Secretary For Scotland's Report for Guild Council Meeting 19.9.2002

• NHSScotland Forum Meeting 8.7.02
• Association of Scottish Trust Chief Pharmacists Meeting 23.8.02
• Scottish NHS Committee 4.9.02
• Questions to Deputy Health Minister 4.9.02

I attended the inaugural meeting of the NHSScotland Forum, which is the successor to the previous Modernisation Forum. A full report of the meeting is available here. I am unable to attend the next meeting on 27^th September, but Don Page has kindly agreed to attend in my place.

back to top

ASTCP Meeting 23.8.02
Pam Warrington, Deputy Chief Pharmacist, gave a presentation entitled ‘A Year in the Life of the Pharmacy Division’ on the role of the Chief Pharmacists Office. The office staff consists of the Chief Pharmacist, the Deputy Chief Pharmacist and 6 civil servants.

• green folders – i.e. replies to MSP/MPs by the Minister
• diary cases – i.e. can the Minister attend this meeting? Minister will require briefing, speaker notes and details of who will be present
• written Parliamentary questions – answers to be researched and provided within 3 days
• oral Parliamentary questions – answers to be researched and provided within 3 days but more difficult as they need to be more comprehensive since further questions may be asked
• official replies to questions from members of the public.
• Parliamentary debates

• Safety and control of medicines – involves consultation, production of a report which is sent to the Medicines Control Agency. It then goes from there to the Committee on Safety of Medicines, then the Medicines Commission and then to the Minister.
• Extension of nurse prescribing
• Nicotine Replacement Therapy on prescription
• Patient Group directions
• Supplementary Prescribing
• Pharmaceutical aspects of public health
• Antibiotic resistance
• Post-coital contraception
• Substance misuse
• Immunisation
• Pharmacy Practice in hospitals and the community
• Implementation of The Right Medicine
• Prescribing Policy
• Introduction of new drugs
• Implementation of patient safety legislation
• Pharmaceutical Education and Research
• Liaison with the pharmaceutical industry

The Right Medicine: Laura McIver updated members on progress in the implementation. The members of the Implementation team are preparing action plans for each bullet point in the strategy, based on what progress has already been achieved.

Original Pack Dispensing: Michelle Caldwell presented the sequence of events which had led to the introduction of original pack dispensing in Ayrshire and Arran Acute Trust.

European directive on clinical trials: It was agreed that a one-day meeting on this issue should be arranged for early in 2003.

back to top

Scottish NHS Committee Meeting 4.9.02

Report from Michael Fuller

Pensions: MF wrote to the SPPA asking for a meeting, following a discussion at the West of Scotland Senior Reps Meeting (see District Members Report). He has had a very positive response, with the Chief executive and senior management of the SPPA lined up to meet with an Amicus-MSF delegation. Results of the discussions will be reported to both the WOS and SNHS committees. It was noted that this is a preliminary, informal meeting, hopefully as a prelude to regular meetings.

Agenda for Change: The timetable for negotiations at central level to be completed by the end of September is still valid. The last meeting of the Central Negotiating Group was looking at coverage by Pay Review Body and pay structure. A leak in the Nursing Times reported that there would be between 40-45 grades in the Health Service. The current 68 applications to be early implementers will probably be whittled down to around 12. Unsocial hours discussions are currently stuck. Payments for high cost areas e.g. London weighting are still on the agenda but nothing has been decided. Amicus-MSF is to raise the issue of reducing the working week, but no decisions have been made on this. Workforce ballots will take place in December/January, but any further slippage n the timetable will cause problems in Scotland being able to implement the package in April 2004. It was noted that the NHS NAC will probably make a decision at their November meeting on whether they recommend acceptance or rejection of the package. In order that the Scottish delegate to the NHS NAC, Ray Stewart, knows how to vote, the next meeting of the SNHSC has been changed to October 30th.

NHS Review: This is being run through project groups. Michael Fuller is on the Project Board representing the SPF. The work will produce a report to feed into the white paper to be issued early 2003. The interim report and the white paper are to be placed on the agenda for the next meeting.

