Contents
- Executive summary for the Pharmaceutical Needs Assessment (PNA) 2025
- Section 1: Introduction
- Section 2: Context for the PNA
- Section 3: NHS pharmaceutical services provision, currently commissioned
- Section 4: Other services that may impact on pharmaceutical services provision
- Section 5: Findings from the public questionnaire
- Section 6: Analysis of health needs and pharmaceutical service provision
- Section 7: Conclusions
- Appendix A: List of pharmaceutical service providers in Bexley by locality
- Appendix B: PNA project plan
- Appendix C: PNA Steering Group terms of reference
- Appendix D: Public questionnaire
- Appendix E: Consultation stakeholders
- Appendix F: Summary of consultation responses
- Appendix G: Consultation comments
- Appendix H: List of Abbreviations
7. Section 6: Analysis of health needs and pharmaceutical service provision
The purpose of the analysis of health needs and pharmaceutical service provision is to establish if there is a gap or potential future gap in the provision of pharmaceutical services in Bexley.
6.1 Pharmaceutical services and health needs
The health needs and pharmaceutical service provision for Bexley have been analysed, taking into consideration the priorities outlined in the NHS LTP, JSNA, JLHWS, other local policies, strategies and health needs (Section 2).
Several of the priorities in these strategies and policies can be supported by the provision of pharmaceutical services within Bexley. Some of these services are Essential Services and already provided, and some will be Advanced or Enhanced Services that are new.
Understanding the communities that local pharmacies serve is important for maximising national CPCF services in care pathways as well as commissioning the services that best serve the health and wellbeing requirements of the local communities. Pharmacies play more than a medicine-dispensing role today and the changes in the 2019-2024 CPCF saw services that meet the prevention, medicines optimisation and primary care access agendas. The Public Health built in the CPCF supports communities to be healthy, to self-care and to self-manage long-term conditions. These are all important services that can help reduce the demand on local general practices and hospitals.
6.2 PNA localities
There are 45 contractors in Bexley, all of them community pharmacies (including two DSPs). Table 36 in Section 3.1 provides a breakdown by contractor type and Table 42 in Section 3.2.3.2 provides a breakdown of the number and percentage of community pharmacies open beyond 6 pm and at weekends. Individual community pharmacy opening times are listed in Appendix A.
The health needs of the Bexley population influence pharmaceutical service provision in Bexley. Health and population information was not always provided on a locality basis; where it was provided it has been discussed in the relevant locality section.
For the purpose of the PNA, all Essential Services are considered Necessary Services in Bexley.
All advanced and enhanced services are ‘other relevant services’. Locally commissioned pharmaceutical services are considered those pharmaceutical services that secure improvements or better access or that have contributed towards meeting the need for pharmaceutical services in the HWB area.
The breakdown of Advanced, Enhanced and Locally Commissioned Service provision by locality can be found in Section 3.2.4, Section 3.2.5 and Section 4 respectively.
For the purpose of the PNA, the Bexley geography has three localities:
- North Bexley
- Clocktower
- Frognal
The following have been considered as part of the assessment for Bexley to understand the needs of the population:
- national priorities as set out by the NHS Long Term Plan and Core20PLUS5
- the local strategies across the area for the health needs of the population of Bexley from the JSNA, JHWS and the ICS
- population changes and housing developments across the next three years
- IMD and deprivation ranges compared with the relative location of pharmacy premises
- the burden of diseases and the lifestyle choices people make across Bexley
- the health profiles based on ONS and QOF data
The following have been considered to understand pharmaceutical service provision and access:
- the number and location of pharmacy contractors across each locality
- what choice do individuals have to which pharmacy they choose to visit
- weekend and evening access across each locality
- how long it takes to travel to the nearest pharmacy based on various transportation methods
- what services are provided across each locality
- the views of the public on pharmaceutical service provision
6.2.1 North Bexley
North Bexley locality has a population of 98,452, of which 61.7% is White British, 22.6% is Black/Black British/Caribbean/African, 9.0% is Asian/Asian British, 4.1% Mixed or Multiple ethnicities and 2.6% being of another ethnic group . This is the most diverse locality in Bexley and relatively the most deprived locality in the borough compared to the Bexley and London figures. Population density is relatively higher in the north of the locality.
