CPN
Community Pharmacy News – May 2016
The counter proposal Not dispensing prescription items if the pharmacy team determines the patient already has sufficient stock Recommending alternative products to prescribers for items on a target list of ‘costly’ medicines Dispensing cheaper generic equivalents in place of certain prescribed branded products Identifying excess prescribing of medicines and dressings to care homes Running annual campaigns encouraging patients to return unwanted medicines
PSNC puts counter proposal on the table An alternative plan to make better use of community pharmacy going forward is presented to the Government
Contract monitoring update | New script analysis tool | New-look forms webpage
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PSNC publishes counter proposal Counter proposal tells Department of Health how community pharmacy services could be used to make the necessary savings that the NHS needs, without cutting pharmacy funding. The counter proposal PSNC has published a summary of the counter proposal it made to the Department of Health in response to the Government’s proposals for community pharmacy in 2016/17 and beyond. The counter proposal sets out how community pharmacy services, including an emergency supply of medicines service, could be used to generate the savings the NHS needs to make through pharmacy, without a cut in funding. PSNC’s proposal includes plans that would enable pharmacies to make savings in the prescribing budget and to save on costs for out of hours GP services. PSNC has also proposed payments that would reward the provision of high quality pharmacy services, in response to the Department’s aim to alter community pharmacy funding distribution mechanisms. The counter proposal was made to offer a short-term alternative to the cuts proposed by the Government; PSNC still believes that the service development proposals it made in February are the right way forward for community pharmacy, patients and the NHS, and we are working towards those in the medium to long-term.
Not dispensing prescription items if the pharmacy team determines the patient already has sufficient stock
Recommending alternative products to prescribers for items on a target list of ‘costly’ medicines Dispensing cheaper generic equivalents in place of certain prescribed branded products Identifying excess prescribing of medicines and dressings to care homes Running annual campaigns encouraging patients to return unwanted medicines
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Further details of the counter proposal are outlined in PSNC Briefing 026/16 at: psnc.org.uk/briefings
PSNC urges Prime Minister to consider alternative pharmacy proposals PSNC has urged David Cameron to reconsider his plans for community pharmacy after the Prime Minister told MPs that he wanted to see value for money from the sector following massive increases in spending. The Prime Minister’s comments followed a question from Sue Hayman, Labour MP for Workington, who asked whether the Government would support independent pharmacies which she said were a vital lifeline for rural communities and helped keep high streets alive. PSNC Chief Executive Sue Sharpe responded: “The Prime Minister could have taken the opportunity to recognise the excellent, front-line work carried out every day in community pharmacies all over the country. It seems, however, that Mr Cameron was poorly briefed by his officials. It is not accurate to say that there has been a massive increase in pharmacy spending. The global sum distributed to community pharmacies has grown significantly slower than inflation and rising volumes of prescriptions. It has also grown slower than overall funding for the NHS. Community pharmacies provide excellent value for money to the NHS."
Petition reaches one million signatures
Consultation background pack published
The Support your local pharmacy campaign petition made national papers at the beginning of May as it surpassed the one millionth signature milestone. PSNC Chief Executive Sue Sharpe said: “We know just how much local communities across England value their community pharmacies and their support for this petition proves that. The public seems to recognise what the Government so far has not: that community pharmacy teams are vital front-line NHS providers who can give face-to-face healthcare advice and support at a time and place that is convenient for patients.”
The Department of Health (DH) held a stakeholder engagement event on its consultation on the future of community pharmacy on 28th April. Slides from the event, which gave stakeholders the chance to discuss DH’s proposals in more detail, are now available to view at: ow.ly/4ncBwO Also, a background pack, including a summary of consultation responses so far and ‘source papers’ that were produced to inform initial discussions with PSNC, can be downloaded from: ow.ly/4n3uuT
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CPAF screening survey to be available from June This year’s contract monitoring survey will be available to community pharmacy contractors from June. The short screening survey removes the need for all contractors to complete the full CPAF questionnaire. The 2016/17 Community Pharmacy Assurance Framework (CPAF) screening questionnaire will be available via the NHS Business Services Authority (NHSBSA) from Monday 6th June for four weeks. It is anticipated that contractors will receive an individual email with links to the CPAF screening questionnaire on or around 6th June, if not slightly before this date.