NHS Greater Glasgow: there is to be a meeting on October 2nd of all senior reps within Glasgow. There is a need for Groups within the NHSGG area to meet on a regular basis. All the unions within Glasgow have agreed to look at issues in the whole area on a unified basis. If Trusts disappear, groups will need to be working in this way. Apparently groups in NHS Grampian are already working this way.

Policies and Strategies: Other than through the SNHSC, there is no method for Amicus-MSF to input into policy issues in the way that GHP, CPHVA and possibly CPNA do. MF has been in contact with the chairs of the cancer Strategy sub-groups about the fact that there are no trade union members on the subgroups and no partnership. It was agreed that the committee needs to create a register of members' expertise for future consultations.

Organisational Change Policy: As a result of management concerns about the long-term effects of the policy, all Trusts were asked to detail how much protection was currently costing them. There was a 78% response rate with only 8 or 9 Health Boards and Fife and Borders Primary Care Trusts refusing to respond. There are 1362 staff on protected terms and conditions in NHSScotland - less than 1%. The total cost of this is £3.8m out of a £6.5b budget - less than 0.06%. The SPF secretariat is to meet sometime this month to decide what to do with the figures. They will make a recommendation to the October SPF meeting on whether a review should be conducted. The evidence is supportive of the status quo and staff side will argue against any changes to the policy on the grounds that the financial impact is minimal.

Recruitment: for the period June – July 2002, there were 304 new NHS and 93 new CPHVA members. Overall, Scotland had 1714 new members. This makes Scotland the highest recruiting region in both global and NHS terms and this is on top of high levels of existing membership in the areas that the union is active.

SPF: The 9th PIN guideline, Health at Work, is now out for consultation, and there will be workshops next month to allow input into the consultation. The document is said to be the best in its field. The minister for Health and Community care has declared that all the existing 8 guidelines are obligatory for management to implement.

Working Time Regulations: Advice is to be produced on a whole range of issues, probably starting with compensatory rest. The BMA persuaded the DoH to publish legal advice that the BMA had received, but this agreement has not been implemented in Scotland. 75% of Trusts have varied the agreement and the other 25% haven’t implemented it at all. There will also have to be discussions on the staff levels required to cope with compensatory rest. There is also the problem of succession planning if no one is actually trained to do the job of the individual off on rest.

Working for Health: This document is the first attempt to introduce workforce planning in NHSScotland and is to be circulated to senior reps.

Health Professions Council: RepsDirect no 147 contains a letter from Roger Spiller about the increase in fees for the HPC. Michael Fuller has written to Mark Butler, Director of HR, NHSScotland, to raise issues over the size of the increase but also to try and open a dialogue about professional registration fees being paid by the service. Protest postcards for sending to the HPC will be available from the Glasgow office. It was suggested that a Scottish dimension be added, as NHSScotland is one employer. There is a need to get a meeting of representatives of all professions covered by the HPC. It was noted that the HPC has to be self-financing. It can get grants and donations but its major income will be in the fees paid, which will be used to pay for legal representation for patients against you. The HPC is there to protect the public from you. In addition to the furore over the fees, there are also problems with CPD and the different levels required by each of the bodies being incorporated into the HPC. It was raised that there have been problems in the past where failure to pay the fees required by the predecessors of the HPC resulted in disciplinary action by the employer. This could increase significantly with the change in fee, and it was felt that the onus should be on the employer, not the employee.

Getting Ahead of The Curve: The Health Protection Agency will be taking over from several other groups from April 2003.

Healthcare Scientists: The Strategy exists in England and Wales. A strategy group has been set up and are holding a conference on 23/9/02 in Dunblane. Michael Fuller was invited as the Joint Chair of the SPF but wrote back to say that the group must be constituted on a partnership basis and the SPF has now been promised representation on the steering group.

Motions for NHSNAC: 2 motions on Agenda For Change were presented, amended and agreed.

