KENT LOCAL PHARMACEUTICAL COMMITTEE.
TENTH ANNUAL REPORT.
Year ending March 31st 2012
committee membership
c) Raj Chopra Eastern and Coastal Kent (Resigned)
a) Sunil Chopra West Kent
b) David Entwistle Eastern and Coastal Kent
a) Tarlochan Gill (Chair) Eastern and Coastal Kent
a) Arun Jangra Medway
a) Lodi Lama Eastern and Coastal Kent
b) Nuala McGibbon Medway (Resigned)
b) Viral Parikh Medway
b) David Onuoha (vice) Medway
a) Amish Patel West Kent
a) Bipin Patel West Kent
c) Barrie Smith West Kent
b) Kit Kwok Tse Eastern and Coastal Kent
b) Suzie Bayliss West Kent
c) Mark Wilkinson Eastern and Coastal Kent (Resigned March 2012)
c) Jonathan McCrindle Eastern and Coastal Kent
b) Ana Diaz Eastern and Coastal Kent
b) Tanya Mendes West Kent (resigned)
b) Roger Nichols West Kent
a) Elected Representative of Independent Contractors
b) Representative of The Company Chemists Association
c) Representative of The Association of Independent Multiples
OFFICERS
Chairman…………………………………………………..Tarlochan Gill
Vice Chairman…………………………………………….David Onuoha
Secretary and Chief Executive…………………………….Michael Keen
Treasurer…………………………………………………..Harriet Mearns
Service Development Manager……………………………Stuart McMillan
LPC Office :-
First Floor, Field Pharmacy, 11, Old Road, East Peckham, Kent TN12 5AS
Telephone & Fax :- 01622 873356
E~mail
REPRESENTATIVES TO KENT & MEDWAY PCT COMMITTEES
(These groups and committees will change in 2012/13)
PCT LPC Strategy Group Prescribing Sub Committee
Eastern and Coastal David Entwistle
Eastern and Coastal Lodi Lama
West Kent Barrie Smith (Chair)
West Kent Sunil Chopra
West Kent Bipin Patel Bipin Patel
Medway Tarlochan Gill
West Kent
OTHER COMMITTEES
Dartford Gravesham and Swanley CCG Tali Gill
Medway Medicines Management Group David Onuoha
Nuala McGibbon
West Kent Medicines Management Group Bipin Patel
Sunil Chopra
Medicines Local Health Economy Group Kit Tse
PNA Steering Groups: Eastern and Coastal Kent David Onuoha
West Kent David Onuoha
Medway Tarlochan Gill
All LPC Secretary
Electronic Prescription Service Release 2 Kit Tse
Amish Patel
Eastern and Coastal Kent anticoagulation steering group LPC Secretary
Kent DAAT Shared Care Committee David Onuoha /Chair/ Secretary/ Suzie Bayliss
Pharmaceutical Regulations Committee Stuart McMillan/Secretary
In addition the LPC Secretary represents the LPC on:-
PCT Pharmacy Performance Advisory Group Secretary
SECRETARY’S REPORT
2011-12 has continued to be a very challenging time for contractors in Kent and across England and Wales. The number of pharmacy contractors in Kent has continued to increase driven in part by the considerable increase in 100 hour contract applications and the workload due to increased prescription volumes has continued to rise with pharmacies across Kent and Medway dispensing over 27 million prescription items.
We are spending substantial time representing you and dealing with 100 hour and internet applications and at the time of writing this report we have 29 contract applications outstanding and more on the way. Some of this situation can be laid squarely at the door of the Department of Health who have continued to delay implementation of the new market entry regulations and not stop all exempt applications in good time. The latest estimate is that the new Pharmaceutical Needs Assessment-based market entry regulations will be laid this May or June. The recent opening of considerable numbers of 100 hour contracts each costs the PCTs (Kent and Medway Cluster of PCTs) money for the practice allowance and costs existing contractors through the dilution of fees and funds that community pharmacy receives from the last Global Sum settlement. This is a very unsatisfactory situation and we continue to lobby and work hard on your behalf.
During the year we have seen the commissioning landscape change and there has been a risk of decommissioning of services that you provide. To date that has not happened in Kent and we continue to monitor the situation closely. We have been fortunate in being able to implement schemes the needle collection service in Swale and we now face coming changes to the out of hours arrangements and Kent Drugs and Alcohol Team contracting with CRI taking over from KCA in West Kent. We have furthered a small diabetes project and Kent is well ahead in the implementation of the electronic prescription service (EPSR2). Over 150 pharmacies are currently live on EPSR2 and can dispense electronic prescriptions.