The timing has been chosen to align more with community pharmacies’ usual compliance timeframes – avoiding ‘pressure points’ e.g. particular busy periods such as the flu season.
The contract monitoring process was revised by NHS England with the support of PSNC. The new process requires all NHS community pharmacy contractors to complete a short screening questionnaire consisting of 10 questions; NHS England
NHS England contracted NHSBSA to carry out the administration of CPAF at a national level on its behalf and, during last year’s trial process, this was facilitated by a secure online mechanism for contractors to complete their returns.
will then select only a small number of pharmacies for a monitoring visit or to complete the full CPAF questionnaire.
NHS England publishes whistleblowing policy NHS England has published updated guidance on whistleblowing policies for healthcare providers. It is hoped that a national, integrated whistleblowing policy will standardise the way in which NHS organisations support staff who raise concerns. Community pharmacy contractors should already have a whistleblowing policy in place, but they are advised to review the updated NHS England guidance available at: dld.bz/eznjW
Consultation on standards for pharmacy professionals The General Pharmaceutical Council (GPhC) has launched a consultation on standards for pharmacy professionals. GPhC is requesting feedback on the proposed standards from both members of the public and pharmacy professionals by 27th June 2016. The proposed standards aim to promote professional decisionmaking and encourage person-centred care in pharmacy. Respond to the consultation at: ow.ly/4n3Wif
The PharmOutcomes based CPAF is no longer used by local NHS England teams but remains available to contractors for self-assessment purposes. Additionally, the full CPAF questionnaire is available on the NHSBSA website for use as a training tool or to allow continuous monitoring of compliance against the community pharmacy contractual framework..
Healthcare news in brief NHS England to tackle conflicts of interest NHS England has revealed plans to tackle the problem of conflicts of interests, to provide public reassurance and confidence in how NHS funding is invested. The measures announced include revised guidance for Clinical Commissioning Groups (CCGs), a task and finish group to develop a full set of rules and proposals, and a requirement on providers to maintain and publish a register of gifts, hospitality and conflicts of interest. NHS England publishes business plan NHS England has published its business plan for 2016/17, setting out its main priorities for the coming year. The priorities are grouped under the following themes: improving health, transforming care and controlling costs. PSNC Briefing 025/16 summarises the elements which are of most relevance to community pharmacy. For more information on any of these stories, please see the monthly updates available at: psnc.org.uk/hclbriefings
NHS stationery portal orders Primary Care Support England (PCSE) has investigated concerns about delayed supplies of Electronic Prescription Service (EPS) tokens and late delivery of Drug Tariffs raised by PSNC. It has been confirmed that some regional variations resulted in a backlog of EPS token orders with stocks being drawn from PCSE’s distribution centres to make supplies. However, Drug Tariff delivery is carried out by CitySprint on behalf of PCSE and any pharmacy that does not receive one by the first of the month should email PCSE.enquiries@nhs.net PCSE is creating a user panel to support its service delivery and needs users like you to share their experiences and give feedback on future developments. Find out more at: pcse.england.nhs.uk/user-panel
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CheckRx – a new tool for script item analysis CheckRx is a new service launching soon that gives community pharmacy contractors easy access to a wealth of information about the prescription items they have dispensed. CheckRx, a companion service to Check34, will be available to all contractors from mid-June. It uses the prescription item report (or Px report - see more information on page opposite), which the NHS Business Services Authority (NHSBSA) offers to contractors each month via its website, to give information on: • FP34 payment data (script type, basic prices, fees paid, expensive items, etc.); • Drug Tariff splits of items dispensed (Part VIII Category A/M/C split, Part VIIIB, CheckRx dashboard, showing the six core areas that contractors can click into. appliances, ACBS, etc.); • Brand/generic analysis and product usage by volume, value or of items they are dispensing, how many from the Px report using PSNC’s PRISM number of items; Medicines Use Review (MUR) and New pricing tool – and drill down into the • Top patients by items dispensed, Medicine Service (NMS) consultations are various sections. Other areas on the identified by their NHS number; being conducted, and their EPS dashboard will allow them to see which • Which GP practices your scripts come nominations, as well as which local are the most frequently dispensed from, and Electronic Prescription surgeries prescriptions originate from. medicines (selected by value, number or Service (EPS) nominations; and This information is all sourced from volume), and which section of the Drug • Clinical/therapy area split (by publically available data on the Health & Tariff their items fall under. item/patient). Social Care Information Centre (HSCIC) website. A script source analysis chart shows which CheckRx also provides competitor items have been prescribed by which GP analysis, showing how pharmacies nearby Contractors will be able to review their practice, while another area splits items are performing. It will show the number Schedule of Payments – reconstructed into clinical or therapeutic category
How you can access CheckRx As CPN went to press, it was expected the new service will be available to all contractors from mid-June. The CheckRx subscription fee for a single pharmacy for 12 months will be £144. For contractors who take both services together (CheckRx and Check34), there will be a £24 discount, equivalent to one month of subscription. The National Pharmacy Association (NPA) has entered into an arrangement with PSNC Data Systems that means all NPA members in England will be offered the new service at a preferential rate. It is expected that the NPA will also be managing subscription sales for CheckRx to any independent pharmacies not currently in NPA membership. Further information will appear on the PSNC and NPA websites as details become available. Company Chemists' Association (CCA) members who want to find out more about CheckRx can email CheckRxadmin@psnc.org.uk or contact PSNC Data Systems on 0203 1220 813 for more information.
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(using BNF classifications). Finally, a set of pre-set search filters will allow for specific searches of all sections of the Px report. Clicking on a section of the dashboard, e.g. Part VIII Category M of the Drug Tariff, will provide a report of all dispensed items for that month that fall into Category M. This can be exported for further analysis. Clicking on a line (item) in this report will give all the detail for the specific item, including reimbursement paid, endorsements and fees, and the prescribing practice.
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Although CheckRx has its own web address, it shares the same administration module as Check34, so users can sign in to both services using the same user name and password. Account managers can set up and structure their company as they can in Check34. Users will be able to switch from one service to the other, provided they subscribe to both. What is the Px Report? The Px Report has been available to all contractors from the NHSBSA since the beginning of the year. It provides a line by line reconciliation of what a contractor has
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been paid for their prescription bundle for the relevant month. It details: • Script type (paper or EPS) and form type (FP10, FP10MDA, FP10D, etc.); • Paid, exempt and no charge items; • Drug description, pack size and basic price (and SNOMED code); • Amount paid (at Standard or Zero Discount Rate); • Endorsements and fees paid; • The originating GP practice; and • A version of the patient’s NHS number. It is used to compile a substantial part of the Schedule of Payments (FP34) sent monthly to every contractor. However, the Px report is not very user friendly! It is presented as a 72column spreadsheet, with as many rows as items priced for that month. There is a 31page Transparency Standard User Guide on the NHSBSA website that explains how it all hangs together, but you need to be an Excel expert to apply it to the Px report.
Pre-set search filters will enable specific and detailed searches of the Px report.
CheckRx does all the hard work for you, turning this raw data into useful business intelligence for your pharmacy.
How you might put CheckRx to use in your pharmacy: • Identify missing fees/incorrect endorsements (e.g. Schedule 2/ 3 Controlled Drug scripts); • Determine which items you are dispensing at a loss (e.g. branded generics); • Expensive items reconciliation; • Ensure supplementary fees are correctly paid; • Understanding product usage (Drug Tariff category splits/generic/branded); • Inform stock management and purchasing decisions (generic tendering, Non-Tariff programmes); • Competitor analysis (prescription drift, EPS nomination); and • Understanding therapeutic categories and patient groups to deliver clinically-focussed community pharmacy services locally.
