Agenda item

Report of the Director of Public Health, County Durham.

The Committee considered a report of the Director of Public Health that provided an update on pharmacy services in County Durham (for copy of report, see file of minutes).

A Healy, Director of Public Health, C Jones, Consultant in Public Health and G Morris, Community Pharmacy North East Central were in attendance to present the report.

The report described the work of the Health and Wellbeing Board where they continue to look at the availability of pharmacy services in County Durham that was done every three years as part of the pharmaceutical needs assessment process. They monitor the ongoing changes to the availability of pharmacy services for residents that was completed by a Pharmaceutical Needs Assessment steering group that was run by Public Health.

The report also provided details of a brief overview and links to the new national pharmacy service and general issues that pharmacies were facing.

Councillor Hovvels commented that pharmacies are carrying out more services such as injections. People are unable to obtain a doctor’s appointment and are using the pharmacies which was putting pressure increasing demand onto pharmacies. She had seen in her own community pharmacies going into liquidation and stated that the service was valued, and they needed to be protected. They need to do something about the financial envelope not being big enough and she indicated that they had her full support in taking this message to government. She stated that the first port of call for healthcare was often the pharmacy as you waited three weeks for a doctor’s appointment. She sympathised with the problems and indicated that if there was anything the committee could do to alleviate some of the pressure this should be supported as it was about providing good quality services for residents.

The Community Pharmacist thanked Councillor Hovvels for her support and recognising that they are individual businesses. He continued that one of the challenges was referrals to pharmacies and if patients were not referred from one of the agreed services funded under the pharmacy first contract they could not access the funding. It was essential that the funding of pharmacies reflected the demand and services delivered to patients.

Councillor Earley stated that pharmacies are the most under-used resource within the healthcare system. They needed to do everything they could to protect the service as pharmacies were going to have to do more and more and they needed to make pharmacy an attractive career or they were going to lose pharmacists.

The Community Pharmacist responded that in the North East they do struggle and have a workforce crisis and to encourage pharmacists to move to the North East was difficult. He stated that pharmacists come to the North East to train then head elsewhere and stated that if they do not reward them to stay, they leave. He continued that they had just negotiated a change in the pharmacy technician role who are taking on more duties to free the pharmacist up to carry out consultations, but they needed to keep those technicians and anything they could do to encourage young people to come into the world of pharmacy should be supported.

Councillor Howey stated that GP practices were taking on pharmacies and asked if this was impacting pharmacies in the community such as taking away some of the funding.

The Community Pharmacist responded that some pharmacies were working within GP practices who were doing optimisation work who could also write prescriptions, and this would be coming to pharmacies in the community. The PCN pharmacists are taking some of the prescribing work away from GPs and carrying out the optimisation work and some GP practices own and run a dispensary such as rural areas, but other practices own a community pharmacy. He commented that the market was stable in that space, the disruption was the large distant selling pharmacies that deliver through your letter box that was taking people away from local pharmacies.

Councillor Howey asked if the committee could write a letter to the Secretary of State asking if funding for pharmacies could be looked at.

The Principal Overview and Scrutiny Officer responded that if members wished to follow up on the concerns and comments, he could formulate a letter on behalf of the committee to be sent to the Secretary of State.

Ms McGee indicated that Healthwatch County Durham were undertaking some work on pharmacies this year and were looking at the effects of pharmacy first and how that works. She felt that pharmacies were in the firing line as the accessible face of primary care. She asked if this was a problem that was worse in County Durham or if it was nationwide.

The Community Pharmacist indicated that his personal view was that the North East and Cornwall were the two most difficult areas to recruit, Cumbria was also a challenge. If he looked at where the locum resource came from it was the bigger cities.

Councillor Haney endorsed the proposal to write a letter to the Secretary of State and indicated that he was concerned about the rise in online pharmacies and she should do everything they can to support local pharmacies.

The Community Pharmacist stated that if a pharmacy closes, they move across to the closest pharmacy and the pharmacy receives no additional funding to take on extra staff to meet the new demand. He asked when commissioning local services make the burden of how commission as light as possible as sometimes, they have to attend multiple training sessions and obtain DBS checks.

The Director of Public Health asked if a copy of the letter to the Secretary of State could be copied to the Chair of the Health and Wellbeing Board as the board has responsible for looking at the pharmaceutical needs assessment. She continued that they were working closely with colleagues across the North East and North Cumbria to look at other areas.

In response to a question from the Chair, the Community Pharmacist indicated that online medications were the same standards as a local pharmacy.

Councillor Savory asked if some literature could be circulated in poster form on the value of using pharmacies and how it impacts on the funding.

The Community Pharmacist responded that he would not be surprised if members did not see some literature coming out shortly.

In response to a question from Councillor Howey if a pharmacist would receive more money if she had been referred through the 111 service rather than walk in. The Community Pharmacist responded that if it was antibiotics, she would have ticked one of the seven boxes, but if it was say something in her eye than they would not get the referral in. He indicated that pharmacies should be allowed to see so many walk-ins as they currently carry out this service for no funding.

Resolved: (i) That the information contained in the report be noted.

(ii) That a letter be formulated and sent to the Secretary of State expressing this Committee’s concerns around the inadequacies of the existing Community Pharmacy funding arrangements.