Minutes of the SLPC meeting 18:00 hrs – 21:00 hrs Wednesday 19th July in the boardroom (DaleBuilding room 1.01), first floor, Sciences Complex, University of Sunderland, Chester Road, SR1 3SD
In Attendance:
Umesh Patel / UP / ChairGillian Cucchi / GC / Vice-Chair
Mark Stephenson / MS / Chief Officer
Tim Dobbin / TD / Treasurer
Karen Ayton / KA
BarrieTudberry / BT
Andrea Dickinson / AD
Reminder Sihota / RS
Gemma Donnovan / GD
Ann Gunning / AG
Mark Burdon / MB
Apologies for absence received from:
Cliff Gaines / CG
Kathryn Brown / KB
Nigel Herdman / NH
MukkarromHussain / MH
Sailesh Patel / SP
Presentations by:
Andrew Riley: 18:30 hrs. / Merck Sharp & Dohme (MSD)
Tim Donaldson : 19:00 hrs / Trust Chief Pharmacist/Controlled Drugs Accountable Officer
Northumberland Tyne and Wear NHS Foundation Trust
Item / Topic / Discussion / Action / Status
1. / Community Pharmacy -contraception
Presentation by Andrew Riley, MSD / MSD are currently working with Rowlands Pharmacies to upskill staff in various disciplines to improve quality of patient care including Sexual Health by improving choices in contraception through training. This enables patients to make a more informed decision when choosing contraception appropriate to their lifestyle and to reduce unintended pregnancies. MSD can bring added value to patients through collaborative working which utilises MSD's skills, experience and resources.
a. By up-skilling staff within the Pharmacy (523 pharmacies already trained)
b. Use the existing HLP to promote the contraception options available to patients
c. Six promotions per year which includes all promotion data.
d. Possible IT system alerts to enable staff to promote options
There is a possibility of expanding options and sales in regards to contraception however for some items such as coils pharmacies would need indemnities.
MSD would provide training/KPI’S etc. / Andrew Riley to provide the presentation slides to MS.
MS
to disseminate to all parties
2. / Declaration of Interest and Confidentiality / MS confirmed that all DOI & confidentiality documents had been received from all committee members. / n/a / n/a
3. / Review of minutes 17th May 2017 / The minutes were reviewed and accepted as an accurate record of the meeting held / n/a / n/a
4. / Matters Arising not on the agenda / Gillian advised the members present that she has now sold her business and her last day will be 29th September 2017. Umesh confirmed he would like to arrange a farewell/thank you event for Gillian at a date/venue to be agreed. Umesh also stated that he would like Gillian to remain on the committee – but recognised that this would be guided by the Constitution. / UP
to review date/venue for GC dinner
5. / LPC Officer reports
Chair’s report / Umesh discussed the challenging trading conditions for contractors The expected funding cut was 4% but felt like 20%. This resulted in huge cash flow problems for pharmacy contractors all over England. The steep rise of this unexpected cut was due to monies allocated to the Pharmacy Access Scheme from the Global Sum. Umesh stated that conditions would be very challenging in the next few years.
PSNC has started the process of appointing the new CEO to take over from Sue Sharpe who is stepping down at the end of the year but will continue if necessary until such time as the new CEO is appointed.The appointment panel is chaired by Sir Micahel Pitt who is the chairman of PSNC for further three years.
Umesh also discussed the aggressive and perceived misrepresentation of the NHS by some online pharmacies. It was felt that there was confusion over the NHS logo as a lot of patients think that this promotion has come from NHS England. / n/a / n/a
5.1 / Secretary’s report / Mark provided the committee with an update of his work since the last LPC meeting. A comprehensive list of work undertaken was provided as an enclosure. This included:
Updating the Constitution in preparation for a vote
Working with Live Life Well on the Healthy Living Pharmacy programme
Work on a number of LPC Working Groups (verbal reports have been included as agenda items)
A review of meetings to explore potential developments:
MSD – sexual health; CRUK – cancer awareness training;
NAPP, asthma work.