The number of households in North Bexley that own a car or van is 72.5%, which is just below the Bexley values.
The health of North Bexley's population, based on data from the North Bexley PCN, indicates that the majority of the locality is relatively healthy. However, diabetes prevalence is higher compared to both Bexley and national averages.
North Bexley has the highest percentage of children in both age groups considered obese or with severe obesity compared to the Bexley and England values.
6.2.1.1 Necessary Services: current provision
There are 16 community pharmacies in this locality. The estimated average number of community pharmacies per 100,000 population is 16.3, below the England average of 18.1 and the Bexley average of 18.3. There are 15 pharmacies that hold a standard 40-core hour contract and one Distance Selling Pharmacy. Of the 16 community pharmacies:
- eight pharmacies (50%) are open after 6pm on weekdays
- 15 pharmacies (94%) are open on Saturdays
- one pharmacy (6%) is open on Sundays
There are also a number of accessible providers open in neighbouring locality of Clocktower and HWB areas of Greenwich and Kent.
6.2.1.2 Necessary Services: gaps in provision
There is adequate pharmaceutical service provision across the whole locality to ensure continuity of provision to the new developments. The district population growth is expected to increase slightly over the next six years to 2030 by 0.28% and the number of dwellings is discussed in Section 2.6.6. There is a total of 4,151 that have received planning permission or submitted for approval and are anticipated to be built between 2027 to 2034. These increases can be easily absorbed by the existing community pharmacy network and should not impact access to pharmaceutical services.
With projected increases in population and corresponding demand, pharmacies, particularly those operating as sole providers, may experience increased footfall and service pressures. While current access is considered adequate, this assessment assumes that existing pharmacies will adapt to meet rising demand.
The rationale for determining no current gap in provision is based not only on physical access but also on the expectation that pharmacy contractors will scale and flex their capacity in response to local needs.
Bexley HWB will continue to monitor pharmaceutical service provision in specific areas within the locality where major housing developments are planned, to ensure there is the capacity to meet potential increases in service demand.
No gaps in the provision of Necessary Services have been identified for North Bexley locality.
6.2.1.3 Other relevant services: current provision
Sections 3.2.4 and 3.2.5 show the pharmacies providing Advanced and Enhanced services in North Bexley locality.
Regarding access to Advanced Services, data for which pharmacies had signed up to the service was unavailable; however, NHS BSA data for September 2024-January 2025 demonstrated activity for these services as follows:
- Pharmacy First – 15 (94%) pharmacies delivered this service
- Flu Vaccination – 14 (88%) pharmacies delivered this service
- Pharmacy Contraception – 7 (44%) pharmacies delivered this service
- Hypertension case-finding – 11 (69%) pharmacies delivered this service
- New Medicine Service – 16 (100%) pharmacies delivered this service
- Smoking Cessation – no pharmacies delivered this service
- Appliance use review – no pharmacies delivered this service
- Stoma appliance customisation – no pharmacies delivered this service
- Lateral Flow Device Tests – 6 (38%) pharmacies delivered this service
It can be seen that there is good availability of New Medicine Service (NMS) (100%), Pharmacy First (94%) and Flu vaccination (88%) in the locality. There is currently a lower number of providers of the LFD supply (38%) and Pharmacy Contraception (44%).
At the time of writing, which pharmacies were providing the Enhanced Services was unavailable.
6.2.1.4 Improvements and better access: gaps in provision
Regarding access to services commissioned by ICB in the 15 community pharmacies (excluding the DSP):
- three pharmacies (20%) provide access to the Health and Wellbeing Scheme (Vital 5)
- one pharmacy (7%) provides the Inhaler Recycling Scheme
Regarding access to services commissioned by LBB in the 15 community pharmacies (excluding the DSP):
- one pharmacy (7%) provides Substance misuse service
- three pharmacies (20%) provide Needle exchange services
- eight pharmacies (53%) provide Supervised Administration of Medicine Services
- one pharmacy (7%) provides Sexual health service
All of the Advanced, Enhanced and Locally Commissioned Services are available in North Bexley and have varying opening times.
