otc medicines independent report - rotherham ccg

OTC MEDICINESINDEPENDENTREPORT PREPARED BY STANDOUT MEDIA LIMITED FOR SOUTH YORKSHIRE AND BASSETLAW ICS

DECEMBER 2018

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Contents

Introduction and purpose 3

About the South Yorkshire and Bassetlaw area and its population 4

Who was involved? 5

About the insight and engagement campaign 6

Who were our target audiences? 7

Methodology 7

Toolkits 9

About the people who engaged with us 11

Patient and public survey 14

What did the patients and public tell us? 16

Staff engagement 19

Community engagement 21

Social media 22

Website statistics 24

How our insight campaign compares 26

What we propose – next steps 27

Awards 29

Appendices

Appendix 1 – SYB ICS partner organisations 30Appendix 2 – Rotherham CCG Start Well, Choose Well, Stay Well campaign assets 32Appendix 3 – SYB ICS Citizens’ Panel 33Appendix 4 – Patient and public survey results in graphs 34Appendix 5 – Prescriber survey results in graphs 41Appendix 6 – Doncaster prescriber survey results 45Appendix 7 – Barnsley consultation report 67Appendix 8 – GP practices by CCG area 89Appendix 9 – Community pharmacies by CCG area 95Appendix 10 – Parish councils by CCG area 105Appendix 11 – Libraries by CCG area 107Appendix 12 – Community centres by CCG area 109Appendix 13 – ONS data by CCG area 112Appendix 14 – MPs by CCG area 117Appendix 15 – Comms toolkit 118

OTC MEDICINESINDEPENDENTREPORT

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© Standout Media Limited 2018

Introduction and purpose

In early 2018 NHS England carried out a public consultation on reducing prescribing of over the counter(OTC) medicines for minor, short-term health concerns which could save the NHS high costs andencourage more people to self-care. The NHS is taking this action to make the policy clear and fair acrossthe country – no postcode lottery for over the counter medications.

• Medicines optimisation is a ‘person-centred approach to safe and effective medicines use to ensurepeople obtain the best possible outcomes from their medicines’.

• There are number of elements to medicines optimisation. Our campaign focuses on over the countermedicines.

Over the counter medicines

• In the year prior to June 2017, the NHS spent approximately £569million on prescriptions for medicines which can be purchased over the counter from a pharmacy and other outlets such as supermarkets.

• These prescriptions include items for a condition:

• that is considered to be self-limiting and so does not need treatment as it will heal of its own accord;

• which lends itself to self-care, i.e. that the person suffering does not normally need to seek medical care but may decide to seek help with symptom relief from a local pharmacy and use anover the counter medicine.

• Vitamins/minerals and probiotics have also been included in the consultation proposals as items of limited clinical effectiveness which are of high cost to the NHS.

• Patient activation describes the knowledge, skills and confidence a person has in managing their ownhealth and care. Evidence shows that when people are supported to become more activated, they benefit from better health outcomes, improved experiences of care and fewer unplanned care admissions.

Standout Media partnered with the South Yorkshire and Bassetlaw Integrated Care System (SYB ICS) tocreate and deliver a public engagement campaign designed to gather high-quality insights about publicattitudes to the withdrawal from prescription of common medications that are available over the counter.

Working with teams from Clinical Commissioning Groups and their GP practices, Standout Mediaensured that insight was collected from the widest demographic, including the digitally excluded andeasily-overlooked sectors of the population. The campaign integrated print, digital and GP practicetelephone platforms.

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About the South Yorkshire and Bassetlaw area and its population

The South Yorkshire and Bassetlaw area has a population of nearly 1.5million people, covering the fourboroughs in South Yorkshire – Barnsley, Doncaster, Rotherham and Sheffield – and the northernmostborough of Nottinghamshire, Bassetlaw. More than a third of this population lives within the Sheffieldarea and roughly half of the population lives in Doncaster, Rotherham and Bassetlaw.

With an extensive industrial heritage, the South Yorkshire and Bassetlaw towns and city are a mix ofurban and rural settings.

Each of the five places within SYB has relatively high levels of deprivation compared with the rest ofthe country, with Barnsley and Doncaster in the top 15% of most deprived local authorities nationally.SYB also compares poorly with the rest of the country on a range of health measures such aspreventable mortality rates, smoking and obesity, and adult mental illness.

Each area has its own demographics and challenges within practices and also its own targets toaddress as part of this initiative.

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Who was involved?

SYB ICS is a partnership of 23 organisations, 18 NHS organisations, six local authorities and key voluntarysector and independent partners in the South Yorkshire and Bassetlaw region – covering Bassetlaw,Doncaster, Sheffield, Barnsley and Rotherham. See appendix 1 for full list of partners.

The ICS builds on a history of joint working across South Yorkshire and Bassetlaw. This includes theWorking Together programme – an acute care collaboration which became a vanguard in 2015 – and theCommissioners Working Together collaboration. The establishment of the sustainability andtransformation partnership (STP) was seen as a key step in closer working and joint planning betweenthe organisations, and formed the basis for the ICS.

The campaign also collaborated closely with patient groups, community pharmacies, the voluntarysector and other local groups.

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About the insight and engagement campaign

Big numbers are powerful and facilitate the creation of imaginative, compelling outputs that can be usedwith both staff and the public to drive engagement with the conversation and the concept. £569millionis a big number that has been used nationally by NHS England to support their own messaging. A suite of assets with the 569 Million Reasons branding was prepared in support of the research process.These were used in combination with existing assets from Rotherham CCG to support our conversations.See appendix 2 for examples of the Rotherham CCG assets.

Secondary message lines under the overarching campaign heading of “569 Million Reasons” included“Please don’t ask” and “Don’t delay your treatment”. The campaign message suite was framed using three approaches based on how people receiveinformation. These are:• Direct message about prospective changes

• What’s in it for me?

• Individual responsibility

We believe this to be clear and clearly differentiated from the longer running, Rotherham specific, “StartWell, Choose Well, Stay Well” campaign, making its impact easier to measure and allowing it to bewithdrawn at the end point without impacting onany other campaigns.

We created a web platformwww.569millionreasons.co.uk as the centraltouchpoint for individuals to engage with thecampaign and access the survey digitally totest the messaging and to view self-care/helpeducational resources. Our analytics providedclear insight into the route of access e.g.practice website, CCG website, text link, direct,Google and more to support evaluation of thecampaign.

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Who were our target audiences?

• people who are entitled to free prescriptions• patient groups including children and their parents/care givers• people over 60• people with long term conditions• frequent users of health and care services, especially people with long term conditions (LTC) who

want to take a more active role in their self-management or where professionals want to encouragemore active partnership between themselves and users of the NHS and social care

• GP/ANPs in practices to support them in realising the benefits – ‘what’s in it for me?’ - fewer consultations with people who should be self-caring.

Methodology

We worked with leaders in the healthcare commissioning community to develop a campaign that wouldhave legitimacy across the five distinct populations of Sheffield, Doncaster, Barnsley, Bassetlaw andRotherham.

We held events for commissioners, GPs, practice staff and pharmacists and provided information packsabout the issues and how to deal with objections. We ensured that key groups receiving over the countermedicines on prescription were aware of the campaign. We worked with the citizens’ panel to get theirinput into the design of the survey that was at the heart of the campaign. See appendix 3 for information aboutthe Citizens Panel.

We included NHS statistics in our materials to communicate the benefits of the potential cost savings,gaining support for the campaign from stakeholders. The campaign was carefully budgeted, and theelements were designed for maximum impact. The fully integrated campaign comprised:

• face to face engagement with SY&B ICS and CCGs throughout the campaign and regular phone/ email contact and introductory sessions for CCGs

• face to face staff onboarding workshops held at CCGs with supporting materials and identification ofchampions with practices

• briefing packs• use of existing networks, including those already established by the Be Cancer Safe campaign and

others – building on existing conversations

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• web platform for surveys and information• social media content and interaction• content for practice websites• hardcopy surveys, leaflets and posters for practices• posters and flyers for community outlets• press release• one event per CCG patch for targeted audiences (minimum two members of Standout Media senior

staff) – capturing the beliefs, feelings and behaviours – an open, critical and creative dialogue, encouraging participants to go beyond ‘what they know’

• reporting/evaluation• in-depth analysis• production of this report.

During the course of the campaign we continuously assessed how attitudes shifted, what patients weresaying in feedback and what prescribers were seeing happen on the ground.

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Toolkits

Practice toolkit See appendix 8 for full list of GP Practices.• Survey for GP/ANP – shared via practice managers• Practice staff briefing note• Web based toolkit specifically for GP practices and links to patient platform

www.569millionreasons.co.uk• Links to social media• Text/email content for patients – link to patient survey• Hardcopy patient survey – for waiting areas• Printed assets for waiting areas – leaflet, medicine cabinet/survey poster

CCG toolkit• Web content and links to patient platform www.569millionreasons.co.uk• Links to social media• Press release – co-created in association with CCG communications teams• Briefing pack for CCG staff• Briefing pack for MPs• Samples of practice and community toolkits

Community pharmacy toolkit See appendix 9 for full list of GP Practices.• Survey for prescribers • Staff briefing note• Web based toolkit specifically for community pharmacies and links to patient platform

www.569millionreasons.co.uk • Links to social media• Text/email content for patients• Printed assets – leaflet, medicine cabinet/survey poster

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© Standout Media Limited 2018 STANDOUTMEDIA


Staff on-boarding workshops toolkit• Presentation• Briefing note• Sample of the public survey• GP/prescribing staff survey• Practice comms toolkit• Job description for champions

PPG/community/CVS toolkit See appendices 10-12 for lists.• Sample of the public survey• Sample of the public information leaflet• Posters, leaflets and flyers• Background briefing note

Press toolkit• Press releases• Links to social media platforms• Links to the website• Background briefing note• Contacts list

PublicityWhilst we didn’t have an advertising budget as part of the campaign, we effectively targeted a similarnumber of people through social media and community groups.

See appendix 15 for examples of the full suite of toolkit assets.

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About the people who engaged with us

Patient and public engagementWe co-created the patient and public survey with the heads of medicines optimisation andcommunications leads from the five CCG areas. Using feedback from the citizens’ panel and theintroductory CCG meetings, the general consensus was that the wording/length was far too muchinformation in one questionnaire, and that there was a desire for this to be written more from theperspective of the answers needed. We reduced the survey from seven pages to four pages. We alsosimplified some of the questions, and made them more relevant for the audience to understand(whilst achieving the same answers).

It is our opinion that the survey contained too many demographic questions that were not relevant toour insight with the result that almost 5,000 people who submitted their response did not completethat section of the survey.

We mirrored some of the patient’s questions in the survey for prescribers. This enabled us to reviewthe different perspectives from each side clearly. These were mirrored as follows:

AwarenessPatient – were you aware of changes? 65% of people were awarePrescriber – do you think patients are aware of the changes? Only 28% of respondents believed thatpeople were aware.

Help to manage the conditionsPatient – what do you want us to provide?Prescriber — what do you think would help patients and support you?

Patient and public responses indicated a desire to have an online resource/more informationavailable on social media and an option to call for information.

In contrast, 76% of prescribers believe that a hard copy printed information leaflet or postercombined with a prior notification letter to patients would be the preferred methods.

Only 17% of patients and public agreed that this would be the best communication method.

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Willingness to purchase items themselvesPatient – how willing are you to do this? 82% of respondents would be willing to purchasemedication OTC if they were told to do so.Prescriber – how willing do you think they are? Prescribers indicated that they believe this figure tobe 36% of people would be willing to purchase OTC

Reasons for not backing the changesPatient – why the patient isn't happy. Pre-payment certificates was the largest reason, only 4%believed they have the right to all medication for free on prescription.Prescriber – why do you think patients won't be happy? Prescribers felt that 64% of patients believethey have the right to all medication for free on prescription and 100% due to exemptions.

96% of prescribers think it will have an impact on the level of complaints at their practices,however, the same number of respondents were confident to encourage patients to buy over thecounter.

As a result of this methodology we ended up with relevant separate data from each audience but alsocomparable data relating to perspectives from each side of the key issues.

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More than 14,000 peopletook part in the patient andpublic engagement surveyand shared their views onpurchasing over the countermedicines for minorconditions

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Patient and public survey

More than 14,000 people took part in the patient and public engagement survey (0.96% of thepopulation). The average response rate for UK public consultations is 0.7%, making 569 millionreasons more successful than the previously most successful regional consultation about healthservices conducted in England (Greater Manchester’s Healthier Together campaign in 2014). The responses were in the most part collected via our digital platform, with 12,400 responses. Theremaining hard copy format responses were collected via GP practices and face to face conversationsin communities.

Breakdown of respondents by CCG area are as follows:

DONCASTERBARNSLEY

SHEFFIELD

ROTHERHAM

BASSETLAW

48.8%

23.7%

22.4%

4.2%

0.9%

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We saw spikes in activity that directly relate to text messages being sent out by GP practices inBassetlaw, Rotherham and Doncaster. This highlighted how much more effective the campaign couldhave been with greater engagement from practices getting involved, ultimately benefitting thepractice itself.

Highlights from responses:

• Awareness of the campaign was relatively high but knowledge of what prescriptions actually cost the NHS was relatively low.

• Where the respondents knew about the extra costs that have to be paid, more than half said that this doesn’t change their views.

• However, 82% of respondents then said they would be happy to purchase their medication OTC if told to do so by a GP – suggesting prescribers shouldn’t fear the conversation.

• The difficult conversations will be with people holding an exemption or pre-paid certificate. Some of these responded positively, however it is a stumbling block.

• Only 4% of respondents believe they have the right to have all medicines prescribed, even thoseavailable to buy OTC.

• Respondents cover the full age range and target audiences.

• People told us that they are reasonably confident to treat themselves where appropriate – either without further medical assistance or advice from a pharmacist.

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What did the patients and public tell us?

The following comments are a representative sample of comments made by people who engagedwith the campaign. The uniformity of comments and shared concerns by people who took part,whether in person or online, is an outstanding feature of this engagement work. They are alsorepresentative of comments made by people who took part online via the survey.

Did you pay for your last prescription? 58% of respondents didn’t pay for their last prescription.Here is a sample of the reasons people didn’t pay:

Over 65Thyroxine

Maternity leave and pregnancy

BenefitsRetired Diabetes

Tax credits

Pre-paid certificate

Disabilities

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Of the illnesses or conditions that affect/have affected you, please tell us how confident you wouldfeel treating yourself. Please tick one box for each listed condition that you have experienced –assume that you are treating yourself for the first time.

The two minor ailments that caused the greatest concern were mild dermatitis or eczema and vitaminand mineral deficiencies, with both receiving 12.5% of people sharing that they would not beconfident to self-treat. The areas of least concern were mild constipation, insect bites and stings andcoughs, colds and nasal congestion, each receiving 97% of patients being confident to self-treat.

If you saw your GP about a minor condition and were advised to purchase medication instead ofthem prescribing it, would you be happy to do this?

‘This had happened already and was fine as it was a small item, but if the item was expensive I do havea prepayment certificate so this needs a balanced approach.’

‘Depends how much.’

‘I have a pp card and consider I should be eligible for any medicine I need. I would always buy my ownpain relief eg paracetamol.’

‘Yes if cheaper for me to do so.’

‘I would be happy to buy what was advised.’

‘If it helps cut the cost down I would do it.’

‘Not everyone has money seven days a week. So on some occasions it would be impossible if youhave no money. But they should be a discussion to see if you’re financially able to do so or not.‘

‘In fact, I have in the past asked the pharmacist to ignore the prescription and give me the medicine inthe OTC format. It was cheaper for me to pay for the OTC medicine than pay the prescription fee.’

‘Depends on cost as only on benefits but most medicines yes.’

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‘Even though I no longer pay for medication I'm still happy to buy it wherever I can.’

‘No I wouldn't be happy, but if there was some way of getting from a pharmacy without paying, I thinkI have earned the right to free prescriptions , as I have previously stated , I have been taxed, and havepaid for prescriptions for 43 years, it's about time we made foreign visitors, short or long term pay.’

‘I wouldn't go to the doctors for a minor condition.’

‘I always ask if it would be cheaper to buy is over counter rather than a prescription’

‘Generally, would usually depend if cheaper than prescription cost. Already have annual pre-paidcertificate.’

‘Providing that the unbranded product does not cause me problems with my other meds.’

‘I wouldn't see my GP for a minor condition. Would go to the pharmacy and ask their advice.’

‘I would pay if cheaper. ‘

‘I think medication from the doctors works better but I don't mind getting some advice on what Ishould get that will help me from the chemist.’

See appendix 4 for full patient and public survey results.

‘I think medication from the doctors worksbetter but I don't mind getting some adviceon what I should get that will help me fromthe chemist.’

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Staff engagement

Prescriber surveyWe have had a very poor response to this survey, which is not uncommon and we have seen thiselsewhere with similar campaigns. We received 46 responses and this channel identified twoindividuals who would be willing to become Champions (a GP partner at Tuxford Medical Centre and apractice pharmacist at Scott Practice, Doncaster). We discussed this at each of the workshops andattendees agreed to share internally within their individual practices – not unusual, but there werecases where practice staff either hadn’t received or hadn’t had time to read the communications fromtheir practice managers. At the workshops we were able to identify further champions via face to facediscussions. See appendix 5 for full prescriber survey results.

