LPC – 25 February 2014
ADOPTED MINUTES OF THE
SHEFFIELD LPC MEETING
held on
TUESDAY 25 FEBRUARY 2014
9.30 am – 5.00 pm
Jordanthorpe Medical Centre, Dyche Close, S8 8DX
ATTENDANCE
MEMBER
/ 29/11/12Day / 20/02/13
Day / 30/04/13
Day / 02/07/13
Day / 25/09/13
Day / 27/11/13
Day / 25/02/14
Day
Nominated/ Appointed Contractors
David Russell (Co-op) (Chair)
/ + / + / + / + / + / A / +Ravi Mohan (Vice Chair) / + / + / + / + / + / + / A
James Wood (Secretary) / + / + / + / + / + / + / +
Brigid Murphy (Treasurer) / + / A / + / + / + / A / +
Crispin Bliss
/ + / A / + / + / + / + / ABrigitte Waring
/ + / A / + / + / A / + / RCompany Chemist Reps
Emilia Stelmach (Boots) / A / + / A / + / + / + / AOsama Ali (Boots) / + / + / + / A / + / + / +
Matt Webster (Co-op) (Appointed June 2012) / + / + / A / + / A / A / +
Luke Downs (Lloyds) / + / A / + / + / + / + / +
Lynn Murrie (Lloyds)
(Resigned 11/2013) / + / + / A / + / + / R / R
Terry Relf (Lloyds) / + / + / + / A / + / + / +
Greg Campbell (Lloyds)
(Appointed January 2013) / N/A / A / + / + / + / + / +Laura Reed (Rowlands)
/ + / + / A / + / + / + / +Adam Yates (Weldricks)
(Appointed December 2013) / N/A / N/A / N/A / N/A / N/A / N/A / +Garry Myers (PSNC Rep)
/ + / A / + / A / + / + / +Susie Coates (LPC Support Manager) Appointed November 2012 / + / + / + / + / + / + / +
Observers
Richard Oliver (NHSSCCG)
/ + / + / A / N/A / N/A / + / +Kevin Clifford (NHSSCCG)
/ A / + / A / N/A / N/A / A / APeter Magirr (NHSSCCG)
/ + / + / + / N/A / N/A / + / +Tony Cracknell (Lo’s)
/ A / A / + / N/A / N/A / N/A / N/A+ = PRESENT A = APOLOGIES FOR ABSENCE R = RESIGNED N/A = NOT APPLICABLE
Action1. / Apologies
Apologies for absence are as noted on the attendance sheet.
2. / Welcome
Adam Yates from Weldricks, Darnall was welcomed, with around the table introductions, to his first meeting since his appointment in December, in place of Ravi as an AIMp member, who was no longer working for Weldricks but remained Vice Chair to the end of this Committee, pending the elections. It was noted that Brigitte Waring had left Woodhouse Pharmacy and therefore resigned from the LPC. Members agreed that as LPC elections were currently taking place for the new Committee from 1 April, the outcome of that should be awaited, rather than fill the vacancy for such a short period of time.
3. / Committee Corporate Governance
David drew members’ attention to the Corporate Governance arrangements, together with declaration of interest, incorporating details about competition law asking members to sign if appropriate. / ALL
4. / Minutes
Minutes of the meeting held on 27 November 2013, were agreed as a correct record and would be signed once considered with CCG representatives later in the day, for their part in the last meeting. / DR
5. / Matters Arising:
a) Guide to Contractor Payments – James and Susie were yet to complete this piece of work, although payment mechanisms appeared to be more stabilised.
b) Electronic Discharge – James outlined the changes that are to take place under the NHS Mail 2 Project, which was still on going and would ultimately involve automatic notification to pharmacies electronically, of patient discharges. He went on to suggest that it might be useful in the meantime for community pharmacy through the ‘Call to Action’ campaign, to push locally for access to relevant secondary care electronic record service within STH, which holds discharge details and outcomes of tests etc which can be pulled down with the appropriate access rights.
c) Minor Ailments Scheme – It was noted that for the time being the CCG had elected to leave Head Lice on the scheme. This would be discussed with CCG representatives later in the meeting.