Some public health services have already moved to the Kent Community NHS Trust that is the provider arm cleaved out of the old PCTs. They are creating new specifications for services with some new requirements for you if you are to sub-contract to them. Weight management has commenced and quit smoking is being done now in East Kent. Other areas and services will follow. It is vitally important that you read and check any proposed service specifications and check with the LPC before signing a contract; then you can know if we agreed the proposal or whether there is anything in it that could be detrimental. In future we will be moving to a situation where services we have been a preferred supplier of will become the province of any qualified provider. That will require us to be ready and competitive.
Also during 2011-12 we launched the New Medicines Service. The LPC ran workshops to introduce this service and we had an expert speaker to commence the clinical areas of training starting with diabetes. The statistics show the service growing and in the three months to December the average payments per NMS carried out in Kent rose to just under £18. This is an improvement but shows contractors still unable to claim for all their work and this LPC has been addressing this with PSNC. They have recently announced the very welcome changes to the service payments.
The Global Sum settlement last year was concluded without including the cost of service inquiry results and we suffered yet another claw back and a reduction in the practice payments. This is an unsatisfactory situation and with a growing dominance of generics in our income stream, a worry for the future. PSNC continue to tackle this and we await implementation of the cost inquiry result.
We are now working with new stakeholders and that includes the Local authorities. Your LPC has been building a working relationship with Kent County Council, Directors of Public Health and other new stakeholders. One lesson for us all is that the most important person in all this is the patient or member of the public and it is for us all to engage with patient groups as well as with the new GP Lead Commissioning Consortia.
Kent has a substantial rural geography and I am pleased that we have been included in the PSNC specialist working group on rural matters along with a select number of other rural areas around the country. We have to work with dispensing doctors and face difficult challenges so a working group and shared learning is very welcome.
I wish to take this opportunity to wish you all a prosperous year in 2012/13 and your LPC continues to be here to help contractors in these turbulent times.
CHAIRMAN’S REPORT
This has been my first year as your Chairman. We have, coincidentally, witnessed perhaps the biggest change in the NHS since its inception. Given the publicity, I am sure that you will be aware that we now have The Health and Social Care Act 2012. In a years time Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) will no longer exist and Clinical Commissioning Groups (CCGs) will be the new statutory bodies for Primary Care.
In preparation for this change, the three PCTs in Kent (Eastern & Coastal, Medway and West Kent) have formed a ‘cluster’ and 7 Clinical Commissioning Groups have been established in Kent. As CCGs are new entities, we expect there to be some rationalisation in their numbers over the coming months as they become ‘authorised’. Clearly there is still considerable change ahead.
The Kent Local Pharmaceutical Committee (LPC) is the recognised body that represents all pharmacy contractors in Kent. Despite the challenging times, one major success over the past year was Kent’s selection as a Healthy Living Pharmacy (HLP) Pathfinder Site. In a collaborative bid between the Kent LPC, Public Health and PCTs, and after a very competitive process, we were became one of 20 pathfinder sites across the country (representing 30 PCTs). From 312 community pharmacies in Kent, we received 81 expressions of interest to become an HLP. Due to our limited resources, 36 were selected for the first wave and staff from these pharmacies are in the process of being trained. Once these first wave pharmacies have been accredited, we will commence our second wave of HLPs.
We believe that HLPs will make a positive contribution to the Health Inequalities Strategy for Kent and will be a critical element in delivering health improvements by integrating pharmacies with Public Health initiatives. By promoting health and wellbeing as a core activity, and consistently delivering a broad range of commissioned services to high quality, HLPs will be at the forefront of delivering improved patient outcomes – an attractive resource to commissioners. We believe that HLPs will be an excellent provider of NHS HealthChecks, so we will work with commissioners and General Practitioners to promote seamless patient care.
Given all the changes outlined above, the Kent LPC has also adapted its own ways of working by developing sub-groups to focus efforts on core areas of our business. Furthermore, to ensure that we are best positioned to represent your interests with all the new emerging stakeholders, we will be moving towards having more day meetings when these stakeholders are available. While these changes will require additional resources, we will continue to ensure that contractors receive a proportionate increase in value with any increase in cost.
In addition to working hard towards providing additional services, the LPC has represented contractors against the threat posed by a considerable number of exempt (100 hour) contract applications. I would like to thank Mike Keen, CEO for leading on this important work and for securing some successes for our contractors.
