CCPG AGM 2020

Agenda Canterbury Community Pharmacy Group Annual General Meeting Pegasus House, 401 Madras Street, Christchurch Wednesday 21st October 2020 6.30-7.00 pm

Pre-drinks and nibbles

7:00 pm

Welcome and Introductions

7:10 pm

Approval of minutes of 2019 AGM

7:15 pm

Reports   

7:30 pm

Chairperson Report General Manager Report Treasurer Report & Annual Accounts

Financial Reports and Accounts Motion: Financial Reports and Accounts for year ending 30 June 2019 are received and approved

7:40 pm

Celebration of CCPG Champions

8:00 pm

Election of Officers

8.15pm

General discussion – Q & A session

8.50pm

Election results and Closing of AGM

Previous AGM Minutes

Canterbury Community Pharmacy Group (CCPG) A.G.M. Thursday 24th October 2019 Pegasus Health, Madras Street, Christchurch Time: 6:30pm (pre-drinks), meeting 7:09pm – 8:58pm CCPG Members Present: Maria Morley-Bunker, Jacqui Lawson, Mike Rhodes, Chris Wilkinson, Duncan Hurren, Simon Murphy, Aleisha Whyte, Linda Hermiston, Kim Sinclair-Morris, Kezia Buttle, Steve Thompson, Mark Webster, Katrina Azer, Tim Kennedy, Alex de Roo, Cathy Mills, Lisa Wallace, Mariam Saif, Elena Rimorska, Jeremy Goody, Chris Leggett, Amanda Nuttall, Thomas Choi, William Kim, Simon Church, Rhys Gardiner, Ajay Patel, John Thrupp (quorum exceeded) Others in Attendance: Gareth Frew, Robin Harris, Dr Aarti Patel, Ivette Paul, Anita McIntosh (minutes) Apologies: Carolyn Oakley-Brown, David McKee, Karen Crisp, Philip Crisp, Tracie Miller, Sarah Jane Connell, Steve Hanmer, Keith Elliot, Allan Kitto, Kerry Stokes, Graham Provis, Chris Chapman, Jonathan Ram, Daryl Sayer, Stuart Walker, Sir John Hansen, Karen Frater, Georgia McLean, Michelle Chan

Item

Discussion/Action

Drinks / Nibbles Welcome

Provided 6:30-7:00pm.

Maria McIntyre (Chair) opened the AGM and welcomed the attendees, noting the agenda for the evening.

Approval of the Previous Minutes

Motion: That the AGM minutes of 31st October 2018 are a true and correct record.

Moved: Amanda Nuttall Seconded: Tim Kennedy Carried by a majority vote Chairperson’s Report Maria McIntyre’s written report was included in the AGM pack sent to members, and was taken as read.

Reports

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Maria welcomed members and associates and introduced the CCPG board.

Maria acknowledged Jeremy Grooby, who is currently the Associate Member on the CCPG board, has recently become a pharmacy owner. It was confirmed an associate member position will become available, with more information to the members and associate members to come.

Maria acknowledged pharmacies are experiencing different pressures and it is encouraging so many pharmacists are reaching out to CCPG, and welcome those, especially sole pharmacies to feel connected and supported.

Maria proposed the CCPG AGM minutes be available shortly after the meeting for the convenience of all members.

General Manager’s Report Aarti Patel’s written report was included in the AGM pack sent to members, and was taken as read.  Aarti thanked everyone for attending the AGM, adding we have a presence within Canterbury.

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Discussion/Action  Aarti gave insight into the relationship with Pegasus Health, CCN and CDHB, explaining we have an inequitable access to healthcare.  Aarti acknowledged Simon Church being Chair on the Pharmacy Service Alliance.  CCPG held an Inaugural Ball which was a great success and provided a community feel.  Sustainability – Funding currently by the Canterbury District Health Board and Members. CCPG need to look at other avenues, including training, institutions and ACC.  Aarti acknowledged the motivated CCPG board, members and associates which shows engagement and seeing the value CCPG can provide.  Every week CCPG send feedback forms to patients who have been seen through the MMS service and many say they wish they had known about the service earlier.

