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Introduction and key findings

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1. Introduction

The requirement to produce a Pharmaceutical Needs Assessment (PNA) is a statutory responsibility of the Health and Wellbeing Board by virtue of the National Health Service (NHS) Regulations 2013. The regulations outline the process which NHS England must comply with in dealing with applications for new pharmacies, or changes to existing pharmacies. This process relies on the PNA, which must be robust and fit for purpose.

In Cheshire West and Chester (CW&C), the Health and Wellbeing Board has devolved the authority to develop its PNA to the Director of Public Health. Development was overseen by a PNA multi-professional steering group. Data sources include the Joint Strategic Needs Assessment (JSNA), Census data, Office for Health Improvement and Disparities (OHID) Fingertips public health data tool, prescribing and dispensing data, a pharmacy contractors’ survey, and a public pharmacy survey.

The PNA presents a picture of community pharmacies, and reviews services provided at the time of writing to understand potential gaps in provision. This is a summary of the full PNA. To request the full report please email publichealth@cheshirewestandchester.gov.uk or visit www.cheshirewestandchester.gov.uk/pna-consultation.

2. Key findings

The provision of pharmacy services within Cheshire West and Chester, in terms of location, opening hours and advanced and enhanced services provided, is considered adequate to meet the needs of the population. As such, this PNA has not identified a current need for new NHS pharmaceutical service providers in Cheshire West and Chester at the point this PNA was produced (January 2025).


  • Traditionally the main functioning of pharmacies was the dispensing of medicines, and this is still a central function, but pharmacies are a rich resource with a highly skilled workforce who more than ever are contributing to the health and wellbeing of their local population through a range of services including the advanced ‘Pharmacy First Service’.
  • In the borough of CW&C there are 68 community pharmacies and one distance selling pharmacy (A Distance Selling Pharmacy is a type of pharmacy that works exclusively at a distance from patients. They are online pharmacies, this includes mail order and internet pharmacies that remotely manage patient’s medicine logistics and distribution remotely.)
  • Pharmacy provision at January 2025 is considered sufficient to meet the needs of the population:
    • CW&C has a slightly higher pharmacy-to-population ratio than the England average. There is adequate geographical coverage of pharmacies, with dispensing support from four dispensing doctors and cross-border pharmacies.
    • At January 2025, all residents are within a 15-minute drive of a pharmacy, even in rush hour. There is good access via public transport with over 90% of residents within a 30-minute commute. Access is more limited for walking to a pharmacy – 84% of residents are within a 20-minute walk. The majority of those that are not, live in rural areas.
    • Chronic conditions, obesity, and premature death are higher for residents living in the most deprived areas of the borough and these areas in particular dictate a need for the full range of pharmaceutical services. All residents living in the most deprived areas of the borough are within a 15-minute walk or commute to a pharmacy.
    • Opening hours of pharmacies are considered sufficient at January 2025, but if further amendments to evening and weekend opening take place, the impact on residents should be reviewed.
  • We are mindful of recent pharmacy closures that have taken place both nationally and locally. For CW&C, this includes eight community pharmacy closures since the production of the 2022-25 PNA. Other changes during this time have included an increase in average dispensing volume, and new housing developments focussed in Chester. It must be acknowledged that pharmacies are under pressure, and the impact of further pharmacy closures during the lifespan of this PNA will need to be reviewed, particularly in community partnership areas with already lower pharmacy-to-population ratios than the CW&C average. This includes Chester East, Winsford, Rural, Chester Central, and Ellesmere Port.
  • A broad range of advanced and locally commissioned services are provided in addition to essential services:
    • At January 2025 there is good coverage of all advanced services across the borough. This excludes Appliance Use Reviews (AUR) and Stoma appliance customisation (SAC) services, which are both specialist services. This is not considered a gap as appliances can be accessed remotely from contractors located in Cheshire and Merseyside, supporting both patient confidentiality and delivery of large items.
    • There is at least one pharmacy in each community partnership area providing the COVID-19 vaccination enhanced service for eligible populations. This is in addition to other COVID-19 vaccination services such as the Living Well Bus.
    • Although outside of the scope of the PNA, locally commissioned services have been reviewed. The PNA has demonstrated potential service need and access improvements for pharmacy supervised consumption, needle exchange, and sharps return services, which will be reviewed by commissioners. Cheshire and Merseyside ICB are also reviewing options to harmonise and improve equity of access to the urgent palliative care medicines services across all areas of Cheshire and Merseyside.
  • The CW&C pharmacy survey (November 2024) found that residents value having a pharmacy nearby, but also highlighted medicine unavailability, long waiting times for prescription collection, and long wait times in the pharmacies. This reflects the challenges that pharmacies are facing with increasing demand, medicine shortages and financial pressures.
  • The number of residents accessing community pharmacies is growing:
    • There will be large housing developments during the lifetime of this 2025-2028 PNA in Ellesmere Port and Northwich community partnerships. It is anticipated that capacity within existing services should be able to support the overall pharmaceutical needs of future populations, and pharmacies in these community partnerships have sufficient opening times and availability of services.
    • Population estimates show there is a greater proportion of older people in CW&C than the England average. As older people generally take more medicines than the younger population, community pharmacies will experience a greater workload in terms of dispensing and support for self-care. Furthermore, this workload is likely to increase, as population forecasts suggest that the proportion of people aged 65 and over is expected to rise by 22% by 2033 to an estimated 96,000.
    • Overall health status within CW&C is generally good with residents expected to spend a higher proportion of their lives in good health than the England average. However, CW&C has a higher prevalence of patients with a long-term condition or disease than the England average including cancer, coronary heart disease, stroke, heart failure, atrial fibrillation, Chronic Obstructive Pulmonary Disease (COPD), hypertension, rheumatoid arthritis and osteoporosis. These numbers are expected to rise with our ageing population.

