meeting minutes - opencandi.lpcs.co.uk/wp-content/uploads/2016/08/ci-lpc... · 2017. 10. 5. ·...

Camden&IslingtonLocalPharmaceuticalCommittee

….thevoiceofpharmacyinCamden&Islington

MeetingMinutes-OPEN Thursday26thJanuary2017 09.00to17.30 IbisHotel,3CardingtonStreet,Euston,LondonNW12LW

ATTENDANCE

MemberName Initials

AttendanceP=Present,A=Absent,

Aa=Apologiessent.

SanjayGanvir(Chair) SG P

BipinPatelClockwork(Treasurer) BPC P

ElenaAlexandrou EA P

UditPatel UP P

SanjayPatelAqua SPA P

HinalShah HS P

KimKhaki KK Pfrom09.20

JayeshPatel JP P

BeneetaShah BS Aa

HiteshTailor HT P

KalpenPatel KP Aa

DharmeshPatel DP Aa

ChrisBell CB A

InAttendance

YogendraParmar(CEO) YP P

StuartBrown(Minutes) SB P

JennieMcKeith(Commissionerforyoungpeople’ssexualhealthservicesin

Camden)

JM P(from10.00–10.30)

Zara(C-CardcoordinatorforIslington)

Z P(from10.00–10.30)

RobDarracott(PharmacyVoiceChiefExecutive)

RD P(from15.30–16.45)



1. WELCOMEBYCHAIR&APOLOGIESSGwelcomedeveryonetothemeeting,apologieswerenoted(asabove).Declarationsofinterest/ConflictsofinterestYPaskedmemberstodeclareanydeclarations/conflictofinterest-therewerenone.ThemeetingmembersandSBwereduetosignnewDOIandCOIformsinthebreakoutsessionofthismeeting.2. MINUTESOFTHELASTMEETING(NOVEMBER2016)Thecommitteethensignedofftheminutesofthelastmeetingasaccurate.OutstandingactionsYPtoengageanindividualtomaintaintheLPCwebsite:YPstatedthathehadnotdonethisyet,andhewouldusethecontractorwhohadcarriedouttheupdatetomaintainthewebsiteintheinterim.Actionno. Description Whotoaction1 Toapproachcontacttobeemployedtomaintainthe

LPCwebsite.YP&BPC

YPtoredistributetheKPIscorestoreflectthefollowingweighting-50%=workonQualitypaymentsandHLPdevelopment-50%=remainingLPCwork:Themembersagreedthatthiswouldbereviewedbyallmembers(exceptforthefinancesub-committee,astheyhadotherduties)inthebreakoutsession–tobevotedonandagreedtoday.YPtowritetoDavidWebb,NHSEandCamdenCCG,tohighlighttheLPC’sconcernsoverthisMASguidanceandthelackofconsultationandtheinferenceofapatientsafetyissue:YPstatedthathehadnothadtheopportunitytocompletethisactionashehadbeenconcentratinghiseffortondeliveringsupporteventsforcontractors.AfterdiscussingtherelativemeritsofsendingtheletterthecommitteeagreedthatonbalanceitwasbettertoletsleepingdogslieespeciallyinlightofthedevelopmentofaNHSEMAScommissioningframeworkforLondonCCGs.SGaskedaboutthefutureofaLondonwideMAS.YPstatedthatapilotwouldberuninTowerHamlets,thenthisservice,shoulditbesuccessfulmayberolledoutacrossLondon.YPstatedthatDTR@NHSEwouldbeagreeableforPharmaciesinIslingtontogopaperlessandYPaddedthatwhentheexistingbatchofvoucherswouldbeexhausted,thentheservicewouldbecomepaperlessandpaperexemptiondeclarationswouldhavetobekept.SGaskedhowIslingtoncontractorsarecurrentlyrecordingtheirMASresults.YPstatedthattheseresultsarebeingrecordedonapapertemplate.UPstatedthatasparevouchercouldbekeptandatemplatebemadeoutofthisviascanning/photocopying.Actionno. Description Whotoaction2 ToscantheMASvouchertoformaPDF.Templateto

sendtoIslingtoncontractors.AnIslingtonmemberandYP

BPCstatedthattheGPscurrentlysupportthisservice.



