April 2015 CPN

CPN

Community Pharmacy News – April 2015

Token confusion Demystify Electronic Prescription Service (EPS) forms and tokens with our guide

Additional payment details | Factsheet: Is it valid? | New payment analysis tool

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PSNC and NHS England joint announcement: additional payment to pharmacies Additional payment worth around £2,000 to £2,200 to pharmacies dispensing average volumes will be paid in late May/early June.

NHS England will make an additional payment to pharmacies with their March payments, i.e. along with the final payment for the March 2015 dispensing month which is made in late May/ early June.

In a joint statement, PSNC and NHS England said: “It remains our intention to smooth the delivery of funding to community pharmacy contractors as much as possible.

This additional fee has been agreed in light of the predicted under delivery of margin in 2014/15.”

The payment will be calculated as an additional fee for each pharmacy, based on professional fee numbers. The fee will be 3.3 pence for each professional fee paid from April 2014 to December 2014.

This additional fee is paid in recognition of the reduction in margin available to contractors in the early months of this financial year.

As part of the 2014/15 community pharmacy contractual framework it had been agreed that pharmacies would be

Additional Payment: Frequently Asked Questions Q. When will the additional payment be paid?

A. The additional fee will be paid along with your final payment for the March 2015 dispensing month. The usual payment timescales mean this payment will be made in late May/ early June.

Q. How do contractors claim the extra payment?

A. Pharmacy contractors do not need to do anything to claim the payment – it will be calculated based on the professional fees paid to them between April 2014 and December 2014 and added to their March payments by the Pricing Authority.

Q. Will Welsh pharmacy contractors receive the additional payment for March 2015?

A. The Drug Tariff contains payment and reimbursement information for both English and Welsh pharmacy contractors

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allowed to retain £800 million of margin income and, whilst the final outcome of the Margin Survey will not be known until later in this calendar year, early analysis indicates that this total is unlikely to be reached.

and, unless specified otherwise, will apply to both English and Welsh pharmacy contractors. 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?

A. Across the sector the additional payment to contractors will be worth around £25m. The amount each pharmacy receives will depend on the number of items they dispensed from April 2014 to December 2014. For contractors dispensing average prescription numbers the payment will be around £2,000 – £2,200.

Q. My pharmacy was open between April 2014 and December 2014, but its NHS code (commonly known as the F code) changed during this time – will I still receive the additional fees?

A. In this scenario, the contractor must contact the Pricing Authority to determine whether they are eligible for the additional fee. The team to write to is

PSNC Chief Executive Sue Sharpe said the payment would be a welcome bonus for contractors. “Financial pressures and income volatility continue to be a problem, driven by the instability of prices and supplies. PSNC is pleased that we were able to secure this payment in advance of the final reconciliation of figures for margin earned in the financial year,” she added.

as follows: NHS Business Services Authority, Customer Payment Team Stella House, Goldcrest Way, Newburn Riverside, Newcastle upon Tyne NE15 8NY Q. My pharmacy was open between April 2014 and December 2014, but has since closed – will I still receive the additional payment?

A. Any pharmacy account (determined by an NHS or F code) which ceased to exist prior to 1st March 2015, and therefore is not submitting a claim for payment for the March 2015 dispensing month, is not entitled to the payment.

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Check34 - a new tool to help with prescription analysis New system will enable contractors to monitor the accuracy of their monthly prescription payments as notified on the monthly FP34 Schedule of Payment received from the Pricing Authority.

A new online service to help all contractors analyse the prescription data they receive every month from the Pricing Authority is being rolled out by PSNC this month. A unique collaboration with the National Pharmacy Association (NPA) means all NPA members will gain access to the service, called Check34, without paying a separate subscription fee.

Check34 will enable contractors to monitor the accuracy of their monthly prescription payments as notified on the monthly FP34 Schedule of Payment received from the Pricing Authority. It will also provide the sort of prescription data analysis which until now has only been available to larger companies with substantial IT resources.

