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Pharmaceutical Needs Assessment Community Pharmacy Services – Professionals Questionnaire 2014

Leicestershire

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Contents

Contents Page 2

1: Introduction Page 3

1.1: Pharmaceutical Needs Assessment (PNAs) Page 3

1.2: Community Pharmacy Services: Listening to your views ‘Dataset’

Page 3

1.3: Overall Questionnaire Distribution & Key Stakeholders Page 3

2: The Results: Professional’s (Leicestershire) Page 4-7

3: Main Messages / Key Themes

Page 8-9

Appendix A: Overall Questionnaire Distribution sent to key stakeholders, professionals/public and seldom heard groups

Page 10

Appendix B: Professionals Questionnaire Page 11-13

Appendix C: Response to Leicestershire’s Pharmaceutical Needs Assessment

Page 14-15

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Pharmaceutical Needs Assessments Community Pharmacy Services – Professional Questionnaire 2014

1. Introduction Community pharmacies and the role that they play within the everyday lives of patients, public and healthcare professionals have changed and are evolving in accordance with the ever changing needs of the people they serve. Since April 2013, all the Health and Wellbeing Boards across England have assumed statutory responsibility to publish and update their locally driven ‘Pharmaceutical Needs Assessments’ (PNAs), which will help to ensure everyone living in England has the right access to conveniently located pharmacy services which satisfy the needs of the people they serve. 1.1 Pharmaceutical Needs Assessment (PNAs) The results of a PNA are used as an essential local resource for identifying which pharmaceutical services are currently available within a region. They are also used in identifying any gaps in services. PNAs are used to help commission pharmacy services and to aid the planning of pharmacy services, by identifying which services should be commissioned for the local population within available resources. Anyone applying to open a new pharmacy in the future will have to show their plans to meet the needs of local people, which are identified in the PNA. NHS England makes the decisions about commissioning pharmacy services. Each of the Health and Wellbeing Boards within Leicester, Leicestershire and Rutland is working with the three Public Health Teams in Leicestershire County Council, Leicester City Council and Rutland County Council to produce their local PNAs on behalf of the Health and Wellbeing Boards. 1.2 Community Pharmacy Services: Listening to your views ‘Dataset’ In order to obtain and gain a better understanding of how community pharmacies serve the population of Leicester City, Leicestershire and Rutland, two questionnaires have been distributed seeking people’s views, experiences and opinions of how community pharmacies personally serve them and what, if anything, could be done to improve the service. One questionnaire was aimed at local professionals, and one at patients and the public. An easy read version of the patient/public questionnaire was also produced.

This document summarises the results of professionals for Leicestershire.

1.3 Overall Questionnaire Distribution and Key Stakeholders

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In order to successfully seek a full spectrum of different viewpoints the questionnaire was distributed widely to stakeholder bodies within the public sector, including NHS and local authority bodies and the voluntary sector. A full list of organisations contacted to can be found within Appendix A. Overall the total number of professionals who responded to the questionnaire across Leicester City, Leicestershire and Rutland was 110. The total number who responded to the professional questionnaire within Leicestershire was 46. This comprised 40 who submitted the questionnaire electronically and 6 who filled out paper copies.

2. The Results: Healthcare Professional’s (Leicestershire) This document reflects the overall results from both the online and paper copy version. Qualitative responses will be provided in the main body of this report. A full copy of the questionnaire is available within Appendix B.

Question 1: Which area do you work in?

- 46 responders worked in Leicestershire from the 110 overall professional

responses received. Other reasons stated below (qualitative responses)

Due to the nature of a healthcare professional’s role their cover of care may cross into the regions of Leicester City and Rutland.

It is noted that 1 responder who works in Leicestershire also works in and covers Rutland.

Question 2: Which organisation, if any, do you represent?

- 37 responders answered this question from the 46 Leicestershire professionals who responded.

- 9 responders skipped this question

Overall a large number of the respondents were from pharmacies.

Organisation Number

GP practices/medical/health centres 9

Alpha 3

HHCC 2

PPG 2

Superdrug 2

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Allied healthcare 1

Apa Leicester Ltd 1

Co-op 1

Delivery Pharmacy 1

Health Centre Pharmacy, Hinckley 1

Hinckley Pharmacy Partnership 1

Market Harborough pharmacy 1

Masons chemists 1

Numark pharmacy 1

Pharmacy (parade) 1

Pharmacy 1

Roan Healthcare Limited 1

Sainsbury’s pharmacy 1

Tesco pharmacy 1

WR Evans (Chemist) Ltd t/a Manor pharmacy 1

Wymeswold pharmacy 1

Adult social care 1

ELR CCG 1

Hanover Housing Association 1

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No

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Question 3: What is your role?

