewes district without out of hours provision and Newhaven is an area where there is a greater mental health need.

39.6     The Board asked about the process if option 2 to issue a Supplementary Statement to the Pharmaceutical Needs Assessment (PNA) is taken. Would this lead to the commissioning of replacement pharmacy services.

39.7     Darrell Gale outlined that the process would be to look at the PNA to check the demographic information and to establish where 100 hour (extended hours) pharmacy services needed to be commissioned. There will then be some consultation and engagement work before making a recommendation to the HWB and work with NHS England to commission the new/replacement services. It was clarified that there will be NHS commissioning funding to pay for new/replacement pharmacy services. This may also be of interest to new health centres if they could help with pharmacy provision.

39.8     The Board RESOLVED to:

1) Note the impact on pharmaceutical provision in East Sussex of the Lloyds Pharmacy decision to close its outlets in Sainsburys stores; and

2. Agree to Option 2 and to the issuing of a supplementary statement of the East Sussex Pharmaceutical Needs Assessment.

16.1.    The Board considered a report on the 2022 East Sussex Pharmaceutical Needs Assessment to the Health and Wellbeing Board for approval, and agreement for it to be published, as required by the NHS (Pharmaceutical and Pharmaceutical Services) 2013 Regulations.

16.2.    The Board asked whether there was a risk that demand for pharmacies could increase as the role of pharmacists in diagnosing and treating patients increases, and at the same time that the number of high street pharmacies could reduce due to trends in high streets towards converting class E commercial properties to housing.

16.3.    Darrell Gale, Director of Public Health (DPH), said that community pharmacies are both commercial businesses selling products but also have contracts with the NHS to dispense prescriptions and additional services, and commissioners would wish to continue seeing sufficient provision on the high street. The DPH said he was surprised the number of pharmacies had not contracted more than it did since 2017, but believed this due to the coordinated efforts of pharmacies from 2015 onwards to expand the range of services they provide in support of the wider healthcare system. Pharmacies are able to do this successfully because of their proximity to where people live and the very high level of trust in which they are regarded by the public. The news from the Prime Minister to increase the use of pharmacies is welcomed within this context.

16.4.    Darrell Gale said it is unfortunate there is not a specific planning class for pharmacies and other health providers like optometrists. The PNA, however, demonstrates that the current provision of pharmacies is meeting the needs of the population and there is no need for further consolidation or expansion.

16.5.    The Board asked whether the PNA reported that there was adequate end of life care commissioned in East Sussex.

16.6.    Darrell Gale clarified that the PNA reported adequate end of life care provision from pharmacies (i.e. the supply of appropriate drugs).

16.7.    The Board asked why some rural pharmacies are not open for the duration of their advertised opening times.

16.8.    Darrell Gale explained that rural pharmacies sometimes have to close due to staffing issues or because the consulting room privacy requirements mean that the counter cannot be operated when someone is receiving an emergency consultation that requires more privacy than a booked consultation.

16.9.    The Board asked whether the travel times reported to travel to rural pharmacies are based on projections, or the actual reported times of people travelling to them, which can be longer due to the impact of unadvertised closures.

16.10.  Darrell Gale explained that the travel times have been calculated using Basemap’s TRACC software to model the time taken by residents of East Sussex to access a pharmacy service. They do not take into account the potential that the pharmacy may not be open on arrival and are based around the advertised open hours, as that is the level of data available to the Public Health Team.

16.11.  The Board asked for more details  ...  view the full minutes text for item 16

– Report by Acting Director of Public Health

8.1       The Board considered a draft of the 2017 East Sussex Pharmaceutical Needs Assessment.

8.2       In response to questions from the Board the following answers were provided:

• The Pharmaceutical Needs Assessment (PNA) is a comprehensive assessment of need for everybody and so does not mention specifically the needs of children and young people; the majority of pharmacy users tend to be older people. There is, however, mention of individual projects that are aimed at young people, for example, Chlamydia testing for 15-25 year olds, free emergency hormonal contraception for people under 25 and free pregnancy testing for people under 25.  There are also details of community pharmacy providing tailored advice to parents and children for illnesses and ailments such as eczema and coughs/ colds.
• The PNA emphasises the importance of community pharmacies, which are a vital part of the East Sussex Better Together (ESBT) medicines optimisation workstream. The PNA will help ESBT to target areas for improvement in existing pharmacies and for NHS England to consider new market entries. 
• The PNA indicates that a small number of rural areas are more than two hours away from a pharmacy by public transport on weekends and public holidays, which can make accessing medicine over the weekend difficult for some patients. East Sussex Healthcare NHS Trust (ESHT) hospital pharmacies provide sufficient medicine to patients being discharged to last them over the weekend period when local pharmacy access is more difficult. 
• Pharmacies are independent businesses and as such are paid by NHS England to stay open on days where it would be uneconomical for them to do so, for example, on public holidays and Sundays they are paid £250 per hour. In larger rural areas it is also difficult to encourage pharmacies to be open for 100 hours a week over seven days, and those that do are usually in supermarkets and restricted by its Sunday opening hours. The pharmacy budget is a global sum and is apportioned to provide the best possible spread of pharmacy access for residents in East Sussex; paying pharmacies in rural areas to stay open beyond the hours they do now would, therefore, impact pharmacy availability elsewhere.
• Pharmacies are encouraged to maintain an online presence. NHS Choices contains a profile of all pharmacies, such as its hours of opening and services it provides. Since April 2017, as part of the new Quality Service for Communities, pharmacies qualified for a payment if their NHS Choice profile was updated – 9,700 0f 11,500 pharmacies submitted up-to-date profiles to qualify for this payment. Community pharmacies are also paid to include six health promotion campaigns per year in their window.

36.3     The Board RESOLVED to:

1) approve the final draft of the 2017 East Sussex Pharmaceutical Needs Assessment and agree to its publication; and

2) recommend that the final draft emphasises the pharmaceutical needs of and available pharmaceutical services for children and young people.