Apr 8, 2010 ... By application dated 3 June 2009, Freshphase Ltd (“the Applicant”) applied to
Heywood,. Middleton and Rochdale Primary Care Trust (“the ...
8 April 2010 REF: SHA/15629
APPEAL AGAINST HEYWOOD, MIDDLETON AND ROCHDALE PCT DECISION TO REFUSE AN APPLICATION BY FRESHPHASE LTD FOR PRELIMINARY CONSENT PRIOR TO INCLUSION IN THE PHARMACEUTICAL LIST WITHIN THE VICINITY OF THE QUEENS DRIVE SURGERY, KIRKHOLT
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The Application By application dated 3 June 2009, Freshphase Ltd (“the Applicant”) applied to Heywood, Middleton and Rochdale Primary Care Trust (“the PCT”) for preliminary consent prior to inclusion in the pharmaceutical list within the vicinity of the Queens Drive Surgery, Kirkholt. In support of the application it was stated:
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1.1
We intend to provide pharmaceutical services in the Queens Drive area. We believe pharmacy is necessary and desirable in the area as there is going to be a new surgery in the area. In addition, the area is very deprived and would therefore benefit from the addition of a new pharmacy.
1.2
Neighbourhood definition: 1.2.1
North – Queensway
1.2.2
East – Oldham Road (A671)
1.2.3
South – M62 Motorway
1.2.4
West – A627
The PCT Decision The PCT considered and decided to refuse the application. The decision letter dated 21 January 2010 states: 2.1
Your application was considered at the PCT’s Pharmacy Group Meeting on 14 January 2010, along with two other applications for the same location.
2.2
I am now writing to inform you that the PCT has decided that there is adequate provision of pharmaceutical services already in the neighbourhood identified, and therefore none of the applications were approved. A copy of the Pharmacy Group’s decision report is attached. Extracts from Pharmacy Group Decision Report of 14 January 2010
2.3
Three separate applications have been received to open a new ‘normal hours” pharmacy in the vicinity of the new Equitable Access GP practice on Queens Drive (Kirkholt Medical Practice), Kirkholt, Rochdale, which opened on 2nd November 2009.
2.4
A site visit had been undertaken. Queens Drive is a connecting road between Queensway (a busy dual carriageway) and Kirkholt, which is a large local authority housing estate. Located on Queens Drive is the new Kirkholt Medical Practice, a
2 small number of private houses, two blocks of local authority flats, and a small parade of shops close to its junction with Hartley Lane. 2.5
The Group gave consideration to the neighbourhood and agreed as set out below: 2.5.1
North Boundary — travelling east from the motorway bridge which crosses Queensway at Queens Drive, along Queensway to its junction with Oldham Road.
2.5.2
East Boundary — travelling south down Oldham Road to its junction with Broad Lane, then travelling along Broad Lane to the point where it crosses over the M62 motorway.
2.5.3
South Boundary — travelling west along the M62 to the A627(M) motorway slip road.
2.5.4
West Boundary — travelling north along the A627(M) slip road to the point where its crosses Queensway.
2.6
Contained within the Pharmacy Group’s pre-defined neighbourhood, there are currently 2 GP Practices – Kirkholt Medical Practice, Queens Drive (3GP5) and The Strand Medical Centre, The Strand (2 GPs), 1 pharmacy (The Strand Pharmacy – owned by Mrs Sanghvi, one of the applicants), no dental practices and no optical premises.
2.7
The opening hours for the GP practices within the pre-defined Kirkholt neighbourhood are: Kirkholt Medical Practice, Queens Drive, Kirkholt Monday / Wednesday / Friday 8am – 6.30pm Tuesday / Thursday 08:00 – 7:00pm Saturday 9am —12 noon The Strand Medical Centre, The Strand, Kirkholt Monday / Tuesday / Thursday / Friday 9am — 6pm Wednesday 9am — 12:30pm Saturday 10am — 11am
2.8
The opening hours for the pharmacy within the pre-defined Kirkholt neighbourhood are: The Strand Pharmacy, The Strand, Kirkholt is open Monday to Friday 9am — 6pm (closed 1pm — 2pm for lunch) Saturday 9am — 1pm closed Sunday Consideration
2.9
The Group noted that Kirkholt is a significantly deprived area, based on the statistics available (relating to various aspects of health, deprivation, economic activity, car ownership etc).
