CPWY Minutes

Location: Village Hotel, Capitol Boulevard West, Tingley, , LS27 0TS Date: Wednesday 22nd November 2017

1.1 Present 1.2 Apologies Ian Ainsworth CCA IA Gulam Arsiwalla AIMp GA David Broome Independent DB Anne Cawdron Independent AC Helen Davis CCA HD Fiona Fox CCA FF Mohammed Hussain Independent MH Apologies Mohammed Ikhlaq Independent MI Bali Kaila CCA BK Shabnam Kosar CCA SK Sue Lee Independent SL Keith Sandhu CCA KS Adeel Sarwar Independent ASa Amanda Smith Independent ASm Beverley Thornton CCA BT

2.1 In Attendance 2.2 Apologies Ruth Buchan Chief Executive Officer RB Melissa Burnley Service Implementation Lead MB Darren De Souza Public Health and Engagement Lead DDS Kathryn Kelly Head of Operations and Support KK Lisa Meeks Service Implementation Lead LM am only

3.0 WELCOME TO THE MEETING • Apologies were received from Mohammed Hussain • Katie Linstead from Day Lewis Pharmacy, attending as an observer, was welcomed to the meeting. • Members were asked to observe meeting etiquette. 4.0 COMMITTEE GOVERNANCE Members were asked to note the contents of the LPC Code of Conduct and inform the Chair of any changes to their Declaration of Interests.

Members were also asked to note the Competition Law Compliance Guidelines. 5.0 MINUTES OF THE LAST MEETING The minutes of the meeting on 13th September 2017 were proposed as a true record of the meeting by HD and seconded by ASa. These were signed by FF. 6.0 MATTERS ARISING AND REVIEW OF THE ACTION POINTS OF FROM THE MINUTES SL left the meeting during this session to take a conference call for around an hour.

6.1 6.1 – Electronic Repeat Dispensing (eRD) • Following feedback from HD and DB at the July meeting around their concerns about the key messages and knowledge of NHS Digital staff relating to eRD, this was fedback to MH. • RB advised that she is meeting with NHS Digital regarding potential training events. • HD had become aware of some work being done in by Well around training pharmacists on the GP elements of eRD. BT reported that this was some work done locally with a GP practice who was reluctant to engage with eRD. BT advised that arrangements can be made for a local trainer to go into a practice for a week, if the GP funds this. • MB is working on a guide on how eRD works in both community pharmacy and GP practice. • An A4 “how to do” on the main systems and the pitfalls and troubleshooting has been completed. 6.2 6.2 – 7-Day Prescribing Guide MI has undertaken work on preparing a notification around 7-day prescribing. Work on this will continue and the document will be circulated Action: 7-Day Prescribing notification to be finalised and circulated to pharmacies. RB 6.3 6.7 – Pharmacy Integration Fund No additional suggestions have been received from members for topics for Pharmacy Integration funding bids. The following two suggestions from RB will be put forward: • Work around care navigators looking at better directing patients, possibly using mobile DoS • Using pharmacy integration funding for the community pharmacy referral scheme 6.4 7.3 – Sharps Returns Information regarding pharmacies who will accept sharps returned by patients has been received from the Area Team and has been updated on the Community Pharmacy West website. 6.5 15.3 - Rebate Schemes • RB has been in contact with Bolton LPC regarding rebate schemes as it was thought that these had been stopped in the area, however, this is not the case. • Following discussions at the previous meeting around FoI requests, PSNC have advised that they are looking into rebate schemes and have asked that no FoI requests are instigated. 6.6 15.4 – Healthwatch RB and DDS have made contact and are speaking with Healthwatch in the area. 6.7 15.6 – EHC No formal response has been received to the letter sent to Bradford Public Health around the termination of the EHC service in Bradford. It was felt that there is little other action which can now be taken to overturn this decision. 6.8 16.0 – Committee Skills Mapping Following on from the committee skills mapping exercise, a letter is to be prepared and circulated to all contractors detailing the committee members for each locality along with the members’ contact details. Action:- Letter of introduction to be drafted to be approved by the committee. RB 6.9 All other items have been completed or are agenda items.

