Minutes of LPC Meeting 11th November 2014

ATTENDEES: Len Dalton, Heather Elliott, Chris Doolan, Hilary Kijak, Jayne Healy, Phil Maslin, Brijesh Chopra, Sher Khan

Ross Flavell, Paul Lowe, Mike O’Donnell, Mike Williams

IN ATTENDANCE: Carol McNidder (Secretary)

Item / Discussion / Action / Who /
Apologies /
Minutes of Previous Meeting
09.09 2014 / Proposed by Jayne, seconded by Hilary and accepted...
Matters Arising / .Contract Applications – the area Team had stated there was no longer a statutory requirement to notify other pharmacies or the LPC of a change of ownership.
All other matters arising dealt with under Agenda items
Governance Committee / The governance committee had met once; Ross did not wish to chair the committee as, as Treasurer, he would be under scrutiny.
Advice had been sought from Mike King at PSNC and the following areas were to be reviewed.
·  Expenses policy needs to be rewritten
·  Employment/Self Employment status of Secretary –
·  Employment of Chair and Treasurer rather than honorarium
·  Funding of evening meetings.
·  Review of mileage allowance
It was apparent that the recommendation was that the Chair, Secretary and Treasurer should have official contracts rather than being awarded an honorarium. Model contracts are available from PSNC and it is possible to obtain 290 minutes of free advice from one of PSNC’s legal partners.
The employed/self-employed status of the Secretary would need to be considered within HMRC rules re being able to send in a replacement to do the job etc. The contract would require a home worker clause to be inserted, there would need to be consideration as to the rate of remuneration – a fixed annual salary, an average rate per hour or a variation of rates between attendances at meetings etc./purely administrative work. If the Secretary were to be employed there would be additional considerations such as holiday pay, sick pay, Employer Liability Insurance etc. to be taken into account, also job descriptions, appraisals etc (also applicable to Chair and Treasurer).
Carol was asked to make a note of her hours and exactly what they had been spent on and to advise the Governance Committee accordingly to better inform discussions/decisions.
It was agreed that the LPC could fund evening meetings (e.g. Strategy or Governance Committee meetings)
at a rate of £70 for a 2 hour meeting.
It was agreed that the mileage allowance should be set at 45p per mile (in accordance with HMRC limits).
The Governance committee were asked to produce say two A4 sheets outlining HMRC rules, Employment rules etc. and setting the annual budget
It was also agreed to change the structure of LPC meetings to all day meetings. The Strategy and Governance Committees would meet separately from 9 – 11 and then from 11 onwards the whole LPC would come together for the LPC meeting.
Strategy Committee / The Strategy Committee had met twice; reports from the meetings had been circulated to all LPC members prior to the meeting. Solihull LPC’s Mission Statement and Vision Statement were approved for the website.
The strategy document (to appear on the website) had been discussed around nine key areas and how local policies fit within each of those nine areas. The final document needs to be commissioner, contractor and patient friendly with timelines, goals and opportunities reflecting a professional/commercial balance. / ,
PNA / The Contractor questionnaire is to imminently be available for completion on PharmOutcomes, it has been redesigned with existing services at the top followed by the ‘wish list’ of prospective services which could be commissioned in the future.
Contractors to be reminded to complete the questionnaire, to only tick existing services that they are actually signed up to and being paid for and to ensure the split between core and supplementary hours declared accurately reflects the list held by the NHSE Area Team.
The patient questionnaire is modelled on the Coventry one, Pharmacy contracts will be an additional outlet, not the sole one. / CM
Buddy
Enhanced Services / NE/SAM?BBV
The Bridge have reported that Solihull has an above average use of heroin on top of Methadone, the number of prescriptions for Methadone is static but the number of supervised supplies (46 including 10 Subutex) is up. There have been increased Disulfuram/Campral scripts. There is a will to move an alcohol service forward so a working group is to be set up to include Chris Clarke, Kevin Ratcliffe (from the Birmingham service) and Solihull LPC, this could also encompass revisiting the BBV service which needs improved engagement and awareness (possible training).
Contractors to be reminded about checking dates on prescriptions over the Christmas/New Year period particularly January 1st
Rota/OOH
Agenda item for the BSBC LPC Forum meeting, the evening of 11th November. Paul waiting to hear back from the Area Team once it had been discussed at a meeting.
Solihull LPC to discuss with the CCG their views on the continued Rota Service
Solihull LPC will ensure that following agencies have been made aware of the rota cover – Walk-in Centre, Badger, Police, NHSE, local press, Public Health.
Smoking Cessation
The requirement for the NVQ3 level trained personnel to undertake the service, as specified in the original SLA to a level NVQ2 had been agreed verbally.
Smoking Cessation service to go out to tender in January
Flu Service
It had become apparent that many of the GPs were unhappy about Community Pharmacy undertaking the Flu Vaccination Service and were complaining that some pharmacies were harassing patients to receive their vaccinations and arguing that some patients were missing out on pneumococcal and shingles vaccinations as a result. As there is a possibility that the scheme, if successful, could be extended to include all vaccinations, it is important to build bridges and bed in a high quality service this year. All contractors to be encouraged therefore to ensure all paperwork is completed properly and the service is operated within its constraints, a non-compliant, low quality service by only a few contractors could jeopardise the service for all.
Minor Ailments
