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10. Required statements from pharmaceutical

10.1 Statement one: Necessary services: Current provision

Provide a statement of the pharmaceutical services that the Health and Wellbeing Board (HWB) has identified as services that are provided:

a) in the area of the HWB and which are necessary to meet the need for pharmaceutical services in its area; and

b) outside the area of the HWB but which nevertheless contribute towards meeting the need for pharmaceutical services in its area (if the HWB has identified such services).

This PNA has shown that the 68 community pharmacies in CW&C provide adequate coverage of services in terms of geographical location, accessibility through walk and drive times and convenient opening times throughout the week and at weekends. This coverage is supplemented by suitably commissioned rotas, dispensing doctors, distance-selling pharmacies, and pharmacies in neighbouring Local Authorities (LA’s). All pharmacies provide essential services with a range of advanced, enhanced and commissioned services, which are considered necessary and collectively provide sufficient cover across CW&C. These services are thought adequate, taking into account such factors as the local demography and deprivation patterns.

CW&C has a larger number of pharmacies in relation to the size of its population (18.9 per 100,000) when compared to England average (18.4 per 100,000). However, CW&Cs average number of prescription items per month per 1,000 population is higher than the England average.

CW&C residents will also access dispensing doctors of which there are four in the borough and one in Cheshire East providing support to registered CW&C patients, and pharmacy services in the neighbouring boroughs Cheshire East, Wirral, Warrington, Halton and Shropshire, as well as North Wales. Services are considered sufficient for the population’s needs.

10.2 Statement two: Necessary services: Gaps in provision

Provide a statement of the pharmaceutical services that the HWB has identified (if it has) as services that are not provided in the area of the HWB but which the HWB is satisfied:

a) need to be provided (whether or not they are located in the area of the HWB) in order to meet a current need for pharmaceutical services, or pharmaceutical services of a specified type, in its area.

b) will, in specified future circumstances, need to be provided (whether or not they are located in the area of the HWB) in order to meet a future need for pharmaceutical services, or pharmaceutical services of a specified type, in its area.

Current provision across CW&C as a whole is adequate. No gaps in the provision of essential pharmaceutical services have been identified in this PNA. There are on-going housing developments planned over the lifetime of this PNA, predominantly in Northwich and Ellesmere Port which have higher or similar pharmacy-to-population ratios than the CW&C average, respectively.

Some geographical differences in provision have been highlighted through this PNA. In keeping with the national picture, services are predominantly situated in more densely populated areas of the borough where opening hours after 6pm are more available, as is weekend opening. The lowest rates of pharmacy-to-population ratios are seen in Chester East and Winsford community partnerships. Neston and Willaston community partnership has no pharmacies that are open after 6pm and does not have a pharmacy open on a Sunday. Helsby and Frodsham also does not have a pharmacy open on a Sunday and Rural community partnership has one open for just one hour. However, coverage across CW&C is sufficient. The need for ‘emergency prescriptions’ will almost always be centred on patients using out of hours services. CW&C is currently covered by GP Out of Hours (via NHS 111) and the Urgent Care Centre at the Countess of Chester Hospital.

Respondents to the public survey commonly commented that it is not always easy to access pharmacy services in the evening, i.e. after 6pm, and weekends. ICB commissioning can direct existing pharmacies to open for additional hours such as extending existing opening hours as a locally commissioned Enhanced Service if required.

Community Pharmacy England notes that:

“if the needs of people in the area are not met, and no pharmacies are able or willing to participate in an out of hours Enhanced service, an ICB has the power to issue a direction requiring the pharmacy to open, but must if doing so ensure the pharmacy receives reasonable remuneration. The process of issuing such a direction begins with discussions with the Local Pharmaceutical Committee (LPC) and the affected pharmacies must be contacted by the ICB and the proposals outlined so that the pharmacy owner can make representations. There are rights of appeal against ICBs decisions to issue such directions, and the direction would be valid only if the statutory procedure is followed.”