d) NHS 111 / Emergency Supply – James advised that the CCG had purchased a PharmOutcomes licence to operate the pilot Emergency Supply service via NHS 111 and given access rights to he and Susie. There is now also an intention to include the Not Dispensed Scheme from April to make the process of claiming, more streamlined and efficient. The system will also generate the letter to the GP and calculate the claim. Contractors will have a better idea of the payment due in advance. / JW/SC
JW
6. / CCA Reporting: Laura had completed the last report and Greg offered to report on this meeting to the CCA. / GC
7. / Secretary’s Contract: Members agreed that the updated contract, once finalised, could be ratified via email. / JW/SC
8. / NHS 111 / Emergency Supply: James reported on the pilot which had been established just before the Christmas and New Year holiday, intended to operate from Wicker Pharmacy and Lloydspharmacy, Alderson Road. Lloyds had experienced some technical difficulties with regard to NHS mail for Summary Care Record access but Greg confirmed he hoped these were almost resolved so that they could have the service up and running for the Easter holiday. It was agreed that if Lloyds could get the system working too, this would bode well for further roll out across the City to more pharmacies both independents and multiples. This would be discussed further with CCG representatives later in the day.
Clearly the CCG would be concerned about the costs involved, but once some evaluation over a reasonable period of the pilot had been done, it was hoped this would confirm it as a cost effective service to commission. James gave a demonstration of how the service worked via PharmOutcomes.
9. / PSNC Briefings: James ran through the list of briefings received since the last meeting highlighting those of particular significance.
10. / Community Pharmacy ‘Call to Action’ (CTA):
James ran through the presentation he had given at the last City Wide Update Event and provided members with copies of the four questions set as part of the CTA consultation. Dave reported on a recent meeting with the CCG and NHS England about urgent care that had debated this initiative, where they were keen to encourage novel ideas of how community pharmacy could help keep patients out of hospitals. They were strongly supporting the CTA event scheduled for 4 March at Tankersley Manor, with Dr Richard Oliver leading one of the debates to be held.
There had been a suggestion of commissioning community pharmacists to spend some time in local general practices dealing with patient discharges and ensuring medicines reconciliation, with follow up offered within the pharmacy as additional support. The CCG Medicines Management Team had undertaken some of this work but was occupied with prescribing efficiencies. There was also a suggestion of referring patients on treatments to Independent Pharmacist Prescribers in order to stop inappropriate A&E attendances. Funding could be sought from Health Education England / LETB. Members acknowledged that this was a real opportunity for Sheffield to be a ‘trail blazer’.
Members discussed the difficulties associated with freeing up pharmacist time for a more hands-on patient approach and the ‘chicken and egg’ situation of needing to offer services before you can market them to create an income. Consideration was given to skills pharmacists could utilise to assist patients that would actually save GP time, ie asthma, diabetes and BP checks. This could create an incentive for surgeries and pharmacies to work more closely together. Adam suggested HLP data collection regarding referrals to and from pharmacy etc could be used to help demonstrate community pharmacy effectiveness.
It was agreed it would be useful to ask patients what they actually wanted by advising what is available; a patient questionnaire could be linked to PharmOutcomes for PSNC to evaluate.
Further consideration of ‘POM’ to ‘P’ should be made for such as antibiotics (via national PGDs) – there were regular requests from patients for these to be available on the Minor Ailments Scheme. Accreditation should be reconsidered for such as EHC where pharmacists provide the same as on a private basis already and are clearly competent. Perhaps consideration could be given to having the right number of pharmacists in the right places and whether consideration should be given to federates as a contract vehicle. There should be more alignment between the GMS and community pharmacy contracts, linking payments for such as ‘not dispensed’ with GP QOF targets. Perhaps pharmacists who were more comfortable with straight dispensing, could refer on to others specialising in additional services and they maintain a main dispensing role. The skill mix within pharmacy is very important and ACTs could take on more responsibility.
Brigid suggested local posters could be devised to use in schools and community centres to promote pharmacy services. The public needs to think of pharmacy first rather than ‘Dr Google’! or google should directly link to pharmacy as a referral pathway. Greg queried about the awaited, longer opening hours of GP surgeries, which could be supported by pharmacies, this may link to GP Associations bidding for additional funded hours.