Contractors who use the service will be able to view a number of key performance indicators (KPIs) for their prescription business and look back at up to 24 months of historical data. KPIs include: • Items dispensed per month • Average item value • Fees and drug costs • Working hours (to ensure correct Practice Payment) • Script switches (part 2 and not signed) and fees lost • Expensive items (value, number, % of total account) • Zero discount (value, number, % of total account) • MURs completed per month and in year to date • NMS completed per month and in year to date Users will see an easy to navigate dashboard when they first sign in, and the KPIs will be shown graphically. The graphs will have overlays to enable contractors to compare their performance with the national average and that of the nearest pharmacies to theirs geographically. Companies with multiple branches can compare a branch performance to regional and/or company averages.

For users who wish to use the information in other applications, any data that appears on the monthly FP34 (with the exception of service fees) can be downloaded as a .csv or .xls file. Check34 also offers contractors the option of entering their monthly FP34C

submission figures and reconciling these against those shown by the Pricing Authority on that month’s FP34.

The ability to offer Check34 derives from the prescription audit work that PSNC carries out on behalf of contractors.

Accessing Check34 • NPA Members: The NPA has entered into an arrangement with PSNC that means all NPA members in England will be offered the new service as part of their subscription package.

The NPA plans to fast track member access to the new service with the aim of having all eligible pharmacies subscribed by autumn 2015. Thereafter access to the service will be renewed in line with their annual NPA subscription.

NPA members should visit the NPA website at npa.co.uk/check34 for more information.

• Non-NPA members: The NPA will be managing subscription sales for Check34 to non-NPA member pharmacies. Contact check34@npa.co.uk or call Katie Smith on 01727 858687 for subscription rates and more information.

• CCA member companies: CCA members who wish to find out more about Check34 can email check34admin@psnc.org.uk or contact the PSNC office on 0203 1220 820.

PSNC stresses value of pharmacy teams PSNC has once again highlighted the value that community pharmacy teams can offer patients and the NHS to the Government. In a meeting with pharmacy minister Earl Howe, PSNC Chief Executive Sue Sharpe and independent contractor Gary Warner outlined the potential benefits of pharmacy services such as minor ailments schemes, re-ablement services, public health advice, and flu vaccinations. The meeting formed part of PSNC’s ongoing work to develop the community pharmacy service.

Gary Warner said: “It was great to hear the Minister so interested in how community pharmacies can help patients and the NHS. He said our approach was innovative, timely and sensible. For example we discussed the emergency supply of medicines and the Minister was interested in the potential costs savings of an NHS service – we hope the national clinical audit on this topic provide more evidence to help us to make the case for this.”

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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.

NHS England guidance on urgent repeats NHS England has published guidance for commissioners and NHS 111 providers on how NHS 111 services can establish a direct referral to a pharmacy that is commissioned to provide urgent repeat medication as a locally commissioned NHS service. NHS England is encouraging commissioners of NHS 111 and local community pharmacy services to use this guide to inform the transformation of urgent care by shifting the burden of repeat medication requests away from GP out of hours services and other urgent care settings to an appropriately commissioned community pharmacy emergency supply service. See: tinyurl.com/nhs111pharmacyguide Greater roles for CCGs Following on from the news in February that 64 Clinical Commissioning Groups (CCGs) will take on greater delegated commissioning (dld.bz/d9FJw) for the majority of GP services, a further 87 CCGs have been approved for joint commissioning. This means over 70% of CCGs will take on greater commissioning responsibilities for GP services from April 2015.

151 CCGs take on greater commissioning roles Vanguard sites NHS England has announced the first 29 vanguard sites (dld.bz/d9FJx) that will lead on transforming care for patients across England.

In January 2015, the NHS invited individual

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organisations and partnerships, including those within the voluntary sector, to apply to become vanguard sites for the New Care Models Programme, the first major step towards delivering the NHS Five Year Forward View (dld.bz/d9FK5) and supporting improvement and integration of services.

National NHS Diabetes Prevention Programme The National NHS Diabetes Prevention Programme has been launched in England as a major national initiative to prevent illness. The programme, which is a joint initiative between NHS England, Public Health England and Diabetes UK, aims to significantly reduce the four million people in England otherwise expected to have type 2 diabetes by 2025.

4 million people expected to get diabetes CQC rating displays Health and care providers will have to prominently display their Care Quality Commission (CQC) rating from 1st April 2015. This requirement follows an amendment to regulation that was laid before Parliament on 28th January 2015 by the Department of Health that required providers to display their CQC ratings across their services and on their websites.

