CPN
Community Pharmacy News – June 2015
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New pharmacy minister appointed Reshuffle sees former communities and local government minister take on responsibility for pharmacy and primary care Last month’s cabinet reshuffle has seen a few changes in the Department of Health, including the minister in charge of pharmacy. Following Earl Howe’s move out of the Department and the loss of the Liberal Democrat members of government, three new Health ministers have been appointed: Alistair Burt MP, Ben Gummer MP and David Prior (a newly appointed Lord). Jeremy Hunt MP, Jane Ellison MP and George Freeman MP remain in their positions. Alistair Burt has been appointed Minister of State, replacing Liberal Democrat Norman Lamb, taking on most of the same responsibilities, such as mental health, but also picking up the primary care brief which includes pharmacy. Mr Burt’s brief also includes older people, local government, and integration. Mr Burt first became an MP back in 1983 and is currently MP for North East Bedfordshire. He has previously held ministerial roles in the Department of Communities and Local Government, and the Department of Social Security, and the Foreign and Commonwealth Office.
PSNC Chief Executive Sue Sharpe said: “Earl Howe was a front bench health team member for very many years and he has consistently been supportive of community pharmacy. He was, among other things, responsible for agreeing the implementation of the New Medicine Service despite the financial crisis at the time; and he will be missed. However; the opportunity and value that community pharmacy represents is now well recognised and I am confident that the new minister will pick up the baton. We look forward to working with Alistair Burt and are pleased to note that his responsibilities also include care for older people and integration, both of which are important areas for community pharmacy.”
Resources: look out for updated local lobbying toolkit Following the general election LPCs may wish to be making contact with any newly elected or continuing MPs. The weeks before Parliament breaks for summer can be a good opportunity to make contact with MPs and to educate them about pharmacy or restate key messages about the sector. This will build on any previous work and LPCs may see it as a good time to invite MPs to visit a local community pharmacy to showcase any new services. PSNC is working with other pharmacy organisations to ensure
that LPCs have all the resources they need to help with this – look out for information on template letters, briefings, key messages and more on our website and in our email newsletters. We are also working with the other pharmacy organisations to support the reconstitution of the All-Party Pharmacy Group (APPG). This group has raised a number of issues concerning community pharmacy in Parliament in the past and we hope it will continue to do so in the future.
Ebola: Update from Department of Health
Unsure where to get a new Smartcard?
Since the World Health Organization (WHO) declared Ebola an international public health emergency in August 2014, the Ebola outbreak in West Africa has claimed over 10,000 lives.
PSNC often receives telephone calls and emails concerning how to apply for, or how to make changes to profiles of, Smartcards.
While the risk in the UK remains low, Ebola has not gone away. More than 7,000 people have been screened for Ebola at UK ports of entry, with 228 UK Ebola tests carried out in Public Health England (PHE)’s specialist lab. So pharmacy teams need to be prepared and remain vigilant. It is vitally important that staff continue to follow the established procedure should a suspected case present at a local pharmacy.
Local NHS England teams are responsible for commissioning local ‘Registration Authorities’ to provide and oversee Smartcard issues. Pharmacy teams should contact these authorities to apply for or amend Smartcard details. Your Registration Authority contact information may be available from your local NHS England team, or it might be listed on your LPC site (see lpc-online.org.uk).
The most up-to-date information and guidance for community pharmacy teams is available on the PSNC website: psnc.org.uk/ebola
2 Community Pharmacy News – June 2015
Further details about using Smartcards is available at: psnc.org.uk/smartcards
funding and statistics
contract and it
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Endorsing and Submission Good Practice Workshop – sign up now PSNC‘s online workshop will guide viewers through the process of endorsing and submitting prescriptions correctly to help ensure correct payment. Are you unsure of how to endorse and submit your prescriptions correctly? Are you guilty of over-endorsing your prescriptions because you’re not quite sure of what to include? Do you find the Drug Tariff difficult to understand? If you answered “yes” to any of these questions then sign up to PSNC’s online workshop this month, on Tuesday 30th June at 7:30pm, where our in-house Drug Tariff experts will talk you through the dos and don’ts of endorsing and submitting your prescriptions. Work through our series of prescription examples before the event to test your and your pharmacy team’s knowledge then log in to our workshop to learn how to endorse and sort the examples correctly. Through a series of sample prescriptions seen by the PSNC Pricing Audit Centre the team will show you how to avoid common errors, as well as giving top tips and answering your endorsement and pricing related questions. Please visit psnc.org.uk/webinar for more information and details of how to register.
