Unit 8 Weltech Centre, Ridgeway, Welwyn Garden City, Herts, AL7 2AA Tel: 01707 390095 Fax: 01707 390124 Email: info@hertslpc.org.uk www.hertslpc.org.uk OPEN MEETING MINUTES Wednesday 25 January 2017 Ramada Hotel, Hatfield Present Girish Mehta () - GM Deepak Agrawal DA Nilesh Bathia - NB Hitesh Dodhia - HD Garry Michaels - GMi Raj Patel RP Graham Phillips - GP Diviya Shah - DS Rachel Solanki - RS Roy Winograd - RW Apologies Karsan Chandegra Ingrid Cruickshank Parag Oza Lewis Smart Professional - HM Sara Norwood (Minute Taker) - SN Jeanette Edwards - JE Guests Jane Bray (NHS England) - JB Liz Fisher (PH HCC) - LF Steve Peacock (H&E STP) - SP Alan Spicer (NHS England) - AS Raj Sahota (HBL ICT) - RSa Pauline Walton (ENHCCG) PW Carol Young (PH HCC) - CY Apologies Jane Banbury (PH HCC) Paul Gershlick (VWV LLP) Rachel Lea (LMC) Zara Mehra (CPPE)
Minute Agenda Item No. 1. WELCOME & APOLOGIES FOR ABSENCE GM welcomed everyone to the meeting. Apologies were received from LPC members Karsan Chandegra, Ingrid Cruickshank, Parag Oza and Lewis Smart and guests Jane Banbury, Paul Gershlick, Rachel Lea and Zara Mehra. Lead 2. DECLARATION OF INTEREST None. 3. ITEMS OF URGENT BUSINESS Easter Sunday opening hours. 4. 4.1 4.2 MINUTES OF OPEN MEETING HELD ON 28 SEPTEMBER 2016 Minutes were ratified and approved. Matters Arising Domiciliary MUR project and specials which will be discussed at agenda item 7. 5. COMMUNITY PHARMACY NATIONAL INFORMATION The committee discussed the changes to the Community Pharmacy Contract 2017-2019. The community pharmacy contract judicial review was noted along with the Murray Review recommendations. Unfortunately no one was present from the CCGs at this point but HM queried how the CCGs and the STP could consider implementation of some of the recommendations such as electronic repeat dispensing and clinical MURs. The following issue were raised: Changes to the contract and clarity about the self declaration are unclear and the LPC asked if the contractor can choose which day to submit the declarations. AS informed the committee that the current indications are that assessment to meet quality payments will be by self-declaration similar to the CPAF process. The date is set by NHS England nationally and the declaration must be received before 28 April 2017 to receive payment. However, no documentation or guidance has been issued nationally yet and it is unclear whether local teams will have local discretion. ACTION: AS to clarify the process for self-declaration and whether a pharmacy would still be compliant on 28 April 2017 if for any reason they had an emergency and were not compliant on that day. The advice to pharmacies regarding getting nhs.net email addresses is not clear. Concern was expressed that pharmacies with current nhs.net addresses would not be compliant as they did not have nhs.net shared mailboxes. It was noted that both NHS England and the LPC had sent out advice to all pharmacies to reply and request an nhs.email account by 1 February 2017 even if they already had an nhs.net email account. It was noted that due to the high demand for nhs.net email addresses it was expected that the new email accounts should be up and running by 1 April 2017. AS
6. 6.1 6.2 HERTFORDSHIRE COUNTY COUNCIL Public Health Update GM welcomed Liz Fisher and Carol Young to the meeting. The report was received. Public Health Contracts 2017-2020 CY confirmed that information on service activity for stop smoking and sexual health to date and whether pharmacies would be meeting the new contract criteria have been sent out to all contractors. It was noted that the contracts sent to CCA contractors were sent via email to their respective Head Offices and independent contractors were sent via hard copy in the post. The LPC requested that individual CCA branches should receive a copy of the letter too. ACTION: CY will forward the notification to each CCA branch. It was noted that the LPC had some detailed comments on the sexual health and stop smoking specifications that would be more time effective to send to public health electronically after the meeting. ACTION: HM confirmed she would send LF the comments from the LPC on the specifications. The LPC raised the following issues: The terms and conditions of the public health contract would be signed blind by many independent contractors and all done in goodwill. It would be a challenge, both in time and expertise, to legally check the whole document. HM noted the LPC s continued request to adopt the national public health contract that all pharmacies both CCA and independent would feel more comfortable signing. LF reiterated that this was the advice from the legal team at Hertfordshire County Council and this cannot be changed currently but it was something that would continue to be fed back. CY Comm/ HM Diviya Shah arrived at 11:07am Further questions and concerns were raised and LF confirmed Phase 2 should mitigate these concerns. It was suggested to include the Varenicline PGD service spec and IT data in the contract. The LPC informed LF that the PNA patient questionnaire had been sent out to GPs and CPs with no covering letter and that in some instances these organisations had had to pay to pick up these letters. It was noted that this issue had now been resolved. However HM expressed concern that Hertfordshire County Council and HVCCG communications representatives were unaware of the PNA patient questionnaire and it was queried how information had been sent to communications teams and patient groups represented by the PNA steering group. ACTION: LF to feedback the LPC comments internally and to Soar Beyond managing the PNA process as well as considering an extension to the questionnaire deadline. LF
