East Sussex Local Pharmaceutical Committee “To represent, support, develop and promote NHS Community Pharmacy in East Sussex in the interest of contractors and service users.” 3 Broadmark Way, Rustington, West Sussex BN16 2EY LPC Meeting 10th July 2014 Barnsgate Manor, Heron’s Ghyll, nr Uckfield, TN22 4DB Draft Minutes The meeting commenced at 9.35a.m. Members present Paul Antenen(PA)Treasurer, Brent Auld(BA), Karen Daniels(KD), Sarah Davis (SD), Nasim Ladak (NL), Dunja Kalinic(DK), Craig McEwan(CM) Chair, David Onuoha (DO) , Kathryn Steele(KS), Next Stepper and Time Keeper – David Onuoha Officers present Vanessa Taylor(VT) PEO, Jan Thompson(JT) Secretary. Guests Ian Hunter(IH), PSNC Regional Representative Apologies Ramiz Bahnam, Bharat Chotai, Ian Wilkinson, Sheetal Patel, Sandy Jack, Claire Condon Declarations of Interest None declared. Expectations and Objectives for the meeting EPSr2 Update from Brighton and Hastings and Rother LESs ONPOS feedback CDLin meeting feedback Brighton PNA update LPC Strategy- to build and understand Sub-committees – are they needed? Brighton’s SCR Pilot –update LPC Members’ Skills matrix – what next? Future structure of East Sussex LPC – replacement of Secretary in April 2015 PSNC Update and LPC discussions Minutes The minutes of the meeting on 15th May 2014 were considered and approved. Matters arising It was agreed to leave this until the PEO’s report. Next Steps ONPOS scheme. VT had contacted Manish Suchak of Coldean Pharmacy. He said scheme was working and late payment had been resolved. No further action required. KS said she still had problems with payment- though BACS transfer was requested, a cheque was issued for the second month running despite e-mail correspondence with CCA finance lead. Also problem with CCG formulary as re-imbursement for a specials item was around 20p instead of £35- nowhere near the equivalent. 1 KS to e-mail VT feedback on changes needed to CCG formulary VT to confirm which pharmacies are involved with the ONPOS scheme JT checked with East Sussex National Hotel and Golf Centre as a future LPC meeting venue. Daily rates were £30 + VAT per person- more than those for Barnsgate Manor. It was agreed to continue using Barnsgate Manor for LPC meetings in 2015. VT said the bid portal had changed its name from Supply2Health to Contracts Finder. Succession Planning and future structure of LPC CM gave background information about previous discussions with West Sussex and Surrey LPCs concerning a merger. Though East Sussex LPC favoured the idea, the other two LPCs were not so keen. PSNC are encouraging smaller LPCs to merge and are willing to help pave the way and recently contacted the three chairs to discuss a ‘landscape of change’. At a recent SE Forum meeting, CM discussed his idea of a more integrated Surrey-Sussex LPC where initially a ‘business manager’ could be appointed to cover all three LPCs. This had been prompted by JT’s decision to stand down as Secretary at the end of March 2014. At the S.E Forum meeting, Mike King (PSNC) suggested the Surrey, West and East Sussex Chairs together with other Chairs of LPCs who are thinking of merging, meet in London in July with representatives from West Yorkshire LPC as they have recently gone through a merger. CM hopes a plan can be formulated by end of August. To discuss and develop job description for business manager at Exec meeting. CM to circulate job description to LPC members CM to take job description to Chairs meeting in London LPC Strategy Review As there was no time to review the LPC Strategy and Operating at the last LPC meeting, CM and VT had reviewed them and suggested some amendments. LPC members split into 3 groups and each reviewed one of the pillars of the strategy and operating plan (with suggested amendments) and checked it against the PSNC self-evaluation criteria and then reported back. Each group suggested some useful amendments and these were discussed. A major review of sub-committees was highlighted and it was decided that there should be only three subcommittees in the future—Market Entry, Finance and Governance. VT to re-word strategy as per discussions and to circulate to LPC members LPC members to review and feedback on revised strategy and operating plan LPC members to be allocated to speak to non-attendees at meeting about strategy and operating plan. Self-assessment SD explained the committee had looked at the previous form for evaluating members’ competence and found it not fit for purpose and SD had developed a new form. In addition, the PSNC skills audit form had been sent to members and discussion followed about whether to use it instead as it was simpler to complete. KS suggested the CCA form was a better format. SD and KS to review LPC skills questionnaire and send to CM CM to circulate revised form to LPC members LPC members to complete and return form to SD Market Entry Applications JT went through the recent applications and notifications listed in the Secretary’s report. There were 2 pending applications needing a response from the LPC. Application by Coldean Pharmacy Ltd for a combined change of ownership and no significant change relocation from 10 Beatty Ave, Coldean, Brighton BN1 9ED to 16 Beatty Ave, Coldean, Brighton BN1 9ED Application by Waremoss Ltd for a no significant relocation from 8 York Buildings, Hastings TN34 1NN to 1 York Buildings, Hastings, TN34 1NN. 2 The committee discussed both applications and decided the response to both should be to ask the Area Team to approve them so long as it was satisfied that the relevant regulations were fulfilled CM asked about the progress of the Mid Downs Surgery application for dispensing premises in their Chailey branch. JT said she had received copies of representations from interested parties and explained she usually didn’t circulate these unless there was a point the LPC needed to comment on. Discussion followed about the merits of