Vulnerability examined
Dr Kerry M O'Connor
England
Since 2013, there are only three ways a pharmacy could open up near a dispensing GP practice.
New applications: Under the 2013 regulations, the Pharmaceutical Needs Assessment (PNA) must be used as the basis for deciding a new pharmacy application. PNAs will next be revised in April 2015 and there is no appeal against a PNA. While the PNA may be amended between revisions, any amendments cannot be considered relevant to any decisions on applications.
A pharmacy can open only where the applicant can prove that, according to the PNA, the new pharmacy would:
- Fulfil an identified but unfulfilled current need
- Secure an identified future improvement or better access
- Secure unforeseen benefits
Each application can be for known, best estimate or unknown premises.
Relocations: The minor relocation for under and over 500m rules of the 2005 Regulations have been replaced by Reg 24 "Relocations which do not result in significant change". These relocations are not judged against a PNA
Distance-selling:Pharmacies may also open in controlled locations as a distance selling pharmacy, the only remaining ‘exception' to the 2013 market entry regulations. However, the arrival of such a pharmacy in a controlled location will not affect a practice's dispensing rights.
Under the current regulations, the greatest challenge facing a dispensing practice is a medium- to large- scale new housing development that was unforeseen in the last PNA, and which might make a new pharmacy application viable. As PNAs are four years apart it is possible for a developer to submit planning applications and be ready to break turf between PNAs.
Dispensing practices are well advised to remain vigilant for any such planning applications and the resultant changes to a pharmacy's viability.In terms of the likelihood of application success in England, if the population is over 2,750 and there is no other pharmacy within the one-mile radius, then it is likely that permission to open a pharmacy would be granted.
Scotland
Scottish control of entry regulations make no provision fora ‘one-mile rule'. A successful pharmacy application in a neighbourhood, therefore, results in a total loss of dispensing for the affected practice. The National Health Service (Pharmaceutical Services) (Scotland) (Miscellaneous Amendments) Regulations 2014 may offer some protection for medical services in rural areas prejudiced by a pharmacy application.
Pharmacy viability
Wherever they are based, a dispensing practice wishing to assess its vulnerability to a pharmacy opening nearby has to consider the likelihood of an application being successful and the question of viability. The important questions to ask are:
- How likely is the application to fail?
- How well equipped is the applicant to bankroll a
pharmacy that may make little or no profit for several years?
England
In terms of the likelihood of application success in England, if the population is over 2,750 and there is no other pharmacy within the one-mile radius, then it is likely that permission to open a pharmacy would be granted.
Scotland
From 2014, pharmacy applications in rural areas of Scotland must pass a prejudice test as well as a necessary and desirable test. Prejudice applies only to the rural practice’s NHS GMS and to any existing NHS pharmaceutical services – a definition that excludes dispensing practices.