1. Introduction

The requirement to produce a Pharmaceutical Needs Assessment (PNA) is a statutory responsibility of the Health and Wellbeing Board by virtue of the National Health Service (NHS) Regulations 2013. The regulations outline the process which NHS England must comply with in dealing with applications for new pharmacies, or changes to existing pharmacies. This process relies on the PNA, which must be robust and fit for purpose.

In Cheshire West and Chester (CW&C), the Health and Wellbeing Board has devolved the authority to develop its PNA to the Director of Public Health. Development was overseen by a PNA multi-professional steering group. Data sources include the Joint Strategic Needs Assessment (JSNA), Census data, Office for Health Improvement and Disparities (OHID) Fingertips public health data tool, prescribing and dispensing data, a pharmacy contractors’ survey, and a public pharmacy survey.

The PNA presents a picture of community pharmacies, and reviews services provided at the time of writing to understand potential gaps in provision. This is a summary of the full PNA. To request the full report please email publichealth@cheshirewestandchester.gov.uk or visit www.cheshirewestandchester.gov.uk/pna-consultation.

2. Key findings

The provision of pharmacy services within Cheshire West and Chester, in terms of location, opening hours and advanced and enhanced services provided, is considered adequate to meet the needs of the population. As such, this PNA has not identified a current need for new NHS pharmaceutical service providers in Cheshire West and Chester at the point this PNA was produced (January 2025).