Treasurer’s Report & Annual Accounts Rhys Gardiner presented the Year Ending 30 June 2019. Annual Financial Statements for CCPG Incorporated - an independent Auditors Report through BDO Christchurch. These reports were included in the AGM pack sent to members and associates prior to the meeting.  Term deposits were discussed, advising this provides good interest.  Request from member for clarity on funding received from the CDHB in 2017? It was advised that Integration Stage 3, Te xxx smoking cessation and cultural competencies training had been provided with this funding, and that there is an amount still held at CCPG.  It was proposed that CCPG use the services of BDO as their financial auditor. This was accepted by members in attendance.

Motion: The Annual Financial Reports for the year ended 30 June 2018 are received and approved.

Moved: Mark Webster Seconded: Simon Murphy Carried by a majority vote

Member Suggestions for support for pharmacies

Maria welcomed the attendees to propose suggestions for support from CCPG/Review availability of funding.  Support for newly qualified pharmacists  Use of medicinal cannabis. It was advised that Pegasus Health are providing small group education on this subject.  Under 5yrs respiratory  Mental health first aid training  Childhood vaccines  Developing staff in the workforce  Pharmacy support for patients with asthma  Training for medicine reconciliation

Proposed Rules Changes

Rule Change 15.0 Obligation of Members Extensive discussion took place as to how the rule changes would be managed and what definition of ‘misconduct’.

Action Point: It was agreed by all members, that bullet point 3 of the proposed changes would remove the last 3 words ‘within their communities’.

Motion: Moved: Amanda Nuttall Seconded: Mark Webster Carried by a majority vote

Rule Change 17.0 Joining Fees, Subscriptions and Levies

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Item

Guest Speaker

Discussion/Action Proposal to remove as setting of fees, including subscriptions and levies, as already addressed under the role of the Committee in section 8.

Motion: Moved: Simon Murphy Seconded: Amanda Nuttall Carried by a majority vote Maria welcomed Donovan Ryan who provided a “Your pharmacy’s online presence” presentation.

General Business

Meeting Closure

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Katrina Azer, explained the role of the Pharmacy Council and asked CCPG to consider providing a submission for the ‘naming policy’.

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Independent Pharmacy Association launch. Extensive discussion took place. It was noted that CCPG are well place to offer support and provide connections to services. That the board would be reviewing this as an agenda item in their next board meeting.

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It was proposed that pharmacist should promote their ‘good stories’ both through social network and websites. Suggestions of how stories may be obtained, and shared discussed.

Meeting declared closed at 8.58pm.

Glossary (ALT) Alliance Leadership Team (BPharm) Bachelor of Pharmacy (CCN) Canterbury Clinical Network (CCPG) Canterbury Community Pharmacy Group (CDHB) Canterbury District Health Board (CP) Community Pharmacy (e-health) the intersection of medical informatics, public health and business, health services delivered or enhanced through technology. (eMeds) Electronic Medicines Management (EPA) Entrustable Professional Activities (GP) General Practitioner (GPTs) General Practice Teams

CCPG AGM – 24 October 2019

(HOPWS) Health of Older People’s Workstream (HWNZ) Health Workforce New Zealand (IFHS) Integrated Family Health Service (MDT) Multi-disciplinary Team (MMS) Medicines Management Service (MoH) Ministry of Health (MTA) Medicines Therapy Assessment (MUR) Medication Use Review (PAP) Pharmacy Action Plan (PHO) Primary Health Organisation (PSLA) Pharmacy Service Level Alliance (QFARC) Quality, Finance, Audit and Risk Committee (UoO) University of Otago

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Canterbury Community Pharmacy Group Chair Report October 2020 Hello, Kia Ora Kotou, This time 12 months ago, we were reflecting on the inaugural CCPG Pharmacy Ball and a fantastic visit and learnings from an inspiring Scottish Pharmacist, Bernadette Brown. It is always interesting to look back, but also intriguing to imagine what the following 12 months may hold.