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7.0 NHS - NORTH () – Gill Sealy 7.1 Palliative Care • Work is continuing developing a wide service. Three-months’ notice will be given for the current service and expression of interest letters will be sent out for the new service which is due to start on 1st April 2018. Work is ongoing to finalise the formulary. • RB highlighted that an IT platform is required for this service otherwise the SLA will need to be revisited around costs. • Members expressed concerns around the residual drugs for the terminated service. GS advised that she believed these would be paid for. Action: MW and MB to meet to discuss taking this forward. MW/MB 7.2 Bank Holiday NUMSAS Cover • Christmas cover for pharmacies providing NUMSAS is to be pushed forward. Information to be shared with MB later today. • Area team will write out to pharmacies in January 2018 asking for Bank Holiday coverage plans for the year. RB advised that the PharmOutcomes system would be a good way to capture this information should the Area Team be willing to fund a licence. Action: GS to discuss PharmOutcomes option with Anna Ladd. GS 7.3 NHSmail – Principles of Use • NHSE have email addresses for many community pharmacies and wish to look at moving to electronic communication. RB highlighted the need for principles of use to be in place prior to this becoming the preferred method of communication. • The importance of supporting pharmacies prior to these changes being implemented was highlighted. • Members discussed potential issues with this line of communication which included: ▪ Pharmacies not checking their emails on a regular basis and how to develop habits to ensure that this is done ▪ The need to be able to see that there are emails waiting to be read ▪ Area manager access to NHSmail ▪ Advice from PMR suppliers around not having emails due to the risk of viruses Action: RB to work with NHS England for a proposal to move from letter based RB communications to NHSmail communications. 7.4 CPAF The full CPAF questionnaire has been sent to 37 pharmacies to be completed. 14 of the pharmacies have accessed the questionnaire but not yet completed and 14 have not yet accessed it. Action: GS to share pharmacy information with KK so the pharmacies can be supported GS with this. 8.0 FREEDOM TO SPEAK UP GUARDIAN PSNC have produced template documents to allow LPC members to be a guardian. Following discussion at the last meeting members had concerns about being the representative for their own contractors. A proposal was put forward at the regional PSNC meeting to use a neighbouring LPC. Humber and North Yorkshire LPC had concerns around the number of pharmacies in West Yorkshire, but an option for Community

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Pharmacy West Yorkshire to act for their contractors and the two LPCs to share the West Yorkshire contractors may be an alternative.

Members expressed concerns about the risks to LPCs of undertaking this role and the training requirements to enable members to act appropriately.

Members felt that this should be a role undertaken by NHS England and that Community Pharmacy West Yorkshire would support contractors going through the process. Action: RB to take this back to NHS England RB 9.0 PSNC CONFERENCE RB, FF, MI and DDS attended this year’s conference in Manchester. RB gave members an overview of the main discussion points: • Political engagement • The role of community pharmacy • Working across sectors • New ways of working – Primary Care Home • PSNC reductions in spending and LPCs working at a regional level • Pharmacy funding • The way forward 10.0 PRIMARY CARE HOME RB gave members an overview of primary care home. This is already active in Yeadon, with DB attending these meetings and in Armley with MB attending here.

DB advised that the meetings are evolving to be GP focused and highlighted the need for the groups to see what community pharmacy can offer. MB stated that it is important to go to these meeting with an offer of what community pharmacy can do.

Letters are to be sent out to pharmacies in Leeds and Bradford regarding alignment to neighbourhoods and expressions of interest to represent pharmacy at these meetings.

Members again discussed the funding for contractors to attend these meetings.

Action: RB to send DB details of the Medicines Optimisation service from Bath and ME RB Somerset to share with the Local Care Partnership, if relevant. 11.0 COMMUNITY PHARMACY WEST YORKSHIRE AWARDS DINNER DDS delivered a presentation to members around proposals for an awards dinner to celebrate what pharmacy does. The awards will be targeted at all members of the pharmacy team.

