City and Hackney LPC
MINUTES - OPEN Part
20th July2016
13.00 – 18.00
Tomlinson Centre - Queensbridge Rd, London E8 3ND
Attendance:
Member Name / Initials / AttendanceP=Present,
A=Absent,
Aa= Apologies sent. / Attendance this financial year
Raj Radia(chair) / RR / P / 2 of 2
Stewart Evans / SE / P / 2 of 2
Kirit Shah / KS / P / 1 of 2
Peter Muska / PM / P / 2 of 2
Anish Patel / AP / A / 0 of 2
Parag Oza / PO / P / 2 of 2
Dee Fasan / DF / A / 1 of 2
Sunil Patel / SP / P / 1 of 2
Kirit Sonigra / KSo / P / 1 of 2
Nickil Patel / NP / P / 2 of 2
Kerry Webb of Day Lewis (new AIMp member) / KW / P / 1 of 1
In Attendance
Hitesh Patel (CEO) / HP / P
Stuart Brown (Minute taker) / SB / P
Shakira (GSK) / P
Mas (GSK) / P
Josephine Falade (CCG) / JF / P
1. Presentation from GSK
From 13.30 till 14.00 GSK (Shakira and Mas) gave a presentation on the benefits of a quadravalent Influenza vaccine.
Shakira stated that she currently specialises in Travel Health for GSK and she stated that she would be the rep. for the C&H area.
RR thanked Mas and Shakira for their presentation and for sponsoring the meeting.
2. Welcome by the Chair and to note any apologies
Apologies were noted from AP and DF and the meeting welcomed KW to the committee.
3. LPC membership
Declarations and Conflict of Interest
None were noted.
HP stated that he would get KW to fill out DOI and confidentiality agreement documents.
4. Approve minutes and follow up Actions from Open section of meeting – 28th april 2016.
Accuracy
SB pointed out that he had left the last meet’s date on the minutes.
The minutes would need to be amended to show 28th April 2016.
The members stated that the minutes are an accurate account apart from the date.
Assessment of LPC member’s skills:
HP re-circulated the member skills training sheets for all LPC members (originally drawn up by SE). SE commented that this document had been drawn up several years ago, however it is still relevant.
SE reminded the meeting members that RR and HP attend most of the external meetings at present and that by signing up for any training using this spreadsheet, any other LPC members would be making a commitment to take an active part in going to external meetings.SE reminded the meeting that sending members on these training courses would also be a financial commitment wrt. the LPC.
HP recommended that members go to the PSNC website in order to gain access to the members’ section so that they can then look at the list of training meetings. HP recommended that KW sign up for the new members’ seminar.
SE and HP recommended that every member target only one or two training meetings to attend at present.
SE stated that a “change management” workshop for LPC members and CEO’s is coming up in September 2016.
Previous action:
HP, NP, PO and SE to gather examples of and then compile a LPC guidance for GPs wrt. direction of prescriptions:
HP asked whether this should be the CCG’s job to guide GPs wrt. direction of scripts. NP suggested that there are many resources out there on this subject and the LPC shouldn’t waste time and resources compiling another such document.
SE stated that he had found a resource from the BMA on this very subject, which currently covers all aspects of this topic. SE continued that any future communications on this subject should read something like “we are concerned that the guidance set out by the BMA is not being followed.”
HP asked what he should take back to the medicines management committee meeting.
SE suggested that HP could take this document compiled by the BMA to the MM committee.
RR suggested that members of the LMC should be invited to an LPC meeting.
SE commented that this had been tried many times before with no success.
Action no. / Description / Who to action1 / To invite a member of the LMC to an upcoming LPC meeting. / HP/RR
2 / To flag up the BMA’s direction of prescription guidance at the next medicines Management meeting. / HP
Previous action point:
NP to obtain a paper template for the MOS from Clockwork Pharmacies – to be used in the work to build a PharmOutcomes module:
RR stated that the LPC currently needs to think about evaluating C&H’s MOS (in terms of value for money and of outcomes recording). RR added that this work would help the service’s viability when it would come to be reviewed.
KS commented that Julian (previously employed by the LPC) had done some initial work on evaluating this service).
RR stated that Julian’s work had not been completed.
HP stated that the record keeping and the procedure for this service would need to be unified across C&H, because the SLA is currently very open ended.
NP proposed the LPC pay an external (independent, unbiased) organisation to come in and audit the service.
RR proposed that an LPC sub group be formed to work on this topic outside of LPC meetings.
PO agreed with NP’s proposal, and agreed that the evaluation must be carried out by an unbiased organisation.
PO stated that he would put HP in touch with Karen Rosenbloom (Kings College), who could help with the evaluation.
HP stated that he would also email the contact at UCL who had done some work for the LPC on the alcohol scratch cards.
KS suggested that patient satisfaction surveys should be used to measure the value of the service.
HP stated that all the London MAS’ are being reviewed by an external group of experts and HP feared that the MOS would be next for this kind of review.
SE reminded that the LPC would want to support good coverage for this service across the borough.