- 40 responders answered this question - 6 responders skipped this question

Answer Options Response Percent Response Count

Pharmacist 62.5% 25

Other 22.5% 9

GP 10% 4

Nurse 2.5% 1

Voluntary Sector Worker

2.5% 1

Other roles: Other professionals’ roles were the following:

o Act o NHS 111 nurse advisor o Care coordinator o Director o Manager of a retirement housing estate o Admin/reception o Practice manager o Area manager o Social care manager o Practice nurse o Practice manager o Practice management

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Question 4: Is the community pharmacy in the area where you work adequate for the population you serve?

- 45 responders answered this question - 1 responder skipped this question

The response shows that local professionals in Leicestershire mostly find the community pharmacy in the area where they work adequate.

Answer Options Response Percent Response Count

Yes 95.6% 43

No 4.4% 2

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Question 5: If not, why not, and how could it be improved?

- 2 responders replied to this question

Reasons stated below (qualitative responses)

‘Some rural areas have very limited access to pharmacies during the “out of hours” period and with limited bus services this is made worse.’

‘There can be long waiting lists for dosette box services’

3. Main Messages / Key Themes & Recommendations

Even though the responses obtained from the questionnaire in relation to Leicestershire only reflected a relatively small representation of professionals within the region, a good range of occupations expressed their opinions.

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These range include pharmacists, GPs, voluntary sector worker, NHS 111 nurse advisor and a health and social care manager. It is also noted that alongside the completed questionnaire for West Leicestershire Clinical Commissioning Group (WLCCG) a written response was received that outlined suggestions that ‘recommends a greater role of the community pharmacies that will support the CCG’s commissioning strategy. The full written response can be found within Appendix C however the response highlights that allowing pharmacies to access patient records will support enhanced and cohesive patient care. This would also be an enabler for pharmacists to support general practice through the sharing of care plans. It was also stated that they would like to see services for minor ailments schemes implemented, even if this is initially in pilot form across the region. They also believe that the whole community pharmacy team should be involved to support the strategies outlined within Appendix C. The majority of responders (95.6%) remarked positively that they found the community pharmacies in their region were adequate. However there may be issues to do with limited access within the ‘out of hours’ period which may be exacerbated by limited public transport within rural areas.

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Appendix A: The PNA questionnaires were distributed to the following organisations listed below, in order to seek opinions on pharmaceutical services for professionals and patients.

Organisation

Health and Wellbeing Boards

Health Overview Scrutiny Committees

Local Professionals Network Chair for Pharmacy

NHS England

Clinical Commissioning Groups

Local Pharmaceutical Committee

Directors of Public Health

Multiple Pharmacy Groups (Boots, Lloyds, Co-op)

Independent Community Pharmacies

Healthwatch (Leicester City, Leicestershire and Rutland)

Housing and Planning Authorities

Parish Councils

Patient Participation Groups

GP Practices

Dispensing GPs

Ethnic Minority and other Minority Groups (e.g vulnerable groups)

Macmillan

Safeguarding Adults & Children’s Board

Private Providers

Care Homes

Area Prescribing Committee

Patients and the public

Sexual Health Clinics

Dentists

Specialist Supported Housing

Substance Misuse Service Providers

Staff of CCGs, NHS organisations

111

Library Services

Adult Social Care

Police

Age UK

Media

Neighbouring Local Authorities

Local MPs & Councillors

Out of Hours Services

Schools, Colleges & Universities

Mental Health Trust

Acute Provider Trust

East Midlands Ambulance Service

Prisons

Domiciliary Care Providers

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Appendix B: Professional Questionnaire (Leicester City, Leicestershire & Rutland)

Pharmaceutical Needs Assessments

Community pharmacy services – professionals’ questionnaire 2014 Each of the Health and Wellbeing Boards in Leicester, Leicestershire and Rutland is working to produce local ‘Pharmaceutical Needs Assessments’ (PNAs), which will help ensure everyone living in this area has the right access to pharmacy services. Community pharmacists (chemists) provide a range of health services, some funded by the NHS and some by local authorities. The last PNAs were produced in 2010 and by law, all local authority Health and Wellbeing Boards in England must publish a new PNA by 1st April 2015.

The PNA is a key local tool for identifying what is needed in our pharmaceutical services and for identifying other services that could be delivered by community pharmacies and other providers.

The PNA tells us what pharmaceutical services are currently available and assesses the need for pharmaceutical services in the future

The PNA is used to commission pharmacy services and to aid the planning of pharmacy services, by identifying which services we should commission for our local population within available resources, and where these services should be. Anyone applying to open a new pharmacy in the future will have to show their plans to meet the needs of local people, which are identified in the PNA.

