Community pharmacies and GP practices provide a range of other services. These are not considered ‘pharmaceutical services’ under the Pharmaceutical Regulations 2013 and may be either free of charge, privately funded or commissioned by the local authority or ICB.

These services are listed for information only and would not be considered as part of a market entry determination.

Examples of such services include delivery services, allergy testing, care home services and sexual health services, although this is not an exhaustive list.

4.1 Integrated Care Board (ICB)-commissioned services

The NHS South East London ICB commissions two services across Bexley. A list of all contractors and commissioned services can be found in Appendix A.

• ICBS1: Community pharmacy health and wellbeing service
• ICBS2: Community pharmacy inhaler recycling scheme

4.2 Local authority-commissioned services

LBB commissions four Local Authority-commissioned Services (LAS) from community pharmacies in Bexley.

These services may also be provided from other providers, e.g. GP practices and community health services. A full list of services and community pharmacy providers can be found in Appendix A.

• LAS1: Adult substance misuse treatment system
• LAS2: Needle exchange service
• LAS3: Supervised administration of medicines
• LAS4: Community pharmacy sexual health service, which includes: chlamydia screening, chlamydia treatment, free emergency hormonal contraception, condoms, point of care testing for Human Immunodeficiency Virus (HIV), oral contraception and online genitourinary medicine support¹

4.3 Other services provided from community pharmacies

Due to the low response from the contractor questionnaire, the steering group was unable to ascertain information about other services provided by community pharmacies in Bexley outside of the NHS or locally commissioned services already stated.

4.3.1 Collection and delivery service

The delivery services offered by pharmacy contractors are not commissioned services and are not part of the community pharmacy contractual terms of service. There has been a recommendation from the National Pharmacy Association (NPA) that services like these should be stopped and no longer be available free of charge.

This would not be considered as part of a determination for market entry.

Free delivery is required to be offered without restriction by all DSPs to patients who request it throughout England. There are two DSPs based in Bexley, and there are 409 throughout England. Free delivery of appliances is also offered by DACs, and there are 111 DACs throughout England.

4.3.2 Services for less-abled people

Under the Equality Act 2010² community pharmacies are required to make ‘reasonable adjustments’ to their services to ensure they are accessible by all groups, including less-abled persons. From the 401 responders to the public questionnaire, 10% responded yes to having a disability that affected their day-to-day activities.

4.4 Other providers that reduce the need for pharmaceutical service provision

The following are providers of pharmacy services in Bexley but are not defined as pharmaceutical services under the Pharmaceutical Regulations 2013 however reduce the need for pharmaceutical service provision, in particular the dispensing service.

4.4.1 NHS hospitals

Pharmaceutical services are provided to patients by the hospitals:

• Queen Mary’s Hospital, Frognal Avenue, Sidcup, DA14 6LT
• Erith and District Hospital, Park Crescent, Erith, Kent, DA8 3EE
• Upton Day Hospital, 14 Upton Road, Bexleyheath, Kent, DA6 8LQ
• Darent Valley Hospital, Darent Wood Road, Dartford, DA2 8DA
• Queen Elizabeth Hospital, Stadium Road, Woolwich, London, SE18 4QH
• Princess Royal University Hospital, Farnborough Common, Orpington, Kent, BR6 8ND
• University Hospital Lewisham, High Street, Lewisham, London, SE13 6LH

4.4.2 Personal administration of items by GP practices

GPs are able to personally administer certain items such as vaccines and certain injectable medications for reimbursement from the NHS.

4.4.3 Flu vaccination service by GP Practices

GPs provide access to flu vaccination in addition to the service commissioned in pharmacies through the NHS Enhanced service.

4.5 Other services that may increase the demand for pharmaceutical service provision

4.5.1 Urgent care centres

Residents of Bexley have access to urgent care at:

• Queen Mary’s Hospital, Frognal Avenue, Sidcup, DA14 6LT
• Erith and District Hospital, Park Crescent, Erith, Kent, DA8 3EE
• Darent Valley Hospital, Darent Wood Road, Dartford, DA2 8DA
• Queen Elizabeth Hospital, Stadium Road, Woolwich, London, SE18 4QH
• Princess Royal University Hospital, Farnborough Common, Orpington, Kent, BR6 8ND

4.5.2 Walk-in centres

There are no minor injury unit or walk in centres in Bexley HWB area.

4.5.3 Extended hours access by Primary Care Networks (PCNs)

PCNs are required to provide enhanced access to appointments outside of the standard opening hours for most GPs to accommodate those who may need appointments outside typical opening working times.

4.5.4 Community nursing prescribing

Community nurses work in a variety of settings providing care to individuals outside of a normal acute or general practice setting. This can range from community-based clinics offering specialist services to directly visiting patients in their homes.

4.5.5 Dental services

Dentists are able to prescribe through their dental practices and may issue prescriptions for their patients when necessary.

4.6 Other services

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

Privately provided services – most pharmacy contractors and DACs will provide services by private arrangement between the pharmacy/DAC and the customer/patient.

The following are examples of services and may fall within the definition of an Enhanced Service. However, as the service has not been commissioned by the NHS and is funded and provided privately, it is not a pharmaceutical service:

• care home service, e.g. direct supply of medicines/appliances and support medicines management services to privately run care homes
• home delivery service, e.g. direct supply of medicines/appliances to the home
• PGD service, e.g. hair loss therapy, travel clinics
• screening service, e.g. skin cancer

Services will vary between provider and are occasionally provided free of charge, e.g. home delivery.

Community Pharmacies are contractually obliged to clarify on their patient leaflet which services are NHSE-funded, local authority-funded and privately funded.

¹ This service is currently being recommissioned through the Pharmacy Alliance which looks to provide emergency hormonal contraception, chlamydia treatment and condoms with plans to extend the number of pharmacies providing sexual health services from 6 to 20 pharmacies across Bexley.

² Legislation. Equality Act 2010