YPstatedthatitwillbeimportantthattheanswertothequestion;“whatwouldpatient’sdowithoutaccesstothisservice”wouldbecapturedbycontractorstoshowthevalueoftheMAS.YPtosendoutacommunicationtoallcontractorsinformingthemoftheconnect2pharmaeventinNovember2016:SGaskedwhethertheLPCshouldadviseC&IcontractorstosignuptoConnect2Pharmaservices,sothatcollectivemarketingcouldbeorganisedbytheLPC.YPstatedthatthe“StrepA”testinghasissueswiththeteststripsexpiring(theminimumamounttobuyis50strips).YPstatedthatthesupplierwouldnotsplitthispackof50.BPCstatedthatthepricingofthistestingwouldhavetoreflectthewastagewhichwouldbeincurredbyprovidingthisservice.SGsuggestedthat,shouldthistestbetakenupbyenoughC&Icontractors,themoneysavingfigures(aspatientswouldn’tvisitaGPforasorethroat)couldbeanalysedandadvertisedtotheCCG.SGsuggestedthataservicesuchasthiscouldbefundedfrommoneyfromtheIntegrationfund.SGsuggestedthattheLPCcouldhaveanumberofservicebusinessproposalsreadytogowhichcouldbeusedtobidforfunding.SGstatedthatserviceswhichwouldutiliseIPscouldbeagoodbet.YPstatedthathehasbeenspeakingwithAmalinDutt(HeadofMedicinesManagementatIslingtonClinicalCommissioningGroup)wrt.creatingbusinessplansforserviceswhichwouldtapintothefollowingareas:medicinesadherence,domiciliaryMURsandwraparoundhoursforIHubs.SGstatedthathewouldliketheLPCtoleadonthesebusinessplanideas.ThemembersagreedthatYPshouldspend2-3daysresearchingthefollowingareas:

• Pharmacyintegrationfund.• CHIN(CareClosertoHomeIntegratedNetworks)strategicdocuments• Businesscasesfor-

o “Connect2Pharma”services.o ServicesthatwouldutiliseIPs.

• UrgentCareservices–linkingtoHEEfunding.Actionno. Description Whotoaction3 Tospend2-3daysresearchingthefollowingareas:

• Pharmacyintegrationfund.• CHIN(CareClosertoHomeIntegratedNetworks)

strategicdocuments• Businesscasesfor-

o “Connect2Pharma”services.o ServicesthatwouldutiliseIPs.

• UrgentCareservices–linkingtoHEEfunding.

YP

Actionno. Description Whotoaction



4previousaction

ToobtaintheCamdenpatientvaluedatafromWebstarfortheMAS.

YP

Actionno. Description Whotoaction5previousaction

TodeterminetheprogressonaddingtheaddedvaluequestionstotheWebstarMASconsultationmoduleinIslington.

YP

Actionno. Description Whotoaction6 Tocompilealistofoutstandingpre-regpayments(tobe

paidbyPCSE)fromcontractors.YP

SomemembersstatedthattheycurrentlyhadoutstandingPre-Regpayments.YPstatedthatNHSEareunhappywithCapita’sperformance,andYPaddedthatNHSEhavebeenwarnedthatsomeC&Icontractorsareconsideringlegalactiontotryandgetthismoney,whichhasbeendelayed,paidtothem.ThemembersrecognisedthehypocrisyofNHSE’sbehaviourtowardsoverduepayments.YPstatedthatarescueteamhasbeenputtogetherbyNHSEtomtryandsorttheseissuesout.YPstatedthathewouldcompiletheresultsofthesurveyofoutstandingpaymentsinthenextfewweeks.ToobtainmoredetailsonthevacantpostsatICCG(withaviewtoofferingthesepoststoIslingtoncontractors):SGstatedthathewouldliketoseeaCPcontractorinthisrole.YPstatedthatICCGhadnotinvolvedtheLPCintheprocessofadvertisingforthevacantpost.YPtoapproach“ToHealth”toaskthemiftheywouldpayabonustoPharmacieswhofurtherincreasethenumberofHealthchecksdelivered.Furthertrainingsessionscouldalsobeaskedfor:Actionno. Description Whotoaction7 TocirculatealistoftheHealthcheckfiguresinC&Itoall

LPCmembers.YP

3. C-CARDCONDOMPILOTYPwelcomedJMandZtothemeeting.JMhighlightedthefollowingpoints:

• C&IPharmaciesdonotprovidetheC-Cardscheme.• TheLPChasbeensentadraftspec.ofthepilotservice,whichwouldlastfor1year.• C&IPharmaciesalreadyprovidingtheEHCservicewouldbeeligibletoengageinthis

pilot.• ThepilotwouldinvolvethedistributionofC-Cardonly–notit’sregistration.



• Chlamydiatestingwouldbeavailableforunder18sonly(theC-Cardscheme’supperagelimitis25)–thiswouldbetominimisethewastagewrt.thegivingoutoftheChlamydiakits.

• Training(andrefreshertraining)wouldberequiredforthisservice–transactionswouldberecordedontheC-Cardwebsiteandtrainingwouldbealsoberequiredforthis.

