UNCONFIRMEDDRAFT
Medicines Information Operational sub-Group (MIOG)
of the All Wales Chief Pharmacists Committee
Minutes of meeting held on 19th October 2016
at the MRC Wales Ltd
from 10.00 am – 4.00 pm
Present: / Alana Adams (AA) / Cardiff and ValeDianne Burnett (DiB) / Hywel Dda
Hannah Evans (HE) / Cardiff and Vale
Sarah Evans (SE) / Betsi Cadwaladr
Hannah John (HJ) / Betsi Cadwaladr
Gwenllian Jones (GJ) / Betsi Cadwaladr
Mair Martin (MM) / Betsi Cadwaladr
Jayne Price (JP) / Powys
Nia Sainsbury (NS) / Abertawe Bro Morgannwg
Suzanne Scott-Thomas (SS-T) / Cwm Taf - Attended the morning only.
Rhian Smith (RS) / Cwm Taf
Emyr Stephens (ES) / Cardiff and Vale
Fiona Woods (FW) / Cardiff and Vale (Chair)
16/29 / Apologies
Apologies were received from Scott Pegler (SP), Lorraine Pietrzak-Jones (LP-J) and Trevor Batt (TB).
Action: / None
16/30 / Minutes of last MIOG meeting held on 29th June 2016
The minutes of the meeting held on 29th June 2016 were accepted as an accurate record.
Action: / None
16/31 / Feedback from AWCPC
a) Minutes of meeting held on 29th July 2016
Minutes of meeting held on 29th July 2016 were noted.
FW highlighted the presentation by Rachel Williams and Emma Williams (EW) regarding the Choose Pharmacy roll out. It will roll out initially to Betsi Cadwaladr and Cwm Taf which were the original pilot sites.
MaPPs produces patient information leaflets in plain English.The presentation is very patient friendly and combines information on several medicines into one leaflet to avoid multiple leaflets being handed out. SS-T gave an update from the Chief Pharmacists meeting, it’s been agreed that it will be funded across Wales and all healthcare practitioners will have access to it.
Define and Refine software – RS has used Define within Cwm Taf, to benchmark with England. It would be more valuable if more hospitals used it. Refine comparesdata from different wards/directorates within health boards.
Action: / None
b) Verbal update of meeting held on 30th September 2016
Minutes of meeting held on 30th September 2016 are yet to be confirmed.
FW highlighted key messages – Chief Pharmacists are intending to collaborate on Pharmacy content of Health Board IMTPs for 2017/18– FW and AA have been involved in the process in Cardiff and Vale. SS-T stated that it is a 3 year plan and that now is the time to think of any developments that are needed in MI.
AWCPC is working with WAPSU to develop an application to Efficiency through Technology Fund for money to consider implementation of Define in all Health Boards.
Review of IPFR in Wales is to consider exceptionality, engagement of clinician and patient and feasibility of one panel for Wales. Conclusions expected in December.
Action: / None
c)MIOG annual report
FW had presented the MIOG Annual Report and Work Programme at the July AWCPC meeting and it had been well-received. Key issues noted were roll-out of MiDatabank including Betsi Cadwaladr’s involvement in enquiry sharing, optimal use of Medicines Learning Portal (MLP), Micromedex and the impact of Modernising Pharmacy Careers on training in MI, SPS in England, MI involvement in drug libraries for SMART pumps and information sources for on call pharmacists.
It was agreed that MIOG meetings will now take place as three face to face meetings and one teleconference meeting a year.
Action: / None
d)Quality assurance of service provided outside of MI centres
FW had presented the final paper to AWCPC meeting in July. The committee was particularly interested in ensuring the quality of information provided by on call pharmacists. NS offered to investigate this further and report back to a later meeting.
Action / NS to report back to a future meeting on enquiry answering by on call pharmacists
e)Resource mapping
SS-T gavea demonstration of data from the resource mapping exercise and how they could be used. The data are available to Chief Pharmacists and the Health Board leads. The exercise provided a snapshot in time (November 2015) where all staff completed a data collection form. The system needs a better checking procedure at health board level. Denominators have not been included as yet but are required in the future. AA mentioned that there is a rough cut capacity project ongoing in C&V and she would like to see how the two sources of data could be combined. SS-T will provide everyone with the presentation for use within their teams.
There was discussion about the fact that the Medicines Information heading currently includes work undertaken by specialist MI pharmacists and also other pharmacists. It may be helpful to split this heading. Patient helpline will need to be included under MI heading. SS-T will need any suggested changes to the headings by the end of October 2016.
