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Derbyshire LPC AGM

Derbyshire LPC AGM. John Sargeant, Chairman Morley Hayes Hotel Tuesday 17 th September. AGM Agenda. 7.00 Welcome and introduction: John Sargeant, LPC Chair 7.05 Community Pharmacy Contractual Framework – Garry Myers , Derbyshire LPC and PSNC

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Derbyshire LPC AGM

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  1. Derbyshire LPC AGM John Sargeant, Chairman Morley Hayes Hotel Tuesday 17th September

  2. AGM Agenda 7.00 Welcome and introduction: John Sargeant, LPC Chair 7.05 Community Pharmacy Contractual Framework – Garry Myers , Derbyshire LPC and PSNC 7.40 Community Pharmacy Consultation Service (CPCS) – Jackie Buxton, Chief Officer, Derbyshire LPC 7.50 Q and A 8.05 Introduction to the AGM 8.10 Chair’s Report on the Work of the Committee 2018-19 8.20 Treasurer’s Report and Accounts – Stuart Kelly, Treasurer 8.30 Close

  3. The Community Pharmacy Contractual Framework 2019/20 to 2023/24​ A five-year settlement with a commitment to developing clinical services through community pharmacies​

  4. Context to the negotiations ​ • This was an intense negotiation process involving many 100s of hours • PSNC’s Negotiating Team represents all parts of the sector​ • At the heart of negotiations were the 11,600 community pharmacies ​we represent • At every step of the way, the Negotiating Team asked itself: “Is this in the best interests of community pharmacy contractors?"​

  5. Context to the negotiations • We know from the Judicial Review and an NHS Board paper of 27 June that the proposed trajectory for our funding was downwards: “Material financial pressures that have been absorbed within the commissioner sector financial position for 2018/19 include … the loss of the savings expected from DHSC’s renegotiation of community pharmacy fees that DHSC did not secure.” • We know that NHS funding is now set to deliver the Long-Term Plan • We know that there is political and economic uncertainty ahead • We know that there are those in Government who are naysayers about community pharmacy

  6. Context to the negotiations • We don’t know how the new Prime Minister and his team will view the NHS or our sector • We don’t know how a (no-deal) Brexit and/or a General Election will affect us • We don’t know what retribution might have been dealt by DHSC/NHSE&I if we had walked away • We don’t know what else the NHS might want (to pay for) from community pharmacy in the future

  7. The CPCF 2019/20 – 2023/24​ In summary… • Expansion of clinical services through pharmacies over the next five years, starting with a new national NHS Community Pharmacist Consultation Service (CPCS) from October 2019​ • ​Five-year deal secures funding of £13bn (£2.592 billion a year plus Pharmacy Integration Fund spend) for pharmacies – more than original Government plans​

  8. The CPCF 2019/20 – 2023/24 • Secures the future of community pharmacy and provides a roadmap for delivery and change • Ensures five years of protected funding against an environment of increasing economic uncertainty • Embeds closer integration with NHSE&I and begins to repair the damage of the Judicial Review • Fixes an annual review of costs, capacity and progress within the Contractual Framework

  9. Funding changes • Funding was agreed at £2.592bn a year for the next five years • The proportion of funding delivered via fees and retained margin remains unchanged in 2019/20 at £1.792bn for fees and £800m in retained margin • Establishment Payments and MURs to be phased out by 2020/21 with funding reinvested in new services

  10. Funding changes • Monthly Transitional payments in H2 2019/2020 and 2020/21 to recognise costs (e.g. preparation for SSPs and implementation of FMD) • £10m set aside as a contingency for SSP payments – if not used, this will be added to Transitional payments • SSP fee will be set at £5.35 • PQS – Aspiration payment can be claimed to ease cashflow (for contractors who participated in QPS 2018/19)

  11. Pharmacy Quality Scheme (PQS) • From October 2019, the Quality Payments Scheme (QPS) will continue under a new name – the Pharmacy Quality Scheme. • The PQS will continue to have an overall value of £75m annually • Some quality criteria are being grouped into bundles for payment • An aspiration payment can be claimed • Further information on the requirements for the PQS for 2019/20 are being finalised and guidance and a webinar will be made available as soon as possible • Initial details on the PQS requirements are available here: psnc.org.uk/PQS