BPCqueriedthedecisiontolimittheChlamydiatestingtounder18s,andaskedwherewomenover18wouldsecureakit.JMstatedthatthesepatientswouldbeabletoorderkitsonlineviavarioussites(e.g.https://www.your-life.com/)SGstatedthatthedifferentsexualhealthservicescurrentlyhavedifferentagecriteriaandheaddedthatthisisveryconfusingforthepatients.SGaskedforsomeharmonisationre.theseservicesacrossLondon.SGaskedforasimpleflowchart(detailingtheagelimitationsforeachservice)tobeproducedandincludedinthetrainingforthisservice.BPCwarnedthatlotsofpatientswouldnotaccesstheChlamydiakitsonlineanditwouldbebettertoattendtotheseneedswhentheyarefacetofacewithapharmacist.SGsuggestedmorejoinedupcommissioning&designwouldbedesirable.Hereported:thattheformerChlamydiafreepostkitswouldnoteasilyfitthroughletterboxes:thecommissionerhadproduced“pickupyour-self”kitswhichwereinbigbucketsinpharmacies&othersiteswhichunderminedthesexualhealthtrainingthatPharmacistshadreceived&theeverycontactcountsmessage.

JMstatedthat:• AfterfiveC-CardtransactionsahighlightonthewebsitewouldpromptaPharmacist

tohaveamoreindepthconversationwithapatient.YPstatedthattheadvancedDBScheckrequirementmaybeabarrier(notallcounterstaffhaveDBSchecks),andthiswouldmeanthatonlythePharmacistwouldbeabletodeliverthisservice.JMstatedthatshewouldbehavingaconversationaboutthiscriterionlater,onthisday.SGstatedthatshouldthecounterstaffbepreventedfrombeingabletocarryoutthisservice(duetotheadv.DBScriteria),thenitwouldnotbefinanciallyviableandcontractorswouldnotparticipate.SGstatedthatthenumberofHLPswouldincreaseinLondon,andthisC-Cardschemecouldbepluggedintothismodel.YPaskedwhatthetrainingwouldconsistof.YPadvised“daytime”trainingforPharmacystaffand“eveningsessions”forPharmacists.JMstatedthatthiswouldbetakenintoconsiderationandtrainingwouldbetailoredtothedifferentprofessionals’knowledgebases.SGstatedthattheNPAhaveproducedSexualHealthscratchcards,andthesecouldbeaddedintothisC-Cardscheme(joiningupresources).YPstatedthatwrt.thepilotspecs-thefeewillhavetobediscussedandnegotiated.JMstatedthatthispilotwouldbeduetostartinApril2017,howeverthisdatemaybeputbacktoaccommodatechangesintheservicespecs.YPstatedthatshelfspaceislimitedinmostpharmacies,andconsiderationwouldhavetobemadewrt.howmuchroomtheboxesofcondomswouldtakeup.



JMstatedthatthepharmacistwouldbeinchargeoforderingthecondomsupply.SGsuggestedthatajoineduppublicitydrivewouldbeagoodidea,andapackagetoformadisplaywouldbepreferable.JMstatedthatoystercardstylewalletswillbeavailableforthisscheme.JMaddedthataC-Cardwindowstickerwouldalsobeavailable.JMstatedthatshewouldbeintouchwithanupdateonthispilot,havingtakenintoaccountallthisfeedback.YPthankedJMandZfortheirattendance.4. CEOREPORTCPCFchanges2016/17&2017/18

• YPstatedthatdetailedinformationonthechangesincludingqualitypaymentscanbefoundhere.

• YPaddedthatthefollowingresourceshavenowbecomeavailablesincewedisseminatedourqualitypaymentsworkbook-

o PharmoutcomesmoduleshavebeenreleasedtosupportcontractorsthroughtheQualitypaymentsframeworkandasthmareferrals.

o CPPEhavealsoproducedthistoguidecontractorstotheappropriateCPPEresources.

o NPAresources.CPFV–‘MakingitHappen’YPstatedthatPharmacyVoiceandPSNChavepublishedthisdocumenton19Jan2017.YPaddedthatinthisdocument,theyhave:

• startedtomapoutpathwaystowardthethreefuturescenariosforcommunitypharmacythataredescribedintheForwardView;

• calledonGovernmentandNHSleaderstocommittoworkingcollaborativelywiththesectortodesignandcreatethisfuturetogether;and

• invitedcolleaguesfromacrossthehealthandcaresystemtosharetheirownstoriesoftakingstepsalongthepathwaysdescribed,andthelessonslearnedonhowprogresscanbeacceleratedandbarriersremoved.

LPCQualityPayments&HLPIdiotsguideevent8Dec16YPstatedthatthiseventhadgoneverywell,with42attendees.YPaddedthatthemeanfeedbackscorefortheeventfororganisationand4.6/5(Feedbacksummaryspreadsheetincludedinthemeetingpapers).YPstatedthattheslidedeckandLPCQualitypaymentsworkbookwereemailedtocontractorsshortlyafterthisevent.SGaskedwhetheranyofthemembershadusedthequalitypaymentdocuments.SGaddedthatheandYPwouldbeworkingonupdatingtheseinthebreakoutsession.SGremindedthattheevidenceforthequalitypaymentcriteriawouldbeconfirmedviaself-declaration.YPstatedthatthereisaqualitypaymentmoduleonPharmoutcomesforHLPandasthma.YPaddedthathewouldscrutinisethesemodulesandaddanyusefulinformationtotheLPCresources.YPremindedthattheHLPmoduleisnotfree,andLPC’scurrentlyhavetheopportunitytobuyasubscriptionfortheirareas(whichisunfairbecausethefeeiscurrentlythesameregardlessofthenumberofcontractorsinanLPCarea).