sharing the representations. It was decided to share them in future as the comments made by other interested parties with regards to interpretation of the regulations could be useful. JT to circulate representations from interested parties to Market Entry sub-committee VT expressed her disappointment to learn from Mike King at the S.E Forum meeting that the PSNC Market Entry Masterclass in September will be a repeat. CM and VT both felt an opportunity had been missed where examples of actual applications, their interpretation and replies could have been shared. . PNA Update VT said the East Sussex PNA was signed off at the meeting she attended on July 9th. Surrey, West Sussex and Brighton& Hove have used the East Sussex PNA as their template as it was considered a good document. In Brighton& Hove there was a poor response to the Community Pharmacy PNA questionnaire which was sent out electronically. Some LPC members said they had not received it. VT to check the PNA questionnaire was sent to all contractors NHS England Area Team Liaison meeting SD gave a report of the meeting with Mike Hedley(MH)attended by VT, CM and SD. EPSr2 Rollout In East Sussex, the remaining Hailsham surgeries will be the next release in October followed by Eastbourne in early 2015. In Brighton, Warndene surgery will go live at the end of October with more surgeries to follow. With regard to Smart Cards, in Sussex and Brighton, it has been decided to use a number of hubs. Those applying would need to present with appropriate ID and the Smart Card would be posted to them with a password. It was suggested to MH that the Smart Card could be sent with a password already linked and the card not locked, to help as smooth a process as possible. On 18th July, Area Teams and CSUs are meeting and included in that meeting will be confirmation that everyone who needs a Smart Card will be able to get one, including technicians. Funding for this and nhs.net email addresses has been confirmed with Sarah Creamer. SLA still not finalised and the LPC discussed how it could help move things forward. At the LPC meeting VT raised the subject of dispensing tokens and said Area Team bears the responsibility of delivering them. MH to come up with a process. Discussion followed about delivery to surgeries instead of pharmacies. VT to challenge the delivery of dispensing tokens to surgeries rather than community pharmacies-mixed evidence to support this. Contract Issues A new admin. assistant at Area Team is now collating opening hours, bank holiday info, etc. Any changes should be sent to the generic area team email address. It was noted that for any changes contractors wish to make for Christmas hours, that 90 days notice will need to be given up to 25th September 2014. JT to highlight in LPC newsletter deadline for 90 day notice for change of hours. Flu Vaccinations Evaluation from London can be interpreted negatively as there wasn’t an overall increase in uptake from using pharmacy, so it has deterred a scheme involving community pharmacy being 3 set up in Sussex. . LPC thought evaluation can be viewed in different ways as in Hackney, where the scheme has been running for several years, uptake from pharmacies is good. VT to write to Max Kammerling to request a formal decision on community pharmacy inclusion in flu vaccination service. Co-commissioning 11 CCGs have submitted expressions of interest in co-commissioning between CCGs and the NHS. The only CCG not to submit was Crawley. NHS England will make the decision on what goes forward with this and are working towards Oct ’14 for joint authority and April 2015 for full delegated authority. Health and Wellbeing Boards MH was asked how links were between the H&W Boards and NHS England. Penny Ford, Director of Operations at the NHS Area Team, attends most of the meetings. There seems to be a lack of understanding of community pharmacy with more of a focus on social care. MH and VT will do a joint presentation to the H&W Board on 29th July about the role of pharmacy. NHS111 NHS111 are experiencing an increase in call numbers on a Friday afternoon as some surgeries close early. They do not have an increase in staffing levels to deal with this. Question over whether correct processes are being followed by surgeries and also by the team managing GP contracts as it was felt that pharmacies closing during contracted hours would get a breach notice. Surgeries closing early would not support the focus on clearing prescriptions for the weekend and thus a reduction in calls to NHS 111 / emergency supply requests. The emergency supply of medicines by pharmacies suggested by NHS111 has been put on hold. As the NHS111 funding is changing from block payment to itemised, there could be an increase in requests. VT and CM are attending an Urgent Care Roadshow as it was felt community pharmacy needed to be represented to flag up issues. LPN Update The first LPN meeting was held on 24th June and Sally Greensmith produced plans and ideas for the future. Telephone and Discharge MURs NHS England do not encourage telephone MURs and MH reinforced the requirement for a PREM2 to be completed on each occasion. For DMURs, the issue is getting a DBS check completed. The Area Team fund the DBS check but sometimes there is not a quick enough turn around to be able to get the DMUR completed in a timely manner for the benefit of the patient. Once a DBS is set up, it needs an annual review and be completely renewed every 3 years. PCSS There is still not complete clarity on the changes that are happening. Market Entry may not remain core for them and could revert to the Area Team. Services commissioned by Local Authorities VT said that the onerous training required for some local authority services could mean community pharmacies lose interest. It was felt that recent EHC training was of poor quality with confusing information. Also comments from members that CPPE