The Brighton and Hove Pharmaceutical Needs Assessment (PNA) 2022 is the Health and Wellbeing Board’s statutory duty. It looks at how well the community pharmacy services are meeting the health needs of the city’s residents. NHS Sussex and NHS England commission these services.
The PNA informs the submission of applications for community pharmacies’ inclusion in a pharmaceutical list, and the outcomes of such applications.
It also determines whether:
We can use the PNA to guide other local planning in relation to pharmacy services.
This PNA has been structured according to statutory definitions. The content and services included are statutory requirements.
The Board carried out a phone survey of a representative sample of residents in Brighton and Hove. This gathered information on how well pharmacy services were meeting resident needs. Written surveys of local pharmacies and GP practices were also carried out to get their feedback on relevant issues.
The PNA report, and summary report, were also open for consultation with residents and key stakeholders for the statutory 60 days.
The Health & Wellbeing Board must approve the final PNA report. After this, the Brighton & Hove Public Health and Pharmacy Forum will oversee the progress of any recommendations from the PNA.
The Brighton & Hove population was 291,700 in 2020. It is expected to increase to 297,800 by 2025, an increase of 2%.
Older people aged 65 to 84 and 85 plus are predicted to increase most. This will correlate with an increasing number of adults with multiple long-term conditions.
The overall proportion of older people and children in the city is lower than the national average. However there is a relatively high proportion of younger adults in the city. A fifth of the city’s total population is aged 19 to 28.
The health profile of Brighton & Hove residents is poorer than the national average in some areas. These include smoking, sexually transmitted infections and vaccination uptake.
Community pharmacies play an important role in the provision of:
It remains important that pharmacies are able to support needs in these areas.
Compared with England, Brighton and Hove has more single person households, including single pensioner households. It may be more difficult for these households to access community pharmacies. The city overall also has significantly lower car or van ownership than the South-East or England. This varies greatly across city areas, with lower car ownership for households in the city centre.
A telephone community survey of a sample of 1,000 residents representative of the population was conducted during February and March 2022.
Respondents reported that they mainly choose which pharmacy to use based on proximity to their home, GP surgery or place of work.
Walking (54%) is the main mode of transport used by residents to reach their most often used pharmacy. This is ahead of travelling by car (29%), and public transport (9%).
Nearly all city residential areas are within a 20-minute walk of a community pharmacy. All city areas, except for Stanmer Village, are within 20 minutes of a pharmacy by public transport. All residential areas are within a 10 minute drive of a pharmacy.
Poor health is more likely to be experienced by residents living in deprived areas. As outlined in Section 4.3 of the main report, on the whole, the most deprived areas in the city have a pharmacy within the locality or nearby. However, for three of the city’s more deprived neighbourhoods (East Moulsecoomb, Craven Vale and the Bristol Estate) there is no pharmacy in the immediate locality.
There are fewer pharmacies open later in the evenings in the city, compared to the 2018 Pharmaceutical Needs Assessment:
Tesco Pharmacy at the Holmbush Shopping Centre, Shoreham, provides Emergency Hormonal Contraception. It is open until 8pm six days a week, although it is about 1.5 miles to the west of the city and is not an NHS service.
There is only one pharmacy in Brighton & Hove that provides a late-night emergency hormonal contraception service. It is open until 8pm Monday to Wednesday and on Saturdays, and until 9pm on Thursday and Friday. Younger people responding as part of the community survey reported that they would like to use community pharmacy services on weekday evenings after 8pm and on Sundays. There is a recommendation to expand access for this and in particular for emergency hormonal contraception services.
29% of community survey respondents strongly agreed, and another 55% agreed, they can find, and use, an open pharmacy in Brighton & Hove when they need one. A total of 84%.
Between 2022/23 and 2024/25 the Hove Station and Brighton Station/London Road areas will see the largest amount of new housing supply. The Hove Station development could potentially affect demand for pharmacies in the area.
Community pharmacies are reasonably well spread across the city. More are present in more densely populated areas. However, not all services are available in all pharmacies. One example of this is the lack of smoking cessation services in pharmacies in Portslade.
Pharmacy provision is changing with increasing numbers of distance selling pharmacies providing medications for residents.
Since the last PNA a number of new services such as Covid-19 vaccinations and lateral flow tests have been commissioned and delivered by community pharmacies. Some of these including, lateral flow test provision, have now ceased. Covid-19 vaccination provision continues in four pharmacies.
Public satisfaction with pharmacies remains high. 92% survey respondents reporting they are very or fairly satisfied with pharmacy services. This is an increase in satisfaction since the 2018 PNA. This is despite a reduction in the number of pharmacies in the city from 58 in 2018 to 53 (including one distance selling pharmacy) in 2022. Although there is no national guidance around how many pharmacies should be provided per 100,000 residents, there are currently 17.8 community pharmacies per 100,000 residents living in the city. For comparison the number is 17.6 in East Sussex and 18.0 in West Sussex.
Although there has been an increase in the number of prescriptions, there are reported to be enough pharmacies to fulfil the flow of prescriptions. Of all pharmacies responding to the survey:
Eight out of 11 GPs responding to the GP survey were very or fairly satisfied with the pharmacy they use most. However, two GPs were very dissatisfied.
The PNA has found from the GP survey that there is a lack of knowledge in GP practices of all of the services delivered by pharmacies. This is including essential, advanced and public health services.
Overall it was found that there is good communication between GP practices and community pharmacies. However, Improvements can be made in terms of information sharing regarding services available.
There is a need to consider the opening hours of pharmacies overlapping with GP practices.
There was support expressed through the consultation on the draft PNA report for the ongoing development of the range of services that pharmacies can offer. This is to take pressure off GPs and urgent and emergency care. These could include for example:
However, some potential services, for example the provision of fit notes, are not currently possible due to a lack of access to GP-held patient records.
Nationally and locally, pharmacy numbers have seen a net decrease over the last couple of years. However, the assessment from the PNA Steering Group is that there is no gap in community pharmacy provision resulting in the need for additional pharmacies.
There are recommendations for developing, and in some cases extending, provision of services in current pharmacies.
The Community Pharmacy Contractual Framework in place for 2019-2024 sets out the renumeration for community pharmacy contractors. Pharmacy contractors have had cuts to their funding over the last few years. Combined with an increase in costs, this has the potential to close some pharmacies in the future.
The recommendations below take into account the need for community pharmacies to attract enough custom to operate as functioning businesses. At the same time, increasing the range of services pharmacies are commissioned to provide depends on the capacity of staff within those pharmacies to provide additional services.
There is overarching support for the ongoing work to further integrate pharmacies and pharmacists into primary care clinical services. This will be enabled if:
The Brighton & Hove Flu and Covid-19 Programme Board to consider how community pharmacies can work more closely with GP practices and others in offering and increasing the uptake of the NHS flu vaccination. This is particularly important for staff and residents in care settings.
NHS England and NHS Sussex Integrated Care Board to consider commissioning Pneumococcal Polysaccharide Vaccine (PPV) and shingles vaccinations via community pharmacy. This would maximise delivery alongside the flu vaccination in pharmacies, increasing uptake.
NHS England and the Sussex Integrated Care Board to increase the number and geographical spread of community pharmacies delivering Covid-19 vaccinations. This is to increase access across the city and uptake of Covid-19 vaccinations (including uptake by children). It is also in response to high satisfaction of pharmacy services.
Sussex Integrated Care Board / Integrated Care System and NHS England to review extending the commissioning and provision of evening pharmacy provision. The existing provision is after 8pm Monday to Wednesday and Saturday, after 9pm Thursday and Friday, and after 6pm on Sundays. To improve evening pharmacy provision, a rota service could be commissioned within existing community pharmacies in the city (which operates for longer hours than the core contract of 40 hours).If commissioned, consideration should be given to how the rota service is communicated. Feedback from health services and residents is that a lack of available pharmacy services in the evenings is having an impact on access to health and care. The review should also take into consideration the opening hours of GP practices and a review of whether community pharmacy hours for existing pharmacies need to overlap with GP practice opening hours.
Public health commissioners to review opportunities for pharmacies that are open after 6pm to provide the emergency hormonal contraception service. This would improve accessibility in Brighton & Hove.
NHS England and the Sussex Integrated Care Board to review pharmacy commissioning and capacity in areas with significant increases in future housing developments. Despite increases in housing developments, there is currently considered to be no gap in community pharmacy provision. With a projected population increase, this should be kept under review.
Public health commissioners to review the provision of the stop smoking, Young Persons and Domiciliary Stop Smoking services.They are to support community pharmacies to re-establish these services and encourage their uptake.
NHS England, the Sussex Integrated Care Board and public health commissioners to ensure that stop smoking service pathways are joined up and communicated to people wishing to stop smoking. Other health/social care providers should be made aware of referral pathways into stop smoking services.
NHS England and the Sussex Integrated Care Board to review the need for the community pharmacy Hepatitis C Antibody Testing Service in Brighton and Hove, based on population health needs. They are also to review the commissioning of substance misuse services and to support increasing uptake.
The Community Pharmacy and Public Health Forum to increase participation of Brighton and Hove-commissioned Healthy Living Pharmacies in local health promotion campaigns. They can also encourage increased signposting/referrals into related services such as weight management and drug and alcohol support.
Sussex Integrated Care Board to deliver a communications and engagement campaign to increase utilisation of the newly commissioned hypertension case-finding service, and other new services in community pharmacies. Increasing communications and engagement will lead to increase in the take up of new services. It will also lead to an increase in detection of hypertension, improving cardiovascular disease prevention in the city.
Sussex Integrated Care Board to look at the development and commissioning of new services to be delivered by community pharmacy that result in taking pressure off GP practices and urgent and emergency care. Part of this work is to review the case for developing a urinary tract infection service in community pharmacies. This is in order to improve patient access and reduce pressure on urgent care pathways.
Sussex Integrated Care Board and NHS England to review the needs of residents with disabilities in accessing community pharmacy services in Brighton and Hove. This should build on the findings from the previous PNA (2018) including:
Public health to ensure that the publication of the PNA report adheres to the Public Sector Bodies (Websites and Mobile Applications) (No.2) Accessibility Regulations 2018.
Sussex Integrated Care Board and NHS England to ensure different methods of communicating services in community pharmacies are available to people without internet access.
Sussex Integrated Care Board and NHS England to ensure people with English language needs are aware of the interpreter/translation service available in the city. This is for use in any health and care setting including community pharmacy.
The Brighton & Hove Community Pharmacy and Public Health Forum to agree how to improve GP practice knowledge of services in community pharmacies in order to increase signposting and referrals by GP practice staff to community pharmacies. This includes referrals for all essential, advanced and locally commissioned services.
NHS Sussex Integrated Care Board, NHS England, Brighton and Hove City Council and East and West Sussex Councils to work together to increase public understanding of community pharmacy provision to better communicate across boundaries pharmacy provision including health promotion and prevention services.
NHS England to explore with NHS Digital the possibility of including a wider range of options on the Find My Pharmacy website, so that all services being provided at community pharmacies can be shown. Also to ensure information about accessibility issues (for example ramps, lifts etc) for disabled people are covered.
NHS England to ensure that community pharmacies keep pharmacy information on NHS websites up to date. This is in line NHS Profile Manager guidance and Accessibility standards 2018.
Sussex Integrated Care Board and Brighton & Hove City Council to review how the Community Pharmacy and Public Health Forum fits with the new Sussex NHS structures and the integration of the commissioning of local pharmaceutical services and ensure involvement of community pharmacy in the development of health and wellbeing strategic plans.
NHS England, the Integrated Care Board and the Community Pharmacy and Public Health Forum to ensure commissioned and delivered services are operating in line with NHSE ‘Core20plus5’ approach to address health inequalities.
NHS and Brighton & Hove City Council commissioners and community pharmacies to consider how to encourage, incentivise or commission community pharmacies to undertake further action on becoming carbon neutral. Plans to be monitored by the Community Pharmacy and Public Health Forum.
The Community Pharmacy and Public Health Forum to work with the council’s Sustainability Team to support community pharmacies and those using them to contribute further to carbon reduction.
The purpose of the PNA is to assess and set out how pharmaceutical services can meet the health needs of the population of the Brighton & Hove Health & Wellbeing Board’s area. This will be for a period of up to three years, linking closely to documents in the Joint Strategic Needs Assessment.
Whilst reports in the Joint Strategic Needs Assessment will focus on the general health needs of the population of Brighton & Hove, the PNA looks at how those health needs can be met by pharmaceutical services commissioned by NHS England.
The PNA informs the submission of applications for inclusion in a pharmaceutical list, and the subsequent determination of such applications. The regulations require PNAs to include statements of the pharmaceutical services that the HWB has identified, and these are listed in Appendix A - Section 14.1.
The methodology used for carrying out this PNA is described in Appendix B in Section 14.2.