10.3 Statement three: Other relevant services: Current provision

Provide a statement of the pharmaceutical services that the HWB has identified (if it has) as services that are provided:

a) in the area of the HWB and which, although they are not necessary to meet the need for pharmaceutical services in its area, nevertheless have secured improvements, or better access to pharmaceutical services in its area.

b) outside the area of the HWB and which, although they do not contribute towards meeting the need for pharmaceutical services in its area, nevertheless have secured improvements, or better access, to pharmaceutical services in its area.

c) in or outside the area of the HWB and, whilst not being services of the types described in subparagraph (A) or (B), or paragraph one, of the 2013 regulations, they nevertheless affect the assessment by the HWB of the need for pharmaceutical services in its area.

CW&C has five dispensing doctors in rural areas who can dispense medicines to their patients (one located in Cheshire East). These doctors support the large amount of non-pharmacy dispensing in CW&C. There are strict regulations which stipulate when and to whom doctors can dispense.

CW&C has geographical borders with North Wales, Cheshire East, Shropshire, Warrington, Wirral and Halton. Members of the CW&C population will cross these borders for leisure and work purposes and also access pharmacy services if it is more convenient for them, and not necessarily due to there being sufficient service in CW&C.

The bank holiday rota coordinates services across boundaries to ensure geographical coverage.

In addition to essential services, there is adequate access to the full range of advanced and enhanced services, and locally commissioned public health and sub-integrated care board services to meet local need.

10.4 Statement Four: Improvements and better access: Gaps in provision

Provide a statement of the pharmaceutical services that the HWB has identified (if it has) as services that are not provided in the area of the HWB but which the HWB is satisfied:

a) would, if they were provided (whether or not they were located in the area of the HWB), secure improvements, or better access to pharmaceutical services, or pharmaceutical services of a specific type, in its area.

b) would, if in specified future circumstances they were provided (whether or not they were located in the area of the HWB), secure future improvements, or better access, to pharmaceutical services, or pharmaceutical services or a specified type, in its area.

Based on the information available at the time of developing this PNA, no gaps have been identified in essential, advanced or enhanced services that if provided either now or in the future would secure improvements, or better access, to pharmaceutical services. A review of service need and access to commissioned substance misuse services (needle exchange and supervised consumption) and Sharps Return are being progressed. There is no provision for appliance use reviews (AUR) and stoma appliance customisation service in CW&C. This is provided in bordering localities and undertaken remotely to support patient confidentiality.

All residents are within a 15-minute drive to a pharmacy, and the majority a 30 minute commute on public transport or 20 minute walk.

The most common concerns in the public survey were medicine shortages, waiting times to collect a prescription, and waiting times in the pharmacies. Comments also highlighted that it is not always easy to access pharmacy services in the evening, i.e. after 6pm, and weekends. As well as changes to existing contractor hours, opportunities could also be explored around increasing the use of technology to support timely prescribing where practicable and safe to do so.

It is important that community pharmacy services can continue to support the changes that face the NHS as commissioning intentions change or evolve to reduce the pressures on other patient facing services such as GPs and Accident & Emergency. However, in the current financial climate there is limited capacity to deliver additional services within static or reducing budgets. There should also be recognition and understanding of the context related to a number of national, regional and local strategies and policies from which opportunities may arise in their delivery such as the NHS 10 year Plan and locally the Cheshire West Place Plan.

The skills and expertise of community pharmacists could be further utilised in the provision of locally commissioned services aimed at improving population health. Assessment of future plans for housing developments within CW&C has highlighted increasing populations in Northwich and Ellesmere Port. It is envisaged that capacity within existing services will be able to absorb the increased demand anticipated over the lifespan of this PNA. Any identified change in the situation may be addressed by the ICB commissioning or directing existing pharmacies to open for additional hours under an Enhanced Service without the need for a new community pharmacy.

10.5 Statement five: Other NHS services

Provide a statement of any NHS services provided or arranged by the CW&C HWB, NHS England, Cheshire & Merseyside Integrated Care Board (ICB), any NHS trusts or any NHS foundation trust to which the HWB has had regard in its assessment, which affect:

a) the need for pharmaceutical services, or pharmaceutical services of a specified type, in its area or

b) whether further provision of pharmaceutical services in its area would secure improvements, or better access to pharmaceutical services, or pharmaceutical services of a specific type in its area.

