MINUTES
An Open meeting of Bedfordshire Local Pharmaceutical Committee was held on Wednesday 20th March 2013 at AstraZeneca’s Head Office, Horizon Place, 600 Capability Green, Luton, LU1 3LU.
Present: Members
Coll Michaels (Chair)
Samir Patel (Vice Chair)
Paul Fearon (Treasurer)
Farwaj Chaudhuri
Bhupendra Lakhani
Kiran Patel
Carol Rose
Rupal Sagoo
Pinesh Patel
Satnam Butter
Sundip Sheth
Bedfordshire LPC Office
Gerald Zeidman (Chief Officer)
Ethel Shaw (PA to Chief Officer)
Guests
Carol Hill, Chief Officer, Luton CCG
Andy Cooke, Head of Medicines Management, Bedfordshire CCG
Tess Dawoud, Medicines Management Pharmacist, NHS Luton/ Luton CCG
Niall Spencer, CAN Service Director
Ann Brown, Central Bedfordshire LINk
No.
/Agenda Item
/Action
718
719 / Welcome by ChairThe Chair welcomed members and guests to the meeting.
Apologies for Absence
Mahesh Shah
Madhu Puvvada
Ros O’Connor, Tobacco Control Manager, Public Health, NHS Bedfordshire
Sajida Khatri, Deputy Head of Medicines Management, Bedfordshire CCG
Rupi Bhasin, Healthcare Development Manager, Alliance Boots
Richard Jones, Head of Medicines Optimisation, Luton CCG
720
721 / Declarations of InterestNone
Minutes Approved
The committee approved the Open meeting minutes from 17th of January 2013 as proposed by Paul Fearon and seconded by Kiran Patel.
722
/ Matters Arising from Minutes – Action Log705 – Engagement with Mark Meekins of the 111 service is to be arranged.
708 – Gerald to advise Gerry Taylor of local pharmacies ability to help with flu vaccinations.
709 - LPC to arrange meeting with Mark Cox, Strategic Implementation Manager for Urgent Care at Luton CCG, regarding Walk-In Centres.
John Swain to provide statistics for attendees at the Luton Walk-in Centre to LPC Office.
710 - Reminder was added to the Spring/Summer LPC newsletter advising contractors of new commissioners contact details for enhanced payments.
Boots, LPC and Beds CCG to liaise regarding Norfolk hospital discharge scheme.
Belinda to provide Gerald with email for Jackie Smith. He will distribute to committee members for them to provide feedback regarding new anti-biotic guidelines.
Belinda to ensure that the PCT communicates to contractors regarding commissioning changes.
711 – Members to email Gerald their suggestions on reducing waste relating in relation to dressings supply in Luton / GZ
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723
/ Luton Clinical Commissioning Group updateCarol Hill introduced herself to everyone and gave a brief summary of her past career that included being a former pharmacist within hospital pharmacy.
Carol gave a presentation outlining Luton CCG’s strategic plans for the future together with their main objectives. The slides from the presentation have been sent to the LPC Committee members via email.
The CCG local priorities included the provision of NHS Health Checks, improved primary care access and end of life care. Cancers were often diagnosed in A&E which should have been picked up earlier to improve health outcomes.
The CCG allocation is less than that of the PCT’s budget. Carol stated that people who attend A&E or the Walk in Centre could often be treated at a GP practice or a community pharmacy.
The LPC Chair suggested the CCG should introduce a community pharmacy minor ailment scheme. Sam believed that the introduction of the Healthy Living Pharmacy (HLP) initiative in Luton would provide a suitable platform for the introduction of a minor ailment service.
Carol said that QIPP initiatives were particularly focussed around urgent care, the management of long term conditions and optimising the use medication.
Fudge asked about the CCG’s views on the provision Children Services. He explained that to date pharmacy wasn’t seen as an option for these services but his experience is that there are a number of areas that could be addressed by community pharmacists.
Carol agreed that this was an area that required changing and she would therefore take that as an action from the meeting.