Action / FW to distribute presentation to group.
16/32 / Skills/training and Information Resources
a) Micromedex
i) Community pharmacy access - FW noted that community pharmacists had historically not beenable to access Micromedex, this has now been solved. Community pharmacists are now allowed access to Athens and so to Micromedex. Need to make community pharmacists aware of this.FW to inform Chief Pharmacists, CPW and NPA.
ii) Training – All training has been completed – Training sessions to be rescheduled in C&V and Cwm Taf using the opportunity to include community pharmacists. MM mentioned that trainer can influence what is included in Micromedex and is in support of taking out the SPCs as they are not used.
Action: / FW to inform Chief Pharmacists, CPW and NPA that community pharmacists can have Athens account to access Micromedex.
AA, RS, HE, ES – Liaise about having trainer back for further training dates
FW to inform trainer that MI pharmacists in Wales agree that there is no value to SPCs being included in Micromedex
b) MiDatabank
i) Confidential data - NS highlighted what Jen Smith (West Midlands Regional MI Centre) had raised in her session at the UKMi PDS - her concern is using data from one enquiry to answer another for a subsequent patient.The first point is where you store patient identifiable data (PID)in the first place in the original enquiry - there should be no PID in the question box or answer box. Secondly when it comes to using that enquiry again no PID should be copied to the second enquiry
FW demonstrated the MiDatabank sharer – there is an additional £150 a year charge for the sharer and centres can only have access if enquiries are contributed. Information governance processes will need to be followed locally. – FW to confirm
Action: / FW to confirm Information Governance issues for local centres wishing to use MiDatabank sharer.
c) Pre-reg training
The collated feedback provided by WCPPE from the recent training sessions was noted. MM gave feedback from training in Betsi Cadwaladr – overall the content was considered appropriate but some of the facilities were poor. FW to confirm that all aware of the dates for the next set of training sessions.
Action: / FW to confirm that all aware of the dates for the next set of training sessions.
d) Diploma training
NS shared her and SP concerns about the fee offered for the session. Feedback from the session was that it was necessary to have 2 people to present. It was suggested to consider making it a smaller class that is run twice.
Action: / FW to take up concerns re feeswith Karen Hodson
e) Peer review feedback
NS suggested that it is easier to peer review direct from MiDatabank and finds it very valuable to do.
MM has face to face meetings with the MI team in Betsi Cadwaladr every 4 months with good response. DiB isn’t currently doing peer review but could do so with Bethan Bowen in the future. JP is looking at doing this internally. AA noted that peer review wasn’t currently being undertaken but will resume once new staff are in post.
Action: / None
f)Copyright – references
MM received an email from Trent Regional MI centre with copyright disclaimer. Implication is that only one copy of a reference should be kept at one time. ie you can send it on to the enquirer but must then delete it from your computer. UKMi copyright guidance suggests that digital copies may be stored for 30 days on an intranet or beyond that date they can only be stored on product/project related or function specific database. It is unclear whether MiDatabank would be classed as this?
Action: / FW to gather further information about this from eg librarians, Jen Smith (West Midlands)
g) Peri-operative medicines guide
Produced by UKCPA - developed as a handbook – FW has had a conversation with them and they are planning on doing a second print run. They have a small number of paper copies which are going to contributing authors. FW has said that UKMi would like to run the resource through the assessment tool. The result of this assessment may be to recommend that all MI centres have access to it. They are also trying to work out how it can be made available electronically. FW can provide a copy if needed. FW suggested that it isn’t shared outside of the group at this stage.
Action: / FW to liaise with UKCPA once resource put through UKMi Clinical Governance Working Group resource assessment tool
g)Medicines learning portal
Presentation to be sent to those who haven’t seen it.
Action: / FW to circulate presentation to members as requested
h)On call resources
FW highlighted the on call module in the Medicines Learning Portal.
NS – Suggested that we look at the resources to start with and what we need in Wales. Are on call pharmacists in Wales aware of those resources and how to access/use them. As on call lead for her Health Board NS is going to look at calls for appropriateness.
MM –Noted that they are using AppVieto access MiDatabank – this links access to the individual’s profile rather than to the computer and so makes it easier for on call pharmacists to use MiDatabank at home.
Action: / NS to present on call data at next meeting. All to send data to NS
16/33 / Patient Safety
a) YCC Wales
- Emma Carey is leaving MI (January) to work in primary care.