Prime Minister’s Challenge Fund update NHS England has announced that 37 pilot sites, covering 1,417 practices, have been successful in the second wave of the Prime Minister’s Challenge Fund (dld.bz/d9FJ2) to test innovative ways of delivering GP services and making services more

37 Prime Minister’s Challenge Fund sites accessible to patients. In total there are now 57 pilots covering more than 18m people in over 2,500 practices that will benefit from improved access and transformational change at local level.

Hunt pledges additional £8bn for NHS Health Secretary Jeremy Hunt has pledged that the Conservative party will spend an additional £8bn on funding the NHS Five Year Forward View if they win the general election. The Tories are the second party to pledge to support funding for the Forward View; the Liberal Democrats pledged their support in January.

£8bn for NHS under Conservatives PHE focus on pharmacy Professor Kevin Fenton, Public Health England’s National Director for Health and Wellbeing, was waving the flag for pharmacy in his blog last month. He discussed the important role pharmacists and their teams can play in raising awareness of public health issues, in particular helping patients make healthy lifestyle choices and manage their preexisting conditions. He highlighted some of the great work that community pharmacy is already doing such as NHS Health Checks and the healthy living pharmacy model.

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Summary of EPS-related forms and tokens (England) As uptake of the Electronic Prescription Service (EPS) increases, community pharmacy teams should familiarise themselves with the various prescription forms and tokens they will now encounter. The information provided below will help you to identify the different types of forms and explain when they are used.

Paper Prescriptions Paper FP10 prescription (without an electronic prescription message) Even those GP practices which have gone live with EPS Release 2 will continue using paper FP10 prescriptions forms where necessary. Dentists and hospital doctors do not yet have access to EPS.

Barcoded FP10 prescription (with an electronic prescription message) With a Release 1 EPS prescription, the paper FP10 form will require the prescriber's written signature, and the paper form will be the legal prescription. GP systems print a barcode on a paper prescription which, when scanned at an EPSenabled pharmacy, downloads an electronic prescription message.

This electronic message will autopopulate the pharmacy’s system with the prescription details.

This type of prescription should be dispensed using the paper form, and the paper form needs to be submitted in the usual way for pricing.

EPS Release 2 (R2) tokens (see overleaf) Paper forms that are printed to accompany electronic prescriptions are known as ‘tokens’.

These are only used once a GP practice is using EPS R2.

There are two types: 1. the prescription or authorisation token (generated by a prescriber); and 2. the dispensing token (generated by a dispenser).

Both types are simply paper copies of the electronic prescription and neither can be used to dispense prescription items without the corresponding electronic prescription.

The barcode present on a token can be scanned to retrieve the corresponding electronic prescription from the NHS central Spine (the network which transfers information relating to electronic prescriptions). The prescription identifier code on the tokens is 18 characters. Note: Only R2 enabled dispensing systems will be able to retrieve an electronic prescription message from a token.

The ‘prescriber signature’ area on prescription tokens is overprinted to prevent the prescriber signing the token because it is the electronic signature on the electronic message which makes the prescription legally valid.

Reimbursement is made against the electronic claim message for the electronic prescription and not the paper token. Handwritten amendments are therefore not acceptable; the electronic message must be returned to the Spine so the prescriber can cancel and re-issue.

Wales: Currently, pharmacies in Wales cannot access these electronic prescription messages by scanning these R2 barcodes. Therefore, if a patient wishes to have their prescription dispensed in Wales, or one of the other home countries, a paper prescription form will need to be requested.

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Prescription token (issued in parallel with a legal electronic NHS prescription) The green FP10SS form may be used by the prescriber to print a prescription token.

The right hand side of the token will include a note that the electronic prescription message has been sent to the nominated dispensing site along with the name and address of the site.

Repeat authorisation token (issued in parallel with a legal NHS repeatable electronic prescription) It is mandatory for the prescriber to give the patient a prescription token when authorising an electronic repeatable prescription. This looks similar to the prescription token but has the words ‘repeat dispensing authorisation form’ printed on it.

Dispensing token (can be generated as necessary where a legal electronic NHS prescription has been issued by the prescriber) The 'FP10DT' is white in colour and is generated by a dispenser. It will be printed with the annotation ‘dispensing token’.