Gerald referred to the QIPP deficit in Carol’s presentation and asked if the CCG’s books would balance by the 1st April 2013. Carol pointed out that the deficit was inherited by the PCT. Balancing the books would present the CCG with a challenge but they would use their best endeavours to do so.
Gerald informed the committee that Luton’s pharmacy health checks pilot had been evaluated. He had been informed by Luton’s public health team that the LPC would receive within the next couple of weeks a revised pharmacy health checks LES for consideration.
Coll thanked Carol for her update and welcomed her attendance at the meeting.
724
/ NHS Luton pharmacy updateTess presented slides from the Prescribing and Medicines Optimisation Team led by Richard Jones.
Tess pointed out that community pharmacy was still very important to NHS Luton and Luton CCG, although community pharmacy contractual matters would be moving over to the Area team of the NCB from 1st April 2013. Representatives from the Medicines Optimisation team would continue to attend the bimonthly LPC meetings.
Tess highlighted some of the key functions of her team, which were –
· Medicine budget management
· QIPP delivery
· GP practice support
· Clinical Governance
· Managing the oxygen budget
· Specialist care budgets
Tess advised the committee that the role of Accountable Officer for controlled drugs would be transferred from the PCT to the NCB on 1st April.
Coll questioned the increasing introduction of branded generics by Luton CCG into its medicine formulary. He said that pharmacists’ experience demonstrated that most branded generics were not widely available from wholesalers, would result in reduced patient compliance, and sourcing the products would result in extra costs for the NHS.
He advised Tess in her capacity as a representative of the Medicines Optimisation Team that these additional costs will need to be factored in, as it will ultimately impact on the Medicines Management budget. He pointed out that he was very disappointed there had been no LPC representation or involvement in any decisions regarding branded generics and he would like this fact and his concerns to be taken back to the team.
Tess responded that she had checked some products and they were widely available. However, Coll referred as an example to Sulphasalazine which he knew wasn’t available
ACTION – Tess to investigate availability of Sulphasalazine.
Gerald added that branded generics caused patient confusion and that delays in their availability affected patient treatment.
Gerald reiterated that if the LPC had been involved it would have helped everyone to work more collaboratively.
Sundip confirmed that in his experience supply issues are a big problem. The order had to be put through as a “special” which cost £15 and normally took three days to deliver and as a result patients were inconvenienced by the delay in receiving supplies.
Carol voiced concern about the points raised and she asked for a meeting with Richard, LPC and CCG representatives to be arranged in order to discuss further.
ACTION – Gerald with the Luton Optimization team to arrange meeting to discuss branded generics.
Coll thanked Tess for her update. / TD
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725
/ Bedfordshire Clinical Commissioning Group updateAndy presented the update for Bedfordshire CCG. The CCG had been authorised as a 1st wave CCG with no conditions. Beds CCG consisted of five Localities each with their own strategic plan feeding into the overall CCG plan. The localities were the same as the previous Practice Based Commissioning localities and consisted of 55 GP practices.
The CCG has a budget of £0.5bn with a £19m QIPP gap but the CCG are confident that they will achieve financial balance by the end of 2013/14.
Andy referred the committee to the new CCG website as it contains the new mission statement and a page which details who is who within the new organisation. He said that a letter was being sent out to all pharmacy contractors detailing what services the CCG is now responsible for and where to claim for re-imbursement for commissioned community pharmacy services. Effectively there are no changes for now to avoid any confusion and delays in payments
The CCG Accountable Officer is Dr Paul Hassan, John Rooke is the Chief Operating Officer and Brian Rolfe, a lay member is the CCG Chair.
As with Luton CCG the role of CD Accountable Officer will rest with the NHS Commissioning Board.
The CCG works with two local authorities, Central Bedfordshire and Bedford Borough, and two Health and Wellbeing Boards. There is one Director of Public Health, Muriel Scott covering both local authorities.
