ACTIVITY REPORT
AUGUST 2010 TO JULY 2011
CONTENTS Foreword
1
Chief Executive Officer
2
Accounts
4
Policy and Development
5
Contractor Services
12
Support Services
17
Board Membership & Attendance Details
20
Staff
21
Glossary
22
2010/11 has once again proved a challenging year for Scottish contractors.
FOREWORD 2010/11 has once again proved a challenging year for Scottish contractors across a wide range of issues. In this foreword I will touch on just a few of them and leave the CPS Executive Team to expand on the detail within their department reports. During this year we undertook the financial negotiations for 2011/12 with the intention of improving contractor cash flow because being an owner myself, I was acutely aware of the difficulties being experienced due to various clawback mechanisms being in place. I am sure in next year’s report, mention will be made as to the relative success, or not, of the one year deal that we achieved. The Chronic Medication Service (CMS) progressed throughout this year with each of us having a target of a minimum of 50 patients registered by the 31st December 2010. It is important that we roll this service out at a pace we can achieve and that all the necessary support tools are in place as we go forward. To facilitate this CPS agreed to the establishment of CMS Early Adopter sites to test end to end the robustness of serial prescribing, electronic claiming and electronic payment. I would like to assure you that accurate payment is foremost in our minds when discussions are taking place. Community Pharmacy colleagues continue to deliver excellent results and patient outcomes through our smoking cessation and emergency hormonal contraception public health services and Elspeth expands on this later. I would like to highlight the fact that just under two thirds of smoking cessation interventions provided in a primary care setting are delivered through our contractor network. This is a resounding success, providing tremendous value for money to the NHS in Scotland. Many important decisions were taken by the CPS Board throughout the year, none more so than agreeing to convert CPS to a company limited by guarantee. Harry will cover this in more detail in his report to members. The Executive Team continues to lobby hard, on all our behalf, to Scottish politicians regarding the value and contribution community pharmacy makes to health. This is highlighted by the number of interactions they have had with MSPs at party conferences and events. One such occasion was the hosting, by CPS, of a dinner on board the Royal Yacht Britannia where MSPs and opinion formers from across pharmacy and the health profession spectrum were brought together to discuss policy. I know from the feedback we have received that the event was a resounding success. The above dinner was also the last official contribution that Alex MacKinnon, our Head of Corporate Affairs made to the organisation before he moved to take up the post of Director for Scotland at the Royal Pharmaceutical Society. I would like to formally record my gratitude to Alex for all the hard work, commitment and dedication he showed whilst working with us at CPS. I would like to close by assuring you that my Board and support team at Queen Street remain focused and committed to delivering the best outcomes for our members going forward. by Martin Green, Chairman
1
REPORT from Harry McQuillan Chief Executive Officer
During the last CPS activity year I turned my mind to the resilience of the organisation.
During the last CPS activity year I turned my mind to the resilience of the organisation, prompted by Alex MacKinnon’s acceptance of the Director for Scotland at the Royal Pharmaceutical Society and the opportunity that created to consider whether the structure in place was appropriate going forward. I would like to add at this point my thanks to those that Martin Green, our Chairman expressed in his foreword for everything Alex did and achieved during his time working with both CPS and SPGC. My review and subsequent restructure proposal was accepted by the Board and implemented over the late winter and early spring months. This has resulted in the strengthening of the Policy & Development department with the internal promotion of Malcolm Clubb and the recruitment of Matt Barclay to assist in this area. It became apparent that when Alex moved position much of the expertise went with him and the links made moved as well. This was a situation that I was keen to rectify and CPS now spreads the corporate affairs activity over a much broader staff base in an attempt to prevent such a situation recurring. Following the Board’s decision to incorporate and become a company limited by guarantee a due diligence exercise was undertaken to ensure the new entity met all legal requirements and appropriate assets could be transferred. This exercise was completed and overseen by myself in association with our legal advisors, stockbroker and accountant. An area highlighted over the severe winter was the issue of our IT structure and lack of remote access working for staff members. In conjunction with our new IT provider, CPS has now implemented remote access to our files and an even more robust server network. If you visit the building over the coming year you can take advantage of
2
our secure wi-fi network. Another secure network that we have negotiated access to is the NHS spine via N3. This has allowed CPS to install two of the major PMR supplier systems into the office and we aim to develop our knowledge and expertise in these systems to support contractors in their usage going forward. The Protecting Vulnerable Groups (PVG) legislation that was introduced in early 2011 meant CPS had to consider how best to support contractor members to be compliant with the law. This resulted in our organisation registering with Disclosure Scotland as an umbrella body to perform the administration around this scheme. Internally within Queen Street the CPS staff continues to self manage their progress towards attaining the Silver Healthy Working Lives Programme award. This has resulted in greater staff awareness of health issues and the development of support policies in the workplace. Finally I include a summary unaudited set of financial management accounts within this booklet and a full set is available to all contributing contractor members by contacting me at the CPS offices. I would now encourage you to read the respective department successes contained within their reports.
