Admin: PHARMACEUTICAL COMMITTEE Alison Ellis Chief Officer  [email protected] Nick Hunter  07882289083  [email protected] Fax: 01509 734322 07595 069178 http://psnc.org.uk/doncaster -lpc/ Fax: 01455 634800 http://psnc.org.uk/doncaster-lpc/

Doncaster Local Pharmaceutical Committee Meeting

LPC MEETING 1 Weldricks HO, Railway Court, Ten Pound Walk , Doncaster On Wednesday 8th November 2017 at 1pm

Present: In the Chair Richard Wells (RW) Secretary: Nick Hunter (NH) Members: Mohammed Ahmed (MA), Paul Chatterton (PC), Mark Davison (MD), Richard Harris (RH), Lynn Murrie (LM), Dave Sharp (DS), Darren Powell (DP) Minutes: Alison Ellis (AE)

Attending • Louise Braisby, Aspire • Annie Armitage, FCMS

Apologies • Joanne Lane, CPPE • Kayleigh Wastnage, Doncaster CCG • Garry Myers, PSNC Regional Representative • Stuart Green, Aspire • Nicola Sanders, FCMS • Kelly Smith, Doncaster CCG • Charlotte Wigglesworth, LPC member • Mark France, LPC member • Seonaidh Innes, LPC member

Sponsor presentation:

Jawaid Iqbal – Johnson and Johnson Dermatology - NHS data around Emollients and general update regarding resources for primary care. Happy to do some educational sessions for pharmacists and gps – could do multidisciplinary Do through the LPF – Richard D. and GP Target group (CCG) – AE to provide contact details Discussed Incentivise pharmacies to work with Johnson and Johnson to do questionnaires – Feedback from members that samples would be very useful to go to all pharmacies Weldricks worked with Thornton & Ross doing MURs + on emollient patients - £10 extra Customer preference needs to be listened to and best way to do this is through pharmacies.

Open session Louise Braisby, Aspire ➢ Drugs and Alcohol service update 48% switch over to Physeptone – no issues from service users so far – most have not even noticed. Started looking at clients with Christmas prescriptions – moving from Mon and Tues to Wed prescription pick up. May be a problem for weekly pickups – will only be a few that would need to have 3 weeks given all together - hoping to move across to a different day instead. Sending reminder of home office wording (poster) in December via PharmOutcomes

Page 1 of 11 Doncaster LPC mins 08.11.17 Problems with drug paraphernalia found in Conisbrough area – working with Aspire to look at reasons why this may be happening - too much being given so throwing away (unused items) - only need 2 days’ worth if homeless as not able to carry a lot … more information / training for pharmacy staff, educate service users stating that they will lose the service in the area. Is there scope for having a waste bin / needle exchange in some pharmacies in other areas without the service so these can be collected. Louise will send out leaflets to pharmacies. Increase in steroid use – if come and ask for needles then can give them out and signpost to Roslyn House. There are leaflets on PharmOutcomes on what needles are used for what. Safeguarding issues are always a problem with whether can be given to under 16’s – refer to the Aspire Team, they will see / speak to all ages and refer to appropriate place. Aspire offer safe storage boxes – can have some of these in pharmacies to give out. Council community team – to collect items found – Aspire work well with this team. PharmOutcomes – CCG are looking at using for communications but bit anxious about this – Louise reported that drawback is that it is only a one-way communication. Happy to have her details forwarded to the CCG for any queries.

Annie Armitage, FCMS (Out of Hours) ➢ Update East Laith Gate – opening times have changed – FCMS were not informed of the change and were still sending through out of hours patients. It is NHS that need to ensure that everyone is notified. Other pharmacies have not been notified of this change and so therefore have been directing to them too. DP will feedback to the pharmacy who they needed to contact. FCMS will raise with CCG re notification of pharmacy changes.

Action: Remind pharmacies to contact out of hours re change of hours etc – newsletter article.

