DORSET LOCAL PHARMACEUTICAL COMMITTEE

MINUTES OF LPC MEETING HELD ON THURSDAY 3 MARCH 2016

AT MERLEY HOUSE, MERLEY HOUSE LANE, WIMBORNE BH21 3AA

Attendees:-

Independent:-

Steve Costello, Chris Higgs, Robin Mitchell

CCA:-

Fiona Arnold, Claire Rossiter, Garwyn Morris, Mandy West, Conroy Van Wyk

AIMp:-

Michael Idu

In attendance

Jo Browning (Manager, Minutes), Amanda Moores (Chief Officer)

1. / PRESENTATION – New NICE Type 2 diabetes guidelines NG28 and the positioning of DPP-4 inhibitors – Katie Atkinson, MSD, E mail: Mob: 07779 706428 / ACTION
2. / WELCOME, APOLOGIES FOR ABSENCE
Welcome to new LPC Members Conroy Van Wyk (representing CCA) and Michael Idu (representing AIMp)
Apologies for absence – Janette Best, Gary Warner
Conflicts of interest – a request for any LPC members interests not already declared
LPC members time – a request for any comments
Action plan (FA)
Timekeeper (GM)
Expense forms to be completed and submitted to Treasurer either before meeting/during coffee break only
Requests for AOB on flipchart
OF NOTE:-
Mandy West is holding proxy vote for Janette Best
Michael Idu and Conroy Van Wyk completed Declaration of Interests and Confidentiality Agreements for LPC members.
LPC Members time – comments included time spent on pharmacy contract applications, contractor queries regarding DPS, setting up the LPC office.
2.1 / SPEAKERS
Julia Booth, Primary Care Contracts Manager for Pharmacy & Optometry, NHS England Wessex
Katherine Gough, Head of Medicines Management, NHS Dorset CCG
2.2 / OBSERVERS
Mike Field, CPPE Tutor for Dorset
Ashley Littlewood-Miller, Healthcare Partnership Manager, Boots UK
3. / MINUTES OF DORSET LPC MEETING 14.1.2016
Accuracy
Review of Action Plan
The amends to the draft minutes circulated to LPC members on 22.1.2016 were adopted without further comment. The amends to the minutes were:-4. PSNC – Action: date should be 20.01.2016 not 20.03.2016. 5. DPS –Additional Action: CCA members to check that their tendering teams are aware of deficiencies in tender documents and encouraged to submit questions of clarification via the DPS where relevant.
Review of action plan - all actions on the action plan are complete or in progress.
3.1 / Matters Arising from minutes of 14.1.2016 (for items not elsewhere on the agenda and/or identified by members prior to this meeting)
Nil of note.
3.2 / Matters arising from reading list – see separate circulations (for items identified by members prior to this meeting and placed on supplementary agenda if necessary)
Nil of note
3.3 / Matters arising
HSCIC EPS training dates
Feedback from Area Managers Meeting 25.2.2016
EOIs from independent members – FOR VOTING
3.3.1 / HSCIC EPS System Update training dates
HSCIC are co-ordinating the training and booking is via the HSCIC website. The LPC are promoting the events (taking place first two weeks in April) and encouraging contractors to attend. Attendance is limited to 2 attendees per pharmacy.
ACTIONS:
JBr to circulate training dates to Conroy Van Wyk and Michael Idu.
ALL LPC members to inform Jo Browning which training sessions they can attend training as LPC representative. Ideally members should attend sessions that are relevant to their system. / JBr
ALL
3.3.2 / Feedback from Area Managers Meeting 25.2.2016
The first Dorset LPC area managers meeting took place on Thursday 25th February and took up 2 hours as part of the Steering Group Meeting (which is scheduled for the same day), with SC, AM, GM, CH attending. The LPC provided an overview of ‘hot topics’ in the county which included DPS and local services, EPS and repeat dispensing, community pharmacy in 2016/17 and beyond. The LPC asked for issues from the Area Managers and what they would like to see from Dorset LPC. A number of barriers and issues were identified around local services including a lack of local events that makes it hard to skill up new people, events being cancelled without notification and training courses being available during trading hours.
ACTION: JBr to circulate suggested future dates for meetings which are Thursday 19th May, Thursday 1st September, Thursday 17th November, 11.00 am to 12.00 noon – presentation; 12.00 noon – 1.00 pm buffet lunch, all at Merley House. / JBr
4. / PROVIDER COMPANY DEVELOPMENT UPDATE (AM)
The PNSC has stated that LPCs should go ahead and develop local provider companies now, as contractors may be at risk without. Local Provider company for South Central area – South Central LPCs (Dorset, Hampshire & IOW, Thames Valley and Buckinghamshire) are following the process for formation of a Local Provider Company recommended by the PSNC -which is as follows:-
Phase 1 – Contractor In-principle agreement;
Phase 2 – Preparing documentation;
Phase 3 – Contractor vote;
Phase 4 – assuming a positive outcome of a formal vote, the LPC would then proceed to register the company with Companies House and establish the necessary governance and operational structures.
As stated at the LPC meeting on 26.12.2016, all four of the LPCs in South Central have in principle agreement from their contractors to proceed onto Phase 2 of the consultation process for Local Provider Company Development.
All four Chief Officers for SCLPCs met with the lawyers regarding the next steps/preparing documentation/potential structure for Phase 2 in January 2016.
A potential structure for the local provider company was discussed by LPC members at LPC meeting 14 January 2016. This included a discussion on funding and contractor fees.
Currently the SCLPCs are liaising with CCA companies regarding development of the provider company.
It is envisaged that all four SCLPCs will bring a full proposal to respective LPC meetings in May/June 2016 for voting by LPC members, followed by a contractor vote (meeting)at which lawyers would be present.
5. / PSNC UPDATE (AM)
Community Pharmacy 2016-2017 and Beyond

