Share your views on the East Sussex Pharmaceutical Needs Assessment

Closes 30 Jul 2022

Getting started

We welcome your feedback on our pharmaceutical needs assessment (PNA). Due to the length of the full PNA we have  created a short summary that covers the main points. If you would like to see a copy of the full PNA before you give your feedback please contact Nick Kendall (nick.kendall@eastsussex.gov.uk or 01273 336 079).

Summary of East Sussex PNA 2022

1. What is a Pharmaceutical Needs Assessment? 

Every three years the Health and Wellbeing Board for East Sussex, chaired by the leader of East Sussex County Council, asks for a Pharmaceutical Needs Assessment (PNA) to be written. The PNA is a report on all the NHS community pharmacies in the county. The PNA also includes those family doctors who are permitted to dispense medicines as a pharmacist would (known as Dispensing GPs). 

The main aim of the PNA is to find out if these pharmaceutical services are meeting the needs of the people of East Sussex. The government requires that an up-to-date PNA is published by October 2022 at the latest, covering the period from 2022 to 2025 inclusive. Everyone living in East Sussex, or who has links with East Sussex, has a chance to comment on the PNA when it is in draft form. 

The NHS, including NHS England and NHS Improvement, will use the PNA to work out if any changes are needed in pharmacy services in East Sussex, in particular if there is a need for any new pharmacies to be opened. The East Sussex Public Health Team and the Integrated Care Board will also use the PNA when commissioning services from pharmacies. 

2. Types of services in pharmacies 

Community pharmacies provide different types of services. Some are services that they must provide, and others are optional. 

The ‘essential’ services, which an NHS pharmacy must provide, include the dispensing of medicines, the disposal of unwanted medicines, promotion of healthy lifestyles campaigns, and reducing medicines risks when patients have just been discharged from hospital.  

Pharmacies can choose to provide various ‘advanced’ NHS services with additional professional training. These include: administering flu jabs each year, and the ‘Community Pharmacist Consultation Service’ in which the pharmacist provides medicines advice as a GP would, together with providing replacement medicines when needed. The New Medicines Service provides extra advice to help someone who has just been prescribed a new medicine. 

The other advanced services are:

  • Appliance Use Review (pharmacies and DACs) to support patients in the use, safe storage and disposal of appliances
  • Stoma Customization Service (pharmacies and DACs) to ensure the proper use and comfortable fitting of the stoma appliance
  • Community pharmacy hepatitis C antibody testing service 

The Public Health Team at East Sussex County Council also pays for other local services from some pharmacies such as emergency hormonal contraception (sometimes called the ‘morning after pill’), supply of clean needles for people who are injecting drugs and help with treatments for people who are trying to recover from serious drug addiction. 

East Sussex Clinical Commissioning Group (the local NHS) also pays for a palliative care service that ensures that there is a stock of key drugs available for doctors and nurses to access when managing end-of-life care.

Pharmacies remained open throughout the COVID-19 pandemic and have supplied free rapid tests (lateral flow tests) for COVID-19. Some have provided and may continue to provide vaccination against the COVID-19 virus in future. 

3. Local commissioners and providers of services 

The PNA describes the many organisations working together in the health and social care community in East Sussex.

These include: 

  • East Sussex County Council 
  • East Sussex Clinical Commissioning Group (CCG)
  • General Practitioners 
  • Local hospitals 
  • Local voluntary groups 
  • NHS England 
  • Local Pharmaceutical Committee (East Sussex)
  • Local Medical Committee (Surrey and Sussex)
  • Healthwatch East Sussex 
  • Wealden District Council 
  • Rother District Council 
  • Lewes District Council 
  • Hastings Borough Council 
  • Eastbourne Borough Council

4. How has the East Sussex PNA 2022 report been created? 

The East Sussex Health and Wellbeing Board delegated responsibility for the PNA to the Director of Public Health (DPH). The work has been undertaken by the public health department under the guidance of a Steering Group. 
The Steering Group started meeting in February 2021. The membership includes people from NHS England and Improvement South-East, East Sussex Clinical Commissioning Group (CCG), the Local Pharmaceutical Committee, and the Local Medical Committee. 