In addition, we had responses from 110 prescribers from the separate survey run by Doncaster CCG,this highlights that when the survey is endorsed by the CCG, people are more willing to participate.See appendix 6 for full Doncaster prescriber survey results.

Briefings, introductory sessions and workshopsIntroductory sessions were held as follows:

An introductory session for the ICS Communications and Engagement leads which took place atSheffield CCG on Monday 30th July.

Bassetlaw CCG – Tuesday 2 AugustDoncaster CCG – Tuesday 7 AugustRotherham CCG – Thursday 2 AugustBarnsley CCG – Wednesday 22 AugustSheffield CCG – Thursday 23 August

Following inputs from each of the above introductory sessions we held a session with the Citizens’Panel (covering all five CCG areas) on Monday 17th September. In this session we shared the details ofthe campaign, discussed the three core messages we were testing and gained valuable feedback thatsupported us with finalising our messages and assets, the insight from this group was a goodindication of how these would be received by the wider target audiences and mirrored responsesreceived/conversations. There were 20 people in attendance at this event and representatives fromeach area.

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We ran three successful workshops with a wide range of staff including GPs, clinical and communitypharmacists, practice managers, receptionists and a range of CCG staff at Doncaster, Rotherham andBassetlaw CCGs. Barnsley and Sheffield CCGs declined involvement.

We received some interesting responses regarding the messages we tested with other target groups,in that attendees felt a softer approach would be more appropriate. However, everyone voiced that ifthe messages were mandated by CCGs they would be readily accepted for use with patients and thepublic.

The workshops provided some useful and imaginative ideas about how we could improve the rolloutof the campaign with prescribers. We also had a number of potential solutions voiced and identifiedadditional champions who would be willing to pilot solutions in their practices following the outcomesof the insight work.

Challenges

Barnsley and Sheffield CCGs did not engage as fully as the other CCGs. The repercussions of thisresulted in the flow of messaging not having reached the desired audiences and whilst it also camefrom us directly to the community it may not have been taken as seriously as it wasn’t endorsed bythe CCG.

Sheffield CCG felt the campaign was not relevant to their plan, although we were not privy to thespecific details that sat around this decision. We discussed these issues with the SYB ICScommunications teams and medicines optimisation leads as to whether Sheffield could contribute tothe workstream decision-making around meds optimisation without the insights that engagementwith the campaign provided. We also provided the option should they have a change of mind, that wecollectively could then have a discussion with the Meds Optimisation Steering Board as to thepossibility of extending the deadline of 23 November to give them time to catch up, but doing thatwould have implications for delivery of the final report, the costs of the extended delivery and begin tooverlap with other campaigns such as the important winter campaign.

With regard to Barnsley, we believe they didn’t fully engage because they had just finished their ownlocal consultation in September and that with the insights from that and the limited responses fromtheir area to the survey they felt they had what they needed to make recommendations for the localpolicy response. See appendix 7 for the outcomes from the Barnsley consultation.

We felt that the Sheffield issue was of more concern because they appeared to decide that it wasn’tfor them despite the consensus in the workstream.

These issues were discussed at the Steering Board on Wednesday 28th November 2018. The questionraised was whether or not the policy response could cover all five areas given the lack of engagementfrom Barnsley and Sheffield. We have included our independent comments on this in the ‘What wepropose’ section of this report.

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Community engagement

There was a willingness to distribute flyers / leaflets and have on and offline conversations that carryNHS branding. In particular we had significant support from the voluntary sector regarding this, andalso parish councils.

Online pharmacies became directly engaged with the campaign, particularly when we activelypromoted people referring to their pharmacies rather than seeking advice from their GP.

There was also a negative public reaction through social media to people who did not support thecampaign.

Providing printed materials was key to community engagement. Most were happy to display orforward any materials that were issued to them directly. There was also a willingness to help becauseit was a campaign to benefit the wider public and support the NHS.


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Social media

We had an outstanding reaction to the campaign via social media reaching more than one millionpeople in just over four weeks. Doncaster, Rotherham and Bassetlaw generated almost 60% of theinteraction, with 35% coming from other sources such as pharmacies, politicians and the generalpublic. Only 6% can be attributed to Sheffield and Barnsley, which could have had a significant impacthad they supported it more, given they had 20% of the target followers on social media betweenthem.It is worth noting that personal buy-in from Doncaster and Rotherham’s leadership teams also stoodout, with sharing/likes from the Chairman and Chief Officer to the Head of Communications.

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Twitter worked significantly better thanFacebook in engaging people, althoughwe did get a much higher response ratewhen we paid to ‘boost’ posts onFacebook. Facebook tended to providemore qualitative results and personalresponses/opinions.

Support from MP’s also significantlyincreased the reach of the campaign witha shared tweet from Caroline Flint MPreaching more than 64k people.Chemists getting involved also increasedour audience share.

Highlights from responses• Posts that received the highest interaction related to the additional services that the NHS could

provide if people supported the campaign, or posts that referred to how much the NHS had spent on specific items such as vitamins.

• Only 8% of the comments via social media were negative, and these were often challenged by other people blaming them for the problems within the NHS.

• Concerns about self-medicating were raised, in particular from one GP who was concerned that if she could get it wrong, the risk of others doing so are much higher.

• The campaign raised concerns relating to the NHS’s ability to buy cost effectively, which highlighted the poor level of understanding relating to the real cost of prescriptions.

• There was however significant feedback that it is the GP’s responsibility to stop prescribing, ‘GPs need to stop prescribing certain medications then there wouldn’t be an issue’.

• Issues relating to the number of paracetamol that people can buy were frequently raised withlittle/no understanding that a community pharmacist can supply up to 96.

• Labelling in care homes/schools also came up, as it did in the engagement sessions we ran.• Poor understanding of the role/training of a pharmacist also became apparent with few realising

the greater role that they could play in providing advice and supplying directly. Also, criticism that it is their role to advise people they could buy something more cheaply than through a prescription.

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Website statistics

Between September and November there were more than 118,000 hits to the public facing website.These are broken down as follows:

0 10k 20k 30k 40k 50k 60k 70k 80k

September

18,510

October

27,532

November

72,048

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Other support

NHS England North supported us with community pharmacists by issuing follow up emails thatincluded links to the community pharmacy toolkit. They requested a copy of the final report andshared that they may like to roll-out the campaign elsewhere.

Referrals to the site came from many sources, the top 10 referrals came • Direct• Twitter• Facebook• Google• Health and Care Together site• Doncaster, Rotherham and Bassetlaw CCG websites• GP Practice Sites• Healthwatch• RDASH• Parish Councils

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How our insight campaign compares

How our insight campaign compares

• The average response rate for UK public consultations stands at 0.7%.

• Greater Manchester’s Healthier Together consultation in 2014 attracted a response rate of 0.9% of the population and was commended as “the largest public response to a regional consultation about health services conducted in England, in the last decade.”

• The Greater Manchester consultation received over 23,000 responses based on a population of 2.76million (ONS).

• If we include all areas in SYB ICS we are above the average response rate (population 1,456,464 ONS) and have achieved a larger response rate than the Healthier Together consultation at 0.96%.

• If we take the responses to date for just the Rotherham, Doncaster and Bassetlaw CCG areas who actively took part (population 672,545 ONS) the percentage response rate is 1.9% – this is way above the GM response rate.

See appendix 13 for ONS information covering South Yorkshire and Bassetlaw.

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What we propose – next steps/opportunity

569 Million Reasons has provided a wealth of high quality information that can be used to inform anumber of subsidiary campaigns on specific aspects with specific target audiences. We recommendthat further discussion takes place between ourselves (Standout Media), the steering group and localcommunications leads as to next steps, with a view to further raising public awareness of the issues;paving the way for communication of the new policy and messaging around that; and using theinformation from this survey as a platform for comms about related matters such as self-care.

There are certain key audiences who need to be further engaged with 569 Million Reasons, namelyschools, care homes and community pharmacies and we should consider how best to reach thesegroups ahead of any policy announcements.

The local policy development will only be a success if all parties are in agreement and there is acommitment to engage with each of the audiences throughout the process – from decision makingright through to implementation and delivery.

In our opinion we would recommend that the local policy development includes the three main areasthat participated. The main reason for our decision is based on practices in Sheffield and Barnsley notbeing fully engaged which, in our experience, will make it more challenging to implement and obtainprescriber support.

The messages we tested from the Rotherham campaign, ‘Start Well, Choose Well, Stay Well’ togetherwith our three message types:• A direct message - Over the counter medicines on prescription• What’s in it for me? message - Self-care saves you time and saves the NHS money• Individual responsibility message - Your NHS, your responsibilitywere well received. People understood the rationale and liked the fact that they could make adifference to the NHS as individuals and would be happy to share the information gained with familyand friends. People were particularly receptive to ‘saves the NHS money’. This gives a clear indicationthat ‘direct messages’ mixed with ‘what’s in it for me’ will be well received as opposed to giving peoplea softer message that suggests people should choose to buy over the counter medications.

The 569 Million Reasons campaign messages were also well received which is evident in the largenumber of responses we received. We would recommend using this as a joint campaign platformacross the CCG areas for the subsidiary campaigns proposed overleaf. We would also recommendutilising the content from the Rotherham CCG assets to form part of a suite of 569 Million Reasonsassets that can then be rolled out across the SY&B area.

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Proposed subsidiary campaigns:

Patients/public• Campaign – summary of insight results campaign• Campaign – the real prescription costs

The full costs of prescriptions/what money could buy/OTC costs/saves the NHS money• Campaigns on how to confidently treat/when to see your GP:

- mild dermatitis and eczema- vitamin and mineral deficienciesThese are suggested as a direct result of the conditions where people were least confident to self-treat

• Increase online resources via 569 Million Reasons channels- Documents, videos and videoscribesThese are suggested as this was the preferred communication method of respondents.

Prescribing staff• Campaign – summary of results / need for greater engagement and more prescriber champions• Campaign – don’t fear the conversation• Self-care – prescription pads

These look like a prescription but contain self-care messaging. These ‘prescription pads’ would be designed for GP/ANP use only. Insight suggests that a large number of people want to feel that they are walking out of the practice with a ‘prescription’ – it’s a visual/kinesthetic experience that people have become accustomed to receiving. We introduced this thinking into our workshops andthe champions identified would be willing to run a pilot to test these pads.

• Medication labels – ‘This item could have been bought over the counter for less money’This suggestion came from a GP who attended one of our workshops. In our opinion we believethis would also be worth piloting with champions. The idea is to have this printed across the top of a patient’s prescription where the GP believes the patient should have bought the medication OTC.

• Text messaging direct from practicesReview of what information patients want to receive from their practices and how they want to receive it to enable them to utilise the text messaging to increase engagement and responses to future campaigns.

• Telephone resource for patients to call when unsure if they need to see a GP for a minor ailment. This is in direct response to a large number of people who would welcome a conversation over the phone. A central number would ensure that GP practices don’t receive an increase of incoming calls.

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Community pharmacies• Targeted campaign to increase awareness of what pharmacists can do/are trained to do.

Encouraging people to have a face-to-face conversation with a pharmacist.• Labels for use on medicines purchased OTC

This concept came through in our conversations across each of the workshops and in community pharmacies. In addition, a large number of respondents who either have children of school age or parents/family in a care home provided the same response – the belief that care homes and schools ‘are not allowed’ to administer medications that do not have a pharmacy label with clear instructions of dosage and timings for administering the medications.

Awards

We have submitted the campaign for three Medilink awards following a direct request to enter it. Wewould also recommend that the campaign is submitted for the following awards:

AHCM (Association for Healthcare communications and marketing) AwardsThe UK Public Sector Communications Awards HCA (Healthcare Communicators Association) AwardsHSJ (Health Service Journal) Awards - we would recommend waiting until you have run thesuggested campaigns before entering for these awards.

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APPENDIX 1SYB ICS PARTNERORGANISATIONS

Appendix 1

Clinical Commissioning GroupsNHS Barnsley CCGNHS Bassetlaw CCGNHS Doncaster CCGNHS Rotherham CCGNHS Sheffield CCG

Health and Wellbeing BoardsBarnsleyBassetlaw District CouncilDoncasterNottinghamshireRotherhamSheffield

Independent organisationsDoncaster Children’s Services Trust

Local AuthoritiesBarnsley Metropolitan Borough CouncilBassetlaw District CouncilDoncaster Metropolitan Borough CouncilNottinghamshire County CouncilRotherham Metropolitan Borough CouncilSheffield City Council

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APPENDIX 1SYB ICS PARTNERORGANISATIONS

NHS TrustsBarnsley Hospital NHS Foundation TrustDoncaster and Bassetlaw Teaching Hospitals NHS Foundation TrustEast Midlands Ambulance Service NHS TrustNottinghamshire Healthcare NHS TrustThe Rotherham NHS Foundation TrustRotherham, Doncaster and South Humber NHS Foundation TrustSouth West Yorkshire Partnership NHS Foundation TrustSheffield Children’s Hospital NHS Foundation TrustSheffield Health and Social Care NHS Foundation TrustSheffield Teaching Hospitals NHS Foundation TrustYorkshire Ambulance Service NHS Trust

Associate partnersChesterfield Royal Hospital NHS Foundation TrustThe Mid Yorkshire Hospitals NHS Trust

Strategic partnersHealth Education EnglandNHS EnglandPublic Health EnglandYorkshire and Humber Academic Health Science Network

Transformation programmesCommissioners Working TogetherWorking Together Partnership Vanguard

UniversitiesUniversity of Sheffield


APPENDIX 2ROTHERHAM CCGSTART WELL,CHOOSE WELL,STAY WELLCAMPAIGN ASSETS

Appendix 2

DO YOUR BIT TO HELPPlease don’t ask for paracetamol on prescription, it can be bought affordably elsewhere. Play your part in helping your local NHS to save money.

START WELLCHOOSE WELLSTAY WELL

In Rotherham, almost £600,000 was spent last year on prescribing paracetamol - this could be used for 2,222 emergency ambulance trips!

DID YOU KNOW?The cost to the NHS for prescribing paracetamol every year is £80million – On prescription the cost of 100 tablets is nearly three times more than for a patient to buy locally.

*£3.40 prescriptionfrom your GPfrom

*£1.00

in supermarkets

and pharmacies

PARACETAMOL *Based on the price for 100 tablets.

RotherhamClinical Commissioning Group

DO YOUR BIT TO HELPPlease don’t ask for Hayfever medication on prescription, it can be bought affordably elsewhere. Play your part in helping your local NHS to save money.

START WELLCHOOSE WELLSTAY WELL

In Rotherham, over £70,000 was spent last year on prescribing Hayfever medicine - this could be used for 260 emergency ambulance trips!

DID YOU KNOW?The cost to the NHS for prescribing hayfever medicines every year is £13.6million – On prescription the cost of 30 tablets is double than for a patient to buy locally.

*£2.07 prescriptionfrom your GPfrom

*99p

in supermarkets

and pharmacies

HAYFEVER MEDICINES

*Based on the price for 30 tablets.

RotherhamClinical Commissioning Group

STAY WELLCHOOSE WELLSTART WELL

Clinical Commissioning GrLL WELLELL

oupmmissioning GrRotherham

AMIN DTAMIN DVIT

D

for 30 tablets.

om your GPro

escriptionre

*Based on the price

r*£5.50prprfr

emergency ambulance tripscould be used for 1880

iescribing Vprwas spent last year on In Rotherham, almost £500,000

!mbulance tripsd for 1880

- this itamin D t year on , almost £500,000

an

cies

supermke

nd pharmaci

£1.rmarkem

*£om

ro

fr*

o

000£1 0

e

i

in su

ets

t blets is 5 times mor£13.6million –

itamin D medicines every year is VThe cost to the NHS for pr

DID YOU

emergency ambulance trips

than for a patient to escription the cost of 30 On pr

edicines every year is escribing he NHS for pr

KNOW?

!mbulance trips

–

ti t te cost of 30 r is bing

.buy locally

escription, it can be bought afprt ask for VPlease don’

tablets is 5 times mor

DO YOUR BIT TO HELP

e than for a patient to

fo can be bought afitamin D medication on sk for V

es mor

R BIT TO HELP

dably rdication on

patient to

LP

NHS to save moneye. Play your part in helping your local elsewher

escription, it can be bought afpr

.oneyy your part in helping your local

fo can be bought af

ng your local dably r

The ‘Start Well, Choose Well, Stay Well’ campaign created by Rotherham CCG consists of a series ofhard copy materials together with press advertising to raise awareness with local people ofpurchasing medications at a much-reduced cost than via prescription. The messaging also promotesthe savings benefits that could be realised in Rotherham through the number of ambulance journeysthat could be made in the annum. During our 569 Million Reasons campaign we tested the existingmessages of the Rotherham CCG campaign and also extended this concept to the number ofcommunity nurses, so as to have a more local focus and engage the specified target audiences.