Members were in support of this event and felt it should be held in February 2019. Funding and costings are still to be finalised. DB advised that he had been involved with the Community Pharmacy Humber’s event and would support the team with this. FF, AC ASm and BK also offered their support.

Action: DDS to continue to work on the proposal. 12.0 SERVICE AND EVALUATION UPDATE – Lisa Meeks Key areas for update included: 12.1 Workplan Ref: 18

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LM advised members that despite an initial positive meeting with AWC CCG to discuss the extension of Pharmacy First, they have taken the decision to terminate the service from 8th February 2018. A formal response has been sent to the CCG requesting the rationale behind the decision.

Work is underway on the preparation of a Leeds wide service from April 2018. A business case for a PGD service will be prepared for presentation to Leeds CCG Partnership. 12.2 Workplan Ref: 20 The delivery of the flu vaccination service is going well in pharmacies, although access to data has been withdrawn by the Area Team which means it is now difficult to support pharmacies. DB advised that this is not a national decision and other areas do still have access to this data. It was outlined that this decision is being challenged by the CPWY team. It was highlighted that the PharmOutcomes license is paid for locally, however, it may be an option to put in a FoI request.

Vaccination of care home staff is now included in the PGD. Members discussed whether Community Pharmacy West Yorkshire should write out to care homes to advise of this. It was suggested that this information be sent to www.carehome.co.uk for them to disseminate. Action: LM to send information to www.carehome.co.uk regarding the vaccination of LM care home staff. Work outside of the workplan included: 12.3 Leeds Community Blood Pressure This new service which is still being developed, will be delivered in 6 pharmacies in a selected area. It is expected that the service will go live in January 2018. 12.4 Alcohol Service This service has very limited funding and will be commissioned from 12 pharmacies. Service administration and funding is still to be agreed and once finalised letters for expressions of interest will be sent out to pharmacies. 12.5 LEEDS SUPERVISION Following the transfer to recording provisions on PharmOutcomes there has been an increase in the cost of the service. FF highlighted that the move to 7-day supervision will have an impact on costs. Action: LM to feed back to the commissioner the information regarding 7-day LM supervision. 13.0 SERVICE DEVELOPMENT UPDATE – Melissa Burnley Key areas for update included: 13.1 Workplan Ref: 10 Work is continuing on Walk in My Shoes. BE is working to support pharmacies who wish to engage with this. MB asked members to advise her if they wished to use Walk In My Shoes in their pharmacy/practice. 13.2 Workplan Ref: 13 The NUMSAS service has been extended for a further 6 months. Feedback has been that the service in West Yorkshire has been more efficient than in other areas of Yorkshire. It was reported back that having the support of Community Pharmacy West Yorkshire and the use of PharmOutcomes has been a great help. MI suggested checking with pharmacies that they are being paid correctly for the service.

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Action: MB to investigate how pharmacies would know if they have been correctly paid MB for drugs on the service. Work outside of the workplan included: 13.3 EHC The contract has been extended to the end of March 2018. The new SLA to include Ulipristal is still awaited. 13.4 Wakefield Supervision The commissioner has advised that they will be reducing the payment for Buprenorphine, but this change is still to be finalised. 13.5 Wakefield EHC An update on the new service is still awaited and no confirmation on the roll out date has been received. 14.0 OPERATIONS AND SUPPORT UPDATE – Kathryn Kelly Key areas for update included: 14.1 Workplan Ref: 22 Work on reviewing the fee charged to commissioners is underway. Mapping of funds has determined that there is currently a surplus after the PharmOutcomes licence has been paid, but it is yet to be determined whether this surplus covers the cost of the work done by the team. 14.2 Workplan Ref: 23 It is proving difficult to determine what insurance is in place for PSNC members to replicate for Community Pharmacy West Yorkshire members. Members suggested arranging a meeting with the project group to determine the next steps to take. Action: KK to arrange project group meeting. KK 14.3 Workplan Ref: 25 KK is due to attend GDPR training which will then help to guide the actions necessary to ensure compliance with the regulations when communicating with contractors and when sending out newsletters and events information. Work outside of the workplan included: 14.4 HLP Training Events Work has been done on arranging, marketing and recruiting for HLP Leadership and Champions events. 14 events have now been held with 162 people undertaking leadership training and 253 have undertaken champions training. 14.5 Liaison with MPs Work is ongoing to arrange meetings with a number of MPs in the area. 14.6 Lloyds Bank Online Issues with the setting up of the new banking platform have highlighted the need for an additional staff member to have access to the online system. Work is ongoing on this, with additional consideration being given to governance and transparency. 15.0 PUBLIC HEALTH UPDATE – Darren De Souza Key area for update included: 15.1 Workplan Ref: 5 A draft Patient Participation Group toolkit has been shared with a Leeds pharmacy as part of the CPPE Leadership Programme and their first meeting has been held. Donna Reid is supporting the pharmacy with this. 15.2 Workplan Ref: 26