Annual Report to NHSNAC: This was discussed and agreed. A copy of the report is available here for information.

The meeting was supposed to be attended by the Minister for Health and Community Care, Malcolm Chisholm, but Parliament had just restarted after the recess and he had to attend an afternoon debate on Water in Scotland. Instead, Deputy Minister Mary Mulligan (seen here with Chair Bill Goudie) attended in his place.

Various topics were raised and discussed including

• The inability of management and unions to find the resources to implement the PIN Guidelines
• The effect of the PIN guidelines on staff workload given the reduction in hours involved in most of the guidelines.
• Lack of replacement staff for time off required by the Working Time Regulations
• Proper succession planning for NHSScotland
• Targeting additional funding for PIN Guideline and Working Time Regulation Implementation
• Agenda For Change – there is no Scottish Plan B.
• Protection under Agenda For Change
• Inclusion of out-of-hours money in basic salary – differential payments for differently graded staff doing exactly the same work
• Senior Managers Pay – excluded from partnership or appeals
• The Acute Strategy Review

I asked the Deputy Minister one question on 28 day dispensing, which she promised to investigate, and provided her with two additional questions with a request for a response. The text of the questions is given below.

1. Pharmacists of grade E and above are included in the management costs submitted by each Trust whether they are managers are not, due to the circulated corrigendum to NHS Circular PCS(PH)2001. The Guild of Healthcare Pharmacists is concerned that this reporting is inaccurate, is not applied to a number of other hospital staff (e.g. doctors), is based on annual salary and not role fulfilled and may adversely affect the ability of hospital pharmacy to recruit and to achieve some of the goals of The Right Medicine. We would like to see reporting limited to only the most senior pharmacy managers and all others exempted on the grounds that they are clinical staff.

Explanation

Prior to the circulation of the above circular, only the proportion of time each pharmacist graded E and above spent on management tasks was reported. The corrigendum made no such distinction and asked for details of all pharmacists graded E and above. It is the opinion of the Guild that this is likely to cause problems in the appointment of Clinical Pharmacy Leaders as espoused in The Right Medicine.

With the recent publicity surrounding the figures given for time spent in management duties in the NHS in Scotland and those for south of the border, it would also be an easy way to quickly reduce management figures.

 

2. Since NHS Scotland is intended to appear as one employer and learn from lessons elsewhere in the system, why is each Trust in Scotland having to justify changing from a 7 day supply of medicines to patients on discharge to a 28 day supply? All the arguments have been aired and won in NHS Ayrshire and Arran where patient complaints prompted the discussions. As this situation exists throughout NHS Scotland why has there not been a Health Department directive to all Trust Finance Departments to action this change?

Explanation

As an exemplar employer, pharmacists working in NHS Scotland should be easily able to supply patient information leaflets. Switching to supplying original packs to patients on discharge would solve virtually this entire problem, and yet significant amounts of time are being spent in each Acute Trust to justify the change with the Trust Finance Directors and agree matters with each Primary Care Trust. It has been demonstrated repeatedly that the net effect of making this change is a saving in medicine costs across the whole NHS Board area so why is the same work being repeated in each Acute Trust? This is contrary to the philosophy of not reinventing wheels as stated in Our National Health and reiterated at NHSScotland Forum meetings.

There is a commitment in The Right Medicine to achieve this in 2005 but it should not be necessary to wait that long now that it is in practice in NHS Ayrshire & Arran.

 

3. The Guild of Healthcare Pharmacists would be interested to hear of any reasons why pharmacy is now one of the few professions which does not have a consultant grade.

Explanation

In recent years, many of the other professions working in the NHS have introduced a consultant grade. We would see the Clinical Pharmacy Leaders proposed in The Right Medicine as being worthy of consultant grade and are seriously concerned that without this recognition the service will face great difficulties in recruiting individuals with the appropriate expertise to these posts.

Responses will be reported when they are received.

Colin Rodden
9 September 2002

back to top