The Steering Group has been responsible for overseeing the writing of the PNA and for approving the draft version shared in the consultation. The final PNA will be submitted to the East Sussex Health and Wellbeing Board in September 2022 for review. 

5. How we looked at the information for East Sussex for the PNA 

We examined standard public health indicators describing the health and wellbeing of people in East Sussex. We worked out how close people are to pharmacies and how long it takes them to travel from home to get to the nearest one. We did this for the current situation and considered the situation as we think it might be in 2025, when new homes will have been built in the county. 

Our Steering Group has agreed that people should be within 30 minutes’ travel time of a pharmacy for a one-way journey, whether this is by walking, public transport or by car. Taking into account the health needs of each council area, we decided that if many people in an area seemed to be a lot farther away than this, we would call this a gap. We called this exercise our ‘Gap Analysis’. 

We used special software to do the ‘Gap Analysis’, known as Geographical Information Systems, and map where the pharmacies are. We used professional TRACC software to estimate journey times by car, public transport and walking during the week and at weekends. We also gathered local information from NHS England and NHS Improvement, the East Sussex Public Health team and East Sussex CCG. 

6. The Public Consultation 

The 60-day public consultation on the draft PNA is taking place from 1st June to 30th July 2022. The consultation is available online and hard copies are available by post for people who aren’t online or prefer to respond by post. 

7. The Gap Analysis: Are pharmacy services meeting people’s needs in East Sussex? Current situation 

The county of East Sussex has an estimated resident population of 563,167 in 2022. 

There are 99 community pharmacies in East Sussex. There are three distance-selling pharmacies located in East Sussex which can provide a service to people anywhere in England. Eight of these 99 community pharmacies are ‘100-hour pharmacies’, which are open for extended hours. 

Area

Number of community pharmacies

Eastbourne Borough

     20

Hastings Borough

     20

Lewes District

     18

Rother District

     17

Wealden District

     27

There are 105 community pharmacies outside East Sussex within 5 miles of our county border. People also have access to distance-selling, internet-based pharmacies anywhere in England, but customers cannot visit them in person. 

8.Changes since the last PNA

There are 10 fewer community and distance selling pharmacies in East Sussex than when the last PNA was published in 2017. At that point there were 112 pharmacies. 

The changes by area are: 

  • Eastbourne: There are two fewer pharmacies in Eastbourne Borough, both 40-hour pharmacies.
  • Hastings: There are two fewer 40-hour pharmacies. 
  • Lewes: There are two fewer pharmacies, both 40 hours.  
  • Rother: There are two fewer (one 40 hour and one 100-hour) pharmacies, but the district has gained one distance selling pharmacy.
  • Wealden: There are two fewer distance-selling pharmacies and the district has lost one 40-hour pharmacy.

9.GP dispensaries
Thirteen general practices in East Sussex are recognised as Dispensing GP practices. Some of the practices have more than one dispensing branch, meaning there are 16 GP dispensaries in total. 

Area

Number of Dispensing GPs

Eastbourne Borough

     0

Hastings Borough

     1

Lewes District

     0

Rother District

     8

Wealden District

     7

10.Essential services in East Sussex 

Community pharmacies are providing the essential services required by the NHS to all parts of East Sussex. 

11. Access to Essential Pharmaceutical Services in East Sussex. Current Situation. 

Overall, car owners living in East Sussex can reach a pharmacy within 30 minutes’ travel time on weekdays, although around 2,300 people (or 0.4% of the population) would have to drive more than 30 minutes on a Sunday.

However, not everyone has access to a car, so how does access change if you have to get to a pharmacy by public transport or walking? We wanted to understand how access might vary between different areas in East Sussex, so we looked at this for 57 electoral wards (these are the areas represented by district/borough councillors) where more than 15% of people don’t have access to a car and then considered travel times to a pharmacy by public transport and walking. We made the assumption that no one in those wards had access to a car when working out the numbers of people who might have difficulty accessing a pharmacy. There were 101 (pre-2018) wards in East Sussex overall.

Public transport

Around 42,800 residents of East Sussex (7.7%) cannot physically attend any pharmacy (including dispensing GP surgeries) during the day on a weekday within half an hour using public transport, and 29,300 of these people (5% of the county’s population) cannot access any pharmaceutical provision at all (defined as taking longer than two hours).  
The picture differs between the rural and urban areas of the county. 