If a person (a pharmacy or a dispensing appliance contractor) wants to provide pharmaceutical services, they are required to apply to NHS England to be included in the pharmaceutical list for the Health & Wellbeing Board’s area in which they wish to have premises.
In general, their application must offer to meet a need that is set out in the Health & Wellbeing Board’s PNA, or to secure improvements or better access similarly identified in the PNA. However, there are some exceptions to this, such as applications offering benefits that were not foreseen when the PNA was published (‘unforeseen benefits applications’).
In April 2016, NHS England published (updated in April 2019) the Pharmacy Manual which outlines the procedures to be followed which are relevant to pharmacy contractors, including market entry such as applications to join the pharmaceutical list, change of ownership and no significant change relocation.
As well as identifying whether there is a need for additional premises, the PNA will also identify whether there is a need for an additional service or services, or whether improvements or better access to existing services are required. Identified needs, improvements or better access could either be current or will arise within the three year lifetime of the pharmaceutical needs assessment.
Whilst the PNA is primarily a document for NHS England and in the future Integrated Care Systems (ICS) to use to make commissioning decisions, it may also be used by local authorities.
Following advent of the new Health and Care Bill 2022, from 1 July 2022 Clinical Commissioning Groups will be abolished and Integrated Care Boards (ICBs) and Integrated Care Partnerships will be established across England. Commissioning responsibilities for community pharmacies will be delegated to ICBs and Integrated Care Systems for early adopters from 1 July 2022.
Sussex ICS is an early adopter along with:
It is planned a central hub will be hosted by Surrey Heartlands ICS for administration purposes.
There will be a committee in common with membership of senior officers represented from each of the six systems in the South East as well as NHSE. The whole system and process will be reviewed by NHSE and the ICBs after at least six months of operating.
A robust PNA will ensure those who commission services from community pharmacies and dispensing appliance contractors target services to areas of health need and reduce the risk of overprovision in areas of less need.
As part of community pharmacy commissioning, NHSE has established the ‘Core20PLUS5’ approach to support the reduction of health inequalities at both national and system level (NHS England - Core20PLUS5 - An approach to reducing health inequalities).
The approach defines target population cohorts as follows:
The most deprived 20% of the national population as identified by the national Index of Multiple Deprivation (IMD). The IMD has seven domains with indicators accounting for a wide range of social determinants of health
Integrated Care System (ICS)-determined population groups experiencing poorer than average health access, experience and/or outcomes, but not captured in the ‘Core20’ alone. This should be based on ICS population health data.
Inclusion health groups include: ethnic minority communities, coastal communities, people with multi-morbidities, protected characteristic groups, people experiencing homelessness, drug and alcohol dependence, vulnerable migrants, Gypsy, Roma and Traveller communities, sex workers, people in contact with the justice system, victims of modern slavery and other socially excluded groups.
The final part sets out five clinical areas of focus. Governance for these five focus areas sits with national programmes; national and regional teams coordinate local systems to achieve national aims:
The Brighton & Hove Community Pharmacy and Public Health Forum encourages and supports collaborative working between:
The overall aim is to improve health and wellbeing outcomes for patients, service users, carers and local residents.
The Forum strengthens efforts to improve health and wellbeing outcomes for people living in Brighton & Hove to reduce health inequalities, specifically covering the delivery of public health campaigns and quality, cost effective locally commissioned public health services.
Since 1 April 2013 every Health & Wellbeing Board (HWB) in England has a statutory responsibility to publish and keep up to date a statement of the need for pharmaceutical services in its area, otherwise referred to as a Pharmaceutical Needs Assessment (PNA).
PNAs should be published every three years, but due to the impact of the Covid-19 pandemic the deadline for publication of the latest version has been moved to 1 October 2022.
The NHS Pharmaceutical Services Regulations 2013 give the criteria that NHS England (NHSE) must consider whilst dealing with new applications; many refer to the contents of the PNA.
Changes were made in December 2021 to the Regulations (NHS - Charges, Primary Medicinal Services and Pharmaceutical and Local Pharmaceutical Services - Coronavirus - Further Amendments - Regulations 2021 - SI 2021 No. 1346, and make amendments to the NHS - Pharmaceutical and Local Pharmaceutical Services - Regulations 2013 - the Regulations.
The National Enhanced Service (NES) was introduced where NHS England (NHSE) commissions an Enhanced Service with a service specification that sets standard conditions nationally.
Pharmaceutical Services Negotiating Committee becomes the body consulted on the service and its funding, rather than one or more Local Pharmaceutical Committees (LPCs).
In many ways a NES equivalent is already in place with the national coronavirus vaccination Local Enhanced Service; the regulatory changes provide a better structure for what is already happening.
LPCs will continue to be consulted on Local Enhanced Services (LESs).
Enhanced Services are agreed between NHSE and individual contractors/pharmacies. This means both that contractors can choose whether to deliver the service and NHSE can choose whether it wants a specific contractor/pharmacy to deliver the service.
The Contractors’ Terms of Service have been revised to allow NHSE to introduce a pandemic response programme.
A Listed Prescription Item Voucher (LPIV) scheme has been introduced, as a further option for the community pharmacy supply of treatments or medicines during or in anticipation of pandemic disease. This may be used for the supply of medicines without charge to the patient.
Contractors may supply a Patient Only Medicine (POM) to a person in accordance with a Pandemic Treatment Protocol (PTP) or Pandemic Treatment Patient Group Direction (PTPGD), if and when one is issued by NHSE.
The publication date for PNAs of 1 October 2022 has been added to the regulations. In addition, there were changes to the Regulations to allow:
Further information on the Health & Wellbeing Board’s specific duties in relation to pharmaceutical needs assessments and the policy background to pharmaceutical needs assessments can be found in Appendix A - see Section 14.1.
Following publication of its first pharmaceutical needs assessment, the Health & Wellbeing Board must, in summary:
The services that a pharmaceutical needs assessment must include are defined within both the National Health Service Act 2006 and the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013, as amended.
Pharmaceutical services may be provided by a:
In Brighton & Hove, as of January 2022, there were 53 pharmacies (including one distance selling pharmacy) and no dispensing practices. Pharmacy contractors may operate as either a sole trader, partnership or a body corporate and the Medicines Act 1968 governs who can be a pharmacy contractor.
The General Pharmaceutical Council (GPhC) set standards for pharmacy professionals and pharmacies to enter and remain on the GPhC register. As well as meeting GPhC standards, the pharmacy owner must make sure they comply with all legal requirements including those covering medicines legislation, health and safety, employment, data protection and equalities legislation. These standards also lay out for patients and the public what they should expect when they receive pharmacy services from registered pharmacies and the patients/public can make reference to the standards to raise any issues they might have.
This is the third PNA to be published in Brighton & Hove. The second was published in 2018. These PNAs have been published on the dedicated local intelligence Brighton & Hove Connected website.
Findings from previous assessments showed that:
The 2018 PNA’s recommendations and the current status of progress are shown in Appendix D in Section 14.2.
Since the publication of the last PNA there have been changes in the number of community pharmacies, as reflected in the supplementary statement, published in April 2021 alongside the 2018 PNA.
In a recent report (PSNC Briefing 013/22: Summary of the results of PSNC’s 2022 Pharmacy Pressures Survey) the Pharmaceutical Services Negotiating Committee (PSNC) describes findings from a national survey of pharmacy owners and team members carried out in early 2022.
The following issues were reported:
The CCG delivers local health services in the city structured within geographical areas known as Primary Care Network (PCN) localities.
NHS Brighton & Hove Clinical Commissioning Group (BHCCG) is a GP led statutory NHS body responsible for the majority of health services for local people. BHCCG commission local health services including mental health care, urgent and emergency care, elective hospital services and community care for the population of Brighton & Hove. Brighton & Hove PCNs are:
PCNs build on the core of current primary care services and enable greater provision of proactive, personalised, coordinated and more integrated health and social care.
They are based on GP registered lists typically serving communities of around 30,000 to 50,000. Figure 1 shows which GP surgeries fall within each PCN as of June 2022.
There are no controlled localities in Brighton & Hove, and no dispensing GPs.
This section describes the demography of people in Brighton & Hove, and includes population estimates and projections and resident profiles.
We sourced the majority of the data in this chapter from various documents available from the Reports and Needs Assessments pages of the Local Intelligence webpage hosted by Brighton & Hove Connected.
Population size, structure and composition are crucial elements in any attempt to identify measure and understand health and wellbeing. It is important to know how many people live in an area and their demographic characteristics such as age and gender.
According to the Office for National Statistics (ONS) the latest mid-year population estimate (2020) show there are 291,700 residents in Brighton & Hove.
This is an increase of 900 people (0.3%) compared to 2019 and 7,700 people (2.7%) compared to 2015. Between 2015 and 2020 the city has seen a similar increase in its population as the South East (3.0%) and England (3.2%).
In Brighton & Hove it is estimated that 44,800 people (15%) are aged 0 to 15 years, more than two thirds (71%, 208,000 people) are age 16 to 64 years, just over one in ten (11%, 33,100 people) are aged 65 to 84 years, and 5,900 people (2%) are aged 85 years or older.
This compares to the South East (19%, 61%,17% and 3% respectively) and England (20%, 62%, 16% and 2% respectively). So while there are a lower proportion of children in the city, there are also a lower proportion of older people, giving the city a different age-structure to England and the South East (see Figure 2).
Source: 2020 ONS mid-year population estimates
The population of Brighton & Hove is projected to increase from 291,700 in 2020, to 297,800 by 2025, an increase of 2% (see Table 2).
Older people aged 65 to 84 and 85 plus are predicted to increase most with only school aged children predicted to decrease.
The city is a destination for migrants (people living or intending to live in the city for 12 months or more) from outside the UK. The latest ONS figures (2020) estimates that 55,000 residents (19%) were born outside of the UK. This is similar to 2019 (53,000 people, 18%). ONS migration statistics at the local authority level are subject to large confidence intervals. For Brighton & Hove the figure is +/- 13,000 people, therefore the true number of migrants in the city will be between 42,000 and 68,000 people (14% - 23%)
The city population is highly transient with one in five residents (20%, 54,885 people) having moved address within the last 12 months.
Brighton & Hove has a relatively even gender distribution until the age of 75. In 2020 there were estimated to be 147,100 male (50%) and 144,600 female (50%) residents in the city.
There was a relative even distribution (+/-4 percentage points) of males and females across all ages up until the age of 75 years. Beyond the age of 75 years the proportion of female residents increases, similar to the picture across England.
There were an estimated 18,300 residents aged 75 or older, of whom 57% (10,400 people) were female and 43% (7,800 people) were male. By the age of 90 or older the difference is almost two to one with 1,600 female (66%) to 800 male (34%) residents.
It is estimated that between 1,500 (0.6%) and 2,500 (1%) transgender adults live in Brighton & Hove (JSNA Executive Summary November 2021 - Joint Strategic Needs Assessment (JSNA) Executive Summary November 2021). The true figure is probably greater than this because a significant proportion of trans people do not disclose their gender identity in surveys.
In addition, as Brighton & Hove is seen as inclusive, many transgender people who live elsewhere visit Brighton & Hove to socialise study and/or work.
Data suggest that transgender people in Brighton & Hove:
Our best estimate of the number of LGB residents is 11% to 15% of the population aged 16 years or more. This estimate draws on information collected via large scale surveys and audits (including Count Me In Too).
According to the 2011 UK Census, 6,425 people aged 16 and over (and living in a household) were living as part of a same sex couple (in a civil partnership or cohabiting).
This represents 2.9% of all residents aged 16 and over, three times higher than the rate for both the South East (0.9%) and England (0.9%).
According to the 2011 UK Census there are 121,540 households in Brighton & Hove.
A quarter of households in Brighton & Hove are single person households aged under 65 (25%, 29,835 households) compared to only 16% in the South East and 18% in England.
More than a quarter of households (29%) with dependent children in Brighton & Hove are lone parent families compared to 25% in England.
Less than a fifth of households (17%) in Brighton & Hove are pensioner households, although a high proportion of these are single pensioner households (70%). In England the comparable figures are 21% and 60% respectively.
Out of 317 authorities, Brighton & Hove is ranked the 131 most deprived authority in England (using the most commonly used summary measure, the Index of Multiple Deprivation (IMD) average score). This means we are just in the third quintile (41%) of most deprived authorities in England.
Of the 312 authorities where comparisons can be made, between IMD 2015 and IMD 2019, Brighton & Hove’s ranking improved by 29 places, the eighth biggest improvement among all authorities and the joint best (with Exeter) outside of London.
The IMD 2019 is made up of seven domains of deprivation one of which is Health Deprivation & Disability. For the Heath Deprivation & Disability domain Brighton & Hove is ranked 114 most deprived.
The day to day activity of more than one in twenty Brighton & Hove residents (20,445 people, 7.5%) is ‘limited a lot’ due to a long term health problem or disability. For a further 24,124 residents (8.8%) their day to day activity is ‘limited a little’. This is similar to the proportions found in the South East and England (Census 2011).
