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MINUTE of MEETING of the
AREA PHARMACEUTICAL COMMITTEE
Board Room, Assynt House /
27 November 2006 – 10.00 am
PresentDr David Raeburn (Chairman)
Mr Colin Costello
Mr John Cromarty
Mr Alex Kelso
Ms Wendy Laing
Ms Fiona MacFarlane
Ms Sandra Melville (by videolink)
Ms Clare Morrison
Ms Mary Morton
Mr Peter Mutton
Ms Fiona Nicholas
Mr Andrew Paterson
In AttendanceMrs Barbara Simpson, Board Committee Administrator
1WELCOME AND APOLOGIES
Apologies were received from Ms Catherine Beaton, Mr Gareth Dixon, Mr Scott Nicol, Ms Sharon Pfleger and Ms Fiona Thomson.
2AREA PHARMACEUTICAL COMMITTEE, APRIL 2006 – MARCH 2009
2.1Appointment of Office Bearers – Vice-Chairman and Secretary
The following appointment was made:
Vice-Chairman - Ms Fiona MacFarlane (nominated by Professor Cromarty and seconded by Dr Raeburn)
Secretary – As there were no volunteers forthcoming and on the suggestion of Professor Cromarty, Dr Raeburn agreed to write to members to inform them of the importance of the role of Secretary to the Committee and urge for a volunteer. Professor Cromarty was happy to participate in this draft.
The Committee:
aNoted the appointment of Ms Fiona MacFarlane as Vice-Chairman.
bRemitted to Dr Raeburn and Professor Cromarty to draft a letter to members informing them of the importance of the role of Secretary to the Committee and urge for a volunteer.
2.2Election of Representatives 2006 – 2009
Representatives were appointed as follows:
(a)Pharmacy Practices Committee
- Ms Fiona Nicholas
- Mr Gareth Dixon (nominated by Dr Raeburn – to be confirmed)
(b)Reference Committees
- Dr David Raeburn
- Ms Sandra Melville (to check how many have to be contractors and if the nominee has to be a contractor this appointment to be taken back to the Committee)
(c)Discipline/Joint Discipline Committees
- Dr David Raeburn
- Ms Sandra Melville (to check how many have to be contractors and if the nominee has to be a contractor this appointment to be taken back to the Committee)
- Ms Wendy Laing
(d)Argyll & Bute CHP Committee
Ms Melville agreed to contact community pharmacists for volunteer representative. Members noted that Ms Fiona Thomson was attending these meetings at present.
(e)North CHP
- Ms Clare Morrison
The Committee:
aAgreed the nominations as indicated.
bRemitted to Ms Melville to check out the position regarding contractors as far as the Reference and Discipline/Joint Discipline Committees were concerned. If the nominee has to be a contractor this appointment will have to be taken back to the Committee.
cAgreed that Ms Melville contact community pharmacist for volunteer representative on the Argyll & Bute CHP Committee.
3MINUTE OF MEETING OF 25 SEPTEMBER 2006
The Minute of the meeting held on 25 September 2006 was approved.
4MATTERS ARISING
4.1Leave of Absence
At the last meeting of the Committee, members agreed that Ms Catherine Beaton be given a leave of absence from the Committee and that, if possible, she should provide a deputy for this period. Ms Clare Morrison, Co-op Pharmacy, Thurso has agreed to deputise for Ms Beaton to cover Area Pharmaceutical Committee meetings up to May 2007.
The Committee Noted the position.
5PHARMACY CONTRACT
A report on the Pharmacy Contract by Professor J Cromarty, which was submitted to the NHS Highland Board on 7 November 2006, had been circulated. The Board had been asked to note the funding arrangements and requirements of the new Community Pharmacy Contract and agree the means by which the projected shortfall in the funding of the new Community Pharmacy Contract would be met within the current financial year. Professor Cromarty spoke to his report and confirmed that the Scottish Office had recognised the shortfall to complete the new pharmacy contract and had agreed that it would be met with savings from the current budget.
The Committee Noted the position.
6MEDICINES USE REDESIGN PROJECT (MURP)
Mr Peter Mutton gave a verbal update on the MURP. The fire alarm upgrading at RaigmoreHospital had meant a change of project ward but this would not stop the input to Raigmore and confirmation was given that the service was continuing in the other project hospitals. The permanent appointment of the Project Nurse was a great boost, both on the hospital side and the wider service. There was a need to focus on individual areas so that the roll out could be completed with the minimum financial output. Pressure regarding development monies and the potential use of non pharmacy staff was discussed. Members noted that Argyll & Bute CHP was further forward with their project. Ms Melville stated that the project was sold there as a technician led service but the right balance had to be achieved. Nurses also had to keep their skills up to date and take ownership of the project.