Consideration should be given to incentives for further uptake from current providers and extending provision through community pharmacies, including plans for increasing the uptake of the recently introduced Advanced Services – Pharmacy First, the hypertension case-finding service, PCS and the smoking cessation Advanced Service. The ICS needs to look at increasing service uptake through existing providers working with place-based stakeholders.
No gaps have been identified that if provided either now or in the future (next three years) would secure improvements or better access to services across North Bexley locality.
6.2.2 Clocktower
Clocktower locality has a population of 79,769 of which 73.6% is White British, 13.8% is Asian/Asian British, 6.4% is Black/Black British/Black Welsh/Caribbean/African, 3.2% is Mixed/Multiple ethnic groups and 3.0% are another ethnic group. This is a quite relatively affluent locality in the borough, compared to the Bexley and London figures. Population density is relatively lower compared to the other two localities.
The number of households in Clocktower that own a car or van is 80.9%, which is higher than the Bexley value.
The health of the population of Clocktower, mainly taken from Clocktower PCN data and APL PCN data, shows that the locality is relatively healthier, with hypertension and cancer higher than the Bexley and England values, diabetes is similar to the Bexley value and higher than England and chronic heart disease is higher than the Bexley value and lower than the England value.
6.2.2.1 Necessary Services: current provision
There are 15 community pharmacies in this locality. The estimated average number of community pharmacies per 100,000 population is 18.8, higher than the England average of 18.1 and the Bexley average of 18.3. There are 14 pharmacies that hold a standard 40-core hour contract and one 72+ hour pharmacies. There are no DSPs in Clocktower. Of the 15 community pharmacies:
- seven pharmacies (47%) are open after 6pm on weekdays
- 12 pharmacies (80%) are open on Saturdays
- two pharmacies (13%) are open on Sundays
There are also a number of accessible providers open in neighbouring localities of North Bexley and Frognal, and HWB areas of Greenwich and Kent.
6.2.2.2 Necessary Services: gaps in provision
Generally, there is adequate pharmaceutical service provision across the whole locality to ensure continuity of provision to the new developments.
With projected increases in population and corresponding demand, pharmacies, particularly those operating as sole providers, may experience increased footfall and service pressures. While current access is considered adequate, this assessment assumes that existing pharmacies will adapt to meet rising demand.
The rationale for determining no current gap in provision is based not only on physical access but also on the expectation that pharmacy contractors will scale and flex their capacity in response to local needs.
Bexley HWB will continue to monitor pharmaceutical service provision in specific areas within the locality where major housing developments are planned, to ensure there is the capacity to meet potential increases in service demand.
No gaps in the provision of Necessary Services have been identified for Clocktower locality.
6.2.2.3 Other relevant services: current provision
Sections 3.2.4 and 3.2.5 show the pharmacies providing Advanced and Enhanced services in Clocktower locality.
Regarding access to Advanced Services, data for which pharmacies had signed up to the service was unavailable, however NHS BSA data for September 2024 – January 2025 demonstrated activity for these services as follows:
- Pharmacy First – 15 (100%) pharmacies delivered this service
- Flu Vaccination – 14 (93%) pharmacies delivered this service
- Pharmacy Contraception – 9 (60%) pharmacies delivered this service
- Hypertension case-finding – 12 (80%) pharmacies delivered this service
- New Medicine Service – 13 (87%) pharmacies delivered this service
- Smoking Cessation – no pharmacies delivered this service
- Appliance use review – no pharmacies delivered this service
- Stoma appliance customisation – no pharmacies delivered this service
- Lateral Flow Device Tests – 8 (53%) pharmacies delivered this service.
It can be seen that there is good availability of Pharmacy first (100%), Flu Vaccination (93%) and NMS (87%) in the locality. There is currently a lower number of providers of LFD supply (53%) and Pharmacy Contraception (60%).
