Minutes of the Meeting held Tuesday 7th July 2013 at the Showroom Lincoln LN6 7QW

Chairman

Mr Paul JenksLPC Chairman and LPC Member CCA rep

LPC Members present

Mr John McKerracher LPC Member AIMp rep

Mr Les GuiblinLPC Member CCA rep

Ms Penny MosleyLPC Member AIMp rep

Mrs Christine BassLPC Member CCA rep

Mr Paul McGorry LPC Member CCA rep

Mr Stephen HughesLPC Treasurer and Member AIMp rep

Mr James SoarLPC Member CCA rep

Blazej Jasnowski, LPC Member Independent rep

Marc Brooks LPC Member AIMp rep (Attending for afternoon session)

Mr Chris KennyLPC Member Independent rep

Mr Jon NormanLPC Member CCA rep

Mr Adrian NicholsLPC Member CCA

In attendance

Mrs Avril McDermottLPC Chief Officer

Apologies

Apologies had been receivedfrom, and rep Mr Alastair Farquhar, LPC Vice-Chair and Member AIMp rep and Mr Ramesh Gohil LPC Member Independent rep

Declarations of Interest

  • There were no declarations of interest.

Minutes from LPC meeting14th May 2013.

  • The minutes wereaccepted as a true record and approved by the committee.

Matters Arising

Palliative Care

  • Meeting has now taken place, A Farquhar and A McDermott met with Petra Clark on 6th June and presented the LPC paper.
  • Requested that those collecting meds should be given priority and not be required to wait in the pharmacy – a primary phone call to the pharmacy will further facilitate this.
  • In the unlikely event that formulary stock has been used and not replenished, pharmacy staff will locate available stock and signpost the patient rep accordingly. Again a phone call phone call to the pharmacy will facilitate this approach.
  • The LPC will draw up a flow chart outlining the roles and responsibilities for all involved.

Feedback from meeting with Assistant Director of Public Health (AD)

Enhanced Services

  • NHS England continues to manage enhanced services processes on behalf of Local Authority. LCC still make the payments however and it was stated that first payment run had gone well.
  • LCC is undertaking this year a review of all enhanced services by HWB themes.
  • Lifestyles – Terri Roche
  • Children and maternity – TBC
  • Social Detriments – Tony McGinty
  • Effective Healthcare and Chronic Disease management – Robert Wilson

It was agreed that LPC would be contacted to input at the relevant stages of the review cycle.

  • LPC were asked to submit a paper outlining community pharmacy potential to work in partnership with LCC in delivering the PH outcomes strategy
  • Key areas outlined for pharmacy involvement were smoking cessation, health checks, sexual health, flu vaccination healthy eating and alcohol advice, and substance misuse. PH is keen to improve HIV testing, introducing a same day results approach. Other more challenging areas would perhaps be legal highs and identifying domestic violence.
  • AD was keen to emphasise that the chosen route for re-commissioning would be as simple as possible and should not be a barrier to pharmacies taking up services
  • AD was keen to gauge the LPC willingness to act as a Programme Management Agency with regard to the pharmacy enhanced services.

Pharmaceutical Needs Assessment (PNA)

  • Responsibility of Chris Weston Public Health consultant.
  • Whilst it is recognised that the local authority have until 2015 to publish a new PNA the LPC urged them to commence as soon as possible and this could be a long process. LPC requested to be involved in the PNA re-write, but were informed that LCC buys pharmaceutical advice from GEM. LPC reps questioned GEM’s grasp of Community Pharmacy matters and depth of knowledge.

Patient Group Directions (PGDs)

  • LCC take the view that PGDs will be updated in a timely manner and this is one of the services they are purchasing from GEM. LPC again advised reassurance of Community Pharmacy expertise and representation, advising that the Chief Officer had recently been called upon to sign the Chlamydia PGD on behalf of Community pharmacy.

