MINUTES
An Open meeting of Bedfordshire Local Pharmaceutical Committee was held on Thursday 17thJanuary 2013 at AstraZeneca’s Head Office, Horizon Place, 600 Capability Green, Luton LU1 3LU.
Present:LPC Members
Coll Michaels (Chair)
Samir Patel (Vice Chair)
Paul Fearon (Treasurer)
Satnam Butter
Farwaj Chaudhuri
Kiran Patel
Pinesh Patel
Madhu Puvvada
Carol Rose
Rupal Sagoo
Mahesh Shah
Sundip Sheth
Beds LPC Office
Gerald Zeidman (Chief Officer)
Ethel Shaw (PA to Gerald Zeidman)
Guests
Tess Dawoud – Medicines Management Pharmacist & Community Pharmacy Lead, NHS Luton
Carl Raybold – Beds & Herts LMC Ltd
John Swain – Management Support, Luton CCG
Mark Meekins – 111 Strategic Development Manager, NHS Luton and Bedfordshire PCTs
Irfan Moledina – Pharmacy pre-registration student
Belinda Ekuban – Chiltern Vale Pharmacy Locality Lead, NHS Bedfordshire
Rupi Bhasin – AllianceBootsHealthcare Development Manager
Agenda Item
/Action
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/ Welcome to members & guestsThe Chair welcomed members and guests to the meeting.
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/ Apologies for absenceApologies were received from Bhupendra Lakhani, Richard Jones, Luton LINkand Andy Cooke.
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Declaration of interests
None.111 service development for NHS Luton and Bedfordshire
Mark Meekins explained that when a telephone call is made to the free phone 111 service, the caller will initially speak to a trained adviser who is not a clinician. The 111 pilot has been running in Luton for the past two years and has very different pathways from NHS Direct.
The call may then be transferred to a nurse advisor whose prime function is to provide patients with advice and where necessary signpost them to the most appropriate clinician such as the GP, A&E or community pharmacy.
A DOS, Directory of Services, obtained from Primary Care Contracting for all local health providers is used to ensure the caller is correctly signposted.
Clinical profiling, using information from GP practices, help the 111 service to be aware of what services GPs are providing, an example being minor sutures.
Coll asked if 111 could signpost patients to a specific pharmacy if asked to do so by a patient.Mark responded that the service has been approached to perform this function.
Farwaj queried if 111 would have up-to-date information regarding enhanced services within community pharmacies. Mark replied that whenPCTs are notified of providerservices changes they would inform 111.
Sam asked what percentages of patients are directed to pharmacies. Mark responded that where appropriate calls are directed to pharmacy and self-care; he could provide a further breakdown for community pharmacies if required.
Mark emphasised he would like all pharmacies to provide the 111 service with up-to-date information relating to services they provide. 111 will be live nationally in March 2013 and will receive extensive publicity on media and social networking sites.
Gerald remarked that Bedfordshire LPC, as yet, had not been involved in the work of 111 and asked Mark if communicationscould be improved. Coll agreed and suggested that Mark and the 111 service work closely with the Beds LPC office.
Mark agreed that communications with the LPC would be improved.
ACTION: LPC Office to engage with 111 service.
Mahesh asked for a profile of the 111 service todate, based on data from the two year trial. Mark gave the following figures, which included:
- 20% self-care and pharmacy
- 11% A&E
- 60% GP
Healthy Living Pharmacy update
Gerald updated members and guests on progress with the Health Pharmacy Initiative (HLP). He reminded the committee thatpharmacists’ participation in a leadership training course was one of the steps requiredfor pharmacies to become an HLP.The LPC had arranged with the Centre for Pharmacy Postgraduate Education (CPPE) to deliver a full day’s training on 27th January 2013. This event has 32 delegate places and is fully booked. As a result a second event will be planned. Venue and date to be confirmed.
A stakeholder event for commissioners and invited guests is planned for March,with a community pharmacy contractor launch event tofollow in late April / early summer.