RR and HP wondered whether visits by LPC members to random pharmacies currently delivering this service would benefit the evaluation of this service.
SE reminded the meeting that the LPC must discover what the cost effectiveness of this service currently is, as commissioners will be most interested in this factor.SE endorsed NP’s original proposal – fund an external group to conduct an evaluation of the MOS.
NP stated that he would take his proposal forward.
The members agreed with this course of action.
Action no. / Description / Who to action3 / -To develop a remit for an external body to evaluate C&H’s MOS.
-To contact several external bodies to get quotes for evaluating the MOS. / NP
Previous action point:
HP to approach the company (used by LSL LPC) to obtain quotes on potential work around gathering patient satisfaction data for a C&H MA service evaluation document:
HP stated that external experts are currently reviewing the MAS across London, with a view to having a London wide service commissioned.
Previous action point:
HP and All to access the LPC Dropbox folder:
HP stated that he would grant KW access to the LPC Dropbox folder.
Action no. / Description / Who to action4 / To send out link and instructions on how to access Dropbox to all LPC members. / HP
Accelerate’s dressings service pilot
In a previous action point HP was tasked with obtaining the facts and figures re. Accelerate’s dressings service pilot, when the contract comes to an end in March 2016.
Action no. / Description / Who to action5 / To report back to the meeting on the results of the evaluation done on Accelerate’s dressings service pilot. / HP
Previous Action Point:
To look into getting an LPC member invited to the Long term conditions board meetings going forward:
HP wondered if this action point should be shelved.
RR disagreed with this suggestion and re-iterated that a member should still try to get on the long term conditions board.
SE reminded the meeting that four LPC members had been attending the quadrant meetings (they are held four times a year) – SE added that he felt that this had been a waste of time for these members, as CP’s voice was not given a chance to be heard. SE added that attendance to these meetings was currently costing the LPC 6% of its budget (these meetings take place during the day).
SE suggested that the LPC looks at all the meetings that the members currently attend to target which ones should be cut – dependent on which meetings can bring the most benefit to C&H contractors.
HP wondered whether the LPC levies should be increased, or voluntary levies could be introduced to help fund the attendance at these potentially important meetings.
SE wondered what benefit the contractor would see from these levy increases – when the results so far from attending these quadrant meetings has been minimal.
SE added that the LPC would not need to raise levies at the moment as the LPC reserves currently show an excess of £30,000.
HP proposed that the next two quadrant meetings be attended and reviewed for value to C&H contractors.
NP proposed that these Quadrant meetings should be attended going forward in order to know what discussions will be taking place, even if CP does not actively have an input at present.
Action no. / Description / Who to action6 / To contact Richard Bull so that HP can get invited to attend the Long Term Conditions Board meetings. / HP
SE stated that for HP to attend the Long Term Conditions board meetings would coat the LPC more money - paying for his attendance.
RR reminded the meeting that the four LPC members had only attended one quadrant meeting.
SE and HP proposed that the members attend the next couple of quadrant meetings, after which their value will be assessed and then the LPC will vote on whether to continue to attend.
RR wanted it recorded that he disagreed strongly with this proposal.
SE wanted to go on record by saying that the role of the LPC FAC is currently to raise issues like this one (which meetings are value for money wrt. LPC member attendance) so that the LPC can debate them.
Action no. / Description / Who to action7 / To attend the next couple of quadrant meetings, after which their value will be assessed and then the LPC will vote on whether members should continue to attend. / All
KS stated that in his opinion, the Health and Scrutiny board meetings were a waste of time and he proposed that he be replaced as LPC attendee.
RR disagreed with this proposal and stated that this meeting was an important one to attend (the last meeting had the subject of immunisation discussed there).
SP stated that he thought that this meeting would be an important one to attend as it was currently hosted and led by local councillors. SP added that GPs were often held to account at these meetings.
SE reminded the meeting that any LPC members attending an external meeting should prepare a report which should be presented to the LPC in some form.
purm service
HP commented that the PURM service is still not fit for purpose and that it will probably not be recommissioned in 2017.
Previous Action:
HP to upload the “Diabetes” and “Vitamin D” Guidelines to the LPC website:
HP stated that there is no current “Diabetes” guidelines to upload to the website, and he would raise this issue with the prescribing board.
SP stated that some GPs are currently prescribing Vitamin D treatments which are not presently branded and licenced.
HP asked SP to send him an email which would detail this matter.
Action no. / Description / Who to action8 / To raise the following issues at the next prescribing Board meeting:
-The lack of current Diabetes guidelines.
-The fact that some GPs are currently prescribing Vitamin D treatments which are not presently branded and licenced. / HP
Action no. / Description / Who to action
9 (ongoing) / To upload the training guidelines for all LES’ to the LPC website. / HP
PGD training:
HP reminded the meeting that he is trying to set up a new method of PGD training where PGD training can be carried out in a cascade format within a Pharmacy – i.e. a Pharmacist who has undergone face to face training can peer train another member of staff in that same pharmacy.