LPCHLPLeadership/BusinessSolutionsEvent29Jan2017YPstatedthat53Pharmacistshavesignedupforthistraining.HealthChampionfundingSGstatedthatfundinghasbeensecuredfromHEEtofund300healthchampionplacesacrosstheHENCLarea.YPstatedthathewouldbesendingdetailsouttocontractorsaboutthisshortly.PSNCSpeciallevyforlegalchallengetotheDepartmentofHealth'sImpositionYPstatedthat,asreportedbeforeChristmas,PSNCareseekingaspecialsupplementarylevy(£11,000fromC&ILPCreserves)tosupportthelegalactionagainsttheimposition.YPaddedthattheLPChadcalculatedthisonthesamebasisastheannuallevy.YPstatedthatPSNCwillaccountforthisseparately,andcreditanysurplustoLPCsinproportiontothecontribution.YPstatedthatPSNCwouldliketheinvoicepaidassoonaspossible.YPstatedthatthetextbelowhasbeenpastedfromtheletterfromMarkBurdon,chairofthePSNCResource,DevelopmentandFinancesubcommittee:“AsyouknowwehavecommencedlegalactionagainsttheDepartmentofHealth,tochallengetheimposition.PSNCvotedunanimouslytotakeproceedings.Itisthefirstjudicialreviewwehavesoughtthiscentury,andtheCommitteetooktimetobalancetheprosandconsbeforemakingthedecisiontoproceed.Leadingcounselhasadvisedusthatwehaveastrongcase,andwebelieveitisessential,fornowandinthefuture,thatweseektoensurethatconsultationprocessesareconductedproperlyandensurethatdecisionsarewellinformedandconsidered.PSNChasspentconsiderablesumsfromitsreservesthisyearonthecampaign,andwedonothavesufficientreservefundstocoverthecostsofthelitigation,ensuringthatwepresentthebestpossibleargumentinsuchapivotalcaseforthefutureofoursector.Inadditiontothecostsoflawyers,includingveryseniorandexperiencedleadingcounsel,weareobtainingexpertevidencethatchallengessomeoftheassertionsmadebytheDepartmentofHealthandtheMinister.TheCommitteehasconsideredourfinancialpositionandhowtofundthelitigation.IthasconcludedthatweshouldseekaoneoffsupplementarylevyfromLPCs,equatingtoanaveragecostof£100perpharmacy.Thiswouldbeusedspecificallytofundthecostsofthelegalaction.ItwillbeaccountedforseparatelyandanysurpluscreditedtothecontributingLPCsinproportiontotheircontribution,againstfuturelevies.Thesumweareseekingtoraiseislarge:over£1million,andthisreflectsboththeinevitableuncertaintiesofthecostsoflitigationsuchasthis,butisalsoseekingtoprovidefortheriskoflosingthecaseandpayingtheotherside’scosts.LPCswillunderstandthefinancialsituationourcontractorsarefacingatpresent.Manyhavereserves,thataretoprovideforcontingenciesandunexpecteddemands.Webelievetherehasneverbeenagreaterneedtoacttosupportourcontractors,andwewouldencourageLPCstofundthesupplementarylevyfromtheirreserves,ifatallpossible.”BPCandKKobjectedtopayingthisamount,andBPCstatedthatthePSNCshouldcurrentlybeusingtheirownreservestomountthisJR.KKstatedthathecurrentlyhadnoconfidenceinthePSNCasanegotiatingbody.