- YCC won 1st place in the practice research category of the poster presentations at the UKMi PDS.
- Hoping for the YCC website to be launched by the end of next month. New merchandise has been purchased with the new logo. Twitter account is now up and running.
- New interactive drug analysis profiles. Data can now be analysed by age, sex, year etc.
- Presentation has been revamped and will be distributed to the champions.
- Annual report submitted to MHRA
Action: / None
b) Injectable medicines guide
MM will come back to FW with who will be BetsiCadwaladr'sfollowing Cath Riley’s retirement.Dianne is attending the meeting in London and has asked if anyone else was going. JP asked ifit is still possible topay for monographs to be updated - JP will speak with GW.
Action: / MM to let FW know who will be lead for Betsi Cadwaladr.
All to reply if interested in attending Injectable Medicines Guide meeting
16/34 / Research
a) All Wales R&D project
CH has suggested that there is more work to be done in some areas but will need someone to take it on.
Action: / No longer needed on the agenda
b) Fridge stability/cost savings
SE started looking at how to improve costs by costing all the fridge queries.SE thinks she has 100 queries. All details have been put into a spreadsheet.
GJ suggested that it is worth looking at the clinical risk as well as the financial impact. Group discussion around whether this could be a pre-reg project.
Action: / SE to share template with FW to distribute to the group.
c) Adverse effects/ hospital admissions
AA spoke about published work on number of patients admitted to hospitals with an ADR (Pirmohammed et al). This is frequently cited. AA would like to repeat his work. DiB to do a pilot in Withybush along with C&V of data collection.
Action: / DiB/AA to pilot data collection for ADRs as cause of hospital admission
d) All Wales pre-reg project
Discussion of ideas but nothing to move forward with yet.
Action / All to think of ideas that could be used for the All-Wales pre-reg project.
e) PIPA survey of UKMi
Results of survey are available - waiting to see if theycan be shared. Will do so at next meeting if permission received.
Action: / FW to give presentation on PIPA survey of UKMi if permission received.
16/35 / Medication selection decisions
a) AWTTC update
The latest update from AWTTC was noted. FW highlighted that on the prescribing guidance on dry eye will go to the December AWMSG meeting and the Vitamins for babies, children and pregnant women document is going to the November meeting. FW is trying to put Ben Rehman and the authors of the All Wales prescribing guidelines for asthma and COPD in touch to look at getting the All Wales guidance onto the Right Breath website.
Action: / None
b) Common ailments service
Emma Williams(EW) is working with MWIS on the roll out of Choose Pharmacy - she has contacted FW – she is keen to have the patient information leaflets for the formulary system. EW has suggested that leaflets produced by an organisation called Self Care Forum which are also translated into Welsh are considered. Not sure that it’s appropriate for the leaflets for Choose Pharmacy to be written/adapted in MI – MI role could be a quality assurance one. Community pharmacists may be better placed to write/adapt the leaflets. FW to contact EW
MaPPs–MM has concerns about this resource. Welsh translation is only available for 25 medicines with an additional cost for more. Discussion about the concerns around the wording. MM isgoing to discuss further with patient safety team locally.
Action: / FW to talk to EW about leaflets for Choose Pharmacy scheme
16/36 / Wales SPS
FW noted that although SPS is an England structure and development there may be some scope and benefit to replicate that in Wales. FW has met with Mark Francis and Mark Oldcorne to see if there is scope for collaboration. There are a signification number of issues that could be addressed together eg unlicensed medicines, drug shortages, hazardous medicines waste, drug contracting process and storage of medicines outside recommended conditions
Action: / None
16/37 / UKMi Executive
a)Feedback from September Exec meeting –
- SPS website - hopefully speed is better now. Over the next couple of months all the clinical therapeutic content will go from UKMi and NICE Evidence to SPS. UKMi website will be gone completely however the branding will remain for now.
- Training course will next be run in May 2017.
- MLP – Simon Wills mentioned at the Exec meeting that one of the new modules he wanted to do is reviewing an antibiotic prescription and is keen for any volunteers to help work with them on that.
FWto send photo of group that attended PDS to all – agreed it can be tweeted.
AA–Would like a copy of Justine’s presentation about how MI helps patient facing services. Found it to be very useful.
c)IRMIS report –Included 10 enquiry incidents and 1 publication incident. AA shared that at WMIC they get one of the diploma pharmacists to read the IRMIS report and feedback to staff members so that they get an understanding of the governance around MI, this has been found to be really useful.
d)Feedback from Clinical Governance Working Group –Highlights document hasn’t been finalised, FW will circulate once agreed.
