MINUTES OF THE MEETING OF THE LIVERPOOL LOCAL PHARMACEUTICAL COMMITTEE HELD ON THURSDAY 13thOCTOBER AT 60 HOPE STREET, LIVERPOOL, L1 9BZ
Attendance Statistics 2016/17
The table below shows the LPC members’ attendances at the nine committee meetings held between April 2016 and the end of March 2017.
Members / Apr / May / Jun / Jul / Sep / Oct / Nov / Jan / Mar / Individualattendance
L Benyon / / / / - / - / - / - / - / - / 3/3
P Brennan / / / / / / / 6/6
B Cremin / / / / / / / 6/6
J Davey / / / 0 / / / 0 / 4/6
L Davies / - / - / - / - / / / 2/2
C De Vincentis / 0 / 0 / 0 / / - / - / - / - / - / 1/4
M Djuheric / / 0 / 0 / - / - / - / - / - / - / 1/3
P Glenn / / / / / 0 / / 5/6
E Goodwin / / / / 0 / 0 / / 4/6
D Jones / 0 / 0 / / / 0 / 0 / 2/6
R Lightowler / - / - / - / - / - / / 1/1
K McCarthy / / / / / / / 6/6
J Parker / / / / / 0 / / 5/6
P Quigley / - / - / - / / / / 3/3
D Sanchez / / / / / / / 6/6
TOTAL / 10 / 9 / 9 / 10 / 7 / 10 / 4/5
Present: PBrennan (PB), B Cremin (Treasurer)(BC), L Davies (LD), P Glenn (PG),E Goodwin (EG), R Lightowler (RL) K McCarthy (KM), J Parker (JP), P Quigley (PQ) and D Sanchez (Vice-Chair)(DS) 10
In Attendance:M Harvey (Chief Officer) (MH)
M16/101 Welcome
Due to the absence of the Chair, the Vice-chair (DS) chaired the meeting. He welcomed all present and introduced RL as the new AIMp member of the committee. He then made the necessary fire and housekeeping announcements, and asked for any declarations of interest. MH requested RL complete a declaration of interest from in accordance with committee governance. DS then reminded members of the agreed policy (M12/87) on mobile phones, namely that “mobile phones are to be switched off for calls and texts during the course of LPC meetings”.
M16/102 Apologies for absence
Apologies had been received from: J Davey
M16/103 Minutes of the last meeting
Copies of which had been previously circulatedwere agreed as being a true and proper record and were signed by the chairman.
M16/104 Actions from September Minutes
The actions from the previous meeting were reviewed and commented on.
M16/105LPC Business – for discussion
M16/105.1Strategy and Work Plan Development
Following on from work done at the previous meeting, members broke out into their three sub groups: Communications and Marketing; Governance and Finance; and Service Development. Time was taken by the sub groups to reflect on the visions and goals produced at the last meeting. These were then fed back and ratified by the committee.
After this, the sub-groups then started to develop a work plan that could be worked towards going forward. The committee would then regularly review this and further actions can be taken to ensure goals are realized. Again; the work plans were fed back to the full committee by each sub-group and discussed before being ratified.
Governance and Finance:
It was noted that there had been no line management put in place for the Chief Officer; with no clear development plans or reviews set during his probationary period and beyond. In other LPC’s, it is regularly the Chair or Vice Chair that takes on this role. KM offered to be MH’s line manager given her experience of this. DS would be happy to be deputy should the need arise. This was proposed by DS and seconded by JP.
Action KM/MH: Arrange a time to work through a personal development plan for the Chief Officer
Communications and Marketing:
PB informed the committee of the results from the recent contractor survey. A total of 28 responses had been received. Headline figures included:
64% of respondents knew of the LPC
32% did not know what we did.
43% had looked at the LPC website in the last 12 months
81% said they found it unhelpful.
65% of respondents were from multiples, 7% from small chain independents (up to 5 pharmacies) and 28% from independents with less than 4 pharmacies)
Action PB: Forward full results to members and MH to put on the website.
The committee thanked PB for developing the work done in developing the survey and for evaluating the results.
