Welcome to the winter edition of the LLR LPC newsletter. The LPC has recently worked with multiple stakeholders to further support the integration of Community Pharmacy in the local NHS. West Leicestershire CCG have extended commissioning of ERMS (Emergency Repeat Medicines Service) and MAS (Minor Ailments Service).

As you may know, ERMS expressions of interest for East Leicestershire CCG and Leicester City CCG, which has lead to the potential for Community Pharmacy to support winter pressures and reduce urgent care and OOH admissions. The CCG will be contacting successful applicants and providing details of the Pharmoutcomes login to all pharmacies.

There has also been the launch of the Fluenz Mop up pilot for childhood immunisation and we look forward to seeing the outcomes of this service to provide further opportunities for Community pharmacists to support Childhood Immunisation.

The LPC will be working to design deliver and commission more services next year so we will be ensuring all Pharmacists will be provided with access details to

Pharmoutcomes next year in preparation for future services and hopefully using Pharmoutcomes to capture Flu vaccinations for Winter 2016.

We also take this opportunity to extend our thanks to all Pharmacists and teams that supported the Flu service this year and also for attending the GpHC event on 3rd December. Your attendance and support was very much appreciated and we hope to see you all at more events next year. I take this opportunity to wish you and your families a very happy Christmas and new year.

Winter 2015

GpHC Event

We had a very successful GpHC inspection event attended by over 130 pharmacists and team members. Next year we have plans to provide further clinical training around diabetes, respiratory polypharmacy and dermatology to help you keep your clinical knowledge up to date so please look out for the communications.

LMSG Safety Update

All the latest Leicestershire Medicines Strategy Group clinical guidelines and updates are available at:

http://www.lmsg.nhs.uk/

LMSG Statement on Use of Abasaglar (Bio-similar Insulin Glargine)

The patent for Lantus® (Insulin glargine) has expired and a biosimilar preparation called Abasaglar®, which has a lower cost, has been supported for use within LLR.

LMSG recommends that this can be used only in:• New patients • Patients with suboptimal control where a review of therapy is being considered.

Existing patients should continue to receive Lantus®.

Patients should not be routinely switched between brands

Prescribing: It is essential that patients stay on the same brand. All prescribing should be by Brand Name as recommended by the Leicestershire Medicines Formulary for all insulin prescribing.

GpHC Event

On the 3rd of December Leicestershire & Rutland LPC invited the GpHC's head of inspection, Mark Voce and his colleague Colette Cooknell to Leicester, to give an overview of the GpHC inspection model. Mark Koziol (PDA) and Kate Westbrook (Pharmacist Support) were also invited to present the services they have to offer. Over 120 pharmacy contractors, pharmacists and pharmacy staff benefitted from attending the event. As well as an insight into the inspection model and what is expected from them during an inspectio, they were also given the opportunity to ask questions to our speaker panel.

We received overwhelmingly positive feedback from attendees, many of whom stated the information shared by the speakers was extremely useful, leaving them with a better understanding of the process.

We hope contractors will continue to support future LPC events in the New Year.

Conducting MUR’s with Substance Misuse Patient– a missed opportunity ?

In primary care LMSG recommends that all practices search for any patients currently prescribed insulin glargine generically and change to the existing branded product, Lantus® before Abasaglar® becomes available, to avoid later confusion.

Dispensing: Pharmacists should dispense the brand ordered and not substitute. If a brand is not specified the prescription needs to be returned to the prescriber for this to be added.

Please note that pharmacists will not dispense insulin glargine unless prescribed by brand as they are not authorised to amend prescriptions. Administration / Record keeping: It is important that a record is kept within the patient’s notes of the brand used. This is to facilitate reporting of adverse effects. At UHL communications with GPs should provide brand details of the product used.

Adverse reactions: (whether suspected or established) should be documented on yellow card reports to the MHRA as previously. Patient information is available on request from the company.

