MINUTES
An Open meeting of Bedfordshire Local Pharmaceutical Committee was held on Thursday 18th July 2013 at AstraZeneca’s Head Office, Horizon Place, 600 Capability Green, Luton, LU1 3LU.
Present: Members
Coll Michaels (Chair)
Samir Patel (Vice Chair)
Paul Fearon (Treasurer)
Farwaj Chaudhuri
Bhupendra Lakhani
Kiran Patel
Carol Rose
Mahesh Shah
Pinesh Patel
Satnam Butter
Sundip Sheth
Bedfordshire LPC Office
Gerald Zeidman (Chief Officer)
Ethel Shaw (PA to Chief Officer)
Guests
Jon Washington, Lead Outreach worker, Building Blocks Children’s Centres
John Hooper, Pharmacy Contract Manager, Herts & South Midlands Area Team
Heather Yuregir, Advanced Health Improvement Specialist, Public Health, Luton Borough Council
Belinda Ekuban, Chiltern Vale Locality, Pharmaceutical Lead, Bedfordshire CCG
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/Agenda Item
/Action
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749 / Welcome by ChairThe Chair welcomed members and guests to the meeting.
Apologies for Absence
Rupal Sagoo
Madhu Puvvada
Carl Rybold, Beds & Herts LMC Ltd
Anita Hazel, Public Health, Luton Borough Council
Emily Clarke, Health Promotion Practitioner, Luton Health Promotion Team
Carol Hill, Accountable Officer Luton CCG
Richard Jones, Head of Medicines Optimisation Luton CCG
Tess Dawoud, Medicines Management Pharmacist, Luton CCG
Healthwatch representatives from Luton, Central Bedfordshire and Bedford Borough
750
751 / Declarations of InterestNone
Minutes Approved
The committee approved the Open meeting minutes from 17th of May 2013 as proposed by Mahesh Shah and seconded by Carol Rose subject to the following changes –
· Mark Meekins name was incorrectly spelt Mark Meerkins as noted by John Hooper.
· LPN is an abbreviation of Local Professional Network and not Local Pharmacy Network as corrected by John Hooper.
752
/ Matters Arising from Minutes740 – Richard Jones has requested a meeting with the LPC at their earliest convenience.
753
/ NHS England Area Team updateJohn Hooper reminded contractors to complete the Community Pharmacy Assurance Framework (CPAF) documentation. The toolkit is a national one. John apologised for its size but added that everyone apart from new contractors should be familiar with its contents, so it shouldn’t pose any problems to complete.
Completion has a 28 day timeline but this year the Area Team is asking for completion in a three phased approach starting with Milton Keynes. Bedfordshire and Luton is expected to be September or October. It was noted that contractors can complete early, ahead of the official response timeline.
An electronic submission to the Area Team is the preferred method to complete CPAF but a paper submission will also be accepted.
Paul noted that completion of the CPAF pre-visit questionnaire documentation is not a requirement within the community pharmacy contract.
John reported on the MUR numbers for year-end. It was noted that within Beds LPC area there are a number of pharmacies that are providing more than the contractual number of 400 MURs yearly. John will confirm actual numbers.
ACTION: John Hooper to confirm actual numbers over performing pharmacies in the Beds LPC area.
Mahesh asked why pharmacists can’t over perform as it would be in patient’s best interest. John responded that there were set targets and as such they cannot be exceeded. The Area Team had no flexibility to increase the number of MURs that a pharmacy could carry perform.
John pointed out that there have been some instances of non-compliance in the requested submission of opening hours and pharmacy attendance returns for 100 hour contractors. The situation is currently being monitored closely. If the Area Team received a complaint regarding opening hours they would take appropriate action if an investigation was to confirm any breaches in pharmacist terms of service.
The new Pharmacy Services Regulations Committee (PSRC) met for the first time on 25th June 2013; the Committee would be meeting monthly, in future. The remit of the committee includes similar functions from the former PCT pharmacy applications panels and additional performance functions.
Gerald said that the LPC were unaware of the meeting date and they had received no meeting information or minutes. John will investigate why. It was noted that a second meeting is due on 23rd July 2013.
ACTION: John Hooper to investigate why the LPC were not informed of the Pharmacy Services Regulations Committee (PSRC) meeting.