The work plan for the communications group is informed by these results and concentrates on getting the right messages to the right people via the right media at the right time. In order to improve relationships we have with contractors, and in order to get important messages out quickly; it was agreed that each pharmacy would have a designated committee member that would act as a key contact. Each committee member would be assigned a number of pharmacies that they would be asked to make contact and develop a relationship with.
Action PB: Complete designated member spreadsheet and forward to MH.
Action ALL: Members to review their list of designated pharmacies and forward any corrections to MH
Members also agreed to put their work contact phone and email addresses on the website.
Action ALL: Forward these details to MH to be added to the website.
Service Development:
The work plan here focuses on increasing uptake of existing services, engaging with contractors to help increase uptake and also engaging with commissioners to develop and commission new services.
The sub group vision, goals and work plan would be written up and disseminated to members for comment. A working document will then be produced. This will allow the committee to audit the work done against the work plan.
Action MH:Write up and forward the work plan for Governance and Finance and Service Development subgroups
Action sub-group leads: Confirm these are correct
Action DS: Write up Communications and Marketing work plan and forward to MH
Action MH: Once agreed, pull this into one document and share with the full committee.
M16/105.2 Pharmacy Ordering of Prescriptions
MH learned that the CCG were planning to include scrapping the ordering of medicines from pharmacies as part of phase 2 of their cost savings plan. MH had replied with a robust counter argument detailing reasons why this should not occur. Fortunately, the CCG have listened and this is no longer part of phase 2. As part of phase 2; the medicines management team will be documenting occurrences of over-ordering and we will work together with the pharmacy, practice and medicines management team to iron out any issues. We want to make this a collaborative working exercise; rather than a working against each other exercise.
As part of this, it is essential all pharmacies are following locally agreed processes if ordering medicines on behalf of a patient. This is something the committee will work on at the next meeting.
M16/105.3 Prepare for the Visit from Peter Johnstone
Peter Johnstone, Primary Care Development Manager at Liverpool CCG was due to meet the committee and so time was taken to discuss what questions to ask him.
M16/105.4 Media Training and future use of Media
DS reported to the committee about the recent media training that he and MH had undertaken. MH had subsequently been interviewed on BBC Radio Merseyside and this had led him to reflect on what else could be done using the media to promote community pharmacy. He subsequently had met with the Marketing Manager from Radio City, who outlined their coverage and what they could do to help; including interviews on Radio City Talk and advertising that could be bought. The committee agreed that further discussions should be had with all local LPC’s and Radio City and this developed further.
Action MH: Arrange a meeting between the Chief Officers of Liverpool; Cheshire and Wirral; Halton, St Helens and Knowsley; and Sefton LPC’s with Radio City.
M16/105.5 Meeting Attendances
MH was going to be unavailable at several points over the coming weeks, and therefore some meetings that he usually attends would need to be covered by other members. The Meetings that needed to be covered were (names of replacement in brackets):
Thursday 20th October: Healthy Living Pharmacy 1-2 PM
Thursday 20th October: Local Professional Network 2-4 PM
Monday 31st October: Hesteltine Institute 2-5 PM (DS)
Friday 4th November: Medicines Optimisation 1-3 PM (KM)
Thursday 17th November: Healthy Living Pharmacy 1-2 PM
Thursday 17th November: Local Professional Network 2-4 PM
Action ALL: Inform MH if able to attend any of these
M16/105.6PSNC Conference
The PSNC annual conference will be held on Wednesday 2nd November with the Chief Officers and Chairs meeting on the afternoon preceding. The committee agreed that MH would attend both, and another member would join him. The Chair would be the obvious choice, but if unavailable then DS would deputise.
M16/105.7 Visit from Peter Johnstone, Primary Care Development Manager, Liverpool CCG.
The committee welcomed Peter Johnstone (PJ) to the meeting. He started by stating the CCG has received a funding cut due to the government changing the formula CCG’s are funded through. There is no money, which has meant the community pharmacy commissioning plan has had to be put on hold. However, this could be an opportunity for pharmacy as there is a workforce crisis in the city. If we are going to move forward with new service ideas, they need to be evidence based, at scale with clear outcomes. Business cases need to also be clear on how services can reduce bed days and appointments, rather than cost. The reason being that for every person pharmacy diverts away from an alternative NHS provider, someone else will fill the space. A lot of providers are on block contracts so there is no money saved to the CCG by diverting people. MH asked if there were tariffs or documents that stated the amount of anticipated bed days for different conditions, and if these could be shared. PJ stated there were (called trim points) and these could be shared.
