Minutes

Community Pharmacy Swindon & Wiltshire Meeting

Thursday17th May 2018 Marlborough Golf Club, Marlborough Common, Marlborough

Item / Actions
Present: Fiona Castle, Chris Shields, Andrew Hobson, Aga Jankowska, Robert Townsend, Sai Jammigumpula, John Hughes, Nick Jephson, Lis Jardine (notes).
Apologies: Zoe Pearce, Sian Williams, Charlie Wu, Arvinder Sagar, Alison Kidner.
Guests: Ali Hashemian, Mags Watson & Fiona Gillison (University of Bath, item 3), Ben Judd (Turning Point, item 6)
Minutes of previous meeting
Accuracy
The minutes were accepted as a true record.
Items for redaction from publicly published minutes
None
Matters Arising
Andrew has accepted the role of Vice Chair.
Zoe Pearce has resigned from Boots and will leave the committee at the end of her notice period.
Action Report
Consulting room audit: pause until after Quality Points deadline. It was suggested that data collection re NHSE ‘pharmacy first’ campaign would be interesting. Possible undergraduate project.
Rebranding as Community Pharmacy Swindon & Wiltshire: URL should be LJ to redraft logo suggestions.
OHH professional line: cuts you off when lines are busy. Newsletter.
OTC guidance: Wilts change from 1st June via GPs - lightly. Swindon –not a high priority.
eRD: Calne area forum being held 5th June.
Flu campaign 2018: LJ workingwith Wessex(LMC/LPC)group.
Quality Points: SW did slightly better than national average. Issues re Independents and Boots (for SCR). Some may need support for safety report – SJ to supply template to LJ.
Naloxone: FC still making slow progress for Wiltshire. No news from Swindon. Boots still unresponsive. / SJ
Guests – Mags Watson & Fiona Gillison University of Bath
Opportunities to work together
Could use student projects to look at ‘real world’ data collected by community pharmacy, e.g. young people with diabetes, engagement between community and practice pharmacists.
Research proposal
FG looking at ways to change behaviour without causing offence. Focus on childhood obesity via encouraging physical activity. Community pharmacy role – offer ‘gateway’ promotion which gamifies activity and raises awareness of inactivity, framed as a positive opportunity.
Link with health promotion activity. 20 random recruits from each of 6 pharmacies. Pharmacist may have role re data interpretation.
The committee suggested staff ‘try out’ accelerometers in advance of study – knowledge and interest raised.
Record how many people approached vs accepted, best methods.
CPSW to provide info on compensation, suggest single payment for participation in training and recruitment.
FC to be contact; will circulate contact details to all. / FC
Chair and Chief Officer Reports
Activity Report
Swindon EHCservicewill be relaunched at end June, CPPE training ready to publicise.
Epistatus and Epipens: educational event proposed. Another training opportunity needed to encourage attendance at an event. Offer alongside Revalidation.
Locally Commissioned Services Report
Public Health campaign: FAST materials and information has not arrived. FC/LJ to follow up with NHSE SW as feedback is mandatory (QP at risk).
More breach notices are being served e.g. for not submitting 100-hour declaration. CS to email FC with details.
Tadpole Lane – several applications on pause until rurality review is complete.
Anticoagulant referrals: AJ has not been receiving any, FC to feed back. Might need to reinvigorate service – should be ready to expand.
Secondment Opportunity
FC expressed interest insecondment role as Lead Pharmacist for AHSNMeds Optimisation projects and asked if the committee would consider releasing her for 7.5 hours a week.
Benefits - closely aligned to AHSN; release money and capacity for Support Officer?
LPC debated whether it could afford to lose so much of FC’s time. It was decided to debate LPC strategy and business needs before making a decision.
Once these discussions had taken place (item 6), the committee reluctantly concluded that FC was an essential component of CPSW’s plans and that the time was not right to release her;the committee also felt it might need to spend more money on employed support. / LJ
FC
FC
CS
FC
Guest – Ben Judd, Implementation Manager for Turning Point

