Kent Local Pharmaceutical Committee
KENT LOCAL PHARMACEUTICAL COMMITTEE.
SIXTH ANNUAL REPORT.
Year ending March 31st 2009
committee membership
a) Ian Barrie Eastern and Coastal Kent 01304 205406
a) Tali Gill Eastern and Coastal Kent 07701000575
(Associate member)
a) Sunil Chopra West Kent 01322 663021
a) Pal Deol West Kent 07838 111171
(Associate member August 2007)
b) Geoff Garfield West Kent 07725 427426
a) Steven Kane West Kent 01474 323828
a) Lodi Lama Eastern and Coastal Kent 01303 892283
c) Taj Matharoo Eastern and Coastal Kent 01233 622245
b) Nuala McGibbon Eastern and Coastal Kent 01227 781189
a) Bipin Patel West Kent 01622 858287
a) Barrie Smith West Kent 07833 932433
b) Kit Kwok Tse Eastern and Coastal Kent 07917 267217
(Joined March 2008)
a) Deepak Wadhwani Eastern and Coastal Kent 01795 664601
b) David Onuoha Medway
b) Chris Styles Eastern and Coastal Kent
a) Representative of Independent Contractors
b) Representative of The Company Chemists Association
c) Representative of The Co-operative Technical Panel
OFFICERS
Chairman…………………………………………………..Barrie Smith
Vice Chairman…………………………………………….Geoff Garfield
Secretary and Chief Executive…………………………….Michael Keen
Treasurer…………………………………………………..Harriet Mearns
LPC Office :-
First Floor, Field Pharmacy, 11, Old Road, East Peckham, Kent TN12 5AS
Telephone & Fax :- 01622 873356
E~mail
REPRESENTATIVES TO KENT & MEDWAY PCT COMMITTEES
Please Note: Professional Executive Committees s became Clinical Leadership Groups and PCTs appointed members or are still in the process of so doing.
PCT LPC Strategy Group Prescribing Sub Committee
Eastern and Coastal Taj Matharoo
Eastern and Coastal Deepak Wadhwani
West Kent Barrie Smith (Chair)
West Kent Sunil Chopra
West Kent Bipin Patel Bipin Patel
Medway Mike Salter
West Kent Geoff. Garfield (Vice Chair)
OTHER COMMITTEES
K&M Drug and Therapeutic Committee Barrie Smith
Dartford Gravesham and Swanley Practice Steven Kane
Based Commissioning Group
Medway Medicines Management Group David Onuoha
Nuala McGibbon
West Kent Medicines Management Group Bipin Patel
Sunil Chopra
In addition the Chief Executive represents the LPC on:-
Kent DAAT Shared Care Committee (Services for addicts)
Pharmacy Performance Advisory Group (Performance Review Panel)
SECRETARY’s REPORT
After three years of reasonable growth, community pharmacy suffered its worst year under the current national contractual framework and saw a significant claw back of purchase profits enforced by the Department of Health, in the second half of the year,. The Pharmaceutical Services Negotiating Committee expects some relief for pharmacy contractors in March, when improved fees implemented in January this year will appear on the end of month statements and deliver the increase negotiated for the Global Sum. This however is too late for those who have had to take bank overdrafts to bridge this difficult time and pay wholesalers’ bills. Your Local Pharmaceutical Committee (LPC) took this up with the PSNC at the recent LPC Conference and actions are being taken to avoid a repeat of this in future years.
Last year was also the first full year after the Pharmacy Contract Implementation Groups ceased to exist and the Kent Collaborative was disbanded. As a result your LPC has been stressing the importance of regular communication meetings at all levels of management, with the three Kent Primary Care Trusts (PCTs) and that has been achieved to a significant extent. This has included quarterly meetings of the LPC and PCT, meetings with PCT medicines management representatives, some at the South East Coast Strategic Health Authority, meetings with commissioning directors and the arranging, with the South East Regional Forum, of a Practice Based Commissioning (PBC) Day at Effingham Park, to which senior PCT personnel and contractors were invited and which was part chaired by the Chief Executive of the South East Coast Strategic Health Authority.
We were disappointed during the on-going national reconfiguration of Professional Executive Committees (PECs) not to have a pharmacist appointed to the new committees (clinical leadership boards) from community pharmacy. This has made the other meetings all the more important and has thrown our focus onto PBC which is one of the most important changes for a number of years, to the way services are purchased by PCTs. We have written to all community pharmacy attendees at the PBC event and commissioning groups; we have a pharmacist appointed to one of the commissioning locality groups in West Kent and we are working towards more of these appointees on other locality groups.