JPstatedthatthis“noconfidence”issueshouldbebroughtupwiththePSNCreps.SPAstatedthathefeltthatthePSNChadbeenslowtoreactwrt.theDoH’saction.YPstatedthatthepayingofthisspeciallevywasnotmandatoryandthePSNChadstatedthattheywouldnotaskforanymoremoneyduringthiscase.YPstatedthatmostoftheotherLPCshavealreadypaidthisspeciallevy.YPaddedthatattheveryleastthislegalactionwoulddelaythecutsbeingenforcedandthiswouldsavecontractorsconsiderablesumsofmoneyfortheinitialsumof£100percontractor.SGstatedthattherecouldbeachancethatthePSNC/NPAcouldwintheircasesandfor£100/contractor,thiswouldbeariskworthtaking.BPCwonderedwhethertheaccounting(fromPSNC)forthespendingofthisspeciallevywouldbetransparent.SGremindedthemeetingthatTheNPAhavealsorequestedaJR–andthishasbeenbasedonhowthecutswillaffectvulnerablepeople.SGaddedthatthePSNCandNPAhadco-ordinatedtorequestJRstochallengedifferentaspectsofthepharmacycontract.YPstatedthatPrakashPatelisC&I’sPSNCrep.andhecurrentlyhasastandinginvitetotheLPCmeetings.YPremindedthatPrakashhasnotattendedanLPCmeeting.BPCwonderedwhethertheindividualC&Icontractorsshouldbeaskedtovoteonthissubject.SGremindedthattheLPCmembershavebeenelectedtomakethesedecisionsonbehalfofthecontractors.YPandSGstatedthatthisspeciallevywouldcomeoutoftheLPCreservefunds,andcontractorswouldn’tbeaskedtosupplymoremoney.Thisissuewasputtothevote:7membersvotedtopaythespecialPSNClevy.2membersabstainedfromthevote.Therefore,thedecisionwasmadetopaythespeciallevyandthisamountwouldbepaidthisafternoon.SustainabilityTransformationPlanYPstatedthatIslingtonCCGsSTPsummarypageisverygood.YPaddedthattheSTPvision/ambitionistocreateprimarycarehubsintheformof“careclosertohomeintegratednetworks”(CHINS)forcommissioninganddeliveringservicesforpopulationcohortsacrossarangeof50-80,000people.YPstatedthattheenclosedistheSTPdraftfordiscussionCHINdesigntemplateYPstatedthattheCHINseffectivelytakeontheresponsibilityofcommissioning,co-ordinatinganddeliveringhealthandcareforthatpopulation.YPaddedthatwithintheseCHINs“hubs”,centresofdeliverywouldemerge.YPremindedthattheconceptofa“hub”isalreadyusedinrelationtoourextendedaccessoffer–I-huboperatesacross3“hubs”.YPstatedthathowandwherehubswouldemergewouldpartlydependupontheavailabilityofestatesinwhichtoco-locateservices,but,forexample,wecouldseethedevelopmentofhubswheresecondarycareconsultantscometodeliverclinics.YPaddedthatthiscouldbealongthelinesofthepaediatrichubideaalreadydiscussedatthePrimaryCareStrategyGroup.YPstatedthatpatientsfromacrosstheCHIN(orfrommorethanoneCHIN)couldaccesstheservicesfromthehubs,muchastheydoalreadyforextendedaccess.



YPstatedthattherearecurrentlymajorgovernanceconcernsastheCHINSaresupposedtobebothcommissionersandproviders.

YPstatedthateachCHINwouldcost£1milliontosetup-belowisanexcerptfromtheICCGprimarycaredirectorsprogramreport.FundingforCHINsandQISTs:Tobeeffectiveinmakinganimpactonthesechallengingareaswehaveassumedeach(50,000population)CHINincludesthefollowingcomplementofstaffworkingwithlocalgeneralpracticesandalignedwiththecommunityandsocialcareteams:

• 1wtecommunitymatron• 4wtespecialistnurses• 2wtetherapists• 1wtepharmacist• 1wtequalifiedsocialworker• 1wtecoordinator

Wehaveestimatedacostof£500,000paperCHINforthiscomplementofstaff.WehaveassumedlocalcommissionerswillassesshowmuchofthistheyhaveandhowmuchmoretheyneedtodelivertheoutcomesandthenworkwiththedevelopingCHINstounderstandthismorefullythroughtheirplanningwork.WehaveassumedtheQualityImprovementSupportTeams(QIST)(basedona50,000population)includethefollowingcomplementofstaffworkingwithandinlocalgeneralpractices:

• 2.5wteGPs



• 2.5wtenurses• 1wtepharmacist• 1wteanalyst• 1wtecoordinator

Wehaveestimatedacostof£500,000perQISTforthiscomplementofstaffandwehaveassumedthatnoCCGhasanyelementofaQISTinplacealthoughtherewillbeanalignmentwithcurrentqualityimprovementwork,forexampleUCLPinitiatives.SGwonderedwhochoseswhothesestaffwouldbe,andanyperceivedconflictofinterestshouldbechallenged.SGstatedthatCPisnotcurrentlyatthetabletohelpmakethesedecisionsastostaffingchoices.SGproposedthattheLPClobbytogettheCHINandQISTPharmacypostschangedto2halftimeor31/3timeequivalentPharmacists,sothatCPscouldapplyfortheseposts.SGalsoproposedthattheLPCshouldactivelygooutandfindanidealcandidatesforthesePharmacypostsfromtheIslingtoncontractorsandthensupportthem.YPstatedthattherewouldbe3CHINssetupinIslingtonand4-6CHINssetupinCamden.SGaskedwhethertheequivalentinformationforCamdencouldberequestedfromtheCCG,followingthisYPcouldmakeaFOIrequestforit.Actionno. Description Whotoaction8 TorequestSTPandCHINinformationfromCamdenCCG–

failingresultsputinanFOIrequestforit.YP

YPstatedthattheCHINswouldbesetupinApril2017.SGsuggestedtheLPCshouldensurethatYPsitsonthestrategicplanningboardfortheCHINsetup&usethistosuggesttheCHIN&QISTshouldutiliseactualpracticingCPs.SGwonderedwhetheranIPcontractorwouldbebettersuitedtotheQISTvacancy.Actionno. Description Whotoaction9 TotalktoDrJosephineSauvage(Chair

ofIslingtonClinicalCommissioningGroup)re.STPengagementandthespecsoftheCHINandQISTpharmacists.