At the time of writing, which pharmacies were providing the Enhanced Services was unavailable.
6.2.2.4 Improvements and better access: gaps in provision
Regarding access to services commissioned by ICB in the 15 community pharmacies:
- three pharmacies (20%) provide access to the Health and Wellbeing Scheme (Vital 5)
- one pharmacy (7%) provides the Inhaler Recycling Scheme
Regarding access to services commissioned by LBB in the 15 community pharmacies:
- two pharmacies (13%) provide Needle exchange services
- three pharmacies (20%) provide Supervised Administration of Medicine Services
- the other two LAS have no pharmacies currently offering them
Consideration should be given to incentives for further uptake from current providers and extending provision through community pharmacies including plans for the implementation of the recently introduced Advanced Service – the hypertension case-finding service – and the smoking cessation Advanced Service.
No gaps have been identified that if provided either now or in the future (next three years) would secure improvements or better access to services across Clocktower locality.
6.2.3 Frognal
Frognal locality has a population of 68,245 of which 84.5% is White British, 6.7% Asian/Asian British or Asian Welsh, 4.0% Black/Black British/Black Welsh/Caribbean/African, 3.2% Mixed/Multiple ethnicities and 1.6% are another ethnic group. This is quite diverse locality in Bexley and relatively affluent compared to the Bexley and London figures. Population density is relatively lower to the east of the locality and higher in the west of the locality.
The number of households in Frognal that own a car or van is 81.3%, which is higher than the Bexley value and the highest across the three localities.
The health of the population of Frognal, mainly taken from Frognal QOF PCN data and APL PCN QOF data, shows that the locality has notified health issues such as atrial fibrillations, cancer, stroke, hypertension and Chronic Obstructive Pulmonary Disease (COPD), where QOF figures are higher than Bexley and England values. For dementia prevalence ranges, Frognal PCN reports the highest prevalence (1.4%), significantly above the England average (0.74%) and the Bexley average (0.80%).
6.2.3.1 Necessary Services: current provision
There are 14 community pharmacies in this locality. The estimated average number of community pharmacies per 100,000 population is 20.5, above the England average of 18.1 and the Bexley average of 18.3. Of the 14 pharmacies, 13 hold a standard 40-core hour contract and one is a DSP.
Of the 14 community pharmacies:
- nine pharmacies (64%) are open after 6 pm on weekdays
- 13 pharmacies (93%) are open on Saturdays
- one pharmacy (8%) is open on Sundays
There is one PhAS in Frognal.
There are also a number of accessible providers open in neighbouring localities of Clocktower and North Bexley, and HWB areas of Greenwich, Bromley and Kent.
6.2.3.2 Necessary Services: gaps in provision
Generally, there is adequate pharmaceutical service provision across the whole locality to ensure continuity of provision to the new developments.
With projected increases in population and corresponding demand, pharmacies, particularly those operating as sole providers, may experience increased footfall and service pressures. While current access is considered adequate, this assessment assumes that existing pharmacies will adapt to meet rising demand.
The rationale for determining no current gap in provision is based not only on physical access but also on the expectation that pharmacy contractors will scale and flex their capacity in response to local needs.
Bexley HWB will continue to monitor pharmaceutical service provision in specific areas within the locality where major housing developments are planned, to ensure there is the capacity to meet potential increases in service demand.
No gaps in the provision of Necessary Services have been identified for Frognal locality.
6.2.3.3 Other relevant services: current provision
Sections 3.2.4 and 3.2.5 show the pharmacies providing Advanced and Enhanced Services in Frognal locality.