Based on the information available at the time of developing this PNA, no gaps in respect of securing improvements, or better access, to other NHS services either now or in specified future circumstances have been identified.

10.6 Statement Six: How the assessment was carried out

Provide an explanation of how the assessment has been carried out, in particular:

a) how it has determined what are the localities in its area.

b) how it has taken into account (where applicable)

  • the different needs of different localities in its area, and
  • the different needs of people in its area who share a protected characteristic and

c) a report on the consultation that it has undertaken.

This assessment has been performed using health needs information obtained from Cheshire West and Chester’s Joint Strategic Needs Assessment and Office for Health Improvement and Disparities (OHID) Public Health Profiles 2025, https://fingertips.phe.org.uk, Crown copyright 2025.

In addition, prescribing and dispensing data was provided by the Cheshire and Merseyside ICB. This was supplemented with results from a questionnaire on pharmacy services sent to all community pharmacy contractors in the county. All data were considered by the PNA working group which comprised representatives from the Local Pharmaceutical Committee, Local Medical Committee, Cheshire West and Chester Council’s Public Health team, Cheshire West and Chester Council’s Insight and Intelligence Team, HealthWatch, and Cheshire and Merseyside ICB under the direction of the Director of Public Health. Decisions were taken according to consensus and the main drafts were scrutinised by the Health and Wellbeing Board.

This PNA has described the pharmaceutical needs and service delivery in terms of the Cheshire West and Chester community partnerships where possible. These were chosen because of the wealth of intelligence available and it being a shared geography by the LA and ICB. It was also considered sensible to use the same boundaries which the Council and ICB use for their planning and development. The differences in CW&C regarding health status, age-sex breakdown and deprivation scores together with other information on protected characteristics from the Equality Act 2010 were highlighted to tease out the implications for pharmaceutical need. The Pharmacy Contractor survey specifically asked if the respondents were aware of any issues related to protected characteristics.

10.7 Map of provision

A map that identifies the premises at which pharmaceutical services are provided in the area of the HWB.

Map showing the spread of community pharmacies in Cheshire West and Chester.

10. Required statements from pharmaceutical

10.1 Statement one: Necessary services: Current provision

Provide a statement of the pharmaceutical services that the Health and Wellbeing Board (HWB) has identified as services that are provided:

a) in the area of the HWB and which are necessary to meet the need for pharmaceutical services in its area; and

b) outside the area of the HWB but which nevertheless contribute towards meeting the need for pharmaceutical services in its area (if the HWB has identified such services).

This PNA has shown that the 68 community pharmacies in CW&C provide adequate coverage of services in terms of geographical location, accessibility through walk and drive times and convenient opening times throughout the week and at weekends. This coverage is supplemented by suitably commissioned rotas, dispensing doctors, distance-selling pharmacies, and pharmacies in neighbouring Local Authorities (LA’s). All pharmacies provide essential services with a range of advanced, enhanced and commissioned services, which are considered necessary and collectively provide sufficient cover across CW&C. These services are thought adequate, taking into account such factors as the local demography and deprivation patterns.

CW&C has a larger number of pharmacies in relation to the size of its population (18.9 per 100,000) when compared to England average (18.4 per 100,000). However, CW&Cs average number of prescription items per month per 1,000 population is higher than the England average.

CW&C residents will also access dispensing doctors of which there are four in the borough and one in Cheshire East providing support to registered CW&C patients, and pharmacy services in the neighbouring boroughs Cheshire East, Wirral, Warrington, Halton and Shropshire, as well as North Wales. Services are considered sufficient for the population’s needs.

10.2 Statement two: Necessary services: Gaps in provision

Provide a statement of the pharmaceutical services that the HWB has identified (if it has) as services that are not provided in the area of the HWB but which the HWB is satisfied:

a) need to be provided (whether or not they are located in the area of the HWB) in order to meet a current need for pharmaceutical services, or pharmaceutical services of a specified type, in its area.

b) will, in specified future circumstances, need to be provided (whether or not they are located in the area of the HWB) in order to meet a future need for pharmaceutical services, or pharmaceutical services of a specified type, in its area.