Action: / FW to forward CGWG Highlights document to group once agreed.
16/38 / Any other business/communication
Discussion around adapting the WMIC Logo for other centres ‘Welsh Medicines Information Service’ and translated into Welsh.
Christmas leave – RPS would like to know when MI centres are open.
There is a need for collaboration between MIOG and the Patient Safety and Quality Group (PSQG). Previously a representative of the PSQG was a member of MIOG – it had been difficult recently to achieve this so FW had suggested to Roger Williams that a member of MIOG should attend PSQG meetings. Anyone who would be interested to inform FW
Action: / HE to ask media resources for the adapted logo and to then distribute to the group
All to provide their opening hours over Christmas to HE if haven’t done so yet.
Group to inform FW if they would like to represent MIOG on the PSQG
16/39 / Agenda items for next meeting
Action: / On call enquiries – NS
PIPA survey of UKMi centres - FW
16/40 / Identification of issues for communication beyond the group
None
Action: / None.
16/41 / Date of next meeting
8th December – teleconference (morning)
HE will seek suggested dates for next year’s meetings. Suitable venues could be Morriston, Llandrindod Wells (possibly Council offices), WCPPE, RPS and CRI meeting room.
Action: / HE to arrange meetings for 2017
Medicines Information Operational sub-Group (MIOG)
of the All Wales Chief Pharmacists Committee
Action Points
Agenda Item / Subject / Action required / Initials16/31 / Feedback from AWCPC
Quality assurance of service provided outside of MI centres / NS to report back to a future meeting on enquiry answering by on call pharmacists / NS
Resource mapping / FW to distribute presentation to group. / FW
16/32 / Skills/training and Information Resources
Micromedex / FW to inform Chief Pharmacists, CPW and NPA that community pharmacists can have Athens account to access Micromedex.
AA, RS, HE, ES – Liaise about having trainer back for further training dates.
FW to inform trainer that MI pharmacists in Wales agree that there is no value to SPCs being included in Micromedex / FW
AA, RS, HE, ES
FW
MiDatabank / FW to confirm Information Governance issues for local centres wishing to use MiDatabank sharer. / FW
Pre-reg training / FW to confirm that all aware of the dates for the next set of training sessions. / FW
Diploma training / FW to take up concerns re fees with Karen Hodson / FW
Copyright – references / FW to gather further information about this from eg librarians, Jen Smith (West Midlands) / FW
Per-operative medicines guide / FW to liaise with UKCPA once resource put through UKMi Clinical Governance Working Group resource assessment tool / FW
Medicines learning portal / FW to circulate presentation to members as requested / FW
On call resources / NS to present on call data at next meeting. All to send data to NS / NS
All
16/33 / Patient Safety
Injectable medicines guide / MM to let FW know who will be lead for Betsi Cadwaladr
All to reply if interested in attending Injectable Medicines Guide meeting / MM
All
16/ / Research
Fridge stability/cost savings / SE to share template with FW to distribute to the group. / SE
Adverse effects/ hospital admissions / DiB/AA to pilot data collection for ADRs as cause of hospital admission / DiB, AA
All Wales pre-reg project / All to think of ideas that could be used for the All-Wales pre-reg project. / All
PIPA survey of UKMi / FW to give presentation on PIPA survey of UKMi if permission received. / FW
16/35 / Medication selection decisions
Common ailments service / FW to talk to EW about leaflets for Choose Pharmacy scheme
Group to inform FW if they would like to represent MIOG on the PSQG / FW
FW
16/37 / UKMi Executive
Feedback from Clinical Governance Working Group / FW to forward CGWG Highlights document to group once agreed. / FW
16/38 / Any other business/communication / HE to ask media for the adapted logo and to then distribute to the group
All to provide their opening hours over Christmas to HE if haven’t done so yet.
Group to inform FW if they would like to represent MIOG on the PSQG / HE
All
All
16/39 / Agenda items for next meeting / On call enquiries – NS
PIPA survey of UKMi centres / NS
16/41 / Date of next meeting / HE to arrange meetings for 2017 / HE
W:\DOCS\Fiona\MIOG-Medicines Information Operational Group\MIOG meetings - from 2011\2016\Minutes\Minutes October 2016 Final draft.docx