WORKSHOP DETAILS When is it? Tuesday 30th June at 7:30pm Who should sign up? Anyone involved in the dispensing and end-of-month process How do I register? Please visit psnc.org.uk/webinar Can this count towards CPD? Yes – for pharmacists and pharmacy technicians
Missed the webinar? Don’t worry, you can watch a recording of the event on the PSNC website from a few days afterwards.
Reminder: Additional payment All community pharmacy accounts that were open between April and December 2014, and submitted a claim for payment for the March 2015 dispensing month, will by now have automatically received the additional payment agreed between PSNC and NHS England earlier this year. This additional fee, paid in recognition of the reduced level of margin available to contractors in the early months of the 2014/15 financial year, was paid as part of the final payment for the March 2015 dispensing month. This was made in late May/ early June. The payment was calculated as 3.3 pence for each professional fee paid to a pharmacy
account between April and December 2014. Any pharmacies which were open during this period but had a change in F code during that time must contact the Pricing Authority to determine whether they are eligible for the additional payment. Contractors should write to the address published in the Drug Tariff Part IIIA(3) (see address below) as soon as possible and, if a payment is due, it will be made with a subsequent month’s payment instead. Contractors are reminded that the deadline for any payment queries is 18 months after the month in question,
therefore in this instance queries must be received by the Pricing Authority by 30th September 2016. However, the sooner a notification of a change in F code is sent to the Pricing Authority, the sooner any required adjustments and payments can be made. The team at the Pricing Authority to write to is as follows: NHS Business Services Authority Customer Payment Team, Stella House, Goldcrest Way, Newburn Riverside, Newcastle upon Tyne, NE15 8NY
Frequently Asked Questions Q. Where does the payment appear on my FP34 Schedule of Payment? A. The fee is listed on the Schedule of Payment for the March 2015 dispensing month, received in late May or early June, as part of the ‘Adjustment – Fees’ line, under the section ‘Details of Other Amounts authorised’.
Q. Will Welsh pharmacy contractors receive the additional payment for March 2015? A. Part IIIA of the April 2015 edition of the Drug Tariff explicitly states that this additional payment is applicable to both English and Welsh contractors.
Q. How much is this payment worth in total and to each pharmacy? A. Across the sector the additional payment will be worth around £25m. The amount each pharmacy receives depends on the number of items dispensed from April to December 2014. For example, a contractor dispensing around 7,000 items per month will receive approximately £2,000.
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Service exchange In this section of Community Pharmacy News we highlight the latest innovation, outcomes and resources for community pharmacy services. If you have ideas or stories for inclusion next time, please email rosie.taylor@psnc.org.uk
HSJ supplement showcases pharmacy services The Health Service Journal (HSJ) and Local Government Chronicle (LGC) have published a supplement focusing exclusively on community pharmacy services and the benefits that pharmacy can offer patients and commissioners. The supplement has been sponsored by PSNC as part of our work to promote service developments and persuade commissioners of the value of community pharmacy services. HSJ and the LGC are highly respected and well-read journals in the NHS and social care sector and the supplement will reach many of the key decision makers that community pharmacy needs to influence. Featuring interviews with commissioners, LPCs, officials from Public Health England
and influential GPs, the supplement is designed to showcase pharmacy services and should alert public health and CCG teams to some of the possibilities of using community pharmacy to deliver more services in the future. The articles in the supplement explore the roles that pharmacy can play in areas such as promotion of healthy living, vaccinations, supporting independent living and managing patients with longterm conditions. They cover some key success stories, such as flu vaccinations in London, as well as setting out the benefits of possible future developments. PSNC will be sending copies of the supplement to LPCs to use in their local
discussions with NHS commissioners and local authorities. We are also supporting the launch of the supplement with the refresh of the commissioners page on the PSNC website. This can be accessed at psnc.org.uk/commissioners and directs commissioners to useful information about pharmacy services. In addition, we will begin sending emails directly to commissioners to highlight relevant pharmacy news to them – look out for more details on this in upcoming email newsletters.
Minor ailments queries: key messages for pharmacy teams Community pharmacy minor ailment schemes have been discussed on a number of social media websites and in the national media over the last few weeks and patients in some areas have been asking their pharmacy teams questions about what they are entitled to. In some cases there has been confusion about what patients can receive free of charge; and pharmacies may still be receiving questions. PSNC and Pharmacy Voice have issued the
following key messages which may be of use to LPCs and pharmacies if this issue continues to come up locally. LPCs and pharmacy teams will of course also need to advise patients in accordance with any local schemes. Key messages for LPCs and pharmacy teams • Minor ailments services are designed to give people with certain conditions easier access to advice and medicines.