Public Health Campaigns

  • AD agreed with the LPC view that an improved approach would be to implement just 2 or 3 campaigns per year which were better coordinated and jointly planned to meet elements identified in the local PH strategy.
  • It was agreed to adoptthis approach from 2014 onwards.

Health and Wellbeing Board (HWB)

  • One of the main focuses of the HWB is to be an Integration Pioneer under the recently announced government proposals and Lincolnshire HWB is to register an Expression of Interest. LPC is to contact Admin Secretary to HWB to offer our assistance,

Healthy Living Advice

  • LPC will work with PH colleagues to ensure Healthy Living messages in pharmacies can feed back to the PH processes. There may be scope to develop Healthy Living Pharmacies in due course.

Report back from PSNC Secs and Chairs meeting

  • The LPC Chairman had attended the full day meeting in London and generally felt that it had been a waste of his time and LPC resources in sending him, . Nothing new had been announced or shared on the day and was generally a discussion forum.
  • The LPC recognises that reps sometimes do attend meetings of this nature, where it can be the odd piece of information or contact made during the day which can prove beneficial for the committee. However it must be noted that LPC pay £95 per delegate to attend the Secs and Chairs meeting.
  • PSNC appeared unwilling to share information with LPCs.It is noted that there is some “behind the scenes” activity in the political environment and representation bodies for pharmacy at this time and perhaps this meeting was not appropriately scheduled
  • The LPC will give due consideration as to whether it will send a delegate to next year’s meeting.

Working with Leicestershire LPC

  • Now that the Area Team (AT) covers both Lincolnshire and Leicestershire it was agreed that closer working with Leicestershire LPC will prove beneficial to ensure there is no duplication or contradiction from the LPCs to the AT.
  • It was agreed to seek a meeting with representative from Leicestershire LPC.

LPC Finance

Update

  • The LPC account currently stands at £39 689 – 01. Insurances and 2012/13 corporation tax have been paid.
  • 116 contractors are currently paying the levy. AMcD is meeting with Area team reps later this week and will raise the matter of identifying non-payers.
  • A prepared balance sheet prepared for year 2012/13 records a £4000 increase in spend for the committee over previous year.
  • It was agreed that the LPC treasurer should have a designated laptop for LPC business.
  • The committee will set up and implement an Assets Risk Register in line with the advice given at the PSNC finance seminar

HMRC feedback and Expenses Policy

  • Concerning the direct claiming of time for LPC business the HMRC technical team have advised that as a representative committee Individuals cannot claim for time, this has to be done via their employers.
  • The expenses policy to be amended accordingly. LPC treasurer will inform PSNC regarding this advice.

Expenses

  • LPC members expenses claims to be submitted and paid at least every 6 months.

NHS England Policies

  • Following a FOI request from PSNC, LPCs now have access to the NHS England policies relating to community pharmacy at
  • Policy areas cover Advancedservices; Dispensing doctors; Inclusion in a pharmaceutical list on fitness grounds;Market entry;Monitoring;Opening hours;Performance management and Rurality
  • At this time it is noted that many of the policy links are not working, but the LPCs are advised that this will be resolved soon.
  • The LPC notes that the Monitoring processes are requiring ATs to send out the Community Pharmacy Assurance Paperwork (CPAF) questionnaire to contractors in June this year. The LPC has not been advised of this matter and no paperwork has been received by pharmacies, The LPC further notes that the procedure calls for a 14 day turnaround from pharmacy contractors.
  • Pharmacy Terms of Service do not require a pharmacy to complete CPAF paperwork, yet the LPC notes that the documentation contains a note that non-return will be considered a breach.
  • AMcD will establish when and if the area team are intending to send paperwork to contractors and also to raise concerns regarding the time frame for return and breach implications.
  • The LPC notes that the policy on rurality includes a new application form for serious difficulty and the process now requires the patient’s GP to add information and submit the request on behalf of the patient.
  • Other policies and processes will be reviewed as the links become established.

