This Pharmaceutical Needs Assessment (PNA) has been produced by Soar Beyond, contracted by the London Borough of Bexley. The production has been overseen by the PNA Steering Group for Bexley Health and Wellbeing Board with authoring support from Soar Beyond Ltd. All information is correct at the time of writing in November 2024.

Important regulatory updates and other changes as part of the PNA process were included in June 2025 for the final document.

Introduction

Every Health and Wellbeing Board (HWB) has a statutory duty to carry out a Pharmaceutical Needs Assessment (PNA) every three years. The last PNA for Bexley was published in September 2022 and has been kept up to date with supplementary statements reflecting changes in provision. This PNA for Bexley HWB fulfils this regulatory requirement.

Aim, objectives and methodology

The aim of the Bexley Pharmaceutical Needs Assessment (PNA) is to enable local pharmacy 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

Soar Beyond were commissioned by Bexley Council to complete the PNA, overseen by a steering group to ensure the process was followed and the PNA intended for publication was fit for purpose as per the NHS Regulations.

The process consisted of:

• governance setup: Forming a Steering Group to oversee the process and define roles and timelines
• data collection: Gathering data on pharmaceutical services, population demographics, and public health needs
• service assessment: Mapping and evaluating existing services, including those from neighbouring areas
• gap identification: Identifying current and future service gaps based on population growth and access issues
• consultation: Conducting a 60-day public consultation to gather feedback from stakeholders and the public
• finalisation and publication: reviewing feedback to finalise the PNA, and publishing

NHS pharmaceutical services in England

NHS pharmaceutical services are provided by contractors on the pharmaceutical list held by NHS England (NHSE). The types of providers are:

• community pharmacy contractors, including Distance-Selling Pharmacies (DSPs): Community contractors refer to persons providing local pharmaceutical services from registered pharmacy premises in Bexley, neighbouring areas and remote suppliers, including DSPs, who are required to offer services throughout England
• Dispensing Appliance Contractors (DACs): DACs are required to provide a range of ‘Essential Services’ including advice on and home delivery of appliances, but they are unable to supply medicines
• Local Pharmaceutical Service (LPS): LPS refers to pharmacy providers contracted by the NHS to perform specified services to their local population or a specific population, outside the national framework
• dispensing doctors: refers to GPs who are allowed to dispense the medicines they prescribe for their patients

NHS pharmaceutical services refers to services commissioned through NHSE. Integrated Care Boards (ICBs) took on the delegated responsibility for the commissioning of pharmacy services from NHS England from 1 April 2023.

Locally Commissioned Services

However, in the absence of a particular service being commissioned by NHS England, it is in some cases addressed by locally commissioned services, funded by the local authorities or ICBs. These are services community pharmacy contractors could choose to provide and are therefore included in the PNA.

The three main categories, as identified in the Community Pharmacy Contractual Framework (CPCF) are as follows:

Essential Services

These are services that every community pharmacy providing NHS pharmaceutical services must provide and are set out in their terms of service. These include the dispensing of medicines and appliances, disposal of unwanted medicines, clinical governance and promotion of healthy lifestyles.

Advanced Services

These are services community pharmacy contractors and DACs can choose to provide, subject to accreditation as set out in the Secretary of State Directions.

Enhanced Services

These are services commissioned directly by NHS England, introduced to assist the NHS in improving and delivering a better level of care in the community. Pharmacy contractors can choose to provide any of these services.

Bexley the place

Bexley is a London borough, located in Southeast London on the south bank of the Thames, between Greenwich and Kent. It is bordered by Bromley to the south, Greenwich to the west, Dartford in Kent to the east and the river Thames to the north. There are 17 wards across the borough. There are three localities in Bexley: North Bexley, Clocktower and Frognal. In addition, there are four Primary Care Networks (PCNs) located in Bexley.

The borough falls within South East London Integrated Care Board (ICB) and Bexley local authority. The population is diverse and classified as urban with major conurbation under the Rural Urban Classification 2011.

The Population

Bexley has a population of 246,466, of which 71.9% are white British and 28.1% are other ethnicities. There is variation in ethnicity across the three localities. The borough has a mixture of affluence and deprivation, with the north, southeast and south of the borough relatively more deprived. The south, centre and southeast of the borough has a relatively higher population density.

Health inequalities

Index of Multiple Deprivation (IMD) data (2019) shows that Bexley is ranked 190 out of 317 local authorities across the whole of England, where 1 is the most deprived and 317 is the least deprived. There is a distinct difference in levels of deprivation across the three localities in Bexley, with North Bexley being the most deprived and Clocktower being least deprived.