Action MH: Liaise with PJ to obtain the required documentation to help with future business cases.
The CCG would look to commission pharmacies across the city for any new services; however they would look at current uptake in pharmacies when deciding where to commission.
Care at the Chemist was then discussed. The plan is to take over commissioning from the 1st April from the CCG. As previously noted, the CCG are looking to limit the number of treatments included in the scheme, but include a number of PGD treatments over time. Effective communications would need to be made to patients and contractors about this.
PJ outlined what will happen with phase 2 of the CCG cost saving plan. Phase two is primarily focused on risk reduction. The service Specification for phase 2 will be shared with the LPC so we can effectively brief pharmacies that may be affected. As part of phase 2, the ordering of prescriptions; including from community pharmacies will be scrutinized. This will involve spot checks and full audits on ordering systems. There is a commitment that pharmacies near the pilot surgeries will be informed and involved in the pilot and if issues are found with systems locally, work will be done locally to resolve these.
EG asked PJ whether there would be a push to switch more patients to branded generic items. PJ responded that there would not, and sympathized with concerns raised about this. EG suggested that the Drug Tariff prices for items with attributed branded generics should be reduced to the lowest branded generic price. This would make the branded generic null and void, and pharmacies could still receive some discount on the tariff price.
Action MH: Raise this possible solution with PSNC
Members then raised issues with branded generic prescribing, especially concerning controlled drugs. PG had an instance of not being able to obtain a branded generic CD item when they had stock of the generic item which meant patients had been unable to obtain their medicine. Pharmacy workload was also being increased due to having multiple CD register entries for different brands of controlled drugs. PJ would take this back to the CCG as a matter of urgency.
Issues were raised whereby the medicines management team had not been notifying local pharmacies when a switch would occur. This has led to stock levels not being managed accordingly in the pharmacy. PJ would raise this with the medicines management team, and would like the LPC to inform him of instances of where this is occurring.
Action MH: Ask contractors for feedback of the medicines management team not notifying local pharmacies of a switch being made.
M16/106 Treasurer’s Report
BC reported to the committee the latest financial status of the committee. A second signatory has finally been added to the bank account, which means cheques can finally be paid. The LPC is holding a year’s worth of cash reserves, when PSNC guidance states this should be 6 months. There are a lot of cheques that need to be paid out and the PSNC levy is due soon. This will bring down reserves considerably but further levy holidays or investment may be looked at in the near future.
There were no changes in contracts to report.
M16/107 Matters of Report
M16/107.1 Flu Update
2153 vaccinations had been recorded on PharmOutcomes so far this season. This was ahead of last year’s figure. It would appear a number of pharmacies had not been using PharmOutcomes to document service provision.
Action MH: Send flu data to members so they can see which pharmacies in their organizations that had been offering NHS vaccinations but had not recorded on PharmOutcomes.
M16/107.2 Service Update
MH had met with representatives from Public Health to aid the writing of a business case for a new Champix PGD within Liverpool pharmacies. He had also met with the commissioner for alcohol services and Drinkaware, a national alcohol charity in order to develop an alcohol intervention service. Drinkaware had created a prototype alcohol brief intervention box that included show material and scratch cards that pharmacies could use to conduct an audit-C on patients. Four pharmacies in the city were being asked to pilot this and feed back to Drinkaware. Results from this would be used to further discussions with the alcohol commissioner regarding an alcohol intervention service within Liverpool.
A discharge referral service from hospital to community pharmacy was going ahead, with planned rollout in the new year after two hospitals in Cheshire had used the two operating systems available.
M16/107.3 MALPS Update
DS updated the committee on the minutes from the recent Merseyside Association of Local LPC’s.
M16/107.4 Blood Pressure Update
There is a push across Cheshire and Merseyside to incorporate community pharmacies into pathways for blood pressure monitoring and management. This has been included in the local Sustainability and Transformation Plan and work would now be done to make these plans into reality.
M16/108Date and Time of Next Meeting
Thursday 24th November 2016 at 9.00am at 60 Hope Street.