Suffolk Health and Wellbeing Board · 2017-10-09 · Health in Suffolk Suffolk is a rural county in...

Draft Pharmaceutical Needs Assessment for Suffolk Health and Wellbeing Board

Pharmaceutical Needs Assessment 2018

Suffolk Health and Wellbeing Board

This Pharmaceutical Needs Assessment has been produced for Suffolk Health and Wellbeing Board by Suffolk County Council in conjunction with Soar Beyond Ltd.


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Contents Executive summary _________________________________________________ 6

Section 1: Introduction ______________________________________________ 14

1.1 Background .................................................................................................... 14

1.1.1 Essential Small Pharmacy Scheme (ESPS) ............................................... 15

1.1.2 Influenza vaccination advanced service ...................................................... 15

1.1.3 NHS Urgent Medicine Supply Advanced Service (NUMSAS) ..................... 15

1.1.4 Pharmacy Access Scheme (PhAS) ............................................................. 16

1.1.5. Quality payment scheme ............................................................................ 16

1.1.6. Pharmacy consolidations ........................................................................... 16

1.2 Purpose of the PNA ....................................................................................... 17

1.3 Scope of the PNA........................................................................................... 17

1.3.1 Pharmacy contractors ................................................................................. 18

1.3.2 Dispensing Appliance Contractors (DACs) ................................................. 21

1.3.3 Local Pharmaceutical Service (LPS) providers ........................................... 21

1.3.4 Dispensing GP practices ............................................................................. 22

1.3.5 Other providers of pharmaceutical services in neighbouring HWB areas ... 22

1.3.6 Other services and providers in Suffolk out of scope of the PNA ................ 22

1.4 Process for developing the PNA .................................................................... 24

1.5 Localities for the purpose of the PNA ............................................................. 25

Section 2: Context for the PNA _______________________________________ 27

2.1 Joint Strategic Needs Assessment (JSNA) .................................................... 27

2.2 Health and Wellbeing Strategy ....................................................................... 28

2.3 Population characteristics .............................................................................. 28

2.3.1 Overview ..................................................................................................... 28

2.3.2 Age ..............................................................................................................29

2.3.3 Predicted population growth ........................................................................ 31

2.3.4 GP-registered population ............................................................................ 31

2.3.5 International migration ................................................................................. 33

2.3.6 Life expectancy ........................................................................................... 34

2.3.7 Specific populations .................................................................................... 35

2.3.8 Deprivation .................................................................................................. 47

2.3.9 Premature mortality ..................................................................................... 48


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2.4 Causes of ill health ......................................................................................... 49

2.4.1 Cardiovascular disease (CVD) .................................................................... 49

2.4.2 Cancers ....................................................................................................... 50

2.4.3 Diabetes ...................................................................................................... 52

2.4.4 Chronic Obstructive Pulmonary Disease (COPD) ....................................... 53

2.4.5 Depression and mental health..................................................................... 54

2.4.6 Accidental injuries ....................................................................................... 56

2.4.7 Asthma ........................................................................................................ 58

2.4.8 Excess weight and obesity .......................................................................... 59

2.4.9 Palliative care .............................................................................................. 61

2.4.10 Influenza ................................................................................................... 61

2.4.11 Coronary heart disease ............................................................................. 62

2.4.12 Strokes and Transient Ischaemic Attacks ................................................. 62

2.4.13 Hypertension ............................................................................................. 62

2.5 Lifestyle .......................................................................................................... 63

2.5.1 Drug and alcohol misuse ............................................................................. 63

2.5.2 Alcohol and related disease ........................................................................ 64

2.5.3 Sexual health and teenage pregnancy ........................................................ 65

2.5.4 Smoking ...................................................................................................... 67

2.5.5 Oral health .................................................................................................. 68

Section 3: NHS pharmaceutical services provision – currently commissioned ___ 71

3.1 Community pharmacies ................................................................................. 71

3.1.1 Choice of community pharmacies ............................................................... 72

3.1.2 Weekend and evening provision ................................................................. 72

3.2 Dispensing Appliance Contractors (DACs) .................................................... 73

3.3 Dispensing GP practices ................................................................................ 73

3.4 Distance-selling pharmacies .......................................................................... 75

3.5 Access to community pharmacies .................................................................. 76

3.5.1 Routine weekday daytime access to community pharmacies and dispensing GP practices ................................................................................................ 76

3.5.2 Routine weekday evening access to community pharmacies and dispensing GP practices ................................................................................................ 79

3.5.3 Routine Saturday daytime access to community pharmacies ..................... 83


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3.5.4 Routine Sunday daytime access to community pharmacies ....................... 90

3.5.5 Routine bank holiday access to community pharmacies ............................. 93

3.6 Advanced service provision from community pharmacies .............................. 93

3.7 Enhanced service provision ........................................................................... 94

3.8 Pharmaceutical service provision provided from outside Suffolk HWB area .. 95

3.9 Locally-commissioned services ...................................................................... 95

Section 4: Other services which may impact on pharmaceutical services provision 96

4.1 Other services provided by dispensing GP practices ..................................... 96

4.2 Healthy Living Pharmacy ............................................................................... 96

4.2.1 Healthy Living Pharmacy enablers .............................................................. 97

4.2.2 Healthy Living Pharmacy and local priorities ............................................... 97

4.3 Collection and delivery services ................................................................... 100

4.4 Provision of services to nursing and residential care homes ........................ 100

4.5 Out-of-hours GP service and Extended Hours ............................................. 100

Section 5: Findings from the public questionnaire ________________________ 102

Section 6: Analysis of Health Needs and Pharmaceutical Service Provision ____ 104

6.1 Localities within Suffolk ................................................................................ 104

6.2 Babergh locality............................................................................................ 104

6.2.1 Necessary services: current provision ....................................................... 104

6.2.2 Necessary services: gaps in provision ...................................................... 104

6.2.3 Other relevant services: current provision ................................................. 105

6.2.4 Improvements and better access: gaps in provision ................................. 105

6.3 Forest Heath locality .................................................................................... 106





6.4 Ipswich locality ............................................................................................. 108





6.4.5 Other services ........................................................................................... 109


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6.5 Mid Suffolk locality ....................................................................................... 109





6.6 St Edmundsbury locality ............................................................................... 111





6.7 Suffolk Coastal locality ................................................................................. 112





6.8 Waveney locality .......................................................................................... 114





Section 7: Summary and conclusions _________________________________ 116

Appendix A: List of pharmaceutical service providers in Suffolk HWB area _____ 118

Appendix B: PNA Steering Group Terms of Reference ____________________ 150

Appendix C: Public questionnaire ____________________________________ 152

Appendix D: Pharmacy contractor questionnaire _________________________ 160

Appendix E: Dispensing GP practice questionnaire _______________________ 168

Appendix F: Commissioner questionnaire ______________________________ 171

Appendix G: PNA Project Plan _______________________________________ 176

Appendix H: Consultation plan and list of stakeholders ____________________ 179

Appendix I: Travel access to pharmacies and dispensing GP practices for Suffolk residents _____________________________________________ 182

Appendix J: New housing and care homes planned in Suffolk _______________ 183

Babergh locality ................................................................................................. 183


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Forest Heath locality .......................................................................................... 183

Waveney locality ................................................................................................ 184

Suffolk Coastal locality ....................................................................................... 184

Mid Suffolk locality ............................................................................................. 185

Ipswich locality ................................................................................................... 185

St Edmundsbury locality ..................................................................................... 186

Appendix K: Results of the dispensing GP practice questionnaire ____________ 189

Appendix L: Results of the commissioner questionnaire ___________________ 195

Appendix M: Results of the public questionnaire _________________________ 199

Appendix N: Results of the pharmacy contractor questionnaire ______________ 210

Appendix O: Equality Impact Assessment ______________________________ 225

Abbreviations ____________________________________________________ 233

Map A: Suffolk pharmacies and population density by output area ___________ 235

Map B: Suffolk pharmacy and dispensing GP practice locations _____________ 236

Map C: GP practice locations in Suffolk (April 2017) ______________________ 237

Map D: Ipswich GP practices (April 2017) ______________________________ 239

Map E: Suffolk GP practices by locations and codes (April 2017) ____________ 240

Map F: Suffolk 1.6 km buffers around pharmacies ________________________ 243

Map G: Suffolk pharmacy opening hours _______________________________ 244

Map H: Suffolk pharmacies and deprivation by LSOA _____________________ 245

Map I: Suffolk pharmacies and Black and Minority Ethnic levels by LSOA _____ 247

Map J: Suffolk off-peak drive time to nearest pharmacy ____________________ 248

Map K: Suffolk peak drive time to nearest pharmacy ______________________ 249

Map L: Suffolk public transport time to nearest pharmacy, Tuesday, 9am to 1pm 250

Map M: Suffolk public transport times to nearest pharmacy, Tuesday, 1pm to 5pm ____________________________________________________ 251

Map N: Suffolk walking times to nearest pharmacy _______________________ 253

Map O: Suffolk pharmacies, dispensing practices and Standard Mortality Ratio (SMR) for all-cause mortality under 75 (2010-2014 inclusive), July 2017 __ 255


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Executive summary Every Health and Wellbeing Board (HWB) is now required to produce a Pharmaceutical Needs Assessment (PNA). After it has published its first PNA, each HWB must publish a statement of revised assessment within three years of its previous publication. However, the HWB must make a revised assessment as soon as it is reasonably practicable after identifying any changes that have occurred since the previous assessment which may have an effect on the needs of the pharmaceutical services.

The responsibility of producing a Pharmaceutical Needs Assessment (PNA) was transferred from Primary Care Trusts (PCTs) to the Health and Wellbeing Board (HWB) of the local authority in 2013 and each HWB had a statutory duty to produce an updated PNA by 1st April 2018.

The PNA is a statement of needs for pharmaceutical service provision within the HWB area. This mapping of pharmaceutical services against local health needs will be used by NHS England in its determination as to whether to approve applications to join the pharmaceutical list, under the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013, as well as applications to change existing services. It will enable local pharmaceutical service providers and commissioners to:

• understand the pharmaceutical needs of the population • gain a clearer picture of pharmaceutical services currently provided • make appropriate decisions on applications for NHS pharmacy contracts • commission appropriate and accessible services from community pharmacies • clearly identify and address any local gaps in pharmaceutical services • target services to reduce health inequalities within local health communities

The PNA was developed by a steering group. The group consisted of a wide range of stakeholders including representatives from Suffolk County Council, Suffolk Local Pharmaceutical Committee (LPC), Suffolk Local Medical Committee (LMC), Clinical Commissioning Groups (CCGs) and NHS England.

Views on the current and potential future provision of pharmaceutical services were sought from residents of Suffolk and current pharmaceutical service providers in Suffolk, through the use of questionnaires.

NHS Pharmaceutical Services in England

NHS Pharmaceutical Services are provided by contractors on the pharmaceutical list held by NHS England. Types of provider are:

• community pharmacy contractors, including distance-selling pharmacies • dispensing appliance contractors • local pharmaceutical service providers • dispensing doctors


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Community pharmacies operate under a contractual framework agreed in 2005 which sets three levels of service:

Essential services: Negotiated nationally. Provided from all pharmacies.

Advanced Services: Negotiated nationally. Community pharmacists can choose to provide advanced services as long as they meet the requirements set out in the Secretary of State Directions.

Enhanced services: Negotiated locally to address local health needs. Provided from selected pharmacies, specifically commissioned.

This contractual framework enables NHS England to commission services to address local needs, while still retaining the pharmacies' traditional role dispensing medicine and access to support for self-care. Other commissioners such as CCGs and local authorities may also use this document to commission services, known as locally-commissioned services.

Health in Suffolk

Suffolk is a rural county in eastern England. It has borders with the counties of Cambridgeshire, Essex and Norfolk and a coastline facing the North Sea. Main urban areas in Suffolk include the county town of Ipswich and the large towns of Bury St Edmunds and Lowestoft. Elsewhere in Suffolk, the population is located in smaller towns and villages and in more isolated settlements in the countryside.

The population

The current estimated population is 741,895 (mid-year estimate 2015). The population of Suffolk has grown by 3.1% since 2010 and is expected to increase 11% by 2039. This number is projected to rise to:

• 777,900 by 2025 • 823,000 by 2039

The ageing population is an important feature of the demography of Suffolk and the proportion of older people in the county is rising. Those aged 65 to 84 will make up the largest proportion of the population by 2026. This group will continue to increase to 2039, when it is forecast to make up almost 25% of the population of Suffolk. In England, approximately 18% of the population is aged 65+ compared with 22.4% in Suffolk. Between 2015 and 2039, there are projected to be an additional 39,393 people aged 65 and over. This will undoubtedly have an impact on health and care services.

A number of housing developments are planned for Suffolk and neighbouring areas, which will impact on the demand for health services. Of particular note are the current and planned developments in Stowmarket in the Mid Suffolk locality, Martlesham in the Suffolk Coastal locality, Ipswich Garden Suburb in the Ipswich locality and several sites in Bury St Edmunds in the St Edmundsbury locality.


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The growing communities created by these neighbouring developments will require detailed and phased service-planning. The precise phasing of new housing is difficult to predict accurately. As this PNA will be reviewed within three years, considerations have been made into new housing growth planned until 2021/22.

Suffolk has a number of care homes spread throughout the county. Due to the generally increased health needs of the elderly, consideration has also been made for future planned care home developments.

The general increasing and ageing population will require flexible service delivery, particularly in rural communities. Provision from distance-selling pharmacies, prescription delivery services from existing community pharmacies and dispensing GP practices are current examples of this flexible service delivery.

Health inequalities

Suffolk has become relatively more deprived compared to other local authority areas in England since 2010. Only three counties/unitary authorities fell more places in the rankings than Suffolk. However, Suffolk continues to experience below-average levels of deprivation. Ipswich remains the most deprived local authority in Suffolk, being ranked 71st out of 326 Local Authorities (LAs) in England. It is also facing the greatest health inequalities and therefore the greatest health need.

Particular populations which may have specific health needs include traveller populations, prisoners, minority ethnic communities and disabled people. The Gypsy and Traveller communities have a life expectancy rate that is 10 years lower than the rest of the population, and they have specific health problems and needs associated with respiratory disease, anxiety and depression.

The first hidden report was published in 2011, and was updated in 2016. The new report includes data from the 2015 Index of Multiple Deprivation and the Social Mobility Index published in 2016 as well as the other indicators. The report highlights that Suffolk, on average, has lower rates of multiple deprivation than England but it includes some of the country’s most deprived neighbourhoods. Over 14% of neighbourhoods in Ipswich and 12% in Waveney are ranked among the most deprived 10% in England. The report also highlights areas of more rural deprivation that are bordered by areas or relative affluence. http://suffolkcf.org.uk/2016/09/hidden-needs-2016/

Health in rural areas

People living in rural areas tend to score higher on standard measures of health such as life expectancy and infant mortality. However, the distances patients have to travel to reach health services are greater and public transport may be limited.

Much of the population has access to a car but certain groups, such as the economically disadvantaged and the elderly living alone, are less likely to have independent mobility.

http://suffolkcf.org.uk/2016/09/hidden-needs-2016/

http://suffolkcf.org.uk/2016/09/hidden-needs-2016/


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The cost of providing services in rural areas is estimated to be significantly higher than the cost of providing services in urban areas.

Suffolk’s rural population is older than its urban population and the proportion of older people in Suffolk’s rural population is increasing faster than the proportion of older people in urban areas. This trend, combined with the higher cost of providing services in rural areas, housing stock which is often difficult to heat and maintain, poor transport and more limited social networks, is likely to lead to high and increasing needs and costs for Suffolk’s rural population now and in the future.

Health and illness

Suffolk is generally a healthy place to live. The average life expectancy for Suffolk overall is higher than the national average for both males (80.7 compared with 79.5 years) and females (84.1 compared with 83.1 years).

However, at PNA locality level there are two areas where life expectancy is lower for both males and females when compared with the Suffolk average: Ipswich (male 78.8, female 83.2 years) and Waveney (male 79.4, female 83.2 years).

The mortality rates from Chronic Obstructive Pulmonary Disease (COPD), Coronary Heart Disease (CHD), stroke / Transient Ischaemic Attack (TIA) and cancer are generally lower than in England as a whole. Forest Heath, however, has a higher mortality rate associated with injuries in the under 75 years’ age group, with directly standardised rates per 100,000 population which are significantly higher (20.4/100,000) than the national average (12.2/100,000). The prevalence of asthma across the HWB area was on average 6.7% and all the CCGs had a significantly higher prevalence of asthma when compared to England overall (5.9% prevalence).

There is a higher prevalence of hypertension (15.2%) when compared to the East of England (14.1%) and England (13.8%). However, modelled estimates at local authority level indicate this figure could be much higher, and there may be a large proportion of Suffolk residents with undiagnosed hypertension. Finding people with high blood pressure is arguably the most effective way to prevent heart attacks, strokes, cognitive decline and premature death and disability. There could be scope for community pharmacies to help with screening the population and helping to identify those with need of follow-up and treatment.

Lifestyle

Lifestyle issues are of concern in some of the areas in Suffolk. These include:

• drug and alcohol use • sexual health and teenage pregnancy • smoking

These are more of an issue in certain areas rather than Suffolk as a whole. Locally-commissioned services, through the local authority, are provided by many community pharmacies to address these issues.


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Pharmaceutical service providers in Suffolk

To appreciate the definition of pharmaceutical services as used in this PNA, it is firstly important to understand the types of providers of NHS pharmaceutical services comprised in the pharmaceutical list maintained by NHS England.

They are:

• pharmacy contractors, including distance-selling pharmacies • dispensing appliance contractors • local pharmaceutical service providers • dispensing doctors

For the purposes of this PNA, pharmaceutical services have been defined as those which are/may be commissioned under the provider’s contract with NHS England. Other providers of pharmaceutical services include hospitals, prisons and military bases.

Suffolk HWB covers the geographical area of West Suffolk CCG, Ipswich and East Suffolk CCG and part of Great Yarmouth and Waveney CCG. Suffolk has 146 community pharmacies (as of 28th April 2017). This equates to an average of 19.7 community pharmacies per 100,000 population, which has decreased from 22 in 2012-13. If we include dispensing GP practices, then the figure rises to 25.4.

Table 1 below shows the data for the average number of community pharmacies for the HWB, the region and England, and compares the data from the previous PNA with 2015-16. Suffolk is currently well-served with community pharmacies, having numbers between England and East of England region averages.

Table 1: Average number of community pharmacies per 100,000 population

Community pharmacies per 100,000 population

England East of England Suffolk HWB

2015-16 21.5 18.8 19.7*

2012-13 21 20 22 *In addition to community pharmacy pharmaceutical services are also provided by dispensing practices. A number of community pharmacies in Suffolk are open weekday evenings, Saturday and Sunday.

NHS legislation allows for GPs in certain areas to dispense NHS prescriptions for defined populations (controlled localities) not having reasonable access to a community pharmacy. In addition to 146 community pharmacies, Suffolk has 43 dispensing GP practices providing pharmaceutical services. Combining these, Suffolk has an average of 25.4 community pharmacies and dispensing GP practices per 100,000 population. This is a decrease of 0.5 per 100,000 population compared to the 2015 PNA.


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Feedback on pharmaceutical services

The views of pharmacy service users were gained from a questionnaire circulated for comments from the general public.

From the 500 responses received from the public questionnaire:

• 77% use a regular or preferred pharmacy • 89% visit the pharmacy for their own needs and 54% for a family member • 62% indicate that they use their pharmaceutical service provider(s) once a

month or more • 69% rated ‘close to home’ as most important reason for choice of pharmacy;

55% rated ‘close to GP Practice’; friendly staff and efficiency were also highly rated

• 62% of respondents report normally travelling by car, 31% walk, 3% use public transport and 2% use a bicycle

• 80% of respondents can get to their pharmacy within 15 minutes and only 1% report having a travelling time of over 30 minutes

• Of the 8% who report they have difficulties when travelling to a pharmacy, 48% indicate this is due to parking difficulties

• 38% prefer to visit the pharmacy Monday-Friday, 50% said their preferred date varied, 10% prefer to visit on a Saturday and just 1% prefer Sunday

• 42% of respondents prefer to visit the pharmacy between 9am and 6pm; 7% prefer early evening and less than 1% prefer to visit after 8pm; 50% however said their preference varied

• 59% indicate they purchase over-the-counter medicines up to once a month or more.

• Only 10% of respondents indicated that they have used an internet pharmacy; of those who did, 85% rated the service as excellent or good

*In some cases, respondents were able to give more than one answer, and so responses may add up to more than 100%.

Suffolk HWB has identified necessary services as essential services and advanced services, as required by Paragraphs 1 and 3 of Schedule 1 to the Pharmaceutical Regulations 2013.

Suffolk HWB has identified enhanced services as pharmaceutical services which secure improvements or better access, or which have contributed towards meeting the need for pharmaceutical services in Suffolk.

Suffolk HWB has identified locally-commissioned services which secure improvements or better access, or which have contributed towards meeting the need for pharmaceutical services in the area in Suffolk.


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Conclusions

Routine access

Respondents to the pharmacy questionnaire indicated that the most important issue when choosing access to pharmaceutical services is having the pharmacy 'close to home'.

Travel analysis shows that 100% of the Suffolk population has an average drive time not exceeding 25 minutes to their nearest provider of pharmaceutical services and the responses to the public questionnaire identified 62% of respondents use their car to travel to their pharmacy. Use of public transport to reach their pharmacy could be an issue, as between 7% and 8% of the population take over 30 minutes to reach their nearest pharmacy. However, the public questionnaire identified only 3% of respondents use public transport to travel to their pharmacy. It is recognised that a large proportion of the population of Suffolk live in a rural area and have rights to dispensing from their dispensing GP practice. There are 146 community pharmacies in Suffolk, 21 (14.4%) of which are open for 100 hours a week or more. The majority of dispensing GP practices are also open at least one evening a week and some are also open on Saturdays.

There are only community pharmacy providers open on Sundays, mostly situated in towns and large villages. Access to pharmaceutical services in the weekday evenings and weekends is therefore generally good, however there is only provision from four pharmacies on Sunday evenings and none through the night.

Provision on some bank holidays in some locations is varied and often for limited hours. NHS England review provision after each Christmas, New Year and Easter bank holiday rota. Based on the results and feedback received, NHS England will make any changes necessary to provide adequate access for the county for the next bank holiday period.

Based on the results and feedback from:

• the public and contractor questionnaires • provision of 100-hour pharmacies in Suffolk compared to nationally and

regionally • access to pharmacies across Suffolk or in neighbouring HWB areas

There is no evidence to suggest there is a gap in service which would equate to the need for access to essential services outside normal hours in this HWB.

It is understood that commercial factors often dictate many pharmacies' decision to open (or not) during bank holidays. Therefore, if there was a need it would be met by existing providers. Suffolk HWB will monitor the uptake and need for necessary services. It will also consider the impact of any changes in the future which may provide evidence that a need exists.


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Improvements and better access

The PNA Steering Group recognises that there are potential opportunities to commission services from community pharmacy or other healthcare providers, which would promote health and wellbeing, address health inequalities and reduce pressures elsewhere in the health system. Where the potential exists for community pharmacies to contribute to the health and wellbeing of the population of Suffolk, this has been included within the document.

Suffolk HWB recognise that the burden of health needs in Suffolk will increase as the population grows and ages and would welcome proactive proposals from commissioners, including NHSE and all CCGs to commission pharmacy services that meet local needs but are beyond the scope of the PNA.


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Section 1: Introduction 1.1 Background

The Health Act 20091 made amendments to the NHS Act 2006, requiring each Primary Care Trust (PCT) to assess the needs for pharmaceutical services in its area and publish a statement of its assessment and any revised assessment. The regulations required the Pharmaceutical Needs Assessment (PNA) to be published by 1 February 2011. There was also a requirement to re-write the PNA every three years or sooner if there were significant changes to the pharmaceutical needs of the area. Suffolk PCT and Great Yarmouth and Waveney PCT produced their first PNAs in 2011. These were subsequently updated in 2015 by Suffolk (Health and Wellbeing Board (HWB.

The responsibility for the development, publishing and updating of PNAs became the responsibility of Health and Wellbeing Boards (HWBs) as a result of the Health and Social Care Act 2012.2 This Act reformed the NHS from 1st April 2013. PCTs were abolished and Health and Wellbeing Boards, Clinical Commissioning Groups (CCGs) and NHS England were formed.

• CCGs are clinically-led NHS bodies responsible for planning, purchasing and monitoring the majority of local health services including hospital, community, emergency and mental health care.

• NHS England oversees the operations of the CCGs, as well as commissioning primary and specialist services (such as cancer care). Along with CCGs, it has the responsibilities of improving health outcomes and reducing health inequalities.

• Health and Wellbeing Boards (HWBs), hosted by each ‘upper tier’ local authority, have their membership drawn from local leaders (often NHS England, CCGs and local government) and are responsible for the continual improvement of the health and wellbeing of the local population.

Suffolk HWB covers Suffolk County, which includes the geographical area of West Suffolk CCG, Ipswich and East Suffolk CCG and part of Great Yarmouth and Waveney CCG.

The NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 (SI 2013/349),3 hereafter referred to as the ‘Pharmaceutical Regulations 2013’, came into force on 1st April 2013.

Unless required to be produced earlier, the Pharmaceutical Regulations 2013 permitted HWBs a temporary extension of the PNAs previously produced by the PCT. HWBs were required to publish their first PNA by 1st April 2015.

1 Health Act 2009 - http://www.legislation.gov.uk/ukpga/2009/21/part/3/crossheading/pharmaceutical-services-in-england?view=plain 2 Health and Social Care Act 2012 - http://www.legislation.gov.uk/ukpga/2012/7/contents/enacted 3 Pharmaceutical Regulations 2013 - http://www.legislation.gov.uk/uksi/2013/349/contents/made

http://www.legislation.gov.uk/ukpga/2009/21/part/3/crossheading/pharmaceutical-services-in-england?view=plain

http://www.legislation.gov.uk/ukpga/2009/21/part/3/crossheading/pharmaceutical-services-in-england?view=plain

http://www.legislation.gov.uk/ukpga/2012/7/contents/enacted

http://www.legislation.gov.uk/uksi/2013/349/contents/made


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The Regulations require each HWB to publish a statement of its revised assessment within three years of its previous publication, and this document fulfils that regulatory requirement.

The Pharmaceutical Regulations 2013 were updated to the National Health Service (Pharmaceutical and Local Pharmaceutical Services) (Amendment and Transitional Provision) Regulations 2014 on 1st April 2014. This PNA has considered these amendments, but the Pharmacy Regulations 2013 have been referenced throughout.

Since the 2015 PNA there have been a number of changes to the contractual framework for community pharmacies and these are briefly described below.

1.1.1 Essential Small Pharmacy Scheme (ESPS)

Financial support for the Essential Small Pharmacy Scheme (ESPS) came to an end on 31st March 2015. Arrangements had existed for many years which provided modest financial support for small pharmacies in areas where they were needed for patients, but where the level of business was otherwise too low for a pharmacy to be viable. At the time, it was estimated there were no more than 100 such pharmacies in England.

Those pharmacies that remained low volume and more than 1 km from the next nearest pharmacy had a number of options:

• Cease to provide pharmaceutical services. • Return to the pharmaceutical list and receive standard funding. • Agree a new LPS contract with the local NHS England team.

There are no pharmacies within Suffolk on LPS contracts.

1.1.2 Influenza vaccination advanced service

On 20th July 2015, as part of the 2015-16 community pharmacy funding settlement, NHS England agreed to allow community pharmacies in England to offer a seasonal influenza (flu) vaccination service for patients in at-risk groups. This became the fifth Advanced Service in the English Community Pharmacy Contractual Framework (CPCF) and provision of the service commenced from 16th September 2015. The service has continued to be recommissioned for subsequent flu seasons. Those pharmacies which provided the service for the 2015-16 flu season are listed in Appendix A.

1.1.3 NHS Urgent Medicine Supply Advanced Service (NUMSAS)

On 20th October 2016, the Department of Health (DH) and NHS England announced that as part of the 2016-17 and 2017-18 community pharmacy funding settlement, money from the Pharmacy Integration Fund (PhIF) would be used to fund a national pilot of an NHS Urgent Medicine Supply Advanced Service (NUMSAS). The pilot service has been commissioned as an Advanced Service and it will run from 1st December 2016 to 31st March 2018, with a review point to consider progress in September 2017. The service can only be accessed via a referral from an urgent care provider, e.g. NHS 111, who holds a list of providers of the service.


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There is no publicly-available list of providers of the service. The PNA recognises that a funded service which supports the supply of urgent medicines from pharmacies would reduce the burden on urgent care services and GPs and improve patient care. Consideration will be given to the type of commissioned service that would be most beneficial once the NUMSAS service evaluation is complete. A commissioned service had been running in Waveney since December 2015 and this had the additional benefits of an IT platform which facilitated service delivery and audit, as well as direct access for patients without the need for referral via NHS 111.

1.1.4 Pharmacy Access Scheme (PhAS)

At the same time, the DH confirmed the introduction of a Pharmacy Access Scheme (PhAS). The aim is to ensure that a baseline level of patient access to NHS community pharmacy services is protected. The PhAS will protect access in areas where there are fewer pharmacies with higher health needs and ensure no area is left without access to NHS community pharmaceutical services. Qualifying pharmacies receive an additional payment which will protect them from the full effect of the reduction in funding which was imposed from December 2016. There are 32 pharmacies who qualify under the PhAS. A full list of those pharmacies can be found in Appendix A. It is uncertain whether this scheme will continue after March 2018.

1.1.5. Quality payment scheme

The Government also introduced a 'quality payment scheme'. To qualify for payment, pharmacies have to meet four gateway criteria:

• provision of at least one advanced service • NHS Choices entry up to date • staff able to send and receive NHS email • ongoing utilisation of the Electronic Prescription Service (EPS)

Fulfilling the gateway criteria does not earn the pharmacy the quality payment in itself. Payment depends on how many of the quality criteria the pharmacy meets and the criteria are weighted based on how difficult they are to meet. At each review point, pharmacies need to make a declaration to NHS Business Services Authority (NHS BSA) and payment will be based on how many criteria are met. It is uncertain whether this scheme will continue after March 2018.

1.1.6. Pharmacy consolidations

On 5th December 2016, an amendment to the Pharmaceutical Regulations 2013 came into effect affecting 'pharmacy consolidations'. This allowed NHS pharmacy businesses to apply to consolidate the services provided on two or more sites into a single site. Applications to consolidate are dealt with as 'excepted applications' under the Pharmaceutical Regulations 2013, which means in general terms that they will not be assessed against the PNA. Instead, consolidation applications will follow a simpler procedure, the key to which is whether or not a gap in pharmaceutical service provision would be created by the consolidation.


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Some provision is also made in respect of continuity of services. For example, if NHS England intends to commission an 'enhanced service' from the applicant that has been provided at or from the closing premises, then the applicant is required to provide undertakings to continue to provide those services following consolidation. If NHS England is satisfied the consolidation would create a gap in service provision, it must refuse the application.

If the Health and Wellbeing Board (HWB) does not consider that a gap in service provision is created as a consequence, it must publish a supplementary statement alongside its PNA recording its view.

1.2 Purpose of the PNA

NHS England is required to publish and maintain pharmaceutical lists for each HWB area. Any person wishing to provide NHS pharmaceutical services is required to be listed on the pharmaceutical list. NHS England must consider any applications for entry onto the pharmaceutical list. The Pharmaceutical Regulations 2013 require NHS England to consider applications to fulfil unmet needs determined within the PNA of that area, or applications for benefits unforeseen within the PNA. Such applications could be for the provision of NHS pharmaceutical services from new premises, or to extend the range or duration of current NHS pharmaceutical services offered from existing premises. As the PNA will become the basis for NHS England to make determinations on such applications, it is therefore prudent that the PNA is compiled in line with the Regulations and with due process, and that the PNA is accurately maintained and up to date. Although decisions made by NHS England regarding applications to the pharmaceutical list may be appealed to the NHS Family Health Services Appeals Unit, the final published PNA cannot be appealed. It is likely the only challenge to a published PNA will be through application for a judicial review of the process undertaken to conclude the PNA.

The PNA should also be considered alongside the Local Authority’s Joint Strategic Needs Assessment (JSNA).4 The PNA will identify where 'necessary' NHS pharmaceutical services (as detailed in Section 1.3) are required to address public health needs identified in the JSNA as a current or future need. In many cases, public health needs may be addressed through locally-commissioned services which has not been considered within the scope of this PNA. Through decisions made by the Local Authority, NHS England and the CCGs, these documents will jointly aim to improve the health and wellbeing of the local population and reduce inequalities.

1.3 Scope of the PNA

The Pharmaceutical Regulations 2013 detail the information required to be contained within a PNA.

4 Current JSNA - https://www.healthysuffolk.org.uk/jsna

https://www.healthysuffolk.org.uk/jsna


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A PNA is required to measure the adequacy of pharmaceutical services in the HWB area under five key themes:

• necessary services*: current provision • necessary services*: gaps in provision • other relevant services, current provision • improvements and better access: gaps in provision • other services

*Necessary services are services that the PNA has identified as services inside and outside of the HWB area which are necessary to meet the need (or contribute to meeting the need) for pharmaceutical services in its area.

In addition, the PNA details how the assessment was carried out. This includes:

• how the localities were determined • the different needs of the different localities • the different needs of people who share a particular characteristic • a report on the PNA consultation

As already mentioned, the PNA is aligned with the Suffolk JSNA.

To appreciate the definition of 'pharmaceutical services' as used in this PNA, it is firstly important to understand the types of providers of NHS pharmaceutical providers comprised in the pharmaceutical list maintained by NHS England. They are:

• pharmacy contractors, including distance-selling pharmacies • dispensing appliance contractors • local pharmaceutical service providers • dispensing doctors

For the purposes of this PNA, 'pharmaceutical services' has been defined as those which are/may be commissioned under the provider’s contract with NHS England. A detailed description of each provider type, and the pharmaceutical services as defined in their contractual framework with NHS England, is set out below.

1.3.1 Pharmacy contractors

Pharmacy contractors operate under the CPCF, initially agreed in 2005 with additional amendments since that time. See section 1.1 for the main changes in regulations affecting community pharmacy since the publication of the previous PNA. The Regulations set three levels of service under which community pharmacies operate.

Essential services – these can be found in Schedule 4 (Part 2) of the Pharmaceutical Regulations 2013.5

5 Pharmaceutical Regulations 2013, Sch 4 (Part 2) http://www.legislation.gov.uk/uksi/2013/349/schedule/4/part/2/made

http://www.legislation.gov.uk/uksi/2013/349/schedule/4/part/2/made


19

These are nationally negotiated and must be provided from all pharmacies:

• dispensing of medicines • repeat dispensing • safe disposal of unwanted medicines • promotion of healthy lifestyles • signposting • support for self-care • clinical governance

Advanced services – these can be found in Parts 2 and 3 of the NHS Act 2006 and in the Pharmaceutical Services (Advanced and Enhanced Services) (England) Directions 2013, the ‘2013 Directions’.6 These are negotiated nationally; any contractor may provide them, as long as they meet the necessary criteria:

• Medicines Use Reviews (MURs) • New Medicine Service (NMS) • Flu Vaccination Service • NHS Urgent Medicines Supply Advanced Service (NUMSAS) • Appliance Use Reviews (AURs) • Stoma Appliance Customisation (SAC)

A full list of provision of advanced services provided by pharmacies in Suffolk (correct as of 1st June 2017) can be found in Appendix A.

Enhanced services – these can be found in Part 4 of the 2013 Directions. They are negotiated locally by NHS England Area Teams and may only be provided by contractors directly commissioned by NHS England.

• anticoagulant monitoring service • care home service • disease-specific management service • emergency supply service • gluten-free supply service • independent prescribing service • home delivery service • language access service • medication review service • minor ailment service* • needle and syringe exchange service*

6 The 2013 Directions and amendment - https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/193012/2013-03-12_-_Advanced_and_Enhanced_Directions_2013_e-sig.pdf https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/266023/pharmaceutical_services_directions_amendment_2013.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/193012/2013-03-12_-_Advanced_and_Enhanced_Directions_2013_e-sig.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/193012/2013-03-12_-_Advanced_and_Enhanced_Directions_2013_e-sig.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/266023/pharmaceutical_services_directions_amendment_2013.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/266023/pharmaceutical_services_directions_amendment_2013.pdf


20

• on-demand availability of specialist drugs service • out-of-hours service • patient group direction service • prescriber support service • schools service • screening service* • stop smoking service* • supervised administration service* • supplementary prescriber service

*These are services which are often commissioned by local authorities or CCGs.

The responsibility for public health services transferred from PCTs to local authorities with effect from 1st April 2013. Where these services are currently commissioned by local authorities, they are not considered enhanced or pharmaceutical services. The 2013 Directions, however, permit NHS England to commission them from pharmacy contractors if asked to do so by a local authority. In this case, if commissioned by NHS England, they are enhanced services and fall within the definition of pharmaceutical services.

In Suffolk, NHS England, as part of their emergency planning responsibilities, commission a provision of potassium iodate tablets service to help manage any radiation leak from Sizewell power station.

A number of public health services are commissioned locally from community pharmacies by Suffolk County Council. These can be found listed in Appendix A. Great Yarmouth and Waveney CCG commission a palliative care medicines service from local community pharmacies. They also commission an emergency supply of medicines service, which is available from all pharmacies in the CCG area.

Pharmacy contractors comprise both those located within Suffolk listed in Appendix A, those in neighbouring HWB areas and remote suppliers, such as distance-selling pharmacies. Although distance-selling pharmacies may provide services from all three levels as described above, and must provide all essential services, they may not do so face-to-face. Additionally, they must provide services to the whole population of England. There was one distance-selling pharmacy located within Suffolk in 2015, but this has now closed:

• Blackbay Ventures Limited, Unit 12, Acorn Business Centre, Oaks Drive, Newmarket, CB8 7SX

However, it should also be noted that distance-selling pharmacies throughout England (there were 266 in 2015-167) must provide services to anyone in England who requests them.

7 General Pharmaceutical Services in England – NHS Digital 2015-16 - http://www.content.digital.nhs.uk/catalogue/PUB22317

http://www.content.digital.nhs.uk/catalogue/PUB22317


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1.3.2 Dispensing Appliance Contractors (DACs)

Dispensing Appliance Contractors (DACs) operate under the Terms of Service for Appliance Contractors as set out in Schedule 5 of the Pharmaceutical Regulations 2013.8 They can supply appliances against an NHS prescription such as stoma and incontinence aids, dressings, bandages etc.

DACs must provide a range of essential services, such as dispensing of appliances, advice on appliances, signposting, clinical governance and home delivery of appliances. In addition, DACs may provide the advanced services of Appliance Use Reviews (AURs) and Stoma Appliance Customisation (SAC). Pharmacy contractors, dispensing doctors and local pharmaceutical service (LPS) providers may supply appliances but DACs are unable to supply medicines.

Table 2: List of DACs in Suffolk

Name Address Opening hours

Charles S Bullen Healthcare Ltd

60 St Matthew's Street Ipswich IP1 3EP

Mon-Fri 09:00-17:00 Sat 09:00-13:00

Fittleworth Medical Ltd 25 Lower Brook Street, Ipswich IP4 1AQ Mon-Fri 09:00-17:00

1.3.3 Local Pharmaceutical Service (LPS) providers

A pharmacy provider may be contracted to perform specified services to their local population or a specific population group. This contract is locally commissioned by NHS England, and provision for such contracts is made in the Pharmaceutical Regulations 2013 in Part 13 and Schedule 7.9 Such contracts are agreed outside the national framework, although may be over and above what is required from the national contract. Payment for service delivery is locally agreed and funded.

In Suffolk there are no LPS pharmacies.

Data gathered from 2015-16 shows that there was a total of 77 LPS pharmacies in England, which is a reduction of 80 since 2013-14. Of these, only ten are Essential Small Pharmacies and there are only two in the whole East of England region. Essential Small Pharmacies were under contract until 31st March 2015, at which time they were invited to either:

• cease to provide pharmaceutical services • return to the pharmaceutical list and receive standard funding • agree a new LPS contract with the local NHS England team

8 Pharmaceutical Regulations 2013, Sch 5 - http://www.legislation.gov.uk/uksi/2013/349/schedule/5/made 9 Pharmaceutical Regulations 2013, Part 13 - http://www.legislation.gov.uk/uksi/2013/349/regulation/102/made; Sch 7 - http://www.legislation.gov.uk/uksi/2013/349/schedule/7/made

http://www.legislation.gov.uk/uksi/2013/349/schedule/5/made

http://www.legislation.gov.uk/uksi/2013/349/regulation/102/made

http://www.legislation.gov.uk/uksi/2013/349/schedule/7/made


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1.3.4 Dispensing GP practices

The Pharmaceutical Regulations 2013, as set out in Part 8 and Schedule 6, permit GPs in certain areas to dispense NHS prescriptions for defined populations. These provisions are to allow patients in rural communities, who do not live within a 1.6 km radius of a community pharmacy, to have access to dispensing services from their GP practice, where the GP practice has dispensing rights. Dispensing GP practices therefore make a valuable contribution to dispensing services, although they do not offer the full range of pharmaceutical services offered at community pharmacies. GP premises for dispensing must be listed within the pharmaceutical list held by NHS England and patients retain the right of choice to have their prescription dispensed from a community pharmacy if they wish.