7 7.1 NHS ENGLAND Central Midlands Area Team Update GM welcomed Alan Spicer and Jane Bray to the meeting. The report was received. AS noted the disappointment expressed in the non-attendance of his team from the previous minutes and apologised. AS confirmed that NHS England is committed to attending LPC meetings but unfortunately this had clashed with an important Performance Service Review Committee meeting at which team members must be present. The following issues were raised: HM requested that those pharmacies that were chosen to submit full CPAF reports are sent to the LPC office so that the LPC can support both contractors and NHS England to ensure that all pharmacies submit the required information. NHS England agreed to undertake this in the future. AS confirmed that NUMSAS will be going live on 1 March 2017. Concerns were expressed regarding Capita and their obligations regarding market entry as the LPC were not always receiving market entry notifications. The LPC informed the meeting that Capita were not fulfilling their obligations and were in breach of NHS regulations. ACTION: HM to continue to copy all details and concerns to NHS England. JB confirmed that despite inviting pharmacies to respond and indicate their opening hours for Easter not all pharmacies had responded and this meant that there was not sufficient pharmacies open on Easter Sunday. Therefore 23 contractors in Hertfordshire would be directed to open on Easter Sunday. The LPC queried what the process was for how pharmacy contractors were chosen to be open on Bank Holidays. JB confirmed that contractors chosen to open on holiday days are selected by town and previous data on whether they had recently been open for a Bank Holiday. It was noted that if the LPC became aware in discrepancies in this process then NHS England should be informed. Concern was expressed by the LPC that there were few customers on New Year s Day when open and that this was a waste in NHS resources. NHS England noted that they do ask for feedback from pharmacies that are open on Bank Holidays so they can assess need. ACTION: HM requested to be copied in on future requests to pharmacies to send in their opening hours for Bank Holidays so that the LPC could encourage pharmacies to respond. HM JB Raj Patel left at 11:57am 8. 8.1 8.2 HERTS VALLEYS CCG Draft QIPP Plan 2017-2018 The QIPP Plan was noted. This item was not discussed as there was no representative from HVCCG in attendance. Stakeholder Update December 2016 The stakeholder update was noted. This item was not discussed as there was no representative from HVCCG in attendance.
9. 9.1 HERTFORDSHIRE AND WEST ESSEX SUSTAINABILITY AND TRANSFORMATION PLAN Update GM welcomed Steve Peacock (Programme Director) to the meeting. Steve Peacock gave an oral presentation which would be shared electronically. The report was received. The following questions were raised: The LPC asked how does the STP plan to involve community pharmacy in its governance structure along with being involved at the beginning of service developments and changes? SP noted that this was still in early development and that this needed further discussion and exploration. SP confirmed that some suggestions would be to use pharmacists as clinical experts as part of the clinical reference group and also through workstreams such as the primary care/community care group. ACTION: SP to contact HM to take forward community pharmacy involvement. SP The LPC informed SP that community pharmacy can work with the STP on so many levels and what was missing from the presentation is the vision on what community pharmacy can do. It was asked if community pharmacy could work with the STP locally. SP confirmed they need to use community pharmacy in the planning work and will use the LPC as its primary contact to work as local and clinical leadership. 10. 10.1 HERTFORDSHIRE, BEDFORDSHIRE & LUTON ICT SERVICES EPS2 Implementation Update and Pharmacy Issues GM welcomed Raj Sahota to the meeting. RSa informed the meeting that nearly all practices who had requested implementation of EPS II were live. It was noted that some GP practices were not interested in going live with EPS. HM noted she has had no updates on practices going EPS live since October 2016 and RSa would rectify this. The following questions were raised: It was enquired how the CCGs and ICT services would be supporting practices to go live with repeat dispensing. RSa indicated that this was reiterated at each go live and this would be an area of work going forward. It was noted that ENCCG would be keen to work with RSa to progress this work. It was requested that it would be useful if EPS meetings between GP practices and community pharmacies could be arranged a little while after EPS had gone live to reflect on any issues. RSa would consider this request. It was asked if tokens can stop being repeated on repeat dispensing. RSa confirmed that they can come off after the first dispense depending on the GP practice system. It was noted that there was work being undertaken on the enhanced Summary Care Record and the LPC queried whether community pharmacies would be getting access to this. The LPC understood that the CCG had to approve this but this was not clear. RSa would investigate this with the CCGs.
It was asked if CPs would be moving to the next phase of EPS. RSa confirmed that a trial was to be undertaken but was unsure of the date. RSa suggested that the next phase will be more auditable as patients will only be given EPS tokens, not prescriptions but patients will not notice any change. ACTION: Follow up meeting regarding EPS to be arranged between HM and RSa to discuss issues. HM/RSa 11. 11.1 12. 12.1 HERTFORDSHIRE HEALTHWATCH Update This item was not discussed as Brian Gunson did not attend the meeting and no apologies were received. EAST & NORTH HERTS CCG Update GM welcomed Pauline Walton to the meeting. PW confirmed the following points: QIPP agenda East & North Herts for 2017/18 has a shortfall of 28m. They would now focus on prescribing by changing medication, deprescribing and pathways in pharmacy. ACTION: PW to send HM highlights from QIPP plan. CPESS will continue to be commissioned until the end of March 2017 and will be decommissioned after that date. Flu outbreak in care homes across Hertfordshire is very high. PW thanked CPs in stepping up to support the need for these patients. PW 13. ANY OTHER BUSINESS None. 14. NEXT OPEN MEETING Wednesday 24 May 2017 (10:30am-1:00pm) Ramada Hotel, Hatfield