doncaster pharmaceutical committee€¦ · send round presentation to pharmacist s with a few words...

of 4 Doncaster LPC Closed minutes 10.07.13

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DONCASTER PHARMACEUTICAL COMMITTEE

1

Doncaster Local Pharmaceutical Committee Meeting

LPC MEETING

Training Room, Weldricks, Railway Court, Doncaster, DN4 5FB On

Wednesday 10th July 2013 at 1pm

Present:

In the Chair Richard Wells

Secretary: Nick Hunter

Members: Chris Bland, Paul Chatterton, Ming Goh, Richard Harris, Catherine Hudson, Sue O’Horan, Darren Powell, Natalie Pratt, Dave Sharp, Claire Thomas, Gillian Woodhouse

Attending

• Dr Beth Rimmer, RCGP Carer Champion for Yorkshire

• Mark Randerson (Doncaster CCG)

Apologies

• Garry Myers, PSNC

• Tracey Newcomb – Head of Service, Doncaster CCG

• Nick Tupper, Doncaster CCG

• Tony Baxter, Doncaster Public Health

• Steve Davies, RDASH

• Emma Kelly, (Drug and Alcohol Team)

• Paula Brocklesby (Drug and Alcohol Team)

• Joyce Parrott, Healthwatch rep

• Michele Clark (Doncaster CCG)

• Rachel Manners (Doncaster Public Health)

• Diana Taylor (CPPE tutor)

• Louise Robson(Doncaster Public Health)

• Victoria Lindon (NHS England)

• Debbie Marks, Healthwatch

• Christopher Alcock, LPC member Guest Speakers

RW welcomed the guests and introductions Dr Beth Rimmer, RCGP Carer Champion for Yorkshire GP in Harrogate. Paid on sessional basis as carer champion – 1 session per week through DH funding. There are 9 similar pilot posts across England. Trying to get local CCGs interested in carers when commissioning care. In particular unpaid carers who provide support – including substance misuse and mental health. 1 in 10 people are carers. Effects on carers – negative on physical (back, lack of sleep) and mental health (depressed, stress), isolated as give up social activities and work. Community pharmacy can help with identifying carers, highlight that gp’s need to be aware they are a carer, ensuring understand medication – carers being involved in MURs. Need to let gp’s know that people are carers. Delivery drivers often see the patients the most and do report back to the pharmacist if feel they are not coping or unwell, but no formal process. MURs – SY have removed barriers to doing domiciliary mur, but can be difficult for pharmacies to do due to costs. Barnsley have an existing scheme – additional fee from the council on top of the MUR

of 4 Doncaster LPC minutes 10.07.13

fee and integrates into social care assessment process. Pharmacy need to be involved in pathways from the beginning – this could be improved if received information on discharge like gps do. These complex patients ideally need to be on repeat ordering and advised to say that should go to the same pharmacy. If acting in the patients best interest then the issues regarding information governance should be able to be overcome. Need to think about how to advertise to carers and signpost to their gp and the carer service. East Riding – pharmacy paid to give MAR sheet with medication for paid carers – instead of being put on dosette boxes to reduce risk and improve adherence. New Medicine Service – explained how the service works and the difficulties with hospital referrals. Send round presentation to pharmacists with a few words explaining from RW and NH.

1.30pm – Tracey Newcomb – Head of Service, Doncaster CCG - CMARAS procedures. Late apologies were received from Tracey so NH will reschedule 1.50pm - Mark Randerson (Doncaster CCG) Gave a brief update on the CCG – good links with medicine management, CCG and pharmacy. Met Rupert Suckling and Kerry Warhurst about smoking cessation, substance misuse and EHC - positive as transfer of LESs in some other areas have not gone as smoothly. MR asked what the priorities of the LPC over the next 12 months and the links (medicine optimisation). Members replied:

- Protect services have got already and then look at service ideas for development - Referral pathways – pharmacy being able to refer to correct practitioners rather than through

GP every time - More service development – falls, dementia – screening tools that can be used by pharmacy. - Respiratory Inhaler Technique Scheme – already proven to reduce attendance at A&E - Improve access to minor ailments scheme

Mark said he can support the links to the pathways but not his role. The CCG delivery plan has five core objectives and unplanned care is one – Julie Turner is the lead officer and this is where MAS would sit. NH advised that he had met Julie and others in the CCG, but there had been no recent follow up. Audits on waste being returned to pharmacy? Could meet with the locality teams and discuss The CCG need to save £800,000 savings on prescribing. They have adopted a matrix working approach. Under the Children’s objectives on the CCG delivery plan there is reducing respiratory tract infection admissions – pharmacy can help with this by providing inhaler technique reviews. If Mark sees areas that he feels that pharmacy should be working / being involved then he will contact LPC and ask if been involved. Need to be targeting the key people on the delivery plans and highlight to them where pharmacy can be involved / instrumental in the outcomes. Area Team has policy for CD Accountable Officer but cannot resource the full role at a local level so memo of understanding drawn up with CCGs for medicines management to support.