Nearly one in ten of the city’s residents (23,967 people, 8.8%) provide unpaid care to a family member, friend or neighbour who has either a long-term illness or disability or problems related to old age. Two thirds of those providing unpaid care (16,401 people, 68%) do so for 1 to 19 hours a week. However, 4,716 people, nearly 20% of the total population, provide more than 50 hours a week of unpaid care. The proportion of residents providing unpaid care (8.8%) is slightly lower than the South East (9.8%) and England (10.2%) (Carers Rapid Needs Assessment 2015-2016).
Source: ONS, 2011 Census, table KS201EW
Table 3 shows that one in five Brighton & Hove residents (53,351, 19.5%) is from a BME background, higher than the South East (14.8%) but similar to England (20.2%).
The largest BME community is White Other with 19,524 people. This is 7.1% of the total population and more than a third (36.6%) of the BME population. It is also higher than that found in the South East (4.4%) and England (4.6%).
Brighton & Hove has a higher proportion of people of Mixed ethnicity (3.8%) than the England average (2.3%), with the proportion of people of Mixed White and Asian (1.2%) and other Mixed ethnicity (1.0%) double the value found in England.
Other ethnicities that are more prevalent in Brighton & Hove than across England include White Irish (1.4%), Chinese (1.1%) and Arab (0.8%).
By contrast, the proportion of Asian people (4.1%) is below that for the South East (5.2%) and England (7.8%), with particularly low numbers of people of Pakistani ethnicity (0.2%) compared with England as a whole (2.1%).
The proportion of Black people in Brighton & Hove (1.5%) is also less than half that for England (3.5%) but similar to the South East (1.6%)
The overall age structure of the Black and Minority Ethnic (BME) population is younger than the city’s White British population (see Table 4).
2011 Census data shows that, while across the city 22% of the population are aged 19 or younger, for residents of a Mixed ethnic background, the proportion is 50%.
For Asian, Black and Arab residents the proportion is also higher than the 22% average. People aged 65 or older make up 13% of the city’s population, with 15% white UK/British and 21% White Irish.
For all other high level ethnic groups, 6% or less are aged 65 or older.
Source: ONS 2011 census, table DC210EW
For one in twelve residents (8.3%, 21,833 people) aged three or over, English is not their first or preferred language. Other than English, Arabic is the most widely spoken language in the city (2,226 people, 0.8%), followed by Polish (2,043 people, 0.8%) Chinese (1,940 people, 0.7%), Spanish (1,624 people, 0.6%), and French (1,335 people, 0.5%).
One in twenty residents (11,985 people, 4.5%) has a European language other than English (and other UK languages) as their main language, proportionally higher than is found in the South East (2.7%) and England (3.2%).
For one in twenty households in Brighton & Hove (5,925, 5%) no adults have English as their main language.
There is an interpreting service available to help people with language needs in accessing health services.
Brighton & Hove is not home to any military installations and therefore does not house a substantial community of armed forces personnel. At the time of the 2011 Census there were 147 residents employed by the armed forces in the city, less than 0.1% of the total population.
As of March 2020, 532 veterans in Brighton & Hove were in receipt of a pension or compensation under the Armed Forces Pension Scheme. This is a rate of 2.2 per 1,000 people aged 18+, much lower than the South East (8.7 per 1,000) or England (6.9 per 1,000).
More than a third of all household in Brighton & Hove do not have access to a car or van (See Table 5). This is significantly higher than both the South East (19%) and England (26%).
Source: ONS 2011 census, table KS404EW
However, car ownership varies across different parts of the city. Up to three quarters (60% to 78%) of households in the centre of Brighton & Hove have no access to a car or van compared to 6% to 15% in other areas (see Figure 3).
Areas of the city with a high concentration of household with no access to a car or van are also area of the city that have a high concentration of community pharmacies.
For the academic year 2019/20 there were 38,380 students at the University of Sussex and University of Brighton. This was a decrease of 3.1% (1,245 students) compared to 2018/19.
In England, there has been a 3.0% increase in the number of students over the same period. In Brighton & Hove in 2019/20, 58% of students were female (22,315 people) compared to 42% male (16,005 people).
It should be noted that not all students at the two universities live in Brighton & Hove.
As a popular tourist destination, Brighton & Hove sees large numbers of UK and overseas visitors each year.
The latest figures (2019) show there were 10.7 million tourism day trips to Brighton & Hove, up 12% compared with 2018. There were also 5.46 million overnight stays, 10% more than in 2018.
There were an estimated 3,078 homeless people living in temporary accommodation arranged by the council in June 2021 (DLUHC. Statutory Homeless Statistics).
During the Street Count by the Rough Sleeper Team on 13th January 2022, 9 street homeless people were identified. During the Covid-19 pandemic many people sleeping rough have been accommodated in Care and Protect and Protect and Vaccinate housing.
There were 1,948 offenders resident in Brighton & Hove in 2019/20 (Ministry of Justice 2020) National statistics - Proven reoffending statistics: January to March 2020.
Figure 4 shows that pharmacies in Brighton & Hove are more concentrated in the more densely populated areas of the city. Central areas of the city are the most densely populated and there is a corresponding concentration of pharmacies in these areas. However, this does not mean that less densely populated areas of the city are lacking in pharmacy provision.
The 2019 Indices of Deprivation provide a local picture of deprivation in England. The maps in Figure 5 shows the distribution of pharmacies mapped against the Index of Multiple Deprivation (upper panel) and separately by health deprivation domain only (lower panel).
The areas shaded darker green are in the 20% most deprived areas in England.
For most of these areas there is a pharmacy within the locality or nearby. However, for three of the city’s most deprived neighbourhoods – East Moulsecoomb, Craven Vale and Bristol Estate – there is no pharmacy in the locality.
Between 2018 and 2020 the average male life expectancy in the city was 79.3 years and 83.2 years for females. Both genders have similar life expectancy to England (England: males 79.4 years, females 83.1 years).
Between 2017 and 2019 the average male healthy life expectancy was 64.4 years and 64.8 years for females. Both genders have similar healthy life expectancy to England (England: males 63.2 years, females 63.5 years).
Life expectancy and healthy life expectancy is associated with deprivation. Average life expectancy for those living in the most deprived area of the city is 9.1 years less for males and 7.7 years less for females compared to those living in the least deprived areas (2018-2020).
Average healthy life expectancy is 14.0 years less for males and 12.5 years for females (2009-2013).
The rate of under 18s conceptions in 2019 was 13 per 100,000. This is similar to England which had a rate of 16 per 100,000.
Brighton & Hove had a higher STI diagnosis rate (1,081 per 100,000) in 2020 than the South East (429 per 100,000) or England (562 per 100,000).
Although new diagnoses of HIV in the city have been decreasing since 2016, the rates in 2020 (Brighton & Hove 12.4 per 100,000) were still significantly higher than the South East (4.6 per 100,000) and England (5.7 per 100,000) in 2020.
In 2020/21, recorded prevalence of depression among adults (18+) on GP records was 12.5% for Brighton & Hove. This is similar to the South East (13.0) and England (12.3%). The percentage of adults on GP Severe Mental Illness Registers in 2020/21 was 1.29% in Brighton & Hove, 0.86% in the South East Region and 0.95% in England.
Health profiles have been produced for each local authority by Public Health England (PHE). The profile consists of 32 indicators grouped under the following seven main domains:
Life expectancy and causes of death
The purpose of health profiles is to help local authorities, health services and commissioners identify problems in their areas and develop strategies to address them. Performance for local authorities in England is benchmarked against the England average for 34 specified indicators. Table 6 Shows indicators for Brighton & Hove where performance is significantly worse than the England average and a fuller set of indicators is provided in Table 7.
Source: Public Health England. Health Profiles - Local Authority Health Profiles
The mortality rate for under 75s from cancer in Brighton & Hove was 144.4 per 100,000 compared to 121.6 per 100,000 for the South East and 129.2 per 100,000 for England, in 2017-19.
In 2016-18, the rate of being killed and seriously injured on Brighton & Hove roads was 56.9 per 100,000. This compared to 49.6 for the South East and 42.6 for England.
In 2019/20, the rate of emergency hospital admissions for intentional self-harm in Brighton & Hove was 272.8 per 100,000 compared to 212.4 per 100,000 in the South East and 192.6 per 100,000 in England.
In 2018, the estimated diabetes diagnosis rate in Brighton & Hove was 60.7%, lower than the South East 75.2% and England 78.0%.
There were 85 under 18s (55.8 per 100,000) admitted for an alcohol specific condition during this period, this was higher than the South East (31.2 per 100,000) and England 30.7 (per 100,000).
Brighton & Hove had a higher proportion of 18+ smoking in 2019 (17.5%) compared to the South East 12.2% and England 13.9%.
In 2020, Brighton & Hove had a higher rate of new STI diagnoses (1,148 per 100,000) than the South East (461 per 100,000) and England (619 per 100,000).
In 2021 Brighton & Hove had significantly lower than England uptake of Pneumococcal Polysaccharide (PPV) and the lowest uptake in the South East. PPV is given to people aged 65 and over and people at high risk because they have long-term health conditions. Brighton & Hove also had significantly lower vaccination coverage for shingles vaccine.
The latest published data from 2017 shows detection rate of hepatitis C in Brighton & Hove to be 42.9 per 100,000; the percentage of eligible persons in drug misuse treatment who have receive a hepatitis C test is in 2017/18 96.4% and the under 75 mortality rate from hepatitis C related end-stage liver disease/hepatocellular carcinoma (2017-2019) was 0.86 per 100,000.
Future health needs will continue to change as the population lives longer. Between 2020 and 2030 Brighton and Hove's population is projected to increase by 3.9%. This is similar to the South East (4.1%) but slower than England (4.7%).
The number of 65+ year olds is projected to increase by 19% (7,400) from 39,000 to 46,400 people between 2020 and 2030. The biggest % increase is expected in 65-69 years (36%, 3,700 more people) and 80-84 (33%, 1,800 people). There are projected to be 500 (14%) more 85-89 year olds and 300 (13%) more 90+ year olds. (Brighton & Hove City Council. Joint Strategic Needs Assessment Executive Summary. November 2021)
A consequence of more people living longer includes an increased risk of dementia. In March 2020 there were 1,781 registered patients with dementia in the city. This is 4.2% of all patients aged 65 years or over. (Office for Health Improvement and Disparities. Local Authority Health Profiles) It is estimated that by 2035, 3,723 people aged 65 and over in the city will have dementia.(Oxford Brookes University and Institute of Public Care - registration required) A higher proportion of older people in Brighton and Hove live alone. 41% compared to 31% nationally. This will increase the risk of loneliness and depression.(Office for National Statistics. Census 2011)
Both dementia and depression have implications for placing increased demands on community pharmacies as more people will require prescribed medications. As providers of services to older people, pharmacies also have their part to play within the Age Friendly City and Dementia Action Alliance initiatives in Brighton and Hove. As people live longer the proportion living with multiple long term conditions requiring medication will also increase. People aged 65-69 years have on average two long term conditions, increasing to three by age 80-84 years. Patients with diabetes, Chronic Obstructive Pulmonary Disease (COPD) and Coronary Heart Disease (CHD) all have on average 3 or more other long term conditions.(Adults with Multiple Long Term Conditions in Brighton & Hove 2018)
The increase in obesity nationally has also led to an increase in the number of people diagnosed with type 2 diabetes. Brighton & Hove has low recorded diabetes prevalence at 4.3% (11,755 people) compared to 7.1% for England (2020/21). There are an estimated 16,600 people in the city with diagnosed and undiagnosed diabetes. (Office for Health Improvement and Disparities. Local Authority Health Profiles)
As diabetes prevalence increases pharmacies will have an important role to play in increasing awareness of the potential risk factors. This could be through participating in the Healthy Living Pharmacy Scheme and signposting people to healthy weight and physical activity services. All of this will help prevent the development of diabetes. As well as opportunistic use of the NICE supported Diabetes UK risk assessment tool and running pharmacy-based diabetes prevention health promotion campaigns.
Other future health needs include:
Cancer is one of the most common causes of death in the city, particularly lung cancer. There continue to be significantly higher rates of smoking in the city than elsewhere and significant inequalities. Community pharmacies will continue to play an important role in reducing this by offering stop smoking and domiciliary stop smoking services via the public health locally commissioned services.
Alcohol and drug misuse continue to be significant issues for the city. 41% of adults are drinking more than the recommended weekly levels.(Office for Health Improvement and Disparities. Local Authority Health Profiles) Households in more deprived areas are less likely to drink at the greater at risk levels but they are more likely to die of alcohol related conditions. Alcohol related hospital attendances in the city are 50% higher in city residents in the most deprived quintile compared to the least deprived quintile. The city has a significantly higher drug related deaths rate than England, as well as higher than average use of opiates and crack amongst adults.(Office for Health Improvement and Disparities. Local Authority Health Profiles) Community pharmacies have an important role in harm minimisation through the provision of needle exchanges and the supervised consumption of methadone and buprenorphine.