A review of correspondence received from contractors / n/a / n/a
5.2 / Treasurer’s report / Tim advised the committee that he had concerns over the budget as expenditure compared to income was significant. Tim believes that this is partially a result of day time meetings as these were more expensive. The PSNC request for financial support for the Judicial Review had also impacted, as had the settlement of invoices for the previous Secretary. Raminder expressed concerns as she felt the budget should be run like a business monies in monies out. Umesh asked Tim to produce a written snapshot of the up to date status of the finances. This will inform whether the next two meeting are to be day – or evening meetings. / TD
to produce a written snapshot of the up to date status of the finances.
6. / Ann Gunning (Transfer of Care and Quality Payments support) / Ann stated that QP data would be available from August 2017, PharmOutcomes hold the data and she can identify who has read the message. There are 16 pharmacies outstanding and Ann will contact these. / n/a / n/a
7. / 7pm. GUEST: Tim Donaldson. Discussion ‘around delivering seamless, high quality pharmaceutical care for people receiving services from ccc, a mental health and disability specialist services provider’ / Tim Donaldson highlighted issues/concerns around mental health patient safety issues resulting from poor communication between hospitals, GPs and community pharmacies this sometimes resulted in readmissions. Life expectancy for these patients on average is 20 years less than others. Tim felt that pharmacies have a big role to play as smoking tends to manifest itself and smoking cessation could help in some cases. All parties stated that communication between GPs and pharmacies could be improved. Tim felt that proactive action could help to address some of the issues seen around medication etc. Umesh felt the best way to address this was to have a ‘joint action discussion’ group (JAD) to identify possible solutions. The group would include the right representative from City Hospital Sunderland and the relevant representative from GPs and community support networks. Tim also advised that the structure of his role was changing therefore he would like to meet with representatives in the short term. / AG/MS
to review who should participate in the JAD and to arrange date and time with Tim.
8. / PSNC update – Mark Burdon (PSNC / PSNC report
1. Jeremy Hunt has retained the Health portfolio. The new Minister is Steve Brine. Sue Sharpe has written to welcome him and to make an offer to work collaboratively.
2-Negotiations - It is not expected that progress will be made before Autumn.
3-Previous negotiations. PSNC has always maintained a good, collaborative relationship with the government, which was undermined last year by their adversarial approach.
4- Impact of the cuts. Contractors are feeling the pain of the imposed funding package. These deep cuts are being managed by the sector in the short-term, but the full extent of the impact will not be seen for some time. The planned closures and mergers will only become apparent once the new PNAs are in place. PSNC still monitoring and assessing contractor funding.
5- Margin. As in previous years, we have over-earned on margin, above the level of allowed retained margin. This has been caused chiefly by Pregabalin and Seretide. After lengthy negotiations, an agreement has been reached. A "payment plan" of £15m per month has been set, over a 12 month period. Further details are available on the PSNC website.
6- Future strategy. Following the Judicial Review proceedings, PSNC has begun the process of rebuilding relationships and taking a strategic view. PSNC CEO will be leaving at the turn of the year and the recruitment process has begun. The committee has embarked on a major piece of work to investigate new funding models, building on the extensive experience amongst the committee and the executive as well as considering international case studies.
7-Judicial Review - Whilst we lost the case, the judge granted leave for appeal. The decision whether to pursue this depends on how the government wishes to engage with us. There are early signs that a consensual agreement can be reached, which have to be our priority. Nonetheless, the option to appeal remains open. We expect the cost of appeal to be considerably lower than the JR and a further call for LPC funding support will not be necessary.
8 Category M claw back– An update of Category M claw back was discussed. / MS
to review PSNC webb site and review the recent letter regarding the payment plan.