3
ACCOUNTS
CPS Financial Accounts 2010/11 Summary
Income Contractor Contributions
1094.5
Bank Interest
0.4
Other Income
100.2
TOTAL
1195.1
Expenditure
£ (K)
Staff Expenses Including Salaries
645.8
IT Support Contract & Purchases
36.3
Professional Fees & Charges
41.2
Advertising & PR
75.9
Members Travel & Meeting Expenses
155.3
Rent, Rates & Utilities
83.0
Printing & Stationery
42.9
Postage & Courier
18.3
Insurance
13.2
Maintenance
8.2
Discount Spot Check
8.5
TOTAL Surplus / (Loss) for 2010/11
4
£ (K)
1128.6 66.5
REPORT
from Elspeth Weir Head of Policy and Development
CPS arranged a
specific day for our Board in May to develop ideas around support for CMS.
Throughout 2010/11 the Policy Department has continued to work closely with the other members of the negotiating team to develop and support the delivery of the pharmaceutical care services contract. We have also prepared briefing papers for the Board on consultation documents received from a number of sources, and produced the final responses which were submitted on behalf of contractors. The Contract Negotiating Team met with officials from the Scottish Government (SG) on a regular basis. There were 7 plenary meetings plus 4 technical meetings. The frequency of meetings was slightly less than last year due to agreement on a financial package early in the year and the Scottish Parliamentary elections.
Pharmaceutical Care Services Contract Service Delivery
The Chronic Medication Service (CMS) has continued to occupy us over the past twelve months. During 2010-11 it was agreed that CMS should commence with an implementation phase which would run to 31 December 2010. Under this plan contractors were asked to: • Identify all the patients with long term conditions who they believe will benefit clinically from CMS • Register no more than 50 patients at the premises • Provide CMS to these patients during this phase From 1 January 2011 contractors were expected to proceed at a pace with which they were comfortable. CMS was supported during 2010/11 with a series of CMS implementation Payments(CIPs). It is fair to say that contractor uptake to the service has been mixed and there are a number of reasons behind that but nationally there has been a levelling out in terms of CMS patients registered over the last quarter of 2011/11. At the end of July over 74,000 patients had been registered with PCR 5
records initiated for more than 40%. We are starting to discuss plans to provide further support to pharmacists in the delivery of this key component of the pharmacy contract. Discussions are also underway on how funding will begin to move from the global sum into this service in the near future. CMS delivery will become increasingly important to recognition of community pharmacy contractors as providers of patient centred, safe and effective care in line with the Scottish Government Quality Strategy and allow us to maintain current funding levels in these challenging times for health budgets. CPS arranged a specific day in Glasgow for our Board in May to develop ideas around support for CMS, both clinical and IT. A day of healthy debate ensued and the resulting outcomes were submitted to SG for consideration. CPS and SG continue to work together to forge the most practical way ahead for CMS. One area we have highlighted is a wish to see information from the PCR analysed and used to support practice development. Changes have already been made to the PCR and we expect to see more in the next 12 months. Feedback has been obtained from our members and shared with the ePharmacy representatives from SG. The Early Adopter Phase, testing the serial dispensing aspect of CMS, has been rolled out over almost all Health Boards and early feedback has indicated that there have been some issues around the workings of GP and PMR computer systems; this has been complicated further by the migration away for many GPs from GPASS to another system. CPS will continue to monitor the information that comes back from our pilot sites to evaluate the appropriate timescales for a more widespread, efficient rollout across the pharmacy estate. CPS also believes that patients in care homes should benefit from the pharmaceutical care provided within CMS. CPS had its own working group and we delivered our outputs to SG; we await their reply. CPS also has representation on the RPS working group on Care Homes which is discussing issues around delivery of care for this group of patients. We will keep you up to date with any developments in this area. Under the Public Health Service the proportion of interventions seen by community pharmacists, in relation to the total number of primary care interventions, grew to 63% for smoking cessation. EHC provision continues to grow in numbers and the associated abortion rate fell for the second consecutive year. Chlamydia has been removed from the national service although many Health Boards have continued to support the service locally. During the course of the year SG conducted a review of the Public Health service and we expect their findings to be published by the end of August. We are grateful to all contractors who identified patients to take part in the survey. A review of the flu vaccination programme was also undertaken within the last year. CPS lobbied for greater community pharmacy input into the administration of vaccines under the NHS banner. Due to legislative restrictions radical change to the primary care set up was unachievable although there is some scope for development in terms of offering vaccinations through health board occupational health departments. We were able to maintain the supply function under GP stock order The end of March saw the abolition of prescription charges in Scotland and a reduction in the level of bureaucracy required within the pharmacy. Over the course of the year the number of patients registered for the Minor Ailment Service has increased slightly with around 50% of contractors sitting in either Band 2 or 3. CPS has been making representation to SG around modifying MAS in light of 6