training is disappointing and not meeting needs-the focus is more on process than clinical information. Members also discussed the amount of paperwork needed by LAs for recording and payment of the public health services now that Sonar is no longer used by Local Authorities. Some pharmacies are still recording on Sonar for their own use. Suggest SONAR get involved in understanding of commissioned public health services to explain what recording can be undertaken by using SONAR to support the reduction in paperwork 4 A Minor Ailments scheme is favoured and a pilot is being considered for Hastings and Rother. The walk-in centre at Station Plaza is oversubscribed. Chairs and Secretarys’ PSNC Conference Update CM reviewed topics covered -- still no settlement, increasing role of CCGs, Category M reduced, targeted MURs more focussed. Looked at the statutory role of the LPC and tried to identify their other roles. Proposed changes to the LPC constitution were discussed and an EGM will need to be held to ratify the new constitution. The most important change was the replacement of PCTs by NHS England and HWBs. Some amendments were requested by NHS England and others were for clarification of election procedures, governance arrangements and levies. The LPC Executive will be meeting to discuss the new document in more detail but CM felt the LPC should be supportive. JT to e-mail draft new constitution to members to review and comment on by July 23rd PSNC have had more issues regarding the formation of LLPs which haven’t ‘taken off’ due to funding requirements and are now looking at Companies Limited by Guarantee. It’s felt they should be independent of LPCs though legal advice seems to differ. In the new constitution, LPCs can support contractors through corporate vehicles. PSNC Conference will be held in Leeds on October 15th and CM asked if anyone present would like to attend. There were no volunteers. VT to e-mail the suggested topics for discussion at PSNC Conference Members to comment and respond on proposed topics by end of July LPC AGM September 17th JT said the venue, Uckfield Civic Centre was booked. Steve Doswell, East Sussex Police Liaison Officer was asked to be the guest speaker. He has confirmed and the topic of his talk will be ‘Controlled Drug Issues within the Pharmacy Arena-a police perspective’. The annual report is being prepared and will be on the LPC website from mid-August so as to meet the LPC constitution requirements of being available to contractors 30 days before the LPC AGM. LPC Members’ Day November 27th At the S.E Forum meeting, it was decided the day would be split into two parts. The first part will focus on GPhC inspections and Head of Inspections at GPhC and Tim Snewin, regional representative for GPhC will be invited. A presentation from NPA was suggested with questions submitted in advance. The second part will focus on Pharmacy Funding. Mike Dent and Harpreet Chana from PSNC will be invited and Sally Greensmith to cover local funding. EPIC update KS gave feedback on recent EPIC meeting. Though still in planning stage the emphasis seems to have moved away from community pharmacy involvement in a minor ailment scheme to independent pharmacist prescribing and clinics. Discussion followed about which pharmacies are involved. SMS Update Brighton & Hove are re-tendering the service and three bidders gave a short presentation to community pharmacists. CD Lin Update JT attended a meeting in Horley on July 3rd. Police Liaison officers reported the variations over the length of time that CDs, that have been dispensed incorrectly, are being stored and said a clear procedure is needed. Problems over the new regulations concerning tramadol –validity of scripts, large quantities dispensed, repeat prescribing were discussed. An out of hours contact number for SMS is still outstanding. A procedure for dealing with breakages and spillage of large quanitities of liquid CDs e.g methadone had been suggested at a previous meeting and a sub group will meet to discuss further. 5 AOB LPC Newsletter The committee agreed they were still happy with the format and the idea that an LPC member write a monthly front page article. JT had asked Aaron Farbridge Brighton &Hove Controlled Drugs Liaison officer to write an article for July as Ramiz was on holiday. It was suggested that Sally Greensmith and Tony Proom be approached to write articles and that the newsletter be discussed again in November. PSNC Ian Hunter(IH), PSNC Regional Representative suggested more of a two way dialogue for PSNC involvement. CM thanked IH for his proactive approach and interest in attending the LPC meetings. Consider ongoing feedback at each LPC meeting for PSNC on what they should stop doing, continue to do and what they should start/ do differently LPC Website VT expressed her frustration that there were still problems with the LPC website which needs rebuilding again. A lot of material has been lost and needs re-entering. She asked the committee’s approval for her son Toby to do the work. She said it would probably take around 40 hours at £15/hour. A vote was taken and the committee agreed to Toby undertaking the work. The matter of a GP surgery sending patients to community pharmacies for blood pressure readings was raised. Patients expected to be seen immediately and it had caused huge pressure on the pharmacy. When contacted the surgery said they were short of nurses. Send VT example of letter sent to patients advising them to go to their pharmacies for BP checks. Write to CCG board to highlight concern about above. Expectations and Objectives were reviewed and it was agreed they had been met. Next Steps were reviewed and agreed. Meeting closed at 4.35p.m Dates for future meetings Thursday, 4th September, 13th November 2014 and 8th January, 12th March, 21st May, 9th July And 10th September 2015. AGM Wednesday, 17th September 2014, Uckfield Civic Centre 6