Community Pharmacy regularly see patients who require support for substance misuse. The Leicestershire Recovery Partnership have provided top tips to support these patients with MUR and NMS to promote medicines Optimisation. tTop Tips for discussion during Medication Use Review where applicable:-

• Pharmacological action of drug • Psychological aspects • Overdose Risks – awareness of signs and actions to take (Nausea and vomiting, pin-point pupils, sedation (drowsiness to coma), cold, clammy, blue-ish skin, reduced heart rate and body temperature, reduced frequency and depth of breath, stopped breathing and convulsions) Use of naloxone in an emergency where applicable Call ambulance • Missed doses = loss of tolerance. After a short period of abstinence, tolerance is lost and the dose that was taken before the period of abstinence can now prove to be a fatal overdose

• If injecting heroin, please refer to Appendix A • Crushing tablets where applicable and route • Poly-pharmacy –prescription and non-prescription drug interactions, OTC, other illicit drugs, alcohol, tobacco use • Dental health • Sexual health – BBV’s

Author : Davina Gadhia – Leicestershire Recovery Partnership

Quit 51 – Stop smoking Services in the County Update

Q51 have now developed and updated the payment report related to the Quit 51 subcontractor agreement. This is a brief guidance and more comprehensive guidance notes will be issued in due course. There are two payments available for subcontractors:

Activity payment and Nicotine Replacement Therapy (NRT) reimbursement. The cut-off date for both reports is on the 5th of each month. The report will automatically run and be available for you to look at the next day.• Activity payment Payment related to Quit date set, 4 week quit and 12 week quit data. The report will capture any data that has been entered during that month, retrospectively of when the dates for the activity is.• NRT payment This report is “live” so any NRT issued during the month needs to be inputted before the report is produced. I.e if the cut off for the report is on the 5th September any NRT issued between the 5th of August and the 4th of September needs to be entered on to Quit manager.

The payment reports will be automatically be paid on a monthly basis. There is no requirement to submit invoices to us.

Entering session data

When entering session data please complete the fields available as comprehensive as possible. NRT batch numbers and expiry date should be entered along with the number of units issued. 1 unit = 1 pack.

If you have collected a prescription fee from the client, entre the number of fees collected at the session in the field allocated.

Reconciliation

All payments are in the process of being reconciled and correct payment will be provided very soon.

The report in Subcontractor payment reports called 10-2015 is a report of all the data up to date (from the 1st April until the 4th October). Q51 use this

to reconcile your payments already received and pay anything outstanding, the report is accurate as of lunchtime today. Then from the 5th of November reports will be available monthly and paid monthly. November report will be inclusive of data inputted form the 5th October until the 4th November.

With regards to reconciling the NRT payment this will be done in December to give all subcontractor a chance to input any outstanding data.

Contact details for Q51

Katty Bailey Operations manager katty.bailey@quit51.co.uk Mobile no 07795283675

Silpa Das Locality Lead East CCG Silpa.das@north-51.com Mobile no 07805 375787

Zahida Niazi Locality Lead West CCG Zahida.Niazi@nhs.net Mobile no 07500 037837

Dear all,

Leicester City PH have commissioned a lifestyle referral hub in the City.

Any patients that need support with diet, exercise , physical inactivity , alcohol misuse can be referred to the lifestyle hub through a simple online referral form.

The patient will receive a telephone consultation l which will identify all their requirements and will be referred by the lifestyle referral hub to specialised services tailored to their needs. This may include free gym membership, dietetic advice, health trainer support , alcohol support and many more services.

This will really help to support patients to prevent disease and promote health and wellbeing in our community.

The link we will use is ;

http://gethealthyuk.com/Can-We-Help

the attached leaflet provides all the key information you need. Please print and keep it In your consultation room .

Please let all your teams and pharmacists know and I hope you can support this.

All details are available at;

http://psnc.org.uk/leicestershire-and-rutland-lpc/signposting-lifestyle-referral-hub-leicester-city/

Free training events now available

The lifestyle referral have also kindly offered Pharmacists and teams the opportunity to undertake level RPSH Level 2 (Royal Society of Public Health Award accreditation ) Free Training now available ;

This award covers:

1. Inequalities in health2. How effective communication can support health messages3. Importance of promoting improvements in health and wellbeing4. Impact of behaviour change on health and wellbeing

I am pleased to be able to offer you some dates for this free one day training on the 18th of December 2015.

The training will take place at Thurnby Lodge Children’s Centre, Dudley Avenue, Leicester, LE5 2EG. 9.30am - 4.30pm.

If you are interested in booking a place please contact Jennifer Ferrar on jennifer.ferrar@parkwoodhealthcare.co.uk specifying which date you would like to book onto, please note there are 10 spaces per course therefore we will take participants on a first come first serve basis.