In 2020, Brighton & Hove had the seventeenth highest rate of new Sexually Transmitted Infections (STIs) of all 152 English upper tier local authorities.(Office for Health Improvement and Disparities. Local Authority Health Profiles) Community pharmacies play an important role preventing STIs and unplanned pregnancies through the C-Card scheme of free condom distribution and provision of Emergency Hormonal Contraception through the public health locally commissioned services.
The Strategic Housing Land Availability Assessment (SHLAA) 2020 update shows the housing supply position for Brighton & Hove between 2022/23 and 2024/25. There are 3,593 units of housing planned to be supplied during the lifetime of this PNA.
Figure 6. Housing Trajectory Revised Position 2020
There will be a supply of 1,979 (6+) units built in Development Areas in the city between 2022/23 and 2024/25. The Hove Station and Brighton Station/London Road areas will see the largest amount of new housing supply. Trinity and Traherne pharmacies are the closest pharmacies to the Hove Station development. The developments listed in Table 8 are currently not considered to be of a sufficient scale to require an additional community pharmacy.
Table 8. Identified supply of 6+ units in Development Areas between 2022/23 and 2024/25
Although the Brighton Gas Works development will not happen within the lifespan of this PNA, this is likely to impact on service provision for three pharmacies in that area.
There are no new transport projects planned between 2022/23 and 2024/25 that will negatively affect access to community pharmacies.
The draft Local Cycling and Walking Infrastructure Plan (LCWIP) looks to increase access to shops and services by walking and cycling, through improving the environment for this. There are no plans that are likely to increase the difficulty or distance it takes to travel to community pharmacies.
There were 52 community pharmacies in Brighton & Hove in May 2022. There has been a decrease in the number of community pharmacies in the city since the last PNA in 2018, when there were 56. At the time of the 2015 PNA there were 60 community pharmacies in the city.
The rate of community pharmacy provision was 17.8 per 100,000 resident population (based on ONS 2020 mid year population estimates) in May 2022. This compares to a rate of 19 per 100,000 in the 2018 PNA and 22 per 100,000 in 2015.
The current rate is similar to that in West Sussex (18) and East Sussex (17.6). There is no national guidance on how many pharmacies should be provided per resident population.
Figure 7 shows the location of community pharmacies as of April 2022 and a list of pharmacies is provided at Appendix E (Section 14.5).
There was one Distance Selling Pharmacy (DSP) In Brighton & Hove in May 2022 – Ashtons Hospital Pharmacy Service – registered to provide NHS pharmaceutical services. These are also called mail order or internet pharmacies.
Orders for medicines are received and sent to patients across England remotely through mail or courier services. This is in addition to the 52 community pharmacies.
There has been a general increase in the use of Distance Selling Pharmacies (DSPs).
The 2013 Regulations require that an assessment of other NHS services which may affect the need for pharmaceutical services within its area are laid out in the PNA. These are as follows:
The consultation is asking for views and comments on the proposal to allow hub and spoke dispensing between pharmacies belonging to different legal entities and to enable dispensing doctors to access the hub pharmacies.
The location of pharmaceutical services will not be affected by adoption of the hub and spoke dispensing model, but it may improve access to and capacity within existing pharmaceutical services.
The Health Education England (HEE) community pharmacy workforce survey 2021 (PSNC) found there were 1,531 pharmacies in the SE Region. The Full Time Equivalent (FTE) composition of the pharmacy staff is shown in Table 9.
Source: Health Education England 2021
Based on the HEE data it can be estimated that with an average of 1.56 FTE pharmacists per pharmacy in the South East, there are approximately 83 FTE community pharmacists working in 53 community pharmacies (including the Distance Selling Pharmacy) in Brighton & Hove.
To support PCNs, the Additional Roles Reimbursement Scheme (ARRS) provides funding for 26,000 additional roles in England to create bespoke multi-disciplinary teams (MDT).
Clinical pharmacists work in primary care as part of a multi-disciplinary team in a patient facing role to clinically assess and treat patients using expert knowledge of medicines for specific disease areas.
They work with and alongside the general practice team, taking responsibility for patients with chronic diseases and undertaking clinical medication reviews to proactively manage people with complex medication use, especially for the elderly, people in care homes and those with multiple conditions.
Brighton & Hove PCNs and practices have employed pharmacists and pharmacy technicians either through the ARRS or using their own funding. This workforce has replaced the role of the Better Care Pharmacists previously employed by the CCG. The medicine optimisation team within the CCG/ICB will continue to support practices and PCNs to identify and address medicines optimisation priorities.
This section lays out the scale of prescribing and dispensing, including cross boundary flows between where items were prescribed and dispensed outside of the city’s boundaries.
In summary, the data show that there has been an increase over the last two years in the number of items dispensed, that 97% of dispensed items in the city happen in community pharmacies, and 96% of items dispensed in Brighton & Hove were prescribed in the city. Nearly 4% of items prescribed in Brighton & Hove are dispensed by a distant selling pharmacy located outside the city.
NB. The following data relate to 2020/21 when the Covid pandemic was at its height, so this might not reflect a typical year.
The data in the following tables has been sourced from NHSE.
In 2020/21, 4,548,858 items were dispensed in Brighton & Hove, of these 4,432,300 (97%) were dispensed by community pharmacies with 50,289 items (1.1%) dispensed by a distant selling pharmacy located in the city (see Table 10).
The number of items dispensed has increased from about 4.2 million in 2018/19.
Of the 4,548,858 items dispensed in Brighton & Hove, the majority (96%) were prescribed in Brighton & Hove, with only 2% prescribed in East Sussex and 1% in West Sussex (see Table 11).
Of the 201,306 items dispensed in the city that were prescribed outside of the city, three quarters (75%) were dispensed by community pharmacies and a quarter (25%) by a distant selling pharmacy located in the city (see Table 12).
In 2020/2021, 4,686,161 items were prescribed in Brighton & Hove with the majority (91%) being dispensed in the city by community pharmacies.
Only 15 items, prescribed in the city are dispensed by a distant selling pharmacy located in the city. (see Table 13). However, a further 171,072 items (3.7%) prescribed in Brighton & Hove are dispensed by a distant selling pharmacy located outside the city.
This section looks at how easily people can get to pharmacies in the city in terms of where they are located and when they are open.
Community pharmacies are required to meet standards laid out by the General Pharmaceutical Council, including a need to comply with equalities legislation which covers equality of access to services for people with different needs. This is described further in Section 2.5.3.
Brighton & Hove City Council is developing a new Accessible City Strategy, and is inviting D/deaf, disabled or neurodiverse people living, working or studying in Brighton & Hove to help develop plans to make the city more accessible. Good access to pharmacies will contribute to this aim.
This section provides information on how long it takes people living in the city to travel to a pharmacy by foot or by car.
The calculations for walking are based on someone walking at an average speed of 5 km/h. However, it should be noted that for people less physically able or mobility impaired this could be much longer, or impossible.
In these circumstances alternative means of accessing pharmacy services are required, such as disabled parking bays or home delivery.
NHS England’s SHAPE Atlas travel time and distance mapping tool shows:
The areas not within a 20-minute walk are:
Source: NHS England SHAPE Atlas (www.shapeatlas.net/PNA)
Note: The white circle containing numbers represents the number of pharmacies within a confined area – these pharmacies are too close together to show individually using this tool.
Source: NHS England SHAPE Atlas (www.shapeatlas.net/PNA)
Note: The white circle containing numbers represents the number of pharmacies within a confined area – these pharmacies are too close together to show individually using this tool.
Source: NHS England SHAPE Atlas (www.shapeatlas.net/PNA)
Note: The white circle containing numbers represents the number of pharmacies within a confined area – these pharmacies are too close together to show individually using this tool.
Opening hours of pharmacies include a pharmacy’s core hours and supplementary hours. Any hours above core opening hours are called supplementary opening hours. Supplementary hours may be varied by giving three months’ notice to NHSE.
Core hours can only be changed on application to NHS England and if required as a result of patient needs, not on account of business need. Since the closure of the contracted 100 hour pharmacy in December 2017, there have been no 100 hour pharmacies commissioned.
Evening, weekend and public holiday opening hours are serviced by voluntary opening arrangements covered by supplementary hours.
Appendix E at Section 14.5 shows the full list of pharmacy opening hours. A majority of pharmacies open at 8.30am or 9am on weekdays and Saturdays.
A quarter (13 out of 52) close for a lunch break on weekdays, and 4 out of the 43 pharmacies which are open on a Saturday close for lunch.
Just under a half of pharmacies (23 out of 52, 44%) are open after 6pm on weekdays (see ). However only 4 pharmacies are open on weekdays after 7pm. Three of these (Asda Hollingbury, Asda Marina and Westons Lewes Rd) close at 8pm, and one (Sainsbury’s Lewes Rd) closes at 8pm Mondays to Wednesdays and 9pm on Thursdays and Fridays. One further pharmacy (Charter, Davigdor Rd) is open until 8pm on Tuesdays and Thursdays only.)
Four out of five pharmacies (43 out of 52, 83%) are open on a Saturday morning. 21 pharmacies are open in the afternoon. Only 3 pharmacies open on a Saturday evening after 6pm, and these close at 8pm.
Compared to 2018 there are four fewer pharmacies open on a weekday evening (after 6pm), one fewer on a Saturday afternoon and four fewer pharmacies open on a Sunday.
In the west of the city (Portslade) there are no pharmacies open between 6:30pm on a Friday and 8:30am on a Monday.
Only six pharmacies are open on a Sunday (see Figure 13). All six are open in the morning and afternoon (two until 4pm, three until 5pm and one until 6pm) but none are open in the evening.
A pharmacy located in the Holmbush Shopping Centre (BN43 6TJ) 1.5 miles to the west of the city’s boundary is open 8am to 8pm on Monday to Saturday and 10am to 4pm on a Sunday.
There is one pharmacy in the city that provides a late-night emergency hormonal contraception service. It is open until 8pm Monday to Wednesday and on Saturdays, and until 9pm on Thursday and Friday. Pharmacy at the Holmbush Shopping Centre, Shoreham about 1.5 miles to the west of the city is also open until 8pm six days a week and provides Emergency Hormonal Contraception (not an NHS service).
In August 2022 there were no 100 hour pharmacies in Brighton & Hove. This is because of changes to the market entry regulations by NHSE; applying for a new pharmacy contract under the 100 hours contract is no longer available. Therefore there is no longer a requirement to provide any 100 hour pharmacies.
The local impact of this is that there are fewer pharmacies open later in the evenings in the city, compared to the 2018 PNA when there were two pharmacies (Westons Lewes Road and Ashtons late night pharmacy) open until 10pm.
These pharmacies now close at 8pm and 6pm respectively. Boots in North Street has also changed its pharmacy closing time from 8pm to 6pm.
Pharmacies open after 7pm are currently as follows:
In summary are no pharmacies open later than 8pm Monday, Tuesday, Wednesday, Saturday and no pharmacies open later than 9pm Thursday and Friday and 6pm Sundays.
In the past Brighton & Hove has not had a late night opening rota due to the range of pharmacies opened after 8pm. As this situation has changed since the last PNA was published, it is recommended NHSE and Sussex Integrated Care Board reviews the situation.
However there continues to be a spread of pharmacies open weekday early evenings and at weekends except in Portslade, although the pharmacy at the Holmbush Shopping Centre, Shoreham approximately 1.5 miles to the west of the city is open until 8pm six days a week.
Community pharmacies provide different types of services. Under the Community Pharmacy Contractual Framework, community pharmacies provide three tiers of pharmaceutical services: Essential services; Advanced services; and Enhanced services.
Some are services they must provide, and pharmacies can opt to provide additional services. There are also services commissioned by the NHS (see Section 10) and Locally Commissioned Services (see Section 11).
All the services listed in Sections 9.1 to 9.3 below as essential, advanced and enhanced services below are considered as ‘necessary’.
All pharmacies have to provide the following essential services:
The Healthy Living Pharmacy (HLP) framework is aimed at achieving consistent provision of a broad range of health promotion interventions through community pharmacies to meet local need, improve the health and wellbeing of the local population and help to reduce health inequalities.
All pharmacies must promote healthy living in line with the Community Pharmacy Contractual Framework (CPCF).
Brighton & Hove City Council (BHCC) Public Health commission (current contract is April 2021 to March 2023) a HLP programme for all community pharmacies in the city to complement the requirements of the CPCF and to support the local health and care priorities.
The B&H HLP programme is supported by the NICE guideline, Community Pharmacies: promoting health and wellbeing. This quality standard covers how community pharmacies can support the health and wellbeing of the local population. It describes the overarching principles of good practice for community pharmacy teams.
