Cambridgeshire Health and Wellbeing Board has published a review of pharmaceutical services in Cambridgeshire, and is consulting the public about what it says.

The review will help in the commissioning of pharmaceutical services, and will be used by NHS England when making decisions on applications to open new pharmacies.

The public consultation runs from 30 January to 30 April.  A short summary and the full report are available at www.cambridgeshireinsight.org.uk/JSNA/PNA where there is also a short questionnaire.

Anyone who cannot complete the questionnaire because they have special needs (for example, problems with vision or language) and has no one to help them do it can contact 01480 379493 in office hours for someone to help them respond to the consultation.

Overall, the review finds that Cambridgeshire is well provided for, with 110 pharmacies across Cambridgeshire and 43 dispensing GP practices.  This may change as population grows, so the Board will monitor developments to consider where new pharmacies might be needed.

The review seems to show that opening hours are good, and 96 per cent of pharmacies (and 62 per cent of dispensing GP practices) offer some kind of home delivery service to those who have no car or cannot use public transport.  84 per cent of community pharmacies offer flu vaccinations.

The review finds that ‘stop smoking’ activities in community pharmacies in Cambridgeshire have decreased since 2014, and there are still many community pharmacies that do not provide this service. The Board thinks there is potential for further development in this area.

Only 26 of the 100 pharmacies offer a chlamydia screening programme, and 28 provide emergency hormonal contraception.  34 pharmacies provide specialist drug and alcohol treatment and support, including access to sterile needs and syringes and supervising the administration of some drugs to reduce drug dependence and misuse.

All pharmacies support six Public Health campaigns every year as part of their NHS contract.  Many pharmacies currently offer weight management advice and advice on physical activity, and the Board thinks that more pharmacies could help with alcohol screening and advice on reducing alcohol consumption.

Pharmacies are encouraged to bid for local health improvement contracts to provide services, and the Royal Pharmaceutical Society recommends that pharmacists collaborate with each other and with other healthcare professions to provide ‘joined-up, patient-centred health and social care’.  The review says the Health and Wellbeing Board should encourage the involvement of pharmacies and pharmacy teams in developing local plans and systems of integrated working for health.

This morning, Cambridgeshire county council’s Economy & Environment Committee will be discussing its response (Item 6 with two appendices) to East Cambridgeshire district council’s revised draft local plan.

The county council isn’t responsible for providing GP facilities.  GP practices are individual businesses, and the responsibility for ensuring there are enough of them to serve their communities, and that they are funded to do what the NHS needs, rests with NHS England together with our local Cambridgeshire & Peterborough Clinical Commissioning Group.

(There is a ‘rule of thumb’ that each full time GP should serve around 1,800 patients.  Most GP practices will operate at this level because, as businesses, they will want to operate as close as they can to full capacity).

The draft local plan for East Cambridgeshire mentions only three specific sites for expanded health facilities:

• Enhanced health facilities in Ely including the Princess of Wales Hospital
• Extension to Staploe Medical Centre in Soham
• Expansion of GP medical services in Sutton

The county council’s draft response recommends that the district council should consult with NHS England and the Clinical Commissioning Group to make sure this fits with their plans.

It also warns that the smaller sites in the draft local plan will have a ‘cumulative impact on health services’ and that the infrastructure development plan should take this into account.

One of the concerns most frequently expressed by local residents is the effect of thousands of new homes in East Cambridgeshire on local schools.

The county council is responsible in law for ensuring that there is a school place for every child of school age.  This morning, Cambridgeshire county council’s Economy & Environment Committee will be discussing its response (Item 6 with two appendices) to East Cambridgeshire district council’s revised draft local plan.

So what does the county council think of the revised draft plan for our area?

There will be ‘real challenges’ in supplying school places

It’s clear that the county council thinks we shouldn’t be starting from here.  It responded to the first draft of the district council’s local plan last year, to say that it preferred ‘growth in the main settlements where the proximity to existing infrastructure could be utilised and expanded and the scale of development on individual allocations could support on-site provision of infrastructure’.

But instead of concentrating development in this way, the district council has decided to spread it evenly across East Cambridgeshire, in proportion to the size of each town and village.  The county council says that ‘this option would pose real challenges to managing the effective provision of infrastructure, particularly school places, to meet the additional demands of the new Plan’, and that there will be ‘major implications for the delivery of school places as a consequence of the new spatial strategy’.

A lot of the proposed developments will not be big enough to require a ‘Section 106’ financial contribution by the developer, nor to enable new schools to be built on-site.

Children may have to travel further to school

In the proposed new local plan, a lot more houses are due to be built in smaller villages, and in larger villages such as Fordham, Isleham, Stretham and Witchford where primary schools have no room to expand.  The county council warns that ‘the limited scope for expansion coupled with increasing pupil roles [sic] may in certain settlements result in the need to travel further to access school places’.

The local plan could mean

• Pupils attending schools outside their own village
• Money from developers going to expand schools in neighbouring towns and villages rather than in the community where the houses are being built
• Loss of ‘community cohesion’ as children are bussed to different schools.

A list of primary schools with no room for expansion is at the end of this post.

Providing more secondary school places will be difficult

The revised draft plan will mean four more forms of entry at secondary schools in Ely, four in Soham, and two in Witchford.  A new secondary school will open at Littleport in September.  But even on top of this another two more forms of entry to secondary school may be needed.  The county council says this too will be a ‘real challenge’ in terms of costs and of finding a suitable site if our secondary schools cannot expand enough where they are.

‘In the longer term,’ the county council says, ‘the level of growth in the plan and the impact of future services will have significant capital and revenue implications for a range of Council service.’