Supporting Public Health with the Exercise Referral Scheme – Leicester City

On Wednesday 7 th October, the event took

staff from A sda Pharmacy a ttended the event

Thurmaston a nd h elpful place in Asda

.

On Thursday 8th October, consultant pharmacist Shabnam Sabur from Boots (pictured right) was present at the Loughborough market place event.

Jit Prakekh from GEM CSU co-ordinated the events.

Healthy You, Happy You – Autumn Health Campaign October 2015

During October, the CCG ran a series of health and wellbeing events across the county, part of the ‘Healthy You, Happy You’ autumn health campaign. These events brought together local organisations such as Public Health, Leicestershire County Council, Leicestershire and Rutland sport and the Alzheimer’s Society. At each event a local community pharmacy was invited to attend to promote winter and respiratory health, as well as other pharmacy services. It was the first time local pharmacies attended a CCG health campaign and it had a great response from the public.

It was a fantastic opportunity to promote community pharmacy as the first point of call for many minor ailments during the winter months, and chance to sign-post the public to other pharmacy services in the store nearby.

On Wednesday 7th October, the event took place in Asda Thurmaston and helpful staff from Asda Pharmacy attended the event.

On Thursday 8th October, consultant pharmacist Shabnam Sabur from Boots (pictured right) was present at the Loughborough market place event.

Jit Prakekh from GEM CSU co-ordinated the events.

Friendly staff at Cohen’s Chemist (pictured left) were present at the event in Hinckley on Friday 16th October.

The Health and Social Care Information Centre (HSCIC) has published new EPS case studies, with pharmacy teams from Bath, Bristol, Cleethorpes and Leeds sharing their views of EPS. A tech-savvy pharmacy manager at Birmingham’s Chemist in Cleethorpes successfully embedded EPS into their training and processes.

Top tips!

Every new member of their team is provided with a mentor, who is responsible for training and shadowing them until EPS is fully understood.

Pharmacist Dr. Jane Wilkins from Living Care Pharmacy, Leeds said “Kim is our branch EPS champion and staff will often go to her for guidance. If she doesn’t know the answers, then she will contact our system supplier for help.”

Jane also arranges GP meetings and helps the practice with problems they may have. She believes that the communication between the pharmacy and GP practices helps the whole process.

Lloyds Pharmacy in Stockwood, Bristol shared some of their top EPS tips such as:• Read the standard operating procedures and visit a good EPS user at least three weeks prior to your go-live date – to refresh your knowledge. • If there is a system error, report it immediately to your IT service desk and contact your surgeries. • Use the prescription tracker! You can trace where a prescription is and it is very useful.• Get nominations in and on the system straight away.

Find out more at psnc.org.uk/eps New mandatory CD requisition forms must be used from November 30th 2015

Further information is available and the new mandatory FP10CDF CD Requisition Form for the requisitioning of all Schedule 2 and 3 drugs can be downloaded from the NHS BSA website.

Requisitions for Schedule 1, 2 and 3 controlled drugs

Further information relating to private CD requisitions can be found on the Home Office website at https://www.gov.uk/government/publications/circular-0272015-approved-mandatory-requisition-form-and-home-office-approved-wording

The FP34PCD submission document for use by English pharmacies can be downloaded here. The new mandatory FP10CDF CD Requisition Form for the requisitioning of all Schedule 2 and 3 drugs can be downloaded here. This form can be downloaded, completed and printed or downloaded and saved locally. Requisitions not received on this mandatory form after 30th November 2015 cannot be accepted.

Career Development and opportunities

NHSE released £15 million pounds of funding for GP practices and Federations to bid for GP practice based pharmacist funds. This is to improve GP capacity and reduce their workload. Leicester City have won the bid in our area and this

EPS Update

means that going forward there will be opportunities to apply for a GP practice based Pharmacist Role. The RPS have released some guidance for interested pharmacists and there is an increasing need for pharmacists with Clinical Diplomas and Independent Prescribing Qualifications. It is an important step as we it ensures greater Multidisciplinary team working and the Pharmacist in practice can also link with the Community Pharmacist to support patient care, improve communications and also to possible refer MUR’s and NMS. The RPS have put together an ultimate guide to working in a GP practice to support pharmacists thinking of a clinical career in general practice or starting work as a practice pharmacist for the first time.

