LPC – 20 February 2013
ADOPTED MINUTES OF THE
SHEFFIELD LPC MEETING
held on
Wednesday 20 February 2013
9.30am – 5.00 pm
Meeting Room, WMS House, 61-67 Wicker, S3 8HT
ATTENDANCE
MEMBER
/ 24/11/11Day / 21/02/12
Day / 17/04/12
Day / 28/06/12
Day / 25/09/12
Day / 29/11/12
Day / 20/02/13
Day
Nominated/ Appointed Contractors
David Russell (Co-op) (Chair)
/ + / +(Chair) / + / + / + / + / +
Ravi Mohan (Vice Chair / AIMp) / + / A / + / + / + / + / +
James Wood (Secretary) / + / + / + / + / + / + / +
Brigid Murphy (Treasurer) / + / + / A / A / + / + / A
Crispin Bliss
/ A / + / + / + / A / + / ABrigitte Waring
/ A / + / + / + / A / + / ACompany Chemist Reps
Emilia Stelmach (Boots) / + / + / + / + / + / A / +Osama Ali (Boots) / N/A / N/A / N/A / N/A / + / + / +
Matt Webster (Co-op) Appointed June 2012 / N/A / N/A / N/A / A / + / + / +
Luke Downs (Lloyds) / A / + / + / A / A / + / A
Lynn Murrie (Lloyds) / + / + / + / + / + / + / +
Terry Relf (Lloyds) / + / + / A / + / + / + / +
Tim Brown (Lloyds)
Resigned January 2013 / A / + / A / + / + / A / RGreg Campbell (Lloyds)
Appointed January 2013 / N/A / N/A / N/A / N/A / N/A / N/A / ALaura Reed (Rowlands)
/ A / + / A / + / + / + / +Garry Myers (PSNC Rep)
/ + / + / + / + / A / + / ASusie Coates (LPC Support Manager) Appointed November 2012 / N/A / N/A / N/A / N/A / N/A / + / +
Observers
PCT – Chief Executive / N/A / N/A / N/A / N/A / N/A / N/A / N/A
Richard Oliver (NHSS)
/ A / A / A / + / + / + / +Kevin Clifford (NHSS)
/ N/A / A / A / A / N/A / A / +Peter Magirr (NHSS)
/ + / + / + / A / A / + / +Tony Cracknell (Lo’s)
/ + / + / + / + / A / A / A+ = PRESENT A = APOLOGIES FOR ABSENCE R = RESIGNED N/A = NOT APPLICABLE
Action1. / Apologies
Apologies for absence are as noted on the attendance sheet.
2. / Committee Corporate Governance
David drew members’ attentionto the Corporate Governance arrangements, together with declaration of interest,incorporating details about competition law asking members to sign if appropriate. Lynn confirmed she had completed the last CCA report and Sam agreed to report on this meeting. / ALL
3. / Re-Appointment of Officers
David as Chair, Ravi as Vice-Chair, James as Secretary and Brigid as Treasurer were all happy to be re-appointed as officers of the Sheffield LPC for the following year and members thanked them for their continued work on behalf of the LPC.
4. / Revised Constitution
The LPC had carefully considered the options for the proposed revised constitution in January 2013 and all members had agreed to call a special meeting of contractors giving the required notice. James outlined the process that had been undertaken to amend the LPC Constitution.The PSNC model had been used, in order to both acknowledge the abolition of the Sheffield PCT and that thestatutory recognition for the LPC would from 1 April 2013 be made by the NHS Commissioning Board (NHS CB). Contractors had been invited to a special meeting the same evening in order to vote or those unable to attend could submit a postal vote indicating their acceptance to the revised constitution administrative alterations. The results would be forwarded to PSNC for them to co-ordinate nationally with the NHS CB for LPC recognition in time for 1 April changes to the NHS.
5. / Minutes
Minutes of the meeting held on 29 November2012, wereagreed as a correct record; the Chair would sign them, once NHS Sheffield representatives had ratified the relevant part later in the afternoon. / DR
6. / Matters Arising:
Several of the matters arising were on the main Agenda and would be dealt with later. Other issues were up-dated as follows:-
a)Re-examination of Methadone Payment following Drug Tariff simplification – James advised that the outcome of the PSNC review of this service and negotiations with DH regarding payment was still awaited. A number of contractors had supplied data to the time and motion study.
b)Up-date Event on Specials – Ravi had provided copies of the form he had seen in pharmacyfrom Sheffield Children’s Hospital that advised pharmacies on the patient’s discharge, of the medication and supplier that they had used; these, were shared with members. There was concern about a line in the form that stated ‘please use the following supplier for continuity of care’; this had caused some confusion as it implied that it was mandatory to use the stated supplier when it is at the pharmacist’s discretion as to which supplier is used. Members agreed however, that the sharing of information across the interface was welcomed. James would follow up with David Upton and arrange for pharmacies to be notified of the form now in circulation, for information.