the removal of prescription charges. We have been lobbying for open access to the service for patients together with the introduction of a restricted formulary. For AMS the expectation is that contractors will continue to engage and raise further the level of electronic claims being submitted from electronically scanned prescriptions. PSD has been charged with providing greater information to contractors around AMS and this should help contractors to work out what they still need to put in place to attain reasonable levels of e-claims. CPS has been receiving regular updates on the level of e-claiming with the majority of contractors achieving over 70% in claims. Outwith the core services of the contract CPS has been looking at various models of delivery for pharmaceutical care services. Malcolm and I visited Holland and looked at their unique system of pharmaceutical care services which included use of offsite dispensing, care planning, use of supervision and IT systems (built in with GP systems). This was useful to see as many aspects of the Dutch model could be incorporated to improve our delivery of services. We were very grateful to the late Professor Steve Hudson of Strathclyde University for facilitating that trip and introducing us to a number of Dutch pharmacists. Down south the Healthy Living Pharmacy (HLP) concept is gathering momentum and CPS visited some of the pioneers of the model. What we witnessed were high volume pharmacies engaging in an array of public health services interventions in areas such as obesity and alcohol brief interventions. The entire pharmacy workforce was involved �and helping to record outcomes. In Scotland we already encompass many of the aspects of the HLP concept; however there is much we can take on board for ourselves for developing within our existing pharmacy framework. We continue to support the path of the Healthcare Quality Strategy for NHS Scotland, attending meetings of the Steering Group charged with Delivering Quality in Primary Care, promoting community pharmacy at Primary Care Events and making sure that other stakeholders are fully aware of what we do and how we can be at the heart of the Quality Strategy.
Keep Well
During 2010/11 contractors across seven health boards were asked to support service delivery of Keep Well health checks. Support provided by contractors varied across the different health board areas and could be for example providing their consultation room for health service staff to do health checks or pharmacists providing opportunistic health checks. The NHS Health Scotland evaluation identified several key issues with service delivery; these included improving joint working with GPs, IT linkages between general practice and community pharmacy, and the benefits of pre-booking appointments on behalf of the community pharmacy. It is expected that Keep Well will be mainstreamed nationally from 2012. Pharmacy contractors may be approached by Health Boards to support projects especially in areas of high deprivation and where previous projects have operated successfully. Targeting in certain patient groups e.g. substance misuse may also lead to pharmacy being contracted during 2012/13.
A Vision for Community Pharmacy in Scotland
In March of this year the Policy Department produced a consultation document to stimulate discussion and debate amongst the members of Community Pharmacy Scotland to define a long term vision for community pharmacy in Scotland. The views 7
...cont. from the discussion around the document are pivotal to providing the basis of the five year plan for the organisation. This document also formed the background for the Council’s World Café day in May (see below).
World Café Event
In May of this year a World Café event took place to facilitate discussion on the priority areas for action over the next five years. These areas were: • Changes to Current Practice (Different Ways of Working) • Patient Services & Service Development (Elderly) • Profile of the Profession • Patient Services & Service Development (PHS) A day of debate ensued around these issues with common themes being collated and then fed-back by members of the Policy Department to the Council. The common themes will be revisited and actions developed at the Council meeting in November 2011. One of the areas flagged as a concern during our discussions was the continuing pressure to supply MDS. We will therefore be looking at this area of service provision during 2011/12.
Review of the Arrangements for the Provision of Stoma Appliances
Following on from the consultation SG held a series of meetings with us and the appliance contractors to confirm the financial details of their proposals. Health Services Scotland (HSS) was then charged with preparing the tender documentation which was issued in the spring and the new arrangements came into place from 1 July 2011.
Contract Funding
Following a difficult series of meetings with SG at which a number of NHS Board Directors of Finance were also present, the negotiating team managed to reach a one year settlement with SG for 2011/12. The settlement was reached much earlier than in recent years due to the election campaign commencing in March 2011 and the outgoing ministers and civil servants being keen to ensure a stable platform for contractors during the election period. The settlement agreed for 2011/12 was made against a backdrop of on-going scrutiny of all aspects of SG spending. One of the main objectives for the negotiating team in reaching this settlement was to ensure that cash flow to contractors was improved and stabilised from that seen by contractors in the latter part of 2010/11. To support this for 2011/12 it has been agreed that the direct link with Category M prices in England and Wales will be 8
broken. Further changes were also made to the ePPP scheme. The nature of the settlement resulted in very few changes to the remuneration arrangements. A series of PCC evenings was arranged to disseminate information about the settlement and progress with service delivery and members of the Policy Department attended a number of these meetings. We also organised a meeting with representatives from each of the PCCs to discuss the findings from the review of their activity and how we could support change for the future.