2.10
The Group agreed that, due to the location of the proposed pharmacy, it would be unlikely to attract significant trade from outside the immediate neighbourhood. The Group considered the site visit report, and noted that Queens Drive is located on the western edge of the Kirkholt estate. A bus service runs along Daventry Road and there are bus stops close to its junction with Hartley Lane, but no services run along Hartley Lane or Queens Drive itself. There is a primary school at the junction of
3 Queens Drive and Hartley Lane, just across from the small parade of shops on Queens Drive. 2.11
Kirkholt Medical Practice has been open to patients since 2 November 2009 and as at the date of the Pharmacy Group meeting, had a patient list size of 234. The majority of these patients reside in the Kirkholt area.
2.12
The new practice is located in a prefabricated building, which is sited on Local Authority leased land on Queens Drive for a 5 year period. The Local Authority has definitive plans for the land through a major regeneration programme and the practice will have to relocate after the lease expires in 5 years’ time.
2.13
The Group believes from information provided by the PCT’s Estates & Facilities Manager that the intention would be for the practice to relocate into the proposed Kirkholt LIFT Centre which would be located close to The Strand, considered to be the heart of the Kirkholt community and 800 metres to the southeast of the Kirkholt Medical Practice site. DECISION
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2.14
Kirkholt is a large Local Authority housing estate, and as such the Group felt that it is unlikely that patients from outside the estate would actively seek to access services on the estate. The Group felt that the population that would be served by a new pharmacy would be the same population which is currently served by the existing pharmacy on The Strand, which is a long established pharmacy situated at the heart of the estate, and already provides comprehensive pharmaceutical services to the local population, and has the support of local organisations and the patients.
2.15
At the present time, there is no evidence to suggest that Kirkholt Medical Practice has brought a significant number of new patients to the area and therefore this has not placed any additional demand on current pharmaceutical provision.
2.16
The Group was concerned that the temporary nature of the location of Kirkholt Medical Practice, and likelihood that it will be forced to relocate from Queens Drive in 5 years when the current lease expires, would mean that a new pharmacy situated on Queens Drive is not necessary in the immediate or long term.
2.17
In conclusion, the Group felt that although the applicants had submitted comprehensive applications for inclusion of a new pharmacy in the vicinity of Queens Drive, there was insufficient evidence to support the need for a pharmacy at this particular location, as there are adequate pharmaceutical services provided to the neighbourhood in the heart of the community, which are well supported by local patients and organisations.
2.18
Therefore the Group decided not to approve any of the 3 applications, on the basis that it does not consider a new pharmacy to be either necessary or expedient in order to secure adequate pharmaceutical provision for the local population.
The Appeal In a letter to the Family Health Services Appeal Unit of the NHS Litigation Authority (“the Appeal Unit”) dated 10 February 2010, one of the applicants, Freshphase Ltd appealed against the PCT’s decision in respect of their application. The grounds of appeal are: 3.1
The opening hours of the existing pharmacy does not coincide with the opening hours of the new surgery. On Monday to Friday the pharmacy opens from 9am to 6pm whereas the surgery opens from 8am – 6:30pm (7pm on Tuesday and Thursday). I intend to open the proposed pharmacy from 8am – 8pm. Therefore patient will have better access to pharmaceutical services.
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The PCT have noted that Kirkholt is a deprived area and would therefore benefit from a new pharmacy.
Summary of Representations This is a summary of representations received on the appeal. A summary of those representations made to the PCT are only included in so far as they are relevant and add to those received on the appeal. 4.1
4.2
4.3
PCT 4.1.1
The PCT would agree that The Strand Pharmacy has slightly shorter opening hours than the new GP surgery, however the PCT does not feel that this affects the neighbourhood’s access to pharmaceutical services as The Strand Pharmacy is open 6 days a week (Monday to Saturday lunchtime), the same days as the new GP practice.
4.1.2
In its decision report, the PCT noted and agreed that Kirkholt is a deprived area, but continued by stating that in its opinion there is no evidence to support the need for additional pharmaceutical services in the neighbourhood, considering current pharmaceutical provision to be more than adequate.
4.1.3
The new GP practice has not brought new patients into the neighbourhood, as patients registered at the practice are already resident in the area, and therefore this has not placed any increased demand on existing pharmaceutical services currently provided by The Strand Pharmacy.
4.1.4
The PCT at no point stated that the neighbourhood would benefit from a new pharmacy.
GORGEMEAD LIMITED 4.2.1
There have been no complaints to our knowledge, regarding current pharmaceutical services in the area. There is no evidence given by Freshphase Ltd that there are any gaps in the pharmaceutical services offered by the local pharmacy.
4.2.2
We agree with the reasons given by the PCT to reject this application. We agree with the PCT neighbourhood.