  12. NHS Community Pharmacist Consultation Service • The CPCS brings together the existing NHS Urgent Medicines Supply Advanced Service (NUMSAS) pilot with local pilots of the Digital Minor Illness Referral Service (DMIRS) • It is intended to give community pharmacies a key role in helping people with minor illnesses • In 2019/20, the CPCS will take referrals from NHS 111, but over the five years this is expected to expand to include referrals from GP practices, NHS 111 online, and urgent treatment centres

  13. NHS Community Pharmacist Consultation Service • A detailed implementation plan is being worked on and will include guidance and a webinar for contractors • Pharmacies who sign up to the service will receive a transitional payment of: • £900 if signed up by 1st December 2019; or • £600 by 15th January 2020 • Fee of £14 per completed consultation • Follow up calls to no-show patients reduced to one (from three)

  14. Further service developments • Several new services will be piloted and, subject to their success, rolled out • The services will enable community pharmacies to do more to help to prevent and detect disease, as well as supporting medicines optimisation • Full details on the timing of pilots and planned service roll outs are on this page: psnc.org.uk/5yearCPCF

  15. Key Service Developments • A Hepatitis C testing service will be introduced in 2019/20 • Data capture will be required for national public health campaigns • A post discharge medicines reconciliation service will be introduced from April 2020 • We will consider NMS expansion to include further conditions • Future pilots will explore: • A model for detecting undiagnosed cardiovascular disease; • Stop smoking support referrals from secondary care; and • Improving access to palliative care medicines

  16. Terms of Service Changes • A key step is the move to require all pharmacies to have achieved Level 1 HLP status from April 2020 • Other new Terms of Service requirements from 1st April 2020: • NHSmail • Summary Care Records access • NHS 111 Directory of Services • NHS.UK pharmacy profile updating • All pharmacies must be able to use EPS

  17. Contractor Support: Information now available • Joint deal document: PSNC, DHSC and NHSE&I​ • PSNC Briefings 026/19, 027/19, 028/19 and 029/19​ • Summary of the deal​ • Frequently Asked Questions​ • Information on funding​ • The Pharmacy Quality Scheme​ • Service development grid​ • Contractor webinar now available to listen to on-demand • See: psnc.org.uk/5yearCPCF​

  18. Contractor Support: CPCF Checklist • PSNC has launched a new email: the CPCF Checklist • This highlights actions that contractors need to take now • The first emails have covered things like reading the deal document and signing up for the MYS service • The Checklist will walk you through the changes and new services, including signposting to detailed resources and training webinars • Sign up now: psnc.org.uk/email

  19. PSNC Roadshows​ • PSNC is hosting a series of roadshows across England ​to help pharmacy teams engage with news elements of the CPCF • These events are free to attend and registration is open • The roadshows are a key opportunity for contractors and LPCs to learn more and to ask questions of PSNC • Sign up via psnc.org.uk​/events

  20. The NHS Community Pharmacy Consultation Service (NHS CPCS)​ ​

  21. Introduction • The NHS CPCS is the first clinical service of the new CPCF to be mobilised and will go live on 29th October • It brings together the learnings from the NUMSAS and DMIRS pilots • There are two strands – Urgent Medicines and Minor Illness and you have to do both • In addition, pilots are underway for GP-CPCS and Online-CPCS which may become future strands

  22. CPCS Urgent Medicines Flow

  23. CPCS Minor Illness Flow

  24. Service requirements • Consultation room (IT within from 1.4.20) • SCR access • Shared NHS mail account • Access to PharmOutcomes (funded until 31.3.21) • SOP including key contact details • Business continuity plan

  25. Training and Development • The necessary knowledge and skills are core competencies for all pharmacists but pharmacists will want to ensure that they: • Can explain the service • Have an up-to-date understanding of the HMR • Can communicate and advise patients effectively on minor illnesses • Can assess the clinical needs of patients including identification of red flags • Can make appropriate referrals to other NHS service and professionals • Locum and relief pharmacists must be able to provide the service • There is a CPCS self assessment tool from CPPE to help pharmacists assess their learning needs • CPD sessions will be available from CPPE from October (not mandatory)