32

33


APPENDIX 3SYB ICS CITIZENS’PANEL

Appendix 3

The Citizens’ Panel (CP) provides an independent view and critical friendship on matters relating tothe Integrated Care System (ICS). In particular, the group has been set up to ensure that the voice of the local population is heard andinfluences any developments. It does this by making sure engagement opportunities are created forcitizens, patients and carers and that they are meaningful, targeted and relative to the changessuggested.The Panel ensures that its work and the issues reflected by citizen engagement are given equalimportance to the work of professional health and care partners.

The specific purpose and aims of the Panel are:• To support the ICS with advice and guidance so that it can meaningfully engage patients, carers

and citizens in the planning and shaping of future services and in the development oftransformation proposals on behalf of all partners

• To review stakeholder engagement plans related to potentially substantial service transformationproposals to ensure engagement activity meets all guidance

• To comment on whether a proposal is a service change and priority areas for engagement• To comment on and promote innovation and improvement in stakeholder engagement• To review (often complex) service related and / or financial information to ensure any information is

easily understandable and clear before being shared with the wider public• To encourage the ICS team to ensure protected and other ‘seldom heard’ groups are given

appropriately tailored opportunities to shape future services• To bring any local issues that may have some bearing on the implementation of the SYB Plan to the

attention of the group

Authority and GovernanceThe CP is an advisory body and as such is not a decision-making body and has no delegated authority.Its role is to advise and make recommendations to the Collaborative Partnership Board. TheCollaborative Partnership Board is made up of leaders from the main health and care organisations inSouth Yorkshire and Bassetlaw and oversees proposals to improve to local care and services. However,the individual organisations that are represented on the Board retain responsibility for makingdecisions using their own governance structures.

Reference page: https://www.healthandcaretogethersyb.co.uk/get-involved/meet-citizens-panel

34


APPENDIX 4PATIENT ANDPUBLIC SURVEYRESULTS INGRAPHS

Appendix 4

62.1%Yes

37.9%33737.37.937.9%No37.9%N37.9%No 24.97%

(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

to say)

9

41.27%Yes

57.98%No

0.75%Don’t know

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

to say)

9

12.42%Yes

76.12%No

11.46%Don’tknow

0

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

to say)

9

0.72% (Free)00.0.70.720.72%0.72% 0.72% (0.72% (F0.72% (Fr0.72% (Fre0.72% (Free0.72% (Free)

8.43%(£5-7)

24.97%22424.24.924.9724.97%(£7-10)24.97%(24.97%(£24.97%(£724.97%(£7-24.97%(£7-124.97%(£7-1024.97%(£7-10)

13.9%(£10-15)

15.05%(£15-20)

36.93%Don’t know

3

24.97%(£7-10)

5

24.97%(£7-10)

52

24.97%(£7-10)

52.

24.97%(£7-10)

52.9

24.97%(£7-10)

52.96

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

to say)

9

Q1 Were you aware that we are asking GPs and otherhealthcare professionals not to prescribe medicines for minorconditions?

Q2 Did you pay for your last prescription?

Q3 Could any of the items on your last prescription have beenbought over the counter at a local pharmacy or supermarket?

Q4 How much do you think each prescription costs theNHS/your GP practice?

35

STANDOUTMEDIA


Appendix 4

24.97%(£7-10)

5

24.97%(£7-10)

52

24.97%(£7-10)

52.

24.97%(£7-10)

52.9

24.97%(£7-10)

52.96

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

0

20

40

60

80

100

120Confident to self-treat without further professional assistance

Confident to self-treat with advice from a local pharmacy

Not confident to self-treat and would seek GP appointment

Min

or c

ondi

tions

ass

ocia

ted

with

pai

n, d

isco

mfo

rt o

r fev

er

Vita

min

and

min

eral

defi

cien

ces

Mild

con

stip

atio

n

Mild

to m

oder

ate

hayf

ever

/ a

llerg

ies

Mild

der

mat

itis

or e

czem

a

Dry

/sor

e/tir

ed e

yes

Mou

th U

lcer

s/te

etin

g/m

ild to

otha

che

Inse

ct b

ites

and

stin

gs

Cou

ghs,

col

ds a

nd n

asal

con

gest

ion

Indi

gest

ion

and

hear

tbur

n

39.09%

17.52%

52.96%

24.97%(£7-10)

5

24.97%(£7-10)

52

24.97%(£7-10)

52.

24.97%(£7-10)

52.9

24.97%(£7-10)

52.96

24.97%(£7-10)

52.96%

38.81%

11.2%

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

An online resource such as a document or a video to watch

A hard copy printed information leaflet

A face-to-face conversation with a healthcare professional such as a nurse or pharmacist

A telephone conversation with a healthcare professional

Other (please specify)

65.72%Yes

34.28%

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%No

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

to say)

9

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

51.99%No

48.01%Yes

5

to say)

9

Q5 Of the illnesses or conditions that affect/have affectedyou, please tell us how confident you would feel treatingyourself. Please tick one box for each listed condition that youhave experienced – assume that you are treating yourself forthe first time.

Q6 If you are not confident to manage these conditionsyourself, what do you think would help you to become moreconfident? Tick all that apply.

Q7 Did you know about these extra costs involved inprescribing?

Q8 Does knowing about these extra costs that have to be paidby the NHS change your views about buying over-the-countermedicines?


36



Appendix 4

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

53.38%

26.66%

6.45%

10.94%

2.57%

to say)

9

Yes

Yes, if they wrote down what I needed to buy

No

Don't know


24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

51.23%

17.1%

8.83%

6.23%

4%

9.52%

3.97%

to say)

9

I’m exempt from paying prescription charges

I have a prepayment certificate

I think that prescribed medicines work better than over the counter medicines

I believe I have the right to have all my medicines prescribed

I believe the NHS should fund all medicine treatment, even to those available to buy

I believe it is more expensive than the prescription charge

My pharmacy delivers my prescription medicines

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

48.8%

23.7%

22.4%

4.2% 0.9%

Rotherham

Doncaster

Bassetlaw

Sheffiield

Barnsley

24.97%(£7-10)

52.96%

3

24.97%(£7-10)

52.96%

34

24.97%(£7-10)

52.96%

34.

24.97%(£7-10)

52.96%

34.2

24.97%(£7-10)

52.96%

34.28

24.97%(£7-10)

52.96%

34.28%

24.97%(£7-10)

52.96%

34.28%N

24.97%(£7-10)

52.96%

34.28%No

Q9 If you saw your GP about a minor condition and wereadvised to purchase medication instead of them prescribingit, would you be happy to do this?

Q10 If you would NOT be happy to buy the medication, whichof these statements might be the reason? Please tick all thatapply.

Q11 Which town or district do you live in? Q12 Who is your GP/GP practice?

This information is too great to tabulate. The results of this wereused to verify the town or district.

37



Appendix 4

0.11% 3.31%

10.5%

13.83%

22.5%25.07%

19.41%

4.47% 0.81%

to say)

9

0–15

16–24

25–34

35–44

45–54

55–64

65–74

75–84

85+

33.87%(Male)

64.82%(Female)

1.31% (Non-binary)

to say)

9

0.5% (Prefer not to say)

97.34%No

2.16%Yes

to say)

9


97.35%No

2.14%Yes

Q13 What age are you? Q14 What is your sex/gender?

Q15 Have you gone through any part of a process to bringyour physical sex appearance, and/or your gender role, morein line with your gender identity?

Q16 Have you had thoughts about going through a process tobring your physical sex appearance, and/or your gender role,more in line with your gender identity?

38



Appendix 4

to say)

9 92.75%

0.95%0.66%

0.94% 0.48%4.22%

Heterosexual/straight

Gay

Lesbian

Bisexual

Other

Prefer not to say

to say)

9

White

White British

White Irish

Other White

Mixed

White and Black Caribbean

White and Black African

White and Asian

Other mixed

Asian or Asian British

Indian

Pakistani

Bangladesh

Other Asian

Black or Black British

Caribbean African

Other Black

Chinese

Other ethnic group

19.74%

75.90%

0.49%

0.63%

0.21%

0.17%

0.12%

0.13%

0%

0.54%

0.19%

0.47%

0%

0.19%

0.30%

0%

0%

0%

0.66%

to say)

9

0 10 20 30 40 50 60

No religion

Christian inc Roman Catholic

AtheistBuddhist

HinduJewishMuslimSikh

OtherPrefer not to say

0

to say)

9

16.11%Yes

81.5%No

2.39% Prefer not to say

Q17 Which of the following options best describes yoursexual orientation?

Q18 What is your ethnic group?

Q19 What is your religion? Q20 Do you consider yourself to have a physical disability?

39



Appendix 4

to say)

9

79.56%No

20.44%Yes

1

to say)

9

15.52%Yes

80.79%No

3.69% Prefer not to say

to say)

9

83.24%No

16.76%Yes

9

to say)

9

98.01%(No)

1.11% (Yes)Prefer not to say0.88%

Q21 If 'yes' to the previous question, does this affect yourability to access services? If so, please tell us briefly how.

Q22 Do you have, or consider yourself to have, a mentalhealth condition?

Q23 If 'yes' to the previous question, does this affect yourability to access services? If so, please tell us briefly how.

Q24 Are you currently pregnant, or expecting a baby?

40



Appendix 4

to say)

9

0

20%

40%

60%

80%

100%

0-3 4-10 11-16 17-21 Over21

Prefernot to say

2 41 3 5 6+

Number of children in each age range

to say)

9

11.96%(Single)

11.96%(Co-habiting)

60.84%(Married)

8.48%(Divorced/separated)

4.65%(Widowed)


to say)

9

22.72%Yes

77.28%No

to say)

9

96.51%No

0.13%Yes serving military

3.36% Yes veteran

0

Q25 Please specify the number of children that you have inthe following age ranges. Leave blank if you do not have anychildren.

Q26 What is your marital status?

Q27 Do you have caring responsibilities? Q28 Are you serving military personnel or a military veteran?

41


APPENDIX 5PRESCRIBERSURVEY RESULTS IN GRAPHS

Appendix 5

8%

0%

8%

12%4%

32%

32%

28%

40%

4

16–2021–2526–3031–4041–5051–6061–7071–80Over 80All age groups

40% Moderately Aware

4%Very little awareness

56%Fully Aware

2

28%Moderatelyaware

72% Very Little Awareness

0% Fully aware

20%

56%

60%

80%

92%

24%

1

Practice newsletter

Leaflets/posters in the surgery

Prior notification with prescriptions for the affected products/medicines - eg letter to affected patients

Regional media

National media


Q1 Which age group of patients do you think this will impactthe most?

Q2 How do you rate your own level of awareness with NHSEngland's Consultation on Self Care?

Q3 How aware do you think the general public is about theseproposed changes?

Q4 How do you think we can raise awareness about thechanges? (Please tick all that apply)

42



Appendix 5

16%Yes

24%Yes with support

from GP/Pharmacies

28%No

8% Don’t know

24%Other

0

0 20 40 60 80 100

They are exempt from paying prescription charges

They have a prepayment certificate


They think that prescribed medicines work better than over the counter medicines

They believe they have the right to have all their medicines prescribed

They believe the NHS should fund all medicine treatment, even to those available to buy

It is more expensive than the prescription charge

Their pharmacy delivers their prescription medicines

5

56%Possibly

40%Yes

4%No

0

Q5 Do you think patients are going to welcome this change insupport of the NHS?

Q6 Are there any specific conditions with which you haveparticular concerns with persuading patients to purchaseinstead and limiting your prescribing to exceptional cases asapplicable?- young children from low income families may suffer if parents not willing to buy otc products.- In those cases where patients use OTC meds regularly for long term illnesses - e.g. paracetamol / cocodamol 8/500 for rthritis pain. Limiting prescription in these circumstances will cause great practicle problems for those who may be frail.- Chronic pain- Coeliac Babies/ young children Just turned 60- PPI’s Children’s paracetamol- It generates complaints as patients are only interested in themselves st that time and not wider context in general. Huge inequalities exists on who gets free scripts and who pays already It has to be national enforced not guidance- Anything for children or anyone else entitled to free prescriptions.- arthritis- Paracetamol as it can only be purchased in small quantities.- potential problems with older age groups buying otc meds for dyspepsia when they should be presenting early to GP for assessment

Q7 What do you think are the reasons that some patientswould rather have medicines prescribed instead of buyingthem over the counter? Please tick all that apply

Q8 Do you think it will have an impact on the level ofcomplaints at your surgery?

43



Appendix 5

0 10 20 30 40 50 60 70 80



A hard copy printed information leaflet (with a statement from your CCG reinforcing it is not optional for GPs to take part)

A face to face conversation with a healthcare professional such as a nurse or pharmacist


2

20%

32%

44%

4%

0%

Extremely confident

Very confident

Somewhat confident

Not very confident

Not at all confident

0 20 40 60 80 100

Young parents

Elderly

Low income / unemployed

Disabled

Other

Q9 Which of the following do you feel would help supportboth yourself and your patients in this transition period toreduce any complaints?

Q10 How confident do you think you would be encouragingyour patients to buy over the counter after a publicitycampaign?

Q11 Which group(s) in society do you feel these changes willimpact the most? (Please tick all that apply)

Q4 How do you think we can raise awareness about thechanges? (Please tick all that apply)

44


Appendix 5 Q12 Please use the space below for any other comments or feedback regarding these changes.

I currently see alot of patient in our drop in minor illness cllinic on a daily basis. Alot of the patient i see could self treat but do not want to payfor otc medicines,, and often expect a prescription as they normally do not pay for it. Older pts complain saying they paid into there nationalinsurance and feel entitled to free medicines, others says they cannot afford to buy medicines, as on low incomes, some of the conditions andself limiting so my advice is to avoid expensive products and just buy cheap otc products such as paracetamol from a supermarket, etc I feelthat pharmacies charge alot more for products such as paracetamol, iburofen, sudofed antihystamines etc which can be bought muchcheaper in supermarkets, but patients are not aware of this. also non branded products which are just as effective with the same ingredientscan be much cheaper so patients need to be advised of this and they may be more willing to pay for things instead of asking for prescriptions.

GMC recommends a prescription should be given if clinically indicated. NHS England advice conflicts with this. If there is a complaint made toGMC re: this , whose side will NHS England or GMC support the rationale behind the decision

If it was made compulsory, I/e GP's can NOT prescribe certain items. If GP's knew that they would have support and back up in the event ofcomplaints.

we have to change the culture and ethos of the NHS so that patients don't expect "everything on the nhs " perhaps charging a lesser amountfor a prescription for everybody so that everyone pays the current system is in equitable some get everything free on prescription (those onlevothyoxine) why ?? whilst others very ill cardiac patient for instance under 60 have to pay there are many more!!

We should have some system in place to protect the ‘vulnerable’

Needs central government policy not local guidelines This puts all the pressure back on the GP Ban prescription for all the items mentionedand make a charge for all scripts of £1 per item irrespective of age and you will reduce waste in the blink of an eye Make everything free andpeople will just take it because it’s free so “what’s the problem “

There should be a national policy to blacklist medications that should not be available on prescription and not a local policy which putspressure on the individual GP faced with an individual patient to raise the sometimes difficult issue of non prescribing and the expectation thatthe patient should self medicate. Any degree of discretion means there will be pressure on GPs and inevitably there will be inequity. It alsoadds to the amount of explanation that needs to be included in the small amount of time GPs have with patients and will lead to complaintswhich need to be responded to and which are also demoralising to encounter (as they are often quite personal). It is also demoralising for GPsto be constantly used as agents of the state. It is not right to expect several million one to one discussions to change patients' behaviour asthis will take for ever to work. (This applies to almost every public health policy too!).

The most difficult discussions I have had about this have been with working people who have a pre-payment certificate and therefore feel theyshouldn't have to 'pay again'. Interestingly, in my experience (we've been discussing this with our patients for a few months now), those whodon't pay for prescriptions anyway, always seem to me more willing to buy (eg the elderly)!

Would help if some items were just black listed - if we really want to fund NHS for years to come then cut the flab now.

Q13 Whilst you can choose to remain anonymous in this survey, you are welcome to include your contact details below.Only those willingto be champions provided full details, please see next question.

Q14 We also welcome representatives to become champions for their area whereby we will hold local forums to share best practice.Would you like to become a champion?- Philippa Harrisson, GP, Kingfisher Surgery, North Road, Retford, Notts, DN22 7FX. Email address: [email protected] Dr J Joseph, GP, Crown House Surgery, Retford. Email address: [email protected] Catherine Harrison, GP Partner, Tuxford Medical Centre, Faraday Avenue, Tuxford, Notts, NG23 6RN. Email address

[email protected] Laura Sharp, Practice Pharmacist, Scott Practice, Doncaster, DN4 0TG

45


APPENDIX 6DONCASTERPRESCRIBERSURVEY RESULTS

Appendix 6 See following pages for full results from the Doncaster Prescriber Survey.

Q1 Where do you work?

Answered: 110 Skipped: 0

Askern MedicalPractice

BarnburghSurgery

ConisbroughGroup Practice

ConisbroughMedical...