In EPS R2, these may be presented at a pharmacy where a patient has nominated a pharmacy but their nominated pharmacy has been unable to dispense the prescription. This is not a legal prescription but the barcode on the form can be used to ‘pull down’ the legal NHS electronic prescription from the Spine.

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Frequently Asked Questions Q. The prescriber has signed a prescription token; does this make it a legal NHS prescription?

A. No. With EPS R2, payment is always based on the electronic message. R2 tokens are designed to minimise the risk of confusion by over-writing the signature box to state that the token should not be used as a prescription.

Q. Which EPS R2 tokens should I send with my prescription bundle?

A. The tokens which should be sent to the Pricing Authority are those where the patient: • is exempt for a reason other than age; or • has paid the prescription charge.

These tokens are sent for audit purposes only as reimbursement is made against electronically submitted R2 messages and the exemption category applied to that message.

The token and prescription illustrations are reproduced here with permission from the Department of Health.

Subject to Crown copyright.

They were the correct version as at the date of publication (April 2015), but medical professionals should check which versions are valid and in use at any given time and should not assume the versions printed are still valid.

Find out more about EPS R2 tokens at: psnc.org.uk/tokens

NHS England teams are responsible for supplying community pharmacies with blank FP10DTs for printing dispensing tokens.

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Changes to the Drug Tariff in April 2015 Community pharmacy contractors should be aware of a number of changes to fees and allowances that are being made in the Drug Tariff from April 2015. The changes are: • An increase in Practice Payment of 4.4p per item, from 49.1p to 53.5p; and • An increase in the thresholds governing access to the Practice and Establishment Payments by c. 2.9%

ensure delivery of the agreed £2bn fees and allowances in the 2014/15 financial year. The April increase of 4.4p per item rebalances this and is designed to ensure smooth delivery of funding in the coming year. It will be reviewed once a funding settlement for 2015/16 has been agreed.

This table outlines Establishment Payments from 1st April:

The following table outlines the Practice Payments from 1st April: Number of items per month

Practice Payments from 1st April 2015

Up to 1,099 1,100 – 1,599 1,600 – 2,499 2,500+

£600 (annual total, 1/12 paid monthly) £5,479 (annual total, 1/12 paid monthly) £7,670 (annual total, 1/12 paid monthly) 53.5p per item

Number of items per month

Establishment Payment from 1st April 2015

2,500 – 2,829 2,830 – 3,149 3,150+

£23,278 (annual total, 1/12 paid monthly) £24,190 (annual total, 1/12 paid monthly) £25,100 (annual total, 1/12 paid monthly)

The increase in threshold for both payments recognises the increases in prescription volumes that have been seen in England.

It is in line with the routine annual increases that were made as part of funding settlements agreed from 2006 until the NHS reforms.

Contractors may recall that in November 2014 there was a reduction in the Practice Payment of around 17p per item to

Can it be dispensed on an FP10?

When pharmacy teams receive NHS prescriptions they must check whether the items prescribed are allowed on the NHS before dispensing. If they are not considered to be allowed, the pharmacy may not be paid for them.

Pharmacy staff can check whether medicinal products and medical devices are allowed using the Drug Tariff.

Medicinal products: assuming the prescriber has the appropriate prescribing rights, any food, drug, toiletry or cosmetic may be prescribed on an NHS prescription unless the product is listed in Part XVIIIA of the Drug Tariff (the ‘blacklist’).

Medical devices: if a product has been registered as a medical device (also known as an appliance), it can only be dispensed on an NHS prescription if it is listed in Part IX of the Drug Tariff. Registered medical devices can be identified by a ‘CE’ mark on the product’s packaging.

Pharmacy staff may wish to check PSNC’s ‘Dispensing on an FP10 database’ psnc.org.uk/FP10database, 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?

If no, is it in the blacklist?

Can it be dispensed on the NHS

Additional information

Bard Interglide Coated Intermittent Catheter D6030

Yes

Yes

n/a

Yes

This item is a registered medical device (CE marked) and appears in Part IXA of the Drug Tariff.

Sildenafil 100mg chewable tablets sugar free

Yes

No

No

Yes

This item is not a registered medical device (CE marked) and does not appear in Part XVIIIA (the ‘blacklist’) of the Drug Tariff.