Action no. / Description / Who to action10 / To develop cascade training guidelines for PGD training. / HP
11 / To proof read HP’s cascade training guidelines. / SE, SP and PO
devo hackney
Action no. / Description / Who to action12 / To contact Chair of Greater Manchester LPC to introduce RR and to gain insight into learnings from DEVO. Manc. / HP
Previous Action:
NP to contact contractors reminding them of the Consultation Skills and PolyPharmacy courses:
NP stated that twenty-one contractors had signed up for the consultation skills workshop which would take place on the next day.
NP added that the next push would be for the PolyPharmacy course in two months’ time (20th September 2016).
Previous Action:
NP & HP to set up a meeting in the next week with head of the local CEPN to discuss the light IP in GP surgeries training course and the possibility of funding vaccination training in C&H:
NP stated that Ravi Sharma is still being talked to about this training. HP stated that no funding bid has been made as yet but there is still time to do so.
Long term conditions board
Action no. / Description / Who to action13 (previous action) / To find out information from Viral Doshi wrt. how many smokers had been recruited to a smoking cessation service by the use of the Vitalograph service. / HP
Previous Action:
HP to share the list of the ten poorest performing pharmacies for the stop smoking service with the relevant cell leads:
HP asked the meeting whether it would be the LPC’s current role to performance manage these pharmacies.
NP, SE and RR stated that if these pharmacies are jeopardising the service for all other pharmacies then it would be the LPC’s role to performance manage.
HP suggested that a training workshop be set up for the poor performers to attend.
PO wondered whether these poor performers would turn up to a workshop and instead recommended that someone go visit these pharmacies to mentor them one to one.
SE agreed that these poor performers would not turn up to a training meeting.
HP wondered whether these poor performers names and figures should be shared.
RR and PM suggested that the cell leads visit the pharmacies on their cell list to mentor them.
SE stated that he would struggle with this role as he is not a working pharmacist.
Action no. / Description / Who to action14 / -LPC members to performance manage their own pharmacies who are currently underperforming wrt. Stop Smoking service.
-HP to look at options of performance managing the remainder of the ten poor performers. / All
PO proposed that the actions be amended going forward such that timescales are added to them, so that ongoing actions are not discussed at length in future meetings – thereby saving time.
It was unsure whether this proposal was backed?
GPHC inspection audit – BRR consulting
HP stated that this company BRR consulting were currently offering a service where they would conduct a mock GPHC inspection for £500.
SE stated that this may be very useful for independent contractors.
HP stated that if the contractors come through the LPC then they would receive a 5% discount.
PO warned that this discount situation would set a precedent with other companies, who would want to sell their services.
SE warned that the LPC could not promote this service.
All members except PO and DF agreed to endorse the advertisement of this service – depending on the wording of the email used to communicate its details, and only if the discount for LPC promotion be disregarded.
The minutes were then signed off as accurate (once corrections had been considered).
5.NHS England London
Summary Care Records – update from RR
HP reported that NHS E together with HSCIC are performing an intervention with a view to improving daily SCR use. HP added that ten C&H pharmacies will be chosen at random to receive an email on a Thursday for three weeks (starting this Thursday) to see if this intervention message will improve daily SCR use.
SE stated that lots of pharmacies, including his own, can’t access SCR because it doesn’t currently work well with the OS Windows XP. SE added that until his company decides to update the hardware/software (to Windows 7) then SCR will not be accessible to his Pharmacies.
RR also commented that the “internet Explorer” browser is the only browser that will currently support SCR access.
Minor Ailments Service – ordering of vouchers, leaflets and posters.
HP stated that instructions on how to order the MAS vouchers are currently on the C&H website.
HP added that a pdf. Is also available so that pharmacies can print their own vouchers and leaflets in an emergency.
Report from HP from last NHSE/LPC meeting
HP stated that NHS E will now meet with all LPC reps on a regular basis, and the first meeting will be held on the 25th July 2016.
6.Devo Hackney
RR stated that Devo Hackney has now been superseded by the NEL STP (Sustainability and Transformation Program). RR added that he is not currently part of the board meetings for the STP, however he does sit on the Health and social care Transformation board, as part of his role as a health and wellbeing board member. RR commented that he doesn’t know the strategic direction of the STP at present. RR commented that RR should continue to attend these meetings to determine the direction of this program. RR added that nothing is being commissioned through the CCG for CP.
SE commented that there is still a commitment to devolve services down to the local (quadrant) level.
7.Community Education Provider Network Update
HP stated that there is currently still funding available for the training of twenty Health Champions. HP stated that
Action no. / Description / Who to action15 / To send out an email to remind C&H contractors that there is funding available to train twenty health champions. / HP
NP stated that he would be working closely with C&I LPC wrt. obtaining funding to train independent prescribers.
RR stated that C&I LPC are currently organising and funding workshops, webinars and videos to help their contractors improve their MUR and NMS and vaccination uptake. RR stated that once perfected, these template aids would be available to other LPCs at a cost. RR stated that KCW LPC are also funding and organising workshops centred around Health Champions and how they can help improve the uptake of various services.