• They offer help at a convenient location, without the need to see a doctor. • The services are not a chance to simply stock up on medicines free of charge and some patients will still have to pay for medicines even if they can receive advice under a scheme. • In England there is no national scheme and so the services vary by region. You can read the full PSNC and Pharmacy Voice statement at psnc.org.uk/news
Resources Roundup New resources for service development hub The service development hub page on the PSNC website is regularly updated and includes links to new tools and information that LPCs may find valuable in their work to negotiate and develop services.
by Public Health England (PHE); • The Health and Social Care Information Centre (HSCIC)’s Statistics on Smoking, England – 2015; and • PHE’s new 2015 Local Health Profiles, which have been added to the Health Profiles website.
Resource links added to the hub this month include: • The Local Alcohol Profiles for England data update for June 2015 published
The hub will continue to be updated as and when tools, data and publications become available. The hub can be found at: psnc.org.uk/servicehub
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HLP webpage updated PSNC has been working with the Healthy Living Pharmacy (HLP) Innovation Group and as a result we have updated our HLP page. New documents include prospectuses created by LPCs and commissioners to provide more details on HLP in their area,
psnc’s work
funding and statistics
contract and it
dispensing and supply
Avon dementia project identifies 150 people affected by memory loss An Avon LPC dementia project funded by Pinnacle Health Partnership has identified 150 patients experiencing memory problems which affected their lifestyle. It also found that 82% of those patients had not yet raised their memory loss concerns with their GP. The successful service aimed to make pharmacies more dementia aware and to improve early identification of dementia through pharmacy interventions, as well as optimising treatment for patients with dementia through medicines reviews. The project was a three tiered service, which included an initial assessment using the CQUIN question, a Mini-Cog test and a medicines review. A follow-up assessment was also conducted four to eight weeks later. In total 180 patients registered to participate in the dementia identification
service. Of these, 169 participated in the tier 1 service with 89% saying their memory had affected their lifestyle over the last 12 months.
This project was funded by a £5,000 grant awarded to Avon LPC by Pinnacle Health Partnership in 2013. The project has now come to an end, but Bath and North East Somerset CCG have expressed interest in the project so this may not be the end for this service.
The tier 2 service (Mini-Cog test) was offered to 152 patients with 18% scoring positively for dementia. 63% of those patients had not yet spoken to their GP about their memory.
Richard Brown, Chief Officer of Avon LPC, said: “This project helped raise awareness of dementia whilst also reducing the stigma surrounding the subject. The mass screening process attempting to identify those experiencing memory loss, with subsequent Mini-Cog assessment, was a huge success as pharmacy teams reported that it was the patients they least expected who were most in need of support.”
The tier 3 service (review of medicines) was offered to 31 patients with 75 medicines being reviewed and 12 out of 13 patients who were followed up saying they had benefited from the review. Extended benefits of the service also included creating over 150 Dementia Friends, raised awareness of dementia in over 70 pharmacies in Avon and their communities, as well as the development of closer links to support organisations such as Alzheimer’s Society and Carers Trust.
Service documents, including the full service outcomes report are available to view on our Services Database at: psnc.org.uk/database
LPCs: Do your services appear on our Database? The PSNC Services Database now has over 700 services listed on it giving LPC members access to a huge amount of useful information about locally commissioned services.
Over 700 service entries on our database
But while we are delighted with this progress, we are aware that some services are still missing and so we are now asking LPCs to check the Database for any missing services and to let us have details of those. LPCs are asked to review the service information listed on the Services Database and if the list of services for your LPC is incomplete, please contact Rosie Taylor on rosie.taylor@psnc.org.uk so she can update your services list. Having more services listed brings many benefits; it provides a great picture of the number of commissioned services across England, it allows LPCs to see what is happening in other areas and it also allows PSNC to conduct analysis on the types of services being commissioned.