The Committee noted the updated information.
7PARTNERSHIP FOR CARE – INTEGRATION OF PHARMACY SERVICES
7.1Production of a Risk Register
Professor Cromarty confirmed that discussions were ongoing with Ms Mirian Morrison, Clinical Governance Manager regarding the production of a risk register. Members noted that the Board produced a corporate risk register but only new contracts appeared on this.
The Committee Noted the position.
7.2Letter from Prof. Cromarty dated 29 September 2006
A letter dated 29 September 2006 by Professor J Cromarty to all NHS Highland Pharmacy Staff and the Area Pharmaceutical Committee had been circulated. Professor Cromarty highlighted the last paragraph which confirmed that a single job description has been developed which would apply to each of the four CHP Lead Pharmacist posts. Matching and mapping was progressing and those affected should receive letters following the meeting of the matching and mapping panel.
The Committee Noted the position.
8PHARMACIST PRESCRIBING
Ms Morton drew members’ attention to Item 16(o), the minute of the MCN Education and Working Group Meeting as submitted by Mrs MacRobbie, Palliative/Community Care Pharmacist. Dr Raeburn confirmed that applications for training would not now be taken up until February 2007. After that the training would consist of one day’s training at the university, one day self-learning and two days in practice.
The Committee Noted the position.
9CONSULTANT IN PHARMACEUTICAL PUBLIC HEALTHPOST
Professor Cromarty reported verbally on the present position with regard to the Consultant in Pharmaceutical Public Health post. At a recent meeting, support had been offered by Public Health Representatives in NHS Grampian and a meeting had been arranged for the following Friday to discuss further. Ms Elaine Gorman, Public Health Specialist, Argyll & Bute CHP was to field Pharmaceutical Public Health issues in the interim. This appeared to be the best arrangement that could be secured. Discussion arose around whether the Board should be informed of the potential risk of this situation.
The Committee Noted the position.
10COST OF DRUGS AND PRESCRIBING AND PROPOSED CHANGES TO THE SUPPLY OF PFIZER MEDICINES
Professor Cromarty reminded members that both this item and the preceding one were related and Dr Raeburn agreed that Items 10 and 11 should be taken together.
A report on the Cost of Drugs and Prescribing by Professor J Cromarty and Mr F Hickey, Acting Pharmacist Prescribing Adviser, which was submitted to the NHS Highland Board on 7 November 2006, had been circulated. Professor Cromarty confirmed that Mr Mutton had also given input to this report which had been in response to the Board’s request for an update on prescribing spend and cost saving initiatives. The report focused particularly on the potential savings which could be achieved on statin prescribing. A great deal of work prior to the Board meeting had ensured that CHPs, GPs and consultants were briefed and signed up to the proposal to switch to simvastatin from atorvastatin or rosuvastatin, where this was clinically appropriate and in advance of the resulting press coverage. The report was not exclusively about statins as there were also another nine top spending drugs involved and there was potential for huge financial savings and cost effective treatment. Argyll & Bute CHP data was not used in the report as this was unavailable. Mr Costello reminded members that identifying patients who may be at risk was an issue and the supply of statins should be based on clinical need. Professor Cromarty confirmed NHS Highland Board’s support and endorsement of the report.
Dr Raeburn confirmed that with the proposal to have only a single supplier, problems would be experienced obtaining Pfizer statins in Highland. Ms Melville felt that the whole ethos was wrong behind the move of one supplier and that the problem was exacerbated in Highland with its remote and rural issues. Ms Morton thought that accessing stock direct would be more practical. After discussion during which Ms Melville expressed concern that this practice may set a precedent it was agreed that the Committee’s concerns should be expressed. Dr Raeburn agreed to draft a letter to Pfizer expressing concerns regarding any proposed change in the supply of their statins, relating the remote and rural issues which affected Highland and ask for a daily supply to pharmacies and dispensaries in this area. The draft would be sent to Ms Morton in the first instance and then on to the Committee for comments.
The Committee:
aNoted the report on the Cost of Drugs and Prescribing.
bRemitted to Dr Raeburn to draft a letter to Pfizer regarding their proposed change of supply of statins. The draft letter was to be sent to Ms Morton in the first instance and then on to the Committee for comments.
