Minutes

Swindon and Wiltshire LPC Meeting Thursday 14th March 2013

Lydiard House Conference Centre, Swindon (guests at noted times)

Item / Actions
Present:Fiona Castle, Jon Phillips, Jane Goodhew, Charlie Wu, Kaushik Patel, Cathy Jones, Lis Jardine (notes), Kantha Moodley, Chris Shields, Zoe Pearce, Shaun Hill, Robert Townsend, Paul Hedge
Apologies: Steve Green, Paul Eyles, Nick Jephson
Minutes of previous meeting
a) Accuracy
The minutes were accepted as a true record.
b) Matters Arising
Inhaler recycling – KM reported it is going well. They have been provided with a box; when it is almost full they will phone “Movianto” who will arrange collection in around a week – ensuring that collection runs are planned and as environmentally friendly as possible. Participating pharmacies are published on the “complete the cycle” website -
Chippenham Forum – LJ has come up with a poster design. Next meeting early May.
Health Checks - leaflets working well – fewer worried well coming in. Highlight in newsletter. Some teething troubles re computer system – not generating end of month report? Can’t get back into the system to see records.
CVD – recent events with Public Health for stop smoking day. Cold weather put some people off. Location very important.
Roadshows – planning GSK inhaler technique session in June.
Contact details – area team not finalised so can’t circulate to contractors.
Palliative care service - not renewed for next year. Questions re stock, what stock to keep, reimbursement. Discuss with Social Services at next month’s meeting. Might be worth making a list of who has supplies for district nurses (a bit like Substance Misuse guide)? / LJ
FC
FC
FC
Current Issues
a) PSNC levy
PH - two instalments of £17,500: 1% increase. Questioned why contractors are paying to investigate errors – surely government should foot the bills for their own errors.
JP opinion - this is a key year: recent evidence suggests PSNC seem to be on the ball and need support. Could damage PSNC from inside, need show of unity. If there isn’t an improvement, future looks bleak: can hold PSNC to account, but need to start thinking about alternatives now rather than next year.
Contact with PSNC could become part of meeting – regularly raising issues via letters. Invite regional representative to attend.
Newsletter: Top Tips – NCSO, endorse with supplier not brand – huge difference in reimbursement (CJ > Indapamide example)
More about where errors occur.
Agree to increased levy, but submit letter emphasising our viewpoint clearly, with feedback re error checking e.g. mention of Wales system – able to check what you’ve been paid.
b) Stock shortages
Currently at its worst. OTC medicines also affected. Process re finding alternative very long and difficult. Dishonesty of suppliers around expectations can be a bigger problem. Rationed goods - run through quota early in month.
Suggestion to PSNC: looking for release and analysis of pharmacy specific data from Prescription Pricing Service in order to support quota claims.
PH suggested we send a letter to local MPs.
c) NHS Regulations change
Maps of local areas: different departments ‘own’ different maps.
PNA due October 2014. Teams already planning next year’s work.
Revised regulations allow pharmacies to relocate in an emergency.
NCB are responsible for pay. DH responsible for medicines reimbursement
Methadone changes: complicated - may need explaining further in a newsletter article.
Prescriber cost centres will be printed on prescriptions; pharmacists must check and refuse if missing. / CJ
PH/FC
FC/LJ
FC
Meeting “open” to guests
Substance Misuse
(Guests Chris Stickler, Phil Lewis, Darren Woodward, David Thwaites)
a) Introduction to Turning Point – new Wiltshire provider service (DW)
Single number for referral. 08456036993
b) Introduction to CRI – new Swindon provider service (PL)
Drugs rather than alcohol. Similar single number.
Swindon - Chris Hetherington (iPresc) given contract to provide prescribing service.
Swindon not a 24 hour helpline – if there is need it will be provided.
Both to send leaflets/further information to FC/LJ for signposting.
c) The “Recovery” Model
Psychosocial core of system, medicines are part of it. Strang report gives full detail. Recovery rather than maintenance– get people back into communities. Families, relationships, self-esteem – treat causes rather than symptoms. Infrastructure building on client’s assets not deficits.
d) Pharmacy role - supporting harm minimisation and recovery.
Substitute endless cycle of prescribing with a stable platform > start getting better > reduce prescription when client stronger. Start with Turning Point/CRI, move on to GP prescribing. Linked by keyworker, keep momentum going?
e) Building on-going relationships
Speaking to each other vital – TP/CRI will be working closely with all in care pathway, communications strong to support each client’s aims.
Pharmacies can help - training in advice? DT able to offer RCGP courses free to pharmacies.
July and October: open days and invitations to meet to see facilities and service. May be possible to plan an LPC Roadshow with Gordon Morse (respected local clinician) and individual team leaders.