Monitoring of Retained Purchase Profit
During 2010/11 we continued to monitor through regular discount spot checks the level of retained purchase profit being achieved. The results of the spot checks have shown a continuing fall in branded discount rate achieved by contractors. The spot checks also showed that as of October 2010 contractors achieved a substantially reduced margin on generic medicines compared with the previous six months of the year. This information was used to inform discussions throughout the latter part of financial year 2010/11. From 2011/12 SG has permitted a minimum retained purchase profit of £67m for contractors and has revised the sharing arrangements on margins achieved beyond this level.
Review of Arrangements with Control of Entry
At the end of October last year SG published a summary of the responses to their consultation on the control of entry regulations in Scotland. Later that year proposals were published for implementation and in April of this year the new regulations came into force. It is unclear at the time of writing how much impact the changes (mainly procedural) will have on the levels of pharmacy applications and contracts awarded.
Consultation Activity
It has been a busy year for the department with responses being prepared on behalf of Community Pharmacy Scotland to a considerable number of consultations which appeared. Amongst these were: • GPhC consultation on the CPD framework • The consultation on the fees payable by registrants for continued inclusion in the register in 2012. • The Department of Health consultation into Value Based Pricing • GPhC call for evidence on the Extemporaneous preparation of Methadone • Contributing to the debate on Modernising Pharmacy Careers - this is looking at the education and training currently delivered by the Schools of Pharmacy and the pre-registration year. CPS also produced guidance surrounding the registration of pharmacy technicians in the run up to the removal of the grand-parenting arrangements.
Departmental Reorganisation - Corporate Affairs Activities
Following the departure of Alex MacKinnon an internal restructuring took place and the Policy Department has now been charged with taking on more activities previously delivered within corporate affairs. In order to assist with this change we were pleased to welcome Matt Barclay as a member of our team in May. Matt will be providing support on clinical development of services and assisting with lobbying activity and as a former Pharmacy Champion, he is well aware of the challenges currently facing contractors.
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Lobbying
CPS continued to lobby actively on your behalf throughout 2010/2011. Our key manifesto intentions have formed the basis for our lobbying with a particular emphasis on access to the electronic patient record and a greater role in flu immunisation services. Lobbying activities included taking MSPs on community pharmacy visits, visiting MSPs at their offices in the Scottish Parliament and attending Parliamentary Committees and Cross Party Working Groups where appropriate. In addition we attended every Scottish Party Political Conference and interacted with a number of patient groups.
Parliamentary MSP Visits
Community Pharmacy Scotland met with the following MSPs at the Scottish Parliament over the last year: Murdo Fraser, Nanette Milne, Mary Scanlon, Jim Eadie.
MSP visits to Community Pharmacies
The following MSP visits took place during the year; the number is slightly down on the previous year due to the departmental re-organisation and the April elections for the Scottish Parliament. • Fergus A Ewing MSP was taken to John A Smith pharmacy in Niddrie. • Alison McInnes MSP was taken to Rowlands Pharmacy in Ellon. These MSP visits are very worthwhile in allowing MSPs to see community pharmacy services in action. As you would expect the MSPs often see much more than they anticipate and realise the positive contribution that can be made by a pharmacist at the heart of the community. The visits also give us an ideal platform to lobby on certain issues. Over the course of the next year the focus will be on increasing our presence in and around parliament and further raising the organisation’s profile by increasing the regularity of MSP visits.
Party Conferences
Community Pharmacy Scotland attended all of the 2010/11 Scottish Political Party Conferences and lobbied MSPs, MPs, and MEPs on your behalf. Using the joint ‘Pharmacy in Scotland’ stand, representatives from CPS and RPS, engaged with politicians and conference delegates to promote the interests of community pharmacy contractor owners and pharmacists working in Scotland. The events covered were: Scottish Labour Party, Oban, 29-31st October, 2010 Scottish National Party Conference, Perth, 14-17th October 2010 Scottish Liberal Democrat Conference, Dunfermline, 9th October 2010 Scottish National Party Conference, Glasgow, 12-13th March 2011 Scottish Conservative Party Conference, Perth, 20th March 2011 Scottish Liberal Democrat Conference, Perth, 4-5th March 2011 Scottish Labour Party, Glasgow, 19th March 2011 CPS called for further development of the role of community pharmacists working in the NHS in Scotland and for the remuneration levels to match that. CPS continued to push for community pharmacists to be represented at the highest level to enable the profession to be part of the key decisions for health policy in Scotland. The party conferences will form a key part of our lobbying tool in the upcoming year. Any contractor who is interested in assisting at the conferences is invited to contact the office. 10
MSP and other stakeholder Hampden Visits
Scotland’s European Championship qualifying games against Liechtenstein and Spain afforded CPS another opportunity to invite some MSPs and representatives of the BMA along to Scotland’s home games at Hampden. These corporate visits have always proved to be an effective way of networking and have afforded our representatives from CPS ideal lobbying opportunities.