  26. Registration • Previous registration for NUMSAS/DMIRS will NOT carry forward • Register with the NHS BSA via Manage Your Service (MYS) portal • Pharmacies with a number of branches can use a bulk registration approach • Registration includes declaration statements that contractors have read the SLA and will be ready to provide the service from 29th October • £900 payment if register before 1.12.19. If subsequently withdraw from service NHSE&I may claim this

  27. PharmOutcomes and NHS mail • PharmOutcomes and NHS mail must be checked regularly and including when a pharmacy opens and before it closes • The pharmacy must attempt to contact the patient when they have received a referral but not been contacted by the patient within 30 mins (Urgent Medicines) or 12 hours (Minor Illness) • If no contact by the next day, the referral should be closed ‘no intervention made’

  28. Funding and payment claims • A consultation fee of £14 will be made for each completed referral • No fee can be claimed when no contact has been made with the patient • All payment claims are through the MYS portal (no paper based process) • EPS tokens that record the patient declared exemption need to be created and sent to the NHS BSA as part of the monthly batch – separated and marked ‘CPCS.’ They are only used for patient exemption accuracy checking

  29. Q&A ​Garry Myers and Jackie Buxton

  30. Chair’s Report for 2018/19 • Represents the interests of contractors within Derbyshire: • Recognised by NHS England North Midlands Regional Team • 221 community pharmacy contractors • Serving over 1 million people locally • LPC Membership and Meetings • CCA x 6 appointed members, AIMp x 5 appointed members and Independent x 4 elected contractors • Met on 6 occasions during the year • Jackie Buxton, Chief Officer, from 1st April 2018

  31. LPC Strategy 2018-22 Lead and Inspire Governance

  32. Develop • New pilot services (NHSE): • AF & Hypertension Screening • Ear, Nose, Throat and Eye Service • Recently, UTI Extension to ENT&Eye • ‘Safe Places’ (Adult Services at Derbyshire County Council) • Promoted scheme and encouraged contractor signup to the service • PharmOutcomes and Local Authorities • Drug Misuse Services & Employee Influenza Vaccination Services • Derby City - Oral Emergency Contraception • Derbyshire County - BBV Testing Pilot

  33. Integrate • Transfers of Care Around Medicines (TCAM) • To improve hospital discharge information • Facebook group for Health Champions • To join group email katherine.newman@derbyshirelpc.org • Quality Improvement Project Working • NHS 111 DMIRS • Started in November 2018 (150 Derbyshire pharmacies) • CCG Changes • Four Derbyshire CCGs merged at the end of March 2019 • Derby & Derbyshire CCG established

  34. Communicate • Chairman’s Monthly Blogs • Topical issues relevant to contractors and pharmacists • Monthly columns for local newspapers • To promote community pharmacy to the general public • Social Media Engagement • LPC Social Media policy • March 2019 - 49 different tweets and 11,150 impressions • Contractor Visits by officers • LPC Update newsletter is produced bimonthly • LPC Website www.derbyshirelpc.org..

  35. Protect • Supported pharmacies around the Quality Payment gateway criteria • More than 90% community pharmacies in Derbyshire were compliant in February 2019 • General Data Protection Regulation (GDPR) event held for contractors • Application Tracker Established • Responded to 10 applications • Contractor Levy Holiday September 2018 • Levy remains at 0.125%

  36. Governance • Audit Subcommittee • For budgeting and financial planning • Governance Subcommittee • LPC adheres to good governance principles • Performance Management of Employees • performance management and appraisal system for all employees • LPC Benchmarking • Value for money comparison of LPC Costs v. other LPCs

  37. LPC Focus 2019-20 • Develop • Community Pharmacy Contractual Changes from October 2019 • Integrate • Primary Care Networks (15) and Lead pharmacist for each PCN • Communicate • Blogs, columns and contact with MPs and LA • Protect • Pharmacy Quality Scheme (PQS) • Governance • Sub-committee established

  38. Treasurer’s Report • LPC Audit Sub-committee • Meeting May 2018 • Meeting September 2018 • Meeting January 2019 • Summary

  39. Thank you for attending

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