Gerald asked John if he could confirm what he thought his team’s role was, if any, in supporting the Health Living Pharmacy initiative. It was noted that John fully supported HLP but he had concern regarding the consistency of HLP accreditation across the area. Gerald replied that Bedfordshire LPC is using the National Pharmacy Association’s (NPA) material and approach to ensure consistency.
John was asked if he had any news on the appointment for the LPN Chair. He confirmed that a job description had been published. He confirmed that the vacancy will be advertised and all LPCs will be made aware. He reminded the LPC that Area Teams are driving the establishment of LPNs
The Chair thanked John for his update.
14:30pm - Jon Washington joined the meeting and there was a 5 minute break for tea and refreshments. / JH
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754
/ To discuss:Luton Sexual Health Public Health Service Contract
Heather Yuregir confirmed that the revised Public Health contract had been sent to community pharmacy contractors. All payments within the contract are now in-line with Luton Public Health policies. Heather pointed out that there were no real changes from the old PCT enhanced service apart from
· Payments would now be paid quarterly
· Pharmacies to receive an enhanced payment for positive results for chlamydia screens returned to the laboratory for testing
Heather raised a concern regarding the low return rate of chlamydia kits in comparison to the number of EHC consultations carried out in pharmacies.
Mahesh wanted it noted that Public Health appeared to be unaware of the time and effort pharmacists put in to chlamydia testing. It is a very sensitive subject to broach with patients. Heather pointed out that in comparison to other areas return rates were very low.
Coll asked if Public Health could research why rates were low. He referred to his pharmacy were he put in a lot of time and effort but some patients just refuse to be tested. Satnam agreed and asked Heather to include demographics in future research.
Coll asked if Public Health would consider reinstating the retainer fee within the new contract, but Heather responded that currently there is no more funding available.
Mahesh pointed out that chlamydia testing required considerable effort for potentially no reimbursement of costs and that payment should be based on the overall tests results and not based just on positive results. Heather agreed that reward for payments based on positive results was unusual but pointed out that it is a national directive to pay providers in this manner.
Heather welcomed the LPCs comments and asked for feedback which she would then present to Public Health on the LPC’s behalf.
Mahesh asked for it to be noted that the policy of quarterly payments is against government policy for paying small businesses. Coll agreed and referred to a document he had obtained from the internet which stated that payments to small businesses should be within 30 days. Heather asked Coll to send the document to her so that she could investigate further.
ACTION – Coll to send Heather document and Heather to investigate the legitimacy of quarterly payments in relation to small businesses.
Mahesh requested that in the interest of data protection all information from individual pharmacies within the Sexual Health Activity Report should be anomymised data in future reports. He also asked that the guidelines are amended to represent the best interests of the patient.
Heather reminded the committee that there is Sexual Health training on 31st July which also includes an update from the LPC on the Healthy Living Pharmacy initiative. Currently 32 Luton contractors had indicated they would be attending.
Coll thanked Heather for her update. / CM/HY
/ Stop Smoking Services - Luton
Emily Clark had sent apologies before the meeting and Jo Meola hadn’t attended, so this agenda item would be carried over to the next meeting.
755
756 / Building Blocks Children CentreJon Washington, Lead Outreach Worker for Luton Building Blocks Children Centre gave a presentation and gave out folders with information about the centres and the work they carried out.
He told the committee that the centre is arranging health fairs to educate the public about the centres and the work they do in the community.
He pointed out that the centres are hoping to engage with pharmacies in relation to the supply of Healthy Start vitamins which are advocated by the centres.
Coll asked if the centres actually distributed the vitamins. Jon confirmed they didn’t. The centres made visitors aware of them and then it is up to the visitors to go on-line and print off vouchers which are then redeemable at the pharmacy.
Jon re-iterated that the centres are a one-stop shop for parents/carers with dependents who have complex needs.
Sam asked how frequently the health fairs are held. Jon replied that they try to hold them approximately every three/four months.
Sam pointed out that the HLP initiative could be something that the centres could tell the public about. Jon agreed and asked the LPC to engage with the centre Hub managers to create awareness.
ACTION: LPC to contact Building Blocks Centre hub managers and arrange meetings to discuss HLP.