and an action plan template. More documents are planned to help support LPCs and contractors – these will be added to the page as and when they become available. The updated page can be viewed at: psnc.org.uk/hlp Improved Medicines Optimisation Dashboard NHS England has launched an updated
42
different types of services listed
81 commissioned supervised administration services – the most of any service type
57
evaluations available for 11 different types of services
Medicines Optimisation Dashboard to help Clinical Commissioning Groups (CCGs) focus on how well patients across the country are being supported to use their medicines, and it may also be a useful stimulus for them to consider community pharmacy’s role in this area. LPCs may find the data useful in identifying local service opportunities and/ or they could use it as supporting evidence when working to get services
commissioned locally. The ‘Community Support’ tab may also be interesting for LPCs and contractors as this includes data per CCG on the percentage of EPS items, percentage of pharmacies conducting MURs, percentage of pharmacies conducting NMS and other useful information. The improved dashboard is available at: tinyurl.com/modashboard
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National target groups for MURs Community pharmacy contractors must carry out at least 70% of their Medicine Use Reviews (MURs) within any given financial year on patients in one or more of the target groups outlined below
70% The patient is taking at least ONE medicine
One of the patient's prescribed medicines or the patient's only prescribed medicine is listed in the following BNF chapter/sub-sections:
The patient falls into target group: High risk medicines
2.2 Diuretics 2.8.1 & 2.8.2 Anticoagulants (including low molecular weight heparin) 2.9 Antiplatelets 10.1.1 NSAIDs
The patient is taking TWO OR MORE medicines
One of the patient's prescribed medicines is listed in the following BNF chapter/sub-sections: 3.1.1 Adrenoceptor agonists
The patient falls into target group: Respiratory
3.1.2 Antimuscarinic bronchodilators 3.1.3 Theophylline 3.1.4 Compound bronchodilator preparations 3.2 Corticosteroids 3.3 Cromoglicate and related therapy, leukotriene receptor antagonists and phosphodiesterase type-4 inhibitors
The patient is taking TWO OR MORE medicines
The patient is taking FOUR OR MORE medicines
Patient has been discharged from hospital within the previous eight weeks AND has had changes to the medicines they are taking while in hospital (patients in this target group should ideally be offered an MUR within four weeks of discharge)
The patient falls into target group: Post-discharge
At least one of the patient's regularly prescribed medicines is listed in the following BNF chapter/sub-sections:
The patient falls into target group: Cardiovascular risk
2 Cardiovascular System 6.1 Drugs used in Diabetes 6.2 Thyroid and Anti Thyroid Drugs
6 Community Pharmacy News – June 2015
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psnc’s work
funding and statistics
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dispensing and supply
PSNC regularly receives questions from LPCs and pharmacy contractors about what is going on in the wider health and care landscape beyond community pharmacy. In this round-up we cover the latest news from the past month. Increased access to online GP services Almost every GP surgery in England is now offering appointments, repeat prescriptions and access to summary information in medical records online. The number tripled in the first three months of the year meaning that 55 million people now have access. The Health and Social Care Information Centre (HSCIC) has published data (dld.bz/dFbkR) which shows that over 97% of patients in England can now access online GP services, a huge increase from the 3% in April 2014. The ambition is that by 2018 every citizen will be able to access their full health records at the click of a button. With such a large number of patients in England now able to manage their repeat prescriptions themselves, community pharmacy teams may wish to ensure they know which online services their local GP practices offer and where to direct patients who want to learn more or sign up to them. Pharmacy teams may wish to contact GP practice managers in their area to discuss what options are available and where they can direct patients to find out more information. Staff at the GP practice will be able to set up a patient’s access and it’s worth knowing how the registration procedure works for patients.
97% of patients in England can now access online GP services “Bold action needed to make NHS fit for the future” NHS England Chief Executive Simon Stevens has called for bold action on prevention, the redesign of care and efficiency to help the NHS through the most challenging period in its history. In his first speech since the general election (dld.bz/dFbmd), Mr Stevens, referring to the NHS Five Year Forward View (dld.bz/d9FK5), said: “Last Autumn the Health Service came together to chart a shared direction for our country’s NHS. Patients groups, caring professionals, national leaders – uniting behind the NHS’ own ‘manifesto’ for the next five years. It’s a plan for better health, more personalised care, and a financially sustainable Health
Service, which we’re now getting going on.” Pointing to the realities of current service pressures, he argued
the Health Service is entering probably the most challenging period in its 67 year history that the Health Service is entering probably the most challenging period in its 67 year history. Alongside action this year to stabilise NHS finances, Mr Stevens argued for a new partnership between the public, government and health service, involving concrete and sometimes controversial action on three broad fronts – prevention, care redesign, and efficiency linked to new investment. Bedfordshire reveals largest ever CCG deficit Bedfordshire Clinical Commissioning Group (CCG)’s deficit reached £43.2m by the end of 2014/15, the largest recorded by any CCG. The CCG had predicted a £4.9m surplus at the start of 2014/15, but by November its forecast deteriorated to a £24m deficit. In the following months the CCG realised the deficit would be “far larger and more complex than originally believed”. The CCG must produce an improvement plan, subject to NHS England approval, which includes a financial recovery plan for how it will operate within its annual budget for the next three years, including a scheme for repayment of its outstanding debt, and a governance plan.
Bedfordshire Clinical Commissioning Group (CCG)’s deficit reached £43.2m by the end of 2014/15
Have you seen our prescription submission resources? Have you seen our page Completing Your FP34C Submission Document & Dispatching Your Prescription Bundle? Here you will find information on the dos and don’ts of completing your FP34C and information about dispatching your bundle. You will also find a link to our Prescription submission factsheet. Head over to psnc.org.uk/interactive-fp34c for more information.