The Solihull scheme had been extended to three surgeries in the South of the Borough however one LPC member reported that that patients had been told by two of the surgeries concerned that they could not use the service. It was agreed that this was to be discussed with the CCG; uncooperative GPs against the service would be extremely detrimental.
The area wide service, which Solihull CCG had refused to join as it was considered it would undermine the Solihull service’ had had some teething problems with one contractor doing over 50 items of service per day, reinforcing the doubts shared by some CCGs. / CM
Buddy
Potential Services / Weight Management
This is to go out to tender in January based on level 2 services which are currently ‘Slimmers World’ led, There is an acknowledgement that that groups are not for everyone, a one to one service is more effective for some individuals and these could be done on the back of MURs and NMS.
NHS Healthchecks
These too can be done effectively through community pharmacy, most GPs do not wish to do them and pharmacy can reach the hard to hit group through accessibility and convenience. These (possibly extending to HbA1c and cholesterol testing) have been identified as part of the Joint Strategic Needs Assessment.
Public Health / Various services are to go to tender in January, registration in advance is required and all contractors need to be made aware of this. Even if there is a separate pot of money for pharmacy, the LPC as an entity cannot tender, this can only be done by LLPs, Limited companies, sole traders etc. All councils have to put services out to tender in some way and in many cases it will be under the single provider model. As the LPC cannot tender the most effective thing the LPC can do is to ensure that delivery through Community Pharmacy is enshrined within the service specification so that the tender winner has to subcontract a part of the service to Community Pharmacy.
Regular meetings with the Public Health department have been re-established (the next is November 13th with Chris and Mike O’Donnell to attend), all members of the team are very pro Pharmacy and keen to see current services extended and new services added in as the evidence base for current services such as Smoking Cessation and Sexual Health is so strong.
The Know Your Numbers campaign is still being evaluated. Contractors need to be reminded to use Pharm Outcomes for feedback on campaigns; robust feedback gives effective data particularly there is now a bespoke tool. PharmOutcomes can also be used for signposting for MECC interventions for Obesity, Smoking, and Alcohol.
Public health is to issue a questionnaire to contractors re MECC training, who has already undertaken it, who will undertake it?
Healthy Living Pharmacies are not being driven this year especially with a tendency to process change and the framework is not being worked up, many early adopters would require re-accreditation due to change of staff etc. however there is a case to be made for the development of a portfolio for pharmacists indicating a level of engagement and training which should improve both quality and perception (evidence backed) of quality.
Public Health after 2015
Len had attended a conference on this subject (papers had been circulated prior to LPC meeting); Masterclasses were on Pharmacy involvement in Point of Care Testing, Healthchecks etc.
. / CM
Buddy
LPC Meetings / BSBC LPC Forum
The minutes of the previous two meetings (September and October) had been circulated prior to the LPC meeting as had the notes of a meeting held with Kieran Patel and Donna McArthur.
It is apparent that we must talk to respective CCGs as all monies are to be devolved back to them (although not dentistry and pharmacy in 2015), they will be commissioning based on models of care and it is essential pharmacy is enshrined within these models and within their thinking in enabling patients to be kept out of secondary care where possible.
As from April 2015 the Area Teams are to be reconfigured and the Birmingham Solihull and Black Country will combine with Worcestershire and Arden encompassing a much larger area.
It was hoped to introduce a mechanism to enable the no blame sharing of critical incidents – possibly through PharmOutcomes.
LPC Conference
Discussion had centred around Local Commissioning, IT requirements, Prescription Direction and the National Framework to inform the next PSNC meeting on how PSNC should be working to support contractors.
The contract is moving away from being dispensing level to service led, NMS money is now wrapped within the global sum so if contractors are not undertaking these they are losing out. The latest settlement has increased overall funding but due to the changes there is a decrease of 5p per item, with opportunities for increases through NMS and MURs therefore being outcome led.
There is to be a National Audit.
Pharmacy needs to be promoting Repeat Dispensing – currently only 7% of prescriptions dispensed.
Quality framework – LPC Self Evaluation / The PharmOutcomes framework had been circulated prior to the meeting, it was agreed this could be used as part of the LPC self-evaluation against the strategic plan.
Finance / The current balances were £5409 in cheque a/c and £12470 in the deposit account
LPC Buddy /
LPC Buddy System
·  PNA Contractor Questionnaire on PharmOutcomes
·  Please also support PNA patient Questionnaire.
·  Methadone Prescription Dates.
·  Keep up quality on Flu Vaccination
Stakeholder Engagement / LMC
Carol had written to the LMC about the presence of Quantum Prescription Portals within certain surgeries in Solihull. The LMC had agreed to send a joint LPC/LMC letter to all GP surgeries and pharmacies within Solihull re Prescription Direction.
It was agreed the LPC should attend a LMC meeting on a quarterly basis.
AOB / PharmOutcomes LPC Dashboard
PharmOutcomes have developed a dashboard which enables the LPC to review how different contractors are delivering advanced and locally commissioned services which are claimed through PharmOutcomes. It was decided to defer discussion and voting on this to the next meeting
Dates of Next Meetings / Tuesday 13th January 2015

Proposed by Heather Elliott, seconded by Brijesh Chopra and accepted

C:\Users\davida\Documents\LPC SECRETARY\LPC Meetings\Minutes\Meeting 090914.doc 8