The B&H HLP programme also aims to support actions defined in the recent publication of the Joint National Plan for Inclusive Pharmacy Practice. The joint initiative aims to provide training and resources to develop and embed inclusive pharmacy professional practice into the ongoing care of patients and communities, to support the prevention of ill-health and address inequalities.
The B&H HLP service specification encourages participation in the programme by offering renumeration for certain elements. These include:
By May 2022, 32 local pharmacies had signed up to BHCC healthy living pharmacies specifications. Figure 14 shows the location of HLPs delivering the BHCC HLP programme in the city, and Appendix F at Section 14.6 provides a list.
The following services may be or have been provided by pharmacies.
It is optional for a pharmacy to deliver these services:
The following subsections provides information on advanced services provided in Brighton & Hove.
As of January 2022, and shown in Figure 15, two thirds of pharmacies (35 out 52, 67%) in Brighton & Hove provide a New Medicines Service.This is a drop in provision since 2016/17 when 55 pharmacies in Brighton & Hove provided the service. NMS activity has dropped from 4,999 consultations in 2018/19, 4,655 in 2019/20 and 4,083 in 2020/21.
Among all pharmacies in the city there is an even geographical spread of pharmacies that provide a New Medicines Service.
8 stoma appliance customisations were carried out in 2018/19 and in 2019/20 and 9 in 2020/21. As of January 2022, 2 out of 52 community pharmacies were providing stoma customisation, although there may be others who could provide this service, but haven’t actually done so.
All 52 community pharmacies in Brighton & Hove provide a flu vaccination service. Income from flu vaccination advanced services in 2020/21 was £156,338.
The Community Pharmacist Consultation Service (CPCS) started in October 2019. Since 1 November 2020, GPs have been able to refer patients for a minor illness consultation via CPCS, once a local referral pathway has been agreed.
All 52 community pharmacies in Brighton & Hove provide a CPCS service. Activity levels were 920 in 2019/20 and 2,337 in 2020/21.
The new NHSE commissioned hypertension case-finding service aims to increase detection of those with hypertension. It started in 2022 and as of April 2022 three out of five community pharmacies (31 out of 52, 60%) in Brighton & Hove provide the service. As of July 2022, this had increased to 39 pharmacies providing the service, and between them a total of 227 patients had been seen. NHSE will continue to monitor take up of this new service.
There is an even distribution of pharmacies providing a hypertension case finding service across the city, as shown in Figure 16.
As of May 2022, no hepatitis C testing service is currently being provided as an advanced service in the city by community pharmacies, however it is possible for pharmacies to deliver the commissioned with a new service specification until 31 March 2023.
No community pharmacy in Brighton & Hove provides an AUR service. The situation remains unchanged from that reported in the 2018 PNA.
These are provided by appliance contractors from outside of the local authority.
This service commissioned by NHS England / Improvement was launched on the 10th March 2022. The service enables hospitals to refer patients to community pharmacy to continue the stop smoking journey they started in hospital.
The service supports patients who started a stop smoking programme in hospital to continue their journey in community pharmacy upon discharge and promotes healthy behaviours to service users. Two community pharmacies in Brighton & Hove have currently signed up to provide the stop smoking advanced service. Their locations are shown in Figure 17.
Enhanced services are the third tier of services that pharmacies may provide and they can only be commissioned by NHSE.
NHSE South East Region currently commission the provision of pharmaceutical services for Christmas Day and Easter Sunday, as well as the Covid-19 vaccination service, all of which are enhanced services.
The provision for all other bank holidays is the same as for Sundays.
Recent updates to Enhanced Services Regulations have been outlined in the introduction (see Section 2.5.1).
As of May 2022 there are four pharmacies delivering Covid-19 vaccinations: Coldean Pharmacy, Kamson’s Pharmacy Moulsecoomb, Kamson’s Pharmacy Preston Park and Osbon Pharmacy, Hove.
Community pharmacies may have their own sustainability plans. The actions community pharmacies have taken to support reducing carbon emissions include the following:
The Sussex Health and Care Partnership in the process of developing a plan to reduce the carbon footprint of the Integrated Care System which lays out opportunities for environmental sustainability for NHS organisations. This includes commitments to work with partners to achieve sustainable healthcare.
Brighton & Hove City Council has a target to become carbon neutral by 2030 and there are opportunities for partnership working with community pharmacies to support this objective.
Other NHS services are those provided as part of the health service. They include services that are provided or arranged by a local authority (for example public health services commissioned from pharmacies), NHSE, CCG, NHS Trust or NHS Foundation Trust.
The local acute hospital trust is University Hospitals Sussex NHS Trust. The pharmacy department provides the following services:
The pharmacy service is split over three sites the largest of which is at Royal Sussex County Hospital Brighton. This has a wholly owned subsidiary pharmacy (Pharm@Sea) for dispensing of prescriptions to outpatients and provision of homecare medicines for patients requiring specialist services. Pharm@Sea was opened to improve workflow for outpatients; but also reduces turnaround times at the main pharmacy which concentrates on inpatient work.
In addition, Pharm@Sea offers commissioned ancillary services such as flu vaccines and smoking cessation. This service may be extended to the Princess Royal Hospital site, Haywards Heath.
Most outpatient appointments result in a recommendation being sent to the patient’s GP for prescribing, that are subsequently dispensed in a community pharmacy. The exceptions to this are immediate need for treatment and unusual or hospital only medicines.
Sussex Community NHS Foundation Trust (SCFT) is the main provider of community health services in the city. SCFT provides the following pharmaceutical services in Brighton & Hove (B&H) with the aim of working with patients and their carers to optimise their use of medicines:
SCFT pharmacy staff liaise with patients/carers, social services, nurses, physiotherapists, occupational therapists, community pharmacists, acute hospital pharmacists, consultants, PCN/GP pharmacists and the patients’ GP when required.
Sussex Partnership NHS Foundation Trust (SPFT) provides care, support and treatment in Brighton & Hove for people with a learning disability and a serious mental illness. The services provided include:
Patients prescribed medication in SPFT community services settings are usually given an FP10 prescription (written by a prescriber in SPFT) when they start a new medicine, to take to their community pharmacy of choice. Prescribing is then transferred to the patient's GP once stable and provided it is approved under the Sussex Health & Care Partnership Joint Formulary or Brighton CCG Formulary. This may be within a shared care agreement between GP and SPFT, so the GP can prescribe, while the patient is still under the care of an SPFT community team for monitoring and assessment (for example). Some specialist medications, such as clozapine, are prescribed on hospital prescriptions and dispensed through a hospital pharmacy. They will continue to be prescribed by community services in SPFT.
SPFT employs dedicated pharmacy staff (pharmacists and pharmacy technicians) within the general community mental health, learning disability, child & adolescent and early intervention teams in Brighton & Hove. These roles liaise with primary and secondary care services and help optimise the use of medicines.
There were seven Public Health Locally Commissioned Services that community pharmacies could sign up for as of July 2022. Table 14 shows the number of pharmacies signed up to each of these.
Table 14. Public Health Locally Commissioned Services, May 2022
Community pharmacies provide specified sexual health services in Brighton and Hove. The Emergency Hormonal Contraception (EHC) service through pharmacies provides access to free EHC for those under 25 years in the city, although available for all ages. Without this service, access would only be available via a GP appointment or sexual health clinics, which would delay or limit access.
Pharmacies which provide the EHC service are expected to also provide the C-Card and chlamydia screening services which are included in the same service specification. The C-Card promotes the effective use and provision of free condoms. The main aim of the service is to reduce rates of sexually transmitted infections (STIs) and teenage pregnancy. At first visit young people are provided with training regarding sexual health and issued with a C-Card. The C-Card can then be presented to any of the service providers who will issue a supply of free condoms. Without this service access would only be available via a limited number of service providers including Sexual Health Service Clinics, some GP surgeries and youth clubs.
The chlamydia screening programme in the city focuses on young people aged below 25, who are at the highest risk of chlamydia infection. Young people who present in various settings, including pharmacies, are encouraged to take a test which involves providing a self-taken sample. Anyone requiring emergency contraception following unprotected intercourse will also be advised to have screening for chlamydia infection. Treatment of positive cases and partner notification is co-ordinated by the chlamydia screening programme.
Figure 18 - Location of pharmacies providing sexual health & contraceptive services, May 2022.
Figure 19. Location of pharmacies providing chlamydia screening and treatment service, May 2022.
There are four local commissioned services that community pharmacies can provided to help residents to stop smoking.
For the three services delivered in pharmacies, stop smoking services tend to be concentrated in central and northern areas of the city with fewer services in the east and particularly in the west. (See Figure 20 - Figure 22)
The stop smoking service is commissioned in 33 community pharmacies of which 21 are also commissioned to provide the Young Persons, and 10 are commissioned to provide the domiciliary stop smoking service. None of the five pharmacies furthest west in the city provide this service (see Figure 20).
Data from 2021/22 shows that no pharmacies recorded a four-week quit through either the young persons or domiciliary stop smoking services for 2021/22. Locally commissioned service provision, particularly domiciliary services have been affected by Covid-19. There are plans to support community pharmacies to re-establish service provision.
Figure 20. Locations of pharmacies providing a stop smoking service
21 out of 52, 40% of community pharmacies in Brighton & Hove provide a young person’s stop smoking service. However, only three pharmacies in Hove and Portslade provide this service and no pharmacies in Rottingdean, Woodingdean and Saltdean (see Figure 21).
Figure 21. Locations of pharmacies providing young persons stop smoking service
Over a half of community pharmacies (28 out of 52, 54%) in Brighton & Hove provide a Varenicline service, although only four pharmacies in Hove and Portslade provide this service (see Figure 22). Varenicline has not been available due to supply issues since June 2021 and therefore this service has been suspended until further information is received regarding product availability. (CAS-ViewAlert)
Figure 22. Location of pharmacies providing Varenicline service
Brighton & Hove Clinical Commissioning Group commissions the Palliative Care Locally Commissioned Service. Seven pharmacies were providing this service in 2021/2022 (see Table 15).
Table 15. Palliative Care Locally Commissioned Service
The need and syringe exchange service is commissioned by the local specialist substance misuse service provider Change Grow Live (CGL). The main purpose of this service is to reduce the transmission of blood-borne infections by providing free, sterile injecting equipment and advice in line with NICE public health guideline PH18.(National Institute for Health and Care Excellence. Needle and Syringe Programmes – NICE Guidelines PH52. 2009) The main beneficiaries are people who inject illicit drugs, including performance and image enhancing drugs.
Commissioned pharmacies supply pre-packed bags containing sterile syringes, needles and other items to adult customers on request. Customers may leave used items, suitably contained in a sharps bin, with the pharmacy for disposal as sharps waste. In August 2022 there were 16 pharmacies in the city providing this service. Their locations can be seen in Figure 23. While there is a reasonable distribution of city of pharmacies providing a needle and syringe services across central areas, there are no pharmacies in the east of the city (Rottingdean and Woodingdean), in Portslade, or in areas to the north of the city around Patcham ward that provide this service.
Figure 23. Distribution of pharmacies providing a needle and syringe exchange service, August 2022
The local specialist substance misuse service provider, Change Grow Live (CGL), co-ordinates a supervised consumption service in the city. They do this through a service level agreement with pharmacists that meet accreditation requirements and service standards.
The service provides community detox from opiates for over 18s, by the pharmacist supervising the whole process of consumption of prescribed medicines (Methadone and Buprenorphine) at the point of dispensing in the pharmacy, ensuring that the correct dose has been administered to the service user.
The need for supervised consumption is assessed by the Change Grow Live clinical team depending on risks and service user needs. In cases where clinicians assess the supervised consumption is not required, the pharmacists dispense the medication to be taken at home.
In August 2022 all community pharmacies in the city were providing this service.
CGL also commission a Take Home Naloxone Service from community pharmacies. Naloxone is a drug which temporarily reverses the effects of opioids such as heroin, methadone, and morphine. UK Guidelines on Clinical Management of Drug Misuse fully endorses the use of naloxone in overdose management and prevention.
As of August 2022 the service was provided by 22 community pharmacies in Brighton and Hove and aims to raise awareness of the availability and supply of naloxone, including training on how to use it, for people at risk of opiate overdose. The location of pharmacies providing this service is shown in Figure 24.
Pharmacies providing a Take Home Naloxone Service are distributed across most of the city although there is no pharmacy in Woodingdean or Portslade provide this service.
Figure 24. Distribution of pharmacies providing a Take Home Naloxone Service, August 2022
Four surveys were undertaken between February to April 2022.
Only one response was received to the care home survey so no further reference will be made to the care home survey in this report.
A total of 1,007 telephone interviews were conducted with Brighton & Hove residents between 4 February and 4 March 2022. Using a telephone interviewing methodology, instead of the self-selecting methodology used for previous PNA community surveys, ensured we were able to collect more respondents’ equalities and demographic information enabling us to analyse the finding by these equalities and demographic groups.
Quotas were set for age (18-34 years, 35-54 years, and 55+ years), gender, postcode district, and ethnicity (UK White British, White Other, and Black and minority ethnic), in order to generate a sample representative of the population of the city.