YP

YPstatedthataftertheresultsofthisconversationhewouldlookintodraftinganexpressionofinterestdocumentforthesetwoIslingtonvacancies.PharmacyLondonYPhighlightedthefollowingpoints:

• CurrentCEOhassteppeddownandinterviewsforthenewCEOwereheldon12Jan2017.Areplacementhasbeenchosenandanofferisbeingprepared.

• AllLPC’sotherthanKingston&RichmondhadapprovedthePLlevyincrease:o Currentlevyis£35/contractor.o TheagreedproposalsfortheLevyincreasetofundtherevisedCEOpackage

optionswere:§ Option1-staggeredrise£42thisyear,&£52nextyear§ Option2-oneoffrise£52now(&norisenextyear).

C&ILPCagreedtofundoption2atourlastmeeting.• AftermuchdeliberationatthePLmeetingK&RLPCagreedtofundoption1.



SGhighlightedthatthePLconstitutionclausewhichstatesthatlevydecisionsmustbeunanimousperhapsneededtobechangedsothatthisissuedoesnotariseinthefuture.SGstatedthatYPhadaskedtobeontheinterviewpanelforthenewPLCEOrole–hehadnotbeeninvitedtodoso,whenthepanelwasformed,duetoperceivedconflictofinterestissues.HLPYPhighlightedthefollowingpoints:

• JenniMillmoreisnowthePublicHealthHLPleadunderBaljinderHeer-Matiana.• RSPH/PSNChavenowpublishedaccreditationandgrandparentingcriteria-

o HLP’saccreditedinthelast2yearswillbeeligibleforgrandparenting.• Planningtohost>100HealthChampiondaytimetrainingcourses(withthehelpof

theNPA)fromLPCreservesoranotherfundingsource:o NPAhavestatedthattheynowcannotcarryoutdaytimetrainingeventso However,HEEhavesaidthattheywouldfundtrainingeventsfor150HC

placesacrossBarnett,Enfield,Haringey,City&hackneyandC&I.o Buttercupscouldbeusedforthistraining.o ThistrainingwouldbeplannedforMarch2017.

IslingtondevelopmentsDressingsprocurementpilot:YPstatedthatDressingsprocurementpilottobeterminatedandhighlightedthefollowingpoints:

o SeeenclosedICCGoptionspaper(discussedatthelastIMOGmeetingon18Jan2017).

o Whittingtonhealthwerecharging£72ktoruntheserviceplus£75kforthedressingcosts.

o Thepilotonlyaccountsfor10%ofthedressingssupply.(CCGannualdressingsspend£750k)

o TerminationnoticetobeservedtoWhittingtonHealth-Pilottoendon31April2017.

o CCGstilltoexplorean‘investtosave’projectfordressingsinordertofullyevaluatethefutureoptions.

SGsuggestedthatanIPinIslingtonshouldbeemployedtowritethescriptsforthisservice.YPremindedthatapprox.£150,000hadbeenspentonthispilot.Themembersagreedthatthishadbeenawasteofmoney.ThemembersvotedunanimouslytogiveauthorityYPtomeetwithMandeepButt(interimdeputyheadofICCGmedicinesmanagement)inordertowriteabusinesscaseforusinganIslingtonIPtowritedressingsscripts.Actionno. Description Whotoaction10 TotalktoMandeepButt(interimdeputyheadofICCG

medicinesmanagement)andthentopitchforandwriteatenderforusinganIslingtonIPtowritedressingsscripts.

YP

CCGrebateschemes:ICCGareproposingtoenterintoa“Seretide”rebateschemebasedonguidancefromtheLondonProcurementPartnership(LPP)



Islingtonprocurementofextendedaccessinprimarycare:YPstatedthataspartoftheGPForwardViewanannouncementhasbeenmadethatfundingwouldbeavailabletosupportextendedaccess.YPaddedthatthisfundingbecameclearattheendofSeptember2016andinLondonthisequatesto£26mtotheendof2018/19.YPstatedthatNorthCentralLondonhasbeenallocated£6.1m,ofwhichIslingtonhasashareof£1.3m.YPaddedthatthefiveNCLboroughsarenowworkingtogethertodevelopacommonspecificationthatcanberolledoutfromApril2017.YPstatedthattheclosedprocurementprocessforthiswillrunfromJantoMarch2017.MedicinesOptimisationGroup:YPstatedthatthisiscurrentlyprojectingbreakevenprescribingspend,however,NHSEnglandhasalsoindicatedthattherewasanoverdeliveryonthemedicinesmarginin2015/16.YPaddedthatshouldthiscontinueatcurrentrate;someofthiswillbeclawedbackin2016/17.OutstandingPayments:NHSEpayments–YPhighlightedthefollowing:

• Thisisahugenationalproblemparticularlyaffectingpre-reg.grantpayments,althoughservicepaymentsarealsoseverelyaffected.GPsandotherprimarycareprovidersarealsoaffected.

