Minutes of a meeting of Calderdale and Kirklees LPC held on Monday 2nd June 2008 In the Meeting Room, Spring Hall Medical Centre, Halifax. Present: Mr A Boyle (AB) Mrs A Cawdron (AC) Mr C Dickinson (CD) Mr A Dobson (AD) Mrs S Hicks (SueH) Mr A Hirst (AH) Mr S Hewitt (SH) Mrs R Ingham (RI) Mrs K Mistry (KM) Mr I Marsland (IM) Mrs E Solomon (ES) Guest Ruth Buchan 1. Apologies for absence were received from Gill Hawksworth and David Wilkinson. 2. Minutes of the last meeting held on 14th April 2008 having been circulated were proposed as correct by IM. They were seconded by SueH and were signed by the Chairman AH. All present were in favour. 3. Stuart Marrett, Thornton and Ross Stuart is the NHS Development Manager for Thornton and Ross and attended the meeting to give the LPC facts about head lice treatments and the use of Hedrin. Stuart gave some useful information about head lice, their life cycle and how different treatment methods work. A document is available from the Public Health Medicine Environmental Group on www.phmeg.org that gives a lot of useful help for pharmacists, school nurses and parents. The document stresses that treatments should only be carried out on heads where a live louse has been found. Two treatments should always be carried out as lice emerge from an egg within 7 days of being laid. This document suggests that alcoholic lotions should not be used on children under five years of age. Malathion is an agrochemical and Pyrethroid an insecticides evolved from sheep dips. They should therefore only be used where a live louse has been proved. Much resistance has been found to these products partially caused by the louse surviving because the application has not been left on the hair long enough. This usually occurs because it is washed off early because of the pungent smell. Hedrin works in a totally different way and has proved to be more effective than the insecticides especially in areas where there is resistance to the commonly used product. It has no smell and is poured onto all the hair and combed through to wet the hair. The carrier agent evaporates leaving the simeticone on the hair overnight. The lice cannot excrete and therefore die. They will have fallen off the hair by the morning. The hair may be washed but this may not be necessary. Plastic fine toothcombs are the best for combing through the hair that should be done weekly to detect any lice early. Stuart is keen to sponsor any further meetings to help with training for pharmacists and pharmacy staff and a range of leaflets are available free from Thornton and Ross. Action Who 4. Matters Arising from the Minutes – it was noted that all the action points from the last minutes had been or were in the process of being dealt with. i) MUR adverts – AD did not have a lot of success following a telephone conversation with a journalist at the Halifax Evening Courier. AD was trying to promote MUR’s but the printed article did not make sense. AC had sent in a letter to the Editor of the Evening Courier signing as Secretary of the Local Branch RPSGB and this supported the waste medication campaign, MUR’s and Repeat Dispensing. In her letter Anne encouraged patients to ask at their local pharmacy for more information. A decision has to be made on the way forward for Kirklees advertisements and also for Calderdale. It was agreed to wait for the result of AD’s meeting with Huddersfield LMC. Action Who ii) SOP’s – AD has had only one SOP sent which is now on the website. Contractors are urged to send any SOP’s that they have written so that they might be shared. iii) Takeda meeting – Lester Evans from New Light was not able to attend this meeting to discuss a way forward with the LPC Strategy. He can attend the next meeting on 15th July when he will have a preliminary meeting with the LPC. iv) Enhanced Service Bids – Gill Bell appears to favour a MAS bid for Kirklees and is currently considering this as a bid v) Vascular checks – AD sent out a questionnaire for CP’s to establish what screening services they are carrying out. Only 9 replied which does not give a true picture. vi) Huddersfield University Pharmacy degree – members were invited to find out how the new pharmacy degree course is developing & LPC members attended. The evening was interesting but it did not include a tour