I would like to take this opportunity to thank Barrie Smith for his leadership of the LPC for the past 5 years and for his continued support as a member. I also thank Mike Keen (CEO), Harriet Mearns (Treasurer), David Onuoha (Vice Chair) and Stuart McMillan for their hard work on behalf of the LPC committee, who I also thank. Finally, I would like to thank the contractors for their commitment and support of the initiatives that we are developing on their behalf.
PRESCRIPTION STATISTICS 2009-2011
There are currently 310 contractors on the Pharmaceutical Lists of the three Kent PCTs
As payments for pharmacy services are paid three months in arrears the figures below represent a calendar year (January to December)
2009 2010 2011
Number of Forms 12,191,917 12,775,437 13,324,751
Number of Items 25,068,968 26,337,007 27,351,598
Average Items per Form 2.06 2.06 2.05
Total of Basic Prices £ 271,236,032 £ 287,345,127 £286,329,262
Discount £ 21,629,948 £ 22,557,374 £22,153,279
Net Cost £ 249,606,084 £ 264,787,753 £264,175,982
Fees £ 54,408,956 £ 55,600,650 £57,933,568
Average Fee £ 2.17 £ 2.11 £2.12
The number of prescriptions dispensed continues to rise but recent clawbacks and reductions in fees have reduced the payments for dispensing. This has caused considerable concern for contractors and it is important that this is addressed to maintain confidence and a desire to invest in community pharmacy.
We now have an extra advanced service, the New Medicines Service in addition to the medicines use review, the appliance use review and the stoma appliance customisation. Enhanced services have become more difficult to develop with the Kent and Medway Cluster of PCTs. Some services have been taken on by the Kent Community NHS Trust that is sub-contracting community pharmacy (e.g. weight management and quit smoking schemes in PCT areas).
PHARMACEUTICAL REGULATIONS COMMITTEE (PRC)
The PRC is empowered to investigate, conduct hearings and make decisions on behalf of the three Kent PCTs, about applications for inclusion in pharmaceutical lists and modification of existing contracts.
Applications have steadily increased during the year with 29 now outstanding.
With the imminent introduction of the new market entry regulations we will be seeing an end to the “exempt” applications such as large shopping centres, health centres and 100 hours. We are waiting to be informed on whether the distance selling pharmacy exemption will continue.
As stated last year we are seeing a number of 100hour pharmacies based at Surgeries which present a threat to the existing pharmacies which provide the full pharmaceutical services for the area. This LPC has worked during the year to ensure pharmacy contractors have a fair hearing and that the robustness of the community pharmacy infrastructure is not jeopardised because of these exempt applications.
LPC MEETINGS 2011 / 12
General Meetings have been held on a two monthly basis, in the evening.
Possible Actual
Suzie Bayliss 6 3
Raj Chopra 1 1
Sunil Chopra 6 5
David Entwistle 6 6
Tarlochan Gill 6 6
Arun Jangra 6 5
Lodi Lama 6 5
Nuala McGibbon 1 1
David Onuoha 6 5
Amish Patel 6 5
Bipin Patel 6 6
Barrie Smith 6 5
Kit Tse 6 5
Mark Wilkinson 6 6
Ana Diaz 4 4
Tanya Mendes 1 1
Viral Parikh 5 4
Roger Nichols 3 2
Jonathan McCrindle 0 0
FINANCE
The Accounts of the LPC for the year ending 31st March 2012 are attached. They show that the LPC has managed spending within the budget set last year.
The LPC requests levy funding from the NHS BSA (prescription pricing division) twice yearly in April and October and we always aim to offer contractors good value for money.
The prepared accounts have been audited by Hughes and Co, chartered accountants and are attached at the end of the report.
COMPLAINT MANAGEMENT
This LPC has worked with the NPA, PCTs and The Royal Pharmaceutical Society, to ensure fair treatment of any pharmacy contractor who has become subject to any investigation into their professional service. The Performance Advisory Group meetings of the PCTs have become less frequent during the year and we continue to monitor the situation.
COMMUNICATING WITH YOU
During 2011 our website has become more comprehensive and the committee is considering a new approach to improve our service to you. You can access our website either directly by typing “kent lpc” into your search engine or via the PSNC website at www.psnc.org and going to individual LPC websites from their front page.
We mainly communicate with pharmacies in Kent by e mail and it is important that you let us know of any changes to your addresses so that we can keep in touch with you. Please send your up-to-date e mail address to the LPC office at:
Tarlochan Gill, Chairman Mike Keen, Secretary