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EPS: New live service reports HSCIC launch a new tool that allows pharmacy teams to check the live working status of the Electronic Prescription Service. The Health and Social Care Information Centre (HSCIC) has made live service status information available to community pharmacy contractors through their Smartcard. The HSCIC Service Status pages show the availability of national infrastructure services, such as EPS, Spine, N3 and the Care Identity Service, which manages Smartcard access.
This means that a pharmacy team experiencing problems accessing or processing an electronic prescription can see at a glance if there is a national service issue. If it is not a national service issue, it is likely to be a problem with their PMR system or with their local equipment or internet connection. In this case, users can be confident that they should contact their supplier’s helpdesk for support.
The HSCIC has undertaken a wide review of how incidents that affect EPS are logged, communicated and resolved. Analysis of the feedback from a recent questionnaire has provided the HSCIC with a very clear picture of the main issue, the lack of information about incidents and outages for users. Making the service status pages visible to dispensers is the first step, albeit a major one, in filling that gap.
Pharmacy teams are encouraged to bookmark the link to the HSCIC service status webpage (tinyurl.com/EPSchecker), where they will find information about the status of the national infrastructure services; this includes details of any current and recently closed incidents. There is also information on historic incidents and service outages.
A series of recommendations to improve service management further are being developed and will be tested by survey respondents who volunteered to be further involved with the review.
EPS users are also encouraged to continue to sign up to receive text or email alerts at: tinyurl.com/spinealerts
More information will be shared in the EPS bulletin which is available online at: tinyurl.com/EPSbulletin
Are you claiming your £200 monthly EPS allowance? Where a pharmacy contractor is able to operate the Electronic Prescription Service (EPS) Release 1 or Release 2, they are entitled to receive a £200 monthly allowance to contribute towards EPS costs. This article explains the process of claiming and receiving payment of the allowance.
Go live with EPS R1 or R2
Submit a one-off claim form
Check the payment is appearing on your Schedule of Payment
Submit a cancellation letter if you stop using EPS
Once you go live with EPS (either Release 1 or Release 2), you need to: 1. Submit a one-off claim form The £200 monthly allowance is only initiated once the relevant claim form (available at: tinyurl.com/epsallowance) has been sent to your local NHS England team when you first go live with EPS. 2. Check the payment is appearing on your Schedule of Payment The £200 monthly allowance will be listed as your ‘ETP allowance’ on your FP34 Schedule of Payment. The allowance appears in the ‘Details of local amounts authorised’ section.
DETAILS OF LOCAL AMOUNTS AUTHORISED ETP Allowance Total amount authorised
£ 200.00 200.00
3. Submit a cancellation letter if you stop using EPS If you ever cease operating the EPS (Release 1 or 2), you must write to your local NHS England team so that payment of the ongoing monthly allowance is stopped. A template cancellation letter is available at: psnc.org.uk/cancelEPSallowance
8 Community Pharmacy News – June 2015
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he healthcare landscape
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psnc’s work
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What is an EPS Business Change workshop? Attending local business change workshops can help pharmacy teams and GP practice staff get to grips with EPS before they ‘go live’ with the system As EPS introduces changes for pharmacy teams, GP practice staff and patients, it is important to ensure that, before the system goes live, everyone involved understands and agrees how the new processes will work for them. Business change workshops are an opportunity for GPs and pharmacy teams to discuss how the new EPS process will work for them locally. Why is communication between GP practices and pharmacies so important? When EPS Release 2 (EPS R2) goes live in the GP practice and prescriptions become electronic, communication between the GP practice and pharmacies is very important to ensure the smooth running of the system and to ensure that any issues are dealt with quickly and effectively, so that the patient experience of EPS is a positive one. When are workshops being held in my area? Ideally business change workshops will take place prior to system training and no more than three weeks prior to go live in the GP practice. This approach ensures that decisions can be made in advance but also that processes are fresh in people’s minds. Any more than three weeks in advance and some of the key messages may be forgotten. Local pharmacy teams should be invited to the workshops. To find out if one is happening in your area, please email epsimplementation@hscic.gov.uk who can put you in contact with your local EPS lead. What will be covered? • Raising awareness of the EPS processes amongst practice and pharmacy staff. • Reviewing the prescribing processes and agreeing how these will operate after EPS R2 has been enabled. • Reviewing the dispensing processes within the pharmacy and agreeing how these will operate after EPS R2 has been enabled. • Raising any potential issues before the GP goes live – discussing how the practice and pharmacy teams will work together to address issues that could arise after go live. • Discussing the patient communication plan including what literature will be used. • Agreeing the approach including formally ‘signing off’ the agreed processes. Who might attend? Anyone who will work with EPS in the GP practice or pharmacy, such as: • GP Practice Manager • Lead GP (and other GPs if possible) • Member(s) of reception staff/ prescription clerks • Practice IT lead (if applicable) • Any other practice staff who are able to attend • Local pharmacist(s) and dispensing technicians • Local pharmacy locums who will be using EPS How long will it last? This will depend on the number of people in attendance, but be prepared to put aside at least two to three hours for the workshop.