of the new facilities. They are considering whether the course should be 5 years to include several periods in different pharmacies to make up the ‘pre-reg’ year. 5. Correspondence (1) Open session i) PSNC a) PCL(S) 29/08 – LPC Support Seminar – LPC finance. Meeting on 2nd June in Leeds. As this coincided with the LPC meeting no one could attend. b) PCL(S) 30/08 – LPC Support Training – Negotiating skills To book place AD – nearest meeting is at Brighouse on July 1st. AC expressed willingness to attend. c) PCL(S) 31/08 – Draft Enhanced Service Specifications – link to website. d) PCL(S) 32/08 – LPC Briefing – May PSNC meeting report. e) PCL(S) 33/08 – Heatwave plan for England 2008 – details of the DoH guidance. f) PSNC Community Pharmacy News – May issue. g) PCL(S) 34/08 - Basic IT skills for Community Pharmacy staff – with weblink to access the service available to all contractors who use the NPfIT systems. h) PCL(S) 35/08 – Tobacco control, 10 High impact changes – examples of how pharmacy can be involved with the initiative. ii) WYCSA and PCT’s a) Calderdale – request for help arranging a photo shoot for pharmacy. b) Calderdale – Netzone – several copies c) Calderdale – Equitable access – advert for expressions of interest from healthcare providers d) Calderdale – new contact for matters concerning medicines waste. Action Who e) Calderdale – offering a new banner stand for a waste campaign – available on a “first come” basis to CP’s f) Calderdale – agenda for LPC/PCT meeting. g) Calderdale – Community strategy engagement – series of 3 meetings around the area. h) Calderdale – MUR programme application form – not going ahead as RB was not in time to complete the paperwork. i) Calderdale – Not Dispensed scheme – not very keen on the scheme, and prefer to keep EIS. j) Calderdale – data collection questionnaire for waste campaign k) Calderdale – copy of the DoH consultation on registration of health and adult social care providers for comment. Some feedback was given by the PCT. l) Calderdale – flyer for a MSc in clinical pharmacy from Bradford. This would have to be self-funded ~£750 m) Calderdale – Proposed MUR letter that will be sent to all CP’s, regarding the quality of MURs. n) Kirklees – minutes from the LPC/PCT meeting held 14/4 o) Kirklees – Contacts for parties who may be interested in MAS in Kirklees. p) Kirklees – Proposal to supply MRSA decolonisation kits via Express interest AD pharmacy. It was agreed to move forward with this. to Neil Mc q) Kirklees – May bank holiday rota r) Kirklees – copy of the March panel booklet s) Kirklees – request for involvement in Diabetes awareness week – June 8th to 14th – AD had given a press release and there was a possibility of a Radio interview. It was agreed that this would be worthwhile taking up if it was offered. t) Kirklees – Headlice admin queries – problems arising due to To consider AD VAT for headlice supply and NRT. further - take u) Kirklees – Strategy meeting, small group to discuss how the advice White paper fits in with Kirklees strategy – arranged for June 6th at 10am. To discuss M.A.S., sexual health, Attend AD chlamydia testing, MUR’s, repeat dispensing. v) Kirklees – Talkabout – a copy of the May edition. w) WYCSA – various notices re lost Rx iii) Miscellaneous a) Statistical data for Rx dispensed in Feb 08 b) Report from the Regional meeting at Wetherby c) Information on quality indicators survey (GH) d) Kirklees Nex form (ES) e) Notes from the Calderdale Clinical Treatment Monitoring Group meeting (AC) f) Draft letter to Courier re waste, MUR’s and repeat dispensing (AC) – brought issues to patients successfully and correctly at no cost. g) Yorkshire & Humber NHS – copies of “Healthy Ambitions” – the outcome of the NHS review O Action Who 6. PCT Reports Calderdale – AB reported that there would be a meeting tomorrow regarding Equitable Access which he hopes to attend. The Darzi report states that many of the poorest communities experience the worst health outcomes with major health inequalities. There will be new government investment of around £3m in the area as it is recognised that Calderdale is ‘underdoctored’. It is proposed that 9 FTE GP’s will be sought and new GP practices established to improve provision. Kirklees – Medicines management – Scissett branch will not be getting weekly scripts for dosette boxes anymore. Patients would need to be assessed under the DDA arrangement. 