In March, the CCPG Board contracted Advisory Works to complete a scope of our membership to allow us to understand our current members and provide insight into how we can serve you best. Thank you to everyone that participated in the surveys. We have recently received the report from that piece of work which has been very worthwhile. One of the key themes identified in the survey was advocacy.

Advocacy is a service that is often difficult to quantify or in fact be fully aware of from a member perspective. However it has been highlighted by our membership as something that they value and see as a function they want of the CCPG. CCPG advocates for community pharmacy in a variety of ways and success can be seen in the way community pharmacy now has a voice in many places in our health system that it did not always have. Aarti in her role as General Manager as well as the CCPG team advocate on a regular basis, both formally and informally, as do members of the Board in various settings as well as some of our members in their various roles (such as Service Level Alliance Groups and Workstreams). This advocacy typically occurs when engaging with the Canterbury District Health Board, Canterbury Clinical Network and associated groups, each of the Primary Health Organisations in Canterbury, local community groups and NGOs and particularly this year the Canterbury Primary Response Group.

The CCPG board sees the role of our organisation as influencing and advocating for Community Pharmacy primarily at a local level. We do connect with our National sector agents and other community pharmacy groups via the Community Pharmacy Leaders Forum at a national level, and on occasions where the opportunity has presented itself, we have and do advocate beyond the local level.

I was determined to get through at least 2 paragraphs before I mentioned COVID-19‌‌ While it did not affect the first 4-5 months following our last AGM, it certainly has influenced the rest!

My sense is that we have all had similar yet different experiences and challenges over the last 6-8 months. I also suspect that none of us have expected a big thankyou for the monumental effort we and our teams have put in during that time, however we have been grateful to receive it when it was given. I smile when I think of the Prime Minister acknowledging Community Pharmacy’s role (after family members of pharmacists wrote to her suggesting it was well overdue). However much more meaningful for me was when I was stopped in our neighbouring supermarket by a customer. She said thank you for everything the Pharmacy team were doing for the people in our community, and a few other people within hearing distance looked up, smiled and nodded their agreement with her words and sentiment. I continue to appreciate this acknowledgement with gratitude.

It is essential at this time to recognise our General Manager, Dr Aarti Patel for the role she has played during this time. She has provided outstanding pastoral care to many of our members and beyond. She provided quick, decisive and practical leadership when needed – for example instigating and operationalizing protective screens for pharmacies. I also want to recognise that she was wellsupported by the CCPG team, in Ivette, Robyn, Katherine, Gareth and then Aki – who literally was thrown in the deep end!

On behalf of the board and our members I sincerely thank Aarti and each of the team for what they have done over the last year.

I also acknowledge Robyn Harris and her contribution to Canterbury Community Pharmacy. We farewelled Robyn at the end of June. Robyn’s most recent role was our Pharmacy Liaison but she has been involved in a number of roles in her years of service for the CCPG. Robyn has moved on to a role that she has the talent and capability to achieve great things in.

Now as we reflect on the previous year, I continue to maintain a sense of intrigue with what the next year will hold. I would encourage anyone who is keen, willing and able to be more involved with the CCPG to connect with Aarti, myself or one of the board members. The more cohesive our connections are, the more effective we can be as a group. New board members will be needed in the next 12 years, so it would be fantastic for you as a member to consider your potential capacity to put yourself forward for this role in the future.

I wish each of you and your teams the very best over the next 12 months.

Maria

Maria Morley-Bunker Chair - CCPG

Canterbury Community Pharmacy Group Annual General Meeting 2020 General Manager’s Report Aarti Patel, PhD

2 October 2020

Tena koutou katoa Another year has passed, and quite a year it continues to be – all about COVID-19. Alongside COVID-19, we also are dealing with an election and the findings of the Health and Disability Review. Even as we find ourselves in uncertain times, Community Pharmacy remains a key provider of essential services to our communities. We remain buoyed by feedback from our communities, our partners and our colleagues about our contributions to peoples’ wellness and wellbeing. All of us would like to see such recognition translating to additional funding and support for our sector. We are always striving for this.