Antibiotic awareness - Is there a coordinated event for this?? Just doing own in some pharmacies. - Out of hours are seeing more patients presenting. - Majority of pharmacies do not direct patients to gp’s for antibiotics - Focus needs to be on patient education Strep A testing – swab test – CCG not commissioned via pharmacy, some are doing privately. Other issues re out of hours - Been directing to buy chloramphenicol eye drops from the pharmacy without the patient being there - Understanding licencing of over the counter products EPS from Out of Hours – Annie will ask if there is any progress with this. NUMSAS – Nicola has mentioned that they focus on the local emergency medication scheme as its easier for them to refer to otherwise they will need to ask patient to ring NHS 111 for referral to NUMSAS.

Page 2 of 11 Doncaster LPC minutes 08.11.17 1 1.1 Apologies for absence ➢ Charlotte Wigglesworth (maternity leave) ➢ Mark France ➢ Seonaidh Innes (Resigned) NH has contacted CCA to let them know about the vacancy. JMc – non-attendance was noted by members

1.2 Acceptance of the minutes from 13th September 2017 (Attachment A1) The minutes were agreed as an accurate record of the meeting on 13th September 2017 after the following amendments: 1. Actions around data protection and employer liability were incorrect Proposed by LM and seconded by MA

1.3 Matters arising (not on the agenda) – Attachment A2

1.3.1 MAS There are no amendments to the service – CCG will not review the service and will not be publicising – pharmacy should liaise with local surgeries. Prepayment certificate – not able to access MAS. Promoted MAS through Care Navigation

1.3.2 GP find website Pharmacy cannot access the website and Gemma Sessions is aware of this.

1.3.3 Hepatitis B No vaccine available at the moment

1.3.4 NRT pricing DP has not heard anything re price differences

1.3.5 Data protection Changing next April 2018 – LPCs do not hold much information. Need to discuss how the declarations are available – need to have something on the declaration form to agree to these being available on the website. Also with email addresses being available. Bank details are kept by the LPC re expenses. Think the level we are currently registered at is over what we need. More information from PSNC will be sent nearer to April 2018.

1.3.6 Employer liability Agreed to print off the PSNC insurance policy that currently have and discuss this at the January 2018 LPC meeting.

Print off PSNC insurance policy and bring back to the January 2018 LPC meeting

2 Governance Items a) Strategy Plan – Attachment B (NH bringing to meeting) ➢ NH handed out copies for members to review during the meeting, so all items are covered.

b) CCA vacancy 2 vacancies now – CCA are aware

c) LPC elections 2018 update CCA have asked for information of the number of CCA places by beginning of December

d) Member skills – Attachment D1 and D2 ➢ Members were due to send these back before the meeting for review, but decided to leave until new committee in May 2018

Page 3 of 11 Doncaster LPC minutes 08.11.17 3 NHS Contract Matters Regulations guidance –https://www.gov.uk/government/publications/nhs-pharmaceutical- services-assessing-applications

3.1 New contracts-Routine None received

3.2 New contracts-Excepted None received

Contract applications received from other areas None received

3.3 Litigation None received

3.4 Decisions Application offering to meet an identified current need By: Aamir Shahzad At: Queen Mary’s Road, Rossington, Doncaster No decision has been made – AE has checked with PCSE

3.4.2 Application offering unforeseen benefits By: Tariq Khan At: Vicinity of retail zone, Hayfield Lane, Hayfield Green, Doncaster, DN9 3NB Approved Original application was in 2015 and only just been approved (email from PCSE) Potentially could affect Auckley Pharmacy and other neighbouring pharmacies Needs to be open in 6 months (can ask for 3 month extension to make 9 months) – keep a check on progress of applications.