Briefing documents:
December 2015 DH/NHSE Letter to PSNC
Community pharmacy in 2016-17 and beyond foreword
Community pharmacy in 2016-17 and beyond proposals
Summary of PSNC’s service development proposals to DH and NHS England
Parliamentary debate 23.2.2016, which can be found in PSNC Briefing 016/16. This briefing is now available on the PSNC website:
You can also watch the debate on:-
The PSNC held an emergency meeting for Chairs and Chief Officers held on 20.1.2016 in London to discuss the government's plans, PSNC's strategy and how LPCs can support their contractors' interests. The PSNC and pharmacy bodies (RPS, Pharmacy Voice, NPA) are building a campaign in phases. Phase 1 is to communicate and lobby (ie. build up a groundswell of support and create a “noise” from as many different places as possible) regarding:-
The value of pharmacy
Implications for patient care
Uncertainty and the effect of the proposals.
The deadline for action for Phase 1 is 24 March 2016.
LPC members discussed three key messages for each of the above bullet points and formulated a plan for action for Phase 1.
ACTIONS:
ALL to enter information for the pharmacy campaign onto the NPA website, looking for non-patient identifiable personal stories from pharmacy.
ALL to notify Jo Browning if they are available to meet at the LPC Office Merley House on Thursday 10th March and/or Thursday 17th March (mornings only) to put the Phase 1 plan into action. It may be that LPC members can call in/out of the LPC at different times.
FA to draft email to contractors and draft survey monkey
AM to contact Mike Hewitson about the stories on the NPA website and if the LPC can utilise / ALL
ALL
FA
AM
6. / ANNUAL WORK PLAN 2016 – (to include training and development)
Time was spent developing a plan and tool kit of resources for LPC support of the campaign regarding proposed cuts to community pharmacy funding. It is anticipated that this will be ongoing work in 2016.
7. / SERVICES AND IMPLEMENTATION LEAD UPDATE (SAIL) (CR)
Key areas of work:-
Attending meetings outlined in Services & Implementation Lead report 15.1.2016 to 2.3.2016 including Future of Pharmacy PSNC Emergency Meeting, Public Health Dorset Quarterly Community Providers Update meeting, Public Health Dorset Sexual Health Training & Competency Group meeting, NHS England Wessex Urgent Repeat Medicines Service Meeting, Area Managers Meeting.
Listening in the PHD webinar on Smokestop services.
Response to ellaOne PGD
Understanding new Service Level Agreements for Smokestop and Sexual Health Services.
8. / PRESENTATION Complete emollient therapy– Jo Wicks, Dermal, E mail: Mob: 07758 922510
9. / MEETING WITH KATHERINE GOUGH, HEAD OF MEDICINES MANAGEMENT, NHS DORSET CCG
9.1 / Clinical Service Review (CSR)
NHS Dorset CCG announced in July 2015 that it wants to do more work before finalising proposals to take to a formal public consultation as part of its CSR across the county. At the start of the review the CCG had anticipated it would be ready to go to public consultation summer 2015. However, despite a significant amount of work, the public consultation is now more likely to begin in April 2017.
The CCG CSR Clinical Working Group Meetings started in 2014-2015 have been resumed – and the first meeting was held on 2nd September 2015. This was attended by Dorset LPC. There is a further meeting on 16 March 2016.
NHS Dorset CCG are encouraging people to visit to find out more and read the latest updates on the review and to get involved, by joining the Health Improvement Network.
It was noted that it is critical to current CSR plans to have a robust pharmacy estate in Dorset.
ACTION: ALL to submit suggestions about what Community Pharmacy can deliver as part of the CSR (for example minor ailments) to AM for collation and submission to KG. / ALL
9.2 / Minor ailments scheme
NHS Dorset CCG Primary Care Commissioning Team is intending to commission minor ailments(supply of GSL medicines for common conditions) and emergency repeat supply and PGD services. These may be based on Devon’s Pharmacy Firstand Winter Ailments Service.
NHS Dorset CCG Medicines Management Team have been working on PGDs, Service Specification and Formulary Pan Wessex for minor ailments and PGD services, and they are now ready to consult with the LPC on the service specification.
NHS Dorset CCG have asked NHS England Wessex if it might be possible to commission this service via NHSE as an enhanced service.
9.3 / Repeat dispensing
Take up of electronic repeat dispensing by pharmacy contractors is in Dorset currently very poor. Electronic repeat dispensing has a low uptake of around 4% of prescriptions. There are some issues which are mainly around process and communication.