Feedback from PSNC Procurement Seminar

  • AMcD had attended the seminar and provided a quick review of the slides and feed back to the committee of the main point from the day. The slides will be loaded on to the LPC website.
  • The day had considered the commissioning cycle, the processes for commissioning pharmacy services and appeal processes. Consideration had been given to the differences between full tendering processes and AQP. The afternoon session had looked in detail at the PH standard contract which is not mandatory, and the NHS Standard contract which is required for all NHS services.

Pharmacy Applications update

  • In line with the single operating model for NHSE Area teams, LPC and LMC reps no longer attend the meetings in an advisory capacity where applications are considered. The LPC is no longer being supplied with a copy of the AT applications status. AMcD tabled an LPC version of the data which must be recognised as only reflecting the information shared with the committee and will therefore not have details of recent applications or decisions.
  • The LPC notes that the AT continues to grant exemption applications still outstanding from the 2005 regs. but these are now coming to an end.
  • The only outstanding application notified to the committee at this time is a”relocation with no significant change” application for a pharmacy which had previously temporarily relocated, to move back to the original premises. The LPC considered this matter andcould find no concerns relating to the application.

PACEF Update and feedback from Modernising Pharmacy Careers

  • CB as LPC rep on PACEF reported to the committee that there had been some positive feedback in that GMC guidance had advised that Pharmacy MURs are good and should be incorporated into treatment pathways.
  • CB had also attended the Modernising Pharmacy Careers event on behalf of the LPC. It was reported that a workforce strategy was being developed into which the LPC would have input. The process supports the work of the LETB and Health Education England- East Midlands.
  • The stated aims are to establish a workforce which meets the needs of patients and provides innovation.
  • It is recognised that there is no information relating to the numbers of pharmacists currently working in the region. The LPC notes that contractors may be able to supply such information if asked,

LPC Website

  • The new format of both the LPC and the PSNC website will undergo a “soft launch” on 17th July with the full launch on 24th July.
  • The LPC were given a preview of the new website which seems to be an improvement on the existing one. However full access was difficult as links were not working very well.
  • It was agreed to revisit this at the next meeting when hopefully the site will be fully installed and operational.

IT Matters

IG Toolkit Version 11

  • There are no changes to the latest IG toolkit and it just needs to be resubmitted as per last year. There are no LPC actions on this matter.

EPS

  • There are still no live EPS GP practices in Lincolnshire. However the LPC is fully aware that most G Ps now have compliant systems and could switch to EPS2. We continue to keep a watching briefs and work with the AT to ensure laid down procedures will be followed in the event of a practice going live..
  • Pharmacies should be encouraged to continue to collect EPS nominations from patients.

NHS.net emails

  • The LPC will once again try to establish NHS.net emails for the LPC office and for committee members. Also to roll out to pharmacies.
  • AMcD will discuss with AT who now has responsibility for NHS emails.

Working with CCGs

  • The committee worked through the PSNC guidance on working with CCGs and agreed that the LPC is fully aware of the information outlined in the briefing and is working in the manner outlined.
  • It was agreed that the next LPC meeting would work on producing a briefing document for CCGs and update the strategy accordingly.

LPC document to feed into LA Review

  • The earlier notes on the meeting with the assistance director of Public Health outlined a request for a document detailing how community pharmacy is able to support the Local Authority in delivering the PH strategy.
  • The bulk of the remainder of the meeting focussed on the content of this document. Once completed the document will be sent to LCC. A copy will be made available on the LPC website/
  • The LPC needs more information on the AD’s interpretation of a programme management agency and the LPC needs guidance as to whether this is allowed within the constitution of the committee. PSNC to be contacted for guidance.

MDS/Discharge processes

  • The LPC will re-visit the earlier work on MDS with a view to making changes to fit the new NHS agenda

Flu Vaccines

  • Discussions will be opened with the Area Team with a view to implementing a commissioned community pharmacy based NHS Flu vaccination service.

Signed ...... Date......

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