4.2.3
The opening hours of Freshphase Ltd mention are not their core hours so could change after opening. They do not offer any better access to pharmaceutical services on a Saturday, and it is debatable as to whether an hour or two extra a day would offer a great benefit to the local population. I am sure The Strand pharmacy would extend their hours if they felt it was necessary, or the PCT requested it.
4.2.4
We request that the application be rejected on the grounds that it is neither necessary or expedient to secure the adequate pharmaceutical services for this area.
STRAND PHARMACY 4.3.1
The appellant states that his hours of opening more closely match the surgery hours. That may be so but the granting of a contract on this basis is an expensive option for the PCT, since there is no significant demand for extra hours based on requests by patients to the Kirkholt Medical Practice, which whom I work closely, and to the PCT.
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4.3.2
If such a demand is proved to exist I would be most willing to meet this demand from the Strand Pharmacy and save the PCT the cost of an additional unnecessary contract. In the meantime please note that Cohens Chemist on Milkstone Road is open Mon-Fri 9am to 8pm.
4.3.3
Also a new pharmacy is not necessary at this point as Queens Drive is a temporary site for the Kirkholt Medical Practice.
4.3.4
The appellant infers, wrongly in my opinion, that because Kirkholt is a deprived area, it would benefit from a new pharmacy. A new pharmacy would only be beneficial if the existing pharmaceutical provision in the area was inadequate.
4.3.5
Both the LPC and the PCT have stated that this is not the case i.e. there IS adequate provision in the neighbourhood without the need for a new contract.
Consideration 5.1
The Pharmacy Appeals Committee appointed by the Family Health Services Appeal Unit of the NHS Litigation Authority, (“the Committee”) had before it the papers considered by the PCT, together with a plan of the area showing existing pharmacies and doctors’ surgeries and the site (or location) of the proposed pharmacy.
5.2
It also had before it the responses to the Authority’s own statutory consultations.
5.3
On the basis of this information, the Committee considered it was not necessary to hold an Oral Hearing.
5.4
The Committee had regard to Regulation 12(1), the necessary or desirable test, and, in considering that test, had regard in particular to Regulation 12(2), (3) and (4) of the National Health Service (Pharmaceutical Services) Regulations 2005 (as amended) (“the Regulations”).
5.5
The Committee dealt with the application by way of reconsideration of all the issues.
5.6
The Committee noted that the neighbourhood defined by the PCT had not been disputed on appeal. The Committee accepted this neighbourhood without prejudice to any future applications.
5.7
The Committee noted that within the neighbourhood there was currently an existing pharmacy, which was located within one of the existing medical practices in the neighbourhood, with other pharmacies located in adjacent neighbourhoods. In the Committee’s view it is not axiomatic that a contract is needed within a neighbourhood presently containing one pharmacy in order to secure adequacy. While there is no choice within the neighbourhood, the level of adequacy may be dependent on pharmaceutical services elsewhere. The Committee noted that there is one pharmacy on the periphery of the neighbourhood with others located slightly further afield.
5.8
Given the above, the Committee considered that the current provision of pharmaceutical services could not be said to be wholly inadequate and therefore the application was not necessary. The Committee went on to consider, on the spectrum of adequacy, whether the appellation was expedient.
5.9
The Committee noted the comments from the applicant that they seek to offer extended opening times compared with the existing pharmacy. The Committee found the difference in hours to be marginal, with no evidence that there was a need at such additional times or, if there was, that the existing pharmacies could not reasonably fulfil any potential shortfall. If there was any shortfall, for whatever
6 reason, the Committee were of the view that it could be remedied by a direction from the PCT, which they already have the power to do under the regulations.
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5.10
The Committee noted the comments from the applicant with regard to the neighbourhood being a deprived area and that, while this was not disputed, no further information had been provided by the applicant with regards to any potential gap in provision in the neighbourhood that could be remedied by the granting of an additional pharmacy.
5.11
The Committee determined that the applicant had not demonstrated, the onus being on the applicant, that there is a gap on the spectrum of adequacy sufficient to conclude that pharmaceutical services are not currently secured to the standard of adequacy. In the Committee’s view, taking into account the circumstances pertaining to the neighbourhood in question, the Committee determined that pharmaceutical services were currently secured to the extent that it was neither necessary nor expedient to grant the application.
Decision The Committee was of the view that the proposed pharmacy was neither necessary nor expedient to secure the adequate provision of services in the neighbourhood. Accordingly the Committee dismisses the appeal.
Jill Jackson Appeal Officer A copy of this decision is being sent to: Freshphase Ltd Gorgemead Limited Strand Pharmacy Heywood, Middleton and Rochdale PCT