Decisions from other areas None received

3.5 Responses received. None received

3.6 Amendment to Pharmaceutical List 3.6.1 Application for distance selling pharmacy By: Wellbeing Pharma Ltd T/A Rossington Pharmacy At: Unit 3, Bankwood Lane Trading Park, Rossington, Doncaster, South , DN11 0PS Opened on 09.10.17 Need to demonstrate provide medication to the whole of England

Page 4 of 11 Doncaster LPC minutes 08.11.17 4 Treasurer reports 4.1 Finances for September / October 2017 – Attachment E1, E2 and E3 Claims for Target training – Weldricks to claim through their HR, When receive all the expenses for TARGET then see if have enough to give a levy holiday. Not paid PSNC levy yet – will pay this month 2 x new contractors – need to ensure that they are paying – AE to go through list of new contracts and change of ownership and check with RH. HLP - £2000 overspent, but LPC agreed to underwrite in case further funding was not available as it was important for contractors to provide support to implement HLP at pace and scale.

Statement from Complete Catering – outstanding payments AE to look through minutes – check if there was a sponsor for that meeting and then check if they paid. Check emails re sent invoices from 2015/ 2016. AE to contact Complete Catering and ask to confirm the payments etc and explain who and when paid.

Action: AE to check minutes re sponsors and catering invoices. AE to then contact Complete Catering regarding unpaid invoices.

5 Pharmacy Funding Cuts and contract changes Quality Payments update ➢ Healthy Living Pharmacy – update on training sessions More people attended than budgeted – more booked on towards the end and also after these had finished more contact from pharmacies Number of DNA’s – see what the actual amount was and see if need to charge for this. Feedback was that staff expected to come out of the session knowing what to do as an HLP. ? guidance around HLP – PSNC have sent out enough so decided not to do more as just adding to confusion. Only had problems with the catering not arriving one day and issues with parking in the other businesses car park instead of on the street. Otherwise feedback was good.

➢ HLP resits Only 4 – not heard outcomes of these resits yet. Declaration data by LPC area – http://www.psnc.org.uk/QPSstats> Not sure what pharmacies have Champions as some have done internal training – Rowlands, Lloyds, Tesco etc. Also, leadership has been done through CPPE so not sure how many are trained. Only shows those that have self-declared.

➢ QPS dashboard created by Darren Powell – Attachment F Shows the information from SY – can see by LPC or pharmacy Safety report – identified that there is need for support regarding this Signpost to the pharmacy safety / PSNC documents

➢ Medicines Safety Newsletter Issue 1 - October 2017 – Attachment G

➢ NUMSAS update and request for feedback Data from NHS England on the NHS Urgent Medicine Supply Advanced Service (NUMSAS) pilot has revealed that, between December 2016 and July 2017, 12,982 items have been supplied by community pharmacies as part of the service. NHS England is also now inviting community pharmacy contractors, pharmacy teams and LPCs to provide feedback on NUMSAS. Find out more at: ow.ly/7yZA30fVXbJ Only 3 pharmacies in Doncaster do this – maybe need to ask if wish to take part in this feedback exercise NH will feed this back. PharmOutcomes – NUMSAS is not on this for SY but is for WY and Nottinghamshire. Good for auditing the service.

➢ Patient Safety Report

Page 5 of 11 Doncaster LPC minutes 08.11.17 LPC to decide what further support might be required by contractors and how best it might deliver http://psnc.org.uk/wp-content/uploads/2017/10/Completion-of-the-Patient-Safety-Report- Quality-Criterion.pdf https://pharmacysafety.org/ Members felt the Patient Safety Group material was very comprehensive so no need to produce anything separately – signpost to the resource, and support individual queries.

6 Chair reports –

6.1 Freedom to Speak Up Guardian for independent contractors?? Guidance on Whistle Blowing from PSNC All expected to have a nominated guardian – needs to be outside of the line management of the pharmacy. Guidelines state that LDC’s have taken on this role. Does the LPC take on this role for independents? Only person really could be is NH. Not straight forward though as need to pass on to the relevant party and will take considerable tome should a report be made. Added to this is the issue of liability and conflict of interest as the LPC represents the pharmacy contractor so decided that the LPC will not take on this role at the moment – wait for more information.