Looking for a simpler way to monitor your prescription payments? Want to view key performance indicator trends for your prescription business? Hoping to compare your performance with the national average? Find out more at: www.check34.com
Understand your NHS business better with Check34 Not yet got an account? Email check34admin@psnc.org.uk for more information.
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Domiciliary Visit service offers significant benefits More than 85% of the interventions made in a Domiciliary Visit service saved the NHS money as well as providing a valuable service to housebound patients in Cornwall. An evaluation of the Community Pharmacist Domiciliary Visit service in Cornwall found that nearly half of visits led to identification of wasted medicines and 86.3% resulted in a cost saving to the NHS.
Evaluation highlights
It also includes a recommendation that the service is commissioned in all pharmacies across Cornwall so more housebound patients can benefit from the valuable service. The service involves a community pharmacist visiting an older housebound patient in their own home for an informal conversation, allowing the patient to tell their story and voice their concerns in a familiar environment.
30.5%
of patients are likely to have avoided a hospital admission
Nearly half of patients had wasted or excess medicines
This service is different to domiciliary Medicines Use Reviews in that there is no structured questioning; rather, open-ended questions are posed with a Visit Form being used as a conversation guide only. The pharmacist assesses the patient’s adherence, understanding of their condition and treatment, and offers lifestyle support as well as the removal of unwanted medicines for safe disposal.
86.3% of visits resulted in a cost saving
The resulting action plan is shared (with the patient’s consent) with their GP and any other appropriate member of the patient’s healthcare team. Funding for the service has been provided by the Prime Minister’s GP Access Fund (formerly known as the Challenge Fund), the South West Clinical Network Group, and Kernow Clinical Commissioning Group.
One in 20
were within the classes of vulnerable to severely frail
Read the article in full at: ow.ly/4mRrXj
New company to support service development A new national company, Community Provider Support Services Ltd (CPSS), has been set up with the support of the national pharmacy bodies. The purpose of the company – initiated by AIMp, CCA, NPA and PSNC – is to advise and support LPCs and their community pharmacy contractors in negotiations with local authorities and other commissioners. The first major task for the board of directors, made up of representatives from PSNC and the NPA, is to scope, agree and price a compelling offer and prospectus of pharmacy services to support tenders for local commissioning.
New PSNC Regional Representative elected Sunil Kochhar, Vice Chair of Kent LPC, has been elected as PSNC’s South East Coast regional representative. PSNC would like to welcome Sunil to the team and very much look forward to working closely with him to promote community pharmacy in England.
Healthcare news in brief Public Health England publishes strategic plan Public Health England (PHE) has published its strategic plan, setting out how it plans to achieve its aims over the next four years. The report also confirms PHE’s role in building on evidence, prioritising prevention and supporting local government and the NHS.
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NHS England backs innovative care initiative NHS England has announced it will invest £1.75m in a new, innovative ‘Shared Lives’ model. The family-based initiative aims to support more people being cared for in a home, rather than a hospital, by matching people with special needs to a Shared Lives carer.
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Making the Accessible Information Standard work for you The Centre for Pharmacy Postgraduate Education (CPPE) has developed a programme to support community pharmacy teams in implementing the Accessible Information Standard. We are launching an e-learning programme aimed at helping you and your pharmacy team to “implement the Accessible Information Standard, which is mandatory by 31st July 2016. Preparations should already be underway in community pharmacies so this e-learning’s arrival is timely and relevant. Accessible Information Standard – making it work helps pharmacy teams through the five-step approach given in the Standard’s requirements. Teams must elicit, record, flag, share and meet the communication needs of all their customers and patients. It also requires pharmacists and their teams to meet the communication needs of everyone with whom they come into contact, at first registration and at every contact thereafter. The Standard is aimed particularly at people with some sensory loss such as hearing and sight.
Geraldine Flavell Regional Manager, West Midlands
The requirement further stretches pharmacy teams and their resources, so our e-learning programme suggests meeting to discuss the development of a standard operating procedure and to decide who will be responsible for taking the lead on the Standard’s implementation.