Regarding access to Advanced Services, data for which pharmacies had signed up to the service was unavailable, however NHSBSA data for September 2024 – January 2025 demonstrated activity for these services as follows:
- Pharmacy First – 13 (93%) pharmacies delivered this service
- Flu Vaccination – 12 (86%) pharmacies delivered this service
- Pharmacy Contraception – 8 (57%) pharmacies delivered this service
- Hypertension case-finding – 10 (71%) pharmacies delivered this service
- New Medicine Service – 12 (86%) pharmacies delivered this service
- Smoking cessation – no pharmacies delivered this service
- Appliance use review – no pharmacies delivered this service
- Stoma appliance customisation – no pharmacies delivered this service
- LFD Tests – 4 (29%) pharmacies delivered this service
It can be seen that there is good availability of Pharmacy First (93%), Flu vaccination (86%) and NMS (86%) in the locality. There is currently a lower number of providers of Pharmacy Contraception (57%) and the LFD supply (29%).
At the time of writing, which pharmacies were providing the Enhanced Services was unavailable.
6.2.3.4 Improvements and better access: gaps in provision
Regarding access to services commissioned by ICB in the 13 community pharmacies (excluding the DSP):
- two pharmacies (15%) provide the Inhaler Recycling Scheme
- no pharmacies provide the Health and Wellbeing Scheme (Vital 5)
Regarding access to services commissioned by LBB in the 13 community pharmacies:
- three pharmacies (23%) provide Substance Misuse services
- one pharmacy (8%) provides Needle Exchange services
- four pharmacies (31%) provide Supervised Administration of Medicines services
- four pharmacies (31%) provide Sexual health services
Consideration should be given to incentives for further uptake from current providers and extending provision through current community pharmacies, including plans for the implementation of the recently introduced Advanced Service – the hypertension case-finding service – and the smoking cessation Advanced Service, and of current locally commissioned services, to further support those areas of higher deprivation within this locality.
No gaps have been identified that if provided either now or in the future (next three years) would secure improvements or better access to services in Frognal locality.
6.3 Pharmaceutical services and health needs across Bexley
Bexley has a population of 246,466, of which 71.9% is white British, 12.2% Black/Black British/Black Welsh/Caribbean/African, 9.9% Asian/Asian British/Asian Welsh, 3.5% Mixed/Multiple ethnic groups, and 2.6% are another ethnic group, making this borough quite a diverse area. For some members who identify as an ethnic minority, English may not be their first language and therefore may create a barrier to accessing pharmaceutical services. Residents may use apps, such as Google Translate, or a member of pharmacy staff to translate; however, a commissioned translation and interpretation service would be beneficial for current pharmacy contractors.
There is no evidence to suggest there is a gap in service that would equate to the need for additional access to Necessary Services inside or outside normal hours anywhere in Bexley. There is an opportunity for the SEL ICB and HWB to improve understanding of Community Pharmacy services with minority groups to maximise the access from existing Community Pharmacy networks.
Bexley has lower levels of deprivation compared to England averages. The JSNA noted Bexley is in the least deprived quintile, quintile 5, in England according to the IMD, ranking 190 out of 317 upper tier local authorities in England in 2021. There is more relative deprivation to the north, east and south of the borough, with the centre and west of the borough more relatively affluent. Population density is lower in the north and south-east and higher in the centre and south west of the borough. The number of households that own a car or van is 77.6%, higher than the England average.
- 98% of the population are able to walk to a pharmacy within 20 minutes
- 100% of the population in Bexley can get to a pharmacy within 20 minutes when choosing to drive, whether this is off peak or at peak times
- 97% are able to travel via public transport to a pharmacy within 20 minutes
The health of the population in Bexley is affected by a number of factors, including:
- QOF PCN data – there was variability across the four PCNs demonstrated by QOF data with Frognal PCN and APL PCN showing higher QOF levels compared to Bexley and/or England levels
- life expectancy - Healthy life expectancy at birth for males in Bexley is higher than the London and England averages
- cancer screening - Bexley performs above the regional and England average for cervical cancer screening
- obesity - Obesity is a health priority in Bexley, and children from Black minority ethnic backgrounds are more likely to be overweight or obese, particularly in the north of the borough
- winter deaths – reported for men and women was higher than the London and England averages
6.3.1 Necessary Services: current provision across Bexley
There are 45 community pharmacies, including two DSPs, in Bexley. There are 18.3 community pharmacies per 100,000 population in Bexley, compared with 18.1 per 100,000 in England.