Denaby MedicalCentre

Dr Sheikh'sSurgery

DunsvilleMedical Centre

HatfieldHealth Centre

MexboroughHealth Centre

NorthfieldSugery

Oakwood Surgery

Park ViewSurgery

PetersgateMedical Centre

Regent SquareGroup Practice

Same DayHealth Centre

Scawby HealthCentre

St John'sGroup Prctice

St VincentMedical Centre

The BentleySurgery

The BurnsPractice

1 / 21

Doncaster CCG - Self Care Role Out Consultation Survey for GP Practices46

The EdlingtonPractice

The Field RoadSurgery

The FlyingScotsman

The GreatNorth Practice

The KingthorneGroup Practice

The LakesidePractice

The MayflowerMedical...

The MedicalCentre

The MountGroup Practice

The NayarPractice

The NelsonPractice

The New Surgery

The RansomePractice

The RossingtonPractice

TheSandringhram...

The ScottPractice

The VillagePractice

Thorne MoorMedical...

Tickhill &Colliery...

West End Clinic

White HouseFarm Medical...

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

2 / 21


0.91% 1

2.73% 3

1.82% 2

0.00% 0

1.82% 2

2.73% 3

2.73% 3

0.00% 0

0.00% 0

0.91% 1

3.64% 4

1.82% 2

2.73% 3

0.00% 0

0.00% 0

2.73% 3

2.73% 3

4.55% 5

4.55% 5

1.82% 2

8.18% 9

0.00% 0

2.73% 3

0.91% 1

10.00% 11

3.64% 4

1.82% 2

3.64% 4

4.55% 5

0.91% 1

5.45% 6

2.73% 3

1.82% 2

4.55% 5

1.82% 2

0.00% 0

ANSWER CHOICES RESPONSES

Askern Medical Practice

Barnburgh Surgery

Conisbrough Group Practice

Conisbrough Medical Practice

Denaby Medical Centre

Dr Sheikh's Surgery

Dunsville Medical Centre

Hatfield Health Centre

Mexborough Health Centre

Northfield Sugery

Oakwood Surgery

Park View Surgery

Petersgate Medical Centre

Regent Square Group Practice

Same Day Health Centre

Scawby Health Centre

St John's Group Prctice

St Vincent Medical Centre

The Bentley Surgery

The Burns Practice

The Edlington Practice

The Field Road Surgery

The Flying Scotsman

The Great North Practice

The Kingthorne Group Practice

The Lakeside Practice

The Mayflower Medical Practice

The Medical Centre

The Mount Group Practice

The Nayar Practice

The Nelson Practice

The New Surgery

The Ransome Practice

The Rossington Practice

The Sandringhram Practice

The Scott Practice

3 / 21


3.64% 4

0.00% 0

0.91% 1

2.73% 3

1.82% 2

TOTAL 110

The Village Practice

Thorne Moor Medical Practice

Tickhill & Colliery Medical Practice

West End Clinic

White House Farm Medical Practice

4 / 21


36.36% 40

20.91% 23

20.00% 22

3.64% 4

2.73% 3

16.36% 18

Q2 What is your role?


TOTAL 110

GP

PracticeManager

Nurse

HealthcareAssistant

Pharmacist

Other (pleasespecify)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


GP

Practice Manager

Nurse

Healthcare Assistant

Pharmacist


5 / 21


6.36% 7

23.64% 26

53.64% 59

15.45% 17

0.91% 1

Q3 How do you rate your own level of awareness with NHS England'sConsultation on Self Care?


TOTAL 110

Excellent

Very good

Good

Poor

Very poor

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Excellent

Very good

Good

Poor

Very poor

6 / 21


26.36% 29

22.73% 25

50.91% 56

Q4 There are three parts to the roll-out:A) Publicity campaignB)Decommissioning products which affect GP Practice prescribing C) The

removal of self-care products from the minor ailments scheme/cessation of minor ailment schemeIn rolling out self-care in Doncaster,

do you think we should:


TOTAL 110

Do all threeat the same...

Do A, C then B?

Do A, then Band C?

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Do all three at the same time (A, B and C)?

Do A, C then B?

Do A, then B and C?

7 / 21


45.45% 50

30.00% 33

24.55% 27

Q5 Do you think there is a benefit in decommissioning (stoppingprescribing) by condition, over a number of months ( see list in

Question 7)?


TOTAL 110

YES

NO

DON'T KNOW

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


YES

NO

DON'T KNOW

8 / 21


49.09% 54

44.55% 49

6.36% 7

Q6 Do you think we should decommission (stop prescribing) all at once?


TOTAL 110

YES

NO

DON'T KNOW

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


YES

NO

DON'T KNOW

9 / 21


64.55% 71

35.45% 39

Q7 As per the question above, do you agree that the minor ailmentsscheme should be affected by these changes


TOTAL 110

Yes

No

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Yes

No

10 / 21


Q8 Are there any specific conditions / areas within the self-care listbelow, with which you have particular concerns with persuading

patients to purchase instead and limiting your prescribing to exceptionalcases as applicable? If 'YES', please give further details:


Probiotics

Vitamins andminerals

Acute SoreThroat

Infrequentcold sores o...

Conjunctivitis

Coughs andcolds and na...

Cradle Cap(Seborrhoeic...

Haemorrhoids

Infant Colic

Mild Cystitis

Mild IrritantDermatitis

Dandruff

Diarrhoea(Adults)

Dry Eyes/Soretired Eyes

Earwax

Excessivesweating...

Head Lice

Indigestionand Heartburn

InfrequentConstipation

11 / 21


9.43% 5

15.09% 8

28.30% 15

Constipation

InfrequentMigraine

Insect bitesand stings

Mild Acne

Mild Dry Skin

Sunburn due toexcessive su...

Sun Protection

Mild toModerate Hay...

Minor burnsand scalds

Minorconditions...

Mouth ulcers

Nappy Rash

Oral Thrush

Prevention ofdental caries

Ringworm/Athletes foot

Teething/Mildtoothache

Threadworms

Travel Sickness

Warts andVerrucae

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Probiotics

Vitamins and minerals

Acute Sore Throat

12 / 21


15.09% 8

32.08% 17

22.64% 12

11.32% 6

35.85% 19

16.98% 9

9.43% 5

13.21% 7

9.43% 5

20.75% 11

11.32% 6

11.32% 6

16.98% 9

26.42% 14

37.74% 20

9.43% 5

22.64% 12

13.21% 7

9.43% 5

11.32% 6

9.43% 5

9.43% 5

26.42% 14

15.09% 8

24.53% 13

11.32% 6

20.75% 11

30.19% 16

11.32% 6

22.64% 12

13.21% 7

20.75% 11

13.21% 7

26.42% 14

Total Respondents: 53

Infrequent cold sores of the lip

Conjunctivitis

Coughs and colds and nasal congestion

Cradle Cap (Seborrhoeic dermatitis – infants)

Haemorrhoids

Infant Colic

Mild Cystitis

Mild Irritant Dermatitis

Dandruff

Diarrhoea (Adults)

Dry Eyes/Sore tired Eyes

Earwax

Excessive sweating (Hyperhidrosis)

Head Lice

Indigestion and Heartburn

Infrequent Constipation

Infrequent Migraine

Insect bites and stings

Mild Acne

Mild Dry Skin

Sunburn due to excessive sun exposure

Sun Protection

Mild to Moderate Hay fever/Seasonal Rhinitis

Minor burns and scalds

Minor conditions associated with pain, discomfort and/fever. (e.g. aches and sprains, headache, period pain, back pain)

Mouth ulcers

Nappy Rash

Oral Thrush

Prevention of dental caries

Ringworm/Athletes foot

Teething/Mild toothache

Threadworms

Travel Sickness

Warts and Verrucae

13 / 21


33.64% 37

42.73% 47

23.64% 26

Q9 Would you support treatments for these conditions remainingavailable via a pharmacy minor ailments scheme? This could maintain

funded access for potentially vulnerable patient groups at a loweradministrative and financial cost than the prescription route.


TOTAL 110

Yes - for all

Yes - forvulnerable...

No - confusesthe message

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Yes - for all

Yes - for vulnerable groups only

No - confuses the message

14 / 21


2.73% 3

31.82% 35

50.91% 56

11.82% 13

2.73% 3

Q10 Taking into account your contractual position (which means youcan not refuse to prescribe if asked and clinically indicated), how

confident are you currently to persuade your patients (not withstandingconcerns of particular conditions in question 7) to purchase over the

counter rather than receive a prescription.


TOTAL 110

Very confidentthis will...

Confident thiswill happen

Not sure

Confident thiswill not happen

Very confidentthis will no...

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Very confident this will happen

Confident this will happen

Not sure

Confident this will not happen

Very confident this will not happen

15 / 21


7.27% 8

28.18% 31

53.64% 59

8.18% 9

2.73% 3

Q11 And how confident do you think you would be, encouraging yourpatients to buy over the counter after a publicity campaign?


TOTAL 110

Extremelyconfident

Very confident

Somewhatconfident

Not soconfident

Not at allconfident

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Extremely confident

Very confident

Somewhat confident

Not so confident

Not at all confident

16 / 21


54.13% 59

87.16% 95

76.15% 83

46.79% 51

86.24% 94

81.65% 89

Q12 How do you think we can best raise awareness about thechanges? (please check all that apply)



practicenewsletter

leaflets/posters in the...

priornotification...

letter toaffected...

regional media

national media

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


practice newsletter

leaflets/posters in the surgery

prior notification with prescriptions for the affected products/medicines

letter to affected patients

regional media

national media

17 / 21


46.36% 51

90.91% 100

28.18% 31

23.64% 26

11.82% 13

Q13 Which of the following do you feel would help support both yourselfand your patients in this transition period to reduce any complaints?

(check any that apply)



An onlineresource suc...

A hard copyprinted...

A face to faceconversation...

A telephoneconversation...

Other (pleasespecify)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%



A hard copy printed information leaflet (with a statement from your CCG reinforcing it is not optional for GPs to take part)

A face to face conversation with a healthcare professional such as a nurse or pharmacist



18 / 21


58.18% 64

11.82% 13

30.00% 33

Q14 Are you able to support care facilities using a homely remediespolicy eg: reviewing the list of items


TOTAL 110

Yes

No

Unsure

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Yes

No

Unsure

19 / 21


Q15 Are there any particular concerns you have regarding patients whomay be disproportionately affected by these changes? Please use the

space below to give us your feedback, thank you.


20 / 21


0.00% 0

0.00% 0

0.00% 0

0.00% 0

0.00% 0

0.00% 0

0.00% 0

0.00% 0

100.00% 17

0.00% 0

Q16 If you would like to take part in a focus group and share yourviews, please give your nhs email below, thank you.



Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

21 / 21


67


APPENDIX 7BARNSLEYCONSULTATIONREPORT

Appendix 7 See following pages for the Barnsley consultation report.

Promoting self-care and over the counter medicines 2018

Engagement Report 1. Background NHS Barnsley Clinical Commissioning Group (CCG) has the responsibility for the commissioning (planning and buying) of local healthcare services for the benefit of the people of Barnsley. Following a national public consultation, which we promoted locally earlier in 2018, NHS England has published national guidance1 to CCGs on reducing the prescribing of over the counter medicines for some minor, short-term health conditions. They state that for a range of common, minor short-term health conditions that people are encouraged to self-care and that GPs should no longer routinely prescribe. These are conditions which will clear up quite quickly with self-care, or there are medicines available to buy over the counter at your pharmacy or local store which will relieve symptoms. What did we want to find out? Our proposal as a CCG is to adopt this national guidance and promote more self-care in Barnsley and as a result we set out to hear local views on this and to find out what local people think we need to consider in relation to how this guidance is rolled out across Barnsley. This includes views on the Barnsley PharmacyFirst2 scheme, where local pharmacies can currently provide medication and advice on a range of common conditions and local people only pay the price of any recommended medication which is often cheaper than a prescription, or it’s free to those exempt from prescription charges. This report details all of the collective feedback that we received as part of the above engagement exercise. What will we do with the information and feedback received? All the information and feedback we received from a variety of sources will now feed into the CCG Governing Body to aid their decision making process and next steps regarding the roll out of this guidance locally and determining the local impact of this on our PharmacyFirst scheme. 1 https://www.england.nhs.uk/wp-content/uploads/2018/03/otc-guidance-for-ccgs.pdf 2 http://www.barnsleyccg.nhs.uk/patient-help/pharmacy-first.htm

68

2. Summary of the key themes from the collective feedback we have received What people told us Overall we received feedback from 125 individuals and the key themes taken from this engagement are as follows: We asked people to provide general comments on the overall guidance and what we need to consider locally when implementing this. The feedback fell into three broad themes. The majority of people agreed with the proposals within the guidance. They fell into two groups; those respondents who agreed completely and those respondents who agreed but had concerns. The final, smaller group disagreed and shared some of the concerns which are detailed below. Of those people who agreed completely they highlighted that the CCG need to provide plenty of notice before implementing this change locally and that effective communications is key to implementing any change successfully. In terms of concerns expressed, the following key areas were amongst those stated; The GP decision needs to be based on the individual We need to ensure that by implementing this guidance we aren’t widening inequalities and the

‘socially vulnerable’ exception is applied in cases where people are on a limited income Concern over the counter medicines aren’t effective for some minor conditions The CCG has a role in signposting. We asked people what sort of ways they thought we could be providing better or more information and signposting on self-care in Barnsley and the following feedback was provided in relation to the following themes; Advertise what is happening and what it means for people and do it widely. Work with local

people/ patient representative groups to develop the information and sense check it Face-to-face conversations are key with doctors, nurses and pharmacy staff Co-ordinate advice between pharmacies and GPs

We asked people what we need to consider when applying this new guidance specifically in relation to our local PharmacyFirst scheme and the feedback we received broadly fell into the following areas;

- those people who use (patients) or provide (pharmacies) PharmacyFirst on a regular basis, value this and would like to see it stay the same;

- those people who use the scheme and would support changes to this in line with the new guidance;

- those people who have heard of the scheme but haven’t used it and; - those people who have never heard of it.

69

The majority of feedback to this question came from patients and pharmacies in support of keeping the PharmacyFirst scheme as it is due to how effective this has proven to be from their personal experience. The feedback highlighted that for those people who have used PharmacyFirst they have found this to be a really useful scheme that often saves people taking unnecessary GP appointments which people often struggle to access in the first place. The service is especially valued by those people who are on low incomes, parents of young children and older people. We asked people specifically what we need to consider when this guidance is applied in Pharmacies and the feedback we received fell into the following themes; Clear guidance and criteria needs to be provided and in place across the borough. There is a need to improve health education and awareness of what is available and where Privacy issues in terms of accessing confidential advice in a pharmacy

Who fed back and how they heard about this work Over half of the respondents to the survey self- identified as patients (64%).

Over 10% of the responses we received were on behalf of organisations (Pharmacies,

Community Organisations etc.) The survey feedback we received overwhelmingly came from female respondents (80%).

The majority of responses received came from people who are between the ages of 35 and 64

(63%).

Over 90% of respondents to the survey stated their ethnicity as White British and their sexuality as Heterosexual.

Over 50% of respondents identified as living with some form of disability with over 25% stating they had a long term condition.

30% of respondents highlighted that they have unpaid caring responsibilities for a family member

or friend

Over 80% of people who responded felt that enough information was provided to enable them to provide their views and feedback in relation to this topic.

40% of people responded to the survey after seeing the information on social media followed by

over 25% of respondents who were notified of the survey via their local pharmacy.

70

3. Our engagement We set out with the aim to carry out engagement activity that would: Obtain views and feedback from patients, carers, public and clinicians from across Barnsley in

relation to what we need to consider when adopting the new national guidance and the implications on our local PharmacyFirst scheme. Our overall aim is that this feedback shapes our decision making.

Be in accordance with the National Health Service Act 2006 (as amended by the Health and Social Care Act 2012), in which CCGs and NHS England have duties to involve the public in commissioning, (under sections 14Z2 and 13Q respectively).

Feedback has been collected in a variety of ways. Prior to the publication of the national guidance a workshop was held for Barnsley Patient Council members who represent GP practice patient groups from across the borough. Their feedback is captured as part of the general feedback. They also helped shape the wider involvement activity. The minutes from that meeting are available on the CCG website. A survey outlining the new guidance was used to collect views. This was promoted in the following ways: In person: Face to face surveys were carried out at pharmacies in Wath-upon-Dearne and Penistone.

Online: Online on the ‘Get Involved’ section of the NHS Barnsley CCG website. Social media posts via the CCG Facebook and Twitter pages. Targeted Facebook adverts were placed with a direct link through to the survey information.

Sent directly to stakeholders: Circulated by local partners working across the health and social care economy. Sent to members of the NHS Barnsley CCG Patient Council. Sent to members of OPEN (Our Public Engagement Network) database. Paper copies of the survey and posters were sent to every GP practice, pharmacy, library and

children’s centre. Sent directly to a wide list of stakeholders including elected members, MPs, Healthwatch

Barnsley. Press release was issued to local media. Promoted in weekly CCG primary care newsletter. Promoted to pharmacies via the LPC (Local Pharmaceutical Committee) E-bulletin. Promoted to pharmacies via PharmOutcomes, which is a web based system used by community

pharmacists.