Health of Bexley

The health of the people of Bexley is close to England averages. Life expectancy at birth for Bexley residents was 63.9 for females and 66.4 for males (2020 to 2022), which is similar to England’s life expectancy for males than females. Primary Care Network (PCN) Quality and Outcomes Framework (QOF) data showed a variance in health trends across the three localities, which present opportunities to maximise the role of community pharmacists.

Community Pharmacy access

Since the last Bexley PNA, the number of community pharmacies has gone from 46 in 2018 and 2022 to 45 in 2025. In Bexley, there are 18.3 community pharmacies per 100,000 population, which is slightly higher than the England average of 18.1 community pharmacies per 100,000. To note the England average has decreased from 20.6 community pharmacies per 100.000.

At the time of writing the PNA, it was noted that community pharmacies on the border with Greenwich, Bromley and Kent provide access to community pharmacy services.

Community pharmacies are well distributed across the three localities, with the majority of the residents (97%) being able to travel to a pharmacy within 20 minutes by car, public transport or walking. The public transport network in Bexley is well serviced by buses and trains. Bexley residents also have access to the community pharmacies within Greenwich, Bromley and Kent neighbouring areas.

Community Pharmacy market

The PNA steering group has noted the current pressures facing community pharmacy due to financial issues and medicine shortages. This is a national issue. There have been numerous closures nationally and, locally, one closure in Bexley. However, despite this Bexley still has more community pharmacies per 100,000 population than the England average. The viability of community pharmacies has been impacted by external pressures, and the addition of a new pharmacy application following the closure of a community pharmacy could further affect the sustainability of existing pharmacies in the area.

Feedback on pharmaceutical services

A questionnaire to understand the views of the public regarding pharmaceutical service provision in Bexley was conducted from July to September 2024. There was a total of 401 responses:

• between 62 to 90% of patients visited a pharmacy to collect prescriptions for themselves or to buy over-the-counter medicines. Patients also visited a pharmacy to get advice from a pharmacist or access NHS clinical services, which was 39 to 48% of respondents a month. The majority of respondents visited a pharmacy several times to once a month.
• overall, the majority of respondents (73%) visited a pharmacy once a month or more.
• 40% of respondents visited a pharmacy at variable times. The most popular time to visit a pharmacy was 9am to 1pm, which was 37%.
• at least 94% of respondents had a preferred pharmacy, with 1% of respondents using an online pharmacy.
• when choosing a pharmacy, the availability of a medicine (65%) was extremely important, but so too was the quality of service (60%).
• most travelled to the pharmacy walking (61%), and a further 34% by car.

Adequacy of pharmaceutical services in Bexley

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

Conclusions

For the purposes of this PNA, Necessary Services for Bexley HWB are defined as Essential Services. Advanced and Enhanced Services are considered relevant as they contribute toward improvement in provision and access to pharmaceutical services.

Locally Commissioned Services are those that secure improvements or better access to, or that have contributed towards, meeting the need for pharmaceutical services in the Bexley HWB area, and are commissioned by the ICB or local authority, rather than NHS England.

There are 45 community pharmacies (including two DSPs) in Bexley, and all pharmacies provide all Essential Services as per the current CPCF. No gaps have been identified, although recommendations to enhance provision have been highlighted in this report.

This Bexley Pharmaceutical Needs Assessment 2025 concludes that there are no identified gaps in the provision of NHS Necessary Services to meet current and future needs of the population in the next three years. This includes provision during working and non-working hours.

The PNA highlights good uptake of Advanced and Enhanced Services, including the Pharmacy First service, hypertension case-finding, and New Medicine Service, with opportunities to improve awareness in some areas. Ongoing monitoring of service provision is recommended to ensure continued alignment with evolving local health needs. Future priorities include enhancing collaboration between Integrated Care Boards and community pharmacies to further embed services.

There are no gaps in the provision of Advanced or Enhanced Services at present or in the next three years that would secure improvements or better access to services in Bexley.

Bexley Council and South East London ICB commission a range of services that complement the NHS pharmaceutical services. These are aimed at improving access and addressing specific local needs. Opportunities exist for collaboration between the commissioners and to improve awareness of the availability of locally commissioned services to maximise the uptake.

Based on current information, no gaps have been identified in respect of securing improvements or better access to Locally Commissioned Services, either now or in specific future circumstances during the next three years across Bexley to meet the needs of the population.