Combur 7 testing strips

No

Yes

n/a

No

This item is a registered medical device (CE marked) and is not listed in Part IX of the Drug Tariff.

Senset Skin Cleansing Foam

No

No

No

Yes

This item is not a registered medical device (CE marked) and does not appear in Part XVIIIA (the ‘blacklist’) of the Drug Tariff.

BD Luer-Lok Syringe

No

Yes

n/a

No

This item is a registered 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

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Ask PSNC The PSNC Dispensing and Supply Team can give pharmacy teams advice on a range of topics related to the Drug Tariff and reimbursement. Below are some questions the team have been asked in recent months.

1. How long does a repeat prescription remain legally valid?

Repeat prescriptions for Schedule 5 Controlled Drugs (CDs) and items without CD status must be dispensed for the first time within six months of the ‘appropriate date’, with subsequent issues valid for 12 months from the signed date. The ‘appropriate date’ is the later of either the date the prescription was signed or the date indicated as the start date.

For example, consider a prescription for Salbutamol 100micrograms/dose inhaler CFC free requesting 12 months’ supply, split amongst twelve batch issues (RD forms). If the signed date on the prescription (RA form) is 1st January 2015, then if the patient is to obtain all of their medicine, the pharmacy must have dispensed fully within one year, and therefore by 31st December 2015.

Schedule 2 and 3 CDs cannot be prescribed on repeat prescriptions. Repeat dispensing prescriptions for Schedule 4 CDs must be dispensed for the first time within 28 days of the appropriate date with subsequent issues valid for 12 months from the signed date.

2. Is it legal for a GP to post-date prescriptions, say for three or six months, for a patient to retain and get dispensed when required?

Yes. According to The Prescription Only Medicines (Human Use) Order 1997, a prescription must be endorsed with an appropriate date, defined as ‘…the date on which it was signed by the appropriate practitioner giving it or a date indicated by him as being the date before which it shall not be dispensed (15. (4) (a)).’

However, pharmacy teams may wish to suggest the GP considers using repeat prescriptions instead. Repeat prescriptions enable the pharmacist to make checks on whether the continued medication is appropriate for the patient, and are generally a preferred method.

3. There has been an outbreak of scabies within a family. Rather than issuing one prescription per family member, the prescriber has ordered sufficient quantity of Permethrin 5% cream on one prescription to cover the whole family. Is this allowed?

No. Bulk prescriptions are not intended to cover situations such as these. The only exception to this rule is where the prescriber is responsible under their GMS contract for the treatment of 10 or more persons in a school or other institution in which at least 20 persons normally reside; and where the prescriber needs to prescribe for two or more of those persons for whose treatment the contractor is responsible. The prescription should bear the name of the school or institution concerned.

More information about bulk prescriptions can be found in Part VIIIA, Notes, Paragraph 9 of the Drug Tariff. A key point to note is that bulk prescriptions can only be issued for prescribable dressings and for medicines which are not classified as prescription only medicines. (See this month’s factsheet Dispensing Factsheet: Is this prescription form valid? on pages 9–10) 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).

Nutricia Announce Change in Distribution Arrangements Nutricia Advanced Medical Nutrition has announced that with effect from 4th April 2015 it will appoint two solus wholesale partners.

• Alliance Healthcare (Distribution) Ltd will become the sole distributor of its metabolics and allergy products to all pharmacies in England, Scotland and Wales.

• AAH Pharmaceuticals Ltd will become Nutricia’s sole distributor of products to all hospitals with a formal contract or other commercial arrangement with Nutricia, in England, Scotland and Wales.

For more information, including a list of the metabolics and allergy products, and to see Nutricia’s letter visit our website at tinyurl.com/nutricia-news Related Information A summary of the distribution changes for medicine suppliers can be found on our Distribution of Medicines page at psnc.org.uk/distribution

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Colecalciferol in the Drug Tariff The Preface of the April 2015 Drug Tariff annotates the addition of two licensed Colecalciferol products with effect from May 2015 to Part VIIIA. • Colecalciferol 20,000 units, 15 and 30 capsules (Category C) • Colecalciferol 40,000 units, 10 capsules (Category C) Pharmacy staff are reminded that products listed with more than one pack size in Category C, Part VIIIA of the Drug Tariff, are required to have the pack size endorsed on the prescription.