In Suffolk there are 43 dispensing GP practices. Dispensing GP practices may dispense NHS prescriptions for their own eligible patients who live more than 1m/1.6km (as the crow flies) from their nearest community pharmacy. These can be found listed in Appendix A and identified on Map A.

1.3.5 Other providers of pharmaceutical services in neighbouring HWB areas

There are three other HWB areas which border the Suffolk HWB area: Essex, Cambridgeshire and Norfolk HWBs.

Therefore, in determining the needs of, and pharmaceutical service provision to, the population of Suffolk, consideration has been made to the pharmaceutical service provision from the neighbouring HWB areas.

Maps A and B provide a detailed analysis of pharmacy contractors which lie across the Suffolk HWB border but are within easy reach of the Suffolk HWB area.

1.3.6 Other services and providers in Suffolk out of scope of the PNA

As mentioned earlier, for the purpose of this PNA, 'pharmaceutical services' have been defined as those which are, or may be, commissioned under the provider’s contract with NHS England.

The following are providers of pharmaceutical services in Suffolk, but commissioned by organisations other than NHS England and therefore out of scope of the PNA.

Prisons – in Suffolk there are three male prisons: HMP Highpoint (North and South), c1,323 operational capacity for Category C adult males; HMP and YOI Hollesley Bay, 471 operational capacity for Category D adult males; and HMP Warren Hill, 257 operational capacity for Category C adult males. As of December 2016, prison populations in Suffolk were at or just over operational capacity. A pharmaceutical service is provided to the prisoners of these prisons and is directly contracted by the Health and Justice Team of NHS England (Midlands and East of England region). HMP Highpoint (North and South) has an on-site pharmacy, whereas external providers supply all medications to HMP and YOI Hollesley Bay and HMP Warren Hill.


23

Hospitals – Suffolk has two main NHS Hospitals – West Suffolk Hospital NHS Foundation Trust and Ipswich Hospital NHS Trust, providing services to the Suffolk and neighbouring populations. James Paget Hospital in Great Yarmouth is the main hospital used by the Waveney population. There are also a number of smaller community hospitals: Newmarket Community Hospital, Felixstowe Community Hospital, Aldeburgh Community Hospital and Bluebird Lodge Community Hospital. Pharmacy services are provided by Suffolk hospitals to both inpatients and outpatients from these sites. There are plans for Ipswich Hospital NHS Trust and Colchester Hospital University NHS Foundation Trust to reconfigure services.

Minor injury units and walk-in centres – Felixstowe Community Hospital and Beccles and District War Memorial Community Hospital provide an assessment and treatment service for minor illness and minor ailments.

There are no walk-in centres in Suffolk.

Other commissioned services

The following are services provided by NHS pharmaceutical providers in Suffolk, commissioned by organisations other than NHS England or provided privately and therefore out of scope of the PNA.

It should be noted, while the following services fall outside the scope of the PNA, they are important services that in conjunction with the PNA create a strategic plan to address unmet health needs.

Local authority public health services – Suffolk County Council commissions the following services from community pharmacies in Suffolk:

• needle and syringe exchange service • supervised administration of opiates • chlamydia screening and treatment services • support to stop smoking services • emergency hormonal contraception services • NHS Health Checks

Local CCGs – Great Yarmouth and Waveney CCG locally commission a palliative drugs service and emergency supply of medicines service from community pharmacies.

The emergency supply service is available from all contractors so no separate reference is made in Appendix A to those who supply the service.

Non-commissioned – many NHS pharmaceutical providers offer the following services privately:

• care home service • home delivery service • patient group direction service • screening service


24

Services vary between provider and in some cases may be provided free of charge.

1.4 Process for developing the PNA

The Health and Social Care Act 2012 transferred responsibility for developing and updating of PNAs to HWBs.

This meant that from 1st April 2013 the HWB assumed responsibility for the existing PNA – previously published by Suffolk PCT – and that the board must publish its first PNA by April 2015, with a revised assessment at least every three years thereafter. The last PNA for Suffolk was published in March 2015, and is therefore due to be re-assessed by March 2018.

On 26th January 2017, the reassessment of the pharmaceutical needs of Suffolk was raised at the HWB meeting through the Information Bulletin.

The Information Bulletin is a document that is made available to the public with the published agenda papers. It can include updated information requested by the board as well as information that a service considers should be made known to the board.

Public Health Suffolk has a duty to complete this document on behalf of the HWB. Public Health Suffolk commissioned Soar Beyond to undertake the PNA. Soar Beyond was chosen from a selection of potential candidates due to their significant experience in providing services to assist pharmaceutical commissioning, including the production and publication of PNAs. Soar Beyond produced the first Suffolk HWB PNA in March 2015, and continued to support Suffolk County Council to maintain it.

Step 1: Steering group and project group

On 11th January 2017, a PNA Steering Group was established. The terms of reference and membership of the PNA Steering Group can be found in Appendix B.

Step 2: Project management

At its first meeting, Soar Beyond and the Local Authority presented and agreed the project plan and ongoing maintenance of the project plan. Appendix G shows an approved time line for the project.

Step 3: Review of existing PNA and JSNA

Through the project manager, the PNA Steering Group reviewed the existing PNA and subsequent supplementary statements10 and JSNA for Suffolk. It was agreed that the existing PNAs and subsequent supplementary statements were accurate and up-to-date and the public health team, supported by Soar Beyond, would be responsible for the on-going maintenance of the current PNA until this PNA was published.

10 Suffolk PNA, 2015 and supplementary statements - http://www.healthysuffolk.org.uk/joint-strategic-needs-assessment-jsna/reports/reports/pharmaceutical-needs-assessment-pna/PNA2015/

http://www.healthysuffolk.org.uk/joint-strategic-needs-assessment-jsna/reports/reports/pharmaceutical-needs-assessment-pna/PNA2015/

http://www.healthysuffolk.org.uk/joint-strategic-needs-assessment-jsna/reports/reports/pharmaceutical-needs-assessment-pna/PNA2015/


25

Step 4a: Public questionnaire on pharmaceutical service provision

A public questionnaire to establish views about pharmacy services was produced by the Steering Group, which was then circulated to all GP practices and community pharmacies in the Suffolk area. This was supported by a link to the questionnaire on the council’s website and advertised though posters in community pharmacies. A total of 500 responses were received, a summary of which can be found in Section 5. A copy of the public questionnaire can be found in Appendix C and results in Appendix M.

Step 4b: Pharmacy contractor questionnaire

The Steering Group agreed a questionnaire to be distributed to the local community pharmacies to collate information for the PNA. A total of 64 responses were received. A copy of the pharmacy contractor questionnaire can be found in Appendix D. The results of the questionnaire are found in Appendix N.

Step 4c: Dispensing GP questionnaire

A short questionnaire was agreed by the Steering Group which was distributed to the dispensing GP practices to inform the PNA on services provided. A total of 26 responses were received from the 43 dispensing GP practices in Suffolk.

A copy of the dispensing GP practice questionnaire can be found in Appendix E. The results of the questionnaire are found in Appendix K.

Step 4d: Commissioner questionnaire

The Steering Group agreed a questionnaire to be distributed to all relevant commissioners in Suffolk to inform the PNA.

A copy of the commissioner questionnaire can be found in Appendix F and the responses can be found in Appendix L.

Step 5: Preparing the draft PNA for consultation

The steering group, facilitated by the JSNA programme manager for Suffolk County Council, reviewed and revised the content and detail of the existing PNA, taking into account the JSNA and other relevant strategies, in order to ensure the priorities were identified correctly.

1.5 Localities for the purpose of the PNA

The PNA Steering Group, at its first meeting, considered how the localities within Suffolk geography would be defined.

The majority of health and social care data is available at district and local authority level and at this level provides reasonable statistical rigour. It was agreed that the district and borough council geographies would continue be used to define the localities of the Suffolk geography. These were the localities chosen in the previously published PNAs for Suffolk in 2015.


26

The district and borough councils for Suffolk are:

• Babergh District Council • Forest Heath District Council • Ipswich Borough Council • Mid Suffolk District Council • St Edmundsbury Borough Council • Suffolk Coastal District Council • Waveney District Council

Appendix A shows a list of providers of pharmaceutical services in each locality.

Primary care services are commissioned at CCG level. The CCG geographies do not match the district or borough council boundaries in all cases in Suffolk. Figure 1 below shows the geographical relationship between the borough or district council boundaries and the CCGs.

Figure 1: Geographical relationship between CCGs and District or Borough Councils in Suffolk HWB


27

Section 2: Context for the PNA Suffolk is a rural county in eastern England. It has borders with the counties of Cambridgeshire, Essex and Norfolk and a coastline facing the North Sea. Main urban areas in Suffolk include the county town of Ipswich and the large towns of Bury St Edmunds and Lowestoft. Elsewhere in Suffolk, the population is located in smaller towns and villages and in more isolated settlements in the countryside.

The main roads A14 and A12 cross the county, as does the main railway line from London to Cambridge and Norwich. The East Suffolk railway line runs from Ipswich to Felixstowe and Lowestoft. Felixstowe is the largest container port in the UK and there are also small ports at Ipswich and Lowestoft. The RAF and USAF have airbases in Suffolk but there is no commercial airport in the county.

Figure 2: Suffolk County, including geographical features and boundaries of local authority districts

2.1 Joint Strategic Needs Assessment (JSNA)

The purpose of the Joint Strategic Needs Assessment (JSNA) is to accurately assess the health needs of a local population, to improve the physical and mental health and wellbeing of individuals and communities.


28

The JSNA underpins the Health and Wellbeing Strategy. The HWB is responsible for both the JSNA and the Health and Wellbeing Strategy.

A rolling programme of needs assessments, topic-based reports and data analysis all inform the overarching Suffolk JSNA. Suffolk’s first JSNA was published in 2008, with the 2015 State of Suffolk report being the latest major update, however this is being refreshed during 2018. The Suffolk JSNA is not a single document, it is a suite of dynamic resources to inform commissioning of health and social care and provide strategic direction.

2.2 Health and Wellbeing Strategy

The vision of the Suffolk HWB is to enable people in Suffolk to live healthier, happier lives. The HWB want to narrow the differences in healthy life expectancy between those living in the most deprived communities and those who are better off.

Suffolk’s Joint Health and Wellbeing Strategy 2012-22 sets the long term strategic framework for improving health and wellbeing in Suffolk. The Strategy was refreshed in 2016 to review and (where relevant) re-set the outcomes for the next three years to achieve the HWB's vision.

The State of Suffolk 2015 informed the refresh of the Joint Health and Wellbeing Strategy, ensuring that the Strategy is evidence-based and focused on the relevant key issues including: inequalities, demographic pressures and redesigning services to meet needs and enhance opportunities for prevention. The refreshed outcomes for 2016-19 are shown below.

Figure 3: Refreshed Health and Wellbeing Strategy outcomes, 2016-201911

2.3 Population characteristics

2.3.1 Overview

The 2015 mid-year estimate of the resident population of Suffolk was 741,895, comprising 366,043 males (49.3%) and 375,852 females (50.7%). The population has increased by 3.1% since 2010, and is expected to increase 11% by 2039 to 823,000.12

11 Suffolk Health & Wellbeing Board. A Joint Health and Wellbeing Strategy for Suffolk: Refresh 2016-2019. 2016. 12 Office for National Statistics. Population Estimates for UK, England and Wales, Scotland and Northern Ireland: mid-2015. 2016.


29

Suffolk is made up of seven districts and boroughs; Ipswich is the local authority with the highest population with 135,600 residents, Forest Heath has the lowest population (63,691 residents).

Table 3: Local authority population estimates, 2015

Total Males Females

Babergh 89,215 43,450 45,765

Forest Heath 63,691 32,174 31,517

Ipswich 135,600 67,647 67,953

Mid Suffolk 99,632 49,238 50,394

St Edmundsbury 112,523 56,386 56,137

Suffolk Coastal 125,052 60,913 64,139

Waveney 116,182 56,235 59,947

2.3.2 Age

Suffolk has a higher percentage of adults in the older age groups compared to national figures. In the younger age bands, up to the age of 29, men outnumber women, however for the older age bands this is reversed.

Figure 4: Suffolk population by age group, 201513

13 Office for National Statistics. Population Estimates for UK, England and Wales, Scotland and Northern Ireland: mid-2016. 2016. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/latest

4 3 2 1 0 1 2 3 4

0-4

10-14

20-24

30-34

40-44

50-54

60-64

70-74

80-84

% of populationF - Eng and Wales M - Eng and WalesF - Suffolk M -Suffolk

https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/latest



30

A breakdown of the population of Suffolk by district and borough shows that there is a great deal of variation around the county, with some local authorities having higher or lower proportions of each age group, compared to figures for the county overall. Those aged over 65 years comprise over 20% of the total population in five of the local authorities, but less than 20% in Forest Heath (17.6%) and Ipswich (16.0%). These authorities have higher proportions of their populations in the 0-15 age group.

Table 4: Number of residents by age band for local authorities in Suffolk, 201514

Aged 0-15

Aged 16-29

Aged 30-45

Aged 45-64

Aged 65+ Total

Babergh 15,539 11,795 14,028 25,490 22,363 89,215

Forest Heath 12,810 12,562 12,676 14,446 11,197 63,691

Ipswich 27,130 25,630 28,422 32,693 21,725 135,600

Mid Suffolk 17,333 13,890 16,382 28,869 23,158 99,632

St Edmundsbury 20,172 17,988 20,722 29,373 24,268 112,523

Suffolk Coastal 21,064 15,936 18,527 36,383 33,142 125,052

Waveney 19,982 16,943 17,964 30,788 30,505 116,182

Suffolk 134,030 114,744 128,721 198,042 166,358 741,895 Table 5: Proportion of total local authority population by age band in Suffolk, 201515

% aged 0-15

% aged 16-29

% aged 30-44

% aged 45-64

% aged 65+

Babergh 17.4% 13.2% 15.7% 28.6% 25.1%

Forest Heath 20.1% 19.7% 19.9% 22.7% 17.6%

Ipswich 20.0% 18.9% 21.0% 24.1% 16.0%

Mid Suffolk 17.4% 13.9% 16.4% 29.0% 23.2%

St Edmundsbury 17.9% 16.0% 18.4% 26.1% 21.6%

Suffolk Coastal 16.8% 12.7% 14.8% 29.1% 26.5%

Waveney 17.2% 14.6% 15.5% 26.5% 26.3%

Suffolk 18.1% 15.5% 17.4% 26.7% 22.4%

14 Suffolk HWB. A Joint Strategy: Refresh 2016-2019. 2016. 15 Suffolk HWB. A Joint Strategy: Refresh 2016-2019. 2016.


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2.3.3 Predicted population growth

Population projections from the Office of National Statistics (ONS) suggest that the population of Suffolk is expected to increase to 777,900 by 2025 and 823,000 by 2039. The chart overleaf shows how the different age groups are predicted to change over the coming years.

Some younger age groups are forecast to see a fall in numbers, however older age groups are set to increase, most notably those aged 65 to 84, who will make up the largest proportion of the population by 2026. This group will continue increase to 2039, the last year for which figures are currently available, when they are forecast to make up almost 25% of the population of Suffolk.

Those aged over 85 are forecast to more than double by 2039, increasing from an estimated 24,000 in 2014 to 59,000. By contrast, the 35 to 49 population is forecast to reduce in number, from 139,000 in 2014 to 128,000 by 2039, a decrease of 3.1%.

Figure 5: Population projections by age group 2014 to 2039, Suffolk16

2.3.4 GP-registered population

In October 2016, 782,427 people were recorded as being registered with a GP in Suffolk, a small proportion of these may not be Suffolk residents, and will live just over the border in neighbouring counties.17 The following figures show GP practice list sizes by Clinical Commissioning Group (CCG).

16 Office of National Statistics. 2014-based National Population Projections. 2016. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/datasets/2014basednationalpopulationprojectionstableofcontents 17 Suffolk County Council. Knowledge and Information Team, PCMD and GP Registration Data. 2017.

0

50

100

150

200

250

No

in 1

,000

s

Year

0-19 20-34 35-49 50-64 65 -84 85+

https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/datasets/2014basednationalpopulationprojectionstableofcontents

https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/datasets/2014basednationalpopulationprojectionstableofcontents


32

Figure 6: Ipswich and East Suffolk CCG GP practice list sizes, October 201618

Figure 7: Waveney GP practice list sizes, October 201619

18 Suffolk HWB. A Joint Strategy: Refresh 2016-2019. 2016. 19 Suffolk HWB. A Joint Strategy: Refresh 2016-2019. 2016.

2,51

5 3,

850

3,92

0 4,

304

5,39

3 5,

667

5,92

1 5,

990

6,55

9 6,

790

6,79

1 7,

271

7,34

6 7,

371

7,38

3 7,

907

8,12

4 8,

256

8,69

7 9,

031

9,23

9 9,

260

9,30

3 9,

858

9,96

4 10

,511

10

,962

11

,557

12

,208

12

,385

14

,288

14

,531

14

,786

15

,148

15

,496

16

,721

17

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17

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18

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Figure 8: West Suffolk CCG GP practice list sizes, October 201620

The average list size for GPs in Ipswich and East Suffolk CCG is 10,076, in Waveney (excluding Great Yarmouth element of the CCG) it is 10,117. West Suffolk CCG has the highest average list size at 10,581.

2.3.5 International migration

ONS figures for 2015 show that although the rate of international migration to Suffolk is increasing, it remained below the rates for both the East of England and England until 2014, (when the rate exceeded that for the East of England). Data for 2015 shows that the rate of non-British nationals in Suffolk has reached 83.7 per 1,000 population, lower than the figure for England (93.2 per 1,000 population).

Data from the Local Area Migration Indicators also shows that the proportion of live births in Suffolk to mothers born outside the United Kingdom increased from 13.9% in 2005 to 19.7% in 2015.21 The number of non-UK born residents in Suffolk increased from 44,000 (6.4% of the total population) in 2005 to 77,000 (10.6% of the population) in 2015.

20 Suffolk HWB. A Joint Strategy: Refresh 2016-2019. 2016. 21 Office for National Statistics. Local Area Migration Indicators Tool. 2016. [Accessed 1 April 2017]. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/migrationwithintheuk/datasets/localareamigrationindicatorsunitedkingdom.

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34

Figure 9: Estimates of non-British nationals per 1,000 population, Suffolk 201522

2.3.6 Life expectancy

Life expectancy at birth in Suffolk for both males and females is significantly better compared to England. There is, however, variation within the districts and boroughs in Suffolk. In males, the highest life expectancy is 81.9 years in St Edmundsbury, the lowest is 78.8 years in Ipswich, this is significantly worse than the England value. For females, the highest life expectancy is 84.7 years in Suffolk Coastal, the lowest life expectancy for females is 83.2 years in Ipswich and Waveney.

Table 6: Life expectancy at birth 2013-201523

Males Females Babergh 81.6 84.4

Forest Heath 80.5 83.3

Ipswich 78.8 83.2

Mid Suffolk 81.3 84.6

St Edmundsbury 81.9 84.6

Suffolk Coastal 81.4 84.7

Waveney 79.4 83.2

Suffolk 80.7 84.1

England 79.5 83.1

Benchmark = England

22 Office for National Statistics. Local Area Migration Indicators Tool 2015. 2016. [Accessed 1 April 2017]. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/migrationwithintheuk/datasets/localareamigrationindicatorsunitedkingdom 23 Public Health England. Public Health Outcomes Framework. March 2017. [Accessed 1 March 2017]. http://www.phoutcomes.info/public-health-outcomes-framework - page/3/gid/1000049/pat/6/par/E12000006/ati/101/are/E07000206/iid/90366/age/1/sex/1/nn/nn-1-E07000206

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35

2.3.7 Specific populations

2.3.7.1 Ethnicity

At the time of the last Census in 2011, 95.2% of the resident population in Suffolk identified themselves as White, around 5% above the rate for England and 10% higher than for the East of England. Consequently, Suffolk has lower percentages of the other ethnic groups compared to national figures. All local authorities within Suffolk have higher percentages of White residents compared to the county overall, except Forest Heath and Ipswich. Forest Heath is more ethnically diverse, largely due to the presence of American airbases at Mildenhall and Lakenheath.

Table 7: Ethnicity by area in Suffolk, 201124

Usual residents

White ethnicity

Usual residents

Mixed ethnicity

Usual residents

Asian ethnic groups

Usual residents

Black ethnic groups

Usual residents

other ethnicities

Babergh 97.8% 0.9% 0.8% 0.3% 0.2%

Forest Heath 91.9% 2.9% 2.1% 2.2% 0.9%

Ipswich 88.9% 3.6% 4.3% 2.3% 0.9%

Mid Suffolk 97.9% 1.0% 0.7% 0.4% 0.1%

St Edmundsbury 96.0% 1.3% 1.6% 0.8% 0.2%

Suffolk Coastal 96.5% 1.2% 1.6% 0.5% 0.2%

Waveney 97.7% 1.1% 0.8% 0.3% 0.1% Suffolk 95.2% 1.7% 1.8% 0.9% 0.3%

East of England 90.8% 1.9% 4.8% 2.0% 0.5%

England 85.4% 2.3% 7.8% 3.5% 1.0%

2.3.7.2 Children 2015 population estimates indicate 167,186 Suffolk residents are aged between 0 and 19 years, making up 22.5% of the total population, slightly below the figure for England.

24 Nomis. 2011 Census Data. 2011. www.nomisweb.co.uk

http://www.nomisweb.co.uk/


36

Table 8: Child population by age group, 201525

Suffolk England

Number % of total

population Number % of total population

Age 0-4 41,993 5.7% 3,434,680 6.3%

Age 5-11 59,967 8.1% 4,587,326 8.4%

Age 12-19 65,226 8.8% 4,983,721 9.1%

Age 0-19 167,186 22.5% 13,005,727 23.7% Population projections indicate that the proportion of children will decline over the next twenty years, and is forecast to be 22.0% in 2025, falling to 20.5% by 2039.

Figure 10: 0-19 population projections by age group 2014 to 2039, Suffolk26

2.3.7.2.1 School Census The latest available data from the School Census shows 90% of school age children in Suffolk are White. Approximately 84% of these children are White British and 5% any other White background.27 14% of pupils are categorised as minority ethnic pupils, an increase of 1% from 2015.

25 Office for National Statistics. Population Estimates for UK, England and Wales, Scotland and Northern Ireland: mid-2015. 2016. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/latest 26 ONS. 2014-based National Population Projections. 2016. 27 Suffolk County Council. Suffolk School Census. 2016.

34

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37

In addition, 8.9% of primary and 6.3% of secondary school pupils are known or believed to have a first language other than English. Both of these figures have increased since the 2015 School Census, where the percentages were 8.0% for primary schools and 5.6% for secondary schools.28

It is possible to compare the ethnic origin of school children in Suffolk with that of the population from the last Census, which remains the only current equivalent data source. There are around 5% fewer White children than in Suffolk overall, and the proportion of mixed-ethnicity children is 3.2% above that for the county as a whole. This suggests that the younger population of Suffolk is becoming more ethnically diverse.

2.3.7.2.2 Child poverty In 2014 child poverty in Suffolk affected 16.0% of children under the age of 16 equating to nearly 20,000 children. This is significantly lower than the figure for England (20.1%). At local authority level, Ipswich has a significantly higher proportion of children in poverty (21.3%), as has Waveney (22.7%) when compared to the England percentage.

2.3.7.2.3 Criminal justice In 2015, the rate of 10-17 year olds entering the criminal justice system was 303.8 per 100,000 population, significantly lower than the rate for England at 368.6 per 100,000.29

There were 1,636 first-time offenders of any age entering the criminal justice system in 2015, equating to a rate of 221.5 per 10,000 population, lower than the England rate (242.4 per 10,000).30

2.3.7.3 Children and adults in care The number of Children in Care (CiC) increased by 65 from 2015 to 2016, from 730 to 795. Prior to that, it had been slowly reducing, from 775 in 2012 to 725 in 2014. However, the rate per 10,000 children aged under 18 is still below the average for England, and has remained at 60 per 10,000 for the last four years.

28 Suffolk County Council. Suffolk School Census. 2016. 29 Public Health England. Public Health Outcomes Framework. March 2017. [Accessed 1 March 2017]. http://www.phoutcomes.info/public-health-outcomes-framework - page/3/gid/1000049/pat/6/par/E12000006/ati/101/are/E07000206/iid/90366/age/1/sex/1/nn/nn-1-E07000206 30 Public Health England. Public Health Outcomes Framework. March 2017. [Accessed 1 March 2017]. http://www.phoutcomes.info/public-health-outcomes-framework - page/3/gid/1000049/pat/6/par/E12000006/ati/101/are/E07000206/iid/90366/age/1/sex/1/nn/nn-1-E07000206






38

Table 9: Number of children in care and rate per 10,000 children aged under 1831

Numbers Rate (per 10,000)

2012 2013 2014 2015 2016 2012 2013 2014 2015 2016

Suffolk 775 735 725 730 795 51 49 48 48 52

East of England 6,420 6,300 6,350 6,140 6,330 51 50 50 48 49

England 67,070 68,060 68,810 69,480 70,440 59 60 60 60 60

The prevalence of those with learning disabilities who were registered with a GP was 0.42% for Suffolk in 2014/15 significantly lower than for England (0.44%).32

In 2014/15, 4.08 people per 1,000 population aged 18 to 64 were getting long-term support from the local authority due to learning difficulties, a significantly higher rate compared England (3.73 per 1,000).33

2.3.7.4 Older people

ONS population estimates for 2015 indicate that 22.4% of Suffolk residents are aged 65 and over. Population forecasts suggest that this figure is set to rise to 26.1% by 2025 and 31.6% by 2039. In addition, the proportion of the population over the age of 85 is set to rise in the same period from 3.2% to 4.2%, then 7.1%.

This will undoubtedly have an impact on health and care services. In 2015/16 the rate of emergency admissions to hospital due to dementia was 3,115 per 100,000 population, below the national figure. However, this has been steadily increasing since 2012/13 when the rate was 2,708 per 100,000 population.

2.3.7.5 Prison populations

There are several prisons within Suffolk, they are all trainer prisons and the nearest remand prison is Norwich. Prisons within Suffolk are:

• Warren Hill Prison – 257 operational capacity for Category C* adult males (18+). This is distributed with 32 in the Democratic Therapeutic Community; 20 in Psychologically Informed Planned Environment. The majority of the prison population are within the Progression Regime or in transit from open conditions.

• Highpoint – c1,323 operational capacity for Category C* adult males (18+). These are across two distinct sites, Highpoint North and South. This training prison is located near Newmarket, Suffolk.

31 Department for Education. Children looked after in England including adoption: 2015 to 2016. 2017. [Accessed 1 March 2017]. https://www.gov.uk/government/statistics/children-looked-after-in-england-including-adoption-2015-to-2016 32 Public Health England. Learning Disability Profiles – March 2017. 2017. [Accessed 1 March 2017]. https://fingertips.phe.org.uk/profile/learning-disabilities 33 Public Health England. Learning Disability Profiles – March 2017. 2017.

https://www.gov.uk/government/statistics/children-looked-after-in-england-including-adoption-2015-to-2016

https://www.gov.uk/government/statistics/children-looked-after-in-england-including-adoption-2015-to-2016

https://fingertips.phe.org.uk/profile/learning-disabilities


39

• Hollesley Bay – 471 operational capacity for Category D** adult males (18+). This is an open prison in Woodbridge, Suffolk.34,

As of December 2016, prison populations in Suffolk were at, or just over operational capacity.35 The operational capacity refers to the number of inmates the prison can safely hold. Prison populations are a high-risk group for cancer and heart attacks due to tobacco and alcohol use, poor diet and reduced physical activity.36 * Those who cannot be trusted in open conditions but who are unlikely to try to escape. ** Those who can be reasonably trusted not to try to escape, and are given the privilege of an open prison.

2.3.7.6 Less-abled populations

The ONS has produced data comparing activity-limiting illness in local authority districts as recorded at the 2001 Census with that recorded at the 2011 Census. Data for local authority districts in Suffolk is shown below.

Table 10: Changes in activity-limiting illness in Suffolk between 2001-201137

Activity limiting illness No activity limiting illness 2001 2011 2001 2011

Area

Babergh 16.1% 17.4% 83.9% 82.6%

Forest Heath 14.5% 15.1% 85.6% 84.9%

Ipswich 18.0% 17.7% 82.0% 82.4%

Mid Suffolk 15.5% 16.6% 84.5% 83.5%

St. Edmunsbury 15.6% 16.4% 84.5% 83.6%

Suffolk Coastal 17.2% 18.5% 82.8% 81.5%

Waveney 20.7% 22.3% 79.3% 77.7%

Suffolk County 16.5% 18.0% 83.5% 82.1%

East of England 16.2% 16.7% 83.8% 83.3%

England 17.3% 17.6% 82.7% 82.4%

34 Independent Monitoring Board. Annual Report of the Independent Monitoring Board HMP Warren Hill 1 June 2015 – 31 May 2016. 2016. [Accessed 1 March 2017]. https://www.justice.gov.uk/contacts/prison-finder/hollesley-bay. 35 Ministry of Justice. Prison Population Figures 2016. 2017. [Accessed 1 March 2017]. https://www.gov.uk/government/statistics/prison-population-figures-2016 36 Office for National Statistics. Where do we commute to? 2011. [Accessed 1 April 2017]. http://www.neighbourhood.statistics.gov.uk/HTMLDocs/dvc193/#sty=true&flow=flow0&period=0&fix=E07000200&view=357.5,118.75,315,317.5&tr=-2008.3097074030588,-1459.1367882681975&sc=3.784230586902382 37 Nomis. 2011 Census Data. 2011. www.nomisweb.co.uk

https://www.justice.gov.uk/contacts/prison-finder/hollesley-bay

https://www.justice.gov.uk/contacts/prison-finder/hollesley-bay

https://www.gov.uk/government/statistics/prison-population-figures-2016

http://www.neighbourhood.statistics.gov.uk/HTMLDocs/dvc193/#sty=true&flow=flow0&period=0&fix=E07000200&view=357.5,118.75,315,317.5&tr=-2008.3097074030588,-1459.1367882681975&sc=3.784230586902382

http://www.neighbourhood.statistics.gov.uk/HTMLDocs/dvc193/#sty=true&flow=flow0&period=0&fix=E07000200&view=357.5,118.75,315,317.5&tr=-2008.3097074030588,-1459.1367882681975&sc=3.784230586902382



40

Between 2001 and 2011, the percentage of usual residents in local authority districts in Suffolk reporting activity-limiting illness increased in all areas except Ipswich. As with general health, these increases are likely to be in part related to population growth and ageing of the population between 2001 and 2011.

Table 11: Limitation of daily activities as recorded at 2011 Census – residents of local authority districts in Suffolk County and higher geographies – persons aged 16-64 years38

Limitation of daily activities (% of all usual residents aged 16-64 years) All usual

residents aged 16-64

years number

Day to day activities

limited a lot %


limited a little %


not limited %

Area

Babergh 4.3 6.9 88.8 53,065

Forest Heath 3.9 5.8 90.2 38,990

Ipswich 5.5 7.6 86.9 87,566

Mid Suffolk 3.7 6.8 89.5 59,436

St. Edmunsbury 4.1 6.4 89.5 69,693

Suffolk Coastal 4.4 7.1 88.5 73,596

Waveney 6.9 8.4 84.7 67,876

Suffolk County 4.8 7.1 88.1 450,222

East of England 4.6 6.8 88.6 3,714,151

England 5.6 7.1 87.3 34,329,091 At the 2011 Census a total of 4.8% of usual residents of working age in Suffolk reported that their day-to-day activities were limited a lot. This compared with 4.6% in East of England and 5.6% in England as a whole.

In local authority districts in Suffolk, the percentage of usual working age residents reporting that their day-to-day activities were not limited ranged from 84.7% in Waveney to 90.2% in Forest Heath.

Percentages reporting that their day-to-day activities were limited a lot ranged from 3.7% in Mid Suffolk to 6.9% in Waveney. The percentage of usual residents of working age reporting that their day-to-day activities were limited a little was also highest in Waveney (8.4%).

38 Nomis. 2011 Census Data. 2011. www.nomisweb.co.uk



41

Table 12: Long term illness or disability, Suffolk39

Indicator Time period Suffolk East of

England England

People aged 18-64 registered deaf or hard of hearing per 100,000 2009-10 22.4 120.9 172.8

People aged 65-74 registered deaf or hard of hearing per 100,000 2009-10 48.6 290.2 620.4

People aged 75+ registered deaf or hard of hearing per 100,000 2009-10 140.2 1,512.4 3,089.3

People aged 18-64 registered blind or partially sighted per 100,000

2013-14 155.8 188.3 214.1

People aged 65-74 registered blind or partially sighted (number) 2013-14 419 465 569

People aged 75+ registered blind or partially sighted per 100,000 2013-14 4,293.8 3,969.8 4,255.4

Adults with physical disabilities supported throughout the year per 100,000

2013-14 411.3 450.1 461.7

Adults with learning disabilities supported throughout the year per 100,000

2013-14 393.7 432.0 414.0

Adults with mental health problems supported throughout the year per 100,000

2013-14 175.8 352.6 391.3

Approximately 22 people in every 100,000 aged 18-64 are registered deaf or hard of hearing in Suffolk. This is very low compared to the England average. Caution should be taken when interpreting this data, as registration is voluntary and therefore this indicator is not a good proxy for the prevalence of hearing impairments. People who are deaf or hard of hearing and also blind or partially sighted are recorded on the Register of Blind and Partially Sighted Persons, and are excluded from the count of people who are deaf or hard of hearing.

Data indicates that approximately 156 of every 100,000 working age people (18-64) were registered as blind or partially sighted in 2013-14.40

The numbers of adults with physical difficulties or adults with mental ill health were significantly lower than England. Adults with learning disability were significantly lower in Suffolk than nationally. They are also lower than the East of England region which, although on a declining trajectory, remains higher than England.

39 Public Health England. Adult Social Care Profile. 2017. [Accessed 1 March 2017]. http://fingertips.phe.org.uk/adultsocialcare#gid/1000105/ati/102 40 Public Health England. Adult Social Care Profile. 2017.

http://fingertips.phe.org.uk/adultsocialcare#gid/1000105/ati/102


42

2.3.7.7 Maternities

In Suffolk in 2015 there were 7,933 maternities and 8,028 live births.41 A maternity is a pregnancy resulting in the birth of one or more children. This figure includes stillbirths and therefore represents the number of women giving birth rather than the number of babies born. Suffolk has a higher rate of maternities compared to England, and areas within Suffolk exhibit variation in maternity rates. Mid Suffolk has the lowest maternity rate (55.9 per 1,000 women), Forest Heath has the highest (80.1 per 1,000 women).

In terms of absolute numbers, Ipswich had the highest number of maternities (1,956), this represented 25% of all maternities in Suffolk. The age of the mother at birth was slightly lower in Suffolk compared to England. Live birth rates were highest in the 25-29 age group for Suffolk mothers, whereas England rates were highest in the 30-34 age group.

Figure 11: Maternities per 1,000 women aged 15 to 44, 201542

2.3.7.8 Homeless populations

In 2015-16 the rate of statutory homelessness in Suffolk was lower than the national average at 1.7 per 1,000 households compared with 2.5 for England (1.9 for England excluding London). In Suffolk, this equates to 545 homeless households. The rates of statutory homelessness are highest in St Edmundsbury, Forest Heath and Ipswich.

Figure 12: Statutory homelessness rate per 1,000 households, 2015-16 43

41 Office for National Statistics. Births by mothers’ usual area of residence in the UK. 2016. [Accessed 1 April 2017]. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/datasets/birthsbyareaofusualresidenceofmotheruk 42 ONS. Births by mothers’ usual area of residence in the UK. 43 Public Health England. Common Mental Health Disorders. 2016. http://fingertips.phe.org.uk/profile-group/mental-health/profile/common-mental-disorders/data#page/3/gid/8000026/pat/6/par/E12000006/ati/102/are/E10000029/iid/90556/age/164/sex/4

0.020.040.060.080.0

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https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/datasets/birthsbyareaofusualresidenceofmotheruk

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http://fingertips.phe.org.uk/profile-group/mental-health/profile/common-mental-disorders/data#page/3/gid/8000026/pat/6/par/E12000006/ati/102/are/E10000029/iid/90556/age/164/sex/4




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There is no available total number of homeless households in Suffolk. Those in priority need for whom there is a Local Authority statutory duty are recorded, but these are only a proportion of the total. The vast majority of single homeless people are not considered statutorily homeless (for example those ‘sofa surfing’ or residing with friends), and of these there is no record. 44

2015-16 data indicates that there were 155 households recorded as residing in temporary accommodation across Suffolk local authorities, with the highest rate in Babergh (0.9 per 1,000 households) and the lowest rate in Mid Suffolk (0.2 per 1,000 households)*.45 The rate for England during the same period was 3.1 per 1,000 households (1.0 excluding London). * Note: Suffolk coastal figures suppressed as too small to publish.

2.3.7.9 Daytime population (commuter flows)

Data for Suffolk local authorities indicates that Ipswich has the highest net commuter inflow, increasing the overall population size during the working hours. Mid Suffolk has the highest net commuter outflow, resulting in a decreased working hours population.

As well as workday movement, research by Visit England and Office of National Statistics estimated that in 2011 there were a total number of 31,228,000 day visitors to Suffolk. In 2010 there were 1,787,000 staying visitors in Suffolk, staying a total of 6,525,000 nights. The total number of day visitors was 24,808,375.46

Figure 13: Local authority commuter flow data, Suffolk, 201147

44 Suffolk County Council. Minutes of the Suffolk County Council Meeting held on 8 December 2016 at 2pm in the King Edmund Chamber, Endeavour House, Ipswich. 2016. [Accessed 1 April 2017]. https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwi3t8SPxK3TAhXFLsAKHYmUB1MQFgglMAA&url=http://committeeminutes.suffolkcc.gov.uk/LoadDocument.aspx?rID=0900271181f36626&qry=c_committee~~County+Cou 45 Department for Communities and Local Government. Table 784: local authorities’ action under the homelessness provisions of the Housing Acts, financial years 2004-5 to 2015-16. 2016. [Accessed 1 March 2017]. https://www.gov.uk/government/statistical-data-sets/live-tables-on-homelessness 46 Office for National Statistics. Leisure and Tourism. 2011. [Accessed 1 March 2017]. https://www.ons.gov.uk/peoplepopulationandcommunity/leisureandtourism 47 Office for National Statistics. Where do we commute to? http://webarchive.nationalarchives.gov.uk/20160105224014/http://www.ons.gov.uk/ons/rel/census/2011-

https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwi3t8SPxK3TAhXFLsAKHYmUB1MQFgglMAA&url=http://committeeminutes.suffolkcc.gov.uk/LoadDocument.aspx?rID=0900271181f36626&qry=c_committee~~County+Cou



https://www.gov.uk/government/statistical-data-sets/live-tables-on-homelessness

https://www.ons.gov.uk/peoplepopulationandcommunity/leisureandtourism

http://webarchive.nationalarchives.gov.uk/20160105224014/http:/www.ons.gov.uk/ons/rel/census/2011-census/origin-destination-statistics-on-migration--workplace-and-students-for-local-authorities-in-the-united-kingdom/sum---commuting-patterns-in-the-uk--2011.html


44

2.3.7.10 Gypsy and Traveller population

Gypsy and Traveller populations were counted at the 2011 Census for Suffolk. They numbered 604 (0.1%) people in Suffolk, however, this figure is likely to be an underestimate. Estimates suggest there are about 1,500 Gypsies and Travellers living in Suffolk in either trailers or houses based on an average of four persons per unit.48 Across Suffolk there are a number of council- and privately-owned Gypsy and Traveller sites.

The Roma community come from Central and Eastern Europe and recently arrived in the UK, mostly after 2004. An estimate from the Roma community suggests there are about 1,000 Romanian Roma and 100 Bulgarian Roma living in Ipswich.

School Census data for 2016 indicates a larger cohort of primary school age children in Suffolk are of Gypsy/Roma or Irish Traveller heritage, however this is still a relatively small number (400 pupils or 0.4% of all primary school pupils). The proportions are similar to England levels.

Gypsies, Travellers and Roma have their own cultural health beliefs, and generally have a lower rate of GP registrations compared to the general population, as well as a life expectancy that is ten years lower.49 Significant health problems include long-term illness, respiratory disease (asthma and bronchitis), chest pain, chronic cough, higher maternal and neonatal death rates, high smoking rates, and anxiety and depression.