Current provision across CW&C as a whole is adequate. No gaps in the provision of essential pharmaceutical services have been identified in this PNA. There are on-going housing developments planned over the lifetime of this PNA, predominantly in Northwich and Ellesmere Port which have higher or similar pharmacy-to-population ratios than the CW&C average, respectively.

Some geographical differences in provision have been highlighted through this PNA. In keeping with the national picture, services are predominantly situated in more densely populated areas of the borough where opening hours after 6pm are more available, as is weekend opening. The lowest rates of pharmacy-to-population ratios are seen in Chester East and Winsford community partnerships. Neston and Willaston community partnership has no pharmacies that are open after 6pm and does not have a pharmacy open on a Sunday. Helsby and Frodsham also does not have a pharmacy open on a Sunday and Rural community partnership has one open for just one hour. However, coverage across CW&C is sufficient. The need for ‘emergency prescriptions’ will almost always be centred on patients using out of hours services. CW&C is currently covered by GP Out of Hours (via NHS 111) and the Urgent Care Centre at the Countess of Chester Hospital.

Respondents to the public survey commonly commented that it is not always easy to access pharmacy services in the evening, i.e. after 6pm, and weekends. ICB commissioning can direct existing pharmacies to open for additional hours such as extending existing opening hours as a locally commissioned Enhanced Service if required.

Community Pharmacy England notes that:

“if the needs of people in the area are not met, and no pharmacies are able or willing to participate in an out of hours Enhanced service, an ICB has the power to issue a direction requiring the pharmacy to open, but must if doing so ensure the pharmacy receives reasonable remuneration. The process of issuing such a direction begins with discussions with the Local Pharmaceutical Committee (LPC) and the affected pharmacies must be contacted by the ICB and the proposals outlined so that the pharmacy owner can make representations. There are rights of appeal against ICBs decisions to issue such directions, and the direction would be valid only if the statutory procedure is followed.”

10.3 Statement three: Other relevant services: Current provision

Provide a statement of the pharmaceutical services that the HWB has identified (if it has) as services that are provided:

a) in the area of the HWB and which, although they are not necessary to meet the need for pharmaceutical services in its area, nevertheless have secured improvements, or better access to pharmaceutical services in its area.

b) outside the area of the HWB and which, although they do not contribute towards meeting the need for pharmaceutical services in its area, nevertheless have secured improvements, or better access, to pharmaceutical services in its area.

c) in or outside the area of the HWB and, whilst not being services of the types described in subparagraph (A) or (B), or paragraph one, of the 2013 regulations, they nevertheless affect the assessment by the HWB of the need for pharmaceutical services in its area.

CW&C has five dispensing doctors in rural areas who can dispense medicines to their patients (one located in Cheshire East). These doctors support the large amount of non-pharmacy dispensing in CW&C. There are strict regulations which stipulate when and to whom doctors can dispense.

CW&C has geographical borders with North Wales, Cheshire East, Shropshire, Warrington, Wirral and Halton. Members of the CW&C population will cross these borders for leisure and work purposes and also access pharmacy services if it is more convenient for them, and not necessarily due to there being sufficient service in CW&C.

The bank holiday rota coordinates services across boundaries to ensure geographical coverage.

In addition to essential services, there is adequate access to the full range of advanced and enhanced services, and locally commissioned public health and sub-integrated care board services to meet local need.

10.4 Statement Four: Improvements and better access: Gaps in provision

Provide a statement of the pharmaceutical services that the HWB has identified (if it has) as services that are not provided in the area of the HWB but which the HWB is satisfied:

a) would, if they were provided (whether or not they were located in the area of the HWB), secure improvements, or better access to pharmaceutical services, or pharmaceutical services of a specific type, in its area.

b) would, if in specified future circumstances they were provided (whether or not they were located in the area of the HWB), secure future improvements, or better access, to pharmaceutical services, or pharmaceutical services or a specified type, in its area.

Based on the information available at the time of developing this PNA, no gaps have been identified in essential, advanced or enhanced services that if provided either now or in the future would secure improvements, or better access, to pharmaceutical services. A review of service need and access to commissioned substance misuse services (needle exchange and supervised consumption) and Sharps Return are being progressed. There is no provision for appliance use reviews (AUR) and stoma appliance customisation service in CW&C. This is provided in bordering localities and undertaken remotely to support patient confidentiality.