Strategy for those who have been on maintenance doses for long periods: rarely just one problem - changing culture for the client, offering options. Not planning to destabilise. High/low intensity treatment paths. If moving towards goal, high = access to all services; low = priority is to keep them safe. More support so people can be helped alternatively (peer mentors etc.), gain confidence to move on from prescribed drugs.
April 2013: Slow start/transition phase – new numbers to be used however.
Briefing packs will be sent out to community pharmacies etc for signposting.
Newsletter: introduction and contact points - team leaders, numbers, addresses. Include standard template prescription which will be used locally.
‘Border’ areas – clients should have access to both services, overlapping. / DW, PL
PharmOutcomes (Guests from Substance Misuse item were joined by Cherry Jones and then Julie Northcott)
a) What can it do?
FC presented slides (Attachment 6)
Re DT communication issues with pharmacies – functionality to message all relevant providers, read receipts, action receipts.
Can set up reports for both providers and commissioners – how they’re doing in real time.
Local admin of services (can start with a library of services or create from scratch). Benefits on both sides.
b) How do we fund it
LPC willing to be lead commissioner, share out parts of financing proportionally to other stakeholders.
Costs: great value. Future proof. LPC can’t claim back VAT but do get a discount.
Sexual Health Swindon – update
(Guests Julie Northcott, Paul Clarke, Chris Phillips)
a) JN presented ‘LPC Briefing on Sexual Health LES – plan for Swindon 2013/14’.
b) EHC clients should all get ongoing support. Safeguarding/referral vital especially for under 16s.
Re. extending to more pharmacies: 2013/14 seen as a consolidation year. Perhaps extend later.
Re-organisation Update
a) Area Team
CP – In short term activity likely to be the same. SLAs for public health servicesnot known as Enhanced Services any more.
Office space at Bewley House in Chippenham, 45 staff. Nicky Holmes head of primary care. Still in a state of flux.
ODASD not renewed after April in Wiltshire. Continue to reimburse medicines if go out of date within a year after April. Area Team to handle rota, control of entry.
Health and Wellbeing Board to handle PNA (Pharmaceutical Needs Assessment).
Smartcards = CP’s department still handling.
b) Swindon CCG
Jim Sinclair still handling smartcards.
Small – 19 staff in Swindon. Will rely heavily on CSU. Meds optimisation running through it all.
Gentlemen’s agreements on continuing current SLAs for time being.
Fiona Davenport – handling Community Pharmacy matters in Swindon for Area Team.
c) Impact on EPS
Unknown if CCG or AT will be responsible. Needs strong lead to push forward.
Issues re direction to be reported to PALS
Pharmacies will get 8 weeks’ notice of GP intention to start issuing prescriptions by EPS. Begin nominating at that point.
d) Other current issues?
Henrik Kwiatkowski now with with CCG team
Liz Mearns – Area Team Medical Director has controlled drugs responsibility (Accountable Officer)
Pre Acceptance Audits for waste end anticipated to be required in pharmacy from July? CP to send info to FC
All NHS staff now have NHS mail – nhs.net (not wiltshire.nhs…)
Certificates of conformity should still be sent to Toni Lloyd in Swindon (and CCG Medicines management team in Wiltshire).
PC to send a copy of letter going out shortly to pharmacies detailing relevant contacts to FC for web site. / CP
PC
Meeting returned to “closed session”
Chief Officer’s Report
a) Recent work and meetings
Keeping track of who is where in new NHS organisation, looking for venues: next meeting will be at the Sports Pavilion at Beaverbrook in Calne – on bypass - 18th April.
b) Current issues and negotiations
PharmOutcomes: Swindon & Wiltshire LPC agreed unanimously to buy the new system as a commissioner.
Wait until after April before we start pushing re EPS.
Speaking to Paul Clarke in Swindon about potential emergency supply service.
MDS – Wiltshire Social Services visiting us in April to discuss
c) Meetings and training events for members
Finance for LPC members – RT attending in April.
Contract Application Responsetraining - FC and NT attending.
Members seminar in June – all LPC members who haven’t yet should go.
Commissioning seminar – 16 May. FC requested volunteers to attend. NJ has sent off for distance learning pack, FC to ask for feedback. / FC
Treasurer’s Report
£53,451 in main account
£22,004 in CVD account
Groupwork – Podcast storyboards
Jon Phillips, Robert Townsend / Exhortation to provide Advanced Services (recorded)
Kantha Moodley, Zoe Pearce / Services on offer at the different types of pharmacy – High Street, Health Centre, Supermarket, “Healthy Living Pharmacy” others.
Shaun Hill, Paul Hedge, Kaushik Patel / What goes on behind the scenes – dispensing a prescription
Jane Goodhew, Charlie Wu, Chris Shields / Ideas to describe the repeat Prescription journey – from request to dispensing (with and without EPS and managed repeat schemes)
Any other business
FC standing for RPS again: please vote.
JP declared intention to chain himself to the Prime Minister’s house if NMS is cancelled in April.
JP requested that FC work on an Alcohol Intervention project to propose to Maggie Rae. / FC