7 Secretary reports

7.1 World Pharmacist Day – 25.09.17 Had a number of people help – McGills, D&R Sharp, Weldricks, Lloyds Was busy most of the day

7.2 PSNC Leadership Academy – 27th September 2017 (NH) Interesting – facilitated discussion / sharing with colleagues PSNC will now form virtual groups – media and communication etc, post queries into groups. Using technology to support this. PSNC have a growing workload like LPCs – struggling with demand. Reviewing how these groups can help support this.

7.3 LPC chairs and chief officers meeting – 31st October 2017 – (NH) Good briefing from Gordon Hockey – quite a few consultations on legislation / regulation changes - Branded generics - Non-part 8 There are some risks to pharmacy if all legislation goes through

7.4 LPC conference 2017 – 1st November 2017 – (MD/RH/NH) Kevin Barron MP was very positive re pharmacy and frustrated with the government Sue Sharpe stated that the PSNC have no idea about negotiations for 2018/19. Networking dinner was very good the night before the LPC conference – need to do this more often. Next year changing the format – moving the chairs and secs meeting separately.

7.5 NH / PC meeting with DBHT re MDS and dispensing – Attachment H Useful meeting. Pharmacies will have some patients on 7-day supply for clinical risk reasons and this need to be recognised by the hospital. Moving from discharge medications being supplied by the hospital to 28- day prescription being sent to the patients nominated pharmacy. Discharge letters – pharmacy can request these – AB sending through separate telephone number. Suggested using NHSnet mail. Maybe need to have an engagement event between community pharmacy and hospital pharmacists – need to work more closely.

7.6 PSNC pharmacy winter campaign day 21.11.17 – Attachment I ➢ Discussion re lobbying MPs – PSNC are hosting a parliamentary briefing 21.11.17 – RS from Notts LPC attending. LPC have written to MPs – Rosie Winterton has responded and is not able to attend but wishes to do a pharmacy visit – waiting for date. Ask her to ask the Minister to comment on the Murray report and also on changing the pharmacy contract / funding model.

Page 6 of 11 Doncaster LPC minutes 08.11.17 MP / Councillor – collaboration re pharmacy visits DP to contact Caroline Flint MP re attending the parliamentary briefing

7.7 PSNC research – Attachment J Ashridge Research – Doncaster CCG and NHS England SY were part of this There are 3 major barriers - integrated working funding - lack of electronic record sharing - Lack of engagement by pharmacies – links to poor commissioning due to fragmented environment. Advised members to read this report

7.8 Target training Have pharmacies seen any increase in EPS prescriptions? Didn’t have as many conversations with gp’s as would have liked. GP’s asked why pharmacy asked patient questions with eRD Need to pursue the conversations with the gp surgeries locally

8 Tenders and bids / Consultations / Service Opportunities / LPC future - update 8.1 Stop smoking service awarded Doncaster service has been awarded to SWYFT and Rotherham have awarded to Parkwood Email re SLA and PGD – concerns raised by a few pharmacists PGD – why use Zyban when have Champix? Lots of concerns have been raised and let SWYFT know that most pharmacies will not sign the Zyban PGD.

NH will send through the comments received around the PGD to Simon Lister @ SWYFT

9 Members report

9.1 SYResearch Interest Group & Spirometry (RH) Looking at Asthma and allergies in children Spirometry event – 14.11.17 – sponsored by GSK Assessment / diagnosis of the breathless patient Voluntary group – enthusiasts - Asking for help to run the groups

9.2 Doncaster 'Living Independently' Roadshow (25-29 September) (PC) Pharmacy M attended at Mexborough Claire Thomas (Sheffield LPC / Weldricks) attended in Thorne Spoke about flu jabs and MURs – promoted pharmacy in general

Action: Newsletter / website / tweet – PC sending photos and info

10 Correspondence

10.1 NHS Digital Nothing received

10.2 AIMp / CCA PC elections info - Discussed earlier

10.3 LPF Nothing received

10.4 PCSE (Capita) Nothing received

Page 7 of 11 Doncaster LPC minutes 08.11.17 10.5 CPPE Mary Seacole leadership programme for community pharmacy - Attachment K1, K2, K3 Main NHS leadership program – training is funded but need to have 3 study days – January 2018 in Doncaster. Members noted little promotion of the benefits have been made and those most likely to need are unaware of that need – therefore some awareness / support required to help pharmacists to identify their learning needs.