All residents are within a 15-minute drive to a pharmacy, and the majority a 30 minute commute on public transport or 20 minute walk.

The most common concerns in the public survey were medicine shortages, waiting times to collect a prescription, and waiting times in the pharmacies. Comments also highlighted that it is not always easy to access pharmacy services in the evening, i.e. after 6pm, and weekends. As well as changes to existing contractor hours, opportunities could also be explored around increasing the use of technology to support timely prescribing where practicable and safe to do so.

It is important that community pharmacy services can continue to support the changes that face the NHS as commissioning intentions change or evolve to reduce the pressures on other patient facing services such as GPs and Accident & Emergency. However, in the current financial climate there is limited capacity to deliver additional services within static or reducing budgets. There should also be recognition and understanding of the context related to a number of national, regional and local strategies and policies from which opportunities may arise in their delivery such as the NHS 10 year Plan and locally the Cheshire West Place Plan.

The skills and expertise of community pharmacists could be further utilised in the provision of locally commissioned services aimed at improving population health. Assessment of future plans for housing developments within CW&C has highlighted increasing populations in Northwich and Ellesmere Port. It is envisaged that capacity within existing services will be able to absorb the increased demand anticipated over the lifespan of this PNA. Any identified change in the situation may be addressed by the ICB commissioning or directing existing pharmacies to open for additional hours under an Enhanced Service without the need for a new community pharmacy.

10.5 Statement five: Other NHS services

Provide a statement of any NHS services provided or arranged by the CW&C HWB, NHS England, Cheshire & Merseyside Integrated Care Board (ICB), any NHS trusts or any NHS foundation trust to which the HWB has had regard in its assessment, which affect:

a) the need for pharmaceutical services, or pharmaceutical services of a specified type, in its area or

b) whether further provision of pharmaceutical services in its area would secure improvements, or better access to pharmaceutical services, or pharmaceutical services of a specific type in its area.

Based on the information available at the time of developing this PNA, no gaps in respect of securing improvements, or better access, to other NHS services either now or in specified future circumstances have been identified.

10.6 Statement Six: How the assessment was carried out

Provide an explanation of how the assessment has been carried out, in particular:

a) how it has determined what are the localities in its area.

b) how it has taken into account (where applicable)

  • the different needs of different localities in its area, and
  • the different needs of people in its area who share a protected characteristic and

c) a report on the consultation that it has undertaken.

This assessment has been performed using health needs information obtained from Cheshire West and Chester’s Joint Strategic Needs Assessment and Office for Health Improvement and Disparities (OHID) Public Health Profiles 2025, https://fingertips.phe.org.uk, Crown copyright 2025.

In addition, prescribing and dispensing data was provided by the Cheshire and Merseyside ICB. This was supplemented with results from a questionnaire on pharmacy services sent to all community pharmacy contractors in the county. All data were considered by the PNA working group which comprised representatives from the Local Pharmaceutical Committee, Local Medical Committee, Cheshire West and Chester Council’s Public Health team, Cheshire West and Chester Council’s Insight and Intelligence Team, HealthWatch, and Cheshire and Merseyside ICB under the direction of the Director of Public Health. Decisions were taken according to consensus and the main drafts were scrutinised by the Health and Wellbeing Board.

This PNA has described the pharmaceutical needs and service delivery in terms of the Cheshire West and Chester community partnerships where possible. These were chosen because of the wealth of intelligence available and it being a shared geography by the LA and ICB. It was also considered sensible to use the same boundaries which the Council and ICB use for their planning and development. The differences in CW&C regarding health status, age-sex breakdown and deprivation scores together with other information on protected characteristics from the Equality Act 2010 were highlighted to tease out the implications for pharmaceutical need. The Pharmacy Contractor survey specifically asked if the respondents were aware of any issues related to protected characteristics.

10.7 Map of provision

A map that identifies the premises at which pharmaceutical services are provided in the area of the HWB.

Map showing the spread of community pharmacies in Cheshire West and Chester.