As part of preparing contractor pharmacists for future enhanced services roles this LPC has commenced organising and running training sessions on relevant clinical areas of importance such as respiratory and asthma. We hope to continue this trend and involve you all in developing pharmacy’s future role in healthcare delivery in Kent.
The last year has also seen the appearance of a number of very important Government papers. These included the “Responsible Pharmacist Consultation,” “Devolution of the Global Sum” proposals and the Control of Entry debate that will result in changes in the forthcoming but delayed Health Bill. We have responded to these consultations on your behalf, attended the All Party Parliamentary Group hearings on these items and on the future of pharmacy and indeed the outcome of those hearings was a comprehensive report by the APPG that we believe will influence the Health Bill which follows the Galbraith Inquiry and is due to be published soon.
As the new national contractual framework was developed, it was intended that by now pharmacy contractors would be much more involved in the delivery of necessary enhanced pharmacy services; this has not happened and your LPC has been actively pressing PSNC to fight for us and bring us better services. If and when this happens we believe it is absolutely necessary that all pharmacies in the PCT area become involved in the delivery of these services. We are open to receiving communications from you with suggestions on opportunities for services that you can identify in your area.
We have also been negotiating and working locally with PCTs to get better services for pharmacy to deliver and we have seen the beginnings with a new framework for anticoagulation services in Eastern and Coastal Kent, a new smoking cessation service in Medway and an allergy service developed, as part of minor ailments in West Kent.
Next year will see the implementation of Release 2 of the Electronic Prescription Service and significant challenges for us all. Your LPC will continue actively working for you to make sure our concerns are heard before the system goes live and, as ever, we shall work on behalf of all pharmacy contractors in Kent on all matters that affect your contract.
On behalf of all the LPC committee I wish you a successful 2008/9.
CHAIRMAN’S REPORT
2007-8 has proved to be a challenging year, in many ways. Pharmacy contractors will remember it for that painful claw back of purchase profit through Category M; the start of direct to pharmacy wholesaling arrangements; the beginning of the end of RPSGB and of course those large retention fees for members.
Kent Local Pharmaceutical Committee is the recognised body that represent pharmacy contractors. The full potential that community pharmacy can offer NHS commissioners of services has yet to be fully recognised. Despite community pharmacy’s obvious strengths of easy access, long opening hours, convenient location and huge footfall we still only have one advanced service and local enhanced services have been slow to emerge.
During the course of the year the LPC has engaged in business meetings with each of the three PCT’s in Kent. Much of the momentum of previous years has slowed down due to the reorganisation within PCTs, change of personnel and the challenges of recovering from a financial deficit. Despite this, the majority of existing enhanced services have been retained and indeed often rolled out across the whole of the new PCT area.
In West Kent, April sees the re-launch of a Minor Ailments Scheme for hay fever that should help to free hundreds of GP appointments to more deserving patients. In Eastern & Coastal Kent, INR monitoring is the success as commissioners recognise that community pharmacy can offer this service at a time that is often more convenient with the patient. In Medway we look forward to a new payment scheme for enhanced services through the FP34 Schedule of Payments when other payment methods seem fraught with administrative problems.
The future of commissioning is with the newly formed Practice Based Commissioning Groups. The potential for community pharmacy in PbC was explored fully at a day conference at Effingham Park. We do now need ordinary pharmacy contractors to engage in this process and to become active in their local PbC groups. If this is of interest to you please contact the LPC office for help and direction.
The evidence of the need for Medicine Use Reviews is overwhelming. Patients do not use their medicines as originally intended by prescribers. Numbers completed are slowly increasing and contractors are encouraged to constantly review their work schedule to allow more of this valuable work to be achieved.
The LPC communication strategy continues with urgency and contractors can stay in touch with the LPC via the e-portal system of PSNC website. www.psnc.org.uk
My thanks as always goes to the staff of the LPC: Mike, Stuart and Harriet whose hard work in running an efficient office ensures that community pharmacy is well represented in Kent & Medway.