Gerald reported that he and Sam Patel had met with Gerry Taylor, Director of Public Health NHS Luton, together with Richard Jones, Head of Medicines Management NHS Luton,to gauge their interest for HLPon behalf of Luton PCT.
Gerald explained that although the LPC was driving the initiative, it was crucial to have public health andcommissioner support. Belinda agreed and added that HLP will help the future commissioning of new community pharmacy services.
Rupi told the committee that he was involved in the original HLP initiative in Portsmouth. His highlighted the challenge in ensuring that pharmacies were correctly placed within the proposed levels of the HLP.He stressed it was important that this is factored in by Bedfordshire LPC. He also commented that an additional update event,similar to the stakeholder event, would be very useful when HLP is rolled out in Luton and Bedfordshire. / GZ
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/ Approve minutesThe committee approved the open minutes from 15th of November 2012 as proposed by Satnam Butter and seconded by Carol Rose.
Matters arising from previous minutes
691 – John Swain had shared the Luton CCG constitution with Bedfordshire LPC.
692 –Mike Thompson also shared the Bedfordshire CCG constitution. Dr Diane Gray was invited to attend this meeting but was unable to attend due to a CCG Board Development event.
694 – A meeting date with between the LPC and the CAN Partnership is outstanding.
695 – The LPC office will be notified of LMC events by Carl Raybold.
697 – Due to confidentiality issues, Gerald had not forwardedStuart Lines’ email to LPC memberswhich contained the results of the NHS Luton Health Check pilot.
ACTION:Gerald to follow-up the results of the evaluation with Stuart.
Coll reminded guests that pharmacies can provide flu vaccines. Gerald would raise this with Gerry at their next meeting.
ACTION: Gerald to advise Gerry Taylor about pharmacy’s ability to provide flu vaccinations.
Luton shadow Clinical Commissioning Group update
John Swain updated the committee.The CCG had received just six reds as a result of the NCB authorisation visit on the 28thNovember 2012. Three of these had since been actioned and were therefore removed. The remaining three should be green by March 2012. This was an extremely pleasing result.
John reported that the L&D hospital had had its busiest time ever in the period before Christmas. This was providing a financial challenge to the CCG. However, the forecast CCG end-of-year position is break even.
John stated that a community pharmacy minor ailment scheme could help to reduce demand on primary and secondary care services, but evidence of such schemes around the county would be needed to be provided in order for it to be commissioned.
John had confirmed with Mark Cox, Strategic Implementation Manager for Urgent Care at the CCG,that he is willing to have a conversation with the LPC regarding a minor ailment scheme. However, Mark will require evidence from the LPC for any proposals
ACTION: LPC to arrange meeting with Mark Cox.
John announced that he is to retire and therefore this was his last LPC meeting. He thanked the committee for their input into the PCT and CCGand assured LPC members that he would ask another officer from the CCG to attend future LPC meetings.
The committee, led by Coll, thanked John for his attendance and input into the work of the LPC over many years and wished him a healthy and happy retirement.
Coll asked for John’s views on the HLP initiative. John responded that in his opinion it is good for pharmacy; importantly there will be a need to demonstrate its value. He also remarked that there is a real need to communicate about HLP as awareness of the scheme isgenerally low.
Mahesh asked John for statisticsrelating to the types of medical conditions that patients presented with when attending the Luton Walk-in Centre. He suggested that community pharmacists could provide advice and support for people with minor ailments who may otherwise have attended the Walk-in Centre or GP practice.
John replied that a considerable amount of the activity at the Walk-in Centre is from people living outside the area.
John agreed toprovide the LPC office with the information requested by Mahesh.
ACTION: John Swain to provide statistics for attendees at the Luton Walk-in Centre to LPC Office.
Coll thanked John for his update and wished him well in his retirement. / GZ
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717 / NHS Bedfordshire pharmacy update
Belinda advised the committee that only two enhanced community pharmacy services will remain with Bedfordshire CCG after 31st March 2013. These were the supply of gluten free foods and provision by pharmacies of emergency access topalliative care medicines.
70% of pharmacy audits for the Gluten Free Service had been returned to the PCT; feedback about the service had been very positive and a further update would be provided at the next LPC meeting.