c)LPC Future Structure– It was noted that the voting of contractors to confirm the new Sheffield LPC constitution in line with a single LPC arrangement, confirmed the future structure after careful consideration by LPC members. Liaison with neighbouring LPCs remained strong via the Local Professional Network arrangements and separate joint LPC meetings on areas of common interest and on certain projectsto benefit from economies of scale.
d)Research– It was understood that pharmacies across the East Midlands, South Yorkshire and Bassetlaw would be canvassed about capability and enthusiasm to take part in a research initiative but it appeared that some of the branches of multiples had not seen details, which might have been forwarded to head offices.
e)Steve Todd, Sheffield City Council – It was agreed it would be a useful time to follow up on future proposals now staff had begun to imbed within Public Health at SCC etc. Good links had been made with Louise Brewins, who was to attend with James and Peter Magirr, an event the following week in York, regarding the future role of pharmacy in public health. Susie and James had already attended an event at the Town Hall, which had proved very useful as a networking opportunity regarding future public health engagement.
f)LPC Levy – The NHSBSA had been unable to process the levy holiday for January and it was now hoped that this would be reflected in the March payment to contractors.
g)LPC Debit Card – this had now been secured with an initial opening balance of £1,000. Members were advised to arrange any course event or travel arrangements via Susie. / JW/SC
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23. / Working Group:
Training Programme for 2013/14 – Members discussed what training events might be useful to contractors and it was agreed that support over service provision / business related matters rather than clinical training, might be of most benefit. It was agreed that a programme of four events should be drawn up, which would then allow time if currently unidentified issues required an update event during the year. The following topics were agreed: Stop Smoking (late April – carried forward from last year) / A Falls Service in Pharmacy (June) incorporating any outcome to the COSI Inquiry) / Engagement Event on the lines of ‘Think Pharmacy’ to update contractors on new commissioning arrangements (end September) / PharmOutcomes & EPS Update (November). Dates to be confirmed.
Members discussed the content each event might include and acknowledged that the ‘Think Pharmacy’ Event was likely to be joint event covering the South Yorkshire and Bassetlaw area, which would be an ideal opportunity to invite commissioners and showcase what community pharmacy can offer as part of wider engagement across the patch. Nick Hunter (LPC Secretary for Doncaster, Nottingham & Rotherham) had produced some slides giving a suggested outline that James presented to members, with potential costing based on a successful event that had been held in Manchester. James was asked to check the price of a Management Company putting on such an event as a comparator to ensure value for money. Members would also like to see a résumé of the suggested organiser.
LARC – members discussed the CCG’s interest in Long Acting Reversible Contraception (LARC) and whether community pharmacy might be interested in offering this service. It was understood that this had been commissioned in Newcastle and that it would be useful to see some details and then survey contractors for interest. It was acknowledged that infection control issues often create investment costs that dissuade interest without revenue being guaranteed. It was also noted that the APG was considering amending the PGD to include EllaOne under EHC. James had recently met with Amy Buddery, Public Health Lead with the Local Authority responsible for sexual health services to discuss development of pharmacy services.
IV Antibiotics – James explained that Michelle Black,Head of Medicines Management, Primary and Community Servicesat STH had previously asked if community pharmacies would be willing to offer IV Antibiotics and this had been raised again following Michelle’s return from maternity leave. He had discussed with Michelle the possibility of securing a list of specific products prescribed by community matrons, with a stock allocation made. The ‘on-demand’ availability of these specialist medicines would have to be commissioned. There were also training implications. Members were interested in developing a service and James would advise further.
Steroids– Members considered that a service to support steroid users in community pharmacy needle exchanges would be worthwhile, given that the number of steroid users choosing to use pharmacy needle exchange in the City is significant. Members agreed this would be a worthwhile service to develop. Laura highlighted that there was a similar project in Warrington under Health Checks, with a Drug Company providing machines to support the service. James and Susie would scope further information for the next meeting.
PSNC Clinical Governance Survey – Members completed an on-line survey on clinical governance issues of the contractual framework as requested via PharmOutcomes as part of the development of the Site.
PCLS and LPC Update– James ran through the pertinent notifications, which had already been circulated to members. PSNC are holding a Market Entry Regulations Master Class that follows on from previous events attended by Dave, Brigid, Lynn and Susie to support LPCs in looking at market entry applications. Ravi expressed an interest in attending and asked for the details to be forwarded to him.
This year’s Community Pharmacy Conference is to be held in London on 24 April entitled ‘Commissioning Community Pharmacy’. Members were asked to advise if they were interested in attending so delegates could be decided. David and Lynn were interested. It was agreed that it might be useful to invite colleagues from the CCG / Public Health. Ravi asked for details.
Brigid, Terry and Susie are due to attend the Financial Management LPC Support Seminar in Leeds on 16 April and would report back to the next meeting.
Members were reminded about the self-editable links to NHS Choices which contractors had been warned to ensure were up to date as this information would be used by the new NHS111 Service.
James reported on the good national data that had been released on the New Medicines Service, which was being used to negotiate the continuation of the service. The enhanced role of pharmacy in supporting patients with long-term conditions was emphasised and James was asked to localise information for distribution to relevant commissioners; bodies linked to the Sheffield area and send to local media.