Table 13: School pupils of Gypsy, Roma or Irish Traveller heritage, 201650

Gypsy / Roma or Traveller of Irish Heritage

School type Area Number % of all pupils compulsory school age and above

Primary Suffolk 200 0.4%

England 16,788 0.5%

Secondary Suffolk 65 0.2%

England 8,034 0.3%

Special Suffolk 4 0.4%

England 435 0.4%

Total Suffolk 269 0.3%

England 25,257 0.4% census/origin-destination-statistics-on-migration--workplace-and-students-for-local-authorities-in-the-united-kingdom/sum---commuting-patterns-in-the-uk--2011.html. Published 2011. Accessed April 1, 2017. 48 Suffolk County Council. Groups At Risk of Disadvantage Needs Assessment. 2015. https://www.healthysuffolk.org.uk/jsna/reports/health-needs-assessments 49 Suffolk County Council. Groups At Risk of Disadvantage Needs Assessment. 2015. 50 Department for Education. Schools, pupils and their characteristics: January 2016. 2016. [Accessed 1 April 2017]. https://www.gov.uk/government/statistics/schools-pupils-and-their-characteristics-january-2016.



https://www.healthysuffolk.org.uk/jsna/reports/health-needs-assessments

https://www.gov.uk/government/statistics/schools-pupils-and-their-characteristics-january-2016


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2.3.7.11 Housebound populations

There is no single indicator representing the number of housebound residents in Suffolk. However, the following data provides an overview of potential proxy for this indicator. For example, disabled populations may be less likely to leave their homes due to the severity of their disablement, carer populations may be indicative of a housebound resident being cared for, and the carer may be housebound due to their caring commitments.

At the 2011 Census 0.8% of the Suffolk population was residing in medical/care communal establishment (just over 5,600 people).51 The numbers of people in medical/care communal establishment settings were highest in Suffolk Coastal (1,145) and lowest in Forest Heath (285).

Working-age client group data indicates approximately 41,000 Suffolk residents of working age claim some sort of benefit: when expressed as a percentage this is lower than the East of England and Great Britain. When including older people and children, the total number of disability living allowance claimants was 25,000 in August 2016.

Attendance allowance is given to those aged 65+ for personal care because an individual is physically or mentally disabled. Data for Suffolk indicates that in August 2016 20,440 residents were in receipt of attendance allowance.52

Table 14: Working-age client group claimants, 201653

51 Nomis. 2011 Census Data. 2011. 52 Department for Work and Pensions. Cases in Payment Aug 2016 – Stats Xplore. 2016. [Accessed 20 July 2004]. https://stat-xplore.dwp.gov.uk/webapi/jsf/tableView/tableView.xhtml. 53 Nomis. Labour market profile. 2016. [Accessed 1 April 2017]. Retrieved 10 March 2016 from https://www.nomisweb.co.uk/reports/lmp/la/1941962836/report.aspx.

https://stat-xplore.dwp.gov.uk/webapi/jsf/tableView/tableView.xhtml

https://www.nomisweb.co.uk/reports/lmp/la/1941962836/report.aspx


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Table 15: Disability Living Allowance (DLA) cases in payment, August 201654

Aug 2016

Area Children Working age Over State Pension age Total

Babergh 506 1,197 878 2,583

Forest Heath 299 751 647 1,694

Mid Suffolk 514 1,138 983 2,638

Ipswich 1,106 2,720 1,643 5,474

St Edmundsbury 621 1,639 1,150 3,415

Suffolk Coastal 688 1,584 1,421 3,692

Waveney 1,025 2,385 2,105 5,512

Total 4,761 11,416 8,829 25,008 Table 16: Indicator data relevant to more care-dependent population55

Indicator: 2013/14 Time period Suffolk East of

England England

Older people (65+) supported throughout the year per 100,000 2013-14 8,194 8,738 9,781

Permanent admissions to residential and nursing care homes per 100,000 aged 18-64

2013-14 12.9 16.7 14.4

Permanent admissions to residential and nursing care homes per 100,000 aged 65+

2013-14 629.6 649.1 650.7

Adults who received home care during the year per 100,000 2013-14 1,580.2 1,132.1 1,110.0

Adults who received meals during the year per 100,000 2013-14 130.0 79.1 75.4

Adults who received professional support during the year per 100,000

2013-14 332.6 297.8 460.2

Adults who received any community-based support during the year per 100,000

2013-14 2,323.2 2,347.3 2,482.4

Adults receiving day care service per 100,000 2013-14 329.2 305.7 301.1

54 Department for Work and Pensions. Cases in Payment Aug 2016 – Stats Xplore. 2016. 55 Public Health England. Adult Social Care Profile. 2017.


47

2013-14 data indicates that the rate of older people (65+) supported year-round is significantly lower in Suffolk than nationally, however this still amounts to nearly 13,000 Suffolk residents. Data for the same period indicates that during the year there were 2,625 adults in residential care.

The rate of Suffolk residents receiving home care during 2013/14 was significantly higher than England, and equated to 9,240 individuals. Contrary to a national decreasing trend, Suffolk data indicates that the number and rate of those receiving home care increased between 2012-13 and 2013-14.

The rate of Suffolk residents receiving day care was significantly higher than England in 2013-14 although there has been a steady decline in rates both locally and nationally since 2006-07.

2.3.8 Deprivation

The English Indices of Deprivation measure relative levels of deprivation in 32,844 small geographical neighbourhoods, called Lower-layer Super Output Areas (LSOAs), in England.

It is important to note that these statistics are a measure of relative deprivation, not affluence, and to recognise that not every person in a highly-deprived area will themselves be deprived. Likewise, there will be some deprived people living in the least deprived areas.56

A range of economic, social and housing indicators is combined into a single deprivation score for each LSOA. The score is an absolute measure of deprivation. The score allows the 32,482 LSOAs in England to be ranked relative to one another. The overall Suffolk score for 2015 was 18.3, this is lower than England at 21.8.

The indices of deprivation also provide ranking of local authorities, where the lower the rank, the more deprived the area. Ipswich remains the most deprived local authority in Suffolk, being ranked 71st out of 326 LAs in England. Ipswich has risen in the rankings from 99 in 2007, but still remains outside the top 20% of most deprived LAs nationally.

It should be noted, that although Forest Heath appears to have dropped 100 places in the ranking, early data was generated using populations including United States military personnel based in the area.

Suffolk has become more deprived compared to other local authority areas in England since 2010. Only three counties/unitary authorities worsened by more places in the rankings than Suffolk. However, Suffolk continues to experience below-average levels of deprivation.

56 Suffolk County Council. Suffolk Changes in the Index of Multiple Deprivation from 2010 to 2015. 2016. https://www.healthysuffolk.org.uk/uploads/SCC-Index-of-Multiple-Deprivation-2010-2015-FINAL.pdf

https://www.healthysuffolk.org.uk/uploads/SCC-Index-of-Multiple-Deprivation-2010-2015-FINAL.pdf


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Figure 14: Deprivation by LSOAs in Suffolk Comparative IMD distribution in 2010 and 2015

The impact of rurality and deprivation57:

Despite these relatively low levels of overall rural deprivation in Suffolk, small distinct pockets of rural deprivation do clearly exist; these can be hidden by the Indices of Multiple Deprivation being calculated at LSOA level.

The cost of providing services in rural areas is estimated to be significantly higher than the cost of providing services in urban areas.

Suffolk’s rural population is older than its urban population, and the proportion of older people in Suffolk’s rural population is increasing faster than the proportion of older people in urban areas. This trend, combined with the higher cost of providing services in rural areas, housing stock which is often difficult to heat and maintain, poor transport and more limited social networks, is likely to lead to high and increasing needs and costs for Suffolk’s rural population now and in the future.

2.3.9 Premature mortality

Premature mortality is a good high-level indicator of the overall health of a population, being correlated with many other measures of population health. The number of premature deaths in Suffolk from 2013-15 was 6,140, directly standardised rates of premature (under 75) mortality in Suffolk local authorities show variation.

Rates are highest in Ipswich (364 per 100,000 population) equating to 1,114 premature deaths, and are significantly higher than England. Rates are lowest in Babergh (251 per 100,000 population) equating to 698 premature deaths during 2013-15. Map O shows Standard Mortality Ratio (SMR) for all-cause mortality under 75 (2010-2014 inclusive).

57 Suffolk County Council. Rural Deprivation in Suffolk. 2016. https://www.healthysuffolk.org.uk/uploads/Rural-Deprivation-in-Suffolk-May-2016.pdf

https://www.healthysuffolk.org.uk/uploads/Rural-Deprivation-in-Suffolk-May-2016.pdf

https://www.healthysuffolk.org.uk/uploads/Rural-Deprivation-in-Suffolk-May-2016.pdf


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Figure 15: Directly standardised mortality rate for mortality from all causes, aged <75, 2013-1558

Key compared with England:

2.4 Causes of ill health

2.4.1 Cardiovascular disease (CVD)

Cardiovascular disease (CVD) refers to all the diseases of the heart and circulation, including heart attack and stroke. CVD accounts for one in ten of all emergency admissions and is one of the highest causes of emergency hospital admission in Suffolk, with over 7,300 hospital admissions during 2013/14.

In Suffolk, the premature mortality rate (age under 75) from cardiovascular disease was 62.2 per 100,000 population in 2013-15. This was significantly lower than the England rate of 74.6 per 100,000.

When split by gender, Suffolk males had a higher mortality rate (62.2 per 100,000) compared to Suffolk females (35.4 per 100,000). However, these mortality rates were both significantly lower than England males and females.

At local authority level, higher premature mortality rates were identified in males living in Forest Heath, Ipswich and Waveney.

In 2013-15 in Suffolk there were 853 deaths from cardiovascular diseases in those aged under 75 that were considered preventable. During the same period the total cardiovascular disease deaths in those age under 75 totalled 1,317.

In those aged 65 and over there were 5,617 deaths from cardiovascular disease in 2013-15. This number has been steadily declining since 2001-03, mirroring national trends. This figure equates to a rate of 1,116.6 per 100,000 population 65+, and is significantly better than the England rate of 1,191.9 per 100,000.

58 Public Health England. Public Health Profiles: Indicator Definitions and Supporting Information. http://fingertips.phe.org.uk/search/all%20cause%20mortality#page/6/gid/1/pat/6/par/E12000006/ati/101/are/E06000055/iid/108/age/163/sex/4

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Figure 16: Under-75 mortality rate from CVD considered preventable, directly standardised rate per 100,000, 2013-1559

2.4.2 Cancers

Data from Public Health England indicates that compared to England, Suffolk CCGs have a higher rate of new cancer cases and a higher cancer prevalence overall.

Table 17: Cancer summary statistics, by Suffolk CCG, mixed years60

Indicator Year Ipswich and East Suffolk

CCG

West Suffolk

CCG

Great Yarmouth

and Waveney

CCG

England

New cancer cases (Crude incidence rate: new cases per 100,000 population)

2013-14 605 639 664 515

Cancer: QOF % prevalence (all ages)

2015-16 2.80% 3.10% 2.90% 2.40%

Number of emergency admissions with cancer (Number per 100,000 population)

2015-16 567 706 722 538

59 Public Health England. Public Health Outcomes Framework. March 2017. 60 Public Health England. Cancer Services Profile. April 2017. [Accessed 1 April 2017]. https://fingertips.phe.org.uk/profile/cancerservices

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Data for cancer screening indicates that Suffolk has a higher percentage of the eligible population being screened for breast, bowel and cervical cancers compared to England.

Table 18: Cancer summary statistics, for Suffolk, mixed years61

Indicator Date Suffolk England

Cancer screening coverage – cervical cancer 2016 74.5% 72.7%

Cancer diagnosed at early stage (experimental statistics) 2014 57.1% 50.7%

Cancer screening coverage – bowel cancer 2016 62.0% 57.9%

Cancer screening coverage – breast cancer 2016 78.9% 75.5%

Under-75 mortality rate from cancer (persons) (per 100,000) 2013-15 131.8 138.8

Under-75 mortality rate from cancer (male) (per 100,000) 2013-15 143.4 154.8

Under-75 mortality rate from cancer (female) (per 100,000) 2013-15 121.0 123.9

Under-75 mortality rate from cancer considered preventable (persons) (per 100,000) 2013-15 74.6 81.1

Under-75 mortality rate from cancer considered preventable (female) (per 100,000) 2013-15 69.6 74.5

Under-75 mortality rate from cancer considered preventable (male) (per 100,000) 2013-15 80.1 88.4

Benchmark = England

Ipswich and East Suffolk CCG had the highest number of recorded cancer deaths in 2015 (1,116).

61 Public Health England. Public Health Outcomes Framework. March 2017.


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Table 19: Cancer summary mortality statistics, for Suffolk CCGs, 201562

England

Ipswich and East Suffolk

CCG West

Suffolk CCG Great

Yarmouth and Waveney CCG

Cancer deaths (%) % No. % No. % No. %

Persons, all ages 27.4% 1,116 27.4% 580 27.5% 727 28.1%

Persons, aged 0-64 years 37.3% 196 43.0% 106 40.1% 120 38.7%



Persons, aged 85 years and over 14.9% 266 14.0% 127 14.5% 169 15.4%

Note: percentage is the percentage of deaths within the age group.

2.4.3 Diabetes

2015-16 data for Suffolk indicates that the prevalence of diabetes in those aged 17+ is 6.3%, similar to the England prevalence of 6.5%.63 This equates to over 40,300 Suffolk residents with a diagnosis of diabetes. It is estimated that there may be approximately 7,500 people with undiagnosed diabetes in Suffolk.64

In terms of the control of diabetes, at CCG level, the figures for well-controlled blood glucose were 61.4% for Ipswich and East Suffolk CCG (better than the national average) and 61.3% in West Suffolk CCG (similar to the national average). However, cholesterol control in those with diabetes was poorer than the national average for Ipswich and East Suffolk CCG. West Suffolk CCG had a higher percentage of patients with diabetes with good blood pressure control compared to England. For all three indicators, the Great Yarmouth and Waveney CCG had significantly worse levels than the England average. Great Yarmouth and Waveney also has a higher prevalence of diabetes compared to other Suffolk CCGs and England as a whole.

62 Public Health England. End of Life Profiles. April 2017. [Accessed 1 April 2017]. http://fingertips.phe.org.uk/end-of-life 63 Public Health England. Fingertips Disease and Risk Factor Prevalence. 2017. [Accessed 1 April 2017]. http://fingertips.phe.org.uk/prevalence#gid/8000021/ati/102 64 Suffolk County Council. Suffolk Annual Public Health Report 2015. 2015. http://www.healthysuffolk.org.uk/assets/JSNA/Annual-Report/19673-APHR-2015-LR-20151209.pdf

http://fingertips.phe.org.uk/end-of-life

http://fingertips.phe.org.uk/prevalence#gid/8000021/ati/102

http://www.healthysuffolk.org.uk/assets/JSNA/Annual-Report/19673-APHR-2015-LR-20151209.pdf


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Table 20: Diabetes control in Suffolk CCGs, 2015-1665

Ipswich and East Suffolk

CCG

West Suffolk

CCG

Great Yarmouth

and Waveney CCG

England

Prevalence of diabetes (17+) 5.9% 6.4% 7.7% 6.5%

Good blood sugar control in people with diabetes 61.4% 61.3% 54.1% 60.1%

Good blood pressure control in people with diabetes 70.8% 72.0% 67.2% 70.4%

Good cholesterol control in people with diabetes 68.5% 69.2% 64.6% 70.0%

Benchmark = England

2.4.4 Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is the name used to describe a number of lung diseases including chronic bronchitis and emphysema. The main cause of COPD is smoking, which accounts for about 75% of cases.

In 2015-16 there were 1,567 emergency hospital admissions for COPD in Suffolk, and during 2013-15 there were 952 deaths from COPD. In Suffolk local authorities, mortality rates from COPD are higher than the Suffolk average in Forest Heath and Ipswich, and lower in Suffolk Coastal.

Table 21: COPD indicators for Suffolk, 2013-2015, Directly Standardised Rates per 100,000 population66

Indicator (rate per 100,000) Year Suffolk England

Under 75 mortality rate from respiratory disease considered preventable (persons)

2013-15 10.9 18.1

Under 75 mortality rate from respiratory disease considered preventable (male) 2013-15 12.1 20.3

Under 75 mortality rate from respiratory disease considered preventable (female) 2013-15 9.8 16.1

Under 75 mortality rate from respiratory disease (female) 2013-15 21.2 28

Under 75 mortality rate from respiratory disease (persons) 2013-15 23.7 33.1

65 Public Health England. Diabetes Profile. April 2017. [Accessed 1 April 2017]. https://fingertips.phe.org.uk/diabetes 66 Public Health England. Public Health Outcomes Framework. March 2017.

https://fingertips.phe.org.uk/diabetes


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Indicator (rate per 100,000) Year Suffolk England

Under 75 mortality rate from respiratory disease (male) 2013-15 26.4 38.5

Deaths from COPD 2013-15 37.7 52.6

Emergency hospital admissions for COPD 2014-15 331 415

Rate of deaths from respiratory disease among people aged 65 years and over 2013-15 547.5 646.2

Benchmark = England

Figure 17: Deaths from COPD, directly standardised rate per 100,000 population, 2013-1567

2.4.5 Depression and mental health

One in four Suffolk residents experience some form of mental ill health across a spectrum of severity levels in any given year.68

People with mental health conditions experience poor outcomes in terms of physical health and mortality rates.69 Conversely, people with long-term physical conditions experience high levels of mental ill health, as do informal and family carers supporting people at home.70

67 Public Health England. Local Tobacco Control Profiles. April 2017. [Accessed 1 April 2017]. http://www.tobaccoprofiles.info. 68 Suffolk County Council. Suffolk Minds Matter - Annual Public Health Report. 2016. http://www.healthysuffolk.org.uk/assets/JSNA/Annual-Report/APHR-2016/21991-APHR-2016-ONLINE.pdf. 69 The Mental Health Taskforce. The Five Year Forward View for Mental Health. 2016. https://www.england.nhs.uk/wp-content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf. 70 White C. 2011 Census Analysis: Unpaid care in England and Wales, 2011 and comparison with 2001. ONS 15 February 2013. http://webarchive.nationalarchives.gov.uk/20160109213406/http://www.ons.gov.uk/ons/dcp171766_300039.pdf

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Depression is a common and debilitating condition. Figures for 2015/16 indicate that around 9% people aged 18 and over in Suffolk have been recognised by their GP as having depression (over 55,000 people), with only small variation across the CCG areas:71

• Great Yarmouth and Waveney CCG: 9.2% • Ipswich and East Suffolk CCG: 8.7% • West Suffolk CCG: 8.7%

These figures are significantly higher than the England prevalence (8.3%), however, they may underestimate the prevalence of depression, as many cases still remain unreported.

In 2016, the rate of Employment Support Allowance (ESA) claimants for mental and behavioural disorders was lower in Suffolk compared with England. However, there was variation in Suffolk local authorities, with Ipswich and Waveney having significantly higher claimant rates compared with both Suffolk and England.

Figure 18: ESA claimants for mental and behavioural disorders, crude rate per 1,000 working age population, 201672

Benchmark = England Approximately 1% of the population will be affected by severe mental ill health. 2015-16 data indicates that 6,610 people registered at a Suffolk GP were diagnosed with schizophrenia, bipolar disorder or other psychoses (approximately 0.9% prevalence rate).73

71 Public Health England. Mental Health and Wellbeing JSNA. 2017. https://fingertips.phe.org.uk/profile-group/mental-health/profile/MH-JSNA/data#page/0 72 Public Health England. Mental Health and Wellbeing JSNA. 2017. 73 Public Health England. Mental Health and Wellbeing JSNA. 2017.

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There were 187 deaths from suicide between 2012 and 2014 in Suffolk, the majority being men (137), although the age standardised suicide rate per 100,000 people is not significantly different from regional and national averages.74

Self-harming is considered to be a risk factor for the development of mental ill health in young people.75 In Suffolk over the period 2010-11 to 2012-13 there were 1,274 admissions to hospital for self-harm in young people aged 10 to 24. The overall rate of self-harm admissions in Suffolk is similar to the national average (375 per 100,000 people aged 10-24 years compared with 399 per 100,000 in England).76 Hospital admissions data for Suffolk indicates that for children and young people aged 0-19 years, rates of self-harm are three times greater amongst the most deprived Suffolk residents compared with the least deprived.77

2.4.6 Accidental injuries

Suffolk has a lower rate of hospital admissions caused by unintentional and deliberate injuries in children and young people compared to England, and is similar to the East of England.

Figure 19: Rate of hospital admissions caused by unintentional and deliberate injuries in children and young people by age group, per 10,000 resident population, 2015-1678

74 Suffolk County Council. Suffolk Minds Matter - Annual Public Health Report. 2016. 75 Saunders KE, Smith KA. Interventions to prevent self-harm: what does the evidence say? Evid Based Ment Health. July 2016. doi:10.1136/eb-2016-102420 76 Public Health England. Children’s and Young People’s Mental Health and Wellbeing Profile. 2016. http://fingertips.phe.org.uk/profile-group/mental-health/profile/cypmh 77 Suffolk County Council. Suffolk Minds Matter - Annual Public Health Report. 2016 78 Public Health England. Public Health Outcomes Framework. March 2017.

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Figure 20: Age-standardised rate of mortality from injuries in people under 75, per 100,000 population, 2013-1579

Benchmark = England

The mortality rate for people under 75 is generally lower in Suffolk local authorities, the only exception being Forest Heath, where mortality rates are significantly higher than Suffolk and England.

Figure 21: Rate of people killed or seriously injured on the roads, all ages, per 100,000 resident population, 2013-1580

Benchmark = England

During 2013-15, 740 Suffolk residents were killed or seriously injured (KSI) on the roads. Forest Heath had a significantly higher KSI rate. However, it is important to note that areas with low resident populations but which have high inflows of people or traffic may have artificially high rates because the at-risk resident population is not an accurate measure of exposure to transport.

79 Public Health England. Longer Lives. April 2017. http://healthierlives.phe.org.uk/ Babergh data not available 80 Public Health England. Public Health Outcomes Framework. March 2017.

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As people become older, they become increasingly likely to fall. About 1 in 3 people aged over 65 and 1 in 2 people aged over 80 will fall at least once a year. Women are more likely to fall than men. Falls can cause serious physical injury, for example, a fractured hip, and they can also make people fearful and anxious, which means that they restrict their activities and lose their independence.81

In 2014-15 in Suffolk there were 3,048 emergency hospital admissions for injuries due to falls in persons aged 65+; this equates to approximately 8 admissions per day. 71% of these admissions were for people aged 80+. Suffolk has a lower rate of falls compared to the East of England and England overall. None of the local authorities in Suffolk had a significantly higher rate of falls in those aged 65+ compared to England.

Table 22: Age-sex standardised rate of emergency hospital admissions for injuries due to falls in persons aged 65+ per 100,000 population, 2014-1582

Indicator Suffolk East of England England

Injuries due to falls in people aged 65 and over 1,749 1,956 2,125

Injuries due to falls in people aged 65-79 759 874 1,012

Injuries due to falls aged 80+ 4,618 5,096 5,351

2.4.7 Asthma

2015-16 data indicates there were 342 hospital admissions for asthma in those aged under 19 in Suffolk. This equates to a rate of 183.3 per 100,000 population, similar to the England rate (202.4 per 100,000), but worse than the East of England rate (160.0 per 100,000 population).83

The prevalence of asthma across the three Suffolk CCGs was on average 6.7%; all the CCGS had a significantly higher prevalence of asthma when compared to England overall (5.9% prevalence).

81 Suffolk County Council. Suffolk Annual Public Health Report 2015. 2015. 82 Public Health England. Public Health Outcomes Framework. March 2017. 83 Public Health England. Overview of Child Health. April 2017. http://fingertips.phe.org.uk/child-health-overview

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Figure 22: Asthma prevalence for Suffolk CCGs, all ages, 2015-1684

Benchmark = England

2.4.8 Excess weight and obesity

In Suffolk, nearly one in ten children aged 4-5 are obese (9.1%), one in five (19.8%) children aged 10-11 years are obese.

In Suffolk, obesity in school children in reception year, measured under the National Child Measurement Programme, shows a downward trend over the last few years, from 8.7% in 2008-09 to 2010-11 to 8.2% in 2012-13 to 2014-15. The rate of obesity in this age group has been consistently around 1% below the rate for England.

The percentage of obese school children in Year 6 is around twice that of reception year. The trend of this age group is upward, from 16.2% in 2008-09 to 2010-11 to 17% in 2012-13 to 2014-15. In spite of this increase, the rate of obesity in this age group continues to be around 2% below the rate for England.

Approximately 2/3 of Suffolk adults are overweight or obese (66.1%), this is statistically worse than England levels (64.8%).

84 Public Health England. Inhale - INteractive Health Atlas of Lung conditions in England. 2017. https://fingertips.phe.org.uk/profile/inhale.

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Figure 23: Excess weight in Suffolk residents, 2015-1685

Figure 24: The percentage of physically active Suffolk residents, 201586

The Active People Survey 2015 indicates that 57.8% of Suffolk residents achieve at least 150 minutes of physical activity per week in accordance with UK Chief Medical Officer's (CMO) recommended guidelines on physical activity. In addition, the survey results indicate that 28.3% of the adult population in Suffolk takes part in less than 30 minutes of physical activity a week, similar to the figure for England and slightly above the average for the East of England.87

85 Public Health England. Public Health Outcomes Framework. March 2017. 86 Public Health England. Public Health Outcomes Framework. March 2017. 87 Public Health England. Public Health Outcomes Framework. March 2017.

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2.4.9 Palliative care

In 2015, 3.9% of deaths occurred in hospices, compared to 5.6% in England. For those aged 0 to 64 years, the percentage rises to 10.1% in Suffolk, similar to England’s rate of 10.6%.88

Generally, the rate reduces as age increases, with older people (i.e. over the age of 65) people less likely to die in a hospice and more likely to die in hospital or a care home. Compared to England, a statistically higher percentage of Suffolk residents died in their home or in a care home in 2015.

Table 23: Place of death for people of all ages, 201589

2.4.10 Influenza

Flu vaccination reduces the risk of seasonal flu and decreases hospital admissions for influenza, respiratory conditions and exacerbations of other conditions. The national flu vaccination programme for adults is targeted at people most at risk of harm from this: people aged 65 years and over, people under 65 in specific clinical risk groups, and pregnant women. The majority of vaccination is given between September and January each year by the GP practice with many pharmacists also offering the service.

71.2% of the population aged over 65 was vaccinated against influenza in 2015-16, similar to the England figure of 71.0% and the figure for the East of England of 70.9%. By contrast, only 42.4% of those under 65 considered at risk were vaccinated, below the England figure of 45.1% and the same as that for the East of England.90

Data indicates that the more deprived an area, the smaller the proportion of people vaccinated. 22% of the variation in influenza vaccine uptake by area can be explained by deprivation, rising to 26% for pregnant women. Residents in these localities are at greater risk of poor health compared with the county as a whole.

The mortality rate from a range of specified communicable diseases (including influenza) was 6.8 per 100,000 population for 2013-15, lower than the rate for England at 10.5 per 100,000 and the East (8.7 per 100,000 population).

88 Public Health England. Fingertips - End of Life Care Profiles. 2017. [Accessed 1 April 2017]. https://fingertips.phe.org.uk/profile/end-of-life 89 Public Health England. Fingertips - End of Life Care Profiles. 2017. 90 Public Health England. Public Health Outcomes Framework. March 2017.

Number Suffolk East of England England

Hospital deaths 3,276 42.6% 45.0% 46.7%

Care home deaths 2,092 27.2% 24.7% 22.6%

Home deaths 1,885 24.5% 23.4% 22.8%

Deaths in other places 146 1.9% 2.2% 2.2%

Hospice deaths 300 3.9% 4.7% 5.6%

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2.4.11 Coronary heart disease

Data indicates that across the three Suffolk CCGs, on average 3.7% of the population is affected by coronary heart disease, compared with 3.2% in England and the East of England.91

Data for the three CCGs covering Suffolk shows that admissions to hospital (all ages) due to coronary heart disease are higher than the England figure of 539.7 per 100,000 population (2014/15):

• Ipswich and East Suffolk = 558.5 per 100,000 (2,362 admissions) • Great Yarmouth and Waveney = 550.4 per 100,000 (1,353 admissions) • West Suffolk = 619.3 per 100,000 (1,420 admissions)

However, the mortality rates of those under 75 years from coronary heart disease are lower in Suffolk than England, where the figure is 41.5 per 100,000 population (2012-14).92 CCG data is provided below:

• Ipswich and East Suffolk = 30.5 per 100,000 (341 deaths) • Great Yarmouth and Waveney = 40.9 per 100,000 (265 deaths) • West Suffolk = 35.1 per 100,000 (215 deaths)

2.4.12 Strokes and Transient Ischaemic Attacks

2015-16 QOF data indicates that 2.0% of the Suffolk population registered with a GP in Suffolk is recorded as having suffered a stroke or transient ischaemic attack, higher than both the East of England and England values (both 1.7%).93

Additionally, Atrial Fibrillation (AF) is one of the most common forms of abnormal heart rhythm affecting over 15,500 people in Suffolk.94 AF increases with age and is present in nearly a fifth of those aged 85 years and above. AF is a major cause of stroke – the annual risk of a stroke is five to six times greater for people with AF.95

2.4.13 Hypertension

In Suffolk, 15.2% of patients registered with a GP are recorded as having hypertension (high blood pressure), a higher rate compared to the East of England at 14.1% and England at 13.8%.96

91 Public Health England. Fingertips Cardiovascular Disease Profiles. 2017. [Accessed 1 March 2017]. https://fingertips.phe.org.uk/profile/cardiovascular/data#page/0/gid/1938132736/pat/46/par/E39000030/ati/19/are/E38000010 Great Yarmouth and Waveney CCG includes the Great Yarmouth local authority, which falls within the county of Norfolk. 92 Public Health England. Fingertips Cardiovascular Disease Profiles. 2017. 93 Public Health England. Disease and risk factor prevalence. http://fingertips.phe.org.uk/prevalence#gid/8000021/ati/102 94 Public Health England. Disease and risk factor prevalence. http://fingertips.phe.org.uk/prevalence#gid/8000021/ati/102 95 Suffolk County Council. Suffolk Annual Public Health Report 2015. 2015. 96 Public Health England. Disease and risk factor prevalence. http://fingertips.phe.org.uk/prevalence#gid/8000021/ati/102

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However, modelled estimates at local authority level indicate this figure could be much higher, and there may be a large proportion of Suffolk residents with undiagnosed hypertension.

Finding and treating people with high blood pressure is arguably the most effective way to prevent heart attacks, strokes, cognitive decline and premature death and disability.

Table 24: Modelled estimates of hypertension in those 18+, 201597

Modelled estimate of

prevalence (%) Estimated prevalence of

undiagnosed hypertension (%)

Babergh 23.2 13.3

Forest Heath 19.5 12.1

Ipswich 19.3 11.8

Mid Suffolk 22.1 13.2

St Edmundsbury 21.2 12.6

Suffolk Coastal 23.4 13.2

Waveney 26.4 13.5

The majority of people in Suffolk already diagnosed with high blood pressure are managing their condition well. However, over 25,000 people are not managing it to the levels recommended.

Improvements in tackling blood pressure in the last decade have prevented or postponed many deaths. Standards are in place that describe good control of hypertension, however it is estimated that only four in ten adults in Suffolk with high blood pressure are both aware of their condition and are managing it properly.98

2.5 Lifestyle

2.5.1 Drug and alcohol misuse

Prevalence estimates for 2011-12 (latest available) suggest there are 2,398 opiate and/or crack cocaine users resident in Suffolk, giving an estimated prevalence rate of 5.2 per 1,000 population. Not all of these individuals will be in substance misuse treatment services, and many will be unknown to treatment services.99

97 http://fingertips.phe.org.uk/prevalence#gid/8000021/ati/102 98 Suffolk County Council. Suffolk Annual Public Health Report 2015. 2015. 99 Suffolk County Council. Suffolk Minds Matter - Annual Public Health Report. 2016 https://www.healthysuffolk.org.uk/uploads/21991-APHR-2016-ONLINE.pdf


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Mental ill health is common among those in treatment for drug use,100 and in Suffolk 19.1% of all people entering specialist drug misuse services in 2014/15 were having treatment from mental health services for a reason other than substance misuse at the time of assessment.

2.5.2 Alcohol and related disease

Although many people consume alcohol without damaging their health, excessive consumption can cause severe physical and mental health conditions. It is estimated that approximately 15% of the Suffolk population aged over 18 drinks above the advised limits and 3.8%, or 22,000 people, in Suffolk are alcohol-dependent.101

Rates of hospital admissions for alcohol and other substance misuse are lower in Suffolk than regionally or nationally, but in 2014-15 just over 8,000 people in Suffolk had an alcohol-related hospital admission.

Suffolk has a significantly low figure for Years of Life Lost (YLL) due to alcohol-related conditions – 414 per 100,000 of population compared to the average in England at 552 per 100,000.102

Nevertheless, more than 2,000 people in Suffolk per year are in poor health related to alcohol. Suffolk rates of admissions related to alcohol are generally lower than in the East of England and England.

Table 25: Admissions for alcohol related conditions, directly standardised rates per 100,000 population, Suffolk103


Admission episodes for alcohol-related cardiovascular disease conditions (Broad) (persons) (2014-15)

967 1,014 1,077

Admission episodes for mental and behavioural disorders due to use of alcohol condition (Broad) (2014-15)

238 266 390

Admission episodes for alcoholic liver disease condition (Broad) (persons) (2014-15)

72.6 85.4 108.9

Incidence rate of alcohol-related cancer (persons) (2012-14) 36.85 36.07 38.04

Benchmark = England 100 Public Health England. Co-occurring substance misuse and mental health issues. 2016. http://fingertips.phe.org.uk/profile-group/mental-health/profile/drugsandmentalhealth/data#page/6/gid/1938132791/pat/6/par/E12000006/ati/102/are/E10000029/iid/91294/age/168/sex/4 101 Suffolk County Council. Suffolk Annual Public Health Report 2015. 2015. 102 Public Health England. Local Alcohol Profiles for England. 2017. [Accessed 1 April 2017]. https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/3/gid/1938132848/pat/6/par/E12000006/ati/101/are/E07000200/iid/91411/age/1/sex/4 103 Public Health England. Local Alcohol Profiles for England. 2017.

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2.5.3 Sexual health and teenage pregnancy

Suffolk has lower rates of Sexually Transmitted Infections (STIs), HIV and teenage pregnancy compared to England, although there is variation at local authority level. In 2015, Ipswich had the highest rate of all new STI diagnoses at 744 per 100,000 population, similar to the England rate. Mid Suffolk had the lowest new STI diagnoses rate at 325 per 100,000, significantly below the England rate.

Figure 25: All new STI diagnoses, rate per 100,000 population, 2015104

Figure 26: All new STI diagnoses, rate per 100,000 population for Suffolk local authorities, 2015105

Benchmark = England

104 Public Health England. Sexual and Reproductive Health Profiles. 2017. [Accessed 1 April 2017]. https://fingertips.phe.org.uk/profile/sexualhealth 105 Public Health England. Sexual and Reproductive Health Profiles. 2017.

2012 2013 2014 2015Suffolk 569 561 484 445East of England 640 639 612 569England 803 804 796 768

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Table 26: Selected STI diagnoses, rate per 100,000 population for Suffolk local authorities, 2015106

Syphilis diagnostic rate / 100,000

Gonorrhoea diagnostic rate / 100,000

Chlamydia detection rate / 100,000 aged 15-24

Genital warts diagnostic rate / 100,000

Genital herpes diagnosis rate / 100,000

New HIV diagnosis rate / 100,000 aged 15+

Babergh 3.4 7.9 977.0 95.7 39.4 2.7

Forest Heath 6.4 17.5 595.0 79.6 31.8 9.7

Ipswich 3.0 40.0 1,699.0 114.8 60.0 4.5

Mid Suffolk 0.0 7.1 694.0 81.7 44.4 0.0

St Edmundsbury 3.6 11.6 1,139.0 108.0 41.0 4.3

Suffolk Coastal 2.4 16.0 986.0 83.3 45.7 6.6

Waveney 1.7 7.8 787.0 83.7 50.9 8.2

Suffolk 2.7 16.4 1,054.0 93.8 46.3 5.0

England 9.3 70.7 1,887.0 118.9 57.6 12.1 For Chlamydia: Benchmark = England

2.5.3.1 Teenage conceptions Suffolk has a lower teenage conception rate for females aged 15-17 when compared to England. In 2015 there were 196 conceptions in Suffolk females aged 15-17 years.

Figure 27: Crude rate of conception for females aged 15-17 years, 2010-15107

Local authorities within Suffolk show variation, with Ipswich and Waveney having the highest conception rates. Although Waveney has a conception rate that is statistically similar to England, Ipswich has a significantly higher rate of conceptions.

106 Public Health England. Sexual and Reproductive Health Profiles. 2017. 107 Public Health England. Sexual and Reproductive Health Profiles. 2017.

2010 2011 2012 2013 2014 2015Suffolk 26.1 26.0 24.8 19.6 17.4 15.6East of England 29.1 26.6 23.2 21.0 20.2 18.8England 34.2 30.7 27.7 24.3 22.8 20.8

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Figure 28: Crude rate of conceptions for females aged 15-17 years, Suffolk, 2015108

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In Suffolk in 2015, 44.4% of teenage conceptions lead to abortion, lower than the rates for both the East of England (50.0%) and England (51.2%). As with the conception rate, there is variation around the county: 71.4% of conceptions in Mid Suffolk resulted in abortion in 2015, compared to only 27.0% in Ipswich.

2.5.4 Smoking

2015 data indicates that 16.1% of the adult population in Suffolk smokes, a similar proportion to both the East of England (16.6%) and England (16.9%).109 However, for those in routine and manual occupations the smoking prevalence rises to 23.1% in Suffolk, compared with 26.4% for the East of England and 26.5% for England.

Figure 29: Smoking prevalence in local authorities in Suffolk, 2015110

108 Public Health England. Sexual and Reproductive Health Profiles. 2017. 109 Suffolk County Council. Suffolk Changes in the Index of Multiple Deprivation from 2010 to 2015. 2016. 110 Public Health England. Local Tobacco Control Profiles. April 2017.

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Between 2012 and 2014, 3,351 deaths were attributable to smoking, equating to approximately 3 deaths every day. In 2014/15 there were 7,635 smoking-attributable hospital admissions.111

2014-15 data indicates that 8.6% of 15 year olds in Suffolk were current smokers, and 17.6% of 15 year olds used or had tried e-cigarettes.112

Figure 30: Smoking-attributable mortality by local authority, directly standardised rate per 100,000 population, 2012-2014113

Benchmark = England

Smoking-attributable mortality varies across Suffolk local authorities, although none of the areas in Suffolk have significantly higher rates than England.

2.5.5 Oral health

Data from oral health surveys indicates that 93.2% of children aged 3 years are free from obvious dental decay in Suffolk, significantly higher than the national average of 88.4%. Surveys also suggest that the proportion free from obvious dental decay is lower in those age 5, although Suffolk’s figure of 79.1% is still significantly higher than that for England at 75.2%.114

111 Public Health England. Local Tobacco Control Profiles. April 2017. 112 Public Health England. Local Tobacco Control Profiles. April 2017. 113 Public Health England. Local Tobacco Control Profiles. April 2017. 114 Public Health England. Oral Health Profile. April 2017. [Accessed 1 April 2017]. https://fingertips.phe.org.uk/profile/oral-health

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Figure 31: Children aged 3 and 5 years free from obvious dental decay, 2013-15115

(Note: data for 3 year olds is from 2012-13, data for 5 year olds is 2014-15)

There is some variation around the county, although for 3 year olds the figures for all local authorities in Suffolk are all over 90%; the highest figure is 95.5% in Babergh, the lowest 91.4% in Forest Heath.

Figure 32: Children aged 3 years free from obvious dental decay (2012-13) 116

Benchmark = England

For five year olds, the variation is more marked; figures range from 74.9% in Ipswich to 88.4% in Mid Suffolk. For this age group, only two Suffolk local authorities have a significantly higher percent of decay-free children compared with England (Babergh and Mid Suffolk).

115 Public Health England. Oral Health Profile. April 2017. 116 Public Health England. Oral Health Profile. April 2017.

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Figure 33: Children aged five years free from obvious dental decay (2014-15)117

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117 Public Health England. Oral Health Profile. April 2017.

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Section 3: NHS pharmaceutical services provision – currently commissioned 3.1 Community pharmacies

There are 146 community pharmacies in Suffolk, compared to 148 in 2015 PNA, serving a population of 741,895. This equates to an average of 19.7 pharmacies per 100,000 population, which has decreased slightly from the 2015 figure of 20.1 pharmacies. The figure is lower than the England average (2015/16 data) which is 21.5 pharmacies per 100,000 population. Given that over 50% of the population of Suffolk lives in areas defined as rural, the density of community pharmacies varies significantly between each locality (Map A). Table 27 provides a breakdown, by locality, of average number of community pharmacies per 100,000. This table should be used as a guide only, as it does not give any indication of the pharmacies' opening hours.