At CCPG we are proud of the role we continue to play ensuring the community pharmacy perspective remains relevant and heard across all CDHB platforms. Specifically, in dealing with COVID-19, we continue to provide inputs into the Canterbury regional emergency operations centre (EOC) as well as national pharmacy stakeholders meetings. A tangible outcome in the early days was our ability to provide our members with Perspex screens – a safety barrier within a pharmacy. Through the EOC we ensured that community pharmacy had access to PPE and relevant information through healthpathways, CPRG communications and CCPG communications, including calling our pharmacies. Working closely with our Wholesalers - CDC and ProPharma – we established a delivery mechanism to get these screens, and PPE, to the network of pharmacies across Canterbury and the West Coast. I understand there was massive information overload; through our direct engagements we were able to answer questions as well as point people to where the relevant information could be found. This work continues.

Nationally, CCPG is an active member of the Community Pharmacy Leaders Forum (CPLF) with both the CCPG Chair and GM participating in these fora. In Canterbury we are an Alliance Partner of the Canterbury Clinical Network (CCN). Through this we provide key support to the Pharmacy Service Level Alliance as well as supporting our pharmacists on the different service level alliances, advisory groups and work groups. These relationships are critical to ensuring that your voice is a part of all discussions: for service design, implementation, support etc.

I have the privilege of being the General Manager of CCPG from January 2016. I am supported by an engaged Board and our dedicated staff: Gareth Frew (Clinical Leader, on secondment to Health Quality and Safety Commission until February 2021), Akizumi Tominari (current Clinical Programme Manager), Ivette Paul (Coordinator – currently on maternity leave), Leanne Dunhill (current coordinator), Robyn Harris (Liaison Pharmacist, until end of July 2020), and Kathryn Snook (MMS mobile Pharmacist).

This report presents a compilation of operating information for 2020, a summary of operations and factors that affect activities, and other information important to gauge the performance the Canterbury Community Pharmacy Group (CCPG).

The financial statements accompany this report in a separate document.

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CCPG’s mission and objectives drive our work.  Recognition of community pharmacists as Medicines experts and partners in primary health care teams. 

Pharmacy owners having strong, robust and profitable businesses.

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Patients/whanau having better access to and increased connectedness with pharmacies.

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Increasing the range of health services that exercise cognitive skills through evidence based/informed health service innovation.

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Improving quality of health services.

Our strategic approach in managing and operating CCPG is building and strengthening relationships, clinical partnerships and networks across the Canterbury, and nationally.

CCPG is evolving into an organisational structure that must be fit for purpose to deliver on the expectations of our members and partners. This is a shared journey with you and takes time.

For now figure 1 below provides an overall summary of the current organisational, governance and operational structures, our focus areas and our strategic partnerships.

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Fig 1: The Canterbury Community Pharmacy Group

Board Relationships • Members • • • • • •

CPLF MoH Office PHOs CDHB CCN

Contributes to Canterbury Health Systems Outcomes:

Purpose: Enabling inspired and successful pharmacy Members: Pharmacy owners (70% of Canterbury pharmacies) Associates: staff pharmacists + PHO & hospital pharmacists

Pharmacy Staff supported to deliver additional services

Governance: Board Elected at AGM

Staff Relationships • Members • Board

Operations: GM Pharmacists: CL, MMS & Coordinator

• CCN

Focus Areas:

• CDHB

• Network & Leadership

• PHOs

support

• Secondary Care

MMS: adherence & optimization support • Workforce Development • Population health and promotion

• MoH • Pharmacy Society,

Council, Guild, CPGs • Academia • Communities Enabling inspired and successful pharmacy

OPERATING HIGHLIGHTS: 2020 CCPG Contracts

CCPG successfully negotiated the MMS, Leadership and Network contract with CDHB for an extended period until March 2021. Having this in place provides certainty to the team and allows us to focus more of supporting you to deliver on the expectations of these contracts. As of this AGM we are in discussions with CDHB for the next iteration of this contract.

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It is important to recognise the value of our system partners is ensuring we continue with this contract at a time when the CDHB faces financial challenges.

Our current focus is demonstrating the outcomes to clients and the wider system from these services. This task is not a simple one and requires everyone to get on board with quality improvement practices, collecting and interpreting qualitative and quantitative data, and embracing system thinking as part of individual practice planning. We are required to think along these lines to demonstrate value for money – an expectation of all funding partners.

