Confirmed minutes of 14^th October 2004

PRESCRIPTION PRICING AUTHORITY

Minutes of the public meeting held on Thursday 14 October 2004 in the Board Room, Bridge House, Newcastle upon Tyne.

PRESENT

1 CHAIRMAN'S INTRODUCTIONS

The Chairman indicated that members of the public were welcome and outlined the format of the meeting. The PPA is required to hold a public meeting each year to present its Annual Report by the end of October. On this occasion the Annual Report would be presented as part of the normal monthly agenda and members of the public were welcome to stay and observe the remainder of the meeting.

2 ANNUAL REPORT 2002-2003 AND PRESENTATION

Mr King presented the Annual Report and identified the key areas of performance during 2003-2004.

An overview was presented that described our key activities in respect of:

• pricing prescriptions and remuneration to contractors
• prescribing and dispensing information services
• the Drug Tariff
• provision of analysis and advice
• patient services and help with health costs

In particular Mr King referred to our contribution to national NHS developments by providing services, advice and support. He also highlighted internal developments such as:

• the Capacity Improvement Programme
• moving from paper to electronic information
• the expansion of the range of patient services and improved awareness and access
• developing our range of managed services

In conclusion, a summary of our financial performance was provided against a wider portfolio of activities that had remained within budget.

The Chairman welcomed the summary presented by Mr King which was a good reminder of all the achievements and successes throughout the year often under stringent timeframes and difficult circumstances. Members echoed the comments of the Chairman.

3 APOLOGIES FOR ABSENCE

There were no apologies for absence.

4 MINUTES OF THE PREVIOUS MEETING HELD ON 9 SEPTEMBER 2004

The minutes of the previous meeting held on 9 September 2004 were received and confirmed as a correct record.

5 MATTERS ARISING FROM PREVIOUS MEETING

There were no matters arising from the previous meeting.

6 KEY PERFORMANCE INDICATORS

Mr King presented two months data relating to the key performance indicators. He noted that the cumulative target in respect of prescription pre-payment certificates was stretching but that it had nearly been achieved for the month of August 2004.

Mr McDonald clarified that the planned expenditure on recruitment would not significantly increase the data capture cost per thousand.

7 UPDATE ON GROWTH IN PRESCRIPTION VOLUME AND COST YEAR TO JUNE 2004

Mrs Dalton summarised the above report and highlighted the main trends and the factors affecting growth in volume and cost of prescriptions and the complexity of prescription processing. An analysis had shown that for the year to June 2004 prescription volume had increased by 5.8% and that the cost has increased by 8.6%.

In September 2003 the Department of Health (DH) issued a consultation document about the arrangements for the future supply and reimbursement of generic medicines for the NHS that, if implemented, will replace the Maximum Price Scheme for generic medicines. Subsequently, in December 2003, proposals to reduce the reimbursement price of four generic medicines were implemented and further reductions for the same four generics were implemented in September 2004. Those reductions will enable to DH to secure savings of £150 million. As a result of that decision the volume of items for all of the four generic drugs has increased by over 800,000 for 6 months to June 2004 compared to the previous 6 months. Dr Purdy identified the connection between the reduction in price of the drugs and the impact on prescription volume and complexity. It was not felt that this was easily identifiable in the report and it was AGREED that the paper would be amended to highlight this fact prior to publication.

Mr Murphy welcomed the report that if available to PCTs would stimulate debate especially in relation to the current initiative on Practice Based Commissioning. Mrs Dalton confirmed that an annual report on growth in prescription volume and cost is published and available at exhibitions and a periodic update is published on the PPA web site.

8 STAKEHOLDER RELATIONS

Mr King presented an update on the activities with stakeholders in the previous 6 months. In particular attendance at the Primary Care 2004 and the NHS Confederation Conference had generated a lot of interest in the Electronic Drug Tariff.

The Stakeholder Forums had concentrated on the promotion of "Help with Health Costs". Active participants in those forums are the Patient Advice and Liaison Services (PALS) representatives and as a result additional links have been developed.

9 PEOPLE ISSUES

MMr Siswick outlined the HR activities that were progressing across the organisation to support operational initiatives and the delivery of business objectives. In particular he highlighted the

• review of training
• activities of the Race Relations Standing Committee and the National Equality and Diversity groups
• HR policy review

and the work associated with the development of managed services.

Dr Stockwell enquired whether there was a requirement to recruit additional HR and Finance staff to support the additional activities associated with managed services. Mr Siswick confirmed that there is a service level agreement with defined levels of service and that quarterly reviews are held with the organisations to review the level of service. However, each organisation requires different levels of service which is being managed within current establishment. If managed services continue to develop then staffing levels would need to be considered.

Following a review of the management information relating to Ethnic Groups at Appendix G it was requested and AGREED that information would be provided at the next meeting that showed a comparison over the proceeding two years and provides a comparative against the local community.

10 STAFF OPINION SURVEY

Members reviewed the outcome of the 2003 Staff Opinion Survey and were pleased with the 48% response rate which was above the national average. However, although that figure was below previous response rates it was seen as positive indicating that staff were mainly content and did not have issues to raise. Mr Siswick advised that a special edition of PPA People incorporating action plans was shortly to be published.

11 VERBAL UPDATE FROM AUDIT COMMITTEE : 13 MAY 2004

Dr Stockwell provided an update on discussion at the Audit Committee that had included a:

• review of the Internal Audit progress report
• discussion on the draft External Audit management letter that had included a review of the year end position on the annual accounts
• a review of the revised DH risk management process

Members were also advised that the Audit Committee had carried out a self assessment of their performance against DH guidance and information provided by KPMG. A debate had been held regarding the powers of the Audit Committee to seek legal advice which was being clarified.

Dr Stockwell also advised that the Audit Committee would be reviewing their Terms of Reference at the next meeting which would require endorsement by Members in February 2005.

12 FUTURE BUSINESS OF THE AUTHORITY

Members noted the future business.

13 DATE OF NEXT/FUTURE MEETINGS OF THE AUTHORITY

The next meeting of the Authority would take place on Thursday 25 November 2004 at 10.30am in the Somerville Suite, Maften Hall, Maften, Newcastle upon Tyne. That meeting would be immediately followed by a session to review the strategy of the organisation.

Future meetings would be held as follows:

14 ANY OTHER BUSINESS

1. NHS and Social Care Chairs Conference
   Dr Stockwell provided an update on the above conference that he had attended in the absence of the Chairman on 6 October 2004. The Chairman thanked Dr Stockwell for attending on her behalf.
   

2. Agenda for Change Special Health Authority Event
   The Chairman advised that she had addressed the above event on 12 October 2004 organised by the PPA. It was a successful event with positive comments received regarding the role of Mr Siswick and his team with regard to Agenda for Change.