NHSEMRD:YPstatedthatallservicesareunderNHSEreview.YPaddedthatnoreportsonthefindingsasyet.ServiceReviews:YPhighlightedthefollowingwrt.SmokingCessation:

o HealthierFuturesfinalreportwaspublishedbeforeChristmas2016-ItmentionsPharmacyasakeyplayerindeliveringaqualitystopsmokingservice.

o Thewholesmokingserviceisoutfortenderatthemoment.o ‘SolutionsforHealth’isacompanythathasbeenapproached.

BPCstatedthat‘SolutionsforHealth’areoperatinginHaringeyandtheyhavedecommissionedtheservicefromPharmacies.SGsuggestedthatYPcontact‘SolutionsforHealth’totryandinvestigatetheirplansforcommissioningtheservicefrompharmacies.Actionno. Description Whotoaction11 Totalkto‘SolutionsforHealth’totryandinvestigate

theirplansforcommissioningtheservicefrompharmacies

YP

CamdenAgeingBetterBidYPstatedthatAgeUKwilldecidethefutureofthisserviceinApril2017,afterreviewingthereferralactivity.YPstatedthatheiscurrentlywaitingonaninterimupdate.YPstatedthattheyhadsenthimactivitydata–only6ofthe12sitesareactive–andveryfewpositiveoutcomes(57referralsforthelastquarter–only2werepositive).



5. LPCPROVIDERCOMPANYFORMATIONYPreferredthememberstodocument8.0inthemeetingpapers(anemailfromHiteshPatelwrt.PSPLtd.).BPCstatedthatPSPLtd.aredesperatetoknowwhenC&Icontractorscouldengagewiththeprovidercompany.YPstatedthatPSPLtd.havetwodirectorswhoarecurrentlyLPCmembersandtwodirectorswhoarenotLPCmembers.YPaddedthatPSPLtd.havesuggestedthatC&ILPCappointanothermembertobecomeaPSPLtd.director(BPCisalreadyaPSPLtd.member).BPCstatedthatPSPLtd.directorscurrentlyattendbi-monthlymeetingsatSafedaleHouse.SGaskedhowmuchcontractorswouldhavetopaytojoinPSPLtd.BPCstatedthatthefeewouldbe£600.YPandSGwonderedwhetheranyC&Icontractorwouldpay£600inthiscurrentfinancialclimate.YPwonderedwhetheritwouldbeshrewdforC&ILPCtoappointaPSPLtd.director,whenpotentiallynoC&Icontractorswouldjoin.BPCstatedthatinApril2017,inHackney,asmokingcessationandsexualhealthtestingcontractwouldbebidforbyPSPLtd.YPaskedwhetherhecouldbeadirectorofPSPLtd.(notbeingacurrentLPCmember).SGwonderedwhetherBPCandYPshouldberemuneratedbytheLPCfortheirattendanceatPSPLtd.MeetingsastheyarerepresentingC&ILPC.BPCstatedthatPSPLtd.currentlypaythedirectorsforwritingbidsforservices.YPstatedthatshouldattendancetothesemeetingsbecomeonerous,thenhewouldbringthematterbacktotheLPCfordiscussion.YPstatedthathewouldvoicehisconcernsaboutpotentiallownumbersofC&IcontractorsjoiningPSPLtdatthefirstPSPLtd.meetinghewouldattend.ThemembersvotedtoapproveYPandBPCasC&IdirectorsontheboardofPSPLtd.Twomembersabstained,andsixmembersvotedinfavourofapprovingYPandBPCasC&IdirectorsontheboardofPSPLtd.

6. TREASURERSREPORTYPstatedthatthemanagementaccountshadbeenincludedinthepapersandprovidedanoverviewoftheLPCfinances.7. CPFV–‘MAKINGITHAPPEN’ThemeetingwelcomedRobDarracott(PharmacyVoiceChiefExecutive)RDspoketothemeetingandmadethefollowingpointsaboutwhatPVhasbeendoingoverthelastyear:

• PVhasbeeninvolvedheavilyinparliamentaryactivity.• Theseconddebateinparliamentre.thePharmacycutstookplaceonthe24May

2016(approx.45MPshadattended)andthishadcomeaboutduetoPV’scontactwithBarnsleyEast’sMemberofparliament-MichaelDugher.