The postcode area reported in the following sections are shown schematically in Figure 25. For the purposes of this report, BN41 will be referred to as Portslade, BN3 as Hove, BN1 as ‘Brighton central’ and BN2 (roughly all areas east of the A27) as ‘Brighton east’.
Figure 25. Rough indication of postal areas in Brighton & Hove
The following subsections report statistically significant findings from the community survey to help understand the use of pharmacy services by local residents.
There was no statistical difference between the answers of those respondents with or without a disability or a health problem that limits their activity in some way.
The findings below are taken from a fuller report which is available on request. Please email: publichealthintelligence@brighton-hove.gov.uk
More than nine out of ten respondents (92%) were very or fairly satisfied with pharmacy services in Brighton & Hove, including a half who were very satisfied. Only 4% were fairly or very dissatisfied. (See Figure 26)
Figure 26. Satisfaction with pharmacy services in Brighton & Hove
Although not directly comparable due to different survey methodologies, in the 2018 PNA community survey 87% were very or fairly satisfied and 3% fairly or very dissatisfied with pharmacy services in Brighton & Hove.
There was a high level of satisfaction across all demographic groups with no statistically significant differences observed.
The survey began by asking which factors would be the biggest influences on the choice of pharmacy. Respondents were offered a list of options, and they were able to choose up to three of these factors.
Figure 27 shows that ‘near my home’ was the most frequently given response, this was chosen as one of their three factors by almost 9 out of 10 respondents (88%). This was by far the most common reason given and was well ahead of ‘near my local GP’ (42%) and ‘near my work’ (36%).
‘At the supermarket’ was a factor chosen by 25% of respondents. ‘I can park nearby’ was the next most often chosen factor (19%) ahead of ‘opening hours’ (15%). No other factor generated more than 14% of total responses.
Figure 27. Factors in choosing pharmacy used (n=all respondents)
Responses to this question varied across different demographic groups.
For all respondents the pharmacy they use most often was in Brighton & Hove.
Thinking about the pharmacies they used most often, respondents were asked if there was a pharmacy closer to them that they didn’t use. For more than nine out of ten respondents (93%) there was not a pharmacy closer to them that they didn’t use. Only 2% said there was a closer pharmacy.
Respondents who didn’t use the closest pharmacy were asked why this was. The more common themes emerging were around opening hours or what might be termed customer service issues (such as unhelpfulness, rudeness, insufficient attention, or lack of privacy).
More than eight out of ten respondents (84%) agree they can usually find an open pharmacy in Brighton and Hove when they need one (29% strongly agreed). Less than one in ten (8%) disagree with just 1% strongly disagreeing.
For the pharmacies they used most often, four out of five respondents (87%) said the pharmacy’s opening hours met their needs. This was the case for 92% of respondents who do not work, but was significantly lower for those working full-time (86%) and those working part-time (84%).
Figure 28 shows that the two most popular times to use a pharmacy were almost equally ‘weekdays day times between 9am and 5pm’ (67%) and Saturday (66%). Weekday evenings were chosen by just under half of respondents (49%).
Figure 28. Preferred pharmacy opening times (n=all respondents)
There were some differences by demographic groups:
Respondents were asked specifically about using a pharmacy in the evening, at weekend and on bank holidays in the last 12 months. The most frequent use was on a Saturday (67%) followed by late night after 8pm (41%), on a Sunday (31%) and on a bank holiday (25%).
Although 41% of all respondents used a late-night pharmacy service, there were some differences by demographics:
While 67% of all respondents used Saturday pharmacy services,
While 31% of all respondents used Sunday pharmacy services,
While 25% of all respondents used bank holiday pharmacy services, again we could see some differences.
Two out of five respondents (40%) said they visited a pharmacy for health reasons on a monthly basis. This was the most popular visiting frequency. Around one in four (23%) visit a pharmacy every two to three months, and around 1 in 6 (16%) do so fortnightly.
At the two opposite ends of the scale, we can see that 3% claim to never visit a pharmacy, and 4% visit only yearly; whilst in contrast 1% visit daily, and 2% do so two to three times a week. Further information can be seen in Figure 29.
Figure 29. Frequency of visiting pharmacies for health reasons (n=all respondents)
There are differences by demographic groups as follows:
At least two thirds of all prescriptions generated in primary care are for patients needing repeat supplies of regular medicines. Since 2005 repeat dispensing has been an Essential Service within the Community Pharmacy Contractual Framework (CPCF).
Nine out of ten respondents (91%) reported they receive repeat prescriptions, this could be repeat prescriptions for themselves or if they collect repeat prescriptions for others. The proportion of patients registered with a local GP that have repeat prescriptions is not known but the figure is likely to be lower than 91%. It is considered that the 91% of respondents receiving or collecting repeat prescriptions is higher than the general population in receipt of repeat prescriptions. Although the proportion of people answering the community survey in the last PNA published in 2018 was similar at 88%, the methodology was different. There were the following demographic differences in respondents:
For the 91% who get repeat prescriptions, we asked how they ordered their medicines. More than three-quarters (76%) stated that they order them ‘over the internet or via an app’, by far and away the most popular method used.
Around one in five (18%) ‘posted or dropped off a paper request form’, a relatively small number (5%) phoned using Prescription Ordering Direct (POD), and only 1% email the GP practice. Fewer than 1% said they phoned the GP practice.
There are differences by demographic groups:
Nearly nine out of ten respondents (88%) strongly agree (62%) or agree (26%) they ‘travel a short distance to use my pharmacy’. Just 7% disagreed, and only 1% strongly disagreed.
There were some demographic differences in those who strongly agree:
More than half our respondents said that the main way they get to their most often used pharmacy is to walk (54%). Less than a third (29%) travel by car, and 1 in 10 (9%) use some form of public transport. Just 5% cycle and 2% use a taxi (See Figure 30).
Figure 30. Main mode of travel used to reach most used pharmacy (n=all respondents)
All 52 community pharmacies in Brighton & Hove were invited to participate in the survey February and March 2022 which included questions on service provision, staff, working with GPs practices and pharmacies’ capacity to meet increased demand.
In total there were 28 responses to the community pharmacy survey, including six pharmacies where two responses were received. In total 22 pharmacies responded, 41% of all pharmacies in the city. The pharmacies that responded were:
In the 2018 PNA, 26 out of 59 community pharmacies (44%) responded to the pharmacy survey.
For five of the six pharmacies that provided two responses, looking at the responses indicated that the respondent was the same person completing the survey between one and two months apart. For these five pharmacies the later response has been included in this report. For the sixth pharmacy, one respondent was the professional service manager and one the administrative manager. Where responses differed the responses of the professional services manager have been used in this report.
The positions held by respondents were:
Reporting and data in the rest of Section 12.2 refers to the responses from the 22 pharmacies who participated in the survey. The services mentioned in this section refer to the services as listed in the community pharmacy questionnaire.
Advanced Services are commissioned within the Community Pharmacy Contractual Framework (CPCF). Community pharmacies can choose to provide any of these services provided they meet the criteria in the service specifications.
Pharmacies were asked about the Advanced Services they currently provide or intent to provide in the next 12 months. Figure 31 shows the information provided.
Figure 31. Number of pharmacies currently providing or intending to provide Advanced Services
Base: All pharmacies that responded to the survey (n=22)
Locally commissioned services can be contracted from a number of different commissioners, including local authorities, clinical commissioning groups and local NHSE teams.
Figure 32 shows the Locally Commissioned Enhanced Services pharmacies currently provide or would be willing to provide if commissioned.
Figure 32. Number of pharmacies currently providing or willing to provide, if commissioned, Locally Commissioned Enhanced Services
Base: All pharmacies that responded to the survey (n=22)
There are currently a number of housing and other developments taking place across Brighton & Hove with more planned. The PNA needs to identify whether the additional demand from those moving into new homes can be met by the existing spread of pharmacies.
Three quarters of pharmacies (73%, 16 pharmacies) would have sufficient capacity within their existing premises and staffing levels to manage an increase in demand in their area, 18% (4 pharmacies) would need to make adjustments to manage any increase while only 2 pharmacies (9%) would have difficulty managing an increase in demand. (See Figure 33).
Figure 33. Thinking about current and future service provision, which statement best reflects your situation at the moment?
Base: All pharmacies that responded to the survey (n=22)
Section 6.2.1 provides information on the areas of the city with new housing developments planned and capacity to absorb additional demand is relevant to this.
Pharmacies were asked what two new pharmacy services they would like to see commissioned in their pharmacy. Eighteen out of 22 pharmacies responded and the results are shown in Table 16.
Minor ailments (5 pharmacies), diabetes check (4 pharmacies) and stop smoking services (4 pharmacies) were the new pharmacy services most pharmacies would like to see commissioned. Minor ailments and smoking cessation were also in the top 3 selected in the previous PNA 2018.
Two pharmacies did not want to see commissioning of any new services.
Table 16. New services pharmacies would like to see commissioned.
It should be noted that despite the chlamydia, hypertension case finding, stop smoking, walk-in Community Pharmacist Consultation Service (CPCS), blood pressure, and Covid-19 vaccinations services being listed above, they are already being commissioned in community pharmacy.
Nearly three quarters of pharmacies (16 pharmacies) had experienced no difficulties with implementing the Accessible Information Standard and the remaining six pharmacies responded don’t know/not sure. It is a requirement for all public sector bodies to adhere to the Public Sector Bodies (Websites and Mobile Applications) (No.2) Accessibility Regulations 2018.
Nearly all pharmacies (21 out of 22) thought the opening hours of the GP practices they work with, mostly aligned with the opening hours of their pharmacy. Only one pharmacy thought their opening hours did not. In the GP survey, nine out of eleven GPs thought opening times were aligned.
Nearly all pharmacies (19 out of 22) strongly or tend to agree they are aware of the role of Community Pharmacy Primary Care Network (PCN) leads to encourage collaboration between GP practices and community pharmacies (see Figure 34).
Figure 34. Number pharmacies agreeing or disagreeing they are aware of the role of Community Pharmacy Primary Care Network leads
Three quarters of pharmacies (17 out of 22) are very or fairly satisfied with their contact with the GP practices they work with. No pharmacy was dissatisfied with their contact with GP practices. In the GP survey nine out of eleven GP practices were very or fairly satisfied with their professional contact with the pharmacies they work with most (see Figure 35.
Figure 35. Number of pharmacies satisfied with their professional contact with the GP practices they work with.
Three quarters of pharmacies (17 out of 22) strongly agree or tend to agree that the GP practices they work with most are aware of the Advanced or Locally Commissioned Services they provide. Two pharmacies tend to disagree. In the GP survey only one of 11 GPs agreed and three GPs disagreed that they are aware of the services provided by pharmacies.
Figure 36. Numbers of pharmacies who agree or disagree that GP they work with most are aware of the advanced or locally commissioned services they provide.
Just over a half of pharmacies(12 out of 22) strongly or tend to agree that GP practices refer patients to the services their pharmacy provides. Seven pharmacies tend to disagree. In the GP survey, only two out of 11 GPs strongly or tend to agree that they refer patients to advanced or locally commissioned services of the pharmacy they use most. Three GPs strongly disagree that they do.
Figure 37. Number of pharmacies that agree or disagree that GP practices refer patients to the services they provide.
Two pharmacies commented regarding the opportunity for better maximising use of the GP Community Pharmacist Consultation Service (CPCS).
Five pharmacies made comments:
All GPs and medical prescribers in all 34 practices in Brighton & Hove were invited to respond to the PNA GP and non-medical prescribers survey. This included questions on their experience of community pharmacy services and Primary Care Network (PCN) leads. The survey was open between the end of February and mid-March 2022.
Eleven GPs and non-medical prescribers responded to the survey. Eight of 34 practices (24%) in the city were represented:
In the 2018 PNA, 17 out of 37 GP practices (46%) were represented in the GP survey.
Unless otherwise directed respondents were asked to respond to the questions about pharmacy thinking about the pharmacy they use most. The pharmacy used most by respondents are listed below:
NB. Reporting and data in the rest of Section 12.3 refers to the responses from the 11 GPs who participated in the survey.
Eight out of 11 GPs were very or fairly satisfied with the pharmacy they use most often. Two GPs were very dissatisfied (see Figure 38).
Figure 38. Number of GPs satisfied or dissatisfied with the pharmacy they use most often.
Six out of 11 GPs strongly or tend to agree they are aware of the role of Community Pharmacy Primary Care Network (PCN) leads to encourage collaboration between GP practices and community pharmacies. In the PNA pharmacy survey 19 out of 22 pharmacies strongly of tended to agree they were aware of the role.
Figure 39. Number of GPs agreeing or disagreeing they are aware of the role of Community Pharmacy Primary Care Network leads.
GPs were asked to rate the adequacy of Essential, Advanced and Locally Commissioned services provided by the pharmacy they use most in meeting patient’s needs.