Table 27: Breakdown of average community pharmacies per 100,000 population118

Locality

Number of community Pharmacies (as of 21st April 2017)

Mid 2015 population predictions

Average number of community pharmacies per 100,000 population (as of mid

2015)

Average number of community pharmacies

and dispensing GP practices per 100,000 population

Babergh 17 89,215 19 26.9

Forest Heath 11 63,691 17.3 28.2

Ipswich 33 135,600 24.4 24.4

Mid Suffolk 14 99,632 14.1 24.1

St Edmundsbury 19 112,523 16.9 24.1

Suffolk Coastal 24 125,052 19.2 24

Waveney 28 116,182 24.1 27.6

Suffolk HWB area 146 741,895 19.7 25.4

England (2015-16 data) 11,688 - 21.5* - *Figure includes distance-selling pharmacies

Section 1.3 lists the essential services of the pharmacy contract. It is anticipated that provision of all of these services is available from all contractors.

118 General Pharmaceutical Services in England – NHS Digital 2015-16


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Map A shows population densities, community pharmacies and dispensing GP practices. With a high proportion of the population of Suffolk living in a rural area, inevitably residents in some less densely populated areas will incur increased travel times to access community pharmacy or dispensing GP practice services.

3.1.1 Choice of community pharmacies

Table 28 shows the breakdown of community pharmacy ownership, as provided by the Health and Social Care Information Centre (HSCIC). This data shows that the ownership of pharmacies by multiples was less than the national average in Suffolk. For clarity, an Independent contractor is not a member of the Company Chemists' Association (CCA) or Association of Independent Multiple Pharmacies (AIMp), whereas those considered multiples are a member of the CCA or AIMp.

Table 28: Community pharmacy ownership, 2015-16119

Area Multiples (%) Independent (%)

England 62 38

East of England SHA 60 40

Suffolk HWB 49 51 Three pharmacies have closed since the 2015 PNA including one distance-selling pharmacy – see section 3.4:

• Your Local Boots Pharmacy, 34 St Matthew's Street, Ipswich IP1 3EP • Howells and Jolley Ltd, 100 High Street, Southwold, Suffolk IP8 6DP • Blackbay Ventures Ltd (T/A Chemistree), Unit 12, Acorn Business Centre,

Oaks Drive, Newmarket CB8 7SX (this was not included in total number of pharmacies in 2015)

One pharmacy opened since the 2015 PNA:

• Glemsford Pharmacy, The Surgery, Lion Road, Glemsford CO10 7RF

3.1.2 Weekend and evening provision

In 2014, it was estimated that community pharmacies in England were open for 150,000 hours per week more than the 10 years previously.120 This has mainly been driven through the opening of ‘100-hour’ pharmacies. There are now 1,161 pharmacies in England open for over 100 hours per week, which has risen from 773 in 2014. In Suffolk there are 21 community pharmacies open for 100 hours per week or more. This has increased from 20 in 2015, with the additional 100-hour pharmacy being located in Waveney.

119 General Pharmaceutical Services in England – NHS Digital 2015-16 120 Pharmacy Voice. Who do you think we are? Community Pharmacy: dispensers of health. Dispensing Health. 2014. http://www.dispensinghealth.org/wp-content/uploads/2014/01/DH-Launch-FINA1.pdf

http://www.dispensinghealth.org/wp-content/uploads/2014/01/DH-Launch-FINA1.pdf


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Table 29 shows that Suffolk has a much greater percentage of its pharmacies open for 100 hours or more when compared nationally and regionally. All 100-hour pharmacies in Suffolk are open late-night midweek and at the weekends.

Table 29: 100-hour pharmacies

Locality Number (%) of 100-hour pharmacies

England (2015-16 data) 1,157 (9.9%)

East of England (2015-16 data) 90 (11.2%)

Suffolk HWB 21 (14.4%)

Babergh 3 (17.6%)

Forest Heath 1 (9.1%)

Ipswich 5 (15.1%)

Mid Suffolk 1 (7.1%)

St Edmundsbury 5 (26.3%)

Suffolk Coastal 2 (8.3%)

Waveney 4 (14.3%)

3.2 Dispensing Appliance Contractors (DACs)

There are two dispensing appliance contractors (DACs) in Suffolk:

• Charles S Bullen Healthcare Ltd, 60 St Matthew's Street, Ipswich IP1 3EP • Fittleworth Medical Ltd, 25 Lower Brook Street, Ipswich IP4 1AQ

Appliances may be dispensed from community pharmacies and dispensing GP practices. As part of the essential services of appliance contractors, a free delivery service is available to all patients. It is therefore likely that patients will obtain appliances delivered from DACs outside the HWB area. There were 112 DACs in England 2015-16.121

3.3 Dispensing GP practices

NHS legislation allows for GPs in certain areas to dispense NHS prescriptions for defined populations within rural communities. Geographical areas permitting dispensing by a GP practice are known as controlled localities. NHS England must define controlled localities as areas which are rural in character and therefore suitable for the provision of dispensing services by GP practices. It is the responsibility of NHS England to maintain controlled locality maps for Suffolk.

121 General Pharmaceutical Services in England – NHS Digital 2015-16


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Currently NHS England is assessing the controlled locality maps with a view to ensuring that the maps are published in a consistent manner across the country. While this assessment is being undertaken, any enquires regarding the map should be directed to the contract manager for pharmaceutical services in the East of England Area Team. There have been no changes to the controlled locality map since the publication of the last PNA in January 2015 and that is reproduced below.

Figure 34: Map from previous PNA (2015) for Suffolk showing determined controlled localities. A map for Great Yarmouth and Waveney was not available.

There are 77 GP practices in Suffolk (April 2017), of which 43 provide dispensing services. This figure hasn’t changed since the previous PNA produced in 2015. Provision of pharmaceutical services by a GP to a registered patient is only permissible by a GP practice, previously granted rights to dispensing, to a patient who is able to prove one of the following:

• that the patient would have serious difficulty in obtaining any necessary drugs or appliances from pharmacy premises because of distance or inadequacy of means of communication

• that the patient lives in a controlled locality at a distance of more than 1.6 km from any pharmacy premises (with the exception of distance-selling premises) and the doctor has outline consent and premises approval for the premises from which they would provide services

• if the doctor or the practice has historic rights and the patient needs to rely on those. As well as living in a controlled locality at a distance of more than 1.6 km from any pharmacy premises (with the exception of distance-selling premises) the patient must meet other defined criteria.


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Table 30 lists the numbers of patients eligible for dispensing from a dispensing GP practice. West Suffolk CCG and Ipswich and East Suffolk CCG lie entirely within Suffolk, while Great Yarmouth and Waveney CCG lies partly in Suffolk. Using the combined total of these three CCGs as a proxy measure, approximately 15% of the total population of Suffolk is eligible for dispensing from their GP practice. Further detail is provided in Table 30.

Table 30: List of patients eligible for dispensing services from a dispensing GP practice122

CCG

Number of patients eligible for dispensing

services from a dispensing GP practice

% of total registered CCG

population (2013 ONS estimates)

Great Yarmouth and Waveney 17,747 7.9%

West Suffolk 100,282 14.1%

Ipswich and East Suffolk 85,640 22.3%

Total 203,669 15.4% A list of GP dispensing practices in Suffolk can be found in Appendix A. NHS Choices website was accessed on 19th May 2017 to confirm GP practice opening hours and the information can be seen in Appendix A. In Suffolk, 43 dispensing practices (98%) are open after 6pm for at least one evening per week and 12 (27%) are open on Saturdays. No dispensing practices in Suffolk are open on Sundays. There has been no change from 2015.

3.4 Distance-selling pharmacies

A distance-selling pharmacy provides services as per the Pharmaceutical Regulations 2013. It may not provide essential services face-to-face and therefore provision is by mail order and/or wholly internet. As part of the terms of service for distance-selling pharmacies, provision of all services offered must be provided to anyone in England who requests them.

It is therefore likely that patients within Suffolk will be receiving pharmaceutical services from a distance-selling pharmacy outside the HWB area. The public questionnaire identified that just over 10% of respondents do report using an internet (distance-selling) pharmacy.

The one distance-selling pharmacy that used to be in Suffolk has now closed:

114 NHS Business Services Authority, Reports Portal. 2014. https://www.report.ppa.org.uk/ActProd1/iportal/activePortal/viewer/viewframeset.jsp?name=%2fCommon%20Information%20Requests%2fQuarterly%20Patient%20List%20Size%20and%20GP%20Count%2fPatient%20list%20size%20and%20GP%20count2014-04-01%2eroi&repositoryType=Enterprise&userid=ciruser&serverURL=http%3a%2f%2factprod1%3a8000&volume=actprod

https://www.report.ppa.org.uk/ActProd1/iportal/activePortal/viewer/viewframeset.jsp?name=%2fCommon%20Information%20Requests%2fQuarterly%20Patient%20List%20Size%20and%20GP%20Count%2fPatient%20list%20size%20and%20GP%20count2014-04-01%2eroi&repositoryType=Enterprise&userid=ciruser&serverURL=http%3a%2f%2factprod1%3a8000&volume=actprod






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• Blackbay Ventures Ltd (T/A Chemistree), Unit 12, Acorn Business Centre, Oaks Drive, Newmarket CB8 7SX

Figures for 2015-16 identify that there were 266 distance-selling pharmacies in England.

3.5 Access to community pharmacies

The majority of community pharmacy providers in Suffolk are sited in areas co-located with shops, GP practices or other routine destinations; many also provide extended opening hours.

The White Paper, ‘Pharmacy in England: Building on strengths – delivering the future’,123 noted that 99% of the population – even those living in the most deprived areas – can get to a community pharmacy within 20 minutes by car and 96% by walking or using public transport.

A previously published article124 suggests that over 89% of the population of England has a maximum 20-minute walk to a community pharmacy, however this figure falls to as low as 14% in rural areas. The same study found that access is greater in areas of high deprivation. Higher levels of deprivation are linked with increased premature mortality rates. Populations are generally denser in urban areas.

Map A describes the population density of Suffolk and location of community pharmacies and dispensing GP practices. The most densely populated local authority areas are Ipswich and north-eastern parts of Waveney. A high concentration of community pharmacies can also be found in these areas.

A list of community pharmacies in Suffolk and their opening hours can be found in Appendix A.

3.5.1 Routine weekday daytime access to community pharmacies and dispensing GP practices

Average drive time, walking and public transport travel times to community pharmacies and dispensing GP practices for Suffolk population can be found in Appendix I.

Travel analysis data, as shown in Appendix I, shows that 100% of the population of Suffolk has an average drive time to a community pharmacy or dispensing GP practice within 25 minutes.

Around 86% have access within a 20-minute public transport journey, while just over 69% have a maximum 20-minute walk. Almost 25% have a walk of over 30 minutes to their nearest pharmacy.

123 Department of Health. Pharmacy in England: Building on strengths – delivering the future. April 2008. http://www.official-documents.gov.uk/document/cm73/7341/7341.pdf 124 Todd A, Copeland A, Husband A et al. The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England. BMJ Open 2014; Vol. 4, Issue 8. http://bmjopen.bmj.com/content/4/8/e005764.full.pdf%20html

http://www.official-documents.gov.uk/document/cm73/7341/7341.pdf

http://bmjopen.bmj.com/content/4/8/e005764.full.pdf%20html


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From the results of the public questionnaire (Appendix M), 77% of respondents’ report using a regular or preferred community pharmacy, 69% report their choice as it is ‘near to home’, while 55% report as it is ‘near to their GP surgery’.

62% of respondents travel by their own transport, 31% walk, 2% by bike and 3% by public transport. 80% report their travel time to their community pharmacy or dispensing GP practice takes less than 15 minutes. Only 8% of respondents report a difficulty in travelling to their pharmacy.

For some residents, the nearest provider of pharmaceutical services may be across the border in the neighbouring HWB areas. Given the largely rural nature of this HWB area many residents will be familiar with significant travel times, particularly in the evenings and at weekends, to access other services such as a supermarket.

A sample of some of the community pharmacies within easy access of Suffolk locality borders providing services are listed in Table 31.

Table 31: Community pharmacy providers in neighbouring HWB areas*

HWB area Pharmacy name and address Opening hours

(excl. bank holidays)

Essex

Tesco Pharmacy, The Square, Great Notley, Braintree, CM77 7WW

Mon-Sat 08:00-20:00 Sun 10:00-16:00

Boots, Century House, Station Road, Manningtree, CO11 1AA

Mon-Fri 08:30-19:00 Sat 08:30-17:30

Tesco Pharmacy, Highwoods Square, Colchester, CO4 9ED

Mon-Sat 08:00-20:00 Sun 10:00-16:00

Asda Pharmacy, Unit 9 Turner Rise, Petrolea Close, Colchester, CO4 5TU

Mon 08:00-23:00 Tue-Fri 07:00-23:00

Sat 07:00-22:00 Sun 10:00-16:00

Queen Street Pharmacy, 12 Queen Street, Colchester, CO1 2PJ

Mon-Fri 07:00-23:00 Sat 07:00-21:00 Sun 10:30-16:30

Cavalry Road Pharmacy, 15 Cavalry Road, Colchester, CO2 7GF

Mon-Sat 07:00-22:00 Sun 08:00-18:00

Borno Chemists, Fryatt Hospital, 419 Main Road, Dovercourt, Harwich, CO12 4ET

Mon, Wed, Thurs, Fri 08:30-18:30

Tues 08:30-20:30


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HWB area Pharmacy name and address Opening hours (excl. bank holidays)

Cambridgeshire

Tesco Pharmacy, Angel Drove, Ely, CB7 4DJ

Mon 08:00-22:30 Tue-Sat 06:30-22:30

(Sat closes 22:00) Sun 10:00-16:00

Sainsbury’s Pharmacy, Cresswells Lane, Ely, CB7 4AS

Mon 08:00-23:00 Tue-Fri 07:00-23:00

Sat 06:30-22:00 Sun 10:00-16:00

Cambridgeshire

St George’s Pharmacy, St George’s Medical Centre, Parsons Lane, Littleport, Ely, CB6 1JU

Mon-Sat 08:00-22:30 Sun 08:00-21:00

Staploe Pharmacy, The Staploe Medical Centre, Brewhouse Lane, Soham, Ely, CB7 5JD

Mon 08:30-21:00 Tue-Fri 08:30-19:00

Sat 08:30-16:30 Boots, 28 Petty Curry, Cambridge, CB2 3ND

Mon-Sat 08:00-20:00 Sun 11:00-17:00

Boots, Grafton Centre, Cambridge, CB1 1PS

Mon, Tues, Weds, Fri, Sat 08:30-18:00 Thurs 8:30- 20:00 Sun 11:00-17:00

Asda Pharmacy, Beehive Centre, Coldhams Lane, Cambridge, CB1 3ER

Mon-Sat 09:00-21:00 Sun 10:00-16:00

Lloyds Pharmacy (Sainsbury’s), Brook Road, Cambridge, CB1 3HP

Mon–Fri 7:00-23:00 Sat 07:00-22:00 Sun 10:00-16:00

Tesco Pharmacy, Cambridge Road, Milton, Cambridge, CB24 6AY

Mon-Sat 08:00-20:00 Sun 10:00-16:00

Tesco Pharmacy, Yarrow Road, Fulbourn, CB1 9BF

Mon 08:00-22:30 Tue-Sat 06:30-22:30

(Sat closes 22:00) Sun 10:00-16:00

Boots, Cambridge Retail Park, 320 Newmarket Road, Cambridge, CB5 8WR

Mon-Sat 09:00-23:59 Sun 10:00-23:590

Norfolk

Hopton Pharmacy, 1 Warren Road, Hopton on Sea, Great Yarmouth, NR31 6JU

Mon-Fri 09:00-18:00 Sat 09:00-13:00

Boots, Unit E, Gapton Hall Retail Park, Gapton Hall Road, Great Yarmouth, NR31 0LZ

Mon-Weds 08:30-00:00

Thurs 08:30-00:00 Fri-Sat 08:00-00:00

Sun 10:30-16:30


79

HWB area Pharmacy name and address Opening hours

(excl. bank holidays)

Tesco Pharmacy, Pasteur Road, Southtown, Great Yarmouth, NR31 0DW

Mon 08:00-22:30 Tue-Fri 06:30-22:30

Sat 6:30-22:00 Sun 10:00-16:00

Town Pharmacy, 171 King Street, Great Yarmouth, NR30 2PA

Mon-Sat 07:00-22:00 Sun 10:00-20:00

Greyfriars Pharmacy, 5 Greyfriars Way, Great Yarmouth, NR30 2QE

Mon-Fri 07:00-22:00 Sat 08:00-21:00 Sun 08:00-20:00

Norfolk

Asda Pharmacy, Acle New Road, Vauxhall, Great Yarmouth, NR30 1SF

Mon-Sat 08:30-20:00 (Thurs and Fri open

until 21:00) Sun 10:00-16:00

Hado Pharmacy, 66 Mount Street, Diss, IP22 4QQ

Mon-Fri 07:00-23:00 Sat 07:00-20:00 Sun 10:00-17:00

Tanner Street Chemists, 1 Tanner Court, Tanner Street, Thetford, IP24 2BQ

Mon-Fri 07:00-23:00 Sat 08:00-20:00 Sun 10:00-18:00

Lloyds Pharmacy, 10 King Street, Thetford, IP24 2AP

Mon-Fri 09:00-19:00 Sat 09:00-17:30

Lime Pharmacy, Grove Surgery, Grove Lane, Thetford, IP24 2HY

Mon-Fri 07:30-23:00 Sat 08:00-20:30 Sun 08:00-18:00

Lloyds Pharmacy (Sainsbury), London Road, Thetford, IP24 EQL

Mon-Fri 07:00-23:00 Sat 07:00-22:00 Sun 10:00-16:00

Tesco Pharmacy, Norwich Road, Thetford, IP24 2HT

Mon-Sat 08:00-20:00 Sun 10:00-16:00

*This list is not exhaustive, and many more (in some cases, closer) providers may exist, though often with lesser opening hours. NHS Choices website accessed 9.5.17 to confirm opening hours. 3.5.2 Routine weekday evening access to community pharmacies and dispensing GP practices

The number, location and opening hours of community pharmacy and dispensing GP practice providers open beyond 6.30pm, Monday to Friday (excluding bank holidays) varies within each locality; they are listed in Table 32 below. Please note that some providers and GP practices are only open beyond 6.30pm on certain days and only the opening times for those days are given below. These providers will be open on other weekdays but not beyond 6.30pm. Full details of opening times for all community pharmacies and GP dispensing practices can be found in Appendix A.

Considering ‘average’ access is difficult given the variety of opening hours and locations, access is therefore considered at locality level.


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Table 32: Community pharmacy and dispensing GP practice* providers open Monday to Friday (excl. bank holidays) beyond 6.30pm

Locality Type of provider Provider name and address

Opening hours (Mon-Fri, excl. bank holidays)

Babergh Community pharmacy

Tesco, Springlands Road, Sudbury CO10 1GY

06:30-22:30 (Mon open from

08:00)


Lloyds Pharmacy, Armes Trading Estate, Sudbury CO10 2XB

Mon- Fri 7.00-23.00

Tesco, Springlands Road, Sudbury CO10 1GY


08:00) Lloyds Pharmacy, Armes Trading Estate, Sudbury CO10 2XB

Mon- Fri 7.00-23.00

Parade Pharmacy, 6 North Street Parade, Sudbury CO10 1GL

Mon 08:00-Tues 06:00 (non-stop), Tues 08:00-Wed 06:00 (non-stop), Weds, Thurs, Fri

08:00-22:00 Tesco, Copdock Interchange London Road, Ipswich IP8 3TS

08:00-13:30 14:30-20:00

Forest Heath

Community pharmacy

Lord’s Pharmacy, Guineas Shopping Centre, Newmarket CB8 8EQ

07:30-22:30

Tesco, Fordham Road, Newmarket CB8 7AH 08:00-20:00

Dispensing GP practice

Market Cross Surgery, 7 Market Place, Mildenhall IP28 7EG

Tues 08:30-20:00 Thurs 08:00-

20:00

Ipswich Community pharmacy

Kew Pharmacy, 4 Ellenbrook Green, Ipswich IP2 9RR 07:00-22:00

Morrisons Pharmacy, Sproughton Road, Ipswich 08:30-20:00

Aqua Pharmacy, 52 Duke Street, Ipswich IP1 5AS 08:00-20:00

Lloyds Pharmacy, Hadleigh Road, Ipswich IP2 0BX 07.00-23:00

M and M Pharmacy, 14 St. Matthew’s Street, Ipswich IP1 3EU

07:00-22:00

Wellbeing Pharmacy, 29 Chesterfield Drive, Ipswich IP1 6DW

07:00-22:00


81



Mid Suffolk Community pharmacy

Tesco Pharmacy, Cedars Link Road, Stowmarket IP14 5BE

08:00-13:00 14:00-19:00

Asda Pharmacy, 8-9 Wilkes Way, Stowmarket IP14 1DE


08:00)

Mid Suffolk

Community pharmacy

Woolpit Medical Services, Woolpit Health Centre, Heath Road, Woolpit IP30 9QU

(Mon only 07:00-19:45)


Drs Lewis, Partridge & Ahmed, The Health Centre, Eye IP23 7DD

Tues only 08:30-19:30

Mid Suffolk Dispensing GP practice

Fressingfield Medical Centre, Fressingfield, Eye, IP21 5PJ

Mon only 08:00-19:25

Needham Market Country Practice, Barking Road, Needham Market IP6 8EZ

Mon only 08:30-20:00

Stowhealth, Violet Hill Road, Stowmarket, IP14 1NL

Mon only 08:00-20:15

Woolpit, The Health Centre, Bury St Edmunds IP30 9 QU

Mon only 07:00-20:00

St Edmundsbury

Community pharmacy

Tesco Pharmacy, Cangle Road, Haverhill CB9 0BQ

Mon 07:00-23:00

(Mon open from 08:00)

Lloyds Pharmacy, Bedingfield Way, Bury St Edmunds IP32 7EJ

07:00-23:00

Tesco, St Saviour’s Exchange, Bury St Edmunds IP32 7JS


08:00) Lloyds Pharmacy, Haycocks Road, Haverhill CB9 7YL 08:00-22:00

Asda Pharmacy, Western Way, Bury St Edmunds IP33 3SP


08:00) Swan Pharmacy, Swan Surgery, Northgate St, Bury St Edmunds IP33 1AE

08:00-22:00

Haverhill Pharmacy, Christmas Maltings Surgery, Camps Road, Haverhill CB9 8HF

08:30-23:00


Victoria Surgery, Victoria Street, Bury St Edmunds IP33 3BB

Tues and Weds only 08:00-

20:00


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Suffolk Coastal

Community pharmacy

Felixstowe Pharmacy, Grove Med Centre, Grove Road, Felixstowe IP11 9GA

07:00-22:30

Waterton pharmacy, Framfield Med Centre, Ipswich Rd, Woodbridge IP12 4FD

08:00-19:30

Suffolk Coastal

Community pharmacy

Morrisons Pharmacy, Grange Farm Avenue, Felixstowe IP11 2XD

08:00-14:00 15:00-20:00

Your Local Boots Pharmacy, 31 Orwell Road, Felixstowe IP11 7DD

Mon and Tues 08:30-20:00

Tesco Pharmacy, Anson Road, Martlesham Heath IP5 3RU

08:00-20:00 (Fri closes at

21:00) Lloyds Pharmacy, Felixstowe Road, Warren Heath IP3 8TQ 08:00-21:00

Hado Pharmacy, 135 Hamilton Road, Felixstowe IP11 7BL 07:00-23:00

Tesco, Ropes Drive, Kesgrave IP5 2FU

08:00-13:30 14:30-19:00


Framfield House Surgery, Ipswich Road, Woodbridge IP12 4FD

Mon and Tues only 07:00-

19:00 Framlingham Medical Centre, Ipswich Road, Woodbridge IP13 9HA

Mon only 08:00-19:30

The Birches, Twelve Acre Approach, Kesgrave

Mon only 08:00-20:30

Wickham Market Medical Centre, Chapel Road, Wickham Market IP13 0SB

Tues only 08:00-20:00

Waveney Community pharmacy

Asda Pharmacy, Horn Hill, Lowestoft NR33 0PX


08:00)

Beccles HCC Ltd, St Mary’s Road, Beccles NR34 9NQ

08:30-19:30 (Fri closes

18:30) Rosedale Pharmacy, 3 Ashburnham Way, Lowestoft NR33 8LG

07:00-22:30

Tesco Pharmacy, George Westwood Way, Beccles NR34 9EJ


08:00) * Dispensing GP practices may only provide pharmaceutical services to patients eligible for dispensing, registered with that practice.


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There is access to pharmaceutical services in the evening in all localities, although in some areas greater distances are required to be travelled and/or access is provided from cross-border providers. The public questionnaire provided generally very positive feedback about access to pharmaceutical services.

3.5.3 Routine Saturday daytime access to community pharmacies

The number, location and opening hours of community pharmacy providers open on a Saturday vary within each locality. A number of pharmacies are open only for Saturday mornings, while a small number are open until late evening. A full list of community pharmacy and dispensing GP practices and their opening hours can be found in Appendix A.

Table 33: Community pharmacy and dispensing GP practice* providers open Saturday


Opening hours

Saturday


Tesco, Springlands Road, Sudbury CO10 1GY 06:30-22:00

Lavenham Pharmacy, 3 High Street, Lavenham, Sudbury CO10 1PX 09:00-17:30

Boots Pharmacy, 5 Applegate Mews, Poplar Road, Great Cornard CO10 0GL

09:00-13:00

Lloyds Pharmacy, Armes Trading Estate, Cornard Road, Sudbury CO10 2XB

07:00-22:00

Boots Pharmacy, 91 High Street, Hadleigh, Ipswich IP7 5EA 08:45-10:00

Glemsford Pharmacy, The Surgery, Lion Road, Glemsford CO10 7RF 09:00-12:30

Mill Pharmacy, Hadleigh Health Centre, Market Place, Hadleigh, Ipswich IP7 5DN

09:00-18:00

Parade Pharmacy, 6 North Street Parade, Sudbury CO10 1GL 09:00-18:00

Tesco, Copdock Interchange, London Road, Ipswich IP8 3TS

08:00-13:30 14:30-20:00

Day Lewis Pharmacy, The Street, East Bergholt CO7 6SE 09:00-13:00

Boots UK Ltd, 13-14 Market Hill, Sudbury CO10 2EA 08:30-17:30

Clare Pharmacy, 31 High Street, Sudbury CO10 8NY

09:00-13:00 14:00-17:00

Superdrug Pharmacy, 8 North Street, Sudbury CO10 1RB 08:30-17:30


84


Opening hours

Saturday

Lloyds Pharmacy, 29 North Street, Sudbury CO10 1RB 09:00-17:30

Boots Pharmacy, 31 High Street, Hadleigh, Ipswich IP7 5AF 09:00-17:00

The Pharmacy, Richmond House, Hall Street, Long Melford, Sudbury CO10 9JL

09:00-17:30

Babergh

Community pharmacy

The Surgery, The Street, Holbrook, Ipswich IP9 2QS 08:30-10:30

Dispensing GP

practice

Bildeston Health Centre, High Street, Bildeston IP7 7EX 08:30-12:30

The Surgery, The Street, Holbrook, Ipswich IP9 2QS 08:30-10:30

Forest Heath

Community pharmacy

Lord’s Pharmacy, Unit 61, The Guineas Shopping Centre, Newmarket, CB8 8EQ

07:30-22:30

Boots UK Ltd, 82 High Street, Newmarket, Suffolk CB8 8JX 08:30-18:00

Lloyds Pharmacy, Units 1 and 2, The New Rookery, Shopping Centre, Newmarket CB8 8HT

09:00-17:30

Day Lewis Pharmacy, Unit 3, Bellflower Crescent IP28 8JU 09:00-13:00

Boots Pharmacy, 32-34 High Street, Brandon IP27 0AQ

08:30-13:30 14:30-17:00

Boots Pharmacy, 1 Bury Road, Brandon IP27 0BU

09:00-13:30 14:00-17:00

Superdrug, Unit 11, The Rookery, Newmarket CB8 8HT 08:30-17:30

Tesco, Fordham Road, Newmarket CB8 7AH

08:00-20:00

Lloyds Pharmacy, 27 Market Place, Mildenhall IP28 7EF 09:00-17:30

Dispensing GP

practice

The Rookery Medical Practice, The Rookery, Newmarket CB8 8NW 08:30-12:00


Kew Pharmacy, 4 Ellenbrook Green, Ipswich IP2 9RR 8:00-22:00

Barbour Pharmacy, 119 Branford Road, Ipswich IP1 2LW 09:00-13:00

Delta Pharmacy, 57-59 Foxhall Road, Ipswich IP3 8JU 09:00-13:00


85


Opening hours

Saturday

Asda Pharmacy, Goddard Road, Ipswich IP1 5PD 09:00-13:00

Day Lewis Pharmacy, 26 Hening Avenue, Ravenswood, Ipswich IP3 9QJ

09:00-13:00

Welch Stoke Park Pharmacy, 51 Stoke Park Drive, Ipswich IP2 9TH 09:00-12:00

Your Local Boots Pharmacy, 58 Queens Way, Ipswich IP3 9EX 09:00-17:00


Your Local Boots Pharmacy, 58 Queens Way, Ipswich IP3 9EX 09:00-17:00

Lloyds Pharmacy, 204 Hawthorn Drive, Ipswich IP2 0QG 09:00-17:00

East of England Co-operative Society, 310 Sheldrake Drive, Ipswich IP2 9LF

08:45-17:30

Morrisons Pharmacy, Sproughton Road, Ipswich IP1 5AS 09:00-18:00

East of England Co-operative Society 145 Fircroft Road, Ipswich IP1 6PT 08:45-17:30

East of England Co-operative Society, 8 Cox Lane, Ipswich IP4 1HT

08:30-17:30

Aqua Pharmacy, 52 Duke Street, Ipswich IP3 0AQ 08:00-20:00

Burlington Pharmacy, 14 Burlington Road, Ipswich IP1 2EU 09:00-13:00

Boots UK Ltd, 5 Tavern Street, Ipswich IP1 3AA 08:00-18:00

Rushmere Pharmacy, 428 Woodbridge Road, Ipswich IP4 4EL 09:00-13:00

Gainsborough Pharmacy, 13 Reynolds Road, Ipswich IP3 0JL 09:00-13:00

Lloyds Pharmacy, Hadleigh Road, Ipswich IP2 0BX 07:00-22:00

Your Local Boots Pharmacy, Two Rivers Medical Centre, 32 Woodbridge Road East, Ipswich IP4 5PB

09:00-12:00 13:00-17:30

Lloyds Pharmacy, 159 Felixstowe Road, Ipswich IP3 8EB 09:00-17:00

Spring Road Pharmacy, 203 Spring Road, Ipswich IP4 5NQ 09:00-17:30


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Opening hours

Saturday

M and M Pharmacy, 14 St Matthew’s Street, Ipswich IP1 3EU 07:00-22:00

Wellbeing Pharmacy, 29 Chesterfield Drive, Ipswich IP1 6DW

08:00-22:00

East of England Co-operative Society 350 Nacton Road, Ipswich IP3 9NA 08:45-17:30

Rainbow Pharmacy, 289 Norwich Road, Ipswich IP1 4BP 09:00-13:00

Boots UK Ltd, Unit 5 Buttermarket Shopping Centre, Ipswich IP1 1DT

08:30-14:00 15:00-17:30

Mid Suffolk

Community pharmacy

Tesco Pharmacy, Cedars Link Road, Stowmarket IP14 5BE

08:00-13:00 14:00-19:00

Claydon Pharmacy, 1 Station Road, Calydon, Ipswich IP6 0HS 09:00-13:00

Boots UK Ltd, 21 Ipswich Street, Stowmarket IP14 1AH 08:30-17:30

Boots UK Ltd, Stowmarket Health Centre, Violet Hill Road, Stowmarket IP14 1NL

08:30-12:00

Asda Pharmacy, 8-9 Wilkes Way, Stowmarket IP14 1DE 07:00-22:00

Woolpit Medical Services, Woolpit Health Centre, Heath Road, Woolpit IP30 9QU

08:00-11:00

Needham Market Pharmacy, Barking Road, Needham Market IP6 8EZ 09:00-13:00

The Pharmacy, 1 Little Back Lane, Debenham, Stowmarket IP14 6RB 09:00-13:00

Station Pharmacy, Unit 1 Cattlepens, Station Road, Elmswell IP30 9HD 09:00-13:00

Thurston Pharmacy, Thurston Granary, Station Hill, Thurston IP31 3QU

09:00-13:00

Botesdale Health Centre, Back Hills Botesdale, Diss IP22 1DW 09:00-11:00

East of England Pharmacy, Combs Lane, Stowmarket IP14 2DA 08:30-17:30

Eye Pharmacy, 5 Broad Street, Eye IP23 7AF 09:00-13:00

Dispensing GP

practice

Botesdale Health Centre, Back Hills, Botesdale, Diss IP22 1DW

08:30-12:00

Combs Ford Surgery, Combs Lane, Stowmarket IP14 2SY 08:00-11:00


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Opening hours

Saturday

Stowhealth, Violet Hill Road, Stowmarket, Ipswich IP14 1NL 8:30-11:45

Woolpit, The Health Centre, Bury St Edmunds IP30 9QU 08:00-11:00

St Edmundsbury

Community pharmacy

Tesco Pharmacy, Cangle Road, Haverhill CB9 0BQ 07:00-22:00

Lloyds Pharmacy, Bedingfield Way, Bury St Edmunds IP32 7EJ 07:00-22:00

Boots UK Ltd, 15 High Street, Haverhill CB9 8AD 08:30-17:30

Well Pharmacy, 2 Mill Road, Haverhill CB9 8BD 09:00-13:00

St Edmundsbury

Community pharmacy

Boots UK Ltd, 11-13 Cornhill, Bury St Edmunds IP33 1BX 08:30-18:00

Abbey Pharmacy, Lower Baxter Street, Bury St Edmunds IP33 1ET 09:00-13:00

Superdrug Pharmacy, m37-39 Cornhill, Bury St Edmunds IP33 1DX 08:30-17:30

Tesco Pharmacy, St Saviour’s Exchange, Bury St Edmunds IP32 7JS

06:30-17:00

Ixworth Pharmacy, Peddars Close, Ixworth, Bury St Edmunds IP31 2HD 09:00-13:00

Lloyds Pharmacy, Haycocks Road, Haverhill CB9 7YL 08:00-22:00

Croasdale and Sons, 1 The Traverse, Cornhill, Bury St Edmunds IP33 1BE 08:30-17:30

Asda Pharmacy, Western Way, Bury St Edmunds IP33 3SP 07:00-22:00

David Holland Pharmacy, Norton Road (Greenfields Way) Haverhill CB9 8LU

09:00-12:30

Day Lewis Pharmacy, 7 St Olaves Precinct, Bury St Edmunds IP32 6SP 09:00-13:00

Swan Pharmacy, Swan Surgery, Northgate St, Bury St Edmunds IP33 1AE

08:00-23:00

Haverhill Pharmacy, Christmas Maltings Surgery, Camps Road, Haverhill CB9 8HF

08:00-21:45

Barrow Pharmacy, Barrowhill, Barrow, Bury St Edmunds IP29 5DX 09:00-12:00


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Opening hours

Saturday

Dispensing GP

practice

Victoria Surgery, Victoria Street, Bury St Edmunds IP33 3BB 08:00-9:30

Angel Hill, 1 Angel Hill, Bury St Edmunds IP33 1LU 08:30-12:00

The Swan Surgery, Norgate Street, Bury St Edmunds IP33 1AE 08:30-12:00

Suffolk Coastal

Community pharmacy

Felixstowe Pharmacy, Grove Med Centre, Grove Road, Felixstowe IP11 9GA

07:00-22:30

Wickham Market Pharmacy, Unit 2, White Hart Court, Wickham Market IP13 0RA

09:00-13:00 14:00-17:00

Waterton Pharmacy, Framfield Med Centre, Ipswich Rd, Woodbridge IP12 4FD

10:00-13:00

Suffolk Coastal

Community pharmacy

Waterton Pharmacy, Framfield Med Centre, Ipswich Rd, Woodbridge IP12 4FD

10:00-13:00

Lloyds Pharmacy, Unit 1, 11 Thoroughfare, Woodbridge IP12 1AA 09:00-17:30

Kesgrave Pharmacy, 34a Penzance Road, Kesgrave, Ipswich IP5 1JS 09:00-13:00

Framlingham Pharmacy, 32 Market Hill, Framlingham, Woodbridge IP13 9AY

09:00-17:00

Morrisons Pharmacy, Grange Farm Avenue, Felixstowe IP11 2XD

08:00-14:00 15:00-18:00

Your Local Boots Pharmacy, 31 Orwell Road, Felixstowe IP11 7DD 09:00-17:30

Tesco Pharmacy, Anson Road, Martlesham Heath IP5 3RU

08:00-20:00

Boots UK Ltd, 86 Hamilton Road, Felixstowe IP11 7AD 08:30-17:30

Lloyds Pharmacy, 277 High Street, Walton, Felixstowe IP11 9DU 09:00-13:00

Lloyds Pharmacy, Felixstowe Road, Warren Heath IP3 8TQ 08:00-20:00

Square Pharmacy, 696 Foxhall Road, Ipswich IP3 8NQ 09:00-13:00

Hado Pharmacy, 135 Hamilton Road, Felixstowe IP11 7BL 07:00-20:00

Martlesham Pharmacy, 9 The Square, Martlesham Heath, Ipswich IP5 3SL

09:00-12:00


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Opening hours

Saturday

East of England Co-operative Society, 183-185 Hamilton Road, Felixstowe IP11 7DT

08:30-17:30

Aldeburgh Pharmacy, 125 High Street, Aldeburgh IP15 5AR 09:00-17:00

Rendlesham Pharmacy, Unit 7 Rendlesham Mews, Rendlesham IP12 2SZ

10:00-12:00

Lloyds Pharmacy, 62 High Street, Leiston IP16 4BZ 09:00-17:30

Boots UK Ltd, 58 Thoroughfare, Woodbridge IP12 1AL

08:30-12:45 13:45-17:30

East of England Co-operative Society, 7 High Street, Saxmundham IP17 1DF

08:30-17:30

Suffolk Coastal

Community pharmacy

Leiston Pharmacy, 20 High Street, Leiston IP16 4EW 09:00-17:00

Tesco, Ropes Drive, Kesgrave IP5 2FU

08:00-13:30 14:30-19:00

Dispensing GP

practice

Dr Taylor and Partners, 7 Little St John’s Street, Woodbridge, Suffolk IP12 1EE

08:30-11:30

Wickham Market Medical Centre, Chapel Road, Wickham Market IP13 0SB

08:30-11:45


Asda Pharmacy, Horn Hill, Lowestoft NR33 0PX

07:00-22:00

Beccles HCC Ltd, St Mary’s Road, Beccles NR34 9NQ

09:00-12:00

Boots UK Ltd, 5 New Market, Beccles, Suffolk NR34 9HQ 09:00-17:30

Boots UK Ltd, 4 St Mary’s Street, Bungay NR35 1AX

08:30-12:30 13:00-17:30

Boots UK Ltd, 28 St John’s Road, Bungay NR35 1LP

09:00-13:00 14:00-18:00

Boots UK Ltd, 26 Market Place, Halesworth IP19 8AY 09:30-17:00

Boots UK Ltd, 78a London Road North, Lowestoft NR32 1ET 08:30-17:30

Boots UK Ltd, 120 St Peter’s Street, Lowestoft, NR32 1UD

09;00-13:30 14:00-16:30

Boots UK Ltd, 2-4 Stradbrooke Road, Pakefield, Lowestoft NR33 7HT

09:00-13:00 14:00-18:00


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Opening hours

Saturday

Cutlers Hill Pharmacy, Bungay Road, Halesworth IP19 8SG 08:30-12:30

Eastpoint Pharmacy, 216 London Road South, Lowestoft NR33 0HF 09:00-13:00

Hayden Chemist, Bridge Road, Oulton Broad, Lowestoft NR32 3LL 09:00-13:00

Kessingland Pharmacy, 70 High Street, Kessingland NR33 7QF 09:00-17:00

Queen Street Pharmacy, 18 Queen Street, Southwold IP18 6EQ 09:00-17:30

Raydon Pharmacy, Solebay Health Centre, Teal Close, Raydon IP18 6GY

09:00-13:00

Rosedale Pharmacy, 3 Ashburnham Way, Lowestoft NR33 8LG 07:00-22:30

Superdrug Pharmacy, 14 The Britten Centre, Lowestoft NR32 1LR 09;00-17;30


Well Pharmacy, Unit 5,15 Ashburnham Way, Carlton Colville, Lowestoft NR33 8LG

09:00-17:30

Jhoots Pharmacy, 187 London Road South, Lowestoft NR33 0DR 09:00-13:00

Well Pharmacy, 55 Westwood Avenue, Lowestoft NR33 9RW 09:00-13:00

Village Rise Pharmacy, Weston Road, Gunton, Lowestoft NR32 4PT 09:00-13:00

Worlingham Pharmacy, Woodland Avenue, Worlingham, Beccles NR34 7EF

09:00-17:00

Tesco Pharmacy, George Westwood Way, Beccles NR34 9EJ

06:30-22:30

The majority (87%) of community pharmacy providers are open for some hours on Saturday. Around 28% of dispensing GP practices also provide services for some hours on a Saturday. There is access to pharmaceutical services on Saturdays in all localities, although in some areas greater distances are required to be travelled and/or access is provided from cross-border providers.