The programme follows each of the five steps, considering the requirements, what this means for pharmacy teams, and suggesting how pharmacy teams may meet the requirements. It also provides substantial signposting to useful resources. This new CPPE e-learning programme was developed following Hertfordshire LPC successfully winning an implementation bid from NHS England.
“
You can access the e-learning by logging into the CPPE website at: www.cppe.ac.uk/ais (please note you may need to register for access).
New consultation skills programme CPPE has launched an interactive, video-based course called Consultation skills: what good practice looks like. The programme allows the learner to watch experts demonstrate what a patient-centred approach is by showcasing key skills and behaviours. Find out more about this course at: dld.bz/exPVy
Briefing published on Accessible Information Standard PSNC and Pharmacy Voice have produced a briefing on the Accessible Information Standard. NHS England's new Standard will become a legal requirement for providers of NHS and social care services in England, including community pharmacies, on 31st July 2016.
The purpose of the joint briefing is to update community pharmacy contractors on the requirements of this Standard, as well as explaining what steps they need to take next. Download the PSNC and Pharmacy Voice briefing from: ow.ly/4n6Y11
Intelligence packs offer prevention opportunities The National Cardiovascular Intelligence Network has launched the second edition of its Cardiovascular Disease (CVD) Primary Care Intelligence Packs. The packs are a resource for Clinical Commissioning Groups (CCGs) and practices to help improve health outcomes in CVD by identifying gaps in primary care.
Links to further resources NHS England’s Accessible Information Standard webpage: www.england.nhs.uk/accessibleinfo An interactive programme on implementing the Standard: tinyurl.com/AISprogramme
Three million benefit from new NHS programme Three million patients have begun accessing apps, devices and online networks from the NHS Innovation Accelerator programme. The programme gives innovators support to roll out their technology or service.
For more information on any of these stories, please see the monthly updates available at: psnc.org.uk/hclbriefings
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Pharmacy notice board In this section of Community Pharmacy News we have highlighted some key notices for you and your team to be aware of in the coming weeks and months. Hints & Tips for dispensing contractors The latest issue (number 23) of the Pricing Authority’s Hints & Tips for dispensing contractors newsletter contains some really useful information on: Accessing links for Drug Tariff Part IX as csv and Excel files; Claiming out of pocket expenses; Electronic Prescription Service (EPS) exemption/charge paid status; Excessive quantities in EPS Release 2; and The end of month submission process, including EPS Release 2 claims.
You can read issue 23 on the Pricing Authority’s website: www.nhsbsa.nhs.uk/3191.aspx
Research bursary open for applications
Pharmacists have until 30th June to apply for the National Pharmacy Association's Health Education Foundation burs ary for research in community pharmacy practice. Find out more and download your application pack here: ow.ly/4mQApe
Pricing Change to email address Authority’s main changed its
has g Authority ess to: The Pricin email addr enquiries .nhs.uk er m to us @ c es nhsbsa tionservic ip cr es nhsbsa.pr in ess, ending email addr e us in Their old longer is now no @nhs.net d. itore being mon and is not
A practical guide for carers
A guide encouraging carers to check with their local pharmacy about services that might help make life easier has been published by NHS England, in partnership with Carers UK, Carers Trust, Age UK, Public Health England and older carers themselves. The guide aims to provide carers with advice, hints and tips on a range of issues they may face such as how to cope with caring for someone, getting help and using technology. Case studies are featured in the guide as well as a list of useful contacts and an action plan for carers.
Pharmacy teams can order free copies of the guide to provide to carers by phoning Prolog on 0300 123 1002, quoting reference HC1, or online at: www.orderline.dh.gov.uk
PSNC Leadership Academy update
es had their second training day The PSNC Leadership Academy traine in London on 19th April. e’ was the theme for the day – ‘Managing and leading through chang in the community pharmacy ing particularly apt for those work sector at the moment. candidates in more depth next PSNC will be talking to some of the month.
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Cumulative MUR total added to Schedule of Payments Year to date totals to be included on the FP34 Schedule of Payments for the first time to support monitoring of MURs claimed over the financial year. Community pharmacy contractors will see a ‘year to date total’ of Medicines Use Review (MUR) claims on their monthly FP34 Schedule of Payments from April 2016.