71

4. Acknowledgements We would like to take this opportunity to thank all of the individuals and organisations who have taken the time to share their views and also get involved in the promotion of this survey.

5. Detailed feedback received We received responses from 125 respondents in total to the above survey by the closing date of Wednesday 5th September 2018 in addition to groups that fed back including the Barnsley Patient Council and the Barnsley Local Medical Committee. The survey was promoted on Twitter, Facebook and Instagram through both paid for and non-paid for posts. The overall reach of the posts on Facebook was 17,045 people. 28 people commented, 45 shared the post and 36 people liked to posts. 1 person was angry at the post. Twitter posts gained 5,956 impressions with 11 retweets, 7 likes and 29 clicks through to the survey information. A summary of all the feedback we received can be found below. Please note that not everyone answered every question. Who responded? Q1) Please can you tell us who you are responding on behalf of ? Patient 79 (64%)

Family member, carer, friend of patient 11 (10%)

Member of public 18 (15%)

Patient representative organisation 0

Voluntary organisation or charity 3 (2%)

Community Pharmacy 5 (4%)

GP 0

GP Practice Pharmacist 0

Other 6 (5%)

Barnsley Council, GP Receptionist, Nurse, Pharmaceutical Representative

72

The new guidelines Q2) Having read the information on which conditions this applies to and together with the list of conditions, please tell us what you think we need to consider when putting these national guidelines in place across Barnsley? 123 people provided a response in relation to the above question. We asked people to provide general comments on the overall guidance and what we need to consider locally when implementing this. The feedback fell into three broad themes. The majority of people agreed with the proposals within the guidance. They fell into two groups. Those who agreed completely and those who agreed but had concerns. The final, smaller group disagreed and shared some of the concerns. Those who agreed also said: Provide plenty of notice before implementing this change locally Communications is key

o Provide guidance on what self-care is o Provide guidance on how long things should last and when to get further information

and where to go o Ensure language is clear o Advertise it clearly (range of examples given) o Consider promoting cheaper generic brands to reduce cost burden o When the change happens, ensure that current prescriptions aren’t changed without

review of case and conversation with individual Those who agreed but added concerns said:

o Concerned I won’t know when something is getting worse/something more serious is missed

o The GP decision needs to be based on individual o Need to ensure we aren’t widening inequalities and the ‘socially vulnerable’ exception is

applied in these cases o Concern over the counter medicines aren’t effective for some minor conditions o Better advice is needed from pharmacists and advice/ guidance by pharmacists should

not be in front of everyone else Those who didn’t agree said: Keep the PharmacyFirst scheme Still prescribe for people on a limited income

Those who provided further information said the PharmacyFirst scheme should remain in its current format and said that it helped them financially, it was convenient and they didn’t want to take up a GP appointment.

73

Advice and guidance for self-care Q3) What sort of ways do you think we should be providing better or more information and signposting on self-care in Barnsley? The CCG has a role in signposting. We asked people what sort of ways they thought we could be providing better or more information and signposting on self-care in Barnsley. 113 people provided a response in relation to the above question and the feedback fell into the following themes; Advertise what is happening and what it means for people and do it widely

o Use social media but don’t rely on it o Promote in health care settings via leaflets posters BUT do it in lots of other places as

it’s too late once you’re in the GP surgery o Enlist help of GP reception staff o Add message to GP telephone system o Via groups/teams in touch with families

Face-to-face conversations are key with doctors, nurses and pharmacy staff– there are

already enough campaigns and leaflets. Give people confidence to wait it out.

Work with people to develop the information

Improve health literacy o Work with schools

Co-ordinate advice between pharmacies and GPs as experience of conflicting information

on who you should see

Have a triage nurse instead of receptionist for some of the time, who can signpost to pharmacy where appropriate

The Barnsley PharmacyFirst Scheme Q4) What do we need to consider when applying this new guidance to the PharmacyFirst scheme across Barnsley? 108 people provided a response in relation to the above question. We asked people what we need to consider when applying this new guidance specifically in relation to our local PharmacyFirst scheme and the feedback we received broadly fell into the following areas; those people who use (patients) or provide (pharmacies) PharmacyFirst on a regular basis, value this and would like to see it stay the same; those people who use the scheme and would support changes to this in line with the new guidance; those people who have heard of the scheme but haven’t used it and those people who have never heard of it.

74

We received feedback along the lines of the following; Praise for PharmacyFirst and support to retain this in its current form – really useful

scheme that often saves people taking unnecessary GP appointments which people often struggle to access in the first place. The service is especially valued by those people who are on low incomes, parents of young children and older people.

By changing the way in which PharmacyFirst operates this could have an impact on more people seeking a GP appointment then going to see their Pharmacist which could lead to the opposite effect the scheme was designed to have when first implemented.

Concerns expressed over people accessing the advice under the scheme but not

being able to afford the treatment and going without thus making something ‘minor’ more significant and longer term. This could have a particularly harmful effect on children and vulnerable adults.

Get clear advice out to the public and the pharmacists - ensure people are informed

what they are entitled to and what they aren’t and be really clear about the reasons why. Explain the reasons for this and give enough time for people to be made aware of this before it happens as this could lead to people being frustrated if they have come to expect or rely on this service from their local pharmacy.

Health education - Use any change to the scheme to raise awareness of the existence

of PharmacyFirst in terms of the advice element as some people are unaware of what it is and does. Education of the public is imperative to ensure they are aware that, for these type of ailments, a pharmacist is really well qualified to advise.

Q5) What do we need to consider when this guidance is applied in Pharmacies? We asked people specifically what we need to consider when this guidance is applied in Pharmacies and 86 people provided a response in relation to this. The feedback we received fell into the following themes; Clear guidance and criteria

o For pharmacists to follow in terms of PharmacyFirst and the wider guidance o For patients affected by the changes o Consistent messaging across the borough

Improve health education - Through effective advice as part of PharmacyFirst more

people will be equipped and knowledgeable to self- care in the future

Privacy issues - all pharmacies need a location where private consultations can take place and where people can ask for confidential advice without being overheard.

75

Q6) Did we provide enough information for you to be able to comment on the questions we asked? Yes 96 (81%) No 4 (3%) Unsure 18 (16%) Q7) Where did you hear about the survey? Via Pharmacy 32 (27%) Via GP Practice 6 (5%) Via direct emails from CCG 20 (17%) Via CCG website 10 (8%) Via Social Media – CCG/ GP/ Pharmacy/ Community Page or Feed (Facebook/ Twitter)

51 (43%)

Keep in touch 16 people provided their contact details and asked to be kept updated by the CCG regarding this and other work being undertaken in the future.

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Equality Monitoring Section Age of respondents Under 18 0 18 – 24 0 25 – 34 11 (8%) 35 - 44 39 (31%) 45 – 54 20 (16%) 55 – 64 20 (16%) 65 – 74 21 (17%) 75 – 84 7 (6%) 85 + 0 Prefer not to say 7 (6%) Postal code areas indicated HD8, S25, S36, S63, S70, S71, S72, S73, S74, S75 Gender Male 21 (18%) Female 93 (80%) Prefer not to say 2 (2%) Transgender - Do you live and work permanently in a gender other than the one you were born into? Yes 0 No 107 (93%) Prefer not say 8 (7%) Ethnicity White (UK) 112 (96%) White (Irish) 1 (1%) White (Other) 3 (2%) Prefer not say 1 (1%) Sexual Orientation Bisexual 0 Gay Man 2 (2%) Lesbian 1 (1%) Heterosexual 103 (93%) Prefer not to say 5 (4%) Religion No religion 51 (44%) Agnostic 2 (1%) Buddhist 1 (1%)

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Christian 58 (50%) Jewish 1 (1%) Prefer not to say 4 (3%) Disability (Multiple Choice Question) I don’t have a disability 57 (46%) Mental Health Condition 18 (14%) Physical Impairment 18 (14%) Long standing illness 33 (26%) Cognitive Impairment 4 (3%) Sensory Impairment 4 (3%) Speech Impairment 5 (4%) Prefer not to say 5 (4%) Carer Yes 37 (32%) No 80 (68%) 6. Next Steps This engagement process has provided feedback from patients, carers, clinicians and other stakeholders regarding promoting self- care and what we need to consider when adopting the new national guidance for CCG’s in relation to prescribing over the counter medicines and the impact of this on our local PharmacyFirst scheme. This information will now feed into the CCG Governing Body to aid their decision making process and next steps regarding the roll out of this guidance locally and help to understand the potential local impact of this on our PharmacyFirst scheme. This report is to be made publically available and will be sent directly to those respondents who have requested it. Again we would like to reiterate our thanks to all respondents who have given their time to share their views to help inform this process and to all partners who have helped us to gain their feedback.

V2 – 06/09/18

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7. Appendix 1 – Survey Over the counter medicines survey Introduction Introduction: New guidance for GPs on when not to prescribe medication that can be bought over the counter There is new guidance from NHS England on a number of minor health conditions for which GPs, nurses and other healthcare professionals should no longer routinely give you a prescription for when the medication or treatments can be bought from a pharmacy or store. These are minor conditions which will clear up quite quickly with self-care, or there are medicines available to buy over the counter at your pharmacy or store which will relieve symptoms.

These are minor conditions including coughs and colds, constipation, stomach upsets, dandruff, headaches, infant colic, heartburn, headlice, nappy rash. The guidance also covers prescriptions for probiotics and vitamins and minerals.

This means you will no longer normally be able to get medication prescribed by your GP or practice nurse for these minor conditions. This applies if you get free prescriptions or not. It will also apply to most of the conditions in the Barnsley PharmacyFirst scheme. Will this apply to everybody? No there are a number of exceptions. It is important to say that GPs will still prescribe the sorts of medicines which you can by from a pharmacy or store (over the counter) for people with longer-term or more complex conditions, or where minor illnesses are a symptom or a side effect of something more serious. The medicines can also be prescribed if someone isn't as able to self manage a condition because of medical or mental health issues or ’significant social vulnerability’, the guidance says. We are clear that GPs, in conversation with the patient, will still be able to make the final clinical decision to prescribe these over the counter medicines. Why is there new guidance? As the local NHS in Barnsley, we spend around £2million a year on prescribing medications for conditions that:

Are considered to be self-limiting and so do not need treatment as it will heal or be cured of its own accord; Which lends itself to self-care i.e. the person suffering does not normally need to seek GP medical advice and can manage the condition by medical advice from a pharmacist or purchasing over the counter items directly from them or a store.

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As a clinical commissioning group we are responsible for making the most of the NHS money that is available to Barnsley. The new guidance is available to read online at www.barnsleyccg.nhs.uk/haveyoursay. Paper copies are available by calling 01226 433773. We want to hear your views This national guidance has been developed after a full public consultation also available here www.barnsleyccg.nhs.uk/haveyoursay. Before we put this guidance into place in Barnsley, we want to hear from local residents, people working in health and any other interested parties. We want to understand what we need to consider before this guidance is put in place. We will collect everyone's feedback and it will be used to help design how this is rolled out across Barnsley. This is to make sure it is as easy and clear for all patients and healthcare teams as possible to know what the new guidance means for them. The deadline for feedback is Wednesday 5th September. Thank you for taking the time to share your views and suggestions.

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About you We want to hear from a wide range of people. Please help us understand how you are responding today.

I am responding as a: (Please select one answer)

Patient ............................................................................................................... ...............................

Family member, carer, friend of patient ...........................................................................................

Member of public ............................................................................................................................. .

Patient representative organisation ..................................................................................................

Voluntary organisation or charity .......................................................................................................

Community Pharmacy .......................................................................................................................

GP ............................................................................................................................. ........................

GP practice pharmacist .....................................................................................................................

Other (please provide details below) ................................................................................................

If you ticked 'other' please provide details here

Name of your organisation (if applicable)

The new guidelines These are the conditions that are included in the new guidance: The conditions are the ones listed below which you don’t usually need to see a GP for. Even though you may have minor symptoms, these are the conditions where you will either get better quite quickly without needing medication, or you can treat yourself by getting relief from medication purchased from a pharmacy or store. General vitamins/minerals and probiotics are also included as part of the national guidance and would no longer be available on prescription, as these items have limited clinical effectiveness. People suffering severe or long term symptoms would still be prescribed medicines for these conditions or illness. For example people who also have a more serious illness like cancer or a long-term illness like arthritis. Items of limited clinical effectiveness

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Probiotics Vitamins and minerals (exception for people with a medically diagnosed deficiency or Healthy Start vitamins)

Self-Limiting Conditions 1. Acute Sore Throat 2. Infrequent cold sores of the lip 3. Conjunctivitis 4. Coughs and colds and nasal congestion 5. Cradle Cap (Seborrheic dermatitis – infants) 6. Haemorrhoids 7. Infant Colic 8. Mild Cystitis Minor Conditions Suitable for Self-Care 1. Mild Irritant Dermatitis 2. Dandruff 3. Diarrhoea (Adults) 4. Dry Eyes/Sore tired Eyes 5. Earwax 6. Excessive sweating (Hyperhidrosis) 7. Head Lice 8. Indigestion and Heartburn 9. Infrequent Constipation 10. Infrequent Migraine 11. Insect bites and stings 12. Mild Acne 13. Mild Dry Skin 14. Sunburn due to excessive sun exposure 15. Sun Protection 16. Mild to Moderate Hay fever/Seasonal Rhinitis 17. Minor burns and scalds 18. Minor conditions associated with pain, discomfort and/fever. (e.g. aches and sprains, headache, period pain, back pain) 19. Mouth ulcers 20. Nappy Rash 21. Oral Thrush 22. Prevention of dental caries 23. Ringworm/Athletes foot 24. Teething/Mild toothache 25. Threadworms 26. Travel Sickness 27. Warts and Verrucae Please tell us what you think

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Having read the information on which conditions this applies to and together with the list of conditions, please tell us what you think we need to consider when putting these national guidelines in place across Barnsley.

Please give as much detail as possible.

Advice and guidance for self-care This guidance is intended to encourage people to self-care for minor illnesses as the first stage of treatment. In most cases these minor conditions will clear up with appropriate self-care. If symptoms are not improving or responding to treatment, then patients should be encouraged to seek further advice. When implementing this guidance, NHS England has said that clinical commissioning groups will need to supply patients with better information on signposting so that they are able to access the right service. This guidance is not intended to discourage patients from going to the GP when it is appropriate to do so. What sort of ways do you think we should be providing better or more information and signposting on self-care in Barnsley?

The Barnsley PharmacyFirst scheme Pharmacies are able to offer expert, confidential advice and treatment for a whole range of minor common conditions. The new guidance will apply to anyone working in a GP practice or local pharmacy. This includes pharmacy teams who currently provide the Barnsley PharmacyFirst service, where you are encouraged to visit your pharmacy first, rather than see your GP. This scheme is for a range of common conditions very similar to those which are now in the new guidance. The new guidance would mean that in Barnsley, under the PharmacyFirst scheme, participating pharmacies will still give you free advice, which the CCG will continue to pay the pharmacy for, but you would need to buy the 'over the counter' medication yourself, rather than get it for free (if you don't pay a prescription fee). This applies to those common conditions where you can self-care. This brings pharmacies in line with GPs and anyone else working in a GP practice who can issue prescriptions. What do we need to consider when applying this new guidance to the PharmacyFirst scheme across Barnsley?

There are three conditions which do not appear in the national guidance but are included in our current PharmacyFirst scheme.

These conditions will stay in the PharmacyFirst scheme in Barnsley for both medication and advice.

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These are: vaginal thrush, scabies, eczema.

We will encourage people to see a pharmacy first for these things rather than go to a GP. However your pharmacy can advise at what stage you should see a GP if the condition isn't improving.

What do we need to consider when this guidance is applied in pharmacies?

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Equality Monitoring Form Please answer the following questions about yourself. The reason we are asking these questions so that we can better understand the responses we receive. Your answers will remain confidential. When reporting any findings we will only show overall statistics and/or the general themes. Data Protection Statement All information will be kept strictly confidential and in accordance with the Data Protection Act 1998 and associated protocols. Please tell us your postcode

Which age group are you in?

Under 18 ...........................................................................................................................................

18 - 24 ...............................................................................................................................................

25 - 34 ...............................................................................................................................................

35 - 44 ...............................................................................................................................................

45 - 54 ...............................................................................................................................................

55 - 64 ...............................................................................................................................................

65 - 74 ...............................................................................................................................................

75-84 ........................................................................................................ ...............................................

85+ ............................................................................................................................. .............................

What best describes your gender? (Please select one answer)

Female ............................................................................................................................. .......................

Male ..................................................................................................................................................

Prefer not to say ................................................................................................................................

Prefer to self -describe ...................................................................................................................... .......

Please describe.

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Do you live and work permanently in a gender other than the one you were born into?

No ............................................................................................................................. ........................

Yes ...................................................................................................................................................

Prefer not to say ............................................................................................................................. ...

How would you describe your ethnicity?

White - UK ............................................................................................................................. ............

White - Irish .................................................................................................................................