9. / Update from Gemma Donovan (CCG) / Gemma advised there is a possibility of drug shortages. Pharmacies are not offering alternatives where possible. Communication of shortages needs to be reviewed to ensure all interested parties are made aware. It was proposed that CCG could be advised and they should make a decision. MS/GD advised there is to be a rollout of a new care model. As yet there are no dates of the roll out of MCP (Multi Care Speciality Provider). Gemma and Mark are working together to ensure that community pharmacy has a voice during the development of the local model. / UP
Umesh to review the best way to cascade drug shortage message.
10. / Potential Developments: Cancer Research UK and NAPP / CRUK –CRUK can provide some training on issues liked to cancer as this would help with the ‘Be Clear on Cancer’ promotions.
NAPP – Asthma better use of inhalers could be included within MURS. MS met with Ivan Hollingsworth who is involved with therapy projects such as asthma and diabetes and is keen to improve patient care. / MS
will meet with CRUK to work on a training session.
MS will invite Ivan Hollingsworth (NAPP) to the next LPC meeting
11. / Update from the Strategy Work Group / All parties are to review and give feedback on the Strategy and the Work Plan to MS.
MS to update the plan with the CPRS and other recent developments, where appropriate. / ALL
12. / Update from the EPS working Group / Mark updated the committee on the work of the EPS Working Group. The report has now been disseminated widely across Sunderland. On behalf of the group Mark has submitted a TITO application for the December group. Other work, such as the development of training options have also been progressed.
During the EPS feedback there was a discussion on the way in which online national pharmacies are promoting deliveries of prescriptions to patients are advertising on radio, TV and on-line. Some of these promotions give the impression that the services are the NHS. GD thought that GPs could advise patients if they were asked about these agencies. All parties were asked to consider other ways of advising patients that these were not part of the NHS. / ALL
13. / Update from the Care Home Wastage Group / Karen gave a brief overview of her investigation into care home wastage group. Both MS and KA were satisfied that the issues did not lie with community pharmacies as the pharmacies involved were not ordering items. A discussion then ensued about the way to address the issues systemically included ways that hospitals could communicate directly with care homes when patients are released from hospital. It was also stated that PharmOutcomes could be used, however there is a cost associated with the licence. KA/MS advised the committee that the work of the group has now been completed and will now be stood down. / n/a / n/a
14. / Update from the MOGG meeting / Tim advised that Wholesalers/Manufacturers limit the volumes of drugs to pharmacies based on their usage. GPs put pressure on Manufacturers for certain drugs. Some pharmacies have given flu vaccine to patients in the same season. All agreed there was no adverse impact on the patient. No major issues were identified overall.
Tim mentioned that some packs of insulin contained 14 doses however were dispensed as one item rather than 14. / TD/MS
TD to email MS with the insulin details and MS to share with the relevant parties to make them aware.
15. / Any Other Business: NSPCC Charity Giving. Independents / Umesh is to be signatory on the LPC accounts.
Umesh advised that he had NSPCC involvement in Sunderland. A draft letter was circulated to the committee to encourage Independent community pharmacies in Sunderland to have an NSPCC collection tin in their pharmacy. The letter, from the NSPPC, will be sent to independent pharmacies in Sunderland / MS
to speak to Jackie Dawson from NSPCC to progress
15.1 / CPRS / At the last meeting (17th May) Andre Young mentioned the Community Pharmacy Referral Scheme. PIOG will be meeting in London where it was hoped that the service will be approved. There is circa £540k available / MS
To update all parties on the outcome of the meeting.
15.2 / Integration Fund / An event is to be held in September to promote ideas. This is a five year project anticipated cost year one is £42 million. / MS
to monitor.
15.3 / AGM / The date for the next AGM is 9th November. TD/MS to email the annual report prior to the meeting. / TD/MS
To email the annual report prior to the meeting.
16. / Next meeting date / The proposed date of the next meeting is Thursday 7th September. MS to confirm if this meeting is to be a day or evening meeting. / MS
To confirm if this meeting is to be a day or evening meeting.