Changes to Part VIIIB
NHS England has contracted the NHS Business Services Authority (NHSBSA) to take on the role of monitoring MUR activity and recovering payments from contractors for any claims made in excess of the 400 limit for each financial year.
A number of products were added to Part VIIIB of the Drug Tariff in May 2016, namely: • Pizotifen 250micrograms/5ml oral solution; • Pizotifen 250micrograms/5ml oral suspension; • Pyridostigmine bromide 50mg/5ml oral suspension; and • Tamsulosin 400micrograms/5ml oral suspension.
Contractors who claim for more than 400 MURs will receive a letter from NHSBSA stating the cumulative total of MURs claimed, the value of the payment to be recovered and notice of the recovery date.
A full list of products and new reimbursement prices can be found in Part VIIIB of the May 2016 Drug Tariff.
The ‘year to date total’ has been introduced to assist contractors with monitoring the number of MURs claimed during the financial year.
Have you seen our new-look prescription forms page? The PSNC Dispensing and Supply Team is currently in the process of updating the pages in the Dispensing and Supply section of the PSNC website. The updated ‘Is this prescription form valid?’ page provides information on which form types are valid, who they are used by and much more. See below for a look at our new easy to use chart.
Healthcare news in brief Progress in health devolution The Local Government Association has published a briefing document outlining the broad lessons that can be learnt from Greater Manchester’s experience of health devolution. It also discusses the positives, ongoing challenges and key themes from the devolution roundtable discussions. Older People’s Health and Wellbeing Public Health England has published the Older People’s Health and Wellbeing Profile, a tool which can be used to examine the health and care of older people across local authorities in England. The tool contains 95 interactive indicators and allows comparison and monitoring of trends in different regions. Sustainability and Transformation Regional Voices has published a short briefing explaining Sustainability and Transformation Plans and their role in delivering the NHS Five-Year Forward View. It also provides guidance on how to get involved in local areas. For more information on any of these stories, please see the monthly updates available at: psnc.org.uk/hclbriefings
Head over there now using our shortlink: psnc.org.uk/prescriptionforms psnc.org.uk 9
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Drug Tariff listing change for Midazolam Community pharmacy contractors should be aware of changes made to the May Drug Tariff and the Dictionary of Medicines and Devices (dm+d) listings for Midazolam oromucosal solution pre-filled oral syringes. The listings for four Part VIIIA entries of Midazolam oromucosal solution pre-filled oral syringes changed from 1st May 2016 to recognise the sugar-free (SF) status of this product. The listings were deleted from the Drug Tariff and replaced with SF versions. The Department of Health has granted a concession period for the month of May to avoid confusion amongst prescribers and pharmacy teams, and to allow time for system suppliers to update their systems. Prescriptions written with the old
description will continue to be reimbursed against Buccolam or based on endorsement if an ‘unlicensed special’ is supplied during this time. The concession has been put in place to avoid prescriptions being returned to pharmacies for clarification which could lead to a delay in payment. From 1st June 2016, contractors need to ensure that any prescription written generically for Midazolam oromucosal solution pre-filled oral syringes reads as per the new name.
Previous name (deleted) New name (added) Midazolam 10mg/2ml oromucosal solution pre-filled oral syringes Midazolam 10mg/2ml oromucosal solution pre-filled oral syringes SF Midazolam 2.5mg/0.5ml oromucosal solution pre-filled oral syringes
Midazolam 2.5mg/0.5ml oromucosal solution pre-filled oral syringes SF
Midazolam 5mg/1ml oromucosal solution pre-filled oral syringes
Midazolam 5mg/1ml oromucosal solution pre-filled oral syringes SF
Midazolam 7.5mg/1.5ml oromucosal solution pre-filled oral syringes
Midazolam 7.5mg/1.5ml oromucosal solution pre-filled oral syringes SF
Can it be dispensed on an FP10? Community pharmacy teams must check whether the items prescribed on NHS prescriptions are allowed on the NHS before dispensing them. The contractor will not be paid for them if they are not allowed. 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. Below is a list of some products that we have recently received queries about. Product
Is the item listed in the Drug Tariff?