Sam pointed out that there is currently no community pharmacy representation on the BCCG board and asked how they could get involved in its activities.
Andy replied that Sam made a very good point and that this needed to be factored in, but to-date it wasn’t part of the structure. He would welcome such representation. Sam asked Andy to make a note of his interest in being involved in the work of the CCG.
ACTION: Andy to consider how community pharmacy could improve communications with Bedfordshire CCG / AC
Andy stated that patients’ not taking their medicines correctly was a big issue which resulting in a considerable amount of medication being wasted. Medicines optimisation is one of Bedfordshire CCG’s main focuses for 2013. It will involve working with carers, nurses and anyone in contact with patients. He confirmed that pharmacists would play a big part in this initiative.
Andy highlighted two Bedfordshire initiatives involving community pharmacists. One was a dementia pilot helping people with dementia to make the best use of their prescribed medication. The other was pharmacists helping with the switch-over of diabetic patients to use, where appropriate, one of the two Bedfordshire approved blood glucose monitors and test strips.
Coll thanked Andy for his update.
726
727 / Proposal to revise the Bedfordshire Stop Smoking SLARos O’Connor sent her apologies as she was unable to attend this meeting. This agenda item will be covered at a later date.
Update from the CAN partnership
Niall Spencer gave the update and confirmed that the CAN Partnership covers only Bedfordshire and does not include Luton.
He referred to the “Recovery Agenda - Building Recovery”, which is to be a big focus for the Partnership. It will look at the whole life of the patient and not just the treatment that they are receiving. He confirmed that to achieve this, CAN would need to work with pharmacies in order to reach all patients especially those in rural areas.
Since the amalgamation of all CAN services on the 3rd September 2012 into one hub serving Bedford and Dunstable, CAN have been very busy reviewing their work streams. Drugs, alcohol, and the prison service are now under one leadership within CAN. They have now reached a point where they can move forward and start to address issues such as liaison with pharmacies, the community, hospitals and repeat offenders.
The community pharmacy enhanced service had been continued from the previous commissioner of the service. It was now time to review this service and consider introducing new pharmacy services such as alcohol use and addressing frequent attendance at hospital by service users.
The Chair stated he was pleased that CAN recognise the potential of pharmacy and the introduction of new pathways where pharmacy can improve the existing service.
Fudge stated that needle exchange was decreasing but steroid users was increasing and asked Niall for his view. Niall said that there is a stigma around steroid users. They don’t see themselves as drug users and are therefore more likely to go to a pharmacy for treatment. He concluded that the CAN group needed to engage more with steroid users.
Ann asked if CAN had outreach workers for different Bedfordshire localities. Niall replied that users probably prefer to visit community pharmacies for treatment.
Coll thanked Niall and welcomed CAN’s recognition of community pharmacy.
ACTION: Gerald to arrange a meeting with the CAN Partnership and LPC representatives to renegotiate the pharmacy SLA. / GZ
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729
730 / Health Living PharmacyGerald gave an update on Healthy Living Pharmacy initiative. Andy agreed that HLP was the way forward for community pharmacies to deliver the public health agenda and said he was pleased with progress so far in introducing the scheme. He pointed out that HLP needed to be delivered in a consistent way across HLP pharmacies in order to build the confidence of the public and commissioners.
Ann asked if the project group could ensure that the terminology used for HLP didn’t create confusion for patients and the public. Proper communication was therefore essential at all levels.
Any other business of non-confidential nature
Gerald asked Andy if the administration fee of £5.00 per month in relation to the Bedfordshire Stop Smoking SLA would continue to be paid to community pharmacies. Andy agreed to liaise with Ros O’Connor about the fee.
ACTION – Andy Cooke to liaise with Ros O’Connor regarding the administration fee of £5 for the Stop Smoking service.
Date of next open meeting
The date of the next Open meeting is to be confirmed subject to availability of a meeting room at AstraZeneca. / AC/RO’C
731 / Close of meeting
Meeting closed at 15:45pm