10.6 Doncaster Carers Service Doncaster Carers Service October e-circular – Attachment L Carers are able to get NHS Flu vaccines through pharmacy now as eligible – waiting for paperwork to be updated.

Action: AE to contact Carers Service to let them know that pharmacy can provide the vaccine to carers – added to the eligible groups.

11 Reports (some items will be covered in the open meeting)

a. NHS Commissioning Board Area Team update Nothing received

b. Local Authority update i. Yorkshire Smokefree - staff providing Zyban discussion Talked about earlier in the meeting

ii. PNA update Pre consultation draft document DP will look through PNA section for Thorne and also RW

c. CCG update i. Doncaster Health and Care Interoperability Group (DHCIG) – Attachment M For information –

d. LPN Verbal update (NH) No date for meeting

e. Area Prescribing Committee (RH) changing contractor from council to private company re diabetic needles information will be sent out to pharmacies – Gill Bradley

f. supply of parental DMARDs through primary care as opposed the hospital (RH) Methotrexate (Nordimet) – may be some supply issues – Quota is set to 0 for community pharmacy so need these to be changed once the service is agreed. Pre-filled syringes – work better regarding absorption – 2nd line Feel that pharmacy will not be stocking but will be able to provide (order in) – need to let patients know that they will need to wait for delivery. Will need to be allocated purple sharps bin for returns. Better to commission company to pick up from pharmacy rather than individual patients

g. SY LPC i. SYB UECN meeting 03 Oct.17 – Attachment N Next meeting 15.11.17 (RW) One of the STP workstream meetings RW attending the next meeting

ii. 05.10.17 meeting

iii. SYB LPC's future planning discussion

Page 8 of 11 Doncaster LPC minutes 08.11.17 Merging - CCA are in favour. Needs to be a proper discussion across all SY LPCs – need to dedicate the January 2018 meeting to it. Tom Bisset, Barnsley LPC, has sent through information around sharing resources and employing development person across SY. PSNC are now encouraging merger – efficiency is the main purpose. If have one LPC meeting across SY with 15 members – less costs to contractors – less admin and employee costs. Some concerns about how merging will affect Doncaster contractors and relationships with CCG etc Query whether should speak to contractors in WY on how they get their points heard for different areas – Wakefield, Huddersfield etc. Feedback to CCA – need to talk to the LPC and why there is a benefit to merging Hear from contractors who are part of a merged LPC – Lincoln Co-op?? independents Ask Phil Maslin to attend from CCA

Action: 1st meeting for 2018 should be dedicated to these discussions on merging – more information - and then decide if merge or do more collaborative working. Open to all members from LPCs across SY that are interested in attending. Action: NH contact Phil Maslin and ask to attend the January 2018 meeting to explain CCA’s view

i. SYB LPC Shared Resources – Attachment P Discussed earlier item

ii. SYB PCWG 26/10/17 – Attachment O

h. HEE i. Community Pharmacy Education Network Meeting 23.08.17 – next meeting 28.11.17 Attachment Q Chris Bland, Rotherham LPC chair, attending for SY

12 East Midlands Region 12.1 15th September 2017 update ➢ Nothing further to report

13 PSNC Communications Members are advised that many PSNC communications are now communicated electronically and repeated on the PSNC website. It is recommended that members regularly visit the PSNC website ‘ LPC members’ area to access the latest information available onhttp://psnc.org.uk/