11PROPOSED CHANGES TO THE SUPPLY OF PFIZER MEDICINES
This Item was taken with Item 10 above.
12NHS SCOTLAND DIRECTORS OF PHARMACY – REPORT FROM PHARMACEUTICAL CARE DELIVERY GROUP
Professor Cromarty spoke to a report from the Pharmaceutical Care Delivery Group Meeting held on 9 November 2006 which had been tabled and highlighted the following:
(a)Flu Immunisation Update
Professor Cromarty confirmed that 61% of the flu vaccine had now been received in Scotland. Some difficulties had been experienced in the delivery which had been received in relatively small quantities over each calendar month as opposed to single monthly deliveries of larger supplies. However, the Vaccine Monitoring Group and SPGC were working to resolve this problem.
(b)New Community Pharmacy Contract – Pharmacy Champions and I M & T Facilitators
The role of Pharmacy Champions was discussed and the challenges of the geographical spread in Highland. Ms Morton confirmed that there was still work to do on what Pharmacy Champions could deliver.
(c)Pharmacist Prescribing
A presentation had been given at the Pharmaceutical Care Delivery Group Meeting to update on progress. NHS Highland had received an honourable mention in the examples of good practice given.
(d)SEHD Priorities
The key performance targets for the SEHD had been summarised and the SEHD will work with Directors of Pharmacy on implementation of the nCPC.
The Committee Noted thereport.
13CONSULTATION ON THE REVISED CODE OF ETHICS FOR PHARMACISTS AND PHARMACY TECHNICIANS & QUESTIONNAIRE
A Consultation on the Revised Code of Ethics for Pharmacists and Pharmacy Technicians together with a Questionnaire had been circulated. Dr Raeburn asked members to note and deal with individually.
The Committee:
aNoted the report.
bAgreed to deal with the report and questionnaire individually.
14APPLICATIONS FOR INCLUSION IN THE PHARMACEUTICAL LIST
(a)Community Dispensing Services Ltd, the Harbour Development, Balintore, Ross & Cromarty
The Committee Noted the application and closing date of 1 December 2006 for representations.
(b)James Paterson, CampbellBuildings, Main Street, Garelochhead
The Committee Noted that the application had been granted.
(c)Clyde Medical, Unit One, Ferry Road, Rosneath
The Committee Noted that the application had not been granted.
15SYRINGE DRIVER CHANGE PROGRAMME
A letter dated 27 September 2006 from Mrs Alison MacRobbie, Palliative/Community Care Pharmacist together with the Locality Training Schedule had been circulated for information.
The Committee Noted Mrs MacRobbie’s letter and attached schedule.
16REPORTS
The Committee considered the following reports:
(a)Area Drug and Therapeutics Committee
(b)SSU Drug and Therapeutics Committee
(c)Primary Care Drug and Therapeutics Group
(d)Area Clinical Forum
(e)Tobacco Strategy Implementation Group
(f)Coronary Heart Disease Managed Clinical Network
(g)Consultant in Pharmaceutical Public Health
(h)Director of Pharmacy NHS Highland
(i)Head of Community Pharmaceutical Services NHS Highland
(j)Head of Specialist Pharmaceutical Services
(k)Non-Medical Prescribers Steering Group
(l)eHealth Steering Group
(m)Stroke Managed Clinical Network
(n)Diabetes Managed Clinical Network
(o)Diabetes Managed Clinical Network - Education and Training
(p)Strategic Steering Group for the Administration of Medicines in Schools
(q)Drugs Misuse Service
(r)Research Ethics Committee – Highland Representative
The Committee Noted the reports.
17COMMUNICATIONS RECEIVED:
(a)Amendments to List of General Medical Practitioners
(b)NHS Highland’s Pharmaceutical List
The Committee Noted the communications received.
18AOB
18.1Committee Papers
Members were asked to consider whether they wish to continue receiving committee papers in hard copy format or if they would prefer to have them sent by email. It was agreed that the meeting papers would continue to be sent in hard copy format.
The Committee Agreed that the meeting papers would continue to be sent in hard copy format.
19Date and Venue of Meetings for 2007
The following dates were approved:
29 January
26 March
28 May
30 July
24 September
26 November
19.1Date and Venue of Next Meeting
The next meeting will be held on Monday 29 January 2007 in the Board Room, Assynt House, BeechwoodPark, commencing at 10.00 am.
The meeting closed at 12.32 pm
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