In the urban areas of Eastbourne, or Bexhill and Hastings there isn’t an issue for most people with getting to a pharmacy using public transport during weekdays, or at weekends. 

In the more rural areas, it is a different picture. During the daytime in the week:

  • Lewes District: There are 152 people in total who do not have access (over two hours), during the daytime in East Saltdean [44 (less than 1%)], Lewes Bridge [27 (less than 1%)], Seaford East [23 (less than 1%], and Seaford North [58 (1.1%)] wards.
  • Rother District: There are 1,219 people in total with no access (over two hours), on a weekday daytime. Access is most limited in East Rother where 679 (13%) would not be able to reach a pharmacy in less than two hours. In the other wards the proportions are: Battle Town [365 (6.3%)], Rye [10 (less than 1%)], Sidley [139 (2.3%)] and St. Michael’s [26 (less than 1%)].
  • Wealden District: There are 355 people in total with no access (over two hours), on a weekday daytime in Hailsham Central [41 (less than 1%)], Hailsham East [205 (6.5%)], Polegate North [6 (less than 1%)] and Willingdon [103 (1.4%)].

These numbers increase in the evenings and at weekends, most noticeably in the Rother District.

Walking

Not everyone can afford, or will be able, to use public transport, so we also looked at walking times in those wards with low car ownership. Eighty-four per cent of East Sussex residents live within a half-hour walk of a pharmacy which is open on a weekday (including dispensing pharmacies in GP surgeries) during the day. However, this means that 91,900 people (16%) cannot access any pharmaceutical provision by walking for 30 minutes (one-way journey).

During the daytime in the week:

  • Eastbourne Borough: A total of 587 people could not access a pharmacy by walking in a one-hour round trip in Meads [321 (2.7%)], Old Town [188 (1.7%)] and Ratton [78 (less than 1%)] wards.
  • Hastings Borough: A total of 242 people could not access a pharmacy by walking in a one-hour round trip in Ore [102 (1.9%)], and West St. Leonards wards [140 (2.7%)].
  • Lewes District: A total of 3,368 people could not access a pharmacy by walking in a one-hour round trip in East Saltdean [154 (2.0%)], Lewes Bridge [134 (2.6%)], Lewes Priory [50 (less than 1%)], Newhaven Denton [46 (less than 1%)], Peacehaven East [377 (6.0%)], Seaford East [1,372 (28.6%)], Seaford North [1,093 (20.5%)] and Seaford South [142 (3.1%)].
  • Rother District: A total of 6,370 people could not access a pharmacy by walking in a one-hour round trip in Battle Town [1,238 (21.3%)], East Rother [4,722 (94%)], Rye [20 (less than 1%)], Sidley [329 (5.4%)] and St. Michaels [61 (1.2%)].
  • Wealden District: A total of 1,285 people could not access a pharmacy by walking in a one-hour round trip in Hailsham Central [104 (1.7%)], Hailsham East [448 (14.3%)], Hailsham South [300 (3.4%)], Polegate North [79 (1.1%)], Uckfield New [44 (1.5%)], Uckfield North [128 (2.3%)] and Willingdon [182 (2.4%)].

Opening Hours at weekends: Seven pharmacies in East Sussex are closed on Saturday mornings, whilst 54 of the 99 are closed on Saturday afternoons. On Sundays, as well as the eight 100-hour pharmacies, there are 12 other pharmacies open.

We concluded that it can be more difficult to access essential pharmacy services during weekday evenings and over the weekend, particularly in the more rural parts of East Sussex.

12. The Gap Analysis: Will pharmacy services continue to meet people’s needs in East Sussex? Future Situation 2022 to 2025. 

The population is continuing to grow. In total, 7,962 new homes are planned in East Sussex for the period April 2022 to April 2025. 

Local population projections suggest that the population of East Sussex will grow by 2.2%, from 563,167 in 2022 to 575,544 by 2025. This is an increase of 12,376 people. 
Housing Development in East Sussex: We found that proposed new housing developments in East Sussex in the period up to 2025 would have acceptable general access to pharmacies. There is not one proposed large housing development in any given ward or parish that would justify the need for a new pharmacy.

