Minutes

Swindon and Wiltshire LPC Meeting 17 July 2014

Marlborough Golf Club, Marlborough Common, Marlborough

Item / Actions
1.  / Present: Charlie Wu, Fiona Castle, Maz Stapleton, Andrew Hobson, Lis Jardine (notes), Paul Eyles, Sam Ghafar, Robert Townsend, Kaushik Patel, Nick Jephson, Paul Hedge, Rhys Martin, Chris Shields
Apologies: Niamh Sands
Declarations of Interest: MS not a member of the RPS but is GPhC registrant
2.  / Minutes of previous meeting
Accuracy
The minutes were accepted as a true record
Items for redaction from publically published minutes
INR funding costings
Matters Arising
- Proposed extra service: monitoring of patient at fifth repeat of batch script, report back to GP. May not be enough added value to justify a fee.
- Flu: Area Team have complicated commissioning arrangement and are afraid of upsetting GPs dominant in rural areas. Survey result was 40% willing to offer, 30% ‘maybe’ if funding/training needs met. Marketing and targets by large companies drive private service.
Action: Need to feed back the survey data via newsletter. Encouragement to get more willing to offer service. Highlight the good spread across region to County Council: easily access a flu jab via pharmacy anywhere. Support signposting. / LJ
FC
3.  / Officers Reports
Chairman’s report
GPhC meeting
Fiona gave a good presentation, Inspector came across very well. 46 attended. Newsletter article reiterating positives:
·  Results may be published if you’re inspected after September
·  Looking to see pharmacies consistently showing due diligence.
·  Blow your own trumpet.
·  Can call to rearrange visit if pharmacist away, or if distraction may be dangerous
·  Useful to read evaluation sheet
·  CS inspection story. MS review of event.
·  Another event in Westbury area? If there’s enough support… for September/October. Publicise Southampton event too.
Chief Officer Report
Constitution review
Main issues include elections and levy. Fiona noted difficulty in seeing how pharmacy shares are calculated or checking that we’re getting what is being collected on our behalf. LPC may in future be obliged to submit budget to justify levy. Proposal that levies are collected by AT region - unpopular.
Proposed changes to constitution were discussed: see Appendix 1 for issues FC raised. The following were agreed to feed back to PSNC.
4.2 – good idea but needs more positive wording.
5.10 & 5.11 – Places for AIMp will be calculated differently. Loophole needs to be pointed out, round down rather than up?
Section 5 needs a paragraph added: ‘members elected to sit on behalf of pharmacies not otherwise represented’.
5.8 – observer is not the correct terminology; non-member attendee?
6 – there is no point in specifying 3 months wait – ‘CCA will endeavour to nominate within 3 months’.
7.2 – Election organisation ‘as soon as possible after 1st Jan’ – better to say ‘not later than 1st January’. Remove references to 8% throughout. Also, should be able to use electronic means to nominate.
15.8 – quorum: needs clarifying.
Fit and proper person: accuser in any dispute should not be part of decision making group.
AGM – what would happen if contractors don’t approve accounts? / LJ
CS, MS
FC
4.  / Groupwork
Finance Sub-committee / Robert Townsend, Nick Jephson, Paul Hedge, Sam Ghafar
RT is setting up internet banking because many companies now wish to be paid by transfer rather than cheque (e.g. for healthchecks/diabetes project work). A second person will be needed to authorise transactions.
LPC members to get bank details and any references needed to RT nhs.net account, and how want expenses split between personal (travel etc) and business account.
LPC agreed that the administration fees for RT’s time (at normal rates) will be billed from CVD/diabetes account.
Need to coordinate LJ pay/contract with Glos. Contingency plan for August (SW pay full salary, Gloucestershire then pay a full month after that).
Budget: many items not relevant yet hence current surplus. RT will modify format through year as comments/changes occur.
CPAF responses analysis / Chris Shields, Rhys Martin, Maz Stapleton, Andrew Hobson
Anonymous data causing issues – paper recording not best format?
Recording is being done, but needs to be incorporated into system requirements to allow for anonymised reporting.
Reissue child protection officer details on a regular basis
Action: could Area Team circulate a signposting guide to cover most of the issues?
COPD Proposal / Charlie Wu, Kaushik Patel, Paul Eyles
Readmission rates for COPD high. Intervention needs to be done robustly, within 48 hours of discharge; may need to visit at home.
1.  Reduce admission in first place: rebrand existing services into COPD MUR+. May not be sufficient to differentiate from existing MUR.
2.  Simple service - telephone call to check they have sufficient medicines? Possible PharmOutcome system linking discharge team with pharmacy.
3.  London Domiciliary MUR service - rate good. Ask if we can see business case? Would need pharmacists to have CRB check, patient authorisation form. However some GPs have new care plan for high risk 200 patients, to see within 3 days. May duplicate work.
/ All
RT
FC
RM, FC
5.  / Think Pharmacy
Event planning
21st Oct: replicate successful Oxford model in Trowbridge, based at Bridge House with tour of Lloyds, Lauder & Gamlin, and Boots care home hub. Invitation to be sent to all commissioners, Public Health, CCG representatives, Councillors/Mayor, MP, Wiltshire Times etc. at beginning September.
Will need three tour guides, NJ presentation (with case studies), tour hosts at pharmacies. CS, MS volunteered as tour guides.
Opportunity to show potential, e.g. other services you could commission…. Presentation and handout on web site. Possible Tweets. / FC, LJ
6.  / Strategic Plan/Manifesto
May benefit from index and from hyperlinks to more detail on LPC website.
Committee photo (taken by LJ)
Vision statement ideas: accessible, affordable first port of call for healthcare; pharmacy first for healthcare in the heart of your community; trusted local expertise.
Priorities
·  Wider engagement with the wider NHS/integration into care pathway
·  Design, develop and deliver new opportunities
·  Maximising delivery
·  Engaging with all stakeholders, providing leadership and an ambitious voice for our contractors.
·  Support and advisory role.
Engagement with commissioned services
·  Supply support to deliver essential, advanced services *hyperlink*. Safe, accurate advice.
·  Advanced services: take out % target - encouraging and supporting as many as possible to engage. ‘Maximising’ commissioned reviews. Pushing for more national services- our feedback (minor ailments)
Local Commissioned Services
·  Support recognition of skills etc. (HLP).
·  Looking for new ways of expanding and augmenting services.
·  Support viable initiatives.
Developing opportunities
This is a 4 year manifesto – long term aims.
·  Support all evidence based types of services which meet the needs of the local population – for example we are exploring....
·  Develop opportunities and improving outcomes/managing outcomes.
·  ‘Perverse incentive’ = disincentive
·  List all current ‘lifestyle’ services or say ‘these could include’ with link to further info.
·  Continue to build the evidence base. Quality, evidence based, value for money, improved health outcomes. / FC, LJ