White - Gypsy or Traveller ................................................................................................................

Other White Background ...................................................................................................................

Prefer not to say ........................................................................................................................ ........

Arab ............................................................................................................................. .....................

White and Black African ..............................................................................................................

White and Black Caribbean ..............................................................................................................

White and Asian ..........................................................................................................................

Other Mixed/ Multiple Ethnic Background .........................................................................................

Other Black Background ...................................................................................................................

Black Caribbean ............................................................................................................................. ...

Black African ............................................................................................................... ......................

Indian ............................................................................................................................. ...................

Pakistani ...........................................................................................................................................

Bangladeshi ............................................................................................................................. .........

Chinese .............................................................................................................................................

Other Asian Background ............................................................................................................ .......

Other (please state)

How would you describe your sexual orientation? (please select one answer) Heterosexual/straight Lesbian/Gay Gay man .... Bisexual .... Prefer not to Other (please ............................. woman ........ say ............ state) ..........

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Please state How would you describe your religion? No religion ......................................................................................................................................... Buddhist ............................................................................................................................. ..................... Christian ................................................................................................ .................................................. Hindu ................................................................................................................................................. Sikh ............................................................................................................................. ............................ Jewish ............................................................................................................................. ........................ Muslim ............................................................................................................................................... Agnostic ............................................................................................................................................ Prefer not to say ................................................................................................................................ Other ....................................................................................................................... ................................ Do you have any of the following disabilities? (Please tick all that apply) (Please select all that apply) I do not have a disability ................................................................................................................... Mental Health Condition .................................................................................................................... Physical Impairment .......................................................................................................................... Cognitive Impairment ........................................................................................................................ Long Standing Illness ........................................................................................................................ Speech Impairment ........................................................................................................................... Sensory Impairment .......................................................................................................................... Learning Disability ............................................................................................................................. Learning Difficulty ............................................................................................................................. Prefer not to say ................................................................................................................................ Other (please state) Do you provide unpaid care for someone (friend/family member) ? (Please select one answer) Yes ................................................................... No ....................................................................

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21

Almost done Did we provide enough information for you to be able to comment? (Please select one answer) Yes............................................................................................................................................... No ............................................................................................................................. ......................... Unsure ......................................................................................................................................... Where did you find out about this survey? Receiving feedback Would you like to receive regular updates from the CCG about this and similar surveys you can get involved in? Please provide your name and email or postal address. You can unsubscribe at any time by emailing [email protected] Returning your survey by post is free. Please post your completed survey to us by 5th September 2018. Over the counter medicines survey Communications and Engagement Team FREEPOST RTCH-GAZH-TZJH, NHS Barnsley CCG, Hillder House, 49/51 Gawber Road, BARNSLEY, S75 2PY Alternatively you can access and complete the online survey via the following link at www.barnsleyccg.nhs.uk/haveyoursay

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89

APPENDIX 8GP PRACTICES BY CCG AREA

Appendix 8Barnsley GP PracticesApollo Court Medical CentreAshville Medical Practice Pms PracticeBarugh Green SurgeryBHF Highgate SurgeryBHF Surgery, LundwoodBrampton Health Centre PracticeBrierley Medical CentreCaxton House SurgeryDarton Health Centre PracticeDearne Valley Group PracticeDr A MunzarDr John HarbanDr John Harban ( Monk Bretton )Dr Mellor And PartnersGold Street SurgeryGoldthorpe Medical Centre Pms PracticeGrimethorpe SurgeryHigh Street PracticeHill Brow Surgery Pms PracticeHollygreen PracticeHollygreen PracticeHollygreen Practice (Thurnscoe)Hoyland First Pms PracticeHoyland Medical PracticeHuddersfield Road PartnershipKingswell Surgery Pms PracticeLakeside SurgeryLundwood Medical Centre PMS PracticePark Grove SurgeryPark Grove SurgeryPark Grove Surgery

Penistone Group Pms PracticePenistone Group Practice - Silkstone BranchRotherham Road Medical CentreRoyston Group PracticeSaxena Ir ( Cudworth )Singh D (Birdwell)Sriramulu VSt George's Medical Centre Pms PracticeThe Dove Valley Pms PracticeThe Grove Medical PracticeThe Kakoty PracticeThe Kakoty Practice Worsbrough Health CentreThe Rose Tree Pms PracticeThe Roundhouse Medical CentreThurgoland SurgeryVictoria Medical CentreWhite Rose Medical Practice- Monk BrettonWombwell Gms PracticeWombwell Medical Centre PracticeWood Jd ( High Green )Woodland Drive Medical Centre


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Appendix 8Bassetlaw GP PracticesBawtry & Blyth Medical (Blyth)Bawtry And Blyth MedicalCrown House SurgeryHarworth Medical CentreKingfisher Family PracticeLakeside SurgeryLarwood SurgeryNewgate Medical GroupNorth Leverton SurgeryOakleaf SurgeryRiverside Health CentreThe Misterton Group PracticeThe Village SurgeryTuxford Medical CentreWestwood SurgeryWyatt & Partners Gringley


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Appendix 8Doncaster GP PracticesThe Great North Medical GroupThe Ransome PracticeHatfield Health CentreMexborough Health CentreRegent Square Group PracticeThe Burns PracticeThe Mayflower Medical PracticeThe Mount Group PracticeOakwood SurgeryTickhill & Colliery Medical PracticeThe Rossington PracticeThe Lakeside PracticeThe Kingthorne Group PracticeNorthfield SugeryThe Scott PracticeSt John's Group PrcticeWhite House Farm Medical CentreThe Sandringhram PracticeThe Bentley SurgeryConisbrough Group PracticeThe Medical CentreThe Edlington PracticeSt Vincent Medical CentreScawby Health CentreThe Nayar PracticeThe New SurgeryThe Field Road SurgeryPetersgate Medical CentreThe Village PracticeAskern Medical PracticeBarnburgh Surgery

Auckley SurgeryDunsville Medical CentreThe Nelson PracticeThorne Moor Medical PracticeDenaby Medical CentreWest End ClinicDr Sheikh's SurgeryConisbrough Medical PracticePark View SurgeryThe Flying Scotsman Health Centre


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Appendix 8Rotherham GP PracticesValley Health CentreHighthorn Road SurgeryThe Market SurgeryBrinsworth Medical CentreGreasbrough Medical CentreKimberworth Park Medical CentreShakespeare Road Medical CentreClifton Medical CentreFerham ClinicParkgate Medical Centre,Thorogate SurgeryGate SurgeryRose Court SurgeryRawmarsh Health CentreWoodstock Bower SurgeryRotherham General HospitalChantry Bridge Medical PracticeThe Birkdale ClinicSurgery Of LightHigh Street SurgerySpire Elland HospitalYork Road SurgerySt Ann's Medical CentreBroom Lane Medical CentreStag Medical CentreThrybergh Medical Centre


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Appendix 8Sheffield GP PracticesAbbey Lane SurgeryBarnsley Road SurgeryBaslow Road SurgeryBirley Health CentreBlackstock Road SurgeryBroomhill SurgeryBuchanan Road SurgeryBurncross SurgeryBurngreave SurgeryCarrfield Medical CentreCarterknowle Road SurgeryChapeltown SurgeryCharnock Health PC CentreCrookes Valley Medical CentreCrystal Peaks Medical CentreDarnall Primary Care CentreDarnall Health CentreDeepcar Medical CentreDeer Park SurgeryDevonshire Green MCDore Road SurgeryDovercourt SurgeryDuke Medical CentreDunninc Road SurgeryDykes Hall Medical CentreEast Bank Medical CentreEcclesall Medical CentreEcclesfield Group PracticeElm Lane SurgeryFalkland HouseFar Lane Medical Centre

Firth Park SurgeryFoxhill Medical CentreGleadless Medical CentreGreenhill Health CentreGrenoside SurgeryGreystones Medical CentreHackenthorpe Med CentreHanover Medical CentreHandsworth Medical CentreHarold Street Medical CentreHeeley Green SurgeryHerries Road SurgeryHigh Green Health CentreJaunty Springs Health CentreJordanthorpe Health CentreLodge Moor SurgeryLowedges SurgeryLowedges & Batemoor Medical CentreManchester Road SurgeryManor Park Medical CentreManor Top Med Centre (Read)Margaretson SurgeryVeritas Health CentreMelrose SurgeryMiddlewood Medical CentreMill Road SurgeryMosborough Health CentreNethergreen SurgeryNorfolk Park Medical PracticeNorwood Medical CentreOughtibridge SurgeryOwlthorpe SurgeryPage Hall Medical CentrePark Health Centre


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Appendix 8Sheffield GP Practices continuedPitsmoor SurgeryPorter Brook Medical CentreRichmond Medical CentreRustlings Road Medical CentreSelborne Road Medical CentreSharrow Lane Medical CentreSheffield City GP Medical CentreSheffield Hallam Uni Medical CentreSheffield Medical CentreShiregreen Medical CentreShoreham Street SurgerySothall Medical CentreSouthey Green Medical CentreStannington Med Cntr (Shurmer)Stonecroft Medical CentreThe Avenue Medical PracticeThe Crookes PracticeThe Flowers Health CentreThe Health Care SurgeryThe Hollies Medical CentreThe Mathews PracticeThe Meadowhead Group PracticeThe Medical CentreThe Mulberry PracticeThe Sloan PracticeTotley Rise Medical CentreTrafalgar House Medical CentreTramways Medical CentreUniversity Health Service HCUpperthorpe Medical CentreUpwell Street Surgery

Valley Medical CentreWadsley Bridge Medical CentreWalkley House Medical CentreWhite House SurgeryWhite Lane SurgeryWincobank Medical CentreWoodhouse Health CentreWoodseats Medical Centre


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APPENDIX 9COMMUNITYPHARMACIES BYCCG AREA

Appendix 9 Barnsley Community Pharmacies


Lloyds Pharmacy Barnsley Interchange

ASDA Pharmacy Old Mill Lane

Lloyds Pharmacy 7 Cemetery RoadBarnsley EnterprisesLtd 21 Racecommon Rd

Ellisons Chemists 17 Huddersfield Rd

Cohens Chemist3 Victoria CrescentWest

R.T Elliott Ltd 31 Agnes Road

Boots UK 34-40, CheapsideWard GreenPharmacy 95 Vernon Rd

Lo's Pharmacy 2a Baden St

Z.A Akram Ltd Judy Row

Lo's ChemistLundwood MedicalCentre

RD Hill Chemist Ltd 5 Chatsworth Road

Lloyds Pharmacy 512 Doncaster Road

Well SmithiesThe RoundhouseMedical Centre

Barugh GreenPharmacy

12 Higham CommonRd

Rowlands Pharmacy 393 Darton Lane

Tesco Pharmacy Wombwell Lane

Boots UKWorsbrough PrimaryHealth Care Cent

Weldricks Pharmacy 48A High Street

Weldricks Pharmacy 65C Midland Road

Silkstone Pharmacy 3 High StreetKexboroughPharmacy 3 Ballfield Lane

Rowlands Pharmacy 5 George StreetWell Cudworth -Barnsley Road 244 Barnsley Road

Assura Pharmacy 16-18 Market St

Darton Pharmacy 67 Church St, Darton

Rowlands PharmacyChaplefield MedicalCentre

Well Cudworth -Cudworth HC

The Health CentreCarlton St

Shafton Pharmacy Unit 1, High street

Birdwell Pharmacy 148-150 Sheffield RdWell HoylandCommon - HoylandRoad 12 Hoyland RoadWell Hoyland -Hoyland HC

The Hoyland CentreHigh St

McGill Pharmacy 63-67 Knollbeck Lane

Cohens Pharmacy 199 King StreetWell Darfield - SnapeHill Road 2 Snape Hill Rd

Z.A Akram Ltd 22 High Street

Knollbeck Pharmacy 56 Knollbeck Lane

Boots UK Unit 2 Cortonwood

96


Appendix 9 Bassetlaw Community Pharmacies


Boots Health CarePharmacy North Road

Boots the Chemist 46-48 Carolgate

Boots the Chemist 24-26 Bridge StreetBridgegate ChemistLtd 54 BridgegateDudley TaylorPharmacies Ltd

3 The Arcade, LongLane

Dudley TaylorPharmacies Ltd Doncaster Road

Lloyds Pharmacy 6 Newgate Street

Lloyds Pharmacy Ltd 11 Churchgate

Manton pharmacy Richmond Road

Misterton PharmacyThe Retort House,Marsh Lane

M & R PharmacyUnit B, 67 croobyRoad

Ordsall Pharmacy 1A Welbeck Road

Sainsburys InstorePharmacy

Sainsbury'ssupermarket -Pharmacy

Superdrug Pharmacy11-15 CarolgateTesco InstorePharmacy Gateford Road

The Well Pharmacy The Health Centre

Tuxford Pharmacy 5 Newcastle Street

Weldricks Pharmacy 67 Scrooby Road

Worksop Pharmacy 5 Potter StreetWorksop Pharmacy(Prospect) Prospect PrecinctYour Local BootsPharmacy

Larwood HealthCentre

Your Local BootsPharmacy

Harworth MedicalCentre

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Appendix 9 Doncaster Community Pharmacies


RossingtonPharmacy

Unit 3, BankwoodLane Trading Park

H I Weldricks 28/29 Hallgate

Chestnut PharmacyCarcroft HealthCentre

H I Weldricks Station Road

H I WeldricksUnit 3B, White RosePark

D&R Sharp Chemists 59 Montrose Avenue

H I Weldricks40-42 East LaithGate

H I Weldricks81 SandringhamRoad

H I Weldricks 44 Church Street

H I Weldricks 14 High Street

Lloyds Pharmacy Adwick Road

Rowlands Pharmacy Greenfield Lane

H I WeldricksThe HeathfieldCentre, Ash Hill Road

H I Weldricks 100 Amersall Road

Boots 5 Finkle Street

Asda Pharmacy The Asda Store

H I Weldricks 54 Brecks Lane

J M McGill Ltd 125-127 Wath Road

BootsThe White WingsCentre

H I Weldricks 7 St Wilfrids Court


Boots 11 Church Street


J M McGill Ltd65-67 Carr HouseRoad

H I Weldricks 5 York Buildings

H I Weldricks Marlowe Road

J M McGill Ltd 66 Hexthorpe Road

Tesco Pharmacy Thorne Road

Boots10-11 The WheatleyCentre

J M McGill Ltd 94 High Street

H I Weldricks 2-4 Finkle Street

H I Weldricks The Burns Practice

Lloyds Pharmacy 6-8 Cusworth LaneH I Weldricks (wasLloyds) The Cresent RoadFittleworth MedicalLtd

Unit 5, PortlandPlace

H I Weldricks 35 Grange Lane

H I Weldricks 221 Skellow Road

H I Weldricks The Orchard Centre

J M McGill Ltd 120 Sandford Road

H I Weldricks235 SprotbroughRoad

H I Weldricks 61-63 Beckett Road

H I Weldricks 8 Everingham Road

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Appendix 9 Doncaster Community Pharmacies Continued


Superdrug 17-19 Frenchgate

J M McGill Ltd 56 Edlington Lane

Well The Medical Centre

H I Weldricks Field Road

Lloyds Pharmacy (34) 4 Nostell Place

Lloyds Pharmacy 24 High Street

H I Weldricks 122 Thorne Road

D&R Sharp ChemistsUnit 4, BarnsleyRoad

Well240 Great NorthRoad

H I Weldricks 14 Fieldside

Averroes PharmacySandringham RoadMedical Centre

H I Weldricks Stonecastle Centre

Auckley Pharmacy Ellers LaneEightlands(Pharmacy M) The New Surgery

Tesco Pharmacy Woodfield WayGorgemead(Cohens) Harlington Road

Boots 47-48 Market Place

H I WeldricksWhite House FarmMedical Centre

H I WeldricksThe MartinwellsCentre

Balby Late NightPharmacy

St John's GroupPractice

H I WeldricksThe Abbey ShoppingCentre, Station Road

Day Lewis PharmacyThe VermuydenCentre

Lloyds Pharmacy 3 Market Place

D&R Sharp Chemists High Street

Asda Pharmacy The Asda Store

J M McGill LtdSprotbrough VillagePharmacy

Lloyds PharmacyRear of 83b ThorneRoad

H I Weldricks Leedale House

Lloyds PharmacySainsbury'sSupermarket, Thorne

H I Weldricks 296 Thorne Road

J M McGill Ltd106 WarmsworthRoad

J M McGill Ltd The Scott Practice

H I WeldricksDenaby SpringwellCentre

H I Weldricks The Parade

H I WeldricksThe Flying ScotsmanCentre

Well 71 High Street

Boots 13-15 Frenchgate

H I Weldricks 2 Princess Street

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Appendix 9 Rotherham Community Pharmacies