Primary schools with no room for expansion

• Cheveley
• Ely St John’s
• Fen Ditton
• Fordham
• Great Wilbraham
• Isleham
• Isle of Ely
• Kennett
• Kettlefields (Dullingham)
• Little Thetford
• Mepal and Witcham
• Spring Meadow Infants and Ely St Mary’s
• Stretham
• Swaffham Bulbeck
• Swaffham Prior
• Teversham
• Rackham (Witchford)
• Weatheralls (Soham)
• Wilburton

The government’s new ‘apprenticeship levy’ is a levy on UK employers to fund new apprenticeships.  It’s due from all employers with an annual pay bill of over £3 million – who will have to put 0.5 per cent of their pay bill into the fund.

If you’re a school that’s run by the council, whether as a community school or a ‘voluntary controlled’ school, the pay bill that matters isn’t yours, it’s the county council’s as they are the employer of your staff.  So even the smallest local authority schools in Cambridgeshire will have to pay 0.5 per cent of their pay bill to the Government.

However, if you’re an academy or a voluntary aided school, it might be a different story.  If the trust that runs you is too small to reach the £3 million pay bill threshold, you won’t have to contribute to the apprenticeship levy, even if you’re the same size as (or even bigger than) the next door local authority school that does.  And that doesn’t seem fair to me.

There are a lot of other changes to education funding going on this year which will increase or decrease the cash going to individual schools.  The government is short-changing schools by not inflation-proofing the grant it gives them (bad news).  On the other hand, the government is proposing a national funding formula (good news) whose effect has been to move money away from relatively well funded urban areas into rural areas. On the third hand, they have increased the deprivation component and reduced the lump sum that goes to all schools, so some small rural schools serving non-deprived areas will see a small loss.

So it’s a complicated picture of swings and roundabouts, not just a slide.  But it seems wrong that all local authority schools, however small, will have to pay the apprenticeship levy, while the same rules won’t apply to some academies.

With thanks to Huntingdonshire’s Cllr Peter Downes for advising on the technicalities of the rules. Any remaining errors are mine.

The existing taxi rank on Market Street in Ely could be extended to take over the nearby 30 minute parking bays outside Thing-Me-Bobs, if an application to the council’s Licensing Department is granted.

Current taxi rank (in red):

Proposed taxi rank:

Any comments for or against this proposal should be sent in writing to the Senior Licensing Officer, East Cambridgeshire District Council, The Grange, Ely CB7 4EE, or by email to licensing@eastcambs.gov.uk by Thursday 2 March 2017. Comments received after this date will not be accepted.

Any comments received during the consultation period will be considered by the Licensing Committee on Monday 20 March 2017.

Cambridgeshire and Peterborough NHS chiefs have responded to last summer’s wave of public protest at plans to close East Cambridgeshire and Fenland’s minor injury units at Ely, Doddington and Wisbech.

In a welcome development, the local Clinical Commissioning Group (CCG) has announced that it is proposing to pilot ‘Local Urgent Care Service hubs’ in each of these three locations, starting this spring.

The first phase of these ‘hubs’ will be to add GPs to the Minor Injury Unit nurse practitioner teams from Monday to Friday, and increase the range of patients and conditions to be seen and treated locally.  The CCG hopes to improve integration between Minor Injury Unit staff and the GP ‘out of hours’ service at weekends, so that more patients can choose local services instead of travelling to A&E when they do not need to.

The pilot phase will help shape future decisions about the service.  In the longer term, the CCG hopes to be able to

• integrate services, which are currently fragmented, into local service hubs which are easier for patients to understand
• standardise opening times
• increase and strengthen existing links with A&E, ambulatory care (where patients receive hospital treatment without needing to be admitted), and other acute specialties such as orthopaedics
• support general practice to continue to be able to offer a wide variety of services for their patients
• make most efficient use of resources
• develop local but cost effective solutions for the rural geography.

Healthwatch Cambridgeshire has been invited to the CCG’s internal planning group, and when there is formal agreement to take these pilots forward, the CCG will update patient groups, local representatives and staff on how they can be involved.  Any permanent proposals would be opened to formal consultation.

This is very encouraging news after many months of uncertainty, and although the future isn’t settled yet, it’s beginning to look a lot more positive than it was six months ago.

Last September Cambridgeshire County Council reviewed all of the school transport services to Ely College, Soham Village College and Witchford Village College along with many services to primary schools in East Cambridgeshire.

The intention of the changes was to help reduce the cost of school transport in the area by more than 15 per cent.  Some services have not changed, but for other pupils the time or the route of their journey has been affected.

The county council is now seeking feedback on the changes, whether positive, negative or neutral.  It has written to parents but there is an online survey here. (Click the Consultation website link).  The survey runs until Thursday 9 February.

17/00022/FUL
Sutton
34 Lawn Lane, Sutton CB6 2RE
Proposed first floor side extension & internal alterations.

16/01807/FUL
Witcham
Land South and West of 1 Martins Lane, Witcham
Construction of three bedroom, two storey house.

As I’ve previously reported, the County Council decided on 13 December to restore last year’s winter gritting routes, and to reinstate street lighting to previous levels in places where  dimming and overnight shut-down has been implemented.

To put the gritting routes back into place, council officers have contacted the supplier of their leased gritting lorries.  Following some servicing to the vehicles, extra lorries will start arriving in Cambridgeshire from next week.  Trained drivers are supplied by Skanska – this will take a little longer for obvious reasons, and officers expect the full service will be available across the county from mid to late January. The County Council will start to reinstate routes as drivers and vehicles become available.  This is likely to be district by district, with the order of roll out depending on the availability of drivers.

Meanwhile, the County Council has instructed street lighting supplier Balfour Beatty to reinstate street lights to their previous levels as soon as possible in areas where they have been dimmed and shut off overnight.  Council officers hope this will be resolved by Christmas.