Minutes

Gloucestershire LPC Meeting

Thursday 9th March 2017 Premier Inn, Tewkesbury Road, Twigworth

Item / Actions
1.  / Present: Peter Badham (PB), Iqbal Topia (IT), Andrew Kings (AK), Lis Jardine (LJ), Rebecca Myers (RM), Fiona Castle (FC), Wayne Ryan (WR), Sian Williams (SW), Mike Powis (MP), Gary Barber (GB), Milak Rahman (MR)
Apologies: Philip Lewis, Andrew Lane, Pete Arthur, Arvinder Sagar
Guests: Sharon (Lloyds), Julie McCann (item 7), Karen Pitney (item 8), Teresa Middleton (item 6), Philip Kelley (item 6)
RM was selected as chair for today’s meeting in the absence of Andrew and Philip.
2.  / Minutes of previous meeting
Accuracy
RM was present – LJ to correct before publishing.
Items for redaction from publicly published minutes
None / LJ
3.  / Standing items (to note/inform later discussions)
Contractor Progress towards Quality Points
Contractors need encouragement to use the PharmOutcomes tracker.
4.  / Officer Updates
Action Report from previous meeting
·  MAS: strategies to increase delivery so far not working:
o  Hayfever promotion
o  Contact LMC, locality managers re surgery triage?
o  Hints and tips for staff.
Press release
Template letter for contractors to take to surgeries
Stickers/A6 flyer re ‘pharmacy first for hayfever’.
o  PB suggested 6-month review of MAS target. Agreed.
·  Press release material: all to use PharmOutcomes service to provide snippets of ‘what you used your consultation room for this week’.
·  SCR training: FC chasing rollout team.
A few independents not responding to any pressure.
FC data showing 41 Glos have not accessed may be inaccurate. FC to check.
·  Consultation room awareness campaign: FC reminded everyone to send photos to LJ.
·  Strategy document: regular review (6 months?). Add reference to CCG - communication/key stakeholder (FC)
·  Subgroups: LPC decided not to constitute formal groups (remain flexible).
·  ASAP: LJ to create survey to investigate contractor use in consultations.
·  Contractor training: New contract based training schedule. (Informal) training group to discuss.
·  Locum page: FC working on content.
·  HLP train the trainer objective: remove.
Independent champion training access – distance learning much cheaper option so unlikely to organise face to face unless lots of coincident interest.
Chief Officer Activity Report
NUMSAS and MiDoS: NUMSAS is not a complete replacement for URMS. TM needs data to show this, FC to collate evidence.
CCG wants value for their investment in NUMSAS. Local high target for referrals from NHS111. MiDoS allows pharmacies to signpost to other pharmacies/services. NHS England Expression of Interest coming out for NUMSAS.
Treasurer’s Report
LPC happy with accounts. Still running at a surplus.
LJ to circulate claim form again before end March.
2017/18 budget was ratified with 8 positive votes and 1 abstention. / FC
ALL
FC
FC
LJ
5.  / Sub-Group Activities – Developing the LPC Offer
Frailty:
Committee agreed to put together a two-tier service proposal for Teresa Middleton.
1.  In the pharmacy: frailty check/review looking at BP/Glucose/weight etc. and offering appropriate help/referral. £30 fee?
2.  Domiciliary visit: one hour plus travel time etc. Check of house (extra training needed), medication and review as above. £150?
Sustainable Transformation Plan: ideas for how pharmacy can contribute
·  Using MiDoS/other apps for efficient onward referral.
·  Coaching staff through SO
·  POD – supporting transition
·  Educating patients in use of SCR
·  LPC/Provider co keep list of accredited locums re increasing service delivery.
·  MAS consistency: area manager meeting?
·  Awareness of local formulary (cost effectiveness)?
·  Selectively promote not dispensed scheme to minimise waste
·  E-repeat scheme
·  Atrial Fibrillation diagnosis - working with ASHN to enable patients to get an NMS
·  Diabetes MUR+?
·  Collaborative working with Independent Prescribers and ICE etc (Champions/HLP)
·  Pharmacy more involved in local trials/pilots. / FC