Health and Sport Committee and Parliamentary Cross Party Groups
Community Pharmacy Scotland attended meetings of the Health and Sport Committee where appropriate (this included the keynote address from the Cabinet Secretary, Nicola Sturgeon, on her objectives for the new parliamentary term). Cross Party Working groups were also attended on Coeliac Disease, Stroke and Palliative Care.
Engaging with Other Stakeholders
Community Pharmacy Scotland enjoyed building relationships with many other stakeholders throughout the year: Optometry Scotland, GPhC, RPS, NPA, NES, Scottish Stoma Forum, Coeliac UK. Continuing to engage with other stakeholders increases community pharmacy’s profile and allows us to create positive relationships with patient facing organisations.
Scottish Government Daily Record Health Awards
Community Pharmacy Scotland attended the Daily Record Health Awards in Edinburgh on Thursday the 11th of November 2010. Staff and board members from Community Pharmacy Scotland were able to engage with key stakeholders and promote community pharmacy to a wider audience.
Scottish Pharmacist Magazine
The Scottish Pharmacist magazine, a collaborative partnership between Profile Publishing and Community Pharmacy Scotland continued to flourish over the year and its readership has grown in line with expectations. Six editions were delivered this year and the magazine continues to find a positive space in the marketplace with a publication every two months.
Scottish Pharmacist Ball and Awards
In partnership with the Scottish Pharmacist magazine and Profile Events Management the second Scottish Pharmacists Ball and Awards were held on 26th February 2011 in the Edinburgh International Conference Centre. A very enjoyable evening was had by all giving everyone working within the pharmacy community an opportunity to celebrate success. Organisation of next year’s event is well underway and sponsorship is already secured.
11
REPORT
from Carol Farley Head of Contractor Services
We have given presentations at AGMs, locality group meetings and to CCA and independent pharmacy groups.
Information services
Once again Contractor Services has seen an increase in enquiries from our members. There have been plenty of changes this year and we have made every effort to ensure that we have kept you up to date through regular mailings and via web pages. We have also worked hard to ensure that we are up to date with any developments so that we can give the right answers and advice to our members. The team is now working to keep up with developments with CMS and the potential changes to the payment structure with the developments in CMS and ePay.
Chronic Medication Implementation Payments (CIPs)
This year there was a series of Chronic Medication Implementation Payments (CIPs) available to claim at various times. We helped many contractors with their claim forms and as the various deadlines approached we phoned everyone who had not yet claimed. You can phone our team for help with any aspect of your claims and payments as they fall due throughout the year.
Publications
We continue to send a monthly mailing to all our members. This information is also available in the Contractor Services Section of the Community Pharmacy Scotland website. We have also continued to update and issue Community Pharmacy Scotland’s Diary Wall Chart each month. The chart is designed to remind members of any tasks they need to complete that month or any payments, circulars or publications to look out for. It also gives reminders of when and how to claim any new and ongoing payments. If you have not yet made use of the chart please give it a go.
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Other publications produced and circulated this year include: • Compendium of Disallowed Items • Drug Tariff Part 7 Booklet including the Part 7B List which clarifies the pricing of certain items when prescribed on CP2 Forms. • Guide to Prescription Endorsement online version. These publications can all be accessed on our Website.
Services to Local Contractor Committees
Throughout this year members of our staff have attended 28 PCC meetings in 10 NHS Board areas. We help with the organisation of meetings, production of agendas and circulation of documents. We take and produce minutes, write letters and produce newsletters as well as providing information on local issues and payments for local services. Our members’ section continues to grow. This section contains information from your local committees and fees for locally negotiated services. This year Christine McKinlay (Contractor Services Supervisor) and I have continued to give presentations on prescription endorsing and submission of claims for payment. We have given the presentation at AGMs, locality group meetings and to some CCA and independent pharmacy groups. We shall be continuing this service next year. Please contact your local Pharmacy Contractors’ Committee, buying group or your head office/regional manager.