This brand new section of the RPS website contains comprehensive information about:• The role• Practical guidance• Legal and regulatory frameworks• Managing medicines• Professional guidance and ethical issues• Clinical guidance and support tools• How the Faculty & Foundation can be used in GP practice

• Accessing accredited clinical training and support.

The announcement about which sites will be taking part in NHS England’s Clinical Pharmacists in General Practice Pilot is expected any day now, so there’s never been a better time to start preparing for a prospective new role as a practice pharmacist.

You can access this resource quickly and easily at any time, by going to www.rpharms.com/gphub.

Want to learn more about National Institute for Health Research training opportunities?

Are you a nurse, midwife, pharmacist, healthcare scientists or allied health professional curious about a career in clinical health research, or in the early stages of your research career?

Want to learn more about National Institute for Health Research training opportunities?

Ready to be inspired by stories from clinical health researchers?

Then join us at the third non-medical professions researchers

meeting for 130 clinical research active and aspiring researchers on 9 February 2016.

Registration is open to all nurses, midwives, pharmacists, healthcare scientists and allied health professionals. This meeting will provide you with tools and information to start and enhance your career in clinical health research, including:• Information about NIHR infrastructure and training opportunities• Experiences of inspirational clinical researchers who have successfully built an academic research career• Guidance on finding a good mentor and getting the most from the relationship• Support on how to make the most of your training opportunities• Opportunities to network with peers, speakers and NIHR representatives.

Attendance at the meeting is free of charge for all nurses, midwives, pharmacists, healthcare scientists and allied health professionals.

For more details contact Neena Lakhani email : nlakhani@dmu.ac.uk

Pharmacist Support – Your charity

When the Royal Pharmaceutical Society was first founded in 1841, like many professional organisations from that era, it diverted some of its income to a benevolent fund to support pharmacists and their families through times of hardship. Back then with no state benefit system in place a drop in income brought about through illness or death, a lack of work or a failing business was a real concern for many professionals. The social stigma attached to the work house encouraged many professions at that time to set up benevolent funds, creating a charitable structure within the professional world that still exists today.

Things have moved on a great deal since those days and almost 175 years on The Benevolent Fund of the RPSGB has undergone many changes too. The organisation officially registered as a charity in 1963, launched two new services – the Health Support Programme in 1993 and Listening Friends stress helpline in 1996, recruited its own independent board of Trustees in 2006 and relaunched as Pharmacist Support in 2008. The relaunch not

only saw a fresh new look and new name for the charity it also brought about further expansion of its free and confidential support. Responses to an online survey of pharmacists and a series of focus groups led to the introduction of an information and enquiry service and specialist advice service -covering debt, benefits and employment advice. This was followed in 2014 by the launch of the Wardley wellbeing service and national student bursary scheme.

Six years of significant growth

Six years of significant growthIn the six years since relaunch Pharmacist Support has seen a significant growth in the number of pharmacists and their families, former pharmacists, pre-registration trainees and pharmacy students approaching it for assistance. During this period the charity has provided over 7000 individual acts of support – these have included 3000 information and enquiry cases, 2000 listening friends calls to those struggling with a range of stressful situations,

over 180 addiction cases and 700 referrals to our specialist advisers for assistance with debt, benefits and employment law. In financial terms this support has also included the distribution of over a million pounds in financial assistance and over 8 million pounds’ worth of gains secured for service users via state benefits, debt rescheduling, consolidation or write off and pay entitlements from employers.

2016 marks a significant milestone for the charity that, 175 years on, continues to respond to the needs of pharmacists today and to provide relevant and effective support to those in the profession. As a charity Pharmacist Support relies on the generosity of pharmacists and pharmacy organisations to be able to continue our work – be that as donors or fundraisers, volunteers or supporters.

For further information on Pharmacist Support visit www.pharmacistsupport.org, email info@pharmacistsupport.org or call 0808 168 2233.

Compiled and edited by Altaf Vaiya and Luvjit Kandula

PHARMACY SPOTLIGHTWe are looking for examples of best practice and great work in our local community pharmacies to share in our newsletter . If you have any great news to share and can send a brief outline of your news via email to admin@leics-lpc.co.uk We would love to hear from you and give our pharmacies to share best practice and great work across Leicestershire.

LEICESTERHIRE AND RUTLAND LPC OFFICE54 Brandon StreetLeicesterLE4 6AWEmail : admin@leic-lpc.co.ukWebsite: http://psnc.org.uk/leicestershire-and-rutland-lpc/