13.1 PSNC newsletters 13.1.1 Generics supply update | Party conferences | MUR post-payment verification | Key EPS learnings | Pharmacy provides 275k flu jabs | Winter campaign 13.1.2 PSNC News: Quality Payments reminder: Urgent action required by contractors who appear to have not met the gateway criteria for the April review point 13.1.3 September 2017 Price Concessions/NCSO further update 13.1.4 Campaign email 13.1.5 Quality Payments: New NHS Guidance published; April declaration data published 13.1.6 PSNC News Alert: Quality Payments: Have you reviewed your NHS Choices profile yet? 13.1.7 PSNC News: Quality Payments deadline approaches - Urgent action required by contractors who appear to have not met the gateway criteria in April 13.1.8 PSNC at party conferences | Generic supply issues | EPS CD pilot | Flu Vaccination Service news | NHS England plans pharmacy campaign 13.1.9 October 2017 Price Concessions/NCSO 13.1.10 Quality Payments reminder: action required if you haven’t got a pharmacy NHSmail account 13.1.11 Quality Payments reminder: action required if you haven’t got a pharmacy NHSmail account 13.1.12 PSNC News Alert: Flu vaccination for care home workers 13.1.13 November campaign day | Challenging Government | DoS updater volunteers | Patient safety report resource | Staff vaccination reminder | NUMSAS update 13.1.14 October edition of CPN magazine out now 13.1.15 October 2017 Price Concessions/NCSO (update) 13.1.16 PSNC News Alert: Advance payments to rise by 15p per item in 1st November payment Page 9 of 11 Doncaster LPC minutes 08.11.17 13.1.17 Lords hear value of pharmacy | November 1st advance payment to rise by 15p per item | Upcoming campaigning day | Quality Payment updates 13.1.18 Quality Payments reminder: Have you used the Directory of Services profile updater? 13.1.19 October 2017 Price Concessions/NCSO (further update) 13.1.20 Pharmacy Winter campaign day | 190 LloydsPharmacy branches to cease trading | Prescription Services is going digital | Checking your flu payments

LPC newsletters 13.1.21 LPC News: Briefing on priorities and structures; Become an LPC mentor; Working with provide companies; Healthcare Together news; Dates for your diary 13.1.22 LPC News: Greater Manchester 'in the Spotlight'; Quality Payments data by LPC area; Presentation on November review point; Upcoming events 13.1. 23 LPC Communications: Community Pharmacy Campaigning Day, November 21st 13.1. 24 LPC News Alert: LPC Conference and Chairs & COs agendas 13.1.25 LPC News: Commissioning research published; PSNC launches networking platforms; #Pharmacywinter campaign day; Working with other healthcare providers 13.1.26 LPC Communications: #pharmacywinter campaign day

13.2 PSNC Events Nothing planned

13.3 PSNC Pricing audit reports Nothing received

14 Strategy Plan Any outstanding items not covered on the agenda

Relationships NHS England Sheffield CCG – out of pocket expenses – NHS England have a public duty to investigate

Inter professional Learning opportunity for new year – patient with suspected meningitis and septicaemia who had been to see pharmacy. Need to check opinion of hospital re direct referrals. Education on this would be welcome.

15 Any matters for discussion not on the agenda (AOB allocated to either open or closed session as appropriate) – to be informed to the chairman at the start of the meeting Nothing raised

Future meetings

Dates Time Venue 10/01/2018 3pm – 6pm (1pm – Conference Room , Weldricks 3pm open) 14/03/2018 3pm – 6pm (1pm – Conference Room , Weldricks 3pm open) 09/05/2018 3pm – 6pm (1pm – Conference Room , Weldricks 3pm open) 11/07/2018 9pm – 5.30pm (2pm – Conference Room , Weldricks 4pm open) 12/09/2018 3pm – 6pm (1pm – Conference Room , Weldricks 3pm open) 14/11/2018 3pm – 6pm (1pm – Conference Room , Weldricks 3pm open)

Page 10 of 11 Doncaster LPC minutes 08.11.17

The meeting ended at 6pm The next meeting will be held on Wednesday 10TH January 2018 at 1pm

Amendments to minutes (if any):

Signed as a true and proper record:

Proposed by: LM Seconded by: DS

Approved by: original signed by R Wells and members present at the LPC meeting Richard Wells, Chairman. 10th January 2018

Page 11 of 11 Doncaster LPC minutes 08.11.17