James pointed out that community pharmacy is the third largest health profession and that this should be more fully utilised and promoted by political bodies and health leaders.
Pharmacies should have better access to patient records (locally via the ‘ICE’ system at STH) for blood test results etc.
Procedures could be put in place on patient discharge for direct referral to community pharmacy for on-going management. This would benefit from funded home visits. Skype consultations could be undertaken where appropriate.
It was important to look at removing some of the current barriers that prevent more innovative work taking place for such as MURs outside the pharmacy, which currently require individual written requests. Careful consideration should be given to processes and protocols that take up unnecessary time for pharmacists. GPs already rely on pharmacists’ advice regarding medicines and this should be highlighted. Pharmacists are involved on a daily basis in what boils down to commissioning decisions on behalf of NHS England. NPSA reporting is cumbersome and could be refined to be more user- friendly and effective.
Laura referred to a scheme in Manchester that she had been involved in which involved referral to community pharmacy and access to records.
It was regarded as important to ensure ready access to EPS2 and for smart card problems to be resolved without delay. Greg referred to a problem he had been experiencing with his smart card that had been on going for several weeks and Susie agreed to follow this up with the Area Team. / SC
11. / PSNC Update: Garry highlighted the most recent issues being taken forward by the PSNC and gave an updated overview of current negotiations. He advised that the strategic framework would now be decided on the outcome of the Call to Action. Garry pointed out that PSNC considered Business Continuity Plans to be exempted nationally for pharmacy due to waiting for the funding settlement to be determined. He considered any local commissioning would have to link to NHS England’s requirements.
12. / City Wide Events – Update: Susie reported on the events which had taken place and her various attempts to follow up on a recommendation for Conflict Resolution training. Members reconsidered priorities and decided the following topics would be useful to cover, with dates to be determined:
1) Re-launch of the Not Dispensed Scheme – late April
2) Why Talk Cancer – recent promotional material sent through via HLP link. Post meeting note: This option found to be too expensive and set up to train a maximum of 20 attendees.
3) EPS – UIM training and smart card problems resolution (via CSU)
4) Contractual Framework changes, including contract monitoring and GPhC Inspector Visits, via NPA speaker (likely October)
5) Re-launch of Care Home Service, including a clinical intervention (TBC)
13. / Leadership and Development for new LPC: James reported on a meeting he and Susie had recently with Tony Woods of Significantly Consulting regarding a Development Day for the new Committee. It was agreed that this would be a useful, motivational tool for the development of the new Committee and would form the main part of the first meeting on Monday 7 April.
14. / LPC Priorities:
· NHS CB / NHS England
LPN – James confirmed that the LPN had been formally established and appointments to the Network made as follows:
Peter Magirr – Chair
Richard Harris – Training
James Wood, Tom Bissett, Nick Hunter – Pharmacists with expertise
Damian Child – Chief Pharmacist, STH – Secondary Care Specialist
Richard Oliver – GP Representative
Louise Brewins – Public Health Lead – Sheffield City Council / PNA – works with colleagues across South Yorkshire
Healthwatch Sheffield – due to appoint
NHS England Area Team – Victoria Lindon / Matt Auckland
It was noted that the Pharmacy LPN had attracted more interest for membership than the other LPNs, which was most encouraging. The LPN Priority Plan had been circulated for information. Their first main task was to co-ordinate the Call to Action Event. David pointed out that various networking groups would help support the core reference group.
Community Pharmacy Flu Vaccination – James reported on his recent meeting with Fiona Jordan, Public Health England, Area Team. 69 Pharmacies across South Yorkshire had offered the service, with figures available as at 1 January 2014 showing 2,160 vaccinations given. Sheffield had 32 pharmacies participating with 1,154 vaccines delivered. Fiona was really pleased with the uptake in pharmacy acknowledging that the service had not really commenced until the end of October. Evaluation so far indicates the majority were given to under 65 at risk groups / patients who would not have gone to their own GP. 30% were generated through active interventions from pharmacy staff. Discussions for this year’s service have already commenced, so hoping to have everything in place much earlier.