No issues regarding access to pharmaceutical services on Saturdays were raised from the public questionnaire.

3.5.4 Routine Sunday daytime access to community pharmacies

The number, location, and opening hours of community pharmacy providers open on a Sunday vary within each locality.


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Information received from the service provider questionnaires suggests that there are no dispensing GP practices providing services on a Sunday.

Table 34 - Community pharmacy providers open Sundays

Locality Pharmacy name and address Opening

hours (Sundays)

Babergh

Tesco, Springlands Road, Sudbury, CO10 1GY 10:00-16:00 Mill Pharmacy, Hadleigh Health Centre, Market Place, Hadleigh, IP7 5DN 10:00-14:00

Parade Pharmacy, 6 North Street Parade, Sudbury, CO10 1GL 10:00-15:00

Tesco Pharmacy, London Road, Ipswich, IP8 3TS 10:00-16:00 Lloyds Pharmacy, Armes Trading Estate Cornard Road, Sudbury, CO10 2XB 10:00-16:00

Boots, 12-14 Market Hill, Sudbury, CO10 2EA 10:00-16:00

Forest Heath Lord’s Pharmacy, The Guineas Shopping Centre, Newmarket, CB8 8EQ 09:00-19:00

Forest Heath Tesco Pharmacy, Fordham Road, Newmarket, CB8 7AH 10:00-16:00

Boots, 82 High Street, Newmarket, CB8 8JX 10:00-16:00

Ipswich

Kew Pharmacy, 4 Ellenbrook Green, Ipswich, IP2 9RR 09:00-20:00

Morrisons Pharmacy, Sproughton Road, Ipswich, IP1 5AH 10:00-16:00

Boots Pharmacy, Sailmakers Shopping Centre, 5 Tavern Street, Ipswich, IP1 3AA 10:30-16:30

M and M Pharmacy, 4 St Matthew’s Street, Ipswich, IP1 3EU 08:00-18:00

Wellbeing Pharmacy, 29 Chesterfield Drive, Ipswich, IP1 6DW 09:00-20:00

Lloyds Pharmacy, Hadleigh Road, Ipswich, IP2 0BX 10:00-16:00

Mid Suffolk

Tesco Pharmacy, Cedars Link Road, Stowmarket, IP14 5BE 10:00-16:00

Asda Pharmacy, Meadow Centre, 8-9 Wilkes Way, Stowmarket, IP14 1DE 10:00-16:00

St Edmundsbury

Tesco Pharmacy, Cangle Road, Haverhill, CB9 0BQ 10:00-16:00

Lloyds Pharmacy, Bedingfield Way, Bury St Edmunds, IP32 7EJ 10:00-16:00

Boots Pharmacy, 11-13 Cornhill, Bury St Edmunds, IP33 1BX 10:30-16:30

Tesco Pharmacy, St Saviours Exchange, Bury St Edmunds, IP32 7JS 10:00-16:00

Lloyds Pharmacy, Haycocks Road, Haverhill, CB9 7YL 10:00-16:00


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Locality Pharmacy name and address Opening

hours (Sundays)

Asda Pharmacy, Western Way, Bury St Edmunds, IP33 3SP 10:00-16:00

Swan Pharmacy, Swan Surgery, Northgate Street, Bury St Edmunds, IP33 1AE 08:00-23:00

Haverhill Pharmacy, Christmas Maltings Surgery, Camps Road, Haverhill, CB9 8HF 08:00-21:45

Suffolk Coastal

Felixstowe Pharmacy, Grove Medical Centre, Grove Road, Felixstowe, IP11 9GA 10:00-17:00

Waterton Pharmacy, Franfield Medical Centre, Ipswich Road, Woodbridge, IP12 4FD 10:00-12:00

Morrisons Pharmacy, Grange Farm Avenue, Felixstowe, IP11 2XD 10:00-13:00

Tesco Pharmacy, Anson Road, Martlesham Heath, IP5 3RU 10:00-16:00

Boots Pharmacy, 86 Hamilton Road, Felixstowe, IP11 7AD 10:00-16:00

Suffolk Coastal

Lloyds Pharmacy, Felixstowe Road, Warren Heath, IP3 8TQ 10:00-16:00

Hado Pharmacy, 135 Hamilton Road, Felixstowe, IP11 7BL 10:00-17:00

Aldeburgh Pharmacy, 125 High Street, Aldeburgh, IP15 5AR 10:00-14:00

Boots Pharmacy, 58 Thoroughfare, Woodbridge, IP12 1AL 10:00-16:00

Waveney

Asda Pharmacy, Belvedere Road, Horn Hill, Lowestoft,NR33 0PX 10:00-16:00

Boots, 74 London Road North, Lowestoft, NR32 1ET 10:00-16:00

Queen Street Pharmacy, 18 Queen St, Southwold, Suffolk, IP18 6EQ

10:00-16:00 (during busy

periods) Rosedale Pharmacy, 3 Ashburnham Way, Carlton Colville, Lowestoft, NR33 8LG 10:00-17:00

Tesco Pharmacy, George Westwood Way, Beccles, NR34 9QH 10:00-16:00

There are just over one in four community pharmacy providers in Suffolk open on Sundays. Access is generally good, although as would be expected of access to many services, residents in rural areas may experience additional travel time compared with weekdays and Saturdays. No issues regarding access to pharmaceutical services on Sundays were raised from the public questionnaire.


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3.5.5 Routine bank holiday access to community pharmacies

Community pharmacies are not obliged to open on nominated bank holidays. While many opt to close, a number of pharmacies (often those in regional shopping centres, retail parks, supermarkets and major high streets) opt to open, often for limited hours.

The number, location and opening hours of community pharmacy providers open on a bank holiday vary within each locality and on different bank holidays. Number of pharmacies open across the bank holidays for May and August in 2017 has ranged from 22 to 24.

NHS England commission a Christmas Day and Easter Sunday service and review provision after each Christmas, New Year and Easter bank holiday.

Commercial factors often dictate many pharmacies' decision to open or not during bank holidays.

No issues regarding access to pharmaceutical services on bank holidays were raised from the public questionnaire.

3.6 Advanced service provision from community pharmacies

Section 1.3 lists all advanced services which may be provided under the pharmacy contract. As these services are discretionary, not all providers will provide them all of the time.

Data available from the NHS Business Services Authority and posted on the website of the Pharmaceutical Services Negotiating Committee (PSNC)125 has been used to demonstrate in Appendix A which pharmacies had claimed (and therefore provided) MUR, NMS and flu vaccination services in 2015/16. The data shows that around 98% of community pharmacies in Suffolk are providing the MUR service (an increase from 90% reported previously), around 95% are providing the NMS service and 63% provided the flu vaccination service (2015/16 season).

Information on provision of AURs and SACs is presented at HWB level. The latest data available is for 2015-16 and is presented in Table 35.

Table 35: Percentage of community pharmacies and dispensing appliance contractors by HWB, providing AURs and SACs, 2015-16126

Advanced service AUR SAC

Suffolk HWB 0.7% 3.4%

East of England SHA 0.7% 11.4%

England 1.2% 14.7%

125 NMS/MUR/Flu activity data per pharmacy, PSNC website: http://psnc.org.uk/funding-and-statistics/nhs-statistics/mur-statistics/ 126 General Pharmaceutical Services in England – NHS Digital 2015-16

http://psnc.org.uk/funding-and-statistics/nhs-statistics/mur-statistics/

http://psnc.org.uk/funding-and-statistics/nhs-statistics/mur-statistics/


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Demand for the appliance advanced services (SAC and AUR) is lower than for the other two advanced services due to the much smaller proportion of the population that may require the services.

Pharmacies and DACs may choose which appliances they provide and may also choose whether or not to provide the two related advanced services.

3.7 Enhanced service provision

Under the pharmacy contract, enhanced services are those directly commissioned by NHS England. Therefore, any locally-commissioned services commissioned by CCGs or the local authority are not considered here.

The East of England Area Team of NHS England currently commissions the following services:

• rota service – there is often a recognised gap in service provision on the following bank holidays: Christmas Day, Boxing Day, New Year’s Day and Easter Sunday. As part of its responsibility to ensure the ongoing provision of pharmaceutical services to support out-of-hours services, NHS England undertakes to commission rota services on these days when required. The link provides details of the rota service: https://www.england.nhs.uk/mids-east/our-work/pharm-info. Future commissioning is informed after a review of the previous commissioned rota service.

• for the provision of potassium iodate – this service is commissioned as part of NHS England’s emergency planning responsibilities to help manage any radiation leak from the Sizewell power station. This is a very small pharmaceutical service and is provided from only two community pharmacies near to Sizewell, in Leiston.

o Leiston Pharmacy, 20 High Street, Leiston IP16 4EW o Lloyds Pharmacy Ltd, 62 High Street, Leiston IP16 4BZ

The following pharmacy services are included here for information only:

Hospitals: West Suffolk Hospital NHS Foundation Trust, Ipswich Hospital NHS Trust, James Paget University NHS Hospital, Felixstowe Hospital, Aldeburgh Hospital, Newmarket Hospital and Bluebird Lodge Community Hospital all provide inpatient and outpatient dispensing services directly to the patient.

Minor injury units: Felixstowe Community Hospital and Beccles and District War Memorial Community Hospital provide an assessment and treatment service for minor illness and minor ailments.

Prisons: in Suffolk there are three male prisons: HMP Highpoint (North and South), HMP and YOI Hollesley Bay and HMP Warren Hill. A pharmaceutical service is provided to the prisoners of these prisons and is directly contracted with the Health and Justice Team of NHS England (Midlands and East of England region).

https://www.england.nhs.uk/mids-east/our-work/pharm-info/

https://www.england.nhs.uk/mids-east/our-work/pharm-info/


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HMP Highpoint (North and South) has an on-site pharmacy whereas external providers supply all medications to HMP and YOI Hollesley Bay and HMP Warren Hill.

3.8 Pharmaceutical service provision provided from outside Suffolk HWB area

Suffolk is bordered by three other HWB areas: Cambridgeshire, Norfolk and Essex. Maps A, B and F show the cross-border pharmacies within easy reach of Suffolk HWB from which Suffolk residents may access pharmaceutical service provision.

Suffolk residents may also access service provision from the 266 distance-selling (internet) pharmacies and 112 DACs in England.

3.9 Locally-commissioned services

Appendix A provides a summary of locally commissioned services within Suffolk pharmacies. It is important to note the commissioning status of each service as this defines whether or not it is a locally-commissioned service. Please note data collection methods have changed since the 2015 PNA so activity data is not directly comparable.

Locally-commissioned services are included within this assessment where they affect the need for pharmaceutical services or where the further provision of these services would secure improvements, or better access, to pharmaceutical services.

Suffolk County Council currently commission the following locally-commissioned services from community pharmacies:

• chlamydia screening • chlamydia treatment • Emergency Hormonal Contraception (EHC) • stop smoking support • needle exchange* • supervised consumption* • NHS Health Checks*

*These services are not open for all community pharmacies. The selection of pharmacies is based on local commissioning decisions.

The only CCG-commissioned services from community pharmacies currently are the palliative care drugs service and emergency supply of medicines in the Great Yarmouth and Waveney CCG. The CCG commission the palliative care service from only a small number of community pharmacy providers to ensure ongoing access to drugs. The emergency supply of medicines is open to all pharmacy contractors within the CCG so no separate list appears in Appendix A.


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Section 4: Other services which may impact on pharmaceutical services provision

Community pharmacies and dispensing GP practices provide a range of other services. These are not considered pharmaceutical services under the Pharmaceutical Regulations 2013 and may be either privately funded or commissioned by NHS England, the Local Authority or the CCG.

4.1 Other services provided by dispensing GP practices

Although not listed as a pharmaceutical service within the Pharmaceutical Regulations 2013, Dispensing Review of Use of Medicines (DRUMs) may be provided by a dispensing GP practice which has opted to provide the Dispensing Services Quality Scheme (DSQS). The DSQS is an optional service commissioned by NHS England for dispensing GP practices to provide annually. A DRUM is a face-to-face review with the patient to find out their compliance and agreement with their prescribed medicines and to help identify any problems that they may be having. The dispensing GP practices in Suffolk were sent a dispensing GP practice questionnaire to complete in Spring 2017. All GP practices completed the questionnaire. A copy of the questionnaire can be found in Appendix E. The survey identified that 96% of dispensing GP practices confirmed that they are participating in the 2015/16 DSQS and 96% participate in DRUM. Other information provided from the dispensing GP practice questionnaire can be found in Appendix K.

4.2 Healthy Living Pharmacy

The political intention and context for Healthy Living Pharmacies (HLPs) was set out in the 2008 pharmacy White Paper, ‘Pharmacy in England: Building on Strengths, Delivering the Future’.127 This called for community pharmacies to have a greater role and participation in public health provision as healthy-living hubs. This fuelled the pioneering work in Portsmouth to develop the HLP framework and subsequent high profile National Pathfinder Study in which Suffolk participated. In Suffolk, this programme continues to be led by Suffolk LPC, in collaboration with the public health team and large range of partner agencies and stakeholders.

HLPs put their local community’s health and wellbeing at the core of everything they do. They consistently deliver a range of services to a high quality and are recognised with a HLP Quality Mark. The HLP framework involves a system-wide approach to support change across the profession and within the workplace, an organisational development tool and a brand that unites community pharmacy while changing public perceptions about what community pharmacy can offer in supporting their health.

127 Department of Health. Pharmacy in England: Building on Strengths, Delivering the Future. 2008. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/228858/7341.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/228858/7341.pdf


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4.2.1 Healthy Living Pharmacy enablers

Important HLP enablers to support delivery include:

• workforce development • engagement with the community and other providers • premises that are fit for purpose and support health promotion

4.2.2 Healthy Living Pharmacy and local priorities

To date, significant benefits have been realised from HLPs by commissioners, contractors and employees and, imperatively, the public have fully welcomed the concept. Analysis of the National Pathfinder reports indicated the value of HLPs for:

• commissioners showing that community pharmacies are able to deliver health and wellbeing services to meet local health needs

• public health teams who understood the potential for HLPs to deliver these types of health services effectively

• contractors – the results of the quantitative survey to assess the benefits of HLP status on contractors was positive for all contractor types. Implementation of the HLP concept was seen as worthwhile for the business by over 70% of contractors.

Community pharmacies are a local asset and an important resource for Suffolk communities – especially for those that may not access other NHS services. The HLP framework was launched in September 2010, and in March 2011 the national pharmacy bodies started working with DH to launch the HLP pathfinder programme, which resulted in an evaluation being published in April 2013. Following this, Public Health England (PHE) adopted the concept and supported the roll-out in pharmacies across the country. Suffolk pharmacies have been involved with the project since 2011 when they were chosen as a Pathfinder Site for national roll-out.


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Table 36: The Healthy Living Pharmacy Framework

Since 2015, Suffolk County Council has supported the roll out of HLP Level 1 across the county and this has been project-managed by Suffolk LPC. This involved funding the provision of Health Champion Training for members of the pharmacy team and support for developing leadership skills in each pharmacy involved in the roll-out.

Evidence folders were provided to each pharmacy and support was given to pharmacy teams to collect relevant information and to link with other organisations to better support the health of their communities. Pharmacies were assessed against the locally-agreed HLP standards which incorporated all the national guidance, and pharmacies achieved accreditation when all the standards had been demonstrated.

In October 2016, HLP Level 1 became one of the Quality Payment criteria under the new funding model for the National Pharmacy Contract. At this point, pharmacies moved to the Public Health England Quality Criteria for HLP Level 1 Self-assessment128. Suffolk LPC, with the continued support of Suffolk County Council, has committed to provide training, materials and support to pharmacies as they engaged with the new process with a view to achieving Level 1 accreditation in all pharmacies.

The HLP Quality Mark is a useful and important platform by which existing and new public health pharmaceutical services can be developed to target areas of local need, as well as services that can be made available for everyone.

128 http://www.gov.uk/government/publications/healthy-living-pharmacy-level-1-quality-criteria

http://www.gov.uk/government/publications/healthy-living-pharmacy-level-1-quality-criteria


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This includes services that can assist with earlier identification, screening and management of risk factors for life-shortening diseases, reducing premature deaths and major morbidity, and targeting pharmaceutical support for patients with long-term conditions to enhance quality of life, reducing health inequity and health inequalities. This will be increasingly important as the NHS seeks to develop new models of care that are patient-centred and focus care in the community in a way that frees up GP time and reduces the burden on out-of-hours services and secondary care. Suffolk pharmacies are therefore well placed to support such services as they develop. At present, there is no published list of pharmacies which have achieved the HLP Quality Mark under the Quality Criteria, however the twenty pharmacies which achieved accreditation to HLP Level 1 through the initial Suffolk County Council scheme in 2015-16 can be found in table 37. Additional pharmacies accredited by the Royal Society of Public Health are available https://www.rsph.org.uk/our-services/registration-healthy-living-pharmacies-level1/register/east-of-england.html

Table 37: Pharmacies which have achieved HLP1 under the County Council scheme

Acer Road Pharmacy Rendlesham IP12 2GA

Boots Pharmacy Sudbury CO10 2EA

Aqua Pharmacy Ipswich IP3 0AQ

Boots Pharmacy Lowestoft NR32 1ET

Beccles HCC Ltd Beccles NR34 9NQ

Clare Pharmacy Clare, Sudbury CO10 8NH

Boots Pharmacy Hadleigh IP7 5EA

Day Lewis Pharmacy Ipswich IP3 9QJ

Boots Pharmacy Ipswich IP1 1DT

Day Lewis Pharmacy Red Lodge, Bury St Edmunds IP28 8XQ

East of England Co-operative Society, Stowmarket IP14 2DA

Lloyds Pharmacy Ipswich IP2 OQG

Queen Street Pharmacy Southwold IP18 6EQ

Worlingham Pharmacy Worlingham, Beccles NR34 7EF

Lloyds Pharmacy Ipswich IP2 OQG

Tesco In Store Pharmacy Sudbury CO10 6GH

Station Pharmacy Elmswell, Bury St Edmunds IP30 9HG

Day Lewis Pharmacy Colchester CO7 6SE

Tesco In-Store Pharmacy Stowmarket IP14 EBE

Village Rise Pharmacy Lowestoft NR34 7EF

https://www.rsph.org.uk/our-services/registration-healthy-living-pharmacies-level1/register/east-of-england.html

https://www.rsph.org.uk/our-services/registration-healthy-living-pharmacies-level1/register/east-of-england.html


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4.3 Collection and delivery services

From both the pharmacy contractor questionnaire and dispensing GP practice questionnaire, 88% of community pharmacies and 74% of dispensing GP practices provided free home delivery services on request. Both groups often noted restrictions on areas and/or to which specific patient groups they offered free delivery.

100% of pharmacies who responded offer to collect prescriptions from GP surgeries on behalf of their patients. This is an increase from only 95% of respondents willing to provide this service in 2015.

Free delivery is required to be offered without restriction by all distance-selling (internet) pharmacies to patients who request it throughout England. There is no distance-selling pharmacy based in Suffolk, but there 266 throughout England. Free delivery of appliances is also offered by DACs. There are two DACs based in Suffolk providing services nationally and there are a further 110 throughout England.

4.4 Provision of services to nursing and residential care homes

Elderly patients require proportionally more medicines than younger people. Results from the pharmacy contractor questionnaire indicate that currently only 4% provide a service to care homes commissioned via the CCG or LA, but 64% indicate they would be willing to provide if commissioned. The dispensing GP questionnaire identifies 19-25% of dispensing GP practices provide medicines to care home residents. The opening of a new care home may provide a significant increase in dispensing for a pharmaceutical service provider. Appendix J provides a list of larger new care homes planned. Care home pharmaceutical service provision is often a specialised function within community pharmacies. Community pharmacy provision to care homes is often centralised, therefore may not necessarily be provided by the nearest local provider. The information provided in Appendix J therefore should not be interpreted as an indication of need of pharmaceutical service provision within the locality of the planned care home. The impact on local pharmaceutical service providers should be monitored as new care home builds are completed.

4.5 Out-of-hours GP service and Extended Hours

Ipswich and Suffolk CCG commission a GP-Plus service which aims to provide access to a GP appointment outside of normal GP practice working hours. The patients of all Ipswich and East Suffolk CCG practices can access this service. The table below identifies the locations where this service takes place and their opening times. Bank holiday openings are as Saturday.


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Table 38: Locations providing the GP-Plus service and opening times

Location Mon-Fri Saturday Sunday

Riverside, Ipswich 18:30-21:00 09:00-21:00 9am-9pm

MIU, Felixstowe 18:30-21:00 09:00-13:00 Closed

Stowhealth 18:30-21:00 09:00-13:00 Closed

Leiston Surgery 18:30-21:00 09:00-13:00 Closed

Wickham Market Surgery 18:30-21:00 09:00-13:00 Closed

The amount of GP Plus appointments is likely to be extended as part of the winter planning, but exact information is not yet known.

There is also a GP Out of Hours service which is available Monday to Friday from 6.30pm to 8.00am, and for 24 hours at weekends and during bank holidays. Table 39 identifies the locations where this service is available.

Table 39: Locations providing the GP Out of Hours service

Bury PCC West Suffolk Hospital Hardwicke Lane Bury St Edmunds Suffolk IP33 2QZ

Haverhill PCC Haverhill Health Centre Camps Road Haverhill Suffolk CB9 8HF

Mildenhall PCC Mildenhall Health Centre Chestnut Close Mildenhall Suffolk IP28 7NL

Stowmarket Stow health Centre Violet Hill House Stowmarket Suffolk IP14 1NL

Eye PCC Hertismere Hospital 26 Castleton Way Eye Suffolk IP23 7BH

Ipswich PCC Ipswich Hospital (Entrance 5 – Rheumatology) Heath Road Ipswich Suffolk IP4 5PD

Saxmundam Lambsdale Meadow Saxmundam Suffolk IP17 1AS

Sudbury Community Health Centre Church Field Road Sudbury Suffolk CO10 2DZ

In addition to the above two services, there is also a “GP in Accident and Emergency” service and this will operate in Ipswich Hospital between 1pm until 6.30pm and 9pm – 11pm Monday to Friday (excluding bank holidays).


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Section 5: Findings from the public questionnaire

A public questionnaire about pharmacy provision was developed (Appendix C) and compiled by Suffolk PNA Steering Group. This was circulated to the following groups including via a link on the Local Authority’s website:

• community pharmacies in the Suffolk • GP practices • patient groups in Suffolk

A total of 500 questionnaires were received from a range of Suffolk residents. This is down from 610 replies in 2015. A full summary of the results can be found in Appendix M.

Of the respondents, 62% visit their pharmacy at least once a month, either for themselves or someone else, and just under 77% use a regular or preferred provider.

Just under 69% of respondents rated ‘close to home’ as important, which is an 11% increase on the 2015 PNA; 55% rated ‘near to GP surgery’ as important, which has shown an increase from the 2015 PNA by 8%. Friendliness and efficiency were also highly regarded.

The majority of respondents (89%) visit the pharmacy for their own needs, while 54% do so on behalf of a family member. Those that visit on behalf of someone else, state that the reason they visit the pharmacy is that it is the 'most convenient'.

Provision of a collection and home delivery service was important to 84% of respondents.

The most common form of travel to their chosen pharmacy is by car (62%). Walking is used by 31% of respondents, which is down from the 2015 PNA by 7%, and 3% use public transport, which is similar to 2015 PNA. The results indicate that 2% travel by bike. Only 1% of respondents have a journey of over 30 minutes to their pharmaceutical service provider, with 80% reporting less than 15 minutes, and 92% report no difficulties when travelling to a pharmacy. Of those who do report an issue with travelling to their pharmacy, 48% report parking difficulties, 14% availability of public transport and 11% the actual location of the pharmacy.

The survey identifies that Monday to Friday are the most convenient days to visit a pharmacy, with only 10% preferring Saturday and 1% Sunday. Preferred visiting time varies for 50% of respondents, 42% prefer to visit between 9am and 6pm, 7% prefer early evening and less than 1% prefer to visit after 8pm.

When asked about the buying of over-the-counter medications, 59% of respondents purchase items at least once a month or more.

The questionnaire asked respondents to indicate if they had ever used an internet pharmacy to obtain medicines and 10% indicated they had done so. For those who did use an internet pharmacy, 85% rated the service as excellent or good.


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Of those respondents who made additional comments, the vast majority made positive comments about friendly, efficient staff and the service offered. However, a handful commented about services being inefficient, too busy, not enough helpful staff or having poor parking/location.

When asked about which services respondents would like to see provided by their local pharmacy, 94% identified the routine services that are provided in all pharmacies as their preferred choices e.g. repeat dispensing, advice from pharmacist, buying OTC medication and disposal of unwanted medicines. However, there was also interest in seeing other services which are less commonly provided e.g. supervised consumption of methadone (53%), immediate access to specialist drugs (70%) and needle exchange (53%).

Some of the questions permitted more than one answer, resulting in totals above 100%.


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Section 6: Analysis of Health Needs and Pharmaceutical Service Provision 6.1 Localities within Suffolk

As described in Section 1.5, the PNA Steering Group decided that the Suffolk HWB PNA should be divided into seven localities, which are identical to those used in the 2015 PNA. These are the localities of Babergh, Forest Heath, Ipswich, Mid Suffolk, St Edmundsbury, Suffolk Coastal and Waveney. Most health data is available at this level.

Suffolk HWB has identified the necessary services, described in Section 1.3, as essential services and advanced services as required by Paragraphs 1 and 3 of Schedule 1 to the Pharmaceutical Regulations 2013.

Suffolk HWB has identified the enhanced services in Section 3.7 as pharmaceutical services which secure improvements or better access, or which have contributed towards meeting the need for pharmaceutical services in the area of Suffolk.

Suffolk HWB has identified the locally-commissioned services in Section 3.9 which secure improvements or better access, or have contributed towards meeting the need for pharmaceutical services in the area of Suffolk.

Other relevant services. - A change in service provision (see above in 3.) is due to local commissioning decisions.

6.2 Babergh locality

6.2.1 Necessary services: current provision

The population of Babergh locality is 89,215: 12% of the Suffolk population. It is a relatively healthy area, recording amongst the lowest rates of all-cause mortality in England. However, rates of CVD and hypertension are higher than seen nationally.

There are 17 community pharmacies and six dispensing GP practices in Babergh locality, which is an increase of one community pharmacy from the 2015 PNA. Three are open for 100 hours or more per week. The rate of community pharmacies (19 per 100,000 population) is less than national (21.5) and Suffolk rate (19.7) but, when the seven dispensing GP practices in Babergh are included, the rate increases to 26.9 pharmaceutical service providers per 100,000 population. There are six PhAS pharmacies in the Babergh locality.

Access to pharmaceutical services in the evenings and weekends is good, with a number of providers in Babergh open. There are also a number of accessible providers open in neighbouring localities and HWB areas.

All community pharmacies provide the MUR and NMS advanced services.

6.2.2 Necessary services: gaps in provision

A number of new housing developments are planned for the Babergh locality.


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While a number of these are significant, it is considered that there are adequate pharmaceutical service providers locally with sufficient capacity to ensure a continuity of provision to these new developments.

No gaps in the provision of necessary services have been identified for Babergh locality.

6.2.3 Other relevant services: current provision

Provision of local authority-commissioned services is described in Appendix A. There are six (35%) providers of the supervised consumption service and four (23%) providers of the needle exchange service. The sexual health service is provided by ten (59%) community pharmacies and the stop smoking service is provided by 11 (65%) providers. This figure has decreased significantly from 2015 when 94% of community pharmacies provided the stop smoking service. Babergh does however have the lowest smoking-attributed mortality rate compared to the other localities in Suffolk.

6.2.4 Improvements and better access: gaps in provision

Figures for Suffolk indicate that 15.2% of patients registered with a GP are recorded as having hypertension, a higher rate compared to the East of England at 14.1% and England at 13.8%. However modelled estimates at locality level indicate the figure could be much higher, and there may be a large proportion of Suffolk residents with undiagnosed hypertension. Babergh has a modelled estimated prevalence of 23.2% for hypertension and a further 13.3% undiagnosed. It would therefore suggest there is scope for improvement in identifying and treating those with hypertension. Should this be a priority target area for commissioners, they may want to consider the current provision and uptake of screening services from community pharmacies, to help improve the identification of those with hypertension and direct them to appropriate treatment and follow-up. Consideration should be given to incentives for further uptake from current providers and extending provision through community pharmacies.

There are no community pharmacies providing services overnight from Wednesday to Sunday inclusive in the Babergh locality. Based upon the results of the public and pharmacy contractor questionnaires, consultation on the draft PNA, provision of 100-hour pharmacies in Suffolk compared to nationally and regionally, and access to pharmacies across Suffolk or in neighbouring HWB areas, there is no evidence to suggest there is a gap in service which would equate to the need for access to essential services outside normal hours in this locality. Suffolk HWB will monitor the uptake and need for necessary services. It will also consider the impact of any changes in this locality in the future which may provide evidence that a need exists.


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No gaps in service provision have been identified for Babergh locality.

6.3 Forest Heath locality


The population of Forest Heath is 63,691, which is 8.6% of the population of Suffolk. Forest Heath is the least populated locality in Suffolk. As demonstrated in Map A, large parts of Forest Heath are sparsely populated.

There are 11 community pharmacies, a decrease of one from 2015, and seven dispensing GP practice providers, which has increased by one from 2015, in the locality. This results in an overall rate of 28.2 pharmaceutical service providers per 100,000 population. There is one community pharmacy open for 100 hours or more per week and two community pharmacies open in the evenings, which has remained unchanged from 2015.

In addition, Thetford in the north, Cambridge in the west and Bury St Edmunds in the east are a short distance from the locality borders where there are a number of providers open late. There are three PhAS pharmacies in the locality.

All the community pharmacies in Forest Heath locality provide the MUR and NMS advanced services.


A number of new housing developments are planned in the locality. Suffolk HWB will consider the change in health needs in Forest Heath locality as the housing developments listed in Appendix J progress through the three-year time horizon of the PNA. Suffolk HWB will consider the views from the public, pharmacy contractors and other stakeholders when considering the changing health needs of the residents of Suffolk.

No gaps in the provision of necessary services have been identified for Forest Heath locality.


There are eight (73%) providers of the supervised consumption service, and five providers (41%) of the needle exchange service. The sexual health services are now only provided by six providers (54%) from previous eight community pharmacies and the stop smoking service continues to be provided by nine (82%) providers.


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Although in Suffolk the cardiovascular disease mortality rate overall is lower than the national average, there is a higher rate of mortality for males in Forest Heath. When considering COPD, Forest Heath has the highest rate of mortality when compared to the rest of Suffolk.

If deemed a priority for commissioners, improved outcomes may be possible through a review of current service provision and providers to further increase access to related services.

Forest Heath locality has a sizeable all year round visiting population due to the Centre Parcs holiday village in Elveden Forest. There are pharmacies in the surrounding villages of Brandon, Lakenheath and Mildenhall. Although none are open on Sundays or weekday evenings after 6:30pm, there are a number of pharmacies open in nearby Bury St Edmunds, Thetford (Norwich HWB area) and Newmarket. There is therefore sufficient and reasonable access to pharmaceutical services.

However, there remains no commissioned service to provide for those visitors who have arrived at Centre Parcs forgetting to bring their prescribed medication. A private service may be offered from community pharmacies (patients have to pay at least the net cost of the medicines supplied), although some patients may access urgent care services under the NHS to have a prescription supplied to obtain their medication. Based upon the results of the public and pharmacy contractor questionnaires, there is no evidence to suggest there is a need for a new or improved service.

There are no community pharmacies providing services overnight in the Forest Heath locality.

Based upon the results of the public and pharmacy contractor questionnaires, consultation on the draft PNA, provision of 100-hour pharmacies in Suffolk compared to nationally and regionally, and access to pharmacies across Suffolk or in neighbouring HWB areas, there is no evidence to suggest there is a gap in service which would equate to the need for access to essential services outside normal hours in this locality. Suffolk HWB will monitor the uptake and need for necessary services. It will also consider the impact of any changes in this locality in the future which may provide evidence that a need exists.

No gaps in service provision have been identified for Forest Heath locality.


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6.4 Ipswich locality


Ipswich is the most populated locality in Suffolk, providing residence to a population of 135,600, which is 18.3% of Suffolk. The BME population is the highest in Suffolk (11.1% versus 4.7% in Suffolk as a whole, and 14.6% in England). The population is amongst the most deprived in the country.

Ipswich locality has the highest rates of new STI diagnoses. Latest published data (2015) indicates the Ipswich locality to have one of the highest prevalence rates of smoking overall and the third highest in routine and manual occupations.

The population of Ipswich locality has 33 community pharmacies (24.2 per 100,000 population) which is higher than the average in England (21.5 per 100,000 population). Four of these community pharmacies are funded under PhAS. There are no dispensing GP practices in Ipswich. Five pharmacies (15%) are open for 100 hours a week or more. Six are open in the evenings, seven on Sundays and the large majority (27) open on Saturdays. All the community pharmacy providers provide the MUR service and 32 the NMS advanced service.


Ipswich locality will see a number of significant housing developments in the coming three years. A significant housing development (3,500 units) is planned within the Ipswich Garden Suburb, however, no commencement date is available at this time. Suffolk HWB will consider the change in health needs in Ipswich locality as the housing developments listed in Appendix J progress through the three-year time horizon of the PNA. Suffolk HWB will consider the views from the public, pharmacy contractors and other stakeholders when considering the changing health needs of the residents of Suffolk.

No gaps in the provision of necessary services have been identified for Ipswich locality.


There are 26 (79%) providers of the supervised consumption service and 15 providers (45%) of the needle exchange service, which is a decrease of seven providers from 2015. However, the service is not open to all pharmacies and the selection of pharmacies is based on local commissioning decisions and should not be seen as a drop in service.

The sexual health service is provided by 22 (67%) community pharmacies and the stop smoking service is provided by 27 (82%) providers. No change from 2015 PNA.

If deemed a priority by commissioners, there may be an opportunity to improve uptake through reviewing incentives to current providers and the current provider list.


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Although the control of blood sugar and blood pressure is similar or better than the national average for diabetes within the Ipswich and East Suffolk CCG, the control of cholesterol is worse than the national average. There may be scope for community pharmacies to help support patients and encourage them to undertake regular monitoring and compliance with medication.

In addition, mortality rates from COPD are higher than the Suffolk average in Ipswich. If deemed a priority for commissioners, improved outcomes may be possible through a review of current service provision and providers to further increase access to related services. Premature mortality rate is highest in Ipswich locality.

There are no community pharmacies providing services overnight in the Ipswich locality. Based upon the results of the public and pharmacy contractor questionnaires, consultation on the draft PNA, provision of 100-hour pharmacies in Suffolk compared to nationally and regionally, and access to pharmacies across Suffolk or in neighbouring HWB areas, there is no evidence to suggest there is a gap in service which would equate to the need for access to essential services outside normal hours in this locality. Suffolk HWB will monitor the uptake and need for necessary services. It will also consider the impact of any changes in this locality in the future which may provide evidence that a need exists.

6.4.5 Other services

Consideration should be given as to how services are tailored to meet any specific needs of the BME populations, which account for 11.1% of the total population of this locality. An estimate from the Roma community suggests there are around 1,100 Romanian and Bulgarian Roma living in Ipswich.

No gaps in service provision have been identified for Ipswich locality.

6.5 Mid Suffolk locality


Mid Suffolk locality has a total population of 99,632 which is 13.4% of the population of Suffolk as a whole.

This locality has areas which are amongst the least 20% deprived in England and it has one of the highest life expectancy rates in Suffolk for males and females, both of which are higher than the national averages. Mid Suffolk had the lowest new STI diagnosis rate at 325 per 100,000, significantly lower than the England rate (2015 figures). Recently recorded teenage pregnancy rates show that Mid Suffolk has a below-average rate, when compared to the rest of Suffolk and the England average (2015 figures).


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However, 71% of teenage conceptions in Mid Suffolk resulted in abortion. The latest figures for smoking rates show that Mid Suffolk has the lowest prevalence of all the localities and one of the lower attributable mortality rates.

Given its largely rural geography, there is the greatest number of dispensing GP practices (ten) in this locality.

There are 14 community pharmacies, resulting in the lowest ratio in Suffolk of 14.1 pharmacies per 100,000 population. However, if we include GP dispensing practices, this figure rises to 24.1 pharmaceutical service providers per 100,000 population. One pharmacy is open for 100 hours or more per week and two open in the evenings which is a decrease of one from previous PNA. There are eight PhAS pharmacies in the locality.


A number of significant housing developments are planned or are being built in Mid Suffolk, particularly in and around Stowmarket (1,500 units).

Suffolk HWB will consider the change in health needs in Mid Suffolk locality as the housing developments listed in Appendix J progress through the three-year time horizon of the PNA. Suffolk HWB will consider the views from the public, pharmacy contractors and other stakeholders involved in these developments when considering the changing health needs of the residents of Suffolk.

No gaps in the provision of necessary services have been identified for Mid Suffolk locality.


There are six (43%) providers of the supervised consumption service, and two providers (14%) of the needle exchange service. The provision of these two services are not open to all pharmacies and the selection of providers is based on a local commissioning decision.

The sexual health services are provided by ten (71%) community pharmacies and the stop smoking services provided by 11 (78%) providers.


There are no community pharmacy providers providing services overnight in Mid Suffolk locality. Based upon the results of the public and pharmacy contractor questionnaires, provision of 100-hour pharmacies in Suffolk compared to nationally and regionally and access to pharmacies across Suffolk HWB area or in neighbouring HWB areas, there is no evidence to suggest there is a gap in service which would equate to the need for access to essential services outside normal hours in this locality. Suffolk HWB will monitor the uptake and need for necessary services.


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It will also consider the impact of any changes in this locality in the future which may provide evidence that a need exists.

No gaps in service provision have been identified for Mid Suffolk locality.

6.6 St Edmundsbury locality


The population of St Edmundsbury locality is 112,523 which is 15.2% of the population of Suffolk. The locality has the highest rate of statutory homeless population in the HWB.

In this locality, 19 community pharmacies provide services - an average of 16.9 providers per 100,000 population.

There are 24.1 pharmaceutical service providers per 100,000 population when the eight dispensing GP practices are taken into consideration. Five community pharmacies (26.3% of the total for this locality) are open for 100 hours per week or more. Seven pharmacies are open in the evenings. There are four PhAS pharmacies in the locality.


There are a number of new housing developments planned in St Edmundsbury locality. Over 50% of which are planned for the Bury St Edmunds area. Suffolk HWB will consider the change in health needs in the St Edmundsbury locality as the housing developments listed in Appendix J progress through the three-year time horizon of the PNA.

Suffolk HWB will consider the views from the public, pharmacy contractors and other stakeholders when considering the changing health needs of the residents of Suffolk.

No gaps in the provision of necessary services have been identified for St Edmundsbury locality.


There are 15 (79%) providers of the supervised consumption service, an increase of three from the previous PNA and five providers (26%) of the needle exchange service. The sexual health service is provided by 13 (68%) community pharmacies, which is an increase of three more pharmacies compared to 2015, and the stop smoking service is provided by 15 (79%) providers, which is an increase of four providers compared to the 2015 PNA.


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There are no community pharmacies providing services overnight in St Edmundsbury locality. Based upon the results of the public and pharmacy contractor questionnaires, consultation on the draft PNA, provision of 100-hour pharmacies in Suffolk compared to nationally and regionally, and access to pharmacies across Suffolk HWB area or in neighbouring HWB areas, there is no evidence to suggest there is a gap in service which would equate to the need for access to essential services outside normal hours in this locality. Suffolk HWB will monitor the uptake and need for necessary services. It will also consider the impact of any changes in this locality in the future which may provide evidence that a need exists

No gaps in service provision have been identified for St Edmundsbury locality.

6.7 Suffolk Coastal locality


The population of Suffolk Coastal locality is 125,052 which is 16.8% of Suffolk population as a whole. Over one in four residents are over the age of 65 and the locality has the highest life expectancy for females in the HWB. Suffolk Coastal has the highest number of people in medical/care communal establishment settings.