Review of issues
Restart system being reviewed, may not take so long. BJ to provide info re positive reengagement flyer etc for newsletter.
Committee asked for info re who keyworkers are for clients. Reinstate 4-way agreement? Scripts – client details not tallying with NHS spine. Need NHS number on it.
Pain pathways –FC to introduce BJ to MW (Bath University) for potential collaboration.
BJ to look into setting up secure email for client concerns from pharmacies.
Postal acknowledgement of received scripts – these need to be followed up onif not received or they become worthless.
Loss of Chippenham Hub
Moved to an outreach model as specified in the commissioner procurement which specified hubs in Swindon, Trowbridge and Salisbury Range of venues identified – Council buildings, roving recovery vehicle? Might be able to use Swindon hub for some clients.
BJ apologised that the transition process was not handled as well as it could have been.
Working together for Naloxone and Alcohol Brief Interventions
Naloxone: FC negotiating detail of the contract and level of data collection required.
ABI:Info needed on referral routes into the service for clients identified as high risk.
Diversion of buprenorphine: BJ noted that keyworkers expressed concern about diversion of doses where consumption was supervised. The committee requested information on which pharmacies may be affected to highlight and support
FC offered to enable BJ to receive quarterly report re missed Fridays etc however this report is now of less value due to anonymisation. / FC
BJ
FC
Strategy Discussions
Stakeholder Mapping Exercise
Pharmacy teams: majority have little influence, even if some interest. Independent owners, Superintendents have most national influence. Area and Cluster managers are more locally significant. Individuals can be more important than roles.
Partner providers: Medvivo, POD, Practice Pharm, GP leads worth focusing on.
Influencing groups: LMC, STPs, MPs, most influential. HWB could be nudged.
Commissioners: STPs, NHSE, Contract managers are influential but uninterested. Need to generate interest in these groups. Public Health and Turning Point have interest but less influence.
Priorities arising from Stakeholder mapping
STPs, Medvivo, MPs, GP pharmacists, GP locality leads (FC to find out who), POD, secondary care pharmacy teams: create objectives for specific stakeholders. Find out more about them, anticipate needs, interest them. Invite them to meetings.
Area Managers: regular update meetings, June and September this year? What agenda?
What will community pharmacy look like in 5 years’ time?
Hub dispensing. Pharmacists offering both NHS and private clinical services e.g.Urgent Care walk in clinics, Travel clinics etc
Barriers: will there be capacity for every pharmacy to follow this model? There will need to be a change in law for independents to use e.g. Lloyds robot.
Independent prescribing will be needed as pharmacies become places for clinics and medicines review.
What is the vision of CPSW members for Community Pharmacy in 2022 and beyond?
“A network of Healthy Living Pharmacies, led by Pharmacist Independent Prescribers, providing and delivering holistic healthcare services which are accessible to patients where they live, work and visit.”
Pharmacies will need an integrated IT system with the rest of Primary Care, providing
  • Read/write access to a comprehensive patient record
  • Ability to view results of investigations e.g. blood tests
  • Ability to order appropriate Blood Tests
What are the steps in achieving this vision?
To discuss in June meeting. Some initial thoughts:
  • Relationship-building is key
  • Breaking down any “them and us” mentality barriers
  • Ensure existing contractors maintain profitability and sustainability
  • Address lack of engagement with currently commissioned services
  • Encourage engagement with training – diploma/university courses
  • Start to build a group of ‘ready’ pharmacies
  • Focus on clinical assessment skills, offer opportunities
  • Focus on urgent care - NHS needs capacity e.g. travel clinics
  • Be comfortable about pharmacy’s dual role as NHS and private provider

Medvivo
No progress. They will advertise Independent Prescriber position as separate contract. No formal relationship with CPSW. Suggestion from CS that we hold July meeting at Medvivo offices and better understand OOH pathways? / FC