Figure 40. Number of GPs who feel pharmacies are good or poor at providing services that meet their patient’s needs.
Base: All GPs who participated in the survey (n=11)
Figure 41. Number of GPs who feel pharmacies are good or poor at providing services that meet their patient’s needs.
Base: All GPs who participated in the survey (n=11)
Figure 42. Number of GPs who feel pharmacies are good or poor at providing services that meet their patient’s needs.
Base: All GPs who participated in the survey (n=11)
GPs and non-medical prescribers being unaware of the adequacy of essential, advanced and locally commissioned services was also observed in the PNA surveys in 2014 and 2018.
Nine out of 11 GPs thought that the opening hours of the pharmacy they work with the most are aligned with the opening hours of their practice. One GP thought they were not aligned, and one GP did not know or was unsure. In the PNA pharmacy survey 21 of 22 pharmacies thought their opening hours were aligned.
Six out of eleven GPs agree that there are enough pharmacies in their locality to meet the workflow of prescriptions from their practice. One GP strongly disagreed.
Figure 43. Number of GPs who agree or disagree that there are enough pharmacies in the locality to meet the workflow of prescriptions.
Nine out of eleven GP were very or fairly satisfied with their professional contact with the pharmacies they work with most. Only one GP was dissatisfied. In the pharmacy survey 17 out of 22 pharmacies were very or fairly satisfied with their contact with the GP practices they work with most.
Figure 44. Number of GPs satisfied or dissatisfied with their professional contact with the pharmacies they work with.
Only one GP out of 11 agreed that they are aware of the advanced or locally commissioned services provided by the pharmacy you use most. Three GPs strongly disagreed. In the pharmacy survey 17 out of 22 pharmacies though that GPs were aware of the services that they provide.
Only two out of 11 GPs strongly or tend to agree that they refer patients to advanced or locally commissioned services of the pharmacy they use most. Three GPs strongly disagree that they do. In the pharmacy survey 12 out of 22 pharmacies strongly or tend to agree that GP practices refer patients to the services their pharmacy provides.
Figure 45. Numbers of GP who agree or disagree they aware of the Advanced or Locally Commissioned Services provided by the pharmacy they use most?
Figure 46. Number of GPs who agree or disagree that they refer patients to the locally commissioned or advanced services provided by the pharmacy they use most.
Three out of the 11 GPs made comments regarding the opportunity for better communication between GP and pharmacies as well as what public health Local Commissioned Services or Advanced Services pharmacies are providing; patient level issues relating to referrals; the limits to the evening and weekend opening hours and overall satisfaction with pharmacies.
A further comment was received from a GP by email regarding the opportunities to improve communication and joint working between GPs and pharmacies.
This section describes the consultation on the draft PNA, summarises the responses and comments made, and notes key areas where the draft was subsequently amended or updated.
The draft PNA report was discussed at the Brighton & Hove Health & Wellbeing Board meeting in July 2022 and feedback from those discussions has also informed amendments to the final report.
The 2013 Regulations require the following organisations to be consulted on the PNA. These include:
The draft PNA was opened to online public consultation between 8 June and 7 August 2022, slightly longer than the minimum period of 60 days required in the regulations. Publicity was supported by the council’s press office which reached local media. Additionally the organisations above were separately and directly invited to input.
Analysis of the responses was carried out and discussed with the PNA steering group.
There were 28 responses to the consultation.
The responses from organisations included feedback from East Sussex and West Sussex Health & Wellbeing Boards.
The 16 people responding as a member of the public were asked to share their equalities and special characteristics information. Due to the small number of responses and incomplete responses to some questions, it is not possible to analyse responses by these groups.
26 of all 28 respondents (92%) agreed that the purpose and background to the PNA had been clearly explained with one member of the public disagreeing (“It’s all a bit complicated and dull”) and one member of the public was not sure.
Across all respondents only one person (a member of the public) made comments about the accuracy of the PNA. This comment related to how GPs issue prescriptions, but was considered by the Steering Group to be inaccurate.
Some respondents considered that the PNA was too long.
Across all respondents, 15 of 26 (58%) agreed with the conclusions and recommendations of the PNA. Among those with a health and or social care background, 9 of 11 respondents (82%) agreed. Among the comments, one member of the public said that the PNA had not properly considered the needs of disabled residents and this has been addressed within the recommendations. Another local resident was concerned by the closure of Boots pharmacy on London Road, an issue previously considered by the Brighton & Hove Health & Wellbeing Board.
16 out of all 28 (57%) respondents thought that there were unidentified gaps in service provision including 11 out of 16 (69%) members of the public and 4 out of 7 (57%) health and social care professionals. Most comments related to pharmacy opening times and the lack of services at weekend, over bank holidays, during the evening and at lunch time.
Across all respondents, 7 of 27 (26%) disagreed that the PNA reflects the needs of the city, including 6 of 16 (38%) members of the public. Four members of the public made comments which covered a lack of service on Sundays and bank holidays, the needs of disabled people not being taken into account, no mention of residents for whom English is not their first language and differing costs between pharmacies for over-the-counter non-prescription items.
The lack of a pharmacy directly on the London Road shopping street since Boots Pharmacy closed was raised, but this had already been the subject of a Supplementary Statement and the Health & Wellbeing Board in July 2020 agreed that there was no gap that needed to be addressed and approved the Supplementary statement.
Across all respondents, 11 of 27 (41%) thought that there were services that could be provided in a community pharmacy setting that had not been highlighted in the wider PNA, including 6 of 16 (38%) members of the public and 5 of 6 (83%) health care professionals. Members of the public suggested that blood testing, blood pressure, heart monitors, ear syringing and genetic profiling were services that could be provided by pharmacies while health care professionals also suggested urinary tract infections, NHS Health Checks, social prescribing, Attention Deficit Hyperactivity Disorder (ADHD) medication reviews, pulse checks and BMI checks.
The PNA Steering Group considered that issues raised in the consultation around health promotion and signposting to other services were already covered through the recommendations within the PNA building on existing services in Healthy Living Pharmacies.
Both Neighbouring Health & Wellbeing Boards (East Sussex and West Sussex) agreed with the conclusions and recommendation of the PNA. Both boards also agreed that:
The PNA Steering Group discussed the responses and findings from the consultation and the following changes to the PNA report were made.
Below is a summary of the areas that the PNA is required to cover.
A statement of the pharmaceutical services that the Health and Wellbeing Board (HWB) has identified as services that are not provided:
A statement of the pharmaceutical services that the HWB has identified (if it has) as services that are provided in the area of the HWB but which the HWB is satisfied-
A statement of the pharmaceutical services that the HWB has identified (if it has) as services that are provided:
A statement of any NHS services provided or arranged by the HWB, NHS England, a CCG, an NHS Trust or an NHS foundation trust to which the HWB has had regard in its assessment, which affect:
The methodology used in the 2022 PNA was guided by that used for the 2018 PNA report and the requirements of local authorities set out in the Pharmaceutical Needs Assessment information pack for Local Authority Health & Wellbeing Boards 2021.
The Brighton & Hove PNA 2022 has been overseen by a multi-agency steering group, with membership shown in Table 17.
Table 17. PNA 2022 Steering Group membership
The method used included a review and analysis of health needs, using the Joint Strategic Needs Assessment (JSNA), Brighton & Hove City Tracker survey, PHE Health Profiles relevant local and national data and information, strategies and plans in relation to pharmaceutical service provision.
Quantitative data was collected from the CCG, NHS England, Public Health, the NHS Business Services Authority, NHS Trusts and Foundation Trusts.
Qualitative data was collected as part of the engagement process with pharmacy contractors, the public, GPs and care homes. The data collected included:
Recommendations were made in consultation with the Steering Group stakeholders
As a council, we have a legal duty under the Equality Act 2010 to show that we have identified and considered the impact and potential impact of our activities on all people with ‘protected characteristics’ (age, disability, gender reassignment, pregnancy and maternity, race/ethnicity, religion or belief, sex, sexual orientation, and marriage and civil partnership).
In this needs assessment and its recommendations we have paid due regard to the council’s duties, including to:
We have also considered how we can foster good relations between people who share a protected characteristic and those who do not.
1. Recommendation: Brighton & Hove City Council and community pharmacies to increase awareness of the opening hours of pharmacies in areas with a high concentration of young people, by signposting them to this information on the NHS Choices website.
Update: Pharmacy contractors must ensure that there is a comprehensive and accurate profile for their pharmacy NHS website profile and their Directory of Services (DoS) profile. Contractors must also ensure they include their opening hours on Bank Holidays, Christmas Day, Good Friday and Easter Sunday within their DoS profiles. Requirement to update DoS and NHS Website every quarter. From 9 November 2020, under the NHS Terms of Service, contractors must ensure that the profile for their pharmacy is comprehensive and accurate. Additionally contractors must verify and, where necessary, update the information contained within the pharmacy profile at least once each quarter of the financial year
Information about where young people can access sexual health and contraception advice in pharmacies is highlighted on the SHAC website
2. Recommendation: The CCG and Brighton & Hove City Council to co-ordinate a city-wide awareness campaign around services that can be accessed at pharmacies, and how to access out-of-hours services and interpreting services, including BSL for deaf people. The campaign should include the provision of information on services in accessible formats, for example Easy Read for people with low literacy levels and information on how to request specialist provision such as an interpreter, BSL, braille, home visit.
Update: The #HelpMyNHS Campaign opened a public conversation about the challenges facing the NHS. While more people than ever before are calling on its services, the NHS is facing the biggest financial challenge it has known. Health and care services are under pressure and need to change and adapt in response to the continuously increasing demand.
#HelpMyNHS campaign looked at how people use local health and social care – from GP and primary care services, hospitals, pharmacy, social care, community and mental health services. It also celebrated the tireless work of thousands of NHS and social care staff who work around the clock to treat record numbers of patients.
NHS Brighton CCG is fully committed to ensuring their communication activities are accessible to all members of the community, and proactively takes steps to ensure the core key messages created for the campaign were promoted in accessible formats, including British Sign Language and in Easy Read format on request. It also engaged with and informed organisations that provide support for those with protected characteristic and vulnerable patients.
3. Recommendation: With the advent of 8am-8pm GP opening hours, commissioners of pharmacy services (NHSE, CCG, BHCC) should consider whether pharmacy services are needed to match their opening hours with neighbouring GP opening hours. The Pharmaceutical Needs Assessment Steering Group will review the impact on pharmacies of extended GP opening hours.
There are three pharmacies in the city which are open after 8pm in the evening, providing access for patients with prescriptions written in evening surgeries. A question about extended GP opening hours and pharmacies has been included again in the 2022 PNA Survey.
4. Recommendation: Pharmacies should receive training in disability awareness (including learning disability), LGBTQ awareness, and the needs of BME groups to make their services more accessible to these equalities groups.
In May of 2019, a Learning Disabilities Awareness session was delivered by the Learning Disabilities Health Facilitator
Training in disability awareness (including learning disability), LGBTQ awareness, and the needs of BME groups will be included in the training plan for 2022/23 for HLP.
As part of the PQS 2021/22 pharmacy teams are required to promote COVID-19 vaccinations, particularly in Black, Asian and minority ethnic and low uptake communities.
Pharmacists and registered technicians have also completed the CPPE Health Inequalities training
5. Recommendation: Better feedback systems about medicines and pharmacy services should be developed for people with learning disabilities, mental ill health, older people and those with complex needs, and their staff, carers and advocates.
A number of services have been commissioned by NHSE to address the needs of patients with long term conditions.
The New Medicine Service is designed to provide early support to people with long term conditions to maximise the benefits of their newly prescribed medication. This service was extended in September 2021.
The NHS Discharge Medicines Service is a new essential service that has been established to ensure better communication of changes to a patient’s medication when they leave hospital and to reduce incidences of avoidable harm caused by medicines.
6. Recommendation: The Caring Together Partnership Board should strengthen its links with community pharmacies.
The Caring Together Partnership Board no longer exists and has been superseded by other bodies.
7. Recommendation: To improve GPs’ and non-medical prescribers’ knowledge and understanding of the services offered by community pharmacies the CCG and Brighton & Hove City Council should develop a local information campaign to ensure they are aware of, understand and have easy access to up to date information about what, when and where services are provided by pharmacies. This should help to alleviate the pressure on GPs by directing suitable patients to access pharmacy services instead.
A Community Pharmacy page has been set up on Brighton & Hove website to host information to improve GPs’ and non-medical prescribers’ knowledge and understanding of the services offered by community pharmacies in the city. Promoted to primary care providers in city.
8. Recommendation: Pharmacists should provide information and advice on medication aids and medications, including side effects and drug interactions. In particular this advice (or training where appropriate) should be given to people with complex needs, including older people, and those with mental ill health, long term conditions and carers.
New Medicines Service recently expanded on September 1 2021 to include more long-term conditions.