Mahesh asked how referrals to the centres took place. Jon said that the public can contact their local centre who would then engage with them to understand their specific needs.
He confirmed that he was working hard to get the message out to the community about the centres and the work they did. He welcomed pharmacy signposting patients to them.
Coll asked the office to include an article in the next LPC Newsletter.
ACTION: Article on Building Blocks Children Centres to appear in the next LPC newsletter.
Carol asked if the centres are also available in Bedfordshire. Jon will pass all information to the LPC office
ACTION: Jon Washington to provide information to LPC office on Building Blocks Children Centres in Bedfordshire.
Bedfordshire CCG update
Belinda Ekuban said that Bedfordshire CCG had now completed their move to new offices in Wrest Park; everyone within the CCG is now based in the same building and had a new contact number. An email had been sent to all contractors advising them of the move.
She confirmed that Localities still had local offices and suggested the LPC engage with the Localities as many decisions are made at that level. Belinda advised the LPC to make contact with the locality managers.
Belinda pointed out that the CCG budget was tight and everyone had to work smarter. The Bedford Locality has two projects looking at inequalities; local pharmacists are involved.
Gerald asked if the LPC will be involved. Belinda replied the projects were local and there was no necessity for LPC involvement. Gerald pointed out that it would be useful for the LPC as the representative organisation for Bedfordshire community pharmacies to be kept informed of progress and to have the opportunity to comment on the initiatives.
Belinda agreed that she would ask the Localities to keep the LPC informed.
ACTION: Belinda to contact Localities and ask them to keep LPC informed of any projects involving pharmacists.
Belinda advised the committee of a new CCG initiative promoting self-care.
Satnam stated his pharmacies were already seeing patients who are coming in to the pharmacy with requests from GPs to purchase OTC products. Pharmacies were not being kept informed of this initiative.
Carol remarked that some of the requests were for an off-licence use of the medication. This was leading to confusion as the medication could not therefore be supplied over the counter.
Belinda agreed to investigate the issues discussed.
ACTION: Belinda to investigate the issues raised by Satnam and Carol regarding the Promotion of Self Care.
Belinda informed the committee that an LPC representative has been invited to be a member of the Bedfordshire Prescribing Committee. Sam voiced his approval and felt it is beneficial that the LPC has a strategic position within the CCG.
Bedfordshire Medicines Management issues
Belinda apologised to the committee that the Gluten Free and Nicotine Replacement Therapy claims for the present financial year were delayed. This was due to a new payment system being introduced which the CCG were unaware of. This has now been resolved. Gerald asked when pharmacists would be paid and Belinda replied within 30 days.
Belinda informed the committee that Ruth Sawford is retiring on 18th July therefore this is her last day. Ruth was PA to Andy Cooke and other CCG colleagues.
Belinda made the committee aware that there is now an integrated COPD team. It is community based, providing support to GPs and pharmacists. Contractors have been sent an email informing them of the new arrangements.
Belinda highlighted there is an update regarding vitamin D in the Prescribing Newsletter. Recommendations regarding vitamin D are also part of the Self Care initiative and therefore pharmacies may experience an increase demand in patients asking to purchase the vitamin.
Mahesh queried if a blood test was required to diagnose vitamin D deficiency. Belinda responded that Bedfordshire were not promoting blood tests for this purpose.
Kiran informed the meeting that the LMC have a subcommittee considering the necessity for blood tests to diagnose vitamin D deficiency.
Belinda advised the LPC committee that Bedfordshire CCG would like to arrange a joint event on the HLP initiative.
ACTION: Belinda, Sam and Gerald to arrange joint event for HLP.
Coll thanked Belinda for her update. / LPC Office
LPC Office
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758
/ Any other business of non-confidential natureBelinda mentioned that 20 pharmacies were involved in the blood glucose meter switch initiative. Within these 20 pharmacies they carried out 110 consultations and 99 patients switched.
ACTION: Belinda to send a written copy of the outcomes from the Blood Glucose switch figures to LPC office.
Date of next open meeting
The date of the next Open meeting would be held at AstraZeneca on Thursday 19th September 2013, commencing at 1.45pm. The LPC Annual General Meeting will take place at the same venue at 7.30pm. / BE
759 / Meeting closed at 4.15pm