Top Tips • Identify named contact points at the GP practice and pharmacy for queries and to ensure regular two-way communication. • Allocate someone to take notes of the session, so that everyone has a copy of any agreed decisions. These can be emailed to everyone after the meeting. • Book a series of weekly 10 minute catch-up meetings to review the previous seven days. These could be face-to-face meetings or pre-booked telephone calls. • Arrange reciprocal visits to walk through new processes and improve understanding within the GP practice and pharmacy. • Proactively alert patients to the introduction of new ways of working and ask for their support and patience during early implementation (e.g. reception poster). • After your ‘go live’, have further discussions about utilising repeat dispensing and catch up about any other issues that have been experienced. Consider if the agreed processes work. • Share the agreed processes with all attendees after the workshop.
Electronic Prescription Service
Further information There are many tools that can be used to support the business process change sessions. Ready-made tools such as business process slides, a process checklist, and communication materials can be found at: systems.hscic.gov.uk/eps/nhs/buschange Find out more about EPS at: hscic.gov.uk/eps or psnc.org.uk/eps
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Midazolam 10mg/ml oral solution removed from the Drug Tariff Midazolam 10mg/ml oral solution 5ml has been removed from Part VIIIB (specials and imported unlicensed medicines) of the Drug Tariff. Therefore any prescriptions for this product dispensed from 1st June onwards will need additional endorsement as outlined in Part VIIIB. In summary, unlicensed medicines which are not listed in Part VIIIB of the Drug Tariff and are sourced under a manufacturer’s specials or importer’s licence issued by the MHRA, must be endorsed with the following: • Amount dispensed over pack size used • Invoice price per pack size from which the order was supplied less any discount or rebate • Manufacturer’s or importer’s MHRA licence number • Batch number of the product supplied • SP Further information on dispensing and endorsing unlicensed specials and imports can be found at psnc.org.uk/specials
the healthcare landscape
NHSBSA’s Hints & Tips The Pricing Authority produces a quarterly newsletter called Hints & Tips for dispensing contractors. We would like to draw your attention to the latest edition (Issue 19) as it contains some really useful information and advice regarding: • News on NHS Business Services Authority (NHSBSA)’s FP34 Schedule of Payments online portal. • How to find an EPS prescription using the prescription tracker. • Guidance on claiming out of pocket expenses and not dispensed endorsements. • Information on the new web pages for the NHS dictionary of medicines and devices (dm+d). All published editions of the Hints & Tips newsletter can be found on the NHSBSA website: www.nhsbsa.nhs.uk/3191.aspx
Can it be dispensed on an FP10? When pharmacies receive NHS prescriptions they must check whether the items prescribed are allowed on the NHS before dispensing. If they are not allowed, the pharmacy may not be paid for them. Pharmacy teams may wish to check PSNC’s ‘Dispensing on an FP10 database’ (available at: psnc.org.uk/FP10database) for more information on whether an item can be dispensed on an FP10, and we have listed some products below that we have recently received queries about. Product
Is the item listed in the Drug Tariff?
Does it have a ‘CE’ mark?
Is it in the blacklist?
Can it be dispensed on an FP10?
Additional information
Thealoz 3% eye drops
No
Yes
n/a
No
This item is a medical device (CE marked) and is not listed in Part IX of the Drug Tariff.
Cutimed Protect cream
Yes
Yes
n/a
Yes
This item is a medical device (CE marked) and appears in Part IX of the Drug Tariff.
Earol olive oil ear spray
No
Yes
n/a
No
This item is a medical device (CE marked) and is not listed in Part IX of the Drug Tariff.
Kinesiology tape
No
Yes
n/a
No
This item is a medical device (CE marked) and is not listed in Part IX of the Drug Tariff.
NuvaRing 0.12mg/0.015mg per day vaginal delivery system
Yes
No
No
Yes
This item is not a medical device (CE marked) and does not appear in Part XVIIIA (the ‘blacklist’) of the Drug Tariff.
Please note: If the prescription is one of the following, pharmacy staff will need to check the relevant sections of the Drug Tariff/PSNC website: • FP10CN or FP10PN (community nurse prescriber) – Part XVIIB. • FP10D (dental prescriber) – Part XVIIA. • FP10MDA (instalment dispensing) – psnc.org.uk/mda
All details correct at time of printing. No part of this publication may be reproduced without the written permission of the PSNC. Produced for the PSNC by Communications International Group. ©. PSNC. Colour repro and printing by Truprint Media, Margate. The publishers accept no responsibility for any statement made in signed contributions or in those reproduced from any other source.
