This report seeks the approval of members for the publication of the 2022 Herefordshire Pharmaceutical Needs Assessment (PNA) on 1 October 2022 (the statutory deadline).

The chair introduced the final draft version of the Pharmaceutical Needs Assessment (PNA) for approval by the board, it was explained that a 60-day consultation period was still in effect and that the report would be subject to any amendments in relation to responses that may be received in the final days of the consultation.

Emma Lydall (Public Health Training Specialist Registrar), provided a detailed verbal presentation on the report based on the slides included in the agenda Herefordshire 2022 PNA HWB Presentation.

The board asked questions about:

-          The possibility of returning to the report in 18 rather than 12 months, to allow adequate time to monitor the impact of the changing role of the pharmacist?

-          Whether the review covered off anything about the value for money of the services that were already commissioned?

-          Who was responsible for ensuring the recommendations within the report were actioned and who was responsible for feeding back?

The registrar explained that a PNA working group was going to be established in Herefordshire and Worcestershire and that public health would work closely with this group and feedback to the Health and wellbeing board (HWB).

Matt Pearce (Director of Public Health, Herefordshire) explained that it fell to the HWB to provide a level of assurance. The actual delivery of the recommendations would be overseen by the public health team and partners and then approval would be sought from the HWB.

Jane Ives (Managing Director Wye Valley NHS Trust) felt that the relative urgency of the recommendations meant that it would be prudent to come back to them in 12 months rather than 18.

The director of public health noted that many papers were recommending the formation of task and finish groups and that in these instances a joined up approach with Worcestershire would be advisable as there would be potential shared ambitions.

The director of public health emphasised the importance of maximising the use of pharmacies, and noted that they have a great reach especially in deprived communities.

The chair suggested that it was important that new GP surgeries should, whenever possible, have a pharmacy in them.

David Mehaffey (Director for Integrated Care System Development) noted the slide in the presentation pack with the map detailing 10 minute travel times. This showed the reach of Herefordshire facilities across the border of other counties, but did not show their reach into Herefordshire. It was possible that this gave a distorted view of the health inequality gap.

The registrar acknowledged that the report did only look at Herefordshire pharmacies, but that it might be possible to look at the cross-border picture. However, the population of Herefordshire was adequately serviced by pharmacies and dispensing practices.

The registrar and director for ICS agreed that more work on cross-county reach would be a valuable addition to the mapping of future assessments.

Councillor Diana Toynbee noted that pharmacies are businesses and enquired as to whether if a pharmacy decides to close there is any leverage to stop this happening.

The registrar deferred to the director of public health for an answer. The director said he understood that the pharmacies had to get permission to close from NHS England, but it they’re not financially viable there might not be a choice. The director said he would take the question away and seek a definitive answer.

The managing director Wye Valley NHS Trust emphasised the importance of working jointly with Worcestershire when it was appropriate and cost-effective to do so.

The board agreed to keep the annual review timeline in place.

The report recommendations were proposed and seconded and approved unanimously:

RESOLVED:

That:

a) Members note the PNA consultation responses received to date.

b) Members are asked to note the consultation responses received to date (Appendix 1) and to delegate final approval for publication to the PNA working group, subject to any minor or technical amendments recommended by the working group.