Together with the Pharmacy Service level Alliance we are supporting ongoing work around workforce development specifically around cultural competency and cultural safety, reframing of the Long Term Conditions Service, and establishing a more efficient OST programme between secondary care and community pharmacy.

Jointly with our Board, CCPG is responsible for ensuring the objectives of CDHB contracts are met. Services are delivered through pharmacies. Importantly, CDHB contracts are not for the sole use of CCPG members; as the holders of the contracts we provide support services to ALL Canterbury pharmacies. It becomes challenging to demonstrate specific member benefits based on the above contracts alone.

CDHB contracts help fund the CCPG office, staff and operations. Members’ fees contribute to governance structures like the Board, Quality and Finance Committee, member engagement sub-committee and their activities as well as exploring other funding options.

During 2020 the CCPG member engagement sub-committee is focused on two activities:  

Pastoral care – visits by Maria and myself were put on hold due to COVID-19. Expect to see us soon.

COVID-19 support.

We are finalising a piece of work with Advisory Works on providing targeted support for members based on your needs and expectations. We intend rolling this out in 2021.

Even though the new website was launched in September 2019 with a members’ only section, work on COVID-19 meant that our engagement with the website has been limited. We intend making better use of the website in the coming months. This is where you will find the relevant information and support tools to help you better deliver services we contract for.

We remain acutely aware of the risk of having one major funder, CDHB, and the exposure to our members. In August this year there was major change at CDHB with the resignation of seven members of the CDHB executive leadership team. Carolyn Gullery, Executive Director of Planning and Funding was one of these leaders. We are grateful for Carolyn’s support over these years and were to acknowledge her contributions at the August Zoom members meeting.

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We continue to strengthen our relationships with the planning and funding team through the Pharmacy Portfolio Manager, Michael James; as well as with system and community partners.

During 2020, CCPG worked with the University of Otago, Department of Primary Care to pilot the HRC funded knee Osteoarthritis project. Six pharmacies were involved with the aim of demonstrating community pharmacy’s ability to deliver key educational interventions to help people suffering from knee osteoarthritis. Financially small, this initiative, based on the findings, will result in a larger grant, and also allow us to demonstrate that community pharmacy are partners for future research.

STAFFING

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General Manager, Aarti Patel (1 FTE) Clinical Programme Manager, Aki Tominari (1 FTE) Coordinator, Leanne Dunhill(1 FTE) Mobile Medication Management Pharmacist: Kathryn Snook (0.6 FTE)

All roles remain on fixed term contracts till March 2021.

PARTNERSHIPS

CCPG enjoys positive and collaborative working relations with Pegasus Charitable Trust (PTY) Ltd, CCN, CDHB, University of Otago, Te Hā Waitaha, Community and Public Health, Waitaha (Rural) PHO, Christchurch PHO, and Community Groups through Pegasus’s Community and Population Health Services.

Canterbury Clinical Network – CCN o CCPG is an alliance partner of the CCN. We benefit from the Service Level Alliances, especially Pharmacy Service Level Alliance, managed by CCN. o CCPG also works with the community diabetes and respiratory teams that are part of CCN and hosted within Pegasus.

Apart from CCN, community pharmacists, either members or Associates of CCPG, play leadership roles.

Table 1 is a list of community pharmacists and the tables they sit at across Canterbury.

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Table 1: Community Pharmacy Champions.

Pharmacist/Pharmacy Representative Structure CCN Alliance Leadership Team Pharmacy SLA

Pharmacy/Pharmacist Perspective Simon Church (Deputy Chair) Simon Church (Chair) Tracey Miller (Rural Pharmacy) Bevan Harden (Hospital) Kezia Buttle (Community and extended services) Aki Tominari (Clinical Programme Manager)