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Communications International Group Linen Hall, 162-168 Regent Street, London W1B 5TB Tel: 020 7434 1530 Fax: 020 7437 0915
lpcs
psnc’s work
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Ask PSNC The PSNC Dispensing and Supply Team give pharmacy teams support and advice on a range of topics related to the Drug Tariff and reimbursement. Questions asked in recent months have included: 1. If I already operate a prescription collection service for some patients, do I need consent to set their electronic prescription nominations to my pharmacy? Yes. Explicit consent must always be obtained from the patient or their representative before changing a patient’s nomination settings. Explicit consent can be collected in advance of the pharmacy deploying Release 2. If there is a delay between collecting consent and changing the patient’s preference on the Personal Demographics Service, the pharmacy contractor should ensure there has been no change in the patient’s circumstances, including their choice of nominated dispensing site, since the original consent was obtained. Find out more at: psnc.org.uk/nomination 2. Does the Pricing Authority begin pricing electronic prescriptions as soon as they are received in-month? No. The Pricing Authority only begins pricing electronic prescriptions once they have received the bundle of paper
prescriptions with the end-of-month submission form (FP34C). The FP34C form covers the paper prescriptions which have been included in the prescription bundle, and those electronic prescriptions which are assigned to that dispensing month (i.e. dispense message sent in-month, and claim message sent by the 5th of the following month). 3. I have received an FP10 prescription for “160 Madopar 25mg/100mg capsules”. The lid of the product contains a desiccant; would I be reimbursed for supplying 2x100 capsules under special container rules? No. There is strict criteria, which can be found in Part II Clause 10 of the Drug Tariff, which the Department of Health use to determine whether a product should be considered to be packaged in a special container. Although Madopar preparations have integral desiccants in the lid, the manufacturer Roche has not been able to provide any evidence that these products are hygroscopic. Therefore, no Madopar preparations are classed as special containers.
In this example, a contractor would be reimbursed for supplying 160 capsules against a prescription requesting 160 capsules. Broken bulk could be claimed on the residual balance. 4. If a patient uses a pen with an ink colour other than black to complete the exemption declaration, is there a risk that the scanner will not be able to pick this up and will ‘switch’ the prescription to paid? No, there is no requirement for the exemption declaration to be completed using a pen with a particular ink colour. All forms are reviewed by an exception handler before a prescription is considered for switching, therefore, even if the CIP scanner cannot read the signature due to ink colour, the handler will be able to. Look out for more frequently asked questions next month… If you would like more information on any of the topics covered, the PSNC Dispensing and Supply Team will be happy to help (call 0844 381 4180 or 0203 1220 810 or e-mail info@psnc.org.uk).
Prescription requirement changes for Temazepam As of June 2015, Temazepam prescriptions must comply with the following prescription writing requirements as per other Schedule 3 Controlled Drugs: • dose • form • strength (where appropriate) • total quantity of the preparation in both words and figures
The Medicines, Ethics and Practice, published annually by the Royal Pharmaceutical Society, provides more detailed guidance on these requirements. Further information about Controlled Drug prescription forms and their validity can be found on the PSNC website at: psnc.org.uk/cdforms
Have you seen our prescription charge resources?
Problems obtaining a medicine or appliance?
Have you seen our page What Does the Patient Pay? Here you will find links to the Prescription Charge Card and Multi Charge Card. If you don’t already have copies why not print them out and use them as a point of reference for dispensing staff? Other useful information can be found on this page such as an outline of the rules on how to determine the number of prescription charges which are payable. You will also find a collection of ‘how many charges’ examples and some helpful FAQs.
Pharmacy teams who experience problems in obtaining medicines (generic or branded) or appliances are reminded to feed this back to the PSNC Dispensing and Supply Team to support PSNC’s ongoing representation of issues in the supply chain to the Department of Health. Please make sure you let us know about any supply issues by using our online feedback forms at psnc.org.uk/feedback
Head over to psnc.org.uk/charges for more information.