Monitoring of Prescription Pricing.
This year we checked 427 prescription submissions. Of these submissions 200 (a total of 1,274,885 items) were picked at random by ISD and 99 were requests from pharmacy contractor members. Of the 200 submissions checked at random, 137 had errors which amounted to over £50, of which 108 were underpayments to contractors and 29 were overpayments. PSD has an overall accuracy target of 99.8%. This year our checks confirmed that PSD did not breach this target, as each month our checks showed an overall error rate of less than 0.2%. In addition to these checks on full submissions, we check the accuracy of PSD’s deduction of charges using a monthly ‘outlyer’ report received from PSD. This year we have found very few errors made by PSD keyers but still find a significant number of blank or incomplete declarations (where there is no cross in a box) for which PSD deducts a charge. If there is a legible CHI number on these scripts we can reclaim the charges. This year we checked the charges in 128 submissions and were able to recover a total of £14,910.10. We continue to increase the feedback we give to members on the quality of their submissions. For example, we comment on endorsing, completion of GP34s, declarations and stock orders. Please remember that if you have a problem with or are concerned about any aspect of your submission or payment please contact us.
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Contractor Services has been closely monitoring electronic pricing and has found PSD’s pricing to be consistently accurate so long as the item was submitted correctly.
...cont. Disallowed Items
This year we have continued to monitor and report on dispensed items which were disallowed by PSD. Over the first 9 months we have seen a 25% drop in the number of items not passed for payment by PSD. The most common problems include: • Wrong sizes of Dressings – sizes not in the Drug Tariff • Prescription written on the wrong type of form e.g. Doctors prescribing on nurses forms and vice versa • Nurses prescribing items not allowed on Standard Nurse forms • Wrong pack size prescribed on MAS prescriptions We continue to update on a monthly basis the list of most commonly rejected items. We will continue to monitor this issue next year and attempt to reduce the list still further.
Contractor Services Pharmacy Visits
Last year we introduced a new service for pharmacy contractors. On request a member of our team will visit your pharmacy for up to half a day and will use their expertise to help and advise you on your prescription submission. They will look at the prescriptions you are about to submit for pricing and comment on the dispensing and endorsing. They will also answer any questions you may have and will bring some useful hand outs with them. If you have questions about the latest claim forms for new services or need help locating information on our website our staff will be very glad to help you. During this year we have visited 50 pharmacies and the service continues to be well received. Going forward we intend to increase our visits to an average of 5 pharmacies per month. If you think your pharmacy could benefit from this service please either phone us on 0131 466 3540 or email june.mcdonald@communitypharmacyscotland.org.uk or helen.findlay@communitypharmacyscotland.org.uk
Retained Purchase Profit – Spot Checks.
These spot checks began in January 2007 and are designed to inform negotiations on generic discounts and retained purchase profit on proprietary products. They have continued this year with checks in October 2010, and January, April and July 2011. They continue to be important as the discounts from manufacturers change 14
and the number of items for which there is no discount increases. Contractor Services organised the uplift, photocopying and return of all the invoices and statements for the twenty-one pharmacies in each survey. We then extracted the required information from these documents and entered it into a database ready for outside statistical analysis. We expect to continue to be involved in these checks throughout the coming year.
PVG Scheme (Protecting Vulnerable Groups Scheme)
In June this year Community Pharmacy Scotland became a registered umbrella organisation with Disclosure Scotland to facilitate pharmacy owners’ compliance with the PVG scheme. All pharmacists newly employed by contractors after 28th February 2011 have to be members of the PVG scheme. Three of our Contractor Services staff and one from Support Services are now counter signatories with our Chief Executive as the overall lead for the group. We can handle all aspects of the administration of requests on behalf of our members. Contractors have only to cover the cost of the necessary Disclosure Scotland fee. In July we processed eight applications and we expect the service to grow as the scheme is rolled out to other groups of pharmacists in 2012.
Issues relating to Practitioner Services and ISD
We meet with the Heads of Departments at PSD on a monthly basis. During 2010/11 the following have been the main topics of discussion:
CIP Payments
We have worked very closely with Moira Hanley’s team throughout the year to ensure that this payment was made to as many contractors as possible.
New Stoma Contract
A new Stoma Contract came into force at the beginning of July. Contractor services liaised with NS Procurement and the Payments Team to ensure that all our members knew how to sign up for the service and how to claim their fees. We had numerous telephone calls about the requirement for Basic disclosure for drivers involved in the delivery of Stoma supplies to patients so we acquired a stock of the relevant Disclosure Scotland forms and instruction leaflets for those who do not wish to apply on line.