Belinda reminded the committee that substance misuse claims should go to the CAN Partnership only and not to the PCT.
Belinda asked if the LPC could remind contractors in the next LPC Newsletter where invoices for enhanced services should be sent after 31st March.
ACTION: Sam and Ethel to add reminder to next Newsletter.
Belindaadvised members that information relating to only a very few post-hospital discharge MURs and NMSs were being sent to the PCT.
The L&D are piloting a scheme where patients will be given a discharge sheet advising them which pharmacy to go to for an NMS consultation. Rupi said that a similar scheme also took place in Norfolk and he will work with Gerald and Belinda to share this experience.
ACTION: Rupi, Belinda and Gerald to liaise regarding Norfolk hospital discharge scheme.
Belinda stated that so far only 14 out of 44Bedfordshirepharmacies had an nhs.net email account; this excluded pharmacy multiples. Kiran highlighted he had problems using his nhs.net account.
Belinda pointed out that anti-biotic guidelines were currently being reviewed by Jackie Smith and asked the LPC to submit any feedback to Jackie within the next two weeks.
Belinda reported that a Dementia LES is to be piloted by the Medicine Management Team for people living at home suffering with dementia. The pilot will focus on the safe use of medicines in a domiciliary setting.
Medicines Optimisation was very high on the agenda for the Medicines Management Team. Andy Cooke was looking for ways to improve patients’ outcomes in their use of medicines and welcomed suggestions from the LPC as to how this could be done.
LPC members suggested the PCT should consider commissioning a pharmacy LES to assist to patients with respiratory disease such as asthma or COPD.
Rupal request the PCT will communicate to pharmacy contractors which pharmacy serviceswill be commissioned by whom after March 2013.
ACTION: Belinda to ensure the PCT communicates to pharmacycontractors commissioning changes.
Coll thanked Belinda for her update.
NHS Luton pharmacy update
Tess advised the committee that the Luton Health Checks budget will transfer to Public Health from April. John pointed out that the CCG wished to see a considerable increase in the number of health checks.
Gerald reported that the LPC had received the results of the Luton Community Pharmacy Health Checks pilot which were encouraging. He had been informed by the PCT that a much larger pilot may be commissioned by the local authority.
Rupi said that Boots were taking referrals from GPs to carry out NHS health checks. Sundip commented that he had a similar experience at his pharmacies.
Tess reminded the committee that there is an EPS2 Project Board meeting on the 4th of February.
Tess distributed leaflets regarding the Public Health campaign from Mount Vernon about raising awareness of ovarian cancer that would run from 1st February to 31st March.
Tess advised the committee that there had been a reduction in the number of completed MURs and the NMSs. Some contractors were not using the correct paperwork to send in their reports to the PCT.
Improvements in the prescribing of dressings are still on the agenda, in particular the PCT welcomed ways to manage wastage.
Mahesh suggested that adherence to a dressings formulary was vital. Coll asked all stakeholders to join the discussion in assisting the PCT in reducing waste.
ACTION: Members to email the LPC with suggestions on ways to reduce dressings waste.
Gerald asked Tess what communications her team had with the LAT. Tess responded that both Belinda and herself had some contact but that Andy Cooke was leading on this.
Coll thanked Tess for her update.
LMC Update
Carl reported that the imposition of contract changes by Government could affect GP income. The LMC were making contact with the Local Area Team (LAT) and also with other LMCs within the new LAT area to discuss issues such as the hand-over of LESs, new contractual arrangements, and Directed Enhanced Services.
The General Practitioners Committee (GPC) are running a series of road shows in February for GPs, to raise awareness of NHS reforms.
NHS Property Services will hold a portfolio of all NHS properties in the area.
Coll thanked Carl for his update.
Luton Community pharmacy Health Checks - update
Already discussed.
Enhanced Services update
No further updates.
AOB
None
Date of next open meeting
The next open LPC meeting will be on Wednesday 20th March 2013at 1:45pm in the samevenue.
Close of meeting
The meeting closed at 3:45pm. / SP/GZ/ES
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