Ashburton SLA Immunisation SLA Urgent Care SLA Population Health SLA

Carolyn Cameron Chris Wilkinson Sarah Mooney Aarti Patel Other Groups/Structures PSNZ Canterbury Branch President Aleisha Smith Christchurch City Council Multicultural Katrina Azer (Chair) Advisory Group CDHB Clinical Governance Board Aarti Patel Pegasus Clinical Governance Group Aki Tominari South Island Clinical Information Leadership Gareth Frew – on secondment to Health Team (CILT) Quality and Safety Commission Health of Older People Workstream Alex de Roo Mental Health Workstream Simon Church GP Care Methadone Committee Chris Wilkinson Integrated Diabetes Services Group Ajay Patel Maori Caucus Brendon McIntosh Culturally and Linguistically Diverse Advisory Vibhuti Patel Group (CHAG) Equally well regional group Aarti Patel

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CDHB CCPG is one of four similar entities across New Zealand, being the only one in the South Island, allowing us to negotiate more directly with CDHB for additional professional services. CCPG staff have regular meetings with the CDHB Portfolio Manager for Pharmacy: Michael James. The General Manager: Planning and Funding for CDHB, Carolyn Gullery meets with CCPG’s Board, GM and Chair. With Carolyn’s resignation CCPG shall pursue engagement with new staff.

PEGASUS Health Charity (Pty) Ltd (PHCL) o Pegasus HCL is paid a hosting fee from the CDHB contracts per full time equivalent (FTE) staffing by CCPG. These fees pay toward staff salaries, accommodation, ITC services, HR, accounting services, managing pharmacy claims for MMS, and Health and Safety. o GM and CEO of Pegasus HCL meet regularly to discuss common interests around primary health care and general developments. o Clinical Programme Manager of CCPG was appointed onto the Pegasus Health Clinical Governance Board. o We work closely with the different teams within Pegasus including the population health teams, clinical quality and education team, Knowledge Management, Communications, Health Care Home, Practice Support Liaison teams.

CHRISTCHURCH PHO CCPG has an agreement with Christchurch PHO to deliver MMS across its organization. The CEO of Christchurch PHO also sits on the PSLA, which allows for greater engagements.

Waitaha (Rural) PHO GM and CL of CCPG meet regularly with rural PHO exploring opportunities for working together.

CPLF Community Pharmacy Leadership Forum provides a platform for community Pharmacy Leaders to meet and discuss opportunities and challenges facing community pharmacy. The forum includes PSNZ, Pharmacy Guild, Green Cross Health, CCPG, Midlands CPG, Mid-Central CPG and Bay of Plenty CPG. CCPG’s GM and Chair participate in forum meetings, generally held in Wellington.

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GM’s REFLECTIONS

Our work is not possible without the commitment and dedication of the staff, the Board and our members. The work we are doing is not always visible to everyone. We need to recognize the efforts of all. We don’t know what we don’t know.

I cannot do my work with the support I receive from the CCPG Board led by Maria MorleyBunker. Like you, they are busy with their individual pharmacies. Yet, at the drop of a hat I know I can get sensible advice, insights and direction grounded in your reality. Maria MorleyBunker, Kezia Buttle, Simon Church, Georgia Mclean, Chris Wilkinson, Alex de Roo, Rhys Gardiner - thank you.

This year we farewelled Robyn Harris. Robyn has been with CCPG from 2012 and often the CCPG face during her visits to you. Robyn has taken on a role as Senior Advisor: Equity at Pharmac, a role that she is really enjoying.

We are fortunate to be in Canterbury where we are recognized as a key partner representing pharmacy and pharmacy services. You, our members, are behind this. We also recognize we walk a fine line as we negotiate for our members whilst promoting and supporting the contribution of the pharmacist and community pharmacy in primary health care. This is very much a journey as we learn to work better together, build trust, and maintain our independence whilst striving towards common goals. ICPSA offers us opportunities at the local level which we continue to explore. As an operational partner of the Pharmacy Service Alliance, chaired by Simon Church, we are well positioned for this work.

Our challenges remain in terms of funding and adapting our practices to accommodate the shift in focus from dispensing to more population health and clinically focused services. In this regard, I believe we are in a good place as the key partner representing community pharmacy in Canterbury.

As always, we want to go far so we go together.

Thank you for your support.

Nga mihi.

Aarti Patel

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