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Dispensing Factsheet: Is This Prescription Form Valid?

Only certain types of prescription form can be dispensed on the NHS so it is important for pharmacy teams to be able to identify which form types are allowed and which are not. Form types can be identified by the code on the bottom right of a prescription.

Eligibility The following prescription forms can be dispensed by NHS community pharmacies in England and Wales.

For information on forms originating in Scotland, Northern Ireland and the Isle of Man, and prescription forms that are not eligible, see: psnc.org.uk/prescriptionforms Forms originating in England Form type and colour

Who can use or what they are used for

Green FP10 FP10NC FP10HNC FP10SS

GPs, hospital doctors, and Forms annotated with the initials RD are repeat dispensing independent/supplementary prescribers (pharmacists, forms. Forms annotated with the initials RA are repeat midwives, nurses, chiropodists/ podiatrists, authorisation forms. physiotherapists, radiographers, optometrists), or out of hours centres if correctly annotated.

Blue FP10MDA FP10MDA-S FP10HMDA-S FP10MDA-SS FP10MDA-SP

Instalment dispensing prescription form.

More information can be found on our Instalment Dispensing page at: psnc.org.uk/mda

Lilac FP10P FP10PN FP10CN FP10SP

Independent/supplementary prescribers.

The form should be printed with information to identify the type of prescriber, for example, ‘community practitioner nurse prescriber (formerly known as district nurse/health visitors)’ or ‘nurse independent prescriber or supplementary prescriber’. Only items listed in the relevant formularies can be prescribed on this prescription.

Yellow FP10D

Dentists in primary care.

Only items listed in the dental formulary can be prescribed on this prescription.

Further information

Forms originating in Wales Form type and colour

Who can use or what they are used for

Further information

Green WP10 WP10SS WP10SP WP10HP WP10HSP

GPs, hospitals and supplementary prescribers.

Forms annotated with the initials RD are repeat dispensing forms. Forms annotated with the initials RA are repeat authorisation forms.

Green WP10D

Dentists in primary care.

Only items listed in the dental formulary can be prescribed on this prescription.

Green WP10CN WP10PN

Independent/supplementary prescribers.

Only items listed in the relevant formularies can be prescribed on this prescription.

Green WP10MDA WP10HP(AD)

Instalment dispensing prescription form.

More information can be found on our Instalment Dispensing page at: psnc.org.uk/mda

For information relating to prescription charges, refer to the patient charges page on our website at: psnc.org.uk/charges For guidance on prescribing formularies, refer to our webpage at: psnc.org.uk/prescribing psnc.org.uk 9

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How long is a prescription valid for?

The table below summarises the length of validity of the different types of NHS prescription.

Type of prescription FP10 (excluding requests for Schedule 1, 2, 3 or 4 CDs)

1st issue expiry 6 months*

Subsequent issues expiry 12 months for repeatable prescriptions.

FP10 for Schedule 1, 2 or 3 CDs

28 days*

N/A (cannot be on repeatable prescriptions)

FP10 for Schedule 4 CDs

28 days*

12 months for repeatable prescriptions.

FP10MDA prescription

28 days*

In accordance with instalment directions.

A prescriber can request up to 14 days’ supply.

*from the ‘appropriate date’ (either the date the prescription was signed or the date indicated as the start date) Owings The owing balance on prescriptions for Schedule 5 Controlled Drugs (CDs) and other medicines that are not CDs cannot be collected more than 6 months after the appropriate date. The exception is for owings against repeatable prescriptions (which have a maximum validity of 12 months).

For prescriptions requesting Schedule 1, 2, 3 or 4 CDs, owings cannot be dispensed later than 28 days after the appropriate date on the prescription. It is good practice for the pharmacist to make the patient or their representative aware at the outset that they will not be able to collect the balance after the 28 day period has elapsed.

Also, it is important to note that owings are not appropriate for CDs which are being supplied in instalments, as the quantity of the instalment dispensed must be exactly as specified on the prescription. Any missed instalments can only be given on the following day if the prescriber has specified this is permissible.