Pharmaceutical services are provided by 24 community pharmacies and eight dispensing GP practices. There are 19.2 community pharmacies per 100,000 population and 24 pharmaceutical service providers per 100,000 population, if dispensing GP practices are included. Two community pharmacies are open for 100 hours or more per week and eight are open in the evenings. There are five PhAS pharmacies in the locality.


Several housing developments are planned for the locality, the largest of which is planned for the Martlesham area (2,000 units). This could provide an issue with regard to pharmaceutical service provision and Suffolk HWB will consider the change in health needs in Suffolk Coastal locality as the housing developments listed in Appendix J progress through the three-year time horizon of the PNA.

Suffolk HWB will consider the views from the public, pharmacy contractors and other stakeholders involved in these developments when considering the changing health needs of the residents of Suffolk.

No gaps in the provision of necessary services have been identified for Suffolk Coastal locality.


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There are 11 (46%) providers of the supervised consumption service, and six (25%) providers of the needle exchange service. The sexual health service is provided by 13 (54%) community pharmacies, a decrease of three providers, and the stop smoking service is provided by 18 (75%) providers, from the previous 22 (92%) in 2015 PNA.

Two community pharmacies provide a locally-commissioned enhanced service to provide potassium iodate tablets to employees at Sizewell Nuclear power stations to limit exposure to ionising radiation in the unlikely event of an accidental release.


Suffolk Coastal has a large number of visiting tourists. Currently, visitors arriving without their prescribed medication can either, pay for a private supply from a community pharmacy at the discretion of the pharmacist, or make an appointment with a GP as a temporary resident to obtain a prescription.

An opportunity exists, if deemed a priority by the commissioners, to make improvements and better access to the emergency supply of medicines through the commissioning of an emergency supply service from community pharmacies in tourist areas.

Figures for Suffolk indicate that 15.2% of patients registered with a GP are recorded as having hypertension, a higher rate compared to the East of England at 14.1% and England at 13.8%. However modelled estimates at locality level indicate the figure could be much higher, and there may be a large proportion of Suffolk residents with undiagnosed hypertension. Suffolk Coastal has a modelled estimated prevalence of 23.4% and a further 13.2% undiagnosed. It would therefore suggest there is scope for improvement in identifying and treating those with hypertension. Should this be a priority target area for commissioners, they may want to consider the current provision and uptake of screening services, including health checks, that could be provided by local community pharmacies. Consideration should be given to incentives for further uptake from current providers and extending provision through community pharmacies.

There are no community pharmacies providing services overnight in the Suffolk Coastal locality.

Based upon the results of the public and contractor questionnaires, consultation on the draft PNA, provision of 100-hour pharmacies in Suffolk compared to nationally and regionally, and access to pharmacies across Suffolk HWB area or in neighbouring HWB areas, there is no evidence to suggest there is a gap in service which would equate to the need for access to essential services outside normal hours in this locality. Suffolk HWB will monitor the uptake and need for necessary services. It will also consider the impact of any changes in this locality in the future which may provide evidence that a need exists.


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No gaps in service provision have been identified for Suffolk Coastal locality.

6.8 Waveney locality


The population of Waveney is 116,182, which is 15.6% of the total Suffolk population. This locality has the highest percentage of over-65s (26.3%). It has one of the lowest life expectancies for both males and females in the HWB. Prevalence of diabetes and depression are higher than the England average. It also has the lowest percent of physically active residents in the HWB.

There are 28 pharmacies and four dispensing GP practices in this locality. This equates to 24.1 community pharmacies per 100,000 population and 27.6 pharmaceutical service providers per 100,000 population.

Three community pharmacies are open for 100 hours or more per week, and four are open in the evenings. All dispensing GP practices are open weekday evenings up to 18:30, none are open on Saturday or Sunday (previously two were open on all or some Saturdays). There are two PhAS pharmacies in the locality.


There is only one housing development of 250 dwellings or more planned over the lifetime of this PNA. This is a development of 1,440 units in the Kirkley Waterfront and Sustainable Urban Neighbourhood. However, it is anticipated that there will be limited completion within the lifetime of this PNA. This will require consideration in future years beyond the duration of this PNA. Suffolk HWB will consider the change in health needs in the Waveney locality as the housing development listed in Appendix J progresses through the three-year time horizon of the PNA. Suffolk HWB will consider the views from the public, pharmacy contractors and other stakeholders involved in these developments when considering the changing health needs of the residents of Suffolk HWB area.

No gaps in the provision of necessary services have been identified for Waveney locality.


There are 16 (57%) providers of the supervised consumption service, and 16 pharmacy contractors (57%) provide the needle exchange service. The sexual health service is provided by 21 (75%) pharmacy contractors, this is a reduction from 26 (90%) previously. Stop smoking service is provided by 16 (57%) pharmacy contractors, again this is a reduction from 25 (86%) providers previously reported.


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Waveney locality has a large number of visiting tourists. Currently, visitors arriving without their prescribed medication can either pay for, pay for a private supply from a community pharmacy at the discretion of the pharmacist, or make an appointment with a GP as a temporary resident to obtain a prescription.

However Great Yarmouth and Waveney CCG does commission an 'emergency supply service' which is available from all community pharmacy contractors in the CCG.

Great Yarmouth and Waveney CCG is the poorest performing across all three measures for diabetes control. There may be scope for community pharmacies to help support patients and encourage them to undertake regular monitoring and compliance with medication.

In addition, data from 2014/15 shows that admissions to hospital due to CHD are higher than the England average.

There are no community pharmacies providing services overnight in the Waveney locality. Based upon the results of the public and pharmacy contractor questionnaires, provision of 100-hour pharmacies in Suffolk compared to nationally and regionally, and access to pharmacies across Suffolk HWB area or in neighbouring HWB areas, there is no evidence to suggest there is a gap in service which would equate to the need for access to essential services outside normal hours in this locality. Suffolk HWB will monitor the uptake and need for necessary services. It will also consider the impact of any changes in this locality in the future which may provide evidence that a need exists.

No gaps in service provision have been identified for Waveney locality.


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Section 7: Summary and conclusions When assessing the provision of pharmaceutical services in Suffolk HWB area and each of the seven PNA localities, Suffolk HWB has considered the following:

• the map showing the location of pharmacies within Suffolk in relation to ward, locality and population density indicating that pharmacies are generally located within areas of higher population density (Map A)

• the population densities • the Index of Multiple Deprivation and deprivation ranges within Suffolk across

the seven PNA localities (Figure 13) and map H. • ethnicity levels (Table 7) across all seven PNA localities • the percentage of population of Suffolk and the average drive, public transport

and walking times to nearest community pharmacy or dispensing GP practice (Appendix I)

• using average drive time, all residents can access a pharmacy or dispensing GP practice by car within 25 minutes (Appendix I)

• using average walking times, 69% of Suffolk residents can access a pharmacy or dispensing GP practice within 20 minutes (Appendix I)

• the location of pharmacies and dispensing GP practices within each of the seven PNA localities and across the whole HWB area (Maps A to C)

• the number, distribution and opening times of pharmacies and dispensing GP practices within each of the seven PNA localities and across the whole Suffolk (Appendix A)

• the choice of pharmacies covering each of the seven PNA localities and the whole Suffolk (Appendix A)

• results of the public questionnaire (Appendix M) • proposed new housing developments and care homes planned (Appendix J) • projected population growth (Section 2.3.3)

Suffolk has a current estimated population of around 741,895. The population rise between 2012 and 2037 is expected to be 13%. Suffolk has a high percentage of the population aged over 65 (20%). The population is generally affluent, compared to the England average, though pockets of significant deprivation exist. BME populations are lower than seen nationally and there are a number of small-to-medium traveller sites spread through the county.

Over 15% of the population of Suffolk is eligible to have their prescriptions dispensed at their dispensing GP practice. From the public questionnaire, 77% of respondents report using the same provider for pharmaceutical services; 69% report that it is important their provider is ‘close to home’ and 55% report it is important they are ‘close to their GP practice’.

Almost two thirds (62%) of respondents travel by car to their provider, while 31% walk.


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Dispensing GP practices play a significant role, in addition to community pharmacies, in the provision of pharmaceutical services in Suffolk.

There are 146 community pharmacies and 43 dispensing GP practices. In addition, there are two appliance contractors. Community pharmacies are more densely concentrated in populated areas and this generally matches areas of higher all-cause mortality and deprivation. Community pharmacies are therefore well-placed to provide services specifically targeted to improve health outcomes. There are 19.7 community pharmacies per 100,000 population in Suffolk, compared with 21.5 per 100,000 in England.

A higher percentage of community pharmacies in Suffolk are open for 100 hours or more (14.4% versus 9.9% in England). Many dispensing GP practices and the majority of community pharmacies are open on Saturdays. Access to pharmaceutical services on bank holidays, overnight and on Sunday evenings is limited. There is no evidence to suggest there is a gap in service which would equate to the need for access to essential services outside normal hours anywhere in the HWB area.

The majority of community pharmacies and dispensing GP practices offer a free delivery service and many have extended opening hours on weekday evenings and Saturdays. As evidenced from the public questionnaire, the number of respondents currently accessing pharmaceutical services via distance-selling pharmacies has risen to 10%. This compares to only 1% in the 2015 PNA. Of those who do use this service, 85% rate it as either excellent or good.

Areas of Suffolk are frequented by holidaying visitors. In some places, this significantly increases the local populations and may provide extra strain on healthcare resources.

No gaps in pharmaceutical service provision have been identified. Suffolk HWB recognise that the burden of health needs in Suffolk will increase as the population grows and ages and would welcome proactive proposals from commissioners, including NHSE and all CCGs to commission pharmacy services that meet local needs but are beyond the scope of the PNA.


118

Appendix A: List of pharmaceutical service providers in Suffolk HWB area Ipswich locality

Name of Contractor Address

Opening hours

100-

hour

pha

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/N)

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Pharmaceutical services Local authority-commissioned

services

Monday-Friday Saturday Sunday

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Community Pharmacies

Barbour Pharmacy 119 Bramford Road, Ipswich IP1 2LW

09:00-13:00 14:15-17:30 09:00-13:00 Closed N N Y Y Y N

N N N Y Y Y Y Y

Delta Pharmacy 57- 59 Foxhall Road, Ipswich IP3 8JU

09:00-13:00 14:00-18:00 09:00-13:00 Closed N N Y Y N N N N N Y Y Y Y Y

Asda Pharmacy Goddard Road, Ipswich IP1 5PD

09:00-13:00 14:00-17:30 09:00-13:00 Closed N N Y Y Y N N Y N Y Y Y N Y

Vision Pharmacy

Unit 4, Anderson House, Rapier Street, Ipswich IP2 8JS

09:00-13:00 13:30-17:30 Closed Closed N Y Y Y Y N N Y N Y Y Y Y Y

Day Lewis Pharmacy 416 Norwich Road, Ipswich IP1 5DX 09:00-18:00 Closed Closed N N Y Y Y N N Y N Y Y Y N Y

Day Lewis Pharmacy 26 Hening Avenue, Ravenswood, Ipswich IP3 9QJ

09:00-18:00 09:00-13:00 Closed N N Y Y Y N N Y N Y Y Y N Y


119


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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services


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Woodbridge Road Pharmacy

102-104 Lacey Street, Ground Floor, Ipswich IP4 2PH

09:00-13:00 14:00-18:30 Closed Closed N N Y Y Y N

N N N N N N N N

Welch Stoke Park Pharmacy

51 Stoke Park Drive, Ipswich IP2 9TH

09:00-13:00 14:00-17:30 09:00-12:00 Closed N Y Y Y Y N N N N Y Y Y N Y

Kew Pharmacy 4 Ellenbrook Green, Ipswich IP2 9RR

07:00-22:00 08:00-22:00 09:00-20:00 Y N Y Y Y N N N Y Y Y Y Y Y

Your Local Boots Pharmacy

58 Queens Way, Ipswich IP3 9EX 09:00-17:30 09:00-17:30 Closed N N Y Y Y N N Y N N N Y N Y

Lloyds Pharmacy 204 Hawthorn Drive, Ipswich IP2 0QG

08:30-18:30 09:00-17:00 Closed N N Y Y Y N N Y Y Y Y Y Y Y

East of England Co-Operative Society

310 Sheldrake Drive, Ipswich IP2 9LF

08:45-17:30 08:45-17:30 Closed N N Y Y Y N N Y Y Y Y Y N Y

Morrisons Pharmacy Sproughton Road, Ipswich, IP1 5AS 08:30-20:00 09:00-18:00 10:00-

16:00 N N Y Y Y N N Y N N N Y N Y


145 Fircroft Road, Ipswich IP1 6PT 08:45-17:30 08:45-17:30 Closed N Y Y Y Y N N Y N Y Y Y N N


120


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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services


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Wellbeing Pharmacy 8 Cox Lane, Ipswich IP4 1HT 08:45-17:30 08:30-17:30 Closed N N Y Y Y N

N Y N Y Y Y Y Y

Aqua Pharmacy 52 Duke Street, Ipswich IP3 0AQ 08:00-20:00 08:00-20:00 Closed N Y Y Y Y N N Y N Y Y Y Y Y

Burlington Pharmacy 14 Burlington Road, Ipswich IP1 2EU

09:00-13:00 14:00-17:30 09:00-13:00 Closed Y N Y Y Y N N N N Y Y Y N Y

Boots UK Limited 5 Tavern Street, Ipswich IP1 3AA 08:00-18:00 08:00-18:00 10:30-

16:30 N N Y Y Y N N Y N Y Y Y Y N

Rushmere Pharmacy 428 Woodbridge Road, Ipswich IP4 4EL

09:00-13:15 13:45-17:30 09:00-13:00 Closed N N Y Y Y N N N N Y Y Y Y Y

Lloyds Pharmacy

Orchard St Medical Centre, Orchard Street, Ipswich IP4 2PU

08:45-18:30 Closed Closed N N Y Y Y N N Y N N N Y Y Y

Welch Pharmacy 46-48 Westgate Street, Ipswich IP1 3ED

08:30-13:00, 14:00-17:30 Closed Closed N N Y Y Y N N N N Y Y Y N Y

Gainsborough Pharmacy

13 Reynolds Road, Ipswich IP3 0JL 09:00-17:30 09:00-13:00 Closed N N Y Y Y N N N N N N Y N Y


121


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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services


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M & M Pharmacy 14 St Matthew's Street, Ipswich IP1 3EU

07:00-22:00 07:00-22:00 08:00-18:00 Y N Y Y Y N

N N N N N N Y Y

Wellbeing Pharmacy 29 Chesterfield Drive, Ipswich IP1 6DW

07:00-22:00 08:00-22:00 09:00-20:00 Y N Y Y Y N N N Y N N N N N


350 Nacton Road, Ipswich IP3 9NA 08:45-17:30 08:45-17:30 Closed N N Y Y Y N N Y N Y Y Y Y Y

Rainbow Pharmacy 289 Norwich Road, Ipswich IP1 4BP

09:00-13:00 14:30-18:00 09:00-13:00 Closed N N Y Y Y N N N N N N N N N

Boots UK Limited

Unit 5, Buttermarket Shopping Centre, Ipswich IP1 1DT

08:30-14:00 15:00-17:30

08:30-14:00 15:00-17:30 Closed N N Y Y Y N N Y N Y Y Y Y Y

Lloyds Pharmacy Hadleigh Road, Ipswich IP2 0BX 07:00-23:00 07:00-22:00 10:00-

16:00 Y N Y Y Y N N Y Y N N Y N Y


Two Rivers Medical Centre, 32 Woodbridge Road East, Ipswich IP4 5PB

09:00-12:00 13:00-18:00

09:00-12:00 13:00-17:30 Closed N N Y Y Y N N Y N N N Y N N


122


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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services


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Two Rivers Medical Centre, 32 Woodbridge Road East, Ipswich IP4 5PB

09:00-12:00 13:00-18:00

09:00-12:00 13:00-17:30 Closed N N Y Y Y N

N Y N N N Y N N

Lloyds Pharmacy 159 Felixstowe Road, Ipswich IP3 8EB

09:00-18:00 09:00-17:00 Closed N N Y Y Y N Y Y N Y Y Y N Y

Welch Pharmacy 64 St Matthew's Street, Ipswich IP1 3EP

08:30-12:00 13:00-17:30 Closed Closed N N Y Y Y N N N N N N N N N

Spring Road Pharmacy

203 Spring Road, Ipswich IP4 5NQ 09:00-18:30 09:00-17:30 Closed N N Y Y Y N N N N Y Y Y Y Y


Pharmacy Dept, 19 Meredith Road, Ipswich IP1 6ED

08:45-17:30 08:45-17:30 Closed N Y Y Y Y N N Y N Y Y N Y Y

Dispensing Appliance Contractors

Fittleworth Medical Ltd

25 Lower Brook Street, Ipswich IP4 1AQ

09:00-17:00 Closed Closed Y N N Y

Y

Charles S Bullen Healthcare Ltd

60 Matthew's Street, Ipswich IP1 3EP 09:00-17:00 09:00-13:00 Closed Y N N N N


123

Mid Suffolk locality


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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Local authority-commissioned services


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Claydon Pharmacy 1 Station Road, Claydon, Ipswich IP6 0HS

09:00-18:30 09:00-13:00 Closed N Y Y Y Y N

N N N Y Y Y N N

Boots UK Limited 21 Ipswich St, Stowmarket IP14 1AH

08:30-17:30 08:30-17:30 Closed N N Y Y Y N N Y N Y Y Y Y Y

Tesco Instore Pharmacy

Instore Pharmacy, Cedars Link Road, Stowmarket IP14 5BE

08:00-13:00 14:00-19:00

08:00-13:00 14:00-19:00

10:00-16:00 N Y Y Y Y N N Y N Y Y Y N N

Asda Stores Ltd 8-9 Wilkes Way, Stowmarket IP14 1DE

07:00-23:00 (Mon - opens

at 08:00)

07:00-22:00

10:00-16:00 Y N Y Y Y N N Y N Y Y Y Y Y

Boots UK Limited

Stowmarket Health Centre, Violet Hill Road, Stowmarket IP14 1NL

08:30-18:30 08:30-12:00 Closed N N Y Y Y N N N N N N N N N


124


Opening hours

100-

hour

pha

rmac

y (Y

/N)

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Boots UK Limited

Stowmarket Health Centre, Violet Hill Road, Stowmarket IP14 1NL

08:30-18:30 08:30-12:00 Closed N N Y Y Y N

N N N N N N N N

Woolpit Medical Services Ltd

Woolpit Health Centre, Heath Road, Woolpit IP30 9QU

08:30-18:30 (Mon - 07:00-

19:45)

08:00-11:00 Closed N N Y Y Y N Y N N N N N N Y

Eye Pharmacy 5 Broad Street, Eye IP23 7AF 08:30-18:00 09:00-

13:00 Closed N Y Y Y Y N N Y N Y Y Y N Y

Needham Market Pharmacy

Barking Road, Needham Market IP6 8EZ

09:00-18:30 09:00-13:00 Closed N N Y Y Y N N N Y Y Y Y N Y

Debenham Pharmacy-Mid-Suffolk Medical Supplies Ltd

The Pharmacy, 1 Little Back Lane, Debenham, Stowmarket IP14 6RB

09:00-13:00 14:00-17:30

09:00-13:00 Closed N Y Y Y Y N N N N Y Y Y N N


125


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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Green Cross Pharmacy

19 The Street, Bramford, Ipswich IP8 4DU

08:45-13:00 14:00-17:45 Closed Closed N Y Y Y Y N

N Y N Y Y Y N N

Station Pharmacy

Unit 1, Cattlepens Station Road, Elmswell IP30 9HD

09:00-18:00 09:00-13:00 Closed N Y Y Y Y N N Y N Y Y Y N N

Thurston Pharmacy

Thurston Granary, Station Hill, Thurston IP31 3QU

09:00-13:00 14:00-18:00

09:00-13:00 Closed N Y Y Y Y N N N N N N N N N

Botesdale Health Centre Pharmacy

Botesdale Health Centre Back Hills, Botesdale, Diss IP22 1DW

08:30-13:00 14:00-18:30

09:00-11:00 Closed N Y Y Y N N N N N N N Y N N


Combs Ford Pharmacy, Combs Lane, Stowmarket IP14 2DA



126


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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GP Dispensing Practices

Botesdale Health Centre

Back Hills, Botesdale, Diss IP22 1DW

08:00-18:30 08:30-12:00 Closed N

Combs Ford Surgery Combs Lane, Stowmarket IP14 2SY

08:00-18:30 (Tues open from 07:00)

08:00-11:00 Closed Y

Debenham Group Practice

20 Low Lane, Debenham IP14 6QU

Mon 08:30-18:00

Tue 08:30-13:00

Weds and Thurs 08:30-

18:30 Fri 07:30-

13:00

Closed Closed Y

Drs Lewis, Partridge and Ahmed

The Health Centre, Eye IP23 7DD

08:30-18:00 (Tue open until

19:30) Closed Closed Y

Fressingfield Medical Practice

Fressingfield, Eye IP21 5PJ

08:00-18:30 (Mon open until 19:25)

Closed Closed N


127


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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The Barham & Claydon Surgery

Norwich Road, Claydon IP6 0DJ

08:00-13:00 13:45-18:30 Closed Closed Y

Mendlesham Group Practice

Chapel Road, Mendelsham IP14 5SQ

08:00-18:30 Closed Closed Y

Needham Market Country Practice

Barking Road, Needham Market IP6 8EZ

08:30-18:30 (Mon open until 20:00)

Closed Closed Y

Stowhealth Violet Hill Road, Stowmarket IP14 1NL

08:00-18:30 (Mon open until 20:15)

08:30-11:45 Closed N

Woolpit

The Health Centre, Bury St Edmonds IP30 9QU

08:00-18:30 (Mon open

07:00-20:00) 08:00-1100 Closed N


128

Forest Heath locality


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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Lords Pharmacy

Unit 61, The Guineas Shopping Centre, Newmarket CB8 8EQ

07:30-22:30 07:30-22:30 09:00-19:00 Y N Y Y Y N

N Y Y N N N Y Y

Lakenheath Pharmacy

40 High Street, Lakenheath IP27 9JS

09:00-18:30 Closed Closed N Y Y Y Y N N N N N N Y N Y


32-34 High Street, Brandon IP27 0AQ

08:30-13:30, 14:30-18:00

(Wed - closes at 17:00)



1 Bury Road, Brandon IP27 0BU

08:30-13:30 14:00-18:30

09:00-13:30 14:00-17:00 Closed N N Y Y Y N N Y Y N N Y Y Y

Superdrug Stores Plc

Unit 11, The Rookery, Newmarket CB8 8HT

08:30-17:30 08:30-17:30 Closed N N Y Y Y N N N N Y Y Y Y N


129


Opening hours

100-

hour

pha

rmac

y (Y

/N)

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Lloyds Pharmacy

2 Manor Court, High Street, Mildenhall IP28 7EH


N N N N N Y N N


Tesco Stores, Fordham Road, Newmarket CB8 7AH

08:00-20:00 08:00-20:00 10:00-16:00 N Y Y Y Y N N Y N Y Y Y N N

Lloyds Pharmacy

27 Market Place, Mildenhall Suffolk, IP28 7EF

09:00-18:00 09:00-17:30 Closed N N Y Y Y N Y Y Y N N Y Y Y

Boots UK Limited

82 High Street, Newmarket CB8 8JX

08:30-18:00 08:30-18:00 10:00-16:00 N N Y Y Y N N Y N Y Y N N Y

Lloyds Pharmacy

Units 1&2, The New Rookery, Shopping Centre, Newmarket CB8 8HT

09:00-17:30 09:00-17:30 Closed N N Y Y Y N Y Y Y Y Y Y Y Y

Day Lewis Pharmacy

Unit 3, Bellflower Crescent IP28 8JU

09:00-13:00 14:00-18:00 09:00-13:00 Closed N Y Y Y Y N N Y Y Y Y Y N Y


130


Opening hours

100-

hour

pha

rmac

y (Y

/N)

Phar

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Market Cross Surgery

7 Market Place, Mildenhall IP28 7EG

Mon and Fri 08:30-18:30 Tue 08:30-

20:00 Wed 07:00-

18:30 Thur 08:00-

20:00

Closed Closed N

Oakfield Surgery

Vicarage Road, Newmarket CB8 8HP


The Rookery Medical Practice

The Rookery, Newmarket CB8 8NW

08:30-18:30 08:30-12:00 Closed Y

The Surgery 135 High Street, Lakenheath IP27 9EP

08:30-12:30 13:30-18:30 Closed Closed N

Whitehouse Surgery

10 Market Place, Mildenhall IP28 7EF

08:30-18:30 Closed Closed N


131


Opening hours

100-

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Orchard House Surgery

Newmarket CB8 8NU 08:00-18:30 Closed Closed Y

Reynard Surgery

Turnpike Road, Red Lodge, Bury St Edmunds IP28 8LB

08:00- 18:30 (Wednesday 07:00-18:30)

Closed Closed N


132

St Edmundsbury locality


Opening hours

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Tesco Instore Pharmacy Cangle Road, Haverhill CB9 0BQ

07:00-23:00 (Mon - opens at

08:00)

07:00-22:00

10:00-16:00 Y N Y Y Y N

N Y Y Y Y Y Y N

Superdrug Stores Plc 37-39 Cornhill, Bury St Edmunds IP33 1DX 08:30-17:30 08:30-

17:30 Closed N N Y Y Y N N Y Y Y Y Y Y Y

Lloyds Pharmacy Bedingfield Way, Bury St Edmunds IP32 7EJ 07:00-23:00 07:00-

22:00 10:00-16:00 Y Y Y Y Y N N N N N N Y N Y

Croasdales Chemist Mount Farm Surgery, Lawson Place, Bury St Edmunds IP32 7EW

09:00-18:00 Closed Closed N N Y Y Y N N Y N N N Y N Y

Boots UK Limited 15 High Street, Haverhill CB9 8AD 08:30-17:30 08:30-

17:30 Closed N N Y Y Y N N Y Y N N N N Y

Well Pharmacy 2 Mill Road, Haverhill CB9 8BD 08:30-18:30 09:00-

13:00 Closed N N Y Y Y N N Y Y Y Y Y N Y

Boots UK Limited 11-13 Cornhill, Bury St Edmunds, IP33 1BX 08:30-18:00 08:30-

18:00 10:30-16:30 N N Y Y Y N N Y N Y Y N Y Y

Abbey Pharmacy

Guildhall and Barrow Surgery, Lower Baxter Street, Bury St Edmunds IP33 1ET

09:00-18:00 09:00-13:00 Closed N N Y Y Y N N N N N N N N N


133


Opening hours

100-

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Tesco Instore Pharmacy St Saviours Interchange, Bury St Edmunds IP32 7JS

06:30-22:30 (Mon - opens at

08:00)

06:30-22:00

10:00-16:00 Y N Y Y Y N

N Y N N N Y N Y

Ixworth Pharmacy Ixworth Surgery, Peddars Close, Ixworth, Bury St Edmunds IP31 2HD

08:30-18:30 09:00-13:00 Closed N Y Y Y Y N N N N Y Y Y N Y

Lloyds Pharmacy Haycocks Road, Haverhill CB9 7YL 08:00-22:00 08:00-

22:00 10:00-16:00 N Y Y Y Y N N Y Y N N N N Y

Lloyds Pharmacy

17 Victoria Street, Bury St Edmunds IP33 3BB 08:30-18:30 Closed Closed N N Y Y Y N N N N Y Y Y N Y

Croasdale & Sons 1 The Traverse, Cornhill, Bury St Edmunds IP33 1BE

08:30-17:30 08:30-17:30 Closed N N Y Y Y N N Y Y Y Y Y Y Y

Asda Stores Ltd Western Way, Bury St Edmunds IP33 3SP

07:00-23:00 (Mon - opens at

08:00)

07:00-22:00

10:00-16:00 Y N Y Y Y N N Y N Y Y Y N Y

David Holland Pharmacy

Norton Road, (Greenfields Way) Haverhill CB9 8LU

09:00-13:00 14:00-17:30

09:00-12:30 Closed N N Y Y Y N N N N N Y Y Y Y

Day Lewis Pharmacy 7 St Olaves Precinct, Bury St Edmunds IP32 6SP 09:00-18:00 09:00-

13:00 Closed N N Y Y Y N N Y N Y Y Y N Y


134


Opening hours

100-

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Swan Pharmacy Swan Surgery, Northgate Street, Bury St Edmunds IP33 1AE

08:00-22:00 08:00-23:00

08:00-23:00 Y N Y Y Y N

N Y N Y Y Y N N

Haverhill Pharmacy Christmas Maltings Surgery, Camps Road, Haverhill CB9 8HF

08:30-23:00 08:00-21:45

08:00-21:45 Y N Y Y Y N N Y Y Y Y Y N Y

Barrow Pharmacy Barrow Hill, Barrow, Bury St Edmunds IP29 5DX

08:00-14:00 14:30-18:30

09:00-12:00 Closed N Y Y Y N N N N N Y Y Y N N

GP Dispensing practices

Angel Hill 1 Angel Hill, Bury St Edmunds IP33 1LU 08:00-18:30 08:30-

12:00 Closed Y

Hopton Surgery (Avicenna)

The Chase, Stanton, Bury St Edmunds IP31 2XA 09:00-17:00 Closed Closed N

Christmas Maltings & Clements Practice

Norton Road, Haverhill CB9 8LU 08:00-18:30 Closed Closed N

Guildhall and Barrow Surgery

Lower Baxter Street, Bury St Edmunds IP33 1ET 08:00-18:30 Closed Closed N

Ixworth Surgery Peddlers Close, Ixworth, Bury St Edmunds IP31 2HD



135


Opening hours

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The Swan Surgery Northgate Street, Bury St Edmunds IP33 1AE 08:00-18:30 08:30-

12:00 Closed N

Victoria Surgery Victoria Street, Bury St Edmunds IP33 3BB

08:00-18:30 (Tues and Weds open until 20:00)

08:00-09:30 Closed Y

Wickhambrook Surgery Nunnery Green, Wickhambrook, Newmarket CB8 8XU



136

Babergh locality


Opening hours

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Springlands Road, Sudbury CO10 1GY

06:30-22:30 (Mon - opens

at 08:00)

06:30-22:00 10:00-16:00 Y Y Y Y Y N

N Y N Y Y Y N N

Villapharm Ltd 36 The Street, Capel St Mary, Ipswich IP9 2EE

08:30-13:00 14:00-18:15 Closed Closed N N Y Y Y N N N N Y Y Y N N

Lavenham Pharmacy 3 High Street, Lavenham, Sudbury CO10 9PX

09:00-18:00 09:00-17:30 Closed N Y Y Y Y N N Y N Y Y N N Y


5 Applegate Mews, Poplar Road, Great Cornard CO10 0GL

09:00-13:00 14:00-17:30

09:00-13:00 Closed N N Y Y Y N N Y N N N N N N

Mill Pharmacy

Hadleigh Health Centre, Market Place, Hadleigh, Ipswich IP7 5DN

08:00-18:30 09:00-18:00 10:00-14:00 N N Y Y Y N N Y N Y Y Y N N


137


Opening hours

100-

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Parade Pharmacy 6 North Street Parade, Sudbury CO10 1GL

Mon 08:00 - Tues 06:00 (non-stop), Tues 8:00-Wed 06:00 (non-stop),

Wed, Thurs, Fri - 08:00-

22:00

09:00-18:00 10:00-15:00 Y N Y Y Y N

N N N Y Y Y Y Y

Clare Pharmacy 31 High Street, Sudbury, Suffolk, CO10 8NY

09:00-13:00 14:00-17:30

09:00-13:00 14:00-17:00

Closed N Y Y Y Y N N Y N Y Y Y N N

Superdrug Pharmacy 8 North Street, Sudbury, CO10 1RB 08:30-17:30 08:30-

17:30 Closed N N Y Y Y N N N N N N N N N

Lloyds Pharmacy

29 North Street, Sudbury CO10 1RB 09:00-18:00 09:00-

17:30 Closed N N Y Y Y N N Y N N N Y Y N


31 High Street, Hadleigh, Ipswich IP7 5AF

09:00-17:30 09:00-17:00 Closed N N Y Y Y N N Y N N N N N Y


138


Opening hours

100-

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The Pharmacy Hall Street, Long Melford, Sudbury CO10 9JL

09:00-13:00 14:00-18:00

09:00-17:30 Closed N N Y Y Y N

N Y Y Y Y Y N N


Copdock Interchange, London Road, Ipswich IP8 3TS

08:00-13:30 14:30-20:00

08:00-13:30 14:30-20:00

10:00-16:00 N Y Y Y Y N N Y Y N N Y Y Y

Day Lewis Pharmacy The Street, East Bergholt CO7 6SE

09:00-13:00 14:00-18:00

09:00-13:00 Closed N Y Y Y Y N N Y N N N Y N N

Boots UK Limited 13-14 Market Hill, Sudbury CO10 2EA 08:30-17:30 08:30-

17:30 10:00-16:00 N N Y Y Y N N Y Y Y Y Y Y Y

Lloyds Pharmacy

Armes Trading Estate, Cornard Road, Sudbury CO10 2XB

07:00-23:00 07:00-22:00 10:00-16:00 Y N Y Y Y N N Y N Y Y N N N


91 High Street, Hadleigh, Ipswich IP7 5EA

08:45-12:30 13:30-17:30

08:45-10:00 Closed N N Y Y Y N N Y N N N Y N N

Glemsford Pharmacy The Surgery, Lion Road, Glemsford CO10 7RF

08:30-13:00 13:30-18:30

09:00-12:30 Closed N Y Y Y Y N N N N Y Y N N Y


139


Opening hours

100-

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GP Dispensing Practices Bildeston Health Centre

High Street, Bildeston IP7 7EX 08:00-18:30 08:30-

12:30 Closed Y

The Surgery Lion Road, Glemsford, Sudbury CO10 7RF


Hadleigh Boxford Group Practice

Market Place, Hadleigh IP7 5DN 08:00-18:30 Closed Closed N

Hardwicke House Group Practice

Harwicke House, Stour Street CO10 2AY


The Long Melford Practice

The Surgery, Long Melford CO10 9EP 08:00-18:30 Closed Closed N

The Surgery The Street, Holbrook, Ipswich IP9 2QS

Mon 07:00-17:00

Tues, Wed, Fri 08:00-18:30 Thur 08:00-

12:30

08:30-10:30 Closed N


140

Suffolk Coastal locality


Opening hours

100-

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Felixstowe Pharmacy

Grove Medical Centre, Grove Road, Felixstowe IP11 9GA

07:00-22:30 07:00-22:30 10:00-17:00 Y N Y Y Y N

N Y N N Y Y Y N N

Wickham Market Pharmacy

Unit 2, White Hart Court, Wickham Market IP13 0RA

09:00-18:00 09:00-13:00 14:00-17:00 Closed N Y Y Y Y N N Y N N Y Y Y N Y

Waterton Pharmacy

Framfield Medical Centre, Ipswich Road, Woodbridge IP12 4FD

08:00-19:30 10:00-13:00 10:00-12:00 N N Y Y Y N N Y N N N N N N N

Lloyds Pharmacy

Unit 1, 11 Thoroughfare, Woodbridge IP12 1AA

09:00-18:00 09:00-17:30 Closed N N Y Y Y N N Y N N Y Y Y N Y

Morrisons Pharmacy

Grange Farm Avenue, Cavendish Park Estate, Felixstowe IP11 2XD

08:00-14:0, 15:00-20:00

08:00-14:00, 15:00-18:00 10:00-13:00 N N Y Y Y N N N N N N N Y N N


141


Opening hours

100-

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Kesgrave Pharmacy 34a Penzance Road, Kesgrave, Ipswich IP5 1JS

09:00-13:00 14:00-18:00 09:00-13:00 Closed N N Y Y Y N

N N N N N N N N N

Framlingham Pharmacy

32 Market Hill, Framlingham, Woodbridge, IP13 9AY

08:30-18:00 09:00-17:00 Closed N Y Y Y Y N N N N N N N Y N N


31 Orwell Road, Felixstowe IP11 7DD

08:30-18:30 (Mon & Tues -

closes at 20:00) 09:00-17:30 Closed N N Y Y Y N N Y N N Y Y Y Y Y


Tesco Superstore, Anson Rd, Martlesham Heath, Ipswich IP5 3RU

08:00-20:00 (Fri closes at 21:00) 08:00-20:00 10:00-16:00 N N Y Y Y N N Y N N N N N N N

Boots UK Limited 86 Hamilton Road, Felixstowe IP11 7AD 08:30-17:30 08:30-17:30 10:00-16:00 N N Y Y Y N N Y N Y Y Y Y N N

Lloyds Pharmacy 277 High Street, Walton, Felixstowe IP11 9DU

09:00-18:30 09:00-13:00 Closed N N Y Y Y N N Y N N N N Y Y Y

Lloyds Pharmacy Felixstowe Road, Warren Heath, Ipswich IP3 8TQ

08:00-21:00 08:00-20:00 10:00-16:00 N N Y Y Y N N Y N N N N Y N Y


142


Opening hours

100-

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Acer Road Pharmacy 6 Acer Road, Rendlesham IP12 2GA


N N N N N N N N N

Square Pharmacy 696 Foxhall Road, Ipswich IP3 8NQ

09:00-13:00 14:00-18:00 09:00-13:00 Closed N Y Y Y Y N N N N N N N N N N

Hado Pharmacy 135 Hamilton Road, Felixstowe IP11 7BL 07:00-23:00 07:00-20:00 10:00-17:00 Y N Y Y Y N N N N N Y Y Y N N

Martlesham Pharmacy

9 The Square, Martlesham Heath, Ipswich IP5 3SL

09:00-13:00 14:00-18:00 09:00-12:00 Closed N N Y Y Y N N N N N Y Y Y N Y


Pharmacy Department, 189 Hamilton Road, Felixstowe IP11 7DT

08:30-17:30 08:30-17:30 Closed N N Y Y Y N N Y N Y Y Y Y Y Y

Aldeburgh Pharmacy 125 High Street, Aldeburgh IP15 5AR 09:00-18:00 09:00-17:00 10:00-14:00 N Y Y Y Y N N N N Y Y Y Y N N

Rendlesham Pharmacy

Unit 7, Rendlesham Mews, Rendlesham IP12 2SZ

09:00-17:00 10:00-12:00 Closed N N N Y Y N N N N N N N N N N


Ropes Drive, Kesgrave, Ipswich IP5 2FU

08:00-13:30 14:30-19:00

08:00-13:30 14:30-19:00 Closed N N Y Y Y N N Y N N Y Y Y N N


143


Opening hours

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Lloyds Pharmacy 62 High Street, Leiston IP16 4BZ 08:30-18:00 09:00-17:30 Closed N N Y Y Y N N Y Y N Y Y Y Y Y

Boots UK Limited 58 Thoroughfare, Woodbridge IP12 1AL

08:30-12:45 13:45-17:30

08:30-12:45 13:45-17:30 10:00-16:00 N N Y Y Y N N Y N N N N Y N Y

East Of England Co-Operative Society

7 High Street, Saxmundham IP17 1DF

08:30-18:00 08:30-17:30 Closed N Y Y Y Y N N Y N Y Y Y Y Y Y

Leiston Pharmacy 20 High Street, Leiston IP16 4EW 09:00-18:30 09:00-17:00 Closed N N Y Y Y N N Y Y Y Y Y Y Y Y

GP Dispensing practices

Dr Taylor and Partners

7 Little St John's Street, Woodbridge IP12 1EE

08:00-18:30 08:30-11:30 Closed Y

Framfield House Surgery

Ipswich Road, Woodbridge IP12 4FD

08:00-18:30 (Mon and Tues

open until 20:00)

Closed Closed Y


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Framlingham Medical Centre

The Surgery, Pembroke Road, Framlingham, Woodbridge IP13 9HA


07:00-19:00) Closed Closed Y

Martlesham Heath Surgery

23 The Square, Martlesham Heath, Ipswich IP5 3SL


Saxmundham Health Group

Lambsdale Meadows, Saxmundham IP17 1DY


The Leiston Surgery Main Street, Leiston IP16 4ES 08:00-18:30 Closed Closed N

The Peninsula Practice

Alderton Health Centre, Mill Hoo, Alderton, Woodbridge IP12 3DA

08:00-18:30 (Mon and Tues closed at 14:30)

Closed Closed Y

Wickham Market Medical Practice

Chapel Rd, Wickham Market, Woodbridge IP13 0SB

08:00-18:30 (Tues open until

20:00) 08:30-11:45 Closed N


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Waveney locality


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Asda Pharmacy Horn Hill, Lowestoft NR33 0PX

07:00-23:00 (Mon opens at

08:00) 07:00-22:00 10:00-

16:00 Y N Y Y Y N

N Y Y N Y Y Y Y Y

Beccles HCC Ltd St Mary's Road, Beccles NR34 9NQ

08:30-19:30 (Fri closes at 18:30) 09:00-12:00 Closed N N Y Y Y N N Y N N Y Y Y N Y

Boots UK Limited 5 New Market, Beccles NR34 9HQ

8:30-13:30 14:30-17:30 09:00-17:30 Closed N N Y Y Y N N Y N Y Y N N Y Y

Boots UK Limited 4 St Mary's Street, Bungay NR35 1AX

08:30-12:30 13:00-17:30

08:30-12:30 13:00-17:30 Closed N N Y Y Y N N Y N N Y Y Y N Y

Boots UK Limited 28 St John's Road, Bungay NR35 1LP

09:00-13:00 14:00-18:00

09:00-13:00 14:00-18:00 Closed N N Y Y Y N N Y Y N Y Y Y Y Y

Boots UK Limited 26 Market Place, Halesworth IP19 8AY 08:30-18:30 08:30-17:00 Closed N N Y Y Y N N Y Y Y Y Y N N Y

Boots UK Limited 76a London Road North, Lowestoft NR32 1ET

08:30-17:30 08:30-17:30 10:00-16:00 N N Y Y Y N

N Y N Y Y Y Y Y Y


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Boots UK Limited

Oulton Village Medical Centre, Meadow Road, Lowestoft NR32 3AZ


N Y N N N N N N N

Boots UK Limited 120 St Peter's Street, Lowestoft NR32 1UD

09:00-13:00 14:00-18:00

09:00-13:30 14:00-16:30 Closed N N Y Y Y N N Y N N N N N Y Y

Boots UK Limited

2-4 Stradbroke Road, Pakefield, Lowestoft NR33 7HT

09:00-13:00 14:00-18:00

09:00-13:00 14:00-18:00 Closed N N Y Y Y N

N Y N N Y Y N N N

Cutlers Hill Pharmacy

Bungay Road, Halesworth IP19 8SG

08:30-18:30 08:30-12:30 Closed N N Y Y Y N

N N N N N N N N N

Eastpoint Pharmacy 216 London Road South, Lowestoft NR33 0HF

09:00-17:30 09:00-13:00 Closed N N Y Y Y N

N N Y N Y Y Y Y Y

Hayden Chemist Bridge Road, Oulton Broad, Lowestoft NR32 3LL

09:00-17:30 09:00-13:00 Closed N N Y Y Y N

N Y N Y Y Y Y Y Y

High Street Pharmacy

High Street, Lowestoft NR32 1JE 09:00-18:00 Closed Closed N N Y Y Y N N Y Y N Y Y Y Y Y


147


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Holly Pharmacy 1b Bridge Road, Oulton Broad, Lowestoft NR32 3LJ


N Y N N Y Y N N N

Kessingland Pharmacy

70 High Street, Kessingland NR33 7QF

09:00-18:00 09:00-17:00 Closed N N Y Y Y N

N Y N N Y Y Y N Y

Queen St Pharmacy 18 Queen Street, Southwold IP18 6EQ 09:00-17:30 09:00--17:30

10:00-16:00 (Busy

periods)

N Y Y Y Y N

N Y N N Y Y Y N N

Reydon Pharmacy

Solebay Health Centre, Teal Close, Reydon, Southwold IP18 6GY

09:00-18:00 09:00-13:00 Closed N Y Y Y Y N

N N Y N N N N N N

Rosedale Pharmacy 3 Ashburnham Way, Lowestoft NR33 8LG 07:00-22:30 07:00-22:30 10:00-

17:00 Y N Y Y Y N N Y N N Y Y Y Y Y

Superdrug Pharmacy 14 The Britten Centre, Lowestoft NR32 1LR 09:00-17:30 09:00-17:30 Closed N N Y Y Y N N N N N Y Y Y Y Y


George Westwood Way, Beccles NR34 9EJ


08:00) 06:30-22:30 10:00-

16:00 Y N Y Y Y N

N Y Y N N N N N N


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Well Pharmacy

Unit 5, 15 Ashburnham Way, Carlton Colville, Lowestoft NR33 8LG

08:45-18:00 09:00-17:30 Closed N N Y Y Y N

N Y N N Y Y Y N N

Jhoots Pharmacy 187 London Road South, Lowestoft NR33 0DR

08:30-18:30 09:00-13:00 Closed N N Y Y Y N

N N N N N N N N N

Well Pharmacy 55 Westwood Av, Lowestoft NR33 9RW 08:30-18:00 09:00-13:00 Closed N N Y Y Y N N N N N Y Y Y Y Y

Well Pharmacy Alexandra Road, Lowestoft NR32 1PL 08:30-18:30 Closed Closed N N Y Y Y N N N N N N N N N N

Victoria Pharmacy 82 Victoria Road, Oulton Broad, Lowestoft NR33 9LU


N N N N Y Y N N N

FP Cross Ltd

Village Rise Pharmacy, Weston Road, Gunton, Lowestoft NR32 4PT

09:00-13:00 14:00-17:30 09:00-13:00 Closed N N Y Y Y N

N N N Y Y Y Y N N

Worlingham Pharmacy

Woodland Avenue, Worlingham, Beccles NR34 7EF

09:00-18:00 09:00-17:00 Closed N Y Y Y Y N

N Y N Y Y Y Y N Y


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GP Dispensing Practices Bungay Medical Practice

28 St Johns Road, Bungay NR35 1LP 08:00-18:30 Closed Closed Y

Cutlers Hill Surgery Bungay Road, Halesworth IP19 8SG


Field Lane Surgery /Longshore

Kessingland Surgery, Field Lane, Kessingland NR33 7QA


Solebay Health Centre

Teal Close, Reydon IP18 6GY 08:30-18:30 Closed Closed Y

*A list of providers of NHS Urgent Medicines Service is expected to be available later in 2017


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Appendix B: PNA Steering Group Terms of Reference 1. Objective/Purpose To support the production of a Pharmaceutical Needs Assessment on behalf of the Suffolk County Council, to ensure that it satisfies the relevant regulations including consultation requirements.