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DDS is talking with NHS England regarding forthcoming public health campaigns. Considerations being given to communications and briefing for leaders and champions in pharmacies. 15.3 Workplan Ref: 27/28 DDS is looking at the plan for the Community Pharmacy West Yorkshire Development Academy for the next year and looking for funding. There are a number of pharmaceutical companies who have expressed an interest. 15.4 Workplan Ref: 30 Work on the public health strategy has been put on hold. Priority is being given to exploring how the local authority can work with community pharmacy though MECC, public health campaigns and Healthy Living Pharmacy. Work outside of the workplan included: 15.5 • Oral health in Wakefield • Possible opportunity around cancer strategy in Leeds • Obesity services in Bradford 16.0 WISE UP TO CANCER UPDATE – Lisa Wheater LW attended for this section of the meeting to update members on the progress of this service.

625 screens have been done to date. The service has been extended for a further 3 months with the aim of completing the commissioned 1000 screens. LW is working with pharmacies to ensure that targets are met. Pressures in pharmacies are resulting in difficulties in engagement with the service. Target numbers for pharmacies have been increased to ensure the target of 1000 screens is met by the end of March 2018. 17.0 CONTRACTOR QUALITY UPDATE – Bushra Effendi BE attended for this section of the meeting. Key areas for update included: 17.1 Workplan Ref: 31 Newsletters supporting pharmacies around the Gateway and quality criteria have been drafted and circulated to pharmacies.

162 contractors have been contacted by telephone for a second time and 15 pharmacies have received visits from BE to support them with quality payments.

BE is also in contact with area managers of multiples to offer support. 17.2 Workplan Ref: 32 BE attended an open day at NHSBSA in Wakefield to gain further knowledge on their systems to better support pharmacies. A top tips document will be produced, to be shared with pharmacies. Action: Top tips document to be drafted to be shared with contractors. BE 18.0 CHIEF EXECUTIVE UPDATE – Ruth Buchan Key areas for update included: 18.1 Workplan Ref: 1 Kirklees and Bradford PNA documents have been sent out for comments. RB will respond on behalf of Community Pharmacy West Yorkshire, but highlighted the need for members and contractors to read and respond. 18.2 Workplan Ref: 2 RB attended a national meeting and heard about how the Pharmacy Integration Fund is being spent. The £42m initially allocated to the fund will now be reduced but it is not

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currently known how much is available. All decisions about funding have been made centrally. 18.3 Workplan Ref: 3 Community Pharmacy West Yorkshire is repeatedly being asked to include information in newsletters around prescribing policies. RB feels that it is the responsibility of the CCG to send these messages direct to pharmacies.

Members agreed with this, and also felt it was a good idea to attach such messages to the end of the News Digest. 18.4 Workplan Ref: 4 RB advised that Leeds have not, to date, changed their repeat ordering policy. Members were advised of the importance of being proactive with GPs around repeat ordering. The CCG in Leeds has a toolkit to assist with changes to repeat ordering processes where a practice decides to take this action.