Your Local BootsPharmacy

342 HerringthorpeRoad

Maltby PharmacyBlyth Road MedicalCentre

Well 206 Bawtry Road

Day Lewis Pharmacy 6 The Parade

Whitworth Chemists 70A Broom Lane

Tesco Pharmacy Drummond Street

Rowlands Pharmacy 72-78 York Road

Rowlands Pharmacy 2 Church StreetDinningtonPharmacy New Street

Lloyds Pharmacy19-21 KimberworthRoad

Knollbeck Pharmacy 65 Knollbeck Lane

Thurcroft Pharmacy The Village Surgery

SKF Lo (Chemist) Ltd 30A Highthorn Road

Darren Senior LtdUnit E Bellows RoadShopping Centre

North AnstonPharmacy 14 Quarry LaneSouth AnstonPharmacy 13 Sheffield Road

PHARMACYDELIVERED4U 145-147 WELLGATE,

Rotherchem16 Henderson Place,Canklow Road

Lloyds Pharmacy 45C Rawmarsh Hill

Boots Retail World

Well Sough Hall Avenue

Cryer A 1 Kenneth Street

Lo's Pharmacy(Rotherham) Ltd

NHS RotherhamHealth Centre

WickersleyPharmacy

Morthern GroupPractice

Boots Unit 2 Cortonwood

Boots Howard Street

H I Weldricks 27 Brinsworth Lane

J M McGill Ltd 37 High Street

Lloyds PharmacyAston Cum AughtonCentre

Cohens Chemist 10B Station Road

Lloyds PharmacyRotherham HealthVillage

Lloyds Pharmacy New Street

Lloyds Pharmacy 7-8 The Square

Archway PharmacyArch 5 CoronationBridge

H I Weldricks 31/33 High Street

Lloyds Pharmacy 9 Central Parade

Lloyds Pharmacy 1 Fenton Road

Medwin PharmacyUnitA10meadowbank

Whitworth Chemists108 Broom ValleyRoad

Winterhill Pharmacy 2 Fellowfield WayThe OnlineChemists Ltd Unit 5, Farfield Park

Brookside Pharmacy 2A Turner Lane

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Appendix 9 Rotherham Community Pharmacies Continued


Swift DeliveryPharmacy 210B Wellgate Road

Eightlands LtdThe High StreetSurgery

H I Weldricks 1a-3a Church Street

Well Poplar Glade

Good Measure(Internet)(JosephTerence Watson)

Unit 18, AlexanderCentre

Tesco Pharmacy Biscay Way

H I WeldricksMaltby ServicesCentre

Morrison's Pharmacy Stadium Way

Lloyds Pharmacy65 Green ArbourRoad

Lloyds PharmacyKimberworth ParkMedical Centre

Lloyds Pharmacy 239 Doncaster Road

Lloyds Pharmacy 99 Wales Road

Well 22 Park Lane

Morrison's PharmacyCortonwood RetailPark

Heritage Pharmacy 6 Heritage CourtSilverwoodPharmacy 90 Flanderwell Lane

Day Lewis Pharmacy 52 Claypit LaneRotherham DirectPharmacy 36 Shakespeare Road

H I Weldricks 94a High Street

H I Weldricks 3 Laburnum Parade

Lloyds Pharmacy 31-33 Laughton Road

Asda Pharmacy Aldwarke Lane

Well 6 Hollings Lane

H I Weldricks 26 Main Street

Abbey Pharmacy Ltd Abbey Pharmacy

H I Weldricks 17 Crown Street

Lloyds Pharmacy Valley Health Centre

Superdrug 12 Howard Street

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Appendix 9 Sheffield Community Pharmacies


WoodhousePharmacy

Woodhouse MedicalCentre

WincobankPharmacy 122 Wincobank Avenue

Whitworths Chemist Beighton Health Centre

Whitworths Chemist 219 School Road

Well 1A Cobnar Road

Well 255 Southey Green Road

Well The Whitehouse Surgery

Well 294 Ringinglow Road

Well 35 Townhead Road

Well 427 Herries Road

Well 439 Richmond Road

Well 45 Baslow Road

Well 503 - 505 Gleadless Road

Well 517A Manchester Road

Well 54b Holme Lane

Well 58 Greno Crescent

Well 621 Middlewood Road

Well756 - 758 ChesterfieldRoad

Well Birley Lane Health Centre

Well White Lane Pharmacy

Well Crosspool Pharmacy

Weldricks Pharmacy 1 Moorthorpe Bank

Weldricks Pharmacy 171 Main Road

Weldricks Pharmacy 66 Rochester Road

Vantage Pharmacy 2 Ridgeway Road

UK Pharmacy Ltd 286 Abbeydale Rd

Totley Pharmacy 158 Baslow Road

Tesco Pharmacy 50 Montgomery Terrace Rd

Tesco Pharmacy Abbeydale DriveSwift Pharmacy -Burngreave 1 Gower StreetSwift Chemists Ltd(Morrisons) 1 Oxclose Park Road North

Skye Pharmacy The Dovercourt CentreShorehamPharmacy 255 Shoreham StSheffield Late NightPharmacy 277 Fulwood Rd

Sharrow Pharmacy 12 Wostenholm Rd

Rowlands PharmacySheffield ChildrensHospital

Rowlands Pharmacy 149 Burngreave Rd

Rowlands Pharmacy 35 Greenhow St

Rowlands Pharmacy 101 Eccleshall Road South

Rowlands Pharmacy 126 Hartley Brook Road

Rowlands Pharmacy 126 Lowedges Road

Rowlands Pharmacy 149 Burngreave Road

102


Appendix 9 Sheffield Community Pharmacies Continued


Rowlands Pharmacy 22 Chapel Street

Rowlands Pharmacy 493 Bellhouse Road

Rowlands Pharmacy 827 Barnsley Road

Rowlands Pharmacy 58 Dykes Hall Road

Rowlands PharmacyThe Old Surgery, BevanWay

Ranmoor Pharmacy 382 Fulwood Road

Oakbrook Pharmacy 237 Oakbrook RoadNorfolk ParkPharmacy 229 Park Grange Road

Morrisons Pharmacy 299 The Common

Medisun Pharmacy 255 Shoreham StreetMedicine on TimeServices 55-59 WickerM & A PharmaciesLtd 2 Bridge HillLo's PharmacyLimited 1 Deer Park CloseLo's PharmacyLimited 11 Main StreetLo's PharmacyLimited 1a Station RoadLo's PharmacyLimited 251 Broomhall StreetLo's PharmacyLimited 4 Little London RoadLo's PharmacyLimited The Hollies Medical CentreLo's PharmacyLimited 5 Pond RoadLloyds Pharmacy(Sainsbury's) Archer Road

Lloyds Pharmacy 9-13 Exchange St

Lloyds Pharmacy 190 Duke St

Lloyds Pharmacy 26 Talbot Rd

Lloyds Pharmacy 3-7 Alderson Rd

Lloyds Pharmacy 7 Sunderland Street

Lloyds Pharmacy 33 Addy St

Lloyds Pharmacy 36 Ellesmere Rd

Lloyds Pharmacy 1 Market Square

Lloyds Pharmacy 100 Halifax Road

Lloyds Pharmacy 17 - 19 Page Hall Road

Lloyds Pharmacy 17-21 Abbey Road

Lloyds Pharmacy 266 Gleadless Road

Lloyds Pharmacy 292-294 Handsworth Road

Lloyds Pharmacy 30 Addy Street

Lloyds Pharmacy 333 Meadowhead

Lloyds Pharmacy 78 Wincobank Avenue

Lloyds Pharmacy 36 - 38 Ellesmere Road

Lloyds Pharmacy 3a Far Lane

Lloyds Pharmacy 41 Margetson Crescent

Lloyds Pharmacy 428-430 Firth Park Road

Lloyds Pharmacy 52 Birley Moor Road

Lloyds Pharmacy 555 Eastbank Road

103




Lloyds Pharmacy 74 Buchanan Cross

Lloyds Pharmacy 9 Johnson Street

Lloyds Pharmacy 882 Eccleshall Road

Lloyds Pharmacy 96a Mill Road

Lloyds Pharmacy Duke Medical Centre

Lloyds Pharmacy High Green Health Centre

Lloyds PharmacyJordanthorpe HealthCentre

Lloyds PharmacyPorter Brook MedicalCentre

Lloyds PharmacyUnit 39, Crystal PeaksWest Mall

Lloyds Pharmacy Unit 4, Westfield Centre

Lloyds Pharmacy Wincobank Medical CentreHillsboroughPharmacy 58-60 Holme Lane

Greenhill Pharmacy 206 Bocking LaneGilbert & ArmstrongLimited 36 Queen Street

Foxhill Pharmacy Foxhill Road

Fir Vale Pharmacy 29-31 Rushby StreetDerbyshire LanePharmacy 144 Derbyshire Lane

Deepcar Pharmacy 271 Manchester RoadDay LewisPharmacy 298 Glossop Rd

Day Lewis Pharmacy 188 Crookesmoor Rd

Day Lewis Pharmacy 153 Blackstock Road

Day Lewis Pharmacy 150 Crookes

Darnall Pharmacy Darnall Health CentreCharnock HealthPrimary Care Centre White Lane

Bradway Pharmacy 298 Twentywell Lane

Boots Uk 5-6 High Street

Boots Uk 66 The Moor

Boots Uk 252-254, West St

Boots Uk within Waitrose Store

Boots Uk Royal Hallamshire Hospital

Boots Uk 20 Asline Rd

Boots Uk 4-7 Berkeley Precinct

Boots Uk 214 Fulwood Rd

Boots Pharmacy11 - 12 HillsboroughArcade

Boots Pharmacy 119-121 Upwell Street

Boots Pharmacy 252 - 254 West Street

Boots Pharmacy 4-6 High Street

Boots Pharmacy 44A High Street

Boots Pharmacy 50 Manor Park Centre

Boots Pharmacy 628 Abbeydale Road

Boots Pharmacy Units 4-7 Berkley Precinct

Boots Pharmacy Unit 5, Heeley Retail Park

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Boots PharmacyUnit C, Crystal PeaksRetail Park

Boots Pharmacy Waitrose

Basegreen Pharmacy37-39 Jaunty WayAssura PharmacyTinsley Unit 3 Tinsley Centre

Asda Pharmacy 1 Market Street

Asda Pharmacy Handsworth Road

Asda Pharmacy Chaucer Road

Armstrong Pharmacy 867-9 Gleadless Road

Abbeydale Pharmacy 713 Abbeydale Road1ast PharmacyHealth & Wellbeing 236 Abbeydale RdWoodhousePharmacy Direct

Unit 9, Portland BusinessPark

High GreenPharmacy 104 Wortley RoadAttercliffe PharmacyDirect 680 Altercliffe Road

Global Pharmacy Ltd 446a London Road

My Meds Now 1B Gainsford Road

105

APPENDIX 10PARISH COUNCILS BY CCG AREA

Appendix 10 BarnsleyBillingley Parish CouncilC.wthorne Parish CouncilDunford Parish CouncilGreat Houghton Parish CouncilGunthwaite and Ingbirchworth Parish CouncilHigh Hoyland Parish CouncilHunshelf Parish CouncilOxspring Parish CouncilPenistone Town CouncilSilkstone Parish CouncilStainborough Parish CouncilTankersley Parish CouncilThurgoland Parish CouncilWortley Parish Council

BassetlawBabworth Parish CouncilBarnby Moor Parish CouncilBeckingham Prish CouncilBlyth Parish CouncilBothamsall Parish CouncilCarlton-in-Lindrick Parish CouncilClarborough & Welham Parish CouncilClayworth Parish CouncilDunham on TrentEast Drayton Parish CouncilEast Markham Parish CouncilElkesley Parish CouncilEverton Parish CouncilGamston, West Drayton, Eaton Parish CouncilGringley on the Hill Parish CouncilHarworth & Bircotes Town CouncilHayton Parish CouncilHeadon, Grove & Stokeham Parish CouncilHodsock Parish CouncilHolbeck & Welbeck Parish CouncilLaneham Parish Council

Lound Parish CouncilMarkham Clinton Parish CouncilMattersey Parish CouncilMisson Parish CouncilMisterton Parish CouncilNether Langwith Parish CouncilNorth and South Wheatley Parish CouncilNorth Leverton & Habblesthorpe Parish CouncilNorton & Cuckney Parish CouncilRampton & Woodbeck Parish CouncilRanskill Parish CouncilRhodesia Parish CouncilScrooby Parish CouncilShireoaks Parish CouncilSouth Leverton Parish CouncilSturton le Steeple Parish CouncilStyrrup with Oldcotes Parish CouncilSutton Parish CouncilTorworth Parish CouncilTreswell with Cottam Parish CouncilTuxford Town CouncilWalkeringham Parish CouncilWest Stockwith Parish Council

DoncasterAdwick-on-Dearne Parish CouncilArmthorpe Parish CouncilAskern Town Council Auckley Parish CouncilAusterfield Parish CouncilBarnburgh with Harlington Parish CouncilBarnby Dun with Kirk Sandall Parish CouncilBawtry Town CouncilBlaxton Parish CouncilBraithwell with Micklebring Parish CouncilBrodsworth Parish CouncilBurghwallis Parish CouncilCadeby Parish MeetingCantley with Branton Parish Council


106

APPENDIX 10PARISH COUNCILS BY CCG AREA

Appendix 10 Doncaster ContinuedClayton with Frickley Parish CouncilConisbrough Parks Parish CouncilDenaby Parish CouncilEdenthorpe Parish CouncilEdlington Town CouncilFinningley Parish CouncilFishlake Parish CouncilHampole and Skelbrooke Parish MeetingHatfield Town CouncilHickleton Parish CouncilHigh Melton Parish CouncilHooton Pagnell Parish CouncilLoversall Parish CouncilMarr Parish MeetingMoss and District Parish CouncilNorton Parish CouncilOwston Parish CouncilRossington Parish CouncilSprotbrough and Cusworth Parish CouncilStainforth Town CouncilStainton Parish CouncilSykehouse Parish CouncilThorne-Moorends Town CouncilThorpe-in-Balne Parish MeetingTickhill Town CouncilWadworth Parish CouncilWarmsworth Parish Council

RotherhamAnston Civil Pa rishAston cum Aughton Civil ParishBramley Civil ParishBrampton Bierlow Civil ParishBrinsworth Parish CouncilCatcliffe Parish CouncilDalton Parish Council

Firbeck Parish CouncilHarthill with Woodall Parish CouncilHellaby Parish CouncilLaughton en le Morthen Parish CouncilLetwell Parish CouncilOrgreave Parish CouncilRavenfield Parish CouncilThorpe Salvin Parish CouncilThrybergh Parish CouncilThurcroft Parish CouncilTodwick Parish CouncilTreeton Parish CouncilUlley Parish CouncilWales Parish CouncilWentworth Parish CouncilWhiston Parish CouncilWickersley Parish CouncilWoodsetts Parish Council

SheffieldBradfield Parish CouncilEcclesfield Parish CouncilStocksbridge Parish Council


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APPENDIX 11LIBRARIESBY CCG AREA

Appendix 11

BarnsleyCental LibraryCudworth LibraryDarfield LibraryDodworth LibraryGoldthorpe LibraryGrimethorpe LibraryHoyland LibraryMapplewell and Staincross LibraryPenistone LibraryPriory LibraryRoundhouse LibraryRoyson LibraryThurnscoe LibraryWombwell LibraryWorsbrough Library

BassetlawWorksop LibraryRetford LibraryBalmoral LibraryBircotes LibraryCarlton in Lindrick LibraryLangold LibraryMisterton LibrarySutton-on-Trent LibraryTuxford Library

DoncasterDoncaster Central LibraryArmthorpe Community LibraryAskern Community LibraryBalby Community LibraryBawtry Community LibraryBentley Area Community Library

Bessacarr Community LibraryCantley Community LibraryConisbrough Community LibraryDenaby Community Library and HubEdenthorpe Community LibraryEdlington LibraryHatfield Community LibraryIntake Community LibraryMexborough LibraryMoorends LibraryRossington Community LibraryScawthorpe Community LibrarySprotbrough Community LibraryStainforth Community LibraryThorne LibraryTickhill LibraryWarmsworth Community LibraryWheatley Community LibraryWoodlands Community Library and Hub

RotherhamRiverside LibraryAston LibraryDinnington LibraryRawmarsh LibraryWath LibrarySwinton LibraryThorpe Hesley LibraryGreasbrough LibraryKimberworth LibraryMowbray Gardens LibraryBrinsworth LibraryWickersley LibraryMaltby LibraryThurcoft LibraryKiveton Park Library


108

APPENDIX 11LIBRARIESBY CCG AREA

Appendix 11

SheffieldArchives ServiceBroomhill Community LibraryBurngreave LibraryCentral Children's LibraryChapeltown LibraryCrystal Peaks LibraryDarnell LibraryEcclesall LibraryEcclesfield LibraryFirth Park LibraryFrecheville LibraryGleadless LibraryGreenhill LibraryHighfield Library & Children's CentreHillsborough LibraryJordanthorpe LibraryJordanthorpe LibraryLoca Studies LibraryManor LibraryNewfield Green LibraryPark LibraryParson Cross LibraryMoonshine LibraryStannington LibraryStocksbridge LibraryTotley LibraryUpperthorpe LibraryWalkley LibraryWeston Park Hospital Library ServiceWoodhouse Community LibraryWoodseats Library