13.Advanced Services in East Sussex. Current Situation

The coverage of the New Medicine Service (NMS) in pharmacies across East Sussex is very good, with only a few pharmacies not providing this service. 

Most pharmacies in East Sussex have contracted into the Community Pharmacist Consultation Service (CPCS). This service allows patients to consult with a pharmacist as an alternative to a GP appointment when appropriate. The number of people using this service every day in East Sussex is moderate and can be expected to increase as referrals into the service increase from general practice and A&E. 

14. Local Services Commissioned by East Sussex Public Health. Current Situation. 

Emergency Hormonal Contraception (EHC): The aim of the emergency hormonal contraception service for women is to reduce the risk of unintended and unwanted pregnancy. EHC is currently available in 44 out of 99 pharmacies in East Sussex. General practitioners also provide access to EHC where there is no pharmacy service provided.

Needle exchange: Needle and syringe programmes reduce the risk of individuals harming themselves by picking up infections from dirty or shared equipment. The needle exchange service is currently available in 34 out of 99 pharmacies in East Sussex. 

Supervised consumption: The aim of this programme is to help users addicted to opioids, such as heroin, by reducing their feelings of craving and by reducing withdrawal symptoms. A doctor prescribes a substitute opioid medicine, and the pharmacist supervises the patient in consuming it. Supervised consumption is currently available in 56 out of 99 pharmacies in East Sussex. 

15.Locally Commissioned Services: Services Commissioned by East Sussex CCG. Current Situation. 

There is a palliative care service which is commissioned from pharmacies by the CCG. This improves the availability of essential drugs for end-of-life care.

16.What did we learn from the public consultation on the PNA? 

This section will be completed after the public consultation is concluded. 

A public survey of over 2,000 residents in each of the Districts and Boroughs in January 2022 has already been included in our PNA. It has given us valuable insight into how people obtain medicines and what people feel about community pharmaceutical services. 

In the residents’ survey the majority of respondents (81%) most commonly use pharmacies between the hours of 9am and 6pm during the week. This pattern is reflected across all five county districts, and over 90% say their needs are met by those opening hours.

17.Discussion 

We have done our best to write the PNA with thoroughness, attention to local detail, and with transparency, while working closely with colleagues around East Sussex. We have used recommended analytical software to help us, which has given us a good overview of the situation in the county. 

We are confident in the information we have gathered, but we recognise that more insight can be obtained from local communities.

18. Recommendations 

The PNA Steering Group proposes to recommend the following to the East Sussex Health and Wellbeing Board and its partners, including NHS England and NHS Improvement South-East. 

Please note that these are summarised versions of the recommendations. The full details can be found in the full document, which is available on request. 

Recommendations relating to possible needs and gaps: 

(i)    The PNA has not identified gaps in general access during the daytime on weekdays in the present situation in East Sussex.

(ii)    Improving current choice of essential dispensing services in the evenings and weekends could be achieved by consideration of commissioning an extended hours service on a rota basis, particularly in Lewes, Rother and Wealden council areas.

(iii)    The Discharge Medicines Service needs to be promoted and closely monitored by commissioners.

(iv)    If there were to be an increase in contracted GP surgery hours to 8pm on weekdays and to Saturday afternoons from October 2022, then there may be a need for commissioners to consider commissioning an extended hours service.

(v)    Better access to necessary services in evenings and at weekends could also be enabled by improvements in public transport in rural East Sussex.

(vi)    Housing development may increase future need for services, but not sufficiently in any one ward or parish to justify a new pharmacy within the lifetime of the current PNA.

Pharmacists and commissioners should: 

(vii)    Explain to the public the pharmacist’s extended professional role in support of minor conditions, to give medicines advice, and in prevention campaigns, as well as providing the mainstream services of a community pharmacy. 

(viii)    Provide clear information in the pharmacy that the role of pharmacists is to provide information and support and make it clear to customers which members of staff are qualified pharmacists. They should actively encourage the public to ‘ask your pharmacist’. 

(ix)    Address issues highlighted with some residents’ experience of customer service. 

1. Which document is your feedback based on?
(Required)