Is it in the blacklist?
Does it have a ‘CE’ mark?
Can it be dispensed on an FP10?
Additional information
Tubegauz stockinette (all sizes)
No
n/a
Yes
No
This item is a medical device (CE marked) and is not listed in Part IX of the Drug Tariff.
UltraDEX Oral Rinse
No
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.
Dexcom G5 Mobile Continuous Glucose Monitoring System
No
n/a
Yes
No
This item is a medical device (CE marked) and is not listed in Part IX of the Drug Tariff.
Sterile polythene jug 1ltr
No
n/a
Yes
No
This item is a medical device (CE marked) and is not listed in Part IX of the Drug Tariff.
AirLife sterile water for inhalation
No
n/a
Yes
No
This item is a medical device (CE marked) and is not listed in Part IX 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 10 Community Pharmacy News – May 2016
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Ask PSNC The PSNC Dispensing and Supply Team can provide pharmacy teams with support and advice on a range of topics related to the Drug Tariff and reimbursement. Questions asked in recent months have included: Q. Do I need to display a notice about the NHS prescription charge?
A. Yes, it is part of your Terms of Service to have a notice in the prescription reception area about the NHS prescription charge. For further information, please see the clinical governance approved particulars for premises (available from: psnc.org.uk/cg).
Q. If a prescription was dispensed before 1st April but the patient didn't collect it until after 1st April, should the patient pay the old or new prescription charge?
A. There is no national guidance on this issue so pharmacy staff will be required to exercise their professional judgement. Whatever the decision, pharmacy staff are advised to record the charge made and the reasons for doing so on the patient’s medication record.
Q. A patient has ticked the maternity exemption box on the back of their prescription, but they have only applied for a maternity exemption certificate today. Can the patient claim the exemption or should they pay the prescription charge?
A. The patient should pay for their prescription and be issued with an FP57 (Receipt and Refund Form) so that they may claim back the charges once they receive their maternity exemption certificate. Details of prescription charge refunds and the claim procedure can be found on our website: psnc.org.uk/refunds
If you would like more information on any of the topics covered, the PSNC Dispensing and Supply Team will be happy to help (0844 381 4180 or 0203 1220 810 or e-mail info@psnc.org.uk).
Healthcare news in brief Health Committee says primary care is under strain
Charity proposes assessment of NHS funding
The House of Commons Health Committee has published a report, Primary Care, which sets out the challenges faced by primary care and analyses long-term solutions to drive improvements in patient care. The report also examines patients’ and the workforce’s experience of primary care, the new models of care, building the new primary care team and funding.
The Patients Association has announced proposals to establish an independent commission to examine funding levels against the current and future needs of the NHS and social care. The commission will consider how much to spend as a society, as well as possible sources of additional funding, using the principle of free treatment at the point of care as a starting point.
Prescription figures published The Health & Social Care Information Centre (HSCIC) has published its Prescription Cost Analysis (PCA) report, providing data on all prescriptions dispensed in the community across England. The 2015 PCA report states 1.08bn prescription items were dispensed (up by 1.8%) at a cost of £9.27bn (up by 4.7%).
For more information on any of these stories, please see the monthly updates available at: psnc.org.uk/hclbriefings All details correct at time of printing. No part of this publication may be reproduced without the written permission of PSNC. Produced for 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.