Market Entry – James demonstrated the spreadsheet/ database that had been produced by NHS South Yorkshire and Bassetlaw to keep track of community pharmacy applications. This showed those that had now expired and those still in the pipeline. James and Susie were to prepare a list to be kept up to date on the LPC website for the ready reference of contractors, despite interested parties being notified direct. Additional entries would be highlighted via usual email distribution lists.
Strategy / Priorities
Monitoring Pharmacy Opening Hours - James outlined a draft document which had been circulated by NHS South Yorkshire and Bassetlaw setting out the proposed procedure intended to be adopted across the patch to monitor 100 hour pharmacies in particular but also to ensure arrangements are in place to monitor forced pharmacy closures. It was agreed as important to ensure contractors know whom to contact to report unavoidable closures. James would check the sanctions and cross reference with the regulations. Members asked that there be arrangements to be able to ring to advise on closure before details are confirmed by fax as using a fax might not always be possible due to the circumstances involved in the forced closure.
Respiratory Scheme – James showed the figures to date and highlighted that Sheffield figures were particularly low but it was accepted that Sheffield had already made considerable contributions to undertaking respiratory MURs following training and In-Check dials issued in previous years, which made it harder to compete with those undertaking this as a new concept. James offered to remind contractors about the service and ask that they seek to identify patients who would benefit from this service during February and March so as to seek to reflect in the final figures.
Medicine Supply Chain Delays–Ravi reported that this had been discussed at the Area Prescribing Group (APG) where Richard Oliver had asked if there might be a more formal mechanism for reporting difficulties. This would be discussed further when meeting with NHS Sheffield colleagues later in the day. James had already emailed Peter Magirr and Gary Barnfield about supply chain problems. It would also be useful to report back to contractors on action taken.
Pharmacy Voice – Reforming the NHS and Social Care in England – What it means to Pharmacy – this document had been circulated to members by James in December and provided a very useful breakdown of the changes and how this affects community pharmacy. Members discussed how best to communicate to contractors,commissioners and individual GPs about the support and benefits communitypharmacy could offer and it was agreed a regular short bulletin would help get messages across.
Area Prescribing Group (APG) – Ravi reported on the meeting he had attendedrecently and of a potential switch to AYMES® Shakeas acheaper alternative to Complan products, which indicated a potential saving of £65K across Sheffield. This was checked on-line during the LPC meeting and found to be out of stock via AAH. Ravi also referred to other savings being sought including a community service to dispense brands of Coenzyme Q10 via a voucher. It was pointed out that 20% VAT would be added if not prescribed via an FP10. Pregabalin use had been highlighted and intentions raised that referrals be made to the DACT where concerns over misuse. Members agreed it was more appropriate to refer to the prescriber and asked that this be raised. The Group also considered the future arrangements of the APG and would be consulting over the next six months about the best way forward. The Formulary Sub-Group had not been mentioned.
MEETING WITH NHS SHEFFIELD
Richard Oliver, Kevin Clifford and Peter Magirr attended. There were around the table introductions for Kevin as this was his first meeting.
Minutes of the Meeting held on 29 November 2012
The minutes (pages 5-8) were approved as an accurate record and therefore signed by David. Many of the matters arising were already Agenda items.
Matters Arising:
Enhanced Services – Contracts to 31 March 2014 had been issued and a copy should be signed and returned as soon as possible.
DACT (DAAT) – Peter confirmed that the Winter Planning Document had gone out to all pharmacies.
Minor Ailments Scheme – Peter provided some clarification about costs at the Walk in Centre; a set fee is paid per patient (£31.54). In A&E it depends on the category of attendance but mostly the lowest cost of £54 is applied. A major benefit of the Minor Ailments Scheme is the cost avoidance in patients attending hospital. This was not fully explored in the patient questionnaire survey, as respondents were not asked ‘what would you have done if you were unable to get an appointment with a GP within a day or two?’the implications of what they would do / the cost generated from that, would give a better understanding of the benefit and cost effectiveness of patients being treated in community pharmacy under the scheme.
The detailed data now collected through the revised scheme has proved very useful and enables a much more robust case to be made for continuation. James suggested it would be useful to work with Steve and Jo to write up the results and perhaps undertake another patient survey in April, incorporating a change in the question that would more clearly demonstrate the cost implications. Peter highlighted that there are a lot of varieties of Minor Ailments Schemes around the Country, some very complicated, but that the Sheffield Scheme had proved very successful.
Flu Vaccinations – Peter reported that there had been 570 vaccinations under the NHS in community pharmacy from October to January the bulk being undertaken in October (214) and November (217). An evaluation was being prepared which will offer a clearer breakdown of the categories but already it was evident that compared to the previous (first year of service) numbers had quadrupled.
There had been some disappointment over vaccination rates generally across the City, thought in part to be due to the lack of national concern about flu. There had also been a problem over vaccine supplies in the initial stages of the programme; causing the overall targets met to be lower than the previous year, so the contribution of community pharmacy was much appreciated.