Shortages
Shortages of generics available at Drug Tariff prices have escalated this year resulting in over 20 items on the ‘Shortages’ list for some months. We have liaised closely with ISD to ensure that the situation is monitored and the list kept up to date. There have been problems throughout the year for pharmacists who have not endorsed their prescriptions clearly. Contractor Services has worked hard to inform pharmacies of the correct way to endorse their shortages
ePharmacy
The number of products paid electronically has grown month on month over the past year. The list of products where payment could be automated has now exceeded the 2000 mark which correlates to over 95% of items prescribed. Contractor Services has been monitoring the pricing closely and has found PSD’s pricing to be consistently accurate so long as the contractor has submitted the item correctly.
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...cont. The main problem by far is in the submission of items which are dispensed in instalments.
Flu Vaccines
Flu Vaccine claims and payments again proved difficult both for contractors and for PSD. This year 84,416 vaccines were paid at the default price of ÂŁ3.50 per vaccine. The total number of vaccines vaccines dispensed from community pharmacies was 1,129,764. Remember that PSD will only pay the net invoice price if it is clearly endorsed on the stock order/prescription.
Payment Documents
PSD introduced a pilot scheme for on line payment schedules this year. Some contractors can now access their priced data on line and there are plans to roll out the service further next year. Community Pharmacy Scotland now has an N3 connection and will soon be able to access this data. This should help to speed up our request checking and enable us to help contractors with any questions they have on their data.
PSD Adjustment Team
Compatibility problems between PSD’s system and our checking and reporting program continued into the first part of this year but have now largely been resolved and the backlog of adjustments relating to our checks is now being cleared. In conclusion Contractor Services has continued its hard work on your behalf throughout the year to ensure you are kept well informed and able to access and claim any new payments. We have expanded some services and introduced a new one and have kept the checking service running through the vagaries of our system. One member of staff retired in March and in June we welcomed a new member to the team as Administrative Support. This has allowed us to reorganise our work and we shall continue the re-organisation next year in order to make the best use of our skills.
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REPORT
from Jenny O’Donnell Head of Support Services 2010/11
Enquiries began into the possibility of CPS having an N3 connection installed in the office.
Support Services have had another busy year. We are responsible for all aspects that provide support to the organisation.
Finance
All Support Services staff members have been trained on most aspects of Sage Accounts with each person having a different day to day role with processing the accounts. Monthly reports are given to the Board to keep them informed of our finances and also as governance. A presentation on the annual accounts was given at the Council AGM in November 2010 and re-appointment of the Auditors Charles Burrows & Co was sought and approved. Support Services also work along with, and on behalf of SPGC Property Limited in preparing annual accounts and VAT Returns throughout the year.
Website
Over the course of the year the website continued to improve. Webstats are provided to the office on a monthly basis and reported to the Executive Team at its monthly meetings. This enabled the team to look at areas where improvements could be made. Now that our Website Assistant has been with us for over a year we could start comparing the increase in visitors and hits to the website. There has been a steady increase over the year. Taking this a step further we approached Community Pharmacy Wales and the Pharmaceutical Contractors Committee NI to ask if they would be willing to provide us with their statistics on a quarterly basis. They agreed and it was then decided to present these statistics on a quarterly basis to the Board. In May we started to look at other ways the website could be beneficial to our members. Options being explored include web based iPhone/Smart phone apps which are
17
...cont. widely available with today’s technology. The process was started to look into this and will be carried on into next year.
IT Support
The preparation for moving to a new IT support provider began in September. To ensure a smooth transition, Oricom, the new provider, began by doing an audit of our systems. This gave them a better understanding of how things were set up and enabled them to make recommendations. We have since had new anti virus software put in place which has worked well. Another new concept for CPS is being able to work remotely. We had a Terminal Server installed and configured in May to allow this. More recommendations have been made and carried out while others will be investigated in the coming year.
N3 Connection
Enquiries began into the possibility of CPS having an N3 connection installed in the office. The Scottish Government and PSD both supported the request for N3 to be installed within our offices. First the line was installed and then the router. National Information Systems Group (NISG), a division of National Services Scotland liaised with Support Services and Oricom to take this forward. As CPS has a different working environment from pharmacies the setting up has not been straightforward. There are ongoing issues which we expect to be resolved early in the coming year.
Incorporation
After it was agreed that CPS would incorporate to become a Company Limited by Guarantee a due diligence exercise had to be carried out. Support Services had the onerous task of finding and collating all this information. This was then sent to the solicitors by mid November with further information requested and sent by mid December. Another part of becoming incorporated meant new bank accounts were required. This proved to be very problematic as the service from our bank was poor. A new company for payroll also had to be set up with a new PAYE reference. All CPS staff and honoraria recipients were then issued with P45’s and transferred to the new company.