Appendix 1

Issues of Importance in Constitution review:

3.3.4 – To allow for the establishment or assistance of a body corporate.

This would allow involvement with the agreement of two thirds of contractors. However if at a later date contractors withdrew support a simple majority would be required to withdraw.

This may be important in the preparation of an annual budget – as any monies diverted to the body corporate would need to be appropriate. My concerns about a body corporate are not the structural form, but the costs and risks associate with substantial tenders. However this might be a more appropriate mechanism for holding monies as we do for the Diabetes and CVD projects

Various including 3.4.3

A number of terms introduced around collaboration with other committees – probably recognising that most committees have not been in favour of either federation or merger under existing proposals

3.5 “Fit and Proper Person”

See notes on document

4.2 Recognition

The comments state that the wording is supposed to start looking at potential recognition by other bodies, but sounds more negative than that.

5.10 and 5.11 – I don’t like the rounding rules suggested – Under them an organisation (eg AIMp) could be entitled to 0.95 of a member but not be successful. Would suggest a rounding of 0.75. We have a committee of 12. That is one committee member for each 9.75 pharmacies. AIMp HAVE 9!

Paragraphs 5.10 and 5.11 should be at the beginning of the section not at the end after observers

There should be a paragraph in section 5 to state that members shall be elected to sit on behalf of contractors not eligible to appoint.

Statement about representation across HWB areas inappropriate in section 5 in its current form – perhaps better to have a duty to encourage appointment bodies to consider geopraphical representation when appointing?

5.8 Is “observer” the right term to continue using here. Would guests or “non-member” be better?

Paragraph 6

What is the point of specifying 3 months to reveal identity if there is no action which can be taken if places are not filled.

Would it not be better to specify that CCA/AIMp will use their best endeavours to nominate members within 3 months of being informed of the formation of the committee or a vacancy arising?

Paragraphs 6 and 7 – does this mean that the committee does not reform each 4 years, just that the elections take place? Do appointed places roll over. That is how it reads

7.2 – The delay until 1st January is a pain – can it specify that an election process can start as soon as the number of appointed places to be taken up have been confirmed by those eligible to appoint, and not later than the 6th January

7.4.3 – should not make reference to 8%

7.4.8 – should not make reference to 8%

7.4.7 – would natural justice not give AIMp contractors the right to return to election if AIMp overall do not hold enough contracts to have the right to appoint

7.5 – the obtaining of physical signatures for nomination is difficult for contractors – can the constitution be written in such a way that the Returning Officer can support contractors in obtaining confirmation of the nomination and find a way of including electronic confirmation

15.5 – 8% rears its head again

15.8 – should this also include something about quorum not including the vacancy?

16 – This should include a provision that the NHSCB will inform the committee of the proper person to which such communications must be sent.

16 – highlight to the committee issues around the levy and budget

17.1 – would it not be better to incorporate 3.4.2 into this provision rather than having something stand-alone?

17 – Should it not specify that the member of the committee accused and if a member of committee is the accuser that both should be excluded from the committee decision on the grounds of conflict of interest?

18 – what would happen if contractors did not “approve the accounts” and what reason might justify withholding of such approval?

20 – it is only in the notes and verbal communications that it is clear that support for a Body Corporate is in the form of a loan rather than financial support. Can this be clarified in the wording?