6.  / Guest: Teresa Middleton, Philip Kelley (Blue Kite Consulting on behalf of Gloucestershire CCG)
Plans to introduce a “Coventry model” Prescription Ordering System
Patient call centre based in CCG. Looking for feedback from all stakeholders; small scale pilot in development. Hours tbc – during working day. Additional at present to GP online ordering systems. Seek to emulate Swindon system.
Will involve re-education/communication programme. Need to manage expectations re collection time.
Practical issues were raised by LPC members: e.g. notes for pharmacy, ‘script for delivery’, ‘non-screw top lids’. Important to use a local number. Direct line to POC for clinicians? Managing MDS options.
CDs/schedule 2 drugs will need to use completely different system and will not use POC to start with.
May eventually be involved in identifying eRD candidates.
CCG is not looking for LPC representation on steering group. May help with development of POC staff script. Potential for ‘open day’ visit from pharmacists?
Chris Llewellyn working with Berkeley Vale, where locality GPs are setting up a similar but independent scheme managed by G-Doc to ensure same policies and procedures.
TM messages:
Planned prescribing changes, Alzain or Axalid for Pregabalin.
Inhalers may switch.
Sip feeds review in progress.
OTC medicines may no longer be available on prescription.
7.  / Guest: Julie McCann (NHS England)
CD Destruction Process for pharmacies in groups of less than 5 pharmacies
In process of recruiting support officer. JM described the new process of ‘short life authorisation’.
Other CD Issues
Rescheduling of Pregabalin - under review.
Online CD reporting tool in development for all incidents and to request CD destruction authorisation. LPC to help publicise this on launch.
Superintendents meeting: CDAOs. Have discovered that there are certain tablet overages – trying to agree national message re patient returns (treat as stock or patient return) and policy on whether sealed containers should be opened on dispensing.
Spate of fraud - prescription theft, adding items - be vigilant. Julie could provide material for newsletter? / JM
8.  / Guests: Karen Pitney (Public Health)
Public Health issues
Pharmacy contract extensions to 2018 without substance abuse (CGL), or chlamydia screening. Will include sharps bins.
Sexual Health under review; how deliver EHC better? May offer service to a smaller, reliable cohort of pharmacies. LPC members spoke about the use of DoC and how more pharmacists including locums could be given the confidence to offer the service.
Sexual Health ‘triage’ could send people to ‘pharmacy first’ (using MiDoS?)
Will not reoffer grab bin chlamydia but may provide card to order kit online. NB withdrawal of chlamydia screening is related to recommissioning of kit supply and not any pharmacy related issue.
Community Pharmacy could ease GP capacity, other options such as pill reviews?
KP to set up meeting with FC etc to discuss these challenges ASAP.
After Karen Pitney had left the meeting, the LPC discussed the options for pharmacy-delivered Sexual Health services. Referral direct to pharmacy and a big push on DoC will help. Pharmacies could be trained to register for C-Cards. Remote (Skype) consultations? Higher age limit? / FC/KP
9.  / Completing Activities from our Action Plan
LPC Self-Assessment Update
LPC members completed a Self-Assessment, a copy is published on our website.
SWOT Analysis
LPC members completed a SWOT analysis to inform committee planning
10.  / Review of meeting effectiveness
Well chaired.
Invite similar numbers of guests next time. People like ICE Creates (Jane Prendergast), CGL & Lloyds, Teresa Middleton
Venue confirmed as suitable for May meeting.
11.  / AOB
Banners available, useful for raising awareness of CommPharm as part of One Gloucestershire. PB would like to use on 2nd May. MR in June. LJ to investigate putting a resource ordering form on web site.
Suggestion that we run training in positive risk taking this year? Increase confidence in professional judgement. / LJ