  • Traditionally the main functioning of pharmacies was the dispensing of medicines, and this is still a central function, but pharmacies are a rich resource with a highly skilled workforce who more than ever are contributing to the health and wellbeing of their local population through a range of services including the advanced ‘Pharmacy First Service’.
  • In the borough of CW&C there are 68 community pharmacies and one distance selling pharmacy (A Distance Selling Pharmacy is a type of pharmacy that works exclusively at a distance from patients. They are online pharmacies, this includes mail order and internet pharmacies that remotely manage patient’s medicine logistics and distribution remotely.)
  • Pharmacy provision at January 2025 is considered sufficient to meet the needs of the population:
    • CW&C has a slightly higher pharmacy-to-population ratio than the England average. There is adequate geographical coverage of pharmacies, with dispensing support from four dispensing doctors and cross-border pharmacies.
    • At January 2025, all residents are within a 15-minute drive of a pharmacy, even in rush hour. There is good access via public transport with over 90% of residents within a 30-minute commute. Access is more limited for walking to a pharmacy – 84% of residents are within a 20-minute walk. The majority of those that are not, live in rural areas.
    • Chronic conditions, obesity, and premature death are higher for residents living in the most deprived areas of the borough and these areas in particular dictate a need for the full range of pharmaceutical services. All residents living in the most deprived areas of the borough are within a 15-minute walk or commute to a pharmacy.
    • Opening hours of pharmacies are considered sufficient at January 2025, but if further amendments to evening and weekend opening take place, the impact on residents should be reviewed.
  • We are mindful of recent pharmacy closures that have taken place both nationally and locally. For CW&C, this includes eight community pharmacy closures since the production of the 2022-25 PNA. Other changes during this time have included an increase in average dispensing volume, and new housing developments focussed in Chester. It must be acknowledged that pharmacies are under pressure, and the impact of further pharmacy closures during the lifespan of this PNA will need to be reviewed, particularly in community partnership areas with already lower pharmacy-to-population ratios than the CW&C average. This includes Chester East, Winsford, Rural, Chester Central, and Ellesmere Port.
  • A broad range of advanced and locally commissioned services are provided in addition to essential services:
    • At January 2025 there is good coverage of all advanced services across the borough. This excludes Appliance Use Reviews (AUR) and Stoma appliance customisation (SAC) services, which are both specialist services. This is not considered a gap as appliances can be accessed remotely from contractors located in Cheshire and Merseyside, supporting both patient confidentiality and delivery of large items.
    • There is at least one pharmacy in each community partnership area providing the COVID-19 vaccination enhanced service for eligible populations. This is in addition to other COVID-19 vaccination services such as the Living Well Bus.
    • Although outside of the scope of the PNA, locally commissioned services have been reviewed. The PNA has demonstrated potential service need and access improvements for pharmacy supervised consumption, needle exchange, and sharps return services, which will be reviewed by commissioners. Cheshire and Merseyside ICB are also reviewing options to harmonise and improve equity of access to the urgent palliative care medicines services across all areas of Cheshire and Merseyside.
  • The CW&C pharmacy survey (November 2024) found that residents value having a pharmacy nearby, but also highlighted medicine unavailability, long waiting times for prescription collection, and long wait times in the pharmacies. This reflects the challenges that pharmacies are facing with increasing demand, medicine shortages and financial pressures.
  • The number of residents accessing community pharmacies is growing:
    • There will be large housing developments during the lifetime of this 2025-2028 PNA in Ellesmere Port and Northwich community partnerships. It is anticipated that capacity within existing services should be able to support the overall pharmaceutical needs of future populations, and pharmacies in these community partnerships have sufficient opening times and availability of services.
    • Population estimates show there is a greater proportion of older people in CW&C than the England average. As older people generally take more medicines than the younger population, community pharmacies will experience a greater workload in terms of dispensing and support for self-care. Furthermore, this workload is likely to increase, as population forecasts suggest that the proportion of people aged 65 and over is expected to rise by 22% by 2033 to an estimated 96,000.
    • Overall health status within CW&C is generally good with residents expected to spend a higher proportion of their lives in good health than the England average. However, CW&C has a higher prevalence of patients with a long-term condition or disease than the England average including cancer, coronary heart disease, stroke, heart failure, atrial fibrillation, Chronic Obstructive Pulmonary Disease (COPD), hypertension, rheumatoid arthritis and osteoporosis. These numbers are expected to rise with our ageing population.