Distributed for PSNC by:
Communications International Group Linen Hall, 162-168 Regent Street, London W1B 5TB Tel: 020 7434 1530 Fax: 020 7437 0915
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Drug Tariff Watch The Preface lists additions, deletions and alterations to the Drug Tariff. Below is a quick summary of the changes due to take place from 1st June 2016. You may also wish to see our Dispensing Factsheet: The Drug Tariff Preface at: psnc.org.uk/dtresources SC Special Container * This pack only (others already available) Part VIIIA additions Category A: • Atropine 1mg/1ml solution for injection ampoules (10) • Atropine 400micrograms/1ml solution for injection ampoules (10) • Timolol 10mg / Bendroflumethiazide 2.5mg tablets (30) Category C: • Adrenaline (base) 300micrograms/0.3ml (1 in 1,000) solution for injection prefilled disposable devices SC (1) – EpiPen • Lidocaine 4% cream SC 5g – LMX 4 • Liquid paraffin light 63.4% bath additive SC (150ml) – Oilatum Bath Formula • Liquid paraffin light 63.4% bath additive SC (250ml) – Oilatum Emollient • Liquid paraffin light 63.4% bath additive SC (300ml) – Oilatum Bath Formula • Liquid paraffin light 63.4% bath additive SC (500ml) – Oilatum Emollient • Liquid paraffin light 63.4% bath additive SC (600ml) – Oilatum Junior • *Mesalazine 800mg gastro-resistant tablets (84) – Asacol MR
• Riluzole 25mg/5ml oral suspension sugar free (300ml) – Teglutik • White soft paraffin 15% / Liquid paraffin light 6% cream SC (50g) – Oilatum • White soft paraffin 15% / Liquid paraffin light 6% cream SC (150g) – Oilatum • White soft paraffin 15% / Liquid paraffin light 6% cream SC (350ml) – Oilatum Junior • White soft paraffin 15% / Liquid paraffin light 6% cream SC (500ml) – Oilatum • White soft paraffin 15% / Liquid paraffin light 6% cream SC (1050ml) – Oilatum Part VIIIA amendments • Betaxolol 0.5% eye drops SC (5ml) is changing to Category C – Betoptic • Clomifene 50mg tablets (30) is changing to Category C – Clomid • Co-trimoxazole 160mg/800mg tablets (100) is changing to Category C – Aspen Pharma Trading Ltd • Frovatriptan 2.5mg tablets (6) is changing to Category A • Gliclazide 30mg modified-release tablets (28) is changing to Category C – Diamicron MR • Indometacin 75mg modified-release capsules (100) is changing to Category C – Berlind 75 Retard
• Mesalazine 800mg gastro-resistant tablets (180) is changing to Category C – Octasa MR • Nitrazepam 2.5mg/5ml oral suspension (70ml) is changing to Category A • Pholcodine 10mg/5ml linctus strong sugar free (2000ml) is changing to Category C – Galenphol Strong • Pindolol 5mg tablets (100) is changing to Category A • Propranolol 80mg modified-release capsules (28) is changing to Category C – Half Beta-Prograne • Rasagiline 1mg tablets 28 is changing to Category A • Tioconazole 283mg/ml medicated nail lacquer SC (12ml) is changing to Category A 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 as long as the product does not appear in Part XVIIIA (the ‘Blacklist’). However, it will need to be endorsed fully (i.e. brand or supplier name and the pack size from which the item was dispensed). • Co-danthramer 37.5mg/500mg capsules (60) Category C – A A H Pharmaceuticals Ltd
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. Product
Type, size and product code
LoFric Hydro-Kit catheter (Wellspect HealthCare)
Tiemann, 10-18 Gauge (Ch), codes 9871000-9871800
Versiva XC dressing (with Adhesive Border)
Square: 10cm x 10cm, 14cm x 14cm, 19cm x 19cm, 22cm x 22cm Heel: 18.5cm x 20.5cm Sacral: 21cm x 25cm
Versiva XC dressing (without Adhesive Border)
Square: 7.5cm x 7.5cm, 11cm x 11cm, 15cm x 15cm, 20cm x 20cm
Sorbion silver flex dressing
Square: 5cm x 5cm, 10cm x 10cm, 20cm x 20cm Rectangular: 10cm x 20cm
MediSafe Solo lancets (Cambridge Sensors Ltd)
0.50mm/29 gauge
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: Melinda Mabbutt who can be contacted at the above address or by email at: mmabbutt@psnc.org.uk PSNC Office: 0844 381 4180 or 0203 122 0810
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