Actionno. Description Whotoaction12 TotalktoPSPLtd.aboutYPjoiningtheprovider

companyasadirector.BPC



• PVhadalsoreachedouttoMPsatthepartyconferences.• PVhasmade220parliamentarycontacts.• PVhasalsoledonthecreationoftheCPFV:

o PVhadcreatedthisdocumentcollaborativelyin4weeks(apiecesuchasthiswouldnormallytakeatleast6monthstodrawup).

o PVandPSNCsubmittedthedocumentonMay242016totheDoHandNHSEastheconsultationresponse,howeverPVandPSNCsubmitteddifferentversionsofthisdocument(PVincludedthesecond“makingithappen”partalso).

o The“makingithappen”sectionisthepracticalpartofthevisionanditisthemostimportantpartasitdetailshowinvestmentwouldbepulledinandhowtheworkwouldactuallybecarriedout.

o TheNHScurrentlyhasnomoneyandthisfactmustbeworkedwithgoingforward–integrationwillbethenameofthegame.

o TheintegrationfundiscomingoutofNHSE’sbudget,theglobalsumismanagedbytheDoH.

• The“MakingitHappen”sectionoftheCPFVcurrentlylooksatthefollowingareas:o CPsupportingurgentcare-

§ ByApril2018allfundingforurgentcarewillbelocal.§ STPswillbeimportant.

o CPwillhavetohaveaNationallyagreedstrategywrt.HLPandskillsgapswouldhavetobeaddressedwithintheCPworkforce,andCPswillhavetobesupportedwiththeirnetworkingtobodieslikeHEEandPHE.

o CPwillhavetolookatdevelopingserviceswhichwillimprovethecareforelderlypopulation.

• CPmighthavetofavortalkingtoNHSE,goingforward,togettractiononthedevelopmentofnewCPservices–NHSEcurrentlyliketheCPFVandtheycurrentlyholdtheleverstotheSTPs.

• CPshouldhaveconversationswithNHSEatahighlevel,andCPshouldtapintoUrgentcareandlongtermconditionprioritiesthattheNHScurrentlyhave.

• CPhassomegapsinitsstructures–peopleneedtobenetworkedtogetherandthesenetworkscouldbefundedbyNHSE.

• Optometristshave8Nationalclinicalleaders–whobridgethegapbetweenNationalstrategyandlocalcommissioning.

• TherearecurrentlyrolesforalltheNationalPharmacyorganisationslaidoutintheCPFV–theseorganisationsneedtosupportandcommunicatewiththefront-linestaff.

• TheteamofcivilservantsattheDoHhavejustundergonea30%headcountreduction.

• TheMurrayreviewcurrentlystatesthatCPisalwaysgatedoutofimportantdiscussionswrt.buildinghealthcarepathways.

• LPCscanusetheirlinkswithHEEtoinfluencedecisionsgoingforward.SGaskedhowLPCscouldmakebidstoaccessthepharmacyintegrationfund.



RDstatedthatCPneedstoimbeditslocalreps.onboardsandinthenetworks,suchasSTPs.RDaddedthatNHSEcanbepointedtowardsOptometryforanexampleofhowacareindustrycansolvetheproblemsthatCPcurrentlyface.RDsuggestedthattheintegrationfundshouldbeusedtopayfortheworkdonebyCPtobetterengagewiththeircommissioners.RDstatedthatclinicalfellowsshouldbenetworkedwithandtheyshouldbeinvitedtoLPCmeetings.RDstatedthatexistingrelationshipsshouldbecapitalizedupon.RDsuggestedthattheLPCshouldcarryoutanexercisewherethemembersworkoutwhichpotentiallyinfluentialpeopletheycurrentlyknow.RDstatedthatSTPsarecurrentlybuildingtrustaroundtheirboardtablesandCParenotatthesetablecurrently.RDsuggestedthattheLPCsshoulddemandthatthePharmacybodiesshouldgenuinelytalktooneanotherandagreeonastrategicapproachthateveryonewillbuyinto.RDremindedtheroomthattheNHSworksbestwhenpeoplededicatetheirtimetogenuinelytalktootherpeople(patients,commissioners,Pharmacybodiesetc.).RDstatedthathewouldbehappytohelpinanyway.SGandYPthankedRDforhiswords.8. SUBGROUPBREAKOUTSOfthememberspresent–

• Group1:KP,HS,EAandBPCprocessedLPCclaims/payments.• Group2:SGandYPlookedatconsolidatingqualitypaymentcriteriainformation.• Group3:EveryoneelseworkedupanewsetofdraftCEOKPIs–movingpointsfrom

theMURsectiontothequalitypaymentcriteriaworksection.9. A.O.B.TherewerenoA.O.B.s.SGbroughttheopenpartofthemeetingtoaclose.10. NEXTMEETINGDATES:16March2017 09.00-17.30 IbisHotelEuston18May2017 09.00-17.30 IbisHotelEuston11July2017 09.00-17.30 IbisHotelEuston5October2017&AGMfrom7pm 11.00-17.30 IbisHotelEuston14November2017 09.00-17.30 IbisHotelEuston

meeting minutes - opencandi.lpcs.co.uk/wp-content/uploads/2016/08/ci-lpc... · 2017. 10. 5. ·...

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