2. Accountability The Steering Group is to report to the Director of Public Health for Suffolk County Council, who has received delegation from Suffolk Health and Wellbeing Board to produce the 2018 Pharmaceutical Needs Assessment for Suffolk.

3. Membership Core members:

• Head of Knowledge and Intelligence, Public Health, Suffolk County Council • NHS England representative • Suffolk Local Medical Committee representative • Suffolk Local Pharmaceutical Committee representative • Suffolk Local Pharmaceutical Network Lead • Great Yarmouth and Waveney Clinical Commissioning Group Medicines

Management representative • West Suffolk Clinical Commissioning Group Medicines Management

representative • Ipswich and East Clinical Commissioning Group Medicines Management

representative • Communications and Engagement Manager, Great Yarmouth and Waveney

Clinical Commissioning Group • JSNA Programme Manager, Public Health, Suffolk County Council • Council – Consultant in Public Health, Suffolk County Council • Council – Commissioning Manager • Engagement Lead, West Suffolk Clinical Commissioning Group • Engagement Lead, Suffolk County Council • Health Watch representative (lay member)

Members are encouraged to provide a deputy if unable to attend. Soar Beyond members are not core members however will chair and collate minutes of the meetings. Each core member/deputy has one vote. Anna Crispe, the Head of Knowledge and Intelligence, Public Health, Suffolk Council will have the casting vote, if required. Core members may provide a deputy to meetings in their absence. The Steering Group shall be quorate with seven core members in attendance. Non-attending members are unable to cast a vote – that vote may otherwise sway the casting decision.


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Additional members (if required):

• CCG Commissioning Managers • NHS Trust Chief Pharmacists • Dispensing Doctors representative

In attendance at meetings will be representatives of Soar Beyond Ltd who have been commissioned by Suffolk County Council to support the development of the PNA. Other additional members may be co-opted if required

4. Frequency of meetings Meetings will be arranged at key stages of the project plan. The Steering Group will meet in late 2017-early 2018 to sign off the PNA for submission to the Health and Wellbeing Board.

5. Responsibilities • Provide a clear and concise PNA process • Review and validate information and data on population, demographics,

pharmaceutical provision, and health needs • To consult with the bodies stated in Regulation 8 of the Pharmaceutical

Regulations 2013: o Any Local Pharmaceutical Committee for its area o Any Local Medical Committee for its area o Any persons on the pharmaceutical lists and any dispensing doctors list

for its area o Any LPS chemist in its area o Any Local HealthWatch organisation for its area o Any NHS trust or NHS foundation trust in its area o The NHSCB o Any neighbouring HWB

• Ensure that due process is followed • Report to Health & Wellbeing Board on both a Draft and Final PNA. • Publish a Final PNA by end 1st April 2018.


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Appendix C: Public questionnaire

Tell us what you think of pharmacy services in Suffolk

We want to hear what you think of pharmacy services in Suffolk to help us develop services in the future. Your views will help us to develop our Pharmacy Needs Assessment (PNA) which will look at health needs in Suffolk, the level and accessibility of pharmacy services and how these will be maintained and developed in the future.

We would be grateful if you would take a few minutes to answer some questions about your own experience and views. The information in the questionnaire you provide is confidential. Please be honest with your answers so we can accurately assess areas where pharmacies are already performing well and areas that need improvement. Information returned in the ‘A bit about you’ section will be recorded separately from your questionnaire response.

If you would like to complete this online please go to:

https://www.surveymonkey.co.uk/r/_SUFFOLK_Public

Or scan the QR code below:

Closing date for this questionnaire is 31 March 2017.

Please return the questionnaire to your pharmacist or GP practice or post back to:

Natacha Bines, Public Health Suffolk, Suffolk County Council, Endeavour House, 8 Russell Road, Ipswich IP1 2BX

Please provide your postcode: ____________________________________________

Should you require this questionnaire in any other format or language,

please call 08456 066 067

https://www.surveymonkey.co.uk/r/_SUFFOLK_Public


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N.B. All information supplied will be kept strictly confidential, held securely and used for the purpose of planning appropriate services for all communities. It will not be

passed on to any third party.

1) How often have you visited the pharmacy in the last six months?

For yourself: For someone else: Once a week or more Once a week or more Once a month Once a month Once every few months Once every few months Once in six months Once in six months

2) Do you have a regular or preferred pharmacy that you visit?

Yes - if happy to do so, please provide the name and address No ________________________________________________________________

3) When considering a choice of pharmacy, which of the following helps you choose? (Please select all that apply)

Close to home Close to GP surgery Close to work Efficiency They offer a specific service Expertise / quality of advice Friendly staff Other, please specify

_________________________________________________________________

4) Who would you normally visit the pharmacy for? (Please select all that apply)

Yourself A family member Neighbour / friend Someone you are a carer for All of the above Other, please specify

________________________________________________________________

5) If you visit a pharmacy on behalf of someone else, please give a reason why (you may select more than one answer)

Opening hours of the pharmacy not suitable for patient Most convenient Access (for example disability / transport) All of the above Other, please specify

________________________________________________________________

6) How would you usually travel to the pharmacy? (Please select one answer)

Car Taxi Public transport Walk Bicycle Other, please specify

________________________________________________________________

7) On average, how long does it take you to travel to a pharmacy? (Please select one answer)

0 to 15 minutes 16 to 30 minutes Over 30 minutes Varies Don’t know


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8) Do you have any difficulties when travelling to a pharmacy?

Yes No

If yes, please select one of the following reasons:

Location of pharmacy Parking difficulties Public transport availability Other, please specify

________________________________________________________________

9) What is the most convenient day for you to visit a pharmacy? (Pleased select one answer)

Monday to Friday Saturday Sunday Varies Don’t know

10) When do you prefer to visit a pharmacy? (Please select one answer)

Morning (8am-12pm) Lunchtime (12pm-2pm) Afternoon (2pm-6pm) Early evening (6pm-8pm) Late evening (after 8pm) Varies Don’t know

11) How regularly do you typically buy an over the counter (i.e. non-prescription) medicine from a pharmacy? (Please select one answer)

Daily Weekly Fortnightly Monthly Yearly Never

12) Which of the following pharmacy services are you aware that a pharmacy may provide? (Please select all that apply)

Dispensing of prescriptions Repeat dispensing services Needle exchange Advice from your pharmacist Buying over the counter medicines Disposal of unwanted medicines Flu vaccination services Home delivery and prescription collection services Detailed discussion with your pharmacist – how you take your existing and newly prescribed medicines

Stopping smoking / nicotine replacement therapy Sexual health services (chlamydia testing / treating, condom distribution, emergency contraception)

Immediate access to specialist drugs e.g. palliative care medicines Supervised consumption of methadone and buprenorphine Emergency supply of prescription medicines Other, please specify

________________________________________________________________


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13) What services would you like to see provided by your local pharmacy?

Yes No Don’t know

Dispensing of prescriptions Repeat dispensing services Home delivery and prescription collection services Needle exchange Advice from your pharmacist Buying over the counter medicines Disposal of unwanted medicines Flu vaccination services Detailed discussion with your pharmacist how - to

take your existing and newly prescribed medicines Stopping smoking / nicotine replacement therapy Sexual health services (chlamydia testing / treating,

condom distribution, emergency contraception) Immediate access to specialist drugs e.g.

palliative care medicines Supervised consumption of methadone and

buprenorphine Emergency supply of prescription medicines Other, please specify ______________________________________________________________

14) Is there a consultation room available where you cannot be overheard in the pharmacy you normally visit?

Yes No

15) Have you ever used an internet pharmacy to obtain prescription medicines?

Yes No

16) If yes, how would you rate your overall satisfaction with the internet pharmacy?

Excellent Good Fair Poor

Any other comments you would like to make about your pharmacy? ______________________________________________________________

Thank you for completing this questionnaire

Your answers to this survey are private and will be kept in line with the Data Protection Act. If you wish to be kept informed about the Pharmaceutical Needs Assessment and the consultation we will be running, you can give us your contact details here:

Name: _____________________________________________________________

Address:____________________________________________________________


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Telephone number: ___________________________________________________ Email:______________________________________________________________

Preferred method of communication: Telephone Email Post

A bit about you

This information is being collected anonymously and will only be used for the purpose of improving Suffolk’s consultation service.

Please note that this section is optional and you don’t have to complete these questions if you don’t want to.

If you choose not to answer these questions, please tick the ‘Prefer Not to Disclose’ option so that we are aware of your choice.

By providing this information it allows us to see which groups of people are responding to our consultations and which groups are underrepresented. We can then make extra efforts to reach underrepresented groups so that we can consider the views of all groups who may be affected by our plans. It also helps us ensure that everyone is treated fairly and equitably in everything we do. Without your information, we can't always spot trends and issues which enable us to make appropriate changes or improvements.

All responses to these questions are anonymous; responses are added together and no individuals are identified. Any information provided is governed by the Data Protection Act 1998 which will be treated as strictly confidential.

1. If you choose not to answer any of these questions, please tick the ‘Prefer not to disclose’ option below so that we are aware of your choice.

(Prefer not to disclose)

2. Are you:

Female Male Prefer not to say Prefer to self-describe (please specify): ______________________________

3. Which age group do you fit into?

Under 16 16-24 25-34 35-44 45-54 55-64 65-74 75+ Do not want to say

4. The provision for disability within Equalities legislation defines a person as disabled if they have a physical or mental impairment, which has a substantial and long term (i.e. has lasted or is expected to last at least 12 months) and has an adverse effect on the person’s ability to carry out normal day-to-day activities. Do you consider yourself to have a disability according to the terms given in the Equality legislation?

Yes No


157

5. If you have answered yes to the above question, please indicate the type of impairment which applies to you from the list below.

People may experience more than one type of impairment, in which case please select all that apply. If your disability does not fit any of these types, please mark ‘Other’.

Mobility Hearing Vision Learning Mental Health Communication Long standing health condition Other (Please state below):

6. To which of these groups do you consider you belong?

Asian or Asian British: Indian Asian or Asian British: Pakistani Asian or Asian British: Bangladeshi Any other Asian background - please specify in the box below:

Black or Black British: Caribbean Black or Black British: African Any other Black background - please specify in the box below:

Chinese Mixed: White and Black Caribbean Mixed: White and Black African Mixed: White and Asian Any other Mixed background - please specify in the box below:

White: English White: Irish White: Scottish White: Welsh White: British

Gypsy or Irish Traveller Other white background - please describe:

Do not want to say

7. Your religion or belief - What group do you most identify with?

No religion Baha'i Buddhist Christian Hindu Jain Jewish Muslim Sikh Any other religion or belief (specify if you wish)


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8. What is your sexual orientation? Bisexual Gay man Gay woman / lesbian Heterosexual No sexuality Prefer not to say Same-sex relationship with a man Same-sex relationship with a woman Other

Why do you want to know more about me?

We are committed to building a community where everyone can flourish and achieve their full potential and the information you give us will help us achieve our commitment of being fair to all. We value diversity and acknowledge that our residents come from different backgrounds and have different needs, experiences and interests. It’s really important we get to know you better so that we can plan and deliver fair services that are tailored to residents’ needs.

The information you give us will enable us to:

• check whether or not our services are equally accessible to everyone who is entitled to them;

• identify and address any barriers to accessing (information about) our services;

• continually improve the services we deliver

What is an Equal Opportunities Form?

Suffolk County Council monitors the age, disability, gender, race and preferred first language of our service users, as well as whether or not they have caring responsibilities for an adult or a child with a disability. Where relevant and appropriate to the service questionnaire, for example in relation to health or social care services, we also sometimes ask about the sexual orientation, marital or civil partnership status and religion or belief of service users. We collect this information by asking you to fill in an Equal Opportunities Form. The form is very straightforward to complete.

Who chooses the questions listed on the Equal Opportunities Form?

The questions in the Equal Opportunities Form are based on legislation (Equality Act 2010); advice from advisory bodies (Equality and Human Rights Commission) and best practice by other local authorities.

Is it just Suffolk County Council that carries out equal opportunities monitoring?

No. All local authorities across the country monitor characteristics such as the age, gender, disability and ethnic origin of those who use their services.


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Do I have to give you this information?

No. All questions in the Equal Opportunities Form are voluntary. If you feel uncomfortable giving us this information, simply tick the ‘prefer not to say’ box or do not answer the question. However, we can’t get things right without your help so we ask you to help us by completing this form.

I've already given you this information, why do you want it again?

We recognise that people’s circumstances change all the time and we want to make sure that our services are reflective of people’s changing circumstances.

Still have questions? If you have further questions or want more information about this form, please contact: Natacha Bines, Public Health Suffolk, Suffolk County Council, Endeavour House, 8 Russell Road, Ipswich IP1 2BX. [email protected] or telephone 01473 260091.

mailto:[email protected]


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Appendix D: Pharmacy contractor questionnaire

PNA Pharmacy Questionnaire


Soar Beyond are supporting Suffolk County Council to produce their 2018 Pharmaceutical Needs Assessment. We are undertaking a survey of all pharmacy contractors in Suffolk.

We would therefore be grateful if you could spend a few minutes to complete the questions below. If you prefer, you may complete the survey online at:

https://www.surveymonkey.co.uk/r/_SUFFOLK_Pharmacy_Contractor

Please complete the questionnaire by 31 March 2017, and return any completed paper copies of the survey in the enclosed reply-paid envelope.

Premises Details

Contractor Code (ODS Code) Name of contractor (i.e. name of individual, partnership or company owning the pharmacy business)

Trading Name Address of Contractor pharmacy Is this pharmacy one which is entitled to Pharmacy Access Scheme payments?

Yes No Possibly

Is this pharmacy a 100-hour pharmacy? Yes No Does this pharmacy hold a Local Pharmaceutical Services (LPS) contract? (i.e. it is not the ‘standard’ Pharmaceutical Services contract)

Yes No

Is this pharmacy a Distance Selling Pharmacy? (i.e. it cannot provide Essential Services to persons present at or in the vicinity of the pharmacy)

Yes No

Pharmacy email address Pharmacy telephone Pharmacy fax (if applicable) Pharmacy website address (if applicable) Can the LPC store the above information and use it to contact you? Yes No

https://www.surveymonkey.co.uk/r/_SUFFOLK_Pharmacy_Contractor


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Core Hours of Opening

Day Open from To Lunchtime (from - to) Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday Total Hours of Opening

Day Open from To Lunchtime (from - to) Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Consultation Facilities

There is a consultation area (meeting the criteria for the Medicines Use Review service) (tick as appropriate)

On premises

None Available (including wheelchair access) Available (without wheelchair access) Planned within the next 12 months Other (please specify)

Where there is a consultation area, is it a closed room? Yes No

During consultations are there hand-washing facilities

In the consultation area Close to the consultation area None


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Patients attending for consultations have access to toilet facilities Yes No

Off-site

The pharmacy has access to an off-site consultation area (i.e. one which the former PCT or NHS England local team has given consent for use)

Yes No

The pharmacy is willing to undertake consultations in patient’s home / other suitable site

Yes No

Access to the Pharmacy

The pharmacy is accessible for wheelchair users

Ramped access Yes No Wide door Yes No Electric door Yes No

Languages spoken (in addition to English)-please list

IT Facilities in the Pharmacy

Electronic Prescription Service Release 2 enabled Yes No NHS mail being used Yes No NHS Summary Care Record enabled Yes No Up to date NHS Choice entry Yes No

Healthy Living Pharmacies (HLP)

Select the one that applies.

The pharmacy has achieved HLP status The pharmacy is working toward HLP status The pharmacy is not currently working toward HLP status

Services Does the pharmacy dispense appliances?

Yes, all types Yes, excluding stoma appliances Yes, excluding incontinence appliances Yes, excluding stoma and incontinence appliances Yes, just dressings Other (please identify) None


163

Advanced Services

Does the pharmacy provide the following services?

Yes Intending to begin within

next 12 months

No - not intending to

provide Medicines Use Review Service

New Medicine Service

Appliance Use Review Service Stoma Appliance Customisation Service

Flu Vaccination Service NHS Urgent Medicine Supply Advanced Service

Enhanced129 and Other Locally-Commissioned Services

Which of the following services does the pharmacy provide, or would be willing to provide?

Currently providing under contract with the local NHS England Team

Currently providing under contract with CCG

Currently providing under contract with Local Authority

Willing to provide if commissioned

Not able or willing to provide

Anticoagulant Monitoring Service

Anti-viral Distribution Service*

*

Care Home Service

Chlamydia Testing Service* *

Chlamydia Treatment Service*

*

Contraceptive service (not EC)*

*

129 ‘Enhanced Services’ are those commissioned by the local NHS England Team. CCGs and Local Authorities can commission Other Locally-Commissioned Services that are equivalent to the Enhanced Services, but for the purpose of developing the PNA are called ‘Other Locally-Commissioned Services’ not ‘Enhanced Services’


164






Disease-Specific Medicines Management Service:

Allergies Alzheimer’s / dementia

Asthma

CHD

COPD

Depression

Diabetes type I

Diabetes type II

Epilepsy

Heart Failure

Hypertension Parkinson’s disease

Other (please state) Emergency Contraception Service*

*

Emergency Supply Service Gluten Free Food Supply Service (i.e. not via FP10)

Home Delivery Service (not appliances)*

*

Independent Prescribing Service

If currently providing an Independent Prescribing Service, what therapeutic areas are covered? Language Access Service Medication Review Service


165






Medicines Assessment and Compliance Support Service

Minor Ailment Scheme MUR Plus/Medicines Optimisation Service*

*

If currently providing an MUR Plus/ Medicines Optimisation Service, what therapeutic areas are covered? Needle and Syringe Exchange Service

Obesity Management -adults*

*

Obesity Management - children

*

Not Dispensed Scheme On Demand Availability of Specialist Drugs Service

Out-of-Hours Services Patient Group Direction Service

Name the medicines covered by the Patient Group Direction Phlebotomy Service* * Prescriber Support Service

Schools Service Screening Service

Alcohol

Cholesterol

Diabetes


166






Gonorrhoea

H. pylori

HbA1C

Hepatitis

HIV

Other (please state) Seasonal Influenza Vaccination Service*

*

Other vaccinations* Childhood vaccinations * Hepatitis (at risk workers or patients)

*

HPV *

Travel vaccines *

Other (please state) Sharps Disposal Service* * Stop Smoking Service Supervised Administration Service

Supplementary Prescribing Service

If so, what therapeutic areas are covered? Vascular Risk Assessment Service (NHS Health Check)*

*

* These services are not listed in the Advanced and Enhanced Services Directions, and so are not ‘Enhanced Services’ if commissioned by the local NHS England Team. The local NHS England Team may commission them on behalf of the CCG or Local Authority, but when identified in the PNA they will be described as ‘Other Locally-Commissioned Services’ or ‘Other NHS Services’


167

Non-commissioned Services

Does the pharmacy provide any of the following?

Collection of prescriptions from GP practices Yes No

Delivery of dispensed medicines – free of charge on request Yes No Delivery of dispensed medicines – selected patient groups - list criteria Yes No

Delivery of dispensed medicines – selected areas – list areas Yes No

Delivery of dispensed medicines – chargeable Yes No

Monitored Dosage Systems – free of charge on request Yes No

Monitored Dosage Systems – chargeable Yes No

Is there a particular need for a locally-commissioned service in your area? If so, what is the service requirement and why?

Yes No

Details of the Person Completing this Questionnaire - if questions arise

Contact name Contact telephone number


168

Appendix E: Dispensing GP practice questionnaire

Suffolk Pharmaceutical Needs Assessment 2018:

Dispensing Practice Questionnaire

What is this questionnaire about?

As you may be aware, Suffolk County Council has a statutory duty to develop and publish a revised Pharmaceutical Needs Assessment (PNA) at least every three years. The next PNA will be published by 1 April 2018. Work has been underway on the PNA for some time and I would like to update you on the process so far.

A core Steering Group was established to lead the work. The Steering Group includes LMC representation.

Information is being collated on the population and health needs of each of the localities in Suffolk. Alongside that, information is being collated on the pharmaceutical services that are currently available.

The conclusions will start to be drawn leading to the draft PNA for consultation being completed by October 2017. All dispensing doctor contractors will be asked to comment as part of the consultation.

To help us form a clearer picture of the services available to patients living in the more rural parts of the Health and Wellbeing Board area who may have problems accessing services, please can you answer the following questions by Friday 31 March 2017 at the latest, so that the information can be incorporated into the needs assessment.

Who should complete the questionnaire?

This questionnaire should be completed by the Dispensing Doctor / Practice Manager. The responses should be about the dispensary. If your practice offers dispensing services from several branch surgeries, please complete a return for each dispensing site.

If you do not wish to answer a question for any reason, then leave it blank.

If you would like to complete this online please go to:

https://www.surveymonkey.co.uk/r/suffolk_dispensing

https://www.surveymonkey.co.uk/r/suffolk_dispensing


169

1) Is the practice participating in the current Dispensary Services Quality Scheme (DSQS)?

Yes No

2) What are the total number of hours each week when dispensing is available by the practice? _________________________________________________________________

2a) Do the dispensary hours match the surgery hours? If not what are the gaps.

Yes No - the following hours are the gaps: ________________________________________________________________

3) Do you provide any of the following services outside the dispensing service? Please tick those that apply

DRUMs NHS Health Checks commissioned by Public Health Sexual health services Home delivery (if yes, please complete sections 8-10) Compliance aids, please list ________________________________________ Other, please specify ______________________________________________ No additional services

4) Is your practice planning to provide any of the following services? Please tick those that apply

DRUMs NHS Health Checks commissioned by Public Health Sexual health services Home delivery Compliance aids, please list ________________________________________ Other, please specify ______________________________________________ No

Only complete the following questions if you provide a delivery service or are planning to do so in the future

5) Please tell us about your delivery / planned delivery service

We currently offer a delivery service We plan to offer a delivery service from______(provide date / timescale if known)

6) If you provide a delivery service, or are planning to do so in the future, which of these groups do you offer free delivery to? Please select all that apply.

All patients Older people Disabled people People that are housebound Nursing home residents Residential home residents Those specifically requesting delivery Requested by GP Other (please specify) _____________________________________________


170

7) Where do you offer, or plan to offer, free delivery to? Please select one answer.

Any eligible patient within our practice inner boundary Any eligible patient within a smaller area than our practice boundary Any eligible patient wherever they live

8) Do you place any other restrictions on the free delivery (or planned free delivery) of dispensed medicine? _______________________________________________________________

9) In your opinion is the current provision of pharmaceutical services in Suffolk:

Excellent Very Good Good Adequate Poor Very Poor

10) In your opinion do patients in your area have adequate access to the following services commissioned from, or provided by, some community pharmacies? Please select one answer for each row.

Yes No Over the counter medicines Access to local services: • supply of emergency contraception • support to stop smoking • chlamydia screening and treatment • immediate access to emergecy medicines

11) Do you feel that local provision would be improved by: (select all that apply)

Yes No Increasing the number of pharmaceutical service providers locally Increasing the opening hours of existing local pharmaceutical

service providers Other (please specify) _________________________________________________

12) If your practice could be commisionned to provide similar services to those currently available under the additional services sections of the community pharmacy contract, would you be prepared to do so?

Yes (please specify the type of service) ______________________________ No

Thank you for your time completing this questionnaire

Your answers to this survey are private and will be kept in line with the Data Protection Act.

Please return any completed paper copies of the questionnaire in the reply-paid envelope enclosed.


171

Appendix F: Commissioner questionnaire

PNA Commissioner Questionnaire


Soar Beyond are supporting Suffolk County Council to produce their 2018 Pharmaceutical Needs Assessment. We are undertaking a survey of all commissioners who are responsible for commissioning services from community pharmacies in Suffolk (even if they do not commission services currently).

We would therefore be grateful if you could spend a few minutes to complete the questions below. If you prefer, you may complete the survey online at

https://www.surveymonkey.co.uk/r/_SUFFOLK_Commissioner

Please complete the questionnaire by 31 March 2017.

Which of the following services do you commission or may be considering commissioning from local community pharmacies?




May consider commissioning

Not able or willing to commission

Anticoagulant Monitoring Service

Anti-viral Distribution Service

Care Home Service

Chlamydia Testing Service

Chlamydia Treatment Service

Contraceptive service (not EC)

https://www.surveymonkey.co.uk/r/_SUFFOLK_Commissioner


172

Which of the following services do you commission or may be considering commissioning from local community pharmacies?






Disease Specific Medicines Management Service:

Allergies Alzheimer’s/ dementia

Asthma

CHD

COPD

Depression

Diabetes type I

Diabetes type II

Epilepsy

Heart Failure

Hypertension Parkinson’s disease

Other (please state) Emergency Contraception Service

Emergency Supply Service

Gluten Free Food Supply Service (i.e. not via FP10)

Home Delivery Service (not appliances)

Independent Prescribing Service

Language Access Service

Medication Review Service


173






Medicines Assessment and Compliance Support Service

Minor Ailment Scheme

MUR Plus/ Medicines Optimisation Service

Needle and Syringe Exchange Service

Obesity management adults

Obesity management- children

Not Dispensed Scheme

On Demand Availability of Specialist Drugs Service

Out of Hours Services

Patient Group Direction Service (name the medicines covered by the Patient Group Direction)

Phlebotomy Service

Prescriber Support Service

Schools Service


174

Which of the following services do you commission or may be considering commissioning from local community pharmacies? Currently

providing under contract with the local NHS England Team





Screening Service: Alcohol Cholesterol Diabetes Gonorrhoea H. pylori HbA1C Hepatitis HIV

Other (please state) Seasonal Influenza Vaccination Service

Which of the following services do you commission or may be considering commissioning from local community pharmacies? Currently

providing under contract with the local NHS England Team





Other Vaccinations: Childhood vaccinations

Hepatitis (at risk workers or patients)

HPV Travel vaccines

Other (please state) Sharps Disposal Service


175






Stop Smoking Service

Supervised Administration Service

Vascular Risk Assessment Service (NHS Health Check)

Details of the Person Completing this Questionnaire - if questions arise

Contact name Contact telephone number


176

Appendix G: PNA Project Plan

Jan

2017

Feb

2017

Mar

201

7

Apr

201

7

May

201

7

Jun

2017

Jul 2

017

Aug

201

7

Sept

201

7

Oct

201

7

Nov

201

7

Dec

201

7

Jan

2018

Feb

2018

Mar

201

8

Steering Group and Project Governance established • First Steering Group meeting conducted • Project plan shared and agreed • Communications Plan and Terms of reference agreed • PNA localities agreed • Questionnaire templates shared and agreed

Stakeholders identified • For dissemination of information • Contact details obtained and initial contact made • Share project plan and brief on what the pharmacy needs assessment is • Questionnaire circulation (e.g. patient groups, specific populations etc.)

Data collection and stakeholder engagement • Distribution of pharmacy user questionnaire • Public webinar on the Suffolk PNA and feedback on current service provision • Distribution of pharmacy contractor questionnaire • Community pharmacy contractor webinar for engagement on PNA, feedback on current

service provision and future needs • Distribution of commissioner questionnaire • Distribution of dispensing doctor questionnaire • GP dispensing doctor webinar for engagement on PNA, feedback on current service provision

and future needs

Information collection • Review of planning and strategy documents e.g. JSNA, Housing Strategy, Commissioning

Intentions, STP etc. • List of all providers of pharmaceutical services from NHS England e.g. pharmaceutical

contractors, internet pharmacies etc. • List of any commissioned services by CCG e.g. minor ailment services, out of hours, local

hospitals • Information from Public Health Team e.g. demographics, specific health needs and any

commissioned services


177

Jan

2017

Feb

2017

Mar

201

7

Apr

201

7

May

201

7

Jun

2017

Jul 2

017

Aug

201

7

Sept

201

7

Oct

201

7

Nov

201

7

Dec

201

7

Jan

2018

Feb

2018

Mar

201

8

Deadline for questionnaires to be completed

Service provision mapping (maps to be agreed in advance with Suffolk CC)

• Pharmacies categorised by type • Travel access • Opening times • Demographics maps • Lifestyle maps • Housing developments • Pharmacies who provide advanced services including bordering areas • Pharmacies who provide enhanced/locally-commissioned services including bordering areas

Second Steering Group Meeting • Agree data received as final (check no planned revisions in next 4 months) • Commence consultation planning process • Share feedback from questionnaires

Collation and analysis of all information collected • Triangulate information received from duplicate sources, identifying and resolving any

discrepancies and gaps (e.g. opening hours’ information) • Comparison with information and recommendations from 2015 PNA

Review and identify gaps in service, current and future • Identification of any changes (service provision, current and future needs etc.) • Identify potential gaps • Make recommendations

Draft PNA completed • Complete the draft assessment, clearly articulating any gaps and propose recommendations • Compile specific consultation questions • Highlight any specific communities and/or providers identified as potentially affected by the

analysis of gaps

Third Steering Group Meeting • Agree Draft PNA for consultation • Agree consultation plan


178

Jan

2017

Feb

2017

Mar

201

7

Apr

201

7

May

201

7

Jun

2017

Jul 2

017

Aug

201

7

Sept

201

7

Oct

201

7

Nov

201

7

Dec

201

7

Jan

2018

Feb

2018

Mar

201

8

Consultation period (9 Oct-10 Dec 2017) • Host Draft PNA on Suffolk County Council website • ‘Advertise’ consultation through existing consultation channels (e.g. communications and

engagements leads with CCGs, HealthWatch, Patient Participation Groups etc.) • Send links (or copies) of Draft PNA to consultees as required by the Pharmaceutical

Regulations (listed within the Communications Plan), and any specific individuals, populations and stakeholder groups identified within the stakeholder engagement undertaken in the Spring

• Hold direct stakeholder engagement events (face to face meetings, webinars, online surveys etc.) with specific populations/providers identified as potentially affected by the analysis of gaps

Consultation findings report • Collate, analyse and make recommendations on the consultation responses • Share with Steering group

Fourth Steering Group Meeting • Receive consultation findings report • Agree and finalise proposed changes necessary to the draft PNA • Agree Final PNA

Final draft PNA • Produce final document in pdf format and upload to Suffolk County Council website • Send links (or copies) of Final PNA to consultees as required by the 2013 Pharmaceutical

Regulations (listed within the Communication and Engagement Plan), and any specific individuals, populations and stakeholder groups identified within the stakeholder engagement undertaken in the Spring

PNA published ahead of time (due 23 Mar 2018)

Maintenance through production of supplementary statements, annual review and provision of specialist advice

• Ongoing receipt of changes in provision and needs from NHS England, LPC, Commissioners, Suffolk County Council Public Health

• Analysis of changes and production of Supplementary Statements- provided to Suffolk County Council to host on their website

• Annual refresh of the PNA to ensure validity of (for example) commissioned services and providers

• Ongoing Pharmaceutical expertise provided to Suffolk County Council Public Health team in relation to the PNA

Onw

ards


179

Appendix H: Consultation plan and list of stakeholders Stakeholder Engagement during PNA production

Role PNA Briefing

letter sent (Y/N)

Steering group representation

(Y/N)

Questionnaire (Pharmacy contractor/ Public/ Disp

practice/ Commissioner)

Con

sulte

e as

requ

ired

by P

harm

aceu

tical

Reg

ulat

ions

201

3,

Sec

tion

8

LPC Representative Y Y Pharmacy questionnaire

LMC Representative Y Y Dispensing GP practice questionnaire

Pharmacy contractors on Suffolk pharmaceutical list Y Y Pharmacy questionnaire, public questionnaire

Appliance contractors on Suffolk pharmaceutical list Y Y Pharmacy questionnaire

Dispensing GP practices on Suffolk pharmaceutical list Y Y Dispensing GP practice

questionnaire, public questionnaire

Local Healthwatch Y Y Public questionnaire

Pharmacy Local Professional Network Lead Y Y N/A

Suffolk Cancer Support Group N N Public questionnaire

West Suffolk Chronic Pain Group N N Public questionnaire

Ipswich Hospital User Group N N Public questionnaire

Senior Development Officer, Community Action Suffolk N N Public questionnaire


180

Stakeholder Engagement during PNA production

Role PNA Briefing

letter sent (Y/N)


(Y/N)



Con

sulte

e as

requ

ired

by P

harm

aceu

tical

Reg

ulat

ions

201

3,

Sec

tion

8

West Meadows Traveller Site N N Public questionnaire

Sandy Park Traveller Site N N Public questionnaire

Kessingland Traveller Site N N Public questionnaire

Ace Advocacy Database members N N Public questionnaire

Public libraries in Suffolk N N Public questionnaire

Community centres in Suffolk N N Public questionnaire

Age UK Suffolk N N Public questionnaire

Ipswich Hospital NHS Trust N N Public questionnaire

West Suffolk NHS Foundation Trust N N Public questionnaire

JSNA Programme Manager Y Y Public questionnaire, commissioner questionnaire

Head of Knowledge and Information, Public Health, Suffolk Council Y Y Public questionnaire,

commissioner questionnaire

Assistant Director of Public Health, Suffolk Council Y Y Public questionnaire, commissioner questionnaire


181

Stakeholder Engagement during PNA production

Role PNA Briefing

letter sent (Y/N)


(Y/N)



Con

sulte

e as

requ

ired

by P

harm

aceu

tical

R

egul

atio

ns 2

013,

Sec

tion

8

Engagement Lead West Suffolk CCG Y Y Public questionnaire

Head of Medicines Management, Ipswich and East Suffolk CCG Y Y Public questionnaire,

commissioner questionnaire

Chief Operating Officer, Ipswich and East Suffolk CCG N N Public questionnaire, commissioner questionnaire

Chief Operating Officer, West Suffolk CCG N N Public questionnaire, commissioner questionnaire

Head of Medicines Management, West Suffolk CCG Y Y Public questionnaire, commissioner questionnaire

Medicines Management, Great Yarmouth and Waveney CCG Y Y Public questionnaire, commissioner questionnaire

Senior Communications and Engagement Manager, Great Yarmouth and Waveney CCG Y Y Public questionnaire

Community Engagement Group, West Suffolk CCG N N Public questionnaire

Community Engagement Partnership, Ipswich and East Suffolk CCG Y Y Public questionnaire

Healthwatch Norfolk N N Public questionnaire


182

Appendix I: Travel access to pharmacies and dispensing GP practices for Suffolk residents

Driving Times Public Transport Times Walking Times

Average Off-Peak Peak Tuesday 9am to 1pm

Tuesday 1pm to 5pm

Number % Number % Number % Number % Number % Number %

0-5 minutes 425,793 57.4% 450,373 60.7% 401,213 54.1% 102,515 13.8% 104,909 14.1% 80,485 10.8%

0-10 minutes 662,212 89.2% 676,039 91.1% 648,386 87.4% 448,796 60.5% 459,673 62% 283,788 38.3%

0-15 minutes 730,566 98.5% 735,713 99.2% 725,420 97.8% 587,867 79.2% 596,694 80.4% 437,189 58.9%

0-20 minutes 740,491 99.8% 741,895 100.0% 739,087 99.6% 630,618 85% 636,803 85.8% 514,010 69.3%

0-25 minutes 741,895 100.0% 741,895 100.0% 741,895 100.0% 660,116 89% 667,885 90% 546,206 73.6%

0-30 minutes 741,895 100.0% 741,895 100.0% 741,895 100.0% 680,421 91.7% 688,875 92.9% 559,090 75.4%

>30 minutes 741,895 100.0% 741,895 100.0% 741,895 100.0% 741,895 100% 741,895 100% 741,895 100%

Note: Public transport times represent the best-case scenario for journeys by bus, train or coach on a Tuesday, 9am to 1pm and 1pm to 5pm.