Building Redecoration
Support Services managed on behalf of SPGC Property Limited the last phase of redecoration to the premises. A planning meeting took place, then weekly reviews were carried out to ensure work was going to schedule. Work began on the upper floor consisting of the Board Room, Meeting Room and Kitchen. These rooms 18
were redecorated, curtains and blinds replaced and new flooring laid. The Support Services office on the ground floor was also redecorated.
Events Planning
Throughout this year, more so than in the past, Support Services have played a big part in organising events. This included the dinner on the Royal Yacht Britannia and preparations for our forthcoming centenary. Everything from booking venues to organising flowers, invitations, menus and so much more had to be carefully planned. Support Services also liaised with Profile Publishing for some areas of the Scottish Pharmacist Ball and Awards planning. Other areas Support Services have been involved with or responsible for organising throughout the year are: • Design of CPS publications • Installation of new fire alarm system • Maintenance of equipment • Maintenance of property on behalf of SPGC Property Limited • American pharmacy students visits
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BOARD MEMBERSHIP AND ATTENDANCE DETAILS
Details of members’ attendance over the course of the year are listed below.
Name
Actual Totals
Expected Totals
M Green
9
11
J Semple
10
11
C Watt
9
11
E Fairbairn
6
11
I Cowan
6
11
I Duncan
7
11
J Currie
10
11
B Pimlott
9
11
R McGregor
9
11
S Johnstone
8
11
F McCready
10
11
A Macintyre
8
11
C Fergusson
10
11
A Glauch
9
11
C Shimmins
8
11
Completed Declaration of Interest Forms are held within the office and are available for inspection by all members of Community Pharmacy Scotland. When a member fails to attend 3 consecutive meetings the Board will then determine whether that member should continue in office.
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COMMUNITY PHARMACY SCOTLAND STAFF 2010/11 Executive Team Harry McQuillan
Chief Executive Officer
Elspeth Weir
Head of Policy and Development
Malcolm Clubb
Senior Policy Development Pharmacist
Matthew Barclay
Policy and Development Pharmacist (started May 2011)
Alex Mackinnon
Head of Corporate Affairs (ended October 2010)
Carol Farley
Head of Contractor Services
Jenny O’Donnell
Head of Support Services
Pat Keanie
Executive Assistant
Contractor Services Staff Christine McKinlay
Contractor Services Supervisor
Loretta Bain
Contractor Services Assistant Supervisor
Joan Collins-Cormack
Contractor Services Assistant (Part Time)(ended March
Heather Couston
Contractor Services Assistant
Dolores Dangel
Contractor Services Assistant
Heather Drysdale
Contractor Services Assistant (Part Time)
Helen Findlay
Contractor Services Assistant (Part Time)
Ann Gault
Contractor Services Assistant (Part Time)
June MacDonald
Contractor Services Assistant
Greta Russell
Contractor Services Assistant (Part Time)
Janette Shields
Contractor Services Assistant
Brian Maher
Administrative Support Assistant (started July 2011)
2011)
Administrative Staff Laura Donnelly
Website Assistant
Graham Le Tissier
Administrative Assistant
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GLOSSARY
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AMS
Acute Medication Service
Category M
Basis of setting the price for certain products in Part 7
CMS
Chronic Medication Service
CIP
Contract Implementation Payment
eAMS
The electronic infrastructure for AMS
eCMS
The electronic infrastructure for CMS
ePAY
The electronic infrastructure for processing
ETP
The electronic transmission of prescription information
GP34
Declaration form used when submitted prescriptions for payment
ISD
Information Services Division
MAS
Minor Ailment Service
MCC
Material Change of Circumstances
NES
National Education Scotland
NSS
National Support Services for the NHS Scotland
Part 7
List of generic drugs in the Drug Tariff
PAY 001 and PAY 002 B CP
Payment Forms issued by PSD
PCC
Pharmacy Contractors Committee
PCR
Pharmaceutical Care Record
PCS
Pharmaceutical Care Services
PHS
Public Health Service
PMR
Patient Medication Record
PPRS
Pharmaceutical Price Regulation Scheme
PRPS
Pre-registration Pharmacist Scheme
PSD
Practitioner Services Division
QED
Quality, Evaluation and Development Programme
RP
Responsible Pharmacist
RPP
Retained Purchase Profit
SG
Scottish Government
SGPC
Scottish General Practitioners Committee
SOP
Standard Operating Procedure
SVQ
Scottish Vocation Qualification
ZD
Zero Discount
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Community Pharmacy Scotland 42 Queen Street Edinburgh EH2 3NH T: 0131 467 7766 F: 0131 467 7767 W: www.communitypharmacyscotland.org.uk