7. Meeting reports MAS – Kirklees – There was opposition to MAS on a Kirklees basis, but now exploring providing it on a local basis, and if this works roll it out. Finding funding may be difficult. Gill Bell is to look at other MAS to see how they are set up. They have had info from Ruth Buchan on the Calderdale scheme. AD to look at schemes in other LPC areas. Calderdale Clinical Treatment Monitoring Group – Shared care forums – proposals to have 2 levels of forums – one for shared care GP’s and the other for support staff. It is hoped that CP’s are invited to the GP forum that will be more appropriate. Prescribing of Benzo’s should be done by SMS – there was an incident where GP’s were prescribing for a client too. A new alcohol service is to be set up hopefully by summer. Pharmacy SLA is to be sent out shortly. Hopefully CP’s who will be worse off under new payment arrangements will have written to Martin McGroaty. AC to look at producing a claim sheet where each supervision is recorded against day of month. Post-dated Rx are valid for 28 days from date on script. However if a start date is written on Rx different from the date at the bottom of the Rx the Rx will be valid from the date specified as the start date. A newsletter will follow clarifying this. Local Care Direct meeting – core OOH inventory of stock. Performance reviews with GP’s. Occasionally GP’s prescribe out of formulary and cause problems. CP involvement in providing drug packs to on call GP’s. 100-hour pharmacies were represented. Looking ahead to White paper decision where 28 days supply may be given. NHS funded 28 day supply discussed – link with MAS. It may be that a pharmacist may be available on LCD team. Telephoned or faxed Rx should be sent out 1st class post. Regional Secretaries Meeting – the meeting was useful. Contract funding was discussed – report circulated. Pharmacy White Paper – PSNC executive working on proposals with much to do. Important for LPC’s and contractors to engage with LMC and other GP leaders in their own area. PSNC are pressing the PPD to resolve outstanding issues with implementation of CIP. LPC model constitution – requests to allow non-pharmacists to be members of LPC’s – it would be recommended that the majority would have to be pharmacists. Pharmacy IT – good progress being made with EPS Release 1. Bradford LPC are having a succession planning meeting, to which other LPCs will probably be invited – probable date is 7th August. Action Who Calderdale Medicines Management Group - wound formulary going to print. PGD’s to be reviewed by June. Omeprazole now to be prescribed as cheaper than Lansoprazole. Warfarin and Methotrexate booklets should be filled in by CP’s, who check whether INR’s have been done. Homecare medication policy – untrained workers are transferring records of patient’s medication from a 28 day MAR style sheet onto another sheet for 30/31 days with a risk of errors. Going to have a trial to use the 28 days sheets instead. Optometrist Dinner – AH and GH attended the informal dinner and found the evening worthwhile. 8. M.U.R. Strategy It was discussed whether patients could be asked to have an MUR before a planned hospital admission to avoid history taking. A patient may have previously had an MUR during that year although the CP could be asked to update it if meds have changed. A customer satisfaction survey would be a useful tool that the patient fills in after their consultation. This could be presented to the LMC. A flyer could be printed and sent out via a free newspaper of via the GPO. The cost of this would have to be investigated. It was agreed that if AD’s presentation to the Kirklees LMC was successful that this could be repeated with Calderdale LMC. 9. A.O.B. - None End of open session Closed Session 13. Date, time and venue for next meetings The next meetings were confirmed to be : Tuesday 15th July at St Luke’s House, Huddersfield Tuesday 2nd September at Dean Clough, Halifax Tuesday 7th October at St Luke’s House, Huddersfield Monday 17th November at St John’s Medical Centre, Halifax. As there was no other business the Chairman closed the meeting at 4.40 pm.
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