The HSCIC are organising contractor training update events for the first two weeks in April in conjunction with the LPC. HSCIC are co-ordinating the training and booking is via the HSCIC website. The LPC are promoting the events and encouraging contractors to attend.
In addition Dorset CCG, HSCIC & Dorset LPC are working on a joint event with GP practices and pharmacies to support increased use of electronic repeat dispensing.
9.4 / Pharmacists in GP practices
In July 2015 NHS England announced the launch of a new £15m three year pilot to fund, recruit and employ clinical pharmacists in GP practices. NHS Dorset CCG confirmed that interviews were held recently and several clinical pharmacists were appointed. CPPE will be providing the training and Wessex Academic Health Science Network (AHSN) providing the funding for training.
9.5 / Medicines Optimisation plans for 2016-2017
The Dorset CCG Medicines Team will submit a savings plan for 2016-2017 to the Medicines Optimisation Group for approval at their meeting on 8.3.2016. A representative from Dorset LPC will be attending this meeting.
The medicines priorities for 2016/17 will be to maintain the cost effective and evidence based approach to prescribing advice. This will be done in primary care prescribing through the Medicines Optimisation Group, and the locality prescribing lead GPs; and across the health community through the pan Dorset formulary; the CCG will ensure new drugs are safely introduced, traffic light statuses updated and shared care systems are overseen by the Dorset Medicines Advisory Group (DMAG).
9.6 / Hand stamped Prescriptions
The CCG has been made aware that some prescriptions are being issued with details of the prescriber having being stamped rather than printed on the prescription. Contractors may not be being reimbursed for these prescriptions by NHSBSA. LPC to raise awareness with contractors
10. / MEETING WITH JULIA BOOTH, PRIMARY CARE CONTRACTS MANAGER FOR PHARMACY & OPTOMETRY, NHS ENGLAND WESSEX
10.1 / IG Toolkit submission and Business Continuity Plans
The deadline for submission of the information governance (IG) toolkit is 31st March 2016. Guidance on completing the toolkit is available from: psnc.org.uk/ig NHS England did grant community pharmacies an exemption from the business continuity requirements within the Information Governance (IG) Toolkit for 2014-2015. However this does not apply for 2015-2016.
ACTION: JBr to include reminder for contractors to complete business continuity plan in March monthly briefing and on website. / JBr
10.2 / Dispensing GPs - patient validation/review
NHS England Wessex are carrying this out Wessex wide. The mapping is being completed by NHS South, Central and West Commissioning Support Unit (CSU), using the rurality maps. If the whole postcode is within 1.6km, then it is straight forward, however if the postcode straddles the “line”, then CSU look at house level. Information was sent to Dispensing GP practices in January 2016. It was noted that Hampshire is more challenging than Dorset and 900 patients identified from one practice. GP Practices have been provided with a template letter to use to contact patients identified as not eligible for dispensing from the surgery. NHS England Wessex will repeat this work in April 2016 and GP practices who have not taken action will be served with breach notices.
10.3 / Urgent Repeat Medicines Service
This initiative is being led by the Wessex LPN working group, jointly commissioned by NHS Dorset CCG, and NHSE Wessex, with the aim of having an enhanced service in place early2016, however, this service is unlikely to be ready for Easter as initially anticipated. .
Fees will be negotiated between Wessex LPCs and NHSE Wessex. NHSE Wessex are considering going live in one area first – possibly Dorset.
10.4 / Community Pharmacy Outcomes Framework (CPAF)
In order to stream line the process for contract monitoring 2015-2016 allpharmacies were asked to complete a short screening questionnaire (20 mins) in the first instance (deadline for submission 1st November 2015). Following analysis of the results and consideration of other information held by NHS England, 26 pharmacies have now been asked to complete the full CPAF questionnaire (deadline for submission 31st March 2016). Following on from this, NHS England South Wessex will decide which pharmacies will receive a contract monitoring visit in April and May 2016.
In addition, NHSE Wessex will also be visiting 8 community pharmacies to validate the initial short screening questionnaire.
Ultimately, a PDF of CPAF will be available for all pharmacies to use as a training tool for staff members. It was noted that guidance/information on the PSNC website is also extremely useful -