PRESCRIPTION STATISTICS 2007
There are currently 283 contractors (a net increase of 8 over last year) on the Pharmaceutical Lists of the three Kent PCTs
As payments for pharmacy services are paid three months in arrears the figures represent the period of the calendar year (January to December)
2005 2006 2007
Number of Forms 10,014,107 10,425,782 11,136,248
Number of Items 19,846,460 21,129,781 22,635,020
Average Items per Form 1.98 2.03 2.03
Total of Basic Prices £ 235,479,248 £ 245,598,648 £ 255,652,037
Discount £ 21,772,215 £ 21,757,768 £ 22,073,258
Net Cost £ 213,707,033 £ 223,840,880 £ 233,578,779
Fees £ 31,359,158 £ 36,188,733 £ 39,441,236
Average Fee £ 1.580 £ 1.71 £ 1.74
The number of prescriptions dispensed rose during the year but remuneration was substantially affected by the Category M claw back instigated by Government.
This adversely affected the purchase profits available to contractors and was a considerable drawback, coming at a busy time of year when wholesalers’ and other bills had to be paid.
We made representations to PSNC about this matter at the LPC conference. They are in discussion with the Department to ensure that in future, such actions will be taken in a timelier manner and a repeat of this debacle be avoided. The reductions in remuneration were not helped by the Department’s and PCT’s failures to deliver new services for pharmacy as envisaged within the national contractual framework. Your LPC made strong representations about this on your behalf, to PSNC. This is being taken up by the Department of Health and the White Paper (recently published) indicates that designated enhanced services are likely to be implemented although no timescale is indicated and the paper is open to further consultation.
PHARMACEUTICAL REGULATIONS COMMITTEE
This committee (the PRC) is empowered to investigate, conduct hearings and make decisions on behalf of the three Kent PCTs, about contractors’ applications for inclusion in pharmaceutical lists. The constitution of the PRC committee is being re-considered at the moment and this LPC wishes to see more non-executive directors of the PCTs attending the hearings to ensure that governance is seen to be done.
The increase in the number of applications for a contract using the exemption rules (internet pharmacies, 100 hours a week pharmacies) has continued to rise and this trend is seen elsewhere nationally. It is the subject of comment in the White Paper on pharmacy. We continue to monitor these applications to ensure that your best interests are represented.
During the year one NHS Litigation Authority hearing was conducted in Eastern and Coastal Kent and a number of other decisions by the PRC appealed against by pharmacy contractors, to the NHS Litigation Authority.
LPC MEETINGS 2007 / 8
General Meetings have been held on a two monthly basis, in the evening. In addition there have been a couple of extra meetings. The attendance of committee members has been as follows: -
Possible Actual
Ian Barrie 6 4
Neil Carter 4 2
Sunil Chopra 6 6
Pal Deol 6 4
Geoff Garfield 6 4
Steven Kane 6 6
Lodi Lama 6 4
Nuala McGibbon 6 3
Taj Matharoo 6 2
Bipin Patel 6 5
Mike Salter 6 5
Barrie Smith 6 6
Simon Topham 6 4
Kit Kwok Tse 1 0
Deepak Wadhwani 6 5
In addition to the formal LPC meetings, LPC Strategy Group meetings have been held, meetings of officers to discuss services that can be offered to PBCs and PCTs, monitoring visits with PCTs and regular meetings with PCTs. Educational meetings have been held in conjunction with the PCTs and pharmaceutical industry.
FINANCE
The Accounts of the LPC for the year ending 31st March 2008 are attached. They show that the LPC has managed their spending within the budget set last year.
The LPC is requests levy funding twice yearly in April and October and we continue to aim to offer you good value for money. As in previous years the funding that we use continues to be below the national average for LPCs.
The prepared accounts have been audited by Hughes and Co, chartered accountants and are attached at the end of the report.
COMPLAINT MANAGEMENT
Complaints about pharmacy contractors may be received by the PCT and continue to be treated as a customer complaint or patient complaint. They may however be re-directed into the Performance Advisory Group (PAG) of the PCT to be dealt with as a performance issue. Where a performance issue is so serious that danger to a patient is envisaged by the PCT the performance issue may be promptly accelerated to the Decision Making Group (DMG) of the PCT.
This LPC continues to advise PCTs that all complaints should, initially be dealt with at practice level. You should ensure that complaints can be processed in line with the complaints procedure in your pharmacy and guidance is available from your Head Office or the PCT.
This LPC is happy to advise you and be involved in complaints about contractors and it is beneficial that we be involved as early as possible. The process can be long and drawn out and later involve bodies such as the Royal Pharmaceutical Society. Therefore prompt and appropriate handling of complaints at your pharmacy may avoid a considerable amount of work later on.