Separate PNAs will be produced for Leicester, Leicestershire and Rutland. They will be used to determine whether applications to provide new services by pharmacists and dispensing doctors will be approved, for example opening a new pharmacy. The organisation that makes these decisions is NHS England.

Why I am being asked to complete this questionnaire?

In order to produce meaningful PNAs, the Health and Wellbeing Boards need your views. We are asking citizens detailed questions about their use of community pharmacies in a separate questionnaire, but we also need to capture your view as a professional or representative of a professional body on the level of access that people have to pharmacy services and any barriers to that access.

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Once you have completed the questionnaire please return it to: FREEPOST NAT 18685, Public Health, Leicestershire County Council, County Hall, Glenfield, Leicester, LE3 8TB. Alternatively you can complete the questionnaire online by going to www.surveymonkey.com/s/LLRPNASurvey2014Professional The closing date is 14 July 2014. QUESTIONNAIRE Please note: throughout this questionnaire, when we refer to pharmacy this includes GP dispensaries (eg pharmacies in GP surgeries) as well as pharmacies (chemists) in shops. It does NOT include hospital pharmacies. 1. Which area do you work in? (tick all that are applicable) Leicester Leicestershire Rutland 2. Which organisation do you represent, if any ……………………………………………………………………………………………… 3. What’s your role? Care home worker Children’s Centre worker Councillor Dentist District Nurse GP Health visitor Mental health clinician Midwife Nurse Optometrist Pharmacist Prison or probation service School nurse Secondary care clinician Social worker Voluntary sector worker Other (please name)……………………………………………………………………. 4. Is the community pharmacy in the area where you work adequate for the population you serve?

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Yes No (please go to question 5) 5. If not, why not, and how could it be improved? …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… Thank you for taking the time to complete this questionnaire. Please send it to: FREEPOST NAT 18685, Public Health, Leicestershire County Council, County Hall, Glenfield, Leicester, LE3 8TB. Alternatively you can complete the questionnaire online by going to www.surveymonkey.com/s/LLRPNASurvey2014Professional The closing date is 14 July 2014. If you would like to complete a questionnaire as a citizen, rather than a professional, please go to this link www.surveymonkey.com/s/LLRPNA2014Patients

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Appendix C Responses to Leicestershire’s PNA. West Leicester Clinical Commissioning Group

RECEVlED

1 6 JUL 2014

---------------

Response to Leicestershire's Pharmaceutical Needs Assessment Jasmeen Islam, On Behalf of West Leicestershire CCG July 2014

West leicestershire Clinical Commissioning Group's recommends a greater role of community pharmacies that will support the CCG's commissioning strategy and to maximise the opportunities for the pharmacy profession to utilise skills that may be currently under-utilised.

Pharmacies accessing patient records will support enhanced and cohesive patient care and has an opportunity to be an enabler for pharmacists to support general practice and sharing care plans would be beneficial.

We would like to see services for minor ailments schemes implemented, even if this is initially in pilot form, across the CCG. There is tremendous potential for pharmacies to support patient access to GP practices and to free up time for GP practices through targeted minor ailment schemes.

Further recommendations in pilot form include, and potentially could be offered by any qualified provider:

Vaccination for housebound (hard to reach) patients Anti-coagulation services, including screening and detection of Atrial Fibrillation, warfarin clinics provided through independent pharmacist prescribers Monitoring services for drugs that are shared care across GPs and Specialists Pre-diabetes screening & testing, lifestyle advice and interventions that pharmacists can offer without the need to refer to a GP. Home blood pressure monitoring and supporting patient access to tele - health (Flo) Further development of community pharmacy out-of-hours services, including emergency supply of medicines and advice Support for inhaler technique and ensuring patients inhaler medication is optimised, also through the implementation of FeNO (Fractional Exhaled Nitric Oxide) diagnostics to support a measure of airway inflammation and adherence to medication. Integration with multi-disciplinary team meetings within virtual wards to support proactive care Support across the primary and secondary care interface to reduce harm from medicines through post-discharge medicines use reviews

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and medicines reconciliation.

We also believe that the whole community pharmacy team should be involved to support the strategies outlined here. So, for example, Health Care Assistants or Dispensers who have undertaken specific and relevant accreditation would support patient access to services and capitalise on the footfall to community pharmacies.

We would also like to highlight the document provided in the link below: http://www.pharmacyvoice.com/downloads/PV Community brochure AW 14 02 ll.pdf If this PNA is a lever to enable a real step change for the profession, to support the left shift and contribute to relieving 'Winter Pressures' the above would be a significant opportunity to do this, supporting not only the CCG but the wider health economy.