Health and Wellbeing Boards (HWB) across the country have a requirement to produce a Pharmaceutical Need Assessment (PNA) every three years. . This looks at the pharmaceutical services provided by community pharmacy and dispensing practices and reviews if there is sufficient provision for the needs of the patients.
Please note it is looking at the provision of contracts. This review does not look at the quality of the service provided or if the contractor is managing to open all of their contracted hours, this is done through the contract management, it looks at the contracts in place and the services they are signed up to and reviews this against the current population needs and the expected population growth within the lifetime of the PNA (3 years).
There is no exact formula which determines if there is sufficient provision in place, and the feedback from stakeholders helps to inform these decisions.
The document is mainly used for the purposes of assisting with decisions regarding market entry (when there is an application for a new pharmacy). However, in many cases a new pharmacy will not resolve the issues which exist because the problems are with workforce, the financial viability of pharmacies, and shortage of medicines which will still remain.
How is the PNA used, what is it for?
The PNA is referenced by the Regional IBC team when assessing applications to open new pharmacies.
(Applications for relocations, consolidations, changes of hours, closures etc are reviewed based on the regulations, not the PNA. If granted some of these will impact the conclusions in the PNA, as they may cause a gap. However, the PNA will not generally influence if the application is granted or not as the regulations have tight rules on what is and isn’t permitted.)
When an organisation puts in an application to open a new pharmacy the ICB (in our area the Herts & W Essex team on behalf of our ICB) checks the application against the regulations and reviews the PNA and checks if it states that there are any gaps which the application will fill.
If there is a gap the likelihood is that the application will get approved, as long as it is in line with the regulations.
If there are no gaps then an application has to be for ‘unforeseen benefit’ rather than a standard application. Which means it fulfils a need which it was not possible to foresee when drafting the PNA. These generally need to be around providing a specific service to a unique patient group, or where a closure has occurred since the PNA, or a housing development has been built the PNA was not aware of, and therefore the application fulfils a need which was not predicted in the PNA.
In some applications specific stakeholders can submit a view on the individual application. The LMC is one of these stakeholders. In these situations, the LMC Executive goes out to the practices which will be most affected and asks if there is anything which needs to be feedback.
If an application is turned down then the applicant can appeal and this goes to a national forum.
The last few PNA’s have concluded there were no gaps in either Council Area, however, there have been a lot of pharmacy closures in the last couple of years and therefore it is not a given that this will be the same this time around.