The process for CPAF 2016-2017 will begin in June 2016.
ACTION: JBr to include article in monthly newsletter and website to remind community pharmacies selected to complete full CPAF by 31st March 2016 / JBr
10.5 / Health Promotion Campaigns
The health promotion campaign for pharmacies for March 2016 is to support No Smoking Day. NHSE Wessex have arranged for a No Smoking Day pack to be sent to all pharmacies and these should arrive in time for No Smoking Day which is on 9 March 2016.
NHSE Wessex has previously asked pharmacies to order their own resources for health promotion campaigns, but for this year, where it is possible, they will try and make arrangements so that the materials are sent directly to community pharmacies. A timetable of the planned campaigns for the rest of the year will be sent out soon.
10.6 / MUR/NMS Data
NHSE Wessex collected the data for quarter up to December 2015, as per usual. However, for the next quarter, as part of a pilot, NHS Business Services Authority (NHSBSA)will collect this data electronically from Wessex contractors and this data will be shared with Wessex AHSN and uploaded to a portal for community pharmacies to view.
10.7 / Summary Care Records (SCR)
It was announced in June 2015 that pharmacists and pharmacy technicians and pre-registration trainees in community pharmacies in England would be given the opportunity to access the SCR. An e-learning programme has also been launched by the Centre for Pharmacy Postgraduate Education (CPPE) on SCR usage.
NHSE Wessex has commissioned NHS South, Central and West Commissioning Support Unit (CSU) to roll out this programme and deliver the training events. It is envisaged that there will be two training events in Dorset – one east and one west in June 2016. Both LPCs in Wessex have met with CSU to discuss roll-out of this programme and will be supporting this.
11. / COMMUNITY HEALTH IMPROVEMENT SERVICES – DYNAMIC PURCHASING SYSTEM (DPS) & CONTRACT OPPORTUNITIES UPDATE (AM)
The DPS procurement process continues to be a challenging process for contractors. All of the lots are now available and/or have already been put out to tender to pre-approved providers. However, there are concerns that training that is specified as compulsory in the service specifications is not available and that possible caps on activity will mean that community pharmacies will not be able to recoup their investment in the service.
12. / THREE KEY FACTS (Standing item on agenda)
The value of pharmacy
Implications for patient care
Uncertainty and the effect of the government’s proposals.
13. / AOB
13.1 / Putting Community Pharmacy at the Heart of the NHS – Public Policy Exchange Symposium, London 25.5.2016
LPC members agreed to “park” this for now – however, it is envisaged that there will be more clarity re the government’s proposals for pharmacy after the initial consultation period ends on 24.3.2016 – and there may be a need for Dorset LPC to attend.
ACTION:
CR to pencil date in diary as a possibility. / CR
13.2 / EPSR2 Project Meeting 26.5.2016
ACTION:
FA to attend this meeting. / FA
13.3 / Integrated Team Meeting Healthstone Medical, Vanguard 24.3.2016
Healthstone Medical is a federation of all GP practices in Poole and is holding an Integrated Team Meeting (Vanguard) on 24.3.2016
ACTION:
GM to attend this meeting / GM
14. / REVIEW ACTION PLAN
Noted.
DATES OF LPC STEERING GROUP MEETINGS2016-2017:-
7.4.201619.5.2016, 14.7.2016, 1.9.2016, 17.11.2016, 5.1.2017, 23.2.2017
DATES OF LPC MEETINGS 2016-2017:- 21.4.2016(AGM), 9.6.2016, 28.7.2016, 15.9.2016, 24.11.2016, 19.1.2017, 9.3.2017
All meetings at Merley House, Merley House Lane, Wimborne BH21 3AA.

Page 1 of 9