183

Appendix J: New housing and care homes planned in Suffolk Babergh locality

Potential new housing growth (greater than 250 dwellings planned)

Site name Area No of

planned dwellings (2017-21)

Comments

Chilton Woods Sudbury 1,050 Allocated but no permission

East of Sudbury Sudbury 500 Direction of growth identified, no allocation or permission

Wolsey Grange Ipswich Fringe 475 Permitted

Brantham regeneration Brantham 320 Permitted

Former HMS Ganges Shotley 285 Permitted

Hadleigh East Hadleigh 250 Allocated but no permission

TOTAL 2,880 Forest Heath locality

Potential new housing growth (greater than 250 dwellings planned).



Comments

Land west of Mildenhall Mildenhall 1,300 Not expected to commence

within three years

Land east of Red Lodge Red Lodge 382 Permitted

Land at North Lakenheath Lakenheath 375

Proposed allocation (not expected to commence within three years)

Land north of Acorn Way Red Lodge 350

Proposed allocation (not expected to commence within three years)

Elms Road Red Lodge 295 Almost built out

TOTAL 2,702


184

Waveney locality Potential new housing growth (greater than 250 dwellings planned).



Comments

Kirkley Waterfront and Sustainable Urban Neighbourhood

Kirkley 1,440 Limited delivery within three years

TOTAL 1,440

Suffolk Coastal locality Potential new housing growth (greater than 250 dwellings planned).



Comments

Adastral Park Martlesham 2,000 Current application Land north of Walton High Street

Felixtowe 400 Allocated but not permitted

Land off Howett Way, Trimley St Martin 360 Allocated but not permitted

Western part of Trinity Park Purdis Farm 300 Permitted

TOTAL 3,060


185

Mid Suffolk locality Potential new housing growth (greater than 250 dwellings planned).



Comments

Chilton Leys Stowmarket 800 Allocated and permission in part

Former Masons Cement Works

Great Blakenham 426 Full permission

Ashes Farm Stowmarket 400 Allocated but no permission

Union Road Stowmarket 300 Allocated but no permission Needham Chalks

Needham Market 266 Full permission

Castleton Way Eye 250 No permission

TOTAL 2,442

Ipswich locality




Comments

Ipswich Garden Suburb Not provided 3,500 Allocated in total, part

permission

Helena Road Not provided 566 Not expected to commence within three years

Cranfields Mills Not provided 337 Permitted, almost complete Hayhill Road / Woodbridge Road

Not provided 281 Permitted, almost complete

Island Site Not provided 271 Not expected to complete within three years

Regatta Quay Not provided 267 117 already built

TOTAL 5,222


186

St Edmundsbury locality




Comments

North West Bury St Edmunds

Bury St Edmunds 950 Permitted

Westley (West) Bury St Edmunds 450 Allocated, no permission

Moreton Hall Bury St Edmunds 500 Permitted and underway

South East Bury St Edmunds

Bury St Edmunds 1,250 Allocated, no permission

NE Bury St Edmunds

Bury St Edmunds 1,250 Allocated, no permission

Station Hill Bury St Edmunds 300 Permitted

NW Haverhill Haverhill 1,150 Permitted

NE Haverhill Haverhill 2,500 Allocated

TOTAL 8,350

New care home schemes planned in Suffolk

New home location Address Proposed

development Net

change Comments

Beccles Land adjacent to Beccles Station

Three storey Nursing Home 54 Commenced

2nd Sept 2011

Blundeston Grandora Hall Lane, Blundeston NR32 5BL

Two-storey care home annexe 4 Commenced

30th April 2013

Carlton Colville

Carlton Hall, Chapel Road Carlton Colville NR33 8AT

Single-storey extension

4 Commenced 4th Oct 2013

Lound

Lound Hall Nursing Home, Church Lane Lound NR32 5LH

Extension of time for further three years. Two-storey extension and refurbishment of existing building

17

Applicant confirmed commitment to proceed and is actively pursuing funding options


187


development Net

change Comments

Lowestoft Land adjacent to Travelodge Hotel Leisure Way Lowestoft

Care home, plus staff and ancillary accommodation

80

Lowestoft

Former Roman Hill Primary School Love Road Lowestoft NR32 2NY

Care home and community well-being centre

80 Commenced July 2013

Lowestoft 60A Kirkley Cliff Road Lowestoft NR33 0DF

‘Change of Use’ from part Residential Care Home to Flat

-1 Separate from adjacent 'Orme House'

Lowestoft

Broadland Residential Care Home, Borrow Road Lowestoft NR32 3PW

Extension and alteration of residential care home

5

Reydon Oaklands Lowestoft Road Reydon IP18 6RD

Two-storey extension to create additional bedrooms

8

Applicant confirmed intention to implement permission before lapse date

Reydon

Former Playing Field Nightingale Avenue Reydon

Care home (part of a ‘mixed use’ scheme including residential, healthy living centre, retail/commercial units)

60

HealthEast have confirmed commitment to delivery but no timescales

Beccles/ Lowestoft

Stradbroke Court / Blyford Court / The Dell

Closure of SCC beds due to relocation to Britten Court (former Roman Hill Primary School

-109

Mildenhall Great Heath Primary School, Mildenhall

60


188


development Net

change Comments

Haverhill Chalkstone Middle School, Haverhill

60

Bury St Edmunds

Glastonbury Court, Bury St Edmunds

80

Great Cornard

Land east of 66 Cats Lane, Great Cornard

45

Ipswich Redan Street

Change of use from care home to four units of sheltered accommodation for the learning disabled

4 Approved October 2012

Ipswich Aster Road Care home and community well-being centre

80 Approved January 2013

Ipswich St George’s House, St Matthew's Street

Mixed-use redevelopment of site including very sheltered housing

35 Approved September 2013

Ipswich Business Development Land, Ravenswood

Care home and community well-being centre

80 Approved July 2013

Total Committed

646


189

Appendix K: Results of the dispensing GP practice questionnaire Q1. Is the practice participating in the current Dispensary Services Quality Scheme (DSQS)?

Q2. What are the total number of hours each week when dispensing is available by the practice?

34.5 (2) 38

47.5 (2) 49 (2)

50 (4) 52.5 (3)

53 53.5 (2)

54 55

56 63.5

90.5

96%

4%

Yes

No


190

Q3. Do the dispensary hours match the surgery hours? If not, what are the gaps?

Q4. Do you provide any of the following services outside the dispensing service?

Dosette boxes (10) OTC products available to purchase Stoma, catheter, lymphoedema, managed repeats

73%

27%

Yes

No

96%

100%

93%

82%

89%

50%

0%

4%

0%

7%

18%

11%

50%

50%

0%

0%

0%

0%

0%

0%

50%

0% 20% 40% 60% 80% 100% 120%

DRUMs

NHS Health Checks commissioned byPublic Health

Sexual health services

Home delivery

Compliance aids, please list

Other, please specify

No additional services

Don't know

No

Yes


191

Q5. Is your practice planning to provide any of the following services? Please answer yes or no and provide further details where requested

Dosette boxes (2) Delivery service

Q6. Please tell us about your delivery / planned delivery service

90%

100%

60%

50%

67%

0%

40%

10%

0%

20%

38%

17%

50%

40%

0%

0%

20%

13%

17%

50%

20%

0% 20% 40% 60% 80% 100% 120%

DRUMs

NHS Health Checks commissioned byPublic Health

Sexual health services

Home delivery

Compliance aids (please list)

Other, please specify

No additional services

Don't know

No

Yes

93%

7%

We currently offer a deliveryservice

We plan to offer a deliveryservice from (providedate/timescale if known)


192

Q7. If you provide a delivery service, or are planning to do so in the future, which of these groups do you offer free delivery to? Please select all that apply

Sheltered housing People in villages

Q8. Where do you offer, or plan to offer, free delivery to? Please select one answer

19%

56%

63%

69%

19%

25%

56%

75%

13%

0% 10% 20% 30% 40% 50% 60% 70% 80%

All patients

Older people

Disabled people

People that are housebound

Nursing home residents

Residential home residents

Those specifically requesting delivery

Requested by GP

Other

74%

13%

13%

Any eligible patient within ourpractice inner boundary

Any eligible patient within asmaller area than our practiceboundaryAny eligible patient whereverthey live


193

Q9. Do you place any other restrictions on the free delivery (or planned free delivery) of dispensed medicine?

No (8) Controlled drugs unless GP requested We only deliver on Tuesdays and Fridays

Need to be at home to receive medication

Q10. In your opinion is the current provision of pharmaceutical services in Suffolk:

Q11. In your opinion do patients in your area have adequate access to the following services commissioned from, or provided by, some community pharmacies?

40%

25%

20%

15%

0% 0%0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Excellent Very Good Good Adequate Poor Very Poor

95%

91%

95%

85%

86%

5%

9%

5%

15%

14%

0% 20% 40% 60% 80% 100%

Over the counter medicines

Local Services - supply of emergencycontraception

Local Services - support to stop smoking

Local Services - Chlamydia screeningand treatment

Local Services - immediate access toemergecy medicines

No

Yes


194

Q12. Do you feel that local provision would be improved by: (select all that apply)

Q13. If your practice could be commissioned to provide similar services to those currently available under the additional services sections of the community pharmacy contract, would you be prepared to do so?

Anything (4) Asthma

Care home service Weight management (2)

Stop smoking (2) Emergency contraception

5%

11%

95%

89%

0% 20% 40% 60% 80% 100%

Increasing the number of pharmaceuticalservice providers locally

Increasing the opening hours of existinglocal pharmaceutical service providers

No

Yes

35%

65%

NoYes


195

Appendix L: Results of the commissioner questionnaire Q1. Which of the following services do you commission or may be considering commissioning from local community pharmacies?

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

67%

67%

0%

50%

50%

50%

0%

0%

33%

50%

50%

50%

33%

33%

67%

0% 20% 40% 60% 80%

Anticoagulant MonitoringService

Antiviral Distribution Service

Care Home Service

Chlamydia Testing Service

Chlamydia TreatmentService

Contraceptive service (notEHC)

Not able or willing tocommission


Currently commissioned undercontract with LA

Currently commissioned undercontract with CCG

Currently commissioned undercontract with NHSE


196

Q2. Which of the following services do you commission or may be considering commissioning from local community pharmacies?

50%

50%

50%

50%

50%

50%

50%

50%

50%

50%

50%

50%

50%

50%

50%

50%

100%

100%

50%

50%

50%

50%

50%

50%

50%

50%

50%

50%

33%

100%

100%

50%

100%

100%

50%

100%

50%

50%

50%

50%

50%100%

100%

50%

0% 20% 40% 60% 80% 100%

Allergy management service

Alzheimers/dementia…

Asthma management…

CHD management service

COPD management service

Depression management…

Diabetes type I…

Diabetes type II…

Epilepsy management…

Heart Failure…

Hypertension…

Parkinson’s disease

Emergency Hormonal…

Gluten Free Food Supply…

Home Delivery Service…

Independent Prescribing…



Medicines Assessment…


MUR Plus/Medicines…

Needle and Syringe…

Obesity management…

On Demand Availability of…


Phlebotomy Service


Schools Service

Patient Group Direction…



Currently commissioned undercontract with LACurrently commissioned undercontract with CCGCurrently commissioned undercontract with NHSE

Out-of-hours pharmacies are commissioned on Christmas day and Easter Sunday in selected pharmacies

Antibiotics for chlamydia


197


0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

50%

0%

50%

50%

50%

50%

50%

50%

50%

100%

50%

50%

50%

50%

50%

50%

0% 20% 40% 60% 80% 100%

Alcohol screening service

Cholesterol screeningservice

Diabetes screening service

Gonorrhoea screeningservice

H. pylori screening service

HbA1C screening service

Hepatitis screening service

HIV screening service







198


Flu vaccination is currently a national advanced service

100%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

50%

50%

50%

0%

50%

0%

50%

0%

50%

0%

0%

0%

0%

0%

0%

0%

50%

100%

50%

100%

50%

50%

50%

100%

50%

0% 20% 40% 60% 80% 100%

Seasonal InfluenzaVaccination Service

Childhood vaccinations

Hepatitis (at risk workers orpatients)

HPV

Travel vaccines

Sharps Disposal Service


Supervised AdministrationService

Supplementary PrescribingService (what therapeutic

areas are covered?)

Vascular Risk AssessmentService (NHS Health Check)







199

Appendix M: Results of the public questionnaire Q1. How often have you visited your pharmacy in the last six months?

Q2. Do you have a regular or preferred pharmacy that you visit?

14%12%

53%

45%

21%24%

12%

18%

0%

10%

20%

30%

40%

50%

60%

For yourself: For someone else:

Once a week or more

Once a month

Once every few months

Once in six months

23%

77%

No

Yes


200

Q3. When considering a choice of pharmacy, which of the following helps you choose?

Q4. Who would you normally visit the pharmacy for? Please select all that apply

69%

55%

17%

40%

10%

32%

44%

10%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Close to home

Close to GP surgery

Close to work

Efficiency

They offer a specific service

Expertise / quality of advice

Friendly staff

Other

Location (18) Opening hours (5) Parking (4) Reliability (4) Service (10)

89%

54%

6%

7%

2%

1%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Yourself

A family member

Neighbour / friend

Someone you are a carer for

All of the above

Other


201

Q5. If you visit a pharmacy on behalf of someone else, please give a reason why

Carer (12) Child (21) Efficiency (15) Elderly (5) Transport (2)

Q6. How would you usually travel to the pharmacy?

Wheelchair Powered wheelchair (2) Mobility scooter Suffolk Coastal’s connecting services

transport system

15%

51%

15%

10%

21%

0% 10% 20% 30% 40% 50% 60%

Opening hours of the pharmacy not suitablefor patient

Most convenient

Access (for example disability / transport)

All of the above

Other

62%

0%3%

31%

2% 2%0%

10%

20%

30%

40%

50%

60%

70%

Car Taxi PublicTransport

Walk Bicycle Other


202

Q7. On average, how long does it take you to travel to a pharmacy?

Q8. Do you have any difficulties when travelling to a pharmacy?

80%

16%

1%

2%

0%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

0-15 minutes

16-30 minutes

Over 30 minutes

Varies

Don't know

8%

92%

Yes

No


203

Q9. If you answered yes to the previous question, please select one of the following reasons:

Disability related issues (2) Condition of pavements Parking (3) Transport on weekends

Q10. What is the most convenient day for you to visit a pharmacy?

11%

48%

14%

27%

0%

10%

20%

30%

40%

50%

60%

Location of pharmacy Parking difficulties Public Transportavaliability

Other

38%

10%

1%

50%

1%0%

10%

20%

30%

40%

50%

60%

Monday to Friday Saturday Sunday Varies Don't know


204

Q11. When do you prefer to visit a pharmacy?

Q12. How regularly do you typically buy an over the counter (i.e. non-prescription) medicine from a pharmacy?

24%

5%

13%

7%

0%

50%

2%

0% 10% 20% 30% 40% 50% 60%

Morning (8am-12pm)

Lunchtime (12pm-2pm)

Afternoon (2pm-6pm)

Early evening (6pm-8pm)

Late evening (after 8pm)

Varies

Don't know

0%

5%

7%

47%

28%

13%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Daily

Weekly

Fortnightly

Monthly

Yearly

Never


205

Q13. Which of the following pharmacy services are you aware that a pharmacy may provide?

Cholesterol testing Dosette box filling Health checks Medication reviews (2) Monitored dosage MUR Palliative care Specialist medications Travel vaccinations

96%

85%

63%

30%

80%

84%

72%

60%

63%

47%

26%

16%

22%

36%

3%

0% 20% 40% 60% 80% 100% 120%

Dispensing of prescriptions

Repeat dispensing services

Home delivery and prescription collectionservices

Needle exchange

Advice from your pharmacist

Buying over the counter medicines

Disposal of unwanted medicines

Flu vaccination services

Detailed discussion with your pharmacist –how you take your existing and newly

prescribed medicines

Stopping smoking / nicotine replacementtherapy

Sexual health services (chlamydia testing /treating, condom distribution, emergency

contraception)

Immediate access to specialist drugs e.g.palliative care medicines

Supervised consumption of methadone andbuprenorphine

Emergency supply of prescription medicines

Other


206

Q14. What services would you like to see provided by your local pharmacy?

Travel clinic INR Testing

Weight management Health assessments (2)

Minor injuries treatment (2) Mental health

93%

94%

84%

53%

94%

94%

94%

82%

90%

72%

66%

70%

53%

91%

1%

1%

5%

12%

1%

1%

1%

7%

3%

7%

11%

5%

12%

1%

6%

5%

11%

35%

5%

5%

4%

10%

7%

21%

23%

25%

35%

7%

0% 10%20%30%40%50%60%70%80%90%100%

Dispensing of prescriptions

Repeat dispensing services

Home delivery and prescription collectionservices

Needle exchange

Advice from your pharmacist

Buying over the counter medicines

Disposal of unwanted medicines

Flu vaccination services

Detailed discussion with your pharmacist howto take your existing and newly prescribed

medicines

Stopping smoking / nicotine replacementtherapy

Sexual health services (chlamydia testing /treating,condom distribution, emergency

contraception)

Immediate access to specialist drugse.g.palliative care medicines

Supervised consumption of methadone andbuprenorphine

Emergency supply of prescription medicines

Don't know No Yes


207

Q15. Is there a consultation room available where you cannot be overheard in the pharmacy you normally visit?

Q16. Have you ever used an internet pharmacy to obtain prescription medicines?

73%

27%

Yes

No

10%

90%

YesNo


208

Q17. If yes, how would you rate your overall satisfaction with the internet pharmacy?

Q18. Any other comments you would like to make about your pharmacy?

Bad location (2) Bad opening hours

Consultation room too small Convenient (3)

Efficient (2) Excellent service (12)

Excellent staff (7) Friendly staff (9)

Good advice Good location

Helpful staff (6) Inappropriate pharmacist

Inconvenient Inefficient (6)

Lacking Need more helpful staff (2)

Needs better access Poor parking

Too busy (5) Valuable resource (9)

51%

34%

10%

5%

Excellent Good Fair Poor


209

Demographic analysis of respondents Sex (%)

Male Female Prefer not to say 28.2% 71.5% 0.3%

Age (%)

U16 16-24 25-34 35-44 45-54 55-64 65-74 75+ Prefer not to say

0% 4.9% 10.3% 12.9% 23.9% 19.5% 17.5% 10.8% 0.3% Do you consider yourself disabled (%)?

Yes No 19.1% 80.9%

Ethnic origin (%) Asian / Asian British – Bangladeshi 0% Asian / Asian British – Indian 0.5% Asian / Asian British – Pakistani 0.3% Asian / Asian British – Chinese 0.8% Black / African / Caribbean / Black British – African 0.3% Black / African / Caribbean / Black British – Caribbean 0.3%

Black / African / Caribbean / Black British – Other 0.3% White – English / Welsh / Scottish / Northern Irish / British 91.5%

White – Irish 0.3% White – Gypsy or Irish Traveller 0% Mixed/multiple ethnic groups – White and Black Caribbean 0.5%

Mixed/multiple ethnic groups – White and Black African 0%

Mixed/multiple ethnic groups – White and Asian 0.3% Other ethnic group (please state) 0.8% Prefer not to say 2.9%

Your religion or belief (%): Baha'i 0.3% Buddhist 0.5% Christian 48.1% Hindu 0% Jain 0% Jewish 0% Muslim 0.5% Sikh 0.5% No religion or belief 41.5% Prefer not to say 5.2% Other 3.3%


210

Appendix N: Results of the pharmacy contractor questionnaire Responses to Q1-3 are omitted as they relate specifically to the individual contractor

Q4. Is there a consultation area (meeting the criteria for the Medicines Use Review service)?

Q5. Where there is a consultation area, is it a closed room?

82%

18%

0%

0%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Available (including wheelchair access)

Available (without wheelchair access)

Planned within next 12 month

None

100%

0%

Yes

No


211

6. During consultations are there hand-washing facilities?

Q7. Do patients attending for consultations have access to toilet facilities?

56%36%

8%

In the consultation area

Close to the consultation area

None

32%

68%

Yes

No


212

Q8. Off-site consultation areas

Q9. The pharmacy is accessible for wheelchair users

Q10. Languages spoken (in addition to English)

Polish (9) Chinese (4) French (2) Hindi (3) Spanish (3) Portuguese (3) Russian (3) Punjabi (7) Gujarati (3) Czech German Hungarian

2%

63%

98%

37%

0% 20% 40% 60% 80% 100%

The pharmacy has access to an off-siteconsultation area (i.e. one which the formerPCT or NHSE has given consent for use)

The pharmacy is willing to undertake consultations in patient’s home / other

suitable site

No Yes

64%

93%

52%

36%

7%

48%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Ramped access Wide door Electric door

Yes No


213

Q11. IT facilities in the pharmacy

Q12. Please read the following statements and select the one that applies

98%

43%

90%

88%

2%

57%

10%

12%

0% 20% 40% 60% 80% 100%

Electronic Prescription Service Release 2enabled

NHS mail being used

NHS Summary Care Record enabled

Up to date NHS Choice entry

No Yes

20%

75%

5%

0% 10% 20% 30% 40% 50% 60% 70% 80%

The pharmacy has achieved HLP status

The pharmacy is working towards HLP status

The pharmacy is not currently working towardHLP status


214

Q13. Does the pharmacy dispense appliances?

Any appliance dispensed via FP10

Q14. Does the pharmacy provide the following services?

90%

0% 2% 2% 2% 3% 2%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Yes, alltypes

Yes,excluding

stomaappliances

Yes,excluding

incontinenceappliances

Yes,excludingstoma and

incontinenceappliances

Yes, justdressings

None Other

98% 98%

7%15%

81%

22%

0% 2%

22% 23%

10%

47%

2% 0%

70%62%

9%

31%

0%

20%

40%

60%

80%

100%

120%

Medicines usereview

services

New medicineservice

Appliance usereview service

Stomaappliance

customisationservice

Fluvaccination

service

NHS UrgentMedicineSupply

AdvancedService

Yes Intending to begin within next 12 months No - not intending to provide


215

Q15. Which of the following services does the pharmacy provide, or would be willing to provide?

0%

0%

0%

29%

23%

8%

0%

0%

2%

8%

5%

3%

0%

0%

2%

39%

25%

2%

90%

85%

64%

17%

37%

75%

10%

15%

33%

7%

10%

12%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Anticoagulant monitoring service

Anti-viral distribution service

Care home service

Chlamydia testing service

Chlamydia treatment service

Contraceptive service (not EHC)







216

Q16. Which of the following Disease Specific Medicines Management Services does the pharmacy provide, or would be willing to provide?

NHS Travel vaccination – currently provide private service

Delivery is provided by the company

Will consider any service that there is a demand for

2%

5%

2%

2%

2%

29%

26%

2%

16%

2%

2%

2%

2%

2%

2%

2%

2%

2%

2%

2%

2%

5%

14%

3%

29%

2%

2%

2%

85%

85%

84%

88%

88%

86%

88%

88%

86%

88%

88%

86%

34%

55%

83%

74%

72%

14%

12%

9%

10%

8%

12%

8%

8%

12%

10%

10%

12%

3%

3%

13%

5%

28%

0% 20% 40% 60% 80% 100%

Allergies

Alzheimers / dementia

Asthma

CHD

COPD

Depression

Diabetes type I

Diabetes type II

Epilepsy

Heart failure

Hypertension

Parkinson’s disease

Emergency hormonalcontraception service

Emergency supply service

Gluten free food supplyservice (i.e. not via FP10)

Home delivery service (notappliances)

Independent prescribingservice


Willing to provide ifcommissioned

Currently providing undercontract with Local Authority

Currently providing undercontract with CCG

Currently providing undercontract with the local NHSEngland Team


217


22%

23%

0%

0%

0%

3%

9%

0%

0%

0%

38%

0%

0%

3%

0%

35%

69%

92%

94%

89%

3%

0%

8%

3%

11%

0% 20% 40% 60% 80% 100%

Emergency Hormonal Contraception service

Emergency Supply service

Gluten free food supply service (i.e. not viaFP10)

Home delivery service (not appliances)

Independent prescribing service





Currently providing under contract with the local NHS England team


218


0%

28%

6%

0%

6%

2%

6%

2%

0%

2%

0%

4%

0%

0%

0%

81%

63%

89%

96%

87%

17%

0%

4%

4%

6%

0% 20% 40% 60% 80% 100%



Medicines Assessment and ComplianceSupport Service


MUR Plus / Medicines Optimisation Service







219


Chlamydia treatment (6) Flu vaccinations (6)

UTI – Trimethoprim; contraceptives; Champix

Influenza vaccinations

16%

0%

0%

4%

0%

4%

15%

2%

0%

0%

2%

0%

2%

5%

18%

0%

0%

0%

0%

0%

5%

41%

93%

91%

91%

86%

51%

69%

23%

7%

9%

4%

14%

44%

5%

0% 20% 40% 60% 80% 100%

Needle and Syringe Exchange Service

Obesity management - adults

Obesity management - children

Not Dispensed Scheme

On Demand Availability of Specialist DrugsService


Patient Group Direction Service







220


0%

0%

0%

0%

0%

0%

0%

0%

0%

70%

82%

86%

30%

18%

14%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Phlebotomy Service


Schools Service







221

Q21. What Screening Services services does the pharmacy provide, or would be willing to provide?

Flu service (3)

2%

4%

2%

50%

2%

5%

2%

2%

7%

91%

89%

91%

82%

91%

91%

81%

81%

27%

9%

7%

4%

16%

9%

7%

19%

19%

11%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100%

Alcohol

Cholesterol

Diabetes

Gonorrhoea

H. pylori

HbA1C

Hepatitis

HIV

Seasonal influenza vaccination service







222

Q22. What other vaccination services does the pharmacy provide?

4%

2%

2%

79%

76%

74%

79%

21%

22%

25%

18%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Childhood vaccinations

Hepatitis (at risk workers or patients)

HPV

Travel vaccines







223


12%

35%

38%

5%

2%

5%

9%

9%

0%

2%

14%

33%

33%

2%

0%

50%

21%

12%

75%

79%

19%

2%

9%

18%

18%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Sharps Disposal Service


Supervised Administration Service

Vascular Risk Assessment Service (NHSHealth Check)

Supplementary Prescribing Service







224

Q24. Does the pharmacy provide any of the following?

Delivery to housebound patients (7) Local deliveries to elderly

Q25. Is there a particular need for a locally commissioned service in your area? If so, what is the service requirement and why

Payment for deliveries and dosettes (6) Minor ailment (9)

Monitored dosage (2) Delivery service (2)

Elderly patient support

100%

88%

57%

63%

8%

95%

16%

0%

13%

43%

38%

92%

5%

84%

0% 20% 40% 60% 80% 100%

Collection of prescriptions from GP practices

Delivery of dispensed medicines - free ofcharge on request

Delivery of dispensed medicines - selectedpatient groups (list criteria below)

Delivery of dispensed medicines - selectedareas (list areas below)

Delivery of dispensed medicines - chargeable

Monitored Dosage Systems - free of chargeon request

Monitored Dosage Systems - chargeable

No Yes

49%

51%

No

Yes


225

Appendix O: Equality Impact Assessment The characteristics protected by the Equality Act are:

Disability Age Sex (gender) Gender reassignment Marriage/civil partnership Pregnancy/maternity Race Sexual orientation Religion/belief

By law we must have due regard to the need to:

(a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Act

(b) advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it

(c) foster good relations between persons who share a relevant protected characteristic and persons who do not share it.

In effect, this means that we need to ensure that our policies and services are fair, equitable and proportionate and where possible mitigate against any adverse impacts on people from the different protected characteristics.

In addition to the above protected characteristics you should consider the impact of living in a rural area as part of this assessment. Where people live is not a characteristic protected by law, but for an organisation such as Suffolk County Council it is good practice to consider carefully how location may affect people’s experience of a policy or service.

The Rural-Urban definition (DEFRA) introduced in 2004, defines the rurality of very small census-based geographies. Census Output Areas forming settlements with populations of over 10,000 (which are urban), while the remainder are defined as one of three rural types: town and fringe, village or hamlet and dispersed.

Details Service or policy title Suffolk HWB Pharmaceutical Needs

Assessment 2018 Lead officer (responsible for the policy or service/function)

Natacha Bines

Officers carrying out the screening (at least one must have done EIA training and recommended that an officer responsible for the policy or service/function is involved in the screening)

Natacha Bines

Is this new or a revision? (If revision state when previous EIA undertaken)

Revision

Is this the first time this policy or function has been screened? (If not, indicate which iteration this is – 2, 3, etc.)

Second iteration – first undertaken in 2015

Date of completing this EIA screening 31 March 2017


226

Description What exactly is proposed? (Describe the service/policy and the changes that are being planned) An assessment of pharmaceutical service provision in the Suffolk HWB area Why? (Give reasons why these changes are being introduced) Required by Pharmaceutical Regulations 2013 What will the effect of the changes be? (Describe which people, communities, localities etc. will be affected by the changes) All residents of Suffolk HWB area How will it be implemented? (Describe the decision-making process, timescales, process for implementation) Used by NHS England to determine access to pharmaceutical services provision. Used by Suffolk HWB in conjunction with the JSNA to plan services to improve health and wellbeing When is it due to start? (Planned start of new/revised policy/service) 1 April 2018 Any other relevant details A Pharmaceutical Needs Assessment was published in 2015 by Suffolk CC on behalf of Suffolk HWB. An EIA was undertaken as part of this process.

Data about the user population What is the demographic profile of the community you are serving? (A brief overview of quantitative data used and qualitative research undertaken, including customer surveys and focus groups, plus links to reports, local or national data that you have used) Health and Wellbeing data for Suffolk population, access to pharmaceutical services provision in Suffolk, public views on pharmaceutical services provision for a public questionnaire. What is the profile of your service users by protected characteristics? (Where this data is available. If it is not currently available state any plans to collect this in future) Pharmacy user survey, pharmacy contractor survey, GP dispensing practice survey, pharmacy complaints received by NHS England (February 2017-April 2017). Consultation on the Draft 2018 Pharmaceutical Needs Assessment.

Implications for communities and workforce Disability What is the impact on people with a disability (including children with additional needs) and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact


227

Implications for communities and workforce Disability

How does it have a positive or negative impact?

The 2018 PNA takes account of health needs and how differing population groups' needs may vary. It will then consider any actions necessary within the provision of pharmaceutical service provision to reduce these health inequalities. Access and availability to pharmaceutical services in Suffolk will be assessed and options considered to improve access and availability. Persons with this characteristic will be specifically targeted within the consultation. A Steering Group will consider any responses, and the final report will be signed off by the HWB Board.

Do you expect the extent of the impact to be low, medium or high?

Low

What could be done to mitigate any adverse impact or further promote positive impact?

2018 PNA to note any gaps in access or provision, affecting people with a disability. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board.

Age What is the impact on people of different ages and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact


The 2018 PNA takes account of health needs and how differing population groups' needs may vary. It will then consider any actions necessary within the provision of pharmaceutical service provision to reduce these health inequalities. Access and availability to pharmaceutical services in Suffolk will be assessed and options considered to improve access and availability. Persons with this characteristic will be specifically targeted within the consultation. A Steering Group will consider any responses, and the final report will be signed off by the HWB Board. With regard to age, the 2018 PNA is considering in particular the health of pre-school age children and over 65s.


Low


2018 PNA to note any gaps in access or provision for all ages. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board.


228

Implications for communities and workforce Sex (gender) What is the impact on people of different genders and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact




Low


2018 PNA to note any gaps in access or provision for all sexes. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board.

Gender reassignment What is the impact on people who have undergone gender reassignment (i.e. transgender people) and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact


The 2018 PNA takes account of health needs and how differing population groups' needs may vary. It will then consider any actions necessary within the provision of pharmaceutical service provision to reduce these health inequalities. Access and availability to pharmaceutical services in Suffolk will be assessed and options considered to improve access and availability. Persons with this characteristic will be specifically targeted within the consultation. A Steering Group will consider any responses, and the final report will be signed off by the HWB Board


229

Implications for communities and workforce Gender reassignment Do you expect the extent of the impact to be low, medium or high?

Low


2018 PNA to note any gaps in access or provision for people with gender reassignment. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board.

Marriage/civil partnership What is the impact on people who are married or in a civil partnership and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact




Low


2018 PNA to note any gaps in access or provision to married or civil partnership populations. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board.

Pregnancy/maternity What is the impact on people who are pregnant women or those with a young child and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact


230

Implications for communities and workforce Pregnancy/maternity




Low


2018 PNA to note any gaps in access or provision for pregnant people. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board.

Race What is the impact on people from different races or ethnic groups and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact


The 2018 PNA takes account of health needs and how differing population groups' needs may vary. It will then consider any actions necessary within the provision of pharmaceutical service provision to reduce these health inequalities. Access and availability to pharmaceutical services in Suffolk and options considered to improve access and availability. Persons with this characteristic will be specifically targeted within the consultation. A Steering Group will consider any responses, and the final report will be signed off by the HWB Board


Low


2018 PNA to note any gaps in access or provision for race. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board.


231

Implications for communities and workforce Sexual orientation What is the impact on people according to their sexual orientation and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact




Low


2018 PNA to note any gaps in access or provision for sexual orientation. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board.

Religion/belief What is the impact on people according to their religion or belief and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact




232

Implications for communities and workforce Sexual orientation Do you expect the extent of the impact to be low, medium or high?

Low


2018 PNA to note any gaps in access or provision for people of any particular religion or belief. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board.

Rurality Where people live is not a characteristic protected by law: but for an organisation such as Suffolk County Council it is good practice to consider carefully how location may affect people’s experience of a policy or service.

What is the impact on people according to whether they live in an urban or rural environment and what evidence do you have? (If you do not believe there is any impact describe why not)

Positive impact


Effect of rurality specifically reviewed through the needs assessment and travel access maps. Any gaps or improvements in access will be stated in the 2018 PNA, to open up applications from providers to fill.


Low


2018 PNA to note any gaps in access or provision for people living in rural areas. 2018 PNA reviewed by Steering Group (with Healthwatch representation), and signed off by HWB Board

Recommendation to Policy Clearing House In your opinion, should a full Equality Impact Assessment be carried out for this policy or function?

Why? A full EIA involves consultation with all stakeholders: actual and potential service users, staff and management likely to be delivering the policy, partner agencies and Trade Unions. For guidance contact the Equalities Lead Adviser.


233

Abbreviations AF – Atrial Fibrillation

AIMp – Association of Independent Multiple pharmacies

AURs – Appliance Use Reviews

BME – Black and Minority Ethnic Groups

BSA – Business Services Authority

CCA – Company Chemists Association

CCGs – Clinical Commissioning Groups

CHD – Coronary Heart Disease

CMO – Chief Medical Officer

COPD – Chronic Obstructive Pulmonary Disease

CPCF – Community Pharmacy Contractual Framework

CVD – Cardiovascular Disease

DACs – Dispensing Appliance Contractors

DH – Department of Health

DRUM – Dispensing Review of Use of Medicines

DSQS – Dispensing Services Quality Scheme

EHC – Emergency Hormonal Contraception

EPS – Electronic Prescription Services

ESA – Employment Support Allowance

ESPS – Essential Small Pharmacy Scheme

GP – General Practitioner

HIV – Human Immunodeficiency Virus

HLP – Healthy Living Pharmacy

HMP – Her Majesty’s Prison

HSCIC – Health and Social Care Information Centre

HWB – Health and Wellbeing Board

IMD – Index of Multiple Deprivation

JSNA – Joint Strategic Needs Assessment

KSI – Killed or Seriously Injured

LA – Local Authority


234

LMC – Local Medical Committee

LPC – Local Pharmaceutical Committee

LPN – Local Professional Network

LPS – Local Pharmaceutical Service

LSOAs – Lower-layer Super Output Areas

MIU – Minor Injuries Unit

MUR – Medicines Use Review

NHS – National Health Service

NMS – New Medicine Service

NUMSAS – NHS Urgent Medicines Supply Advanced Service

ONS – Office for National Statistics

OTC – Over the Counter

PCT – Primary Care Trust

PhAS – Pharmacy Access Scheme

PHE - Public Health England

PhIF – Pharmacy Integration Fund

PNA – Pharmaceutical Needs Assessment

PSNC – Pharmaceutical Services Negotiating Committee

QOF – Quality and Outcomes Framework

RAF – Royal Air Force

SAC – Stoma Appliance Customisation

SHA – Strategic Health Authority

STI – Sexually Transmitted Infection

TIA – Transient Ischaemic Attack

USAF – United States of America Air Force

YLL – Years of Life Lost

YOI – Young Offenders Institute


235

Map A: Suffolk pharmacies and population density by output area


236

Map B: Suffolk pharmacy and dispensing GP practice locations


237

Map C: GP practice locations in Suffolk (April 2017)


238


239

Map D: Ipswich GP practices (April 2017)


240

Map E: Suffolk GP practices by locations and codes (April 2017)


241

GP Practice Name GP Practice Name D83001 Constable Country Rural Medical Practice D83044 Stow Health

D83002 Alexandra Rd Surgery D83045 Lakenheath Surgery

D83003 Wickhambrook Surgery D83046 Two Rivers Medical Centre

D83004 Felixstowe Road Medical Practice D83047 Rosedale Surgery

D83005 Angel Hill Surgery D83048 Grove Medical Centre

D83006 Bildeston Health Centre D83049 Little St John Street Surgery

D83007 Ixworth Surgery D83050 Deben Road Surgery

D83008 Burlington Road Surgery D83051 The Derby Road Practice

D83009 Beccles Medical Centre D83053 Saxmundham Health Centre

D83010 Longshore Surgeries D83054 The Peninsula Practice

D83011 Bridge Road Surgery D83055 Woolpit Health Centre

D83012 Clements and Christmas Maltings Surgery D83056 Hawthorn Drive Surgery

D83013 The Guildhall and Barrow Surgery D83057 Framfield House Surgery

D83014 The Long Melford Practice D83058 The Norwich Road Surgery

D83015 Howard House Surgery D83059 Barrack Lane Medical Centre

D83016 Victoria Road Surgery D83060 Hardwicke House Group Practice

D83017 Country Practice D83061 Wickham Market Medical Centre

D83018 Market Cross Surgery D83062 Forest Surgery

D83019 Mendlesham Health Centre D83064 Glemsford Surgery

D83020 The Holbrook and Shotley Practice D83067 Oakfield Surgery


242

GP Practice Name GP Practice Name D83021 Haverhill Medical Practice D83069 Fressingfield Medical Centre

D83022 Sole Bay H/C D83070 Stanton Surgery

D83023 High Street Surgery D83073 Orchard Street Medical Practice - Blue

D83024 Ivry Street Medical Practice D83074 Orchard Medical Practice

D83026 Framlingham Surgery D83075 Siam Surgery

D83027 Orchard House Surgery D83076 Clare Guildhall Surgery

D83028 Leiston Surgery D83078 White House Surgery

D83029 The Rookery Medical Centre D83079 Combs Ford Surgery

D83030 Kirkley Mill Health Centre D83080 Martlesham Surgery

D83033 Botesdale Health Centre D83081 Haven Health

D83034 Bungay Medical Centre D83082 Walton Surgery

D83035 Cutlers Hill Surgery D83084 The Birches Medical Centre

D83036 Church Farm Surgery D83608 Andaman Surgery

D83037 Hadleigh Health Centre D83610 Swan Surgery

D83038 Mount Farm Surgery D83615 The Barham & Claydon Surgery

D83039 The Chesterfield Drive Practice D83619 Westwood Surgery

D83040 Victoria Surgery Y00774 Brandon Medical Practice

D83041 Debenham Surgery Y01794 Ravenswood Medical Practice

D83043 Eye Health Centre


243

Map F: Suffolk 1.6 km buffers around pharmacies


244

Map G: Suffolk pharmacy opening hours


245

Map H: Suffolk pharmacies and deprivation by LSOA


246


247

Map I: Suffolk pharmacies and Black and Minority Ethnic levels by LSOA


248

Map J: Suffolk off-peak drive time to nearest pharmacy


249

Map K: Suffolk peak drive time to nearest pharmacy


250

Map L: Suffolk public transport time to nearest pharmacy, Tuesday, 9am to 1pm


251

Map M: Suffolk public transport times to nearest pharmacy, Tuesday, 1pm to 5pm


252


253

Map N: Suffolk walking times to nearest pharmacy


254


255

Map O: Suffolk pharmacies, dispensing practices and Standard Mortality Ratio (SMR) for all-cause mortality under 75 (2010-2014 inclusive), July 2017


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Suffolk Health and Wellbeing Board · 2017-10-09 · Health in Suffolk Suffolk is a rural county in...

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