Reports

a. NHS Commissioning Board Area Team update I. Verbal report from SY LPC Liaison meeting 25 Jun.13 (NH/DS)

Meeting was very overdue so the agenda was extremely long and did not get completed. TOR sorted. Frequency of meeting to be changed to bi-monthly meetings. The AT lack people resource and are often waiting on information from NHS England central support. Send the primary care vision and interests document to members. Structure – Caroline Ogle is contract manager for Doncaster, Victoria is Sheffield but she is


overall for pharmacy. EPS – aware of issues re: CSU support and stationery. AT have temporarily stopped any further roll out until CSU have increased resource. LETB – no one is aware of what is happening locally – will need the LPN to pick up when chair appointed. Pharmacy contractor performance – misunderstanding of roles and responsibilities LPN chair advert – need to create some competition so members to raise awareness of advert. The AT want to avoid someone with strong links with the LPC due to risk of perceptions of conflict of interest. CPAF – some confusion on the timeline – nationally was changed from 2 weeks to 4 weeks although AT will not chase until after the end of July 2013. Generic email – problem with no acknowledgement to emails being sent through. MUR – process for domiciliary MURs agreed and information sent out by email. Matt Auckland sent these out last week. Need to be resent as some contractors have not received this information – NH to contact Matt Auckland.

b. Local Authority (Public Health) update

I. Substance Misuse update (EK/PB) Contractors are reporting that it is costing more money to administrate the invoice process due to the requirements of the local authority. PH services – (EHC, Substance Misuse, Smoking Cessation) to send to Cobi (quarterly email reminder received). Aim is to bundle services so only one PH Services contract per organisation due to complexity of PH Services contracting and it costing more to complete than the value of the service, because many pharmacy service are relatively small units of service. Payment issues - contact NH and let him know details so can chase this up. From the Chairs and secretaries meeting LPCs were advised that for the 20 or so services in the regulations it could be more economical for the local authority to ask the area team to commission on their behalf as a LES, because it is a simpler commissioning process. This also applies for CCGs who have to use the NHS Standard Contract which is 203 pages and would usually require legal advice due to anything in Part C overriding the standard contract.

II. Health and Wellbeing – Attachment 1a and 1b

III. Tobacco control alliance – NH has sent reports and stories re e-cigarettes to Kerry Warhurst

as she is very anti e-cigarettes. NH reported that members of the TCA had been asked what their policies on staff smoking and use of e-cigarettes are – for example near premises, in uniform. Generally members reported that pharmacy policies do not allow staff to smoke or use e-cigarettes on the premises and smoking is not allowed by staff in the immediate vicinity of the pharmacy, in the eye line of patients or while wearing their uniforms.

IV. Sexual Health services – request to expand community pharmacies involvement in Sexual

Health service provision. Carrie Wardle has requested that pharmacies also supply condoms and post chlamydia screening kits as part of the EHC PGD, but there is no money / budget available to provide an additional payment for pharmacies doing so.

c. CCG update I. Medicines Management update (MR/NT/JB) – Already discussed II. APC updates (RH)

Dementia guideline being reviewed – involving prescribing in behaviour difficulties. Felt that pharmacy could monitor the period of treatment of the medication Methotrexate – monitoring to 2 monthly in Doncaster. National guidelines state 3 monthly. Prescribing should still be prescribed a month at a time to avoid waste and safety issues. Brilique ticagrelor – SPC says to do U&E after a month to check renal function – who will do this?? Going to give them a blood form and ask to go to hospital – pharmacies could check by asking as part of NMS or intervention MUR. APC newsletter – still being sent out - some pharmacies reported as not receiving – will check if this is being sent to all pharmacies.


Icaps (Lutine) – grey light – seen more recently. Medicines Management or the GP should be approached

d. South Yorkshire LPC

I. SY LPCs - LAT liaison meeting – Already covered

e. LPN Already covered

15 Future meetings – generally the 2nd Wednesday of odd numbered months

Date Time Venue

11/09/2013 All day meeting 1pm – 3pm - open

?? Rutland house

13/11/2013 1pm –6pm (1pm – 3pm open)

Training Room , Weldricks

The meeting ended at 6.05pm

The next meeting will be held on Wednesday 11th September 2013 at Rutland House Amendments to minutes (if any): Spelling corrections on pages 3 and 4

Signed as a true and proper record: Proposed by: Gillian Woodhouse Seconded by: Chris Bland

Approved by ... Richard Wells (SIGNED AT MEETING) and members present at the LPC meeting Richard Wells, Chairman. 11th September 2013