Agenda and minutes

Apologies had been received from Councillors Sue Baxter, David Chambers and Kit Taylor.

The Chairman reported that for some District Council Representatives this may be their last meeting and thanked them for their contribution to the Committee if that were the case.  In particular, thanks were given to the Vice Chairman, Cllr Frances Smith, who was not standing in the upcoming District Council elections. 

Cllr Lynn Denham declared an interest in Community Pharmacies (Item 5) as a former member of the Royal Pharmaceutical Society.

Members of the public wishing to take part should notify the Democratic Governance and Scrutiny Manager in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 17 April 2023). Enquiries can be made through the telephone number/email listed in this agenda and on the website.

None.

To follow

The Minutes of the Meeting held on 13 March 2023 were agreed as a correct record and signed by the Chairman. 

Attending for this Item were:

NHS England (NHSE) – Midlands Region

Terry Chikurunhe, Senior Commissioning Manager

Satyan Kotecha, Local Professional Network Chair for Pharmacy

Worcestershire County Council Public Health

Matthew Fung, Public Health Consultant

Cllr Karen May, Cabinet Member with Responsibility for Public Health and Well being

The Committee were provided with an introduction to the Report, the main points included:

·       Community Pharmacies (often referred to as ‘high street’ pharmacies) were an important part of everyday life and an integral part of the NHS, especially as they were often more accessible compared to other health professionals. During the COVID-19 pandemic, pharmacies had performed well and services had been maintained

·       The role of pharmacies was moving from only dispensing prescriptions to providing consultations, vaccinations, additional clinical services and supporting general practice and urgent care settings. In addition, the commissioning of community pharmacies was transferring from NHSE to local Integrated Care Boards from 1 July 2023

·       Worcestershire had 95 Community Pharmacies. The latest Worcestershire Pharmaceutical Needs Assessment (PNA) was published in October 2022 and provided detail on current provision and future proposals

·       Examples of other services which community pharmacies could offer included consultations, stop smoking services and flu vaccinations. Across Herefordshire and Worcestershire, 21 pharmacies also delivered COVID-19 vaccinations, either at the pharmacy or off site

·       Some Community Pharmacies were taking part in pilot schemes, such as oral contraception management and the supply of medicines used in palliative care

·       The Herefordshire and Worcestershire Integrated Care Board (HWICB) vision was that community pharmacy was central to primary care and during 2023 was proposing to work more closely with General Practice to improve overall patient experience

·       The main challenge for pharmacies was workforce, especially as the demand for services was increasing. Nationally, a large pharmacy chain was closing stores, further increasing demand on existing provision

·       Some pharmacy buildings may not always be suitable to offer additional services, for example not having the physical space to offer private consultations or vaccinations

·       A further challenge was sometimes sourcing medication, however, there were processes in place if there was a national serious shortage.

Members were invited to ask questions and in the ensuing discussion, the following points were made:

·       The Local Professional Network Chair for Pharmacy highlighted that community pharmacies were contracted to deliver a service, yet many went above and beyond the contract to improve the health of the patient.  In addition, it was believed that staff skills should be fully utilised and there was lots of opportunity to integrate services

·       Current NHSE commissioning teams would transfer to ICBs ensuring knowledge is maintained, however, some finer detail was not yet finalised

·       In relation to medicine shortages, Members learned that at any point, there was a 6 week supply of medicines in the pharmacy system and NHSE encouraged a 28 day interval in prescriptions. Historically, the UK was the cheapest place to buy medicines, however some manufacturers had closed their UK supply, perhaps due to the UK leaving the European Union or other factors

·       Examples of  ...  view the full minutes text for item 1130.

Attending for this Item from Herefordshire and Worcestershire Health and Care NHS Trust (HWHCT) were:

Sue Harris, Director of Strategy and Partnerships

Lisa Yates, Interim Director of Digital/Chief Information Officer

Anna Evans, Senior Operational Lead – Carenotes Restoration

Members were briefly reminded of key points from the Agenda Report. In early August 2022, the supplier of a number of national IT systems was subject to an external cyber security attack, which disabled access to Carenotes, an electronic patient record system used by a number of NHS Trusts across the Country. In Worcestershire, HWHCT was the only Trust affected, however, Carenotes enabled digital input of patient records, clinical notes and the ability to plan, manage, record and analyse care across a range of settings.

There was a nationally directed response by the NHS and HWHCT adopted its business continuity processes, which involved manually recording patient information and other activities. When it was evident that Carenotes would be inaccessible for a prolonged period, an interim electronic system was developed, THEA, and although not a replacement for Carenotes, was in use from early September 2022.

Carenotes was rebuilt by the supplier and after comprehensive testing was received back by HWHCT in December 2022. From January 2023, the phased re-introduction of Carenotes to clinical teams commenced and over eight weeks, 158 clinical teams, with 4,166 individual user accounts, returned successfully to using Carenotes as their electronic patient record.

Restoration of essential clinical information was detailed, alongside recognition that the downtime led to some disruption to patient care and impacted HWHCT’s ability to access and share key information, including performance data. Full restoration to Carenotes was ongoing, however some services had a significant volume, such as the Starting Well Service which had 44,000 documents.

All patient activity continued and no specific cancellations occurred as a result of the downtime. The HWHCT website shared updates and alerted patients on what they could expect during an appointment due to electronic records not being available. HWHCT was extremely grateful to staff, who were already under system pressure, to work flexibly.

Members were invited to ask questions and the following points were raised:

·       For clarity, not all NHS systems were impacted and each Trust would have a number of systems. The supplier of Carenotes was ‘Advanced’ and every organisation who had their systems would have been impacted. Nationally, around 1,000 organisations had been affected

·       When asked why it took several months to restore the system, it was explained that the supplier had to rebuild the system. Information from the supplier had been limited as their priority was to restore or rebuild systems, however a risk assessment had been undertaken and each organisation had been given a rebuild slot. HWHCT was classified as low risk compared to some Trusts which may have had several systems from the supplier or less robust business continuity processes

·       HWHCT had recognised that cyber security attacks were a risk and had agreed to invest in better back-up systems

·       The Committee was reassured that no data  ...  view the full minutes text for item 1131.

The HOSC was asked to consider the 2023/24 Work Programme.

In addition to an update on Community Pharmacies, the Chairman agreed to consider adding ‘Neurological Disorders’ to the Work Programme.