PCN Pharmacists undertake structured medication reviews to help people get the best outcomes from their medicines and be advocates of medicines optimisation and safety and to support safer prescribing systems, identify high risk people and embed principles of shared decision-making. PCN pharmacists are encouraged to work collaboratively with community pharmacist colleagues to support people and carers with complex needs, severe mental health and long-term conditions.
9. Recommendation: Pharmacists should provide advice on paying for prescriptions for people on a low income or benefits
To help patients check their entitlement to free NHS prescriptions, NHSE issued a poster and a supply of booklets (including an easy read version of the booklet) to all pharmacies and dispensing GP practices in May 2018.
During the pandemic the requirement for patient (or their representatives) signatures on NHS prescription, dental and eye care forms was temporarily suspended.
From 1 September 2021 NHSE has produced guidance and a communications toolkit to help pharmacies understand their legislative requirements, follow the correct procedure and provide support to patients.
Not all benefits entitle people to free prescriptions. Patients can find out if they’re entitled to help with NHS costs using the online eligibility checker.
10. Recommendation: In view of the higher rates of self-harm, suicide, depression and anxiety in Brighton & Hove compared to England, it is recommended mental health first aid is included initially as part of the Healthy Living Pharmacies training. HLPs should also be provided with the information to be able to signpost patients to community based mental health and wellbeing services. If this is successful extend the training to all pharmacies. Currently HLPs have the opportunity to run mental health campaigns in May and December.
Pharmacy teams are encouraged to signpost to local Mental Health services.
Mental Health training information was circulated in October 2021 to encourage awareness of local services and engagement advice.
Suicide awareness training – part of Pharmacy Quality Scheme 2020. All patient-facing staff completed the Zero Suicide Alliance (ZSA) training and prepared or updated an action plan which includes the action to take if anyone reports to staff that they have suicidal feelings.
11. Recommendation: In view of the projected increase in the proportion of older people living in the city, it is recommended that all community pharmacies are trained in communicating with older people.
The 2019 HLP training programme included training on the Ageing Well Service.
General good communication training courses would provide advice on how to communicate with all patients in a polite, patient and respectful manner. Communication skills training is a core element of pharmacy assistant courses. Under the Pharmacy Quality Scheme 2021 pharmacists and registered technicians undertook the CPPE remote consultation skills training
People with sensory impairments (which some older people may have), may require additional communication skills in response to their specific needs.
Patient facing Pharmacy staff are trained as dementia friends under the pharmacy quality scheme (PQS)
Dementia Friends Information sessions are available on the Learning Gateway which would be a useful course for pharmacy teams to participate in.
12. Recommendation: Public Health to investigate the possibility of Healthy Living Pharmacies giving neighbouring GP Practices the opportunity to link with them on any health promotion campaigns they are running and to roll this out to all community pharmacies if successful.
Session 2 of the 2021/22 HLP training programme covered linking with Primary Care in a session delivered on local insight data packs in Sept 2021.
Pharmacy Quality Scheme 2021.The contractor must have engaged with the Pharmacy Primary Care Network Lead (Pharmacy PCN Lead) to communicate that they would like to be involved in increasing the uptake of flu vaccination to patients aged 65 and over for the 2021/22 influenza
NHSE have commissioned new advanced services Community Pharmacy Consultation Service referrals from GP Practices and Hypertension Case-finding service. GPs are encouraged to refer into these services
13. Recommendation: Public Health to promote the uptake of Making Every Contact Count (MECC) training amongst community pharmacies.
MECC is a recommended element of the HLP level 1 Quality Criteria. Community Pharmacies were made aware of and encouraged to access free MECC training available on the BHCC learning gateway.
The e-learning has been developed to ensure learners gain the underpinning knowledge and understanding of the importance of supporting people to improve their health and wellbeing. These 3 modules must be completed before attending the course.
These sessions explain the background to MECC, its significance and introduces the idea that understanding however opportunistic, very brief interventions are core to MECC.
Here is a direct link for the Making Every Contact Count course. If you have any difficulties in doing this please contact the Workforce Development Team. You do not need to create an account to complete these, simply sign in as a ‘guest account’.
Session 1: What is MECC and why is it important
Session 2: How to have a MECC conversation
Session 3: Signposting
Session 4 (optional): Five ways to well-being.
14. Recommendation: In view of the higher rates of smoking amongst adults and young people in Brighton & Hove compared to England, the 48 pharmacies offering stop smoking services to increase Making Every Contact Count, to engage more clients with the service and ultimately increasing support for people to quit through stop smoking services.
New smoking cessation service to refer from hospitals into community pharmacy launched on the 10th March 2022.
Stop Smoking Services plan to develop a local provider training and capacity building plan by Summer 2022 and this will encompass MECC training for providers.
15. Recommendation: Pharmacies offering the stop smoking LCS but not achieving a 50% quit rate or 15% lost to follow up rate
This action has now been superseded by the commitment to develop improved network support in 2022
A review of training will be undertaken as part of service improvement efforts in 2022.
All pharmacy staff taking the level 2 adviser training, enabling them to provide the LCS stop smoking service, must first complete the NCST online training and assessment.
This is an essential requirement for all community pharmacy providers of the LCS stop smoking service.
16. Recommendation: BHCC to review the payment schedule for smoking cessation to reflect the effort of advisors, needs of clients and reduce rates of lost to follow up clients.
The Stop Smoking Service will be reviewing its incentives in 2022.
17. Recommendation: When making commissioning decisions the CCG, NHS England and BHCC should take into consideration the role of community pharmacies in addressing the needs of patients with long term conditions.
A number of services have been commissioned by NHSE to address the needs of patients with long term conditions.
The New Medicine Service is designed to provide early support to people with long term conditions to maximise the benefits of their newly prescribed medication.
The NHS Discharge Medicines Service is a new essential service that has been established to ensure better communication of changes to a patient’s medication when they leave hospital and to reduce incidences of avoidable harm caused by medicines.
The Community Pharmacy Hypertension Case-Finding Advanced Service was added to the NHS Community Pharmacy Contractual Framework (CPCF) in October 2021. The service aims to support the NHS Long Term Plan ambitions for prevention of cardiovascular disease.
18. Recommendation: Increase the conversion of electronic prescriptions to electronic repeat dispensing (eRD) - The management of the repeat prescribing and dispensing process is being reviewed nationally and locally by CCGs, with a view to implementing more efficient practice. A 25% target for electronic prescriptions to be converted to electronic repeat dispensing (eRD) has been included in the national General Medical Services contract. Currently Brighton & Hove achieves a 21% conversion rate and will need to increase this.
Patients can now access repeat prescriptions through the Prescription Ordering Direct (POD) telephone system, electronic repeat dispensing (eRD) between GP Practice and chosen pharmacy or by writing or visiting their GP Practice.
The POD reduces waste by discussing the repeat medications order and alerting patients to the need for medication reviews.
19. Recommendation: Review the systems of notification to ensure all GPs, non- medical prescribers and care homes are informed of the outcomes of medicine reviews and any medication changes.
Care Homes. The Brighton & Hove Medicine Optimisation service in Care Homes (MOCH) service is comprised of a team of pharmacists and pharmacy technicians. The service provides structured medication reviews for care home residents and involves liaising with GPs and community pharmacies to advise regarding medicine optimisation and changes.
The NHS Discharge Medicines Service is a new essential service that has been established to ensure an integrated approach to supporting patients with medicines reconciliation and optimisation following discharge. Joint working across healthcare sectors, ensuring clear and identifiable links between community pharmacy, NHS trusts and PCN member practices.
20. Recommendation: CCG to promote the understanding of the role of Better Care pharmacists amongst community pharmacists in each GP Practice cluster.
The Better Care pharmacist role has been largely superseded by the NHSE initiative to recruit Clinical Pharmacists to work within Primary Care Networks (PCN). PCN Pharmacists undertake structured medication reviews to help people get the best outcomes from their medicines and be advocates of medicines optimisation and safety and to support safer prescribing systems, identify high risk people and embed principles of shared decision-making.
21. Recommendation: Communication to be improved between Better Care pharmacists, the Nursing Home Medication Review Team, Nursing Home staff and community pharmacies concerning any changes made to medication.
Better care pharmacists – this service was brought in house and replaced by Medicines Optimisation in Care Homes (MOCH). The MOCH service actively contacts nursing home staff and they have a generic email address they can send queries and requests through to that is checked during working hours.
22. Recommendation: Communication systems should be improved around the process of discharge from hospital pharmacies to community pharmacies and communication around the co-ordination of Medicine Use Reviews.
Discharge Medicines Service is an NHSE commissioned service
University Hospitals East will be going live with this from the 22/11/21 – all other hospitals are already using this service. The MURs is no longer being commissioned from NHSE.
23. Recommendation: Data sharing of patients’ records between GPs and pharmacies to be improved, where appropriate. This will be addressed as part of the Empowering Patients, Carers, and Families to use Technology Project’s Domain 2 work – Share Health & Care Information. This is a multi-agency project being developed across the health network in Brighton & Hove, Horsham Mid Sussex and Crawley CCG, High Weald Lewes Havens, BSUH and Digital Brighton & Hove. The CCG, NHSE and BHCC to support communications with patients and providers to improve data sharing.
Summary Care Records are now shared, patients have to ‘opt out’.
NHS Digital plans to have better facilities for communication across primary care within 2 years (including dentists, community pharmacy, and so on.)
24. Recommendation: Greater use should be made of digital communications by community pharmacies and GP Practices to aid joint working between primary care providers and others. All community pharmacies that have existing NHS net emails, should share these with GP Practices and the CCG should encourage GPs to use these for communicating with pharmacies.
All community pharmacies have nhs.net email addresses, these are available to all healthcare professionals through the local service finder.
GP Community Pharmacy Consultation Service has been launched across Sussex, which should improve communications. LPC is doing the training for practice staff and linking them in with their local pharmacies.
25. Recommendation: Community pharmacies to be reminded of the need to keep counter discussions discreet and to offer the use of private consultation rooms where appropriate.
From 1 January 2021 due to the Healthy Living Pharmacy Level 1 (HLP) criteria becoming Terms of Service requirements, almost all pharmacies will need to have a consultation room (Consultation rooms and remote consultations: PSNC Main site).
The requirements for the consultation room are that it is:
Contractors who have not previously installed a consultation area will need to develop and implement a plan to do so. If the pharmacy is included in a pharmaceutical list on 1 January 2021, but no Advanced services were provided at or from the pharmacy during the 12 months ending 31 December 2020, the contractor will have until 1 April 2023 to install a consultation room within their pharmacy.
26. Recommendations: The Community Pharmacy Postgraduate Education (CPPE) to be approached by Brighton & Hove City Council to provide mental health consultation skills e-learning to registered pharmacists and technicians.
CPPE offer a mental health training for pharmacist and pharmacy technicians. The objective of the course is to develop knowledge and skills to support people who are experiencing mental health problems.
The course can be accessed from the CPPE website and was recently updated in January 2021.
AUR Appliance Use Review
BHCC Brighton & Hove City Council
B&H Brighton & Hove
BME Black and Minority Ethnic
CCG Clinical Commissioning Group
CPCF Community Pharmacy Contractual Framework
CPCS Community Pharmacist Consultation Service
CPPE Community Pharmacy Postgraduate Education
DBS Disclosure and Barring Service
DLUHC Department for Levelling Up, Housing and Communities
DoS Directory of Services
DSP Distance Selling Pharmacy
CPCF Community Pharmacy Contractual Framework
eRD Electronic Repeat Dispensing
GP General Practitioner
HEE Health Education England
HLP Healthy Living Pharmacies
HIV Human Immunodeficiency Virus
HWB Health & Wellbeing Board
ICB/ICS Integrated Care Board/Integrated Care System
JSNA Joint Strategic Needs Assessment
LES Local Enhanced Service
LCS Locally Commissioned Service
LFT Lateral Flow Test
LGBTQ Lesbian Gay Bisexual Trans Queer
LMC Local Medial Committee
LPC Local Pharmaceutical Committee
MECC Making Every Contact Count
MOCH Medicines Optimisation in Care Homes
MUR Medicine Use Review
NCST National Centre for Smoking Cessation and Training
NES National Enhanced Service
NHS National Health Service
NHSE NHS England
NMS New Medicine Service
ONS Office for National Statistics
PCN Primary Care Network
PDG Patient Group Direction
PH Public Health
PHE Public Health England
PNA Pharmaceutical Needs Assessment
POD Prescription Ordering Direct
PPV Pneumococcal Polysaccharide Vaccine
PQS Pharmacy Quality Scheme
PSNC Pharmaceutical Services Negotiating Committee
PTP Pandemic Treatment Protocol
PTPGD Pandemic Treatment Patient Group Directive
PQS Pharmacy Quality Scheme
SCFT Sussex Community NHS Foundation Trust
SHAC Sexual Health and Contraception Service
SPFT Sussex Partnership NHS Foundation Trust
STI Sexually Transmitted Infection