Members discussed whether a letter should be sent to Wakefield CCG outlining the impact that branded generics has on patient and pharmacy contractors. Members felt that it this should be raised in support of contractors. RB Action: RB to a draft letter to be sent to Wakefield CCG. 19.0 COMMITTEE NETWORKS Members gave updates on their progress making contact with pharmacies in their designated areas and on the progress of contact with Health & Wellbeing board councillors.

Main themes from the contractor contacts included: • Work load • Stock availability • Price concession • Branded generics

MI thanked members for their work on this and highlighted the need for contact to continue and the importance of engagement with councillors.

A letter will be sent to contractors detailing the contact information for the members active in their locality.

Action: RB to draft a letter to introduce members to their locality area. RB 20.0 PSNC UPDATE – David Broome • Matters raised at the LPC conference have been discussed in depth. • Drug prices remain a matter of concern and contractors are again asked to feedback where there are issues as, without this information, no concession prices will be applied. • The importance of the advance payment was highlighted. 21.0 LPN UPDATE – Mohammed Hussain There is no update in MH’s absence. 22.0 COMMUNITY PHARMACY WEST YORKSHIRE FINANCES Finance reports for both operational and services accounts were shared with members for information. DB thanked KK and LT for their work on the accounts.

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• Service Accounts The report shows the current position of the funding held for services. • Operations Accounts Members were asked to check their own expenses and report any issues. 23.0 COMMUNITY PHARMACY WEST YORKSHIRE RISK MATRIX DB requested time be allocated at the next meeting to review the matrix. 24.0 QUESTIONS FOR THE COMMITTEE A summary of the outputs from the questions at the last meeting were shared with members. 24.1 1. How do we engage with the new models of care - Primary Care Home? • There is no one best model for community pharmacy representation • Preferred model is for a pharmacist from within the PCH locality, but this may not always be possible • This is a developing model and the approach will need to be flexible Members felt that this attendance should be funded, possibly from hypothecated levy. The other option was that this work could be done by the team. This would require a reallocation of priorities. 24.2 2. How do we ensure consistency and quality of the community pharmacy offer? • The need to raise the profile of pharmacy in the press / social media as the public are unaware of the value and profile of community pharmacy • Regular contact with commissioners is now part of “Service” workplan • Encourage pharmacies to contact local councillors 24.3 3. How do we best protect community pharmacy services from commissioning decisions? • Funding model needs to change • Need to support pharmacies with consistency and quality. This is part of the workplan. 25.0 QUESTIONS FOR THE COMMITTEE - What’s the Offer? Members discussed what the offer in pharmacy should look like. Outputs from this will feed into the funding events in the New Year. 26.0 MEMBERS’ ITEMS AND ANY OTHER BUSINESS 26.1 Members’ Attendance at Meetings Members raised the issue of non-attendance and part day attendance at meetings. The importance for attending and contributing to meeting was highlighted. 26.2 Insulin Passports RB advised that the Diabetes networks are looking to stop promoting the use of insulin passports. Members confirmed that these are not being used in Leeds. 26.3 Research Requests Requests are being received at the office for community pharmacy input into research. Members felt that researchers should ask pharmacies for support via twitter, or directly approach pharmacies. 26.4 Christmas Get Together FF suggested a Christmas get together and will arrange and circulate details. 27.0 CCA REPORTING QUESTIONS HD will complete this report. 28.0 DETAILS OF NEXT MEETINGS All meetings will commence at 9.30am prompt and be held at the Village Hotel, Capitol Boulevard West, Tingley, Leeds, LS27 0TS on the following dates:

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• Wednesday 22nd November 2017 • Wednesday 17th January 2018 • Tuesday 20th March 2018 – Please note revised date for this meeting. • Wednesday 9th May 2018 • Wednesday 18th July 2018 • Wednesday 19th September 2018 • Wednesday 21st November 2018 • Wednesday 16th January 2019 • Wednesday 20th March 2019

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