109

APPENDIX 12COMMUNITYCENTRES BY CCGAREA

Appendix 12 BarnsleyBarnsley Muslim Community Centre LtdWorsbrough Common Housing Estate OfficeValley Community CentreHoyland Common Community CentreCloughfields Community CareDarfield Community CentreCortonwood Comeback Community CentreMapplewell & Staincross Village HallLittle People After School ClubKinsley & Fitzwilliam Learning & CommunityCentreWest Bank House Community AssociationCrofton Community CentreTrinity Community CentreHoughton Road Community CareRainbow Community CentreAgbrigg & Belle vue Community CentreGrenoside Community CentreRavensthorpe Community CentreSt Georges Community CentreSharlston Community CentreWalkely Community CentreEastmoor Community CentreMilton HallWoodhouse Community CentreOssett War Memorial Community Centre

BassetlawCSL at Shrewsbury Road Community CentreHallcroft Community CentreLongfellow DriveThe Crossing Church & Centre

Balmoral Community CentreCrown Place Community CentreKilton Forest Community CentreKingston Close Community CentreRayton Spur Community CentreThievesdale Community CentreWesthill Community CentreDevonshire Road Community CentreCleveland Close Community CentreThe Beeches Community Centre

DoncasterCantley Community CentreScawsby Community CentreThe Wilby Carr Community CentreHighfields Community CentreSt Anne's Community ServicesMaridon Pastoral CentreWoodfield Park Community HallHolmescarr Community Enterprise CentreRossington Parish Community HallArmthorpe Community CentreIntake Community Enterprise LimitedWarmsworth Community CentreThe Junction Community Advice CentreGladys Ambler CentreNether Hall Area CICSikh Bhatra's Community HallPersonalisation Forum GroupEdenthorpe Community CentreDoncaster Central Development TrustYorkshire Main Community CentreWilby Carr Community CentreMoathills Day Centre


110


Appendix 12Doncaster Continued

Quayside Childcare Community CentresDunsville Community CentreThe Ivanhoe Community CentreBullcroft Memorial HallThe Redmond CentreChestnut View Communal HallConisbrough Community AssociationKilnhurst Community Resource CentreRotherham Community CentresBraithwell & Micklebring Recreation & LeisureAssociation LtdSwinton Aged Persons CentreBramley Youth & Community CentreMoorends Family HubSwinton Youth & Community Centre

RotherhamAston Joint Service Centre Community RoomsBroom Valley Club RoomFir Close Community CentreOaklea RetreatSpringwell Gardens Community CentreSwinton Civic HallBrecks Community CentreThe Lanes Community CentreEastwood Youth & Community CentreBrinsworth Parish Council CommunityHall/PavilionUnity CentreRotherham Connexions CentreKimberworth Park Community Partnership

Rotherham Federation of CommunitiesMyplace RotherhamWhiston Parish HallEastwood Village Community CentreSilverwood Miners Welfare Resource CentreRotherham East Community AssociationSt. Thomas Community HallThe High Street CentreCommunity CentreRotherham Community Health CentreTrinity Community CentreThe Oddfellows

SheffieldWalkley EbenezerWesley HallThe Sheffield Chinese Community CentreCroft House SettlementChrist Church CentralSheffield Jesus CentrePark CentreBroomhall CentreVictoria Community Enterprise LtdRe-gather Co-operative LtdSt Bartholemews Church CentreThe Pakistan Muslim Centre GroupMoving Forward Community CentresTinsley Community CentreLongley Four Greens CentreIslamic Community CentreHallam Community Youth CentreWilliams Sutton Community SchoolSplashkittyartistfans Community CentresParson Cross Pavillion


111


Sheffield ContinuedSt Paul's Church & CentreShirecliffe Community CentreLongely Four Greens Community CentreStradbroke Community CentreZest CentrePakistan Muslim CentreVictoria CentreFrecheville Community CentreYemeni Community AssociationChapeltown & Burncross Community CentreAnns Road Community CentreLBJ Community Forum (Lowedges CommunityCentre)SADACCA (Sheffield And District AfricanCaribbean Community Association)The Centre in the ParkVerdon Recreation Centre


112

APPENDIX 13ONS DATA BYCCG AREA

Appendix 13 Barnsley ONS Data


dategeographymeasures value percentVariableAll usual residents 231,221 100.0Males 113,634 49.1Females 117,587 50.9Lives in a household 229,539 99.3Lives in a communa 1,682 0.7Schoolchild or full-t 1,681 -Area (Hectares) 32,905.31 -Density (number of 7.0 -

Barnsley2011

dategeographymeasures value percentAgeAll usual residents 231,221 100.0Age 0 to 4 13,957 6.0Age 5 to 7 7,798 3.4Age 8 to 9 4,764 2.1Age 10 to 14 13,378 5.8Age 15 2,989 1.3Age 16 to 17 5,804 2.5Age 18 to 19 5,597 2.4Age 20 to 24 13,533 5.9Age 25 to 29 14,446 6.2Age 30 to 44 45,725 19.8Age 45 to 59 48,377 20.9Age 60 to 64 14,843 6.4Age 65 to 74 22,080 9.5Age 75 to 84 13,250 5.7Age 85 to 89 3,279 1.4Age 90 and over 1,401 0.6Mean Age 40.4 -Median Age 41.0 -

Barnsley2011 date

geographymeasures value percentEthnic GroupAll usual residents 231,221 100.0White 226,285 97.9English/Welsh/Scott 222,164 96.1Irish 567 0.2Gypsy or Irish Trave 163 0.1Other White 3,391 1.5Mixed/multiple ethn 1,630 0.7White and Black Ca 644 0.3White and Black Afr 178 0.1White and Asian 434 0.2Other Mixed 374 0.2Asian/Asian British 1,661 0.7Indian 442 0.2Pakistani 211 0.1Bangladeshi 60 0.0Chinese 440 0.2Other Asian 508 0.2Black/African/Carib 1,221 0.5African 995 0.4Caribbean 149 0.1Other Black 77 0.0Other ethnic group 424 0.2Arab 168 0.1Any other ethnic gr 256 0.1

Barnsley2011

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Appendix 13 Bassetlaw ONS Data



Bassetlaw2011

dategeographymeasures value percentAgeAll usual residents 112,863 100.0Age 0 to 4 6,105 5.4Age 5 to 7 3,549 3.1Age 8 to 9 2,277 2.0Age 10 to 14 6,816 6.0Age 15 1,414 1.3Age 16 to 17 3,072 2.7Age 18 to 19 2,613 2.3Age 20 to 24 6,021 5.3Age 25 to 29 6,027 5.3Age 30 to 44 21,537 19.1Age 45 to 59 24,403 21.6Age 60 to 64 8,088 7.2Age 65 to 74 11,544 10.2Age 75 to 84 6,842 6.1Age 85 to 89 1,721 1.5Age 90 and over 834 0.7Mean Age 41.5 -Median Age 43.0 -

Bassetlaw2011 date

geographymeasures value percentEthnic GroupAll usual residents 112,863 100.0White 109,892 97.4English/Welsh/Scott 106,663 94.5Irish 381 0.3Gypsy or Irish Trave 94 0.1Other White 2,754 2.4Mixed/multiple ethn 996 0.9White and Black Ca 454 0.4White and Black Afr 85 0.1White and Asian 228 0.2Other Mixed 229 0.2Asian/Asian British 1,255 1.1Indian 440 0.4Pakistani 287 0.3Bangladeshi 74 0.1Chinese 180 0.2Other Asian 274 0.2Black/African/Carib 520 0.5African 221 0.2Caribbean 239 0.2Other Black 60 0.1Other ethnic group 200 0.2Arab 52 0.0Any other ethnic gr 148 0.1

Bassetlaw2011

114


Appendix 13 Doncaster ONS Data



Doncaster2011


Doncaster2011 date

geographymeasures value percentEthnic GroupAll usual residents 302,402 100.0White 288,066 95.3English/Welsh/Scott 277,740 91.8Irish 1,183 0.4Gypsy or Irish Trave 587 0.2Other White 8,556 2.8Mixed/multiple ethn 3,321 1.1White and Black Ca 1,413 0.5White and Black Afr 440 0.1White and Asian 877 0.3Other Mixed 591 0.2Asian/Asian British 7,614 2.5Indian 1,865 0.6Pakistani 2,728 0.9Bangladeshi 117 0.0Chinese 1,121 0.4Other Asian 1,783 0.6Black/African/Carib 2,337 0.8African 1,309 0.4Caribbean 778 0.3Other Black 250 0.1Other ethnic group 1,064 0.4Arab 231 0.1Any other ethnic gr 833 0.3

Doncaster2011

115


Appendix 13 Rotherham ONS Data



Rotherham2011


Rotherham2011 date

geographymeasures value percentEthnic GroupAll usual residents 257,280 100.0White 240,758 93.6English/Welsh/Scott 236,438 91.9Irish 776 0.3Gypsy or Irish Trave 126 0.0Other White 3,418 1.3Mixed/multiple ethn 2,551 1.0White and Black Ca 787 0.3White and Black Afr 301 0.1White and Asian 865 0.3Other Mixed 598 0.2Asian/Asian British 10,551 4.1Indian 961 0.4Pakistani 7,609 3.0Bangladeshi 109 0.0Chinese 592 0.2Other Asian 1,280 0.5Black/African/Carib 2,112 0.8African 1,672 0.6Caribbean 283 0.1Other Black 157 0.1Other ethnic group 1,308 0.5Arab 581 0.2Any other ethnic gr 727 0.3

Rotherham2011

116


Appendix 13 Sheffield ONS Data



Sheffield2011


Sheffield2011 date

geographymeasures value percentEthnic GroupAll usual residents 552,698 100.0White 462,544 83.7English/Welsh/Scott 446,837 80.8Irish 2,891 0.5Gypsy or Irish Trave 358 0.1Other White 12,458 2.3Mixed/multiple ethn 13,289 2.4White and Black Ca 5,450 1.0White and Black Afr 1,296 0.2White and Asian 3,490 0.6Other Mixed 3,053 0.6Asian/Asian British 44,385 8.0Indian 5,868 1.1Pakistani 21,990 4.0Bangladeshi 3,326 0.6Chinese 7,398 1.3Other Asian 5,803 1.0Black/African/Carib 20,082 3.6African 11,543 2.1Caribbean 5,506 1.0Other Black 3,033 0.5Other ethnic group 12,398 2.2Arab 8,432 1.5Any other ethnic gr 3,966 0.7

Sheffield2011

117

APPENDIX 14MPS BY CCG AREA

Appendix 14BarnsleyWentworth and DearneLabour - Mr John HealeyBarnsley CentralLabour - Mr Dan JarvisBarnsley EastLabour - Ms Stephanie PeacockPenistone and Stocksbridge (see Sheffield)Labour - Ms Angela Smith

BassetlawBassetlaw Division of NottinghamshireLabour - Mr John MannNewark Division of NottinghamshireConservative - Mr Robert Jenrick

DoncasterDon ValleyLabour - Ms Caroline FlintDoncaster NorthLabour - Ed MilibandDoncaster CentralLabour - Dame Rosie Winterton

RotherhamRotherhamLabour - Ms Sarah ChampionRother ValleyLabour - Sir Kevin BarronWentworth and DearneLabour - Mr John Healey

SheffieldBrightside and HillsboroughLabour - Ms Gill FurnissCentralLabour - Mr Paul BlomfieldHallamLabour - Mr Jared O’MaraHeeleyLabour - Ms Louise HaighSheffield South EastLabour - Mr Clive BettsPenistone and Stocksbridge (ward shared withBarnsley)Labour - Ms Angela Smith


118

APPENDIX 15COMMS TOOLKIT

Appendix 15


Briefing packs to:

Community and voluntary servicesGP practice staffMembersMPsCommunity pharmaciesSYB ICS staff

119

Appendix 15


Public survey – hard copy


120

Appendix 15


Public survey – digital


121

Appendix 15


Posters and leaflets


Health and care working togetherin South Yorkshire and Bassetlaw

Share your views on purchasing over the counter

medicines for minor conditions

Take part in our online survey

www.569millionreasons.co.uk

There are also hard copy surveys available in your local GP practice

YOUR MEDICINE CUPBOARD

For further information see our leaflet or visit our websitewww.569millionreasons.co.uk

Taking care of yourselfand your family

CRADLE CAP

SUN

PR

OTE

CTI

ON

SUN

BU

RN

HA

EMO

RR

HO

IDS

ACUTESORE THROAT

COUGHS, COLDS& NASAL CONGESTION

NA

PPY

RA

SH c

ream

DRY

SK

INC

REA

M

NA

PPY

RA

SHC

REA

M

MO

UTH

ULC

ERS

TEET

HIN

G &

MIL

D T

OO

THA

CH

E

AC

HES

& P

AIN

S

DA

ND

RU

FF

SUN

C

AR

E

SUN

BU

RN

HEA

D L

ICE

DA

ND

RU

FF

INFANTCOLIC

Headlice

PROBIOTICSVITAMINS& MINERALS

HEADACHE BACK PAIN

SICKNESSTRAVEL

HAYFEVER

CONSTIPATION

PARACETAMOL

FEVER

A well-stocked medicine cupboard is a must-have for every household.We asked doctors, nurses and pharmacists to tell us what could be in yours.

All the items listed can be bought over-the-counter from a chemist or supermarket – you don’t need a prescription.

Calpol and baby ibuprofen; head lice treatments (if you have children or visiting children)Sticking plasters of various sizesCough medicineThroat lozenges e.g. TyrozetsParacetamol tabletsIbuprofen tabletsAspirin tabletsHay fever tabletsEye dropsInsect bite and sting cream (anti-histamine e.g. Piriton)Antiseptic cream (e.g. Savlon)

Antiseptic fluid (e.g. Dettol; TCP)Sterilising fluid or tablets (e.g. Milton)A roll of crepe bandageDressing tapeSafety pins of various sizesTubigrip bandage in various sizesSmall scissors and TweezersIndigestion remedies (liquid or tablet e.g. Gaviscon)Diarrhoea remedies (e.g. Immodium)Constipation remedies (e.g. Senokot)Thrush creamHaemorrhoid cream (e.g. Anusol)

Update your supplies regularly – medicines have a use-by date. Take any unused items to your local pharmacy for safe disposal.


122

Appendix 15



Posters and leaflets

If you need help to find out more about how to take care of yourself or someone else who uses over-the-counter medicines, please ask one of our team.

For further information visit our website

www.569millionreasons.co.uk

By spending less money on treating conditions that will get better by themselves, or can be easily treated by you at home, we will have more money to spend on maintaining the services we have and investing in new ones.

You may find that your doctor or healthcare professional will no longer give you a prescription for a medicine that you can buy over the counter for a minor condition.

The NHS has identified 33 minor ailments and conditions that can be easily treated with over the counter medicines that you can buy from the supermarket or high-street pharmacy.

Items such as vitamins, minerals and other supplements including probiotics will no longer be prescribed.

acute sore throat

cold sores

conjunctivitis and styes

coughs and colds and nasal congestion

cradle cap and colic in babies

haemorrhoids (piles)

mild cystitis

What medicines and conditions will be affected?

Conditions that do not require medical advice or treatment as they will clear up on their own include:

Minor conditions that are suitable for treatment with items that can easily be purchased over the counter include:

contact dermatitis

dandruff

diarrhoea (adults)

dry eyes/sore tired eyes

earwax

excessive sweating (hyperhidrosis)

head lice

indigestion and heartburn

occasional constipation

infrequent migraine

insect bites and stings

mild acne

mild dry skin

mild sunburn

mild to moderate hay fever/allergic rhinitis

minor burns and scalds

minor conditions associated with pain, discomfort and fever (such as aches and sprains, headache, period pain, back pain)

mouth ulcers

nappy rash

oral thrush

prevention of dental caries

ringworm/athletes foot

teething/mild toothache

threadworms

travel sickness

warts and verrucas

Last year the NHS spent approximately £569 million on prescriptions for medicines for minor conditions which could have been bought over the counter from a high street pharmacy or supermarket.

Every £1million saved on prescriptions for over the counter treatments could pay for:

39 more community nurses; or

270 more hip replacements; or

66 more drug treatment courses for breast cancer; or

1,000 more drug treatment courses for Alzheimer’s; or

1,040 more cataract operations; or


60,000 more GP appointments(excluding admin and practice staff time)

123

Appendix 15


Twitter campaign


124

Appendix 15



Facebook campaign

125

Appendix 15



Website banners


Take part in the survey at www.569millionreasons.co.uk

OVER THE COUNTER MEDICINES ON PRESCRIPTION – YOUR VIEWS


OVER THE COUNTER MEDICINES ON PRESCRIPTION – YOUR VIEWSTake part in the survey at www.569millionreasons.co.uk


OVER THE COUNTER MEDICINES ON PRESCRIPTION – YOUR VIEWSTake part in the survey at www.569millionreasons.co.uk

OTC MEDICINESINDEPENDENTREPORT PREPARED BY STANDOUT MEDIA LIMITED FOR SOUTH YORKSHIRE AND BASSETLAW ICS

DECEMBER 2018