| Type of contractor | Number |
|---|---|
| 40-hour community pharmacies (including one PhAS) | 42 |
| 72-hour community pharmacies | 1 |
| DSPs | 2 |
| LPS providers | 0 |
| DAC | 0 |
| GP dispensing practice | 0 |
| Total | 45 |
There is one 72+ hour pharmacy in Bexley and there are many pharmacies open on weekday evenings and on weekends. The majority of community pharmacies (89%) are open on Saturdays, and 53% open after 6 pm on weekdays. There are also four pharmacies (9%) open on Sundays in Bexley.
Bexley has community pharmacies on the border with the HWBs of Bromley, Greenwich and Kent. These pharmacies in the neighbouring HWBs can be accessed by Bexley residents.
6.3.2 Necessary Services: gaps in provision across Bexley
There is excellent pharmaceutical service provision across the whole area to ensure continuity of provision to the new developments. The borough population growth is expected to increase from 2025 to 2030 by 1.9%, and the number of dwellings to increase to 4,151 dwellings, much of which is after 2028, therefore, the majority of these housing developments will fall outside the lifespan of this PNA. This represents a very small change that can be easily absorbed by the existing community pharmacy network. The projected population growth should not impact access to pharmaceutical services.
The ratio of community pharmacies to 100,000 population is higher than the England value. There is good pharmaceutical service provision across the whole borough and access to community pharmacies in neighbouring HWBs to ensure continuity of provision to the new developments.
Bexley HWB will continue to monitor pharmaceutical service provision in specific areas where major housing developments are planned, to ensure there is the capacity to meet potential increases in service demand.
No gaps in the provision of Necessary Services have been identified for Bexley HWB.
6.3.3 Other relevant services: current provision
Sections 3.2.4 and 3.2.5 show the pharmacies providing Advanced and Enhanced Services in Bexley. There is very good availability of advanced services.
Regarding access to Advanced Services, data for which pharmacies had signed up to the service was unavailable, however NHS BSA data for September 2024 – January 2025 demonstrated activity for these services as follows:
- Pharmacy First – 43 (96%) pharmacies delivered this service
- Flu Vaccination – 40 (89%) pharmacies delivered this service
- Pharmacy Contraception – 24 (53%) pharmacies delivered this service
- Hypertension case-finding – 33 (73%) pharmacies delivered this service
- New Medicine Service – 41 (91%) pharmacies delivered this service
- Smoking cessation – no pharmacies delivered this service
- Appliance use review – no pharmacies delivered this service
- Stoma appliance customisation – no pharmacies delivered this service
- LFD Tests – 18 (40%) pharmacies delivered this service
The Flu vaccination service can be provided by any pharmacy that fulfils the criteria.
The Enhanced COVID-19 vaccination service providers can change with each campaign, and the Bank Holiday opening service can change for each bank holiday. Two pharmacies currently deliver the MMR vaccination service in Bexley.
6.3.4 Improvements and better access: gaps in provision across Bexley
Regarding access to services commissioned by ICB:
- six pharmacies (14%) provide the Health and Wellbeing Scheme (Vital 5)
- four pharmacies (9%) provide the Inhaler recycling scheme
Regarding access to services commissioned by LBB:
- four pharmacies (9%) provide the substance misuse services
- six pharmacies (14%) provide needle exchange
- 15 pharmacies (33%) provide the supervised administration of medicines
- five pharmacies (11%) provide sexual health service
All Advanced, Enhanced and locally commissioned services are available in Bexley and have varying opening times.
Consideration should be given to incentives for further uptake from current providers and extending provision through community pharmacies including plans for increase uptake of the recently introduced Advanced Services, Pharmacy First, the Hypertension case-finding service, PCS and the smoking cessation Advanced Service. The ICS needs to look at increasing service uptake through existing providers working with place-based stakeholders.
No gaps have been identified that if provided either now or in the future (next three years) would secure improvements or better access to services across Bexley.