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dispensing and supply
services and commissioning
the healthcare landscape
Drug Tariff Watch
Below is a quick summary of some of the changes due to take place from 1st July 2015 Part VIIIA Additions Category A Additions: SC Special Container • Ampicillin 500mg powder for solution for injection vials (10) • Arachis oil 130ml enema SC (1) • Aspirin 300mg suppositories (10) • Atorvastatin 30mg tablets (28) • Atorvastatin 60mg tablets (28) • Beclometasone 0.025% cream SC (30g) • Chloramphenicol 250mg capsules (60) • Clobetasol 500microgram / Neomycin 5mg / Nystatin 100,000units/g cream SC (30g) • Clobetasol 500microgram / Neomycin 5mg / Nystatin 100,000units/g ointment SC (30g) • Glyceryl trinitrate 400micrograms/dose aerosol sublingual spray SC (180 dose) • Glyceryl trinitrate 400micrograms/dose aerosol sublingual spray SC (200 dose) • Mefenamic acid 50mg/5ml oral suspension (125ml)
Category C Additions: • Alginate raft-forming oral suspension sugar free (150ml) - Gaviscon Original Aniseed Relief • Alginate raft-forming oral suspension sugar free (300ml) - Gaviscon Original Aniseed Relief • Alginate raft-forming oral suspension sugar free (500ml) - Gaviscon Original Aniseed Relief • Alginate raft-forming oral suspension sugar free (600ml) - Gaviscon Original Aniseed Relief • Calcium acetate 475mg tablets (200) Renacet • Calcium acetate 950mg tablets (200) – Renacet • Hyoscine hydrobromide 150microgram tablets (12) - Kwells Kids • Hyoscine hydrobromide 300microgram tablets (12) - Kwells • Lofepramine 70mg/5ml oral suspension sugar free (150ml) - Lomont
• Loperamide 2mg orodispersible tablets sugar free (18) - Imodium Instant Melts • Prednisolone 2.5mg tablets (30) Pevanti • Prednisolone 10mg tablets (30) Pevanti • Prednisolone 20mg tablets (30) Pevanti • Salicylic acid 2% ointment (450g) Thornton & Ross Ltd • Sodium oxybate 500mg/ml oral solution sugar free SC (180ml) - Xyrem • Trospium chloride 60mg modifiedrelease capsules (28) - Regurin XL
Part VIIIA Deletions If a medicinal product has been removed from Part VIIIA and has no other pack sizes listed, it can continue to be dispensed, but it will need to be endorsed fully (i.e. brand or supplier name from whom the product
was purchased and the pack size from which the item was dispensed), and where the Prescription Authority does hold a price on their database (DM+D) the price paid per pack will need to be also be endorsed.
• Loperamide 2mg oral lyophilisates sugar free (18) Category C - Imodium Instants • Pimozide 4mg tablets (100) Category C – Orap • Sodium cromoglicate 4% nasal spray (22ml) Category C - Rynacrom
Part IX Deletions It is important to take careful note of removals from Part IX because if you dispense a deleted product, prescriptions will be returned as disallowed and therefore payment will not be made for dispensing the item. • K Two Start - multi-layer compression bandage kit 18-25cm 25-32cm • UrgoSTART Contact (wound contact layer) 11cm x 11cm • Telfa Max 22.8cm x 38cm 38cm x 45.7cm 38cm x 60.9cm • KoCarbon Hydrophilic 10cm x 10cm 20cm x 20cm • KoCarbon Occlusive 4cm x 6.4cm (non-waterproof)
4cm x 6.5cm (waterproof) 10cm x 15cm (waterproof) 10cm x 25cm (waterproof) • Allevyn Thin (adhesive) Square 10cm x 10cm 15cm x 15cm Rectangular 5cm x 6cm 15cm x 20cm • Coloplast Ltd Closed MC2000/MC2002 White 9011 Flesh 9021 Open MC2000/MC2002 White 9012 Flesh 9022 Mini Decorated Open MC2000
Part VIIIA Amendments SC Special Container • Aspirin 75mg tablets (28) is changing to Catergory A • Atropine 1% eye drops SC (10ml) is changing to Catergory A • Diethylstilbestrol 5mg tablets (28) is changing to Category C Teva UK Ltd
White Flesh White
9013 9023 URO 2002 4260 9014 URO 2002 4240 9015 URO 2002 4241 9016 I ILEO B (Standard) 9003 • Biotrol Integrale bag with filter & skin protector adhesive 40mm 32-440 45mm 32-445 • Biotrol Elite bag with skin protector adhesive and fabric backing Beige 35mm 38-835 White 25mm 34-825 30mm 34-830
Need to know if an item can be dispensed on an FP10? Check on our database at: psnc.org.uk/FP10database
PSNC website For up to date information and news on community pharmacy issues, visit the PSNC website at psnc.org.uk PSNC Community Pharmacy News is published by: The Pharmaceutical Services Negotiating Committee, Times House, 5 Bravingtons Walk, London N1 9AW Community Pharmacy News is edited by: Zoe Smeaton who can be contacted at the above address or by email at: zoe.smeaton@psnc.org.uk PSNC Office: 0844 381 4180 or 0203 122 0810
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