Bulk prescriptions Part VIIIA, Notes, Paragraph 9 of the Drug Tariff outlines the arrangements for bulk prescriptions: A “Bulk” prescription is an order for two or more patients, bearing the name of a school or institution in which at least 20 persons normally reside, for the treatment of at least 10 of whom a particular doctor is responsible. Such a prescription must be an order for a drug which is prescribable under the NHS and which is not designated “Prescription Only Medicine” (POM) under Section 58(1) of the Medicines Act 1968, or for a prescribable dressing which does not contain a product which is designated POM. No prescription charge is payable when a bulk prescription is dispensed.

Dispensing factsheets You may have noticed that since last year we have been publishing one new dispensing related factsheet every month in our CPN magazine. What you might not know is that they are now all available to download from our website.

Previous factsheets have covered such topics as: • Unlicensed specials and imports; • Charges and exemptions; • Using the Drug Tariff; and • Where to obtain external resources.

If you missed any of these factsheets, or want additional copies, download them now at: tinyurl.com/d-sbriefings 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.

Distributed for PSNC by:

Communications International Group Linen Hall, 162-168 Regent Street, London W1B 5TB Tel: 020 7434 1530 Fax: 020 7437 0915

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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Drug Tariff Watch The first section of the Drug Tariff is the Preface. This contains valuable information relevant for both the current edition and the next. It lists additions, deletions and any other alterations to the Drug Tariff. The Preface should ideally be checked each month to identify products which are entering or being removed from the Tariff as well as those products changing between categories or in the case of Category C items, changes to the brand used for pricing.

It is especially important to note which are Drug Tariff listed products as well as which category products are entering and the pack sizes being included in these entries, as reimbursement will be based on this classification and its endorsement requirements. Incorrect endorsement can lead to incorrect payment for items.

It is also important to know the category of an item when claiming certain payments (e.g. OOP expenses) as these are not allowed for some categories. For more information visit psnc.org.uk/oop Below is a quick summary of some of the changes due to take place from 1st May 2015 Part XVI - Notes on Charges Contractors should note: • changes made to People Entitled To Remission note 6.1.1; • changes made to the contact details of NHS Forms Orderline with regards to England; and • changes made to the Prescription Charge Refund Procedure with regards to Universal Credit arrangements.

Part VIIIA Additions Category C Additions: * This pack only (others already available) • Bisoprolol 5mg / Aspirin 75mg capsules (30) - Aspire Pharma Ltd • Bisoprolol 10mg / Aspirin 75mg capsules (30) - Aspire Pharma Ltd • Bisoprolol 5mg / Aspirin 100mg capsules (30) - Aspire Pharma Ltd • Bisoprolol 10mg / Aspirin 100mg capsules (30) - Aspire Pharma Ltd • Colecalciferol 20,000unit capsules (15)

Fultium-D3 • Colecalciferol 20,000unit capsules (30) • Colecalciferol 40,000unit capsules (10) Plenachol • * Morphine sulfate 30mg/1ml solution for injection ampoules (10) Martindale Pharmaceuticals Ltd • Progesterone 100mg pessaries (21) Lutigest Part VIIIA Amendments SC Special Container • Co-phenotrope 2.5mg/0.025mg tablets (100) is changing to Category C AMCo • Demeclocycline 150mg capsules (28) is changing to Category C AMCo • Ferrous fumarate 140mg/5ml oral solution (200ml) is changing to Category C AMCo • Flumetasone 0.02% / Clioquinol 1% ear drops SC (7.5ml) is changing to Category C AMCo • Flumetasone 0.02% / Clioquinol 1% ear drops SC (10ml) is changing to Category C AMCo • Fusidic acid 1% modified-release eye drops SC (5g) is changing to Category C AMCo • Indoramin 25mg tablets (84) is changing to Category C AMCo • Isosorbide mononitrate 25mg modified-release capsules (28) is changing to Category C Elantan LA25 • Liothyronine 20microgram tablets (28) is changing to Category C AMCo • Methadone 10mg/1ml solution for injection ampoules (10) is changing to Category C Physeptone • Methadone 50mg/5ml solution for injection ampoules (10) is changing to Category C Physeptone • Morphine sulfate 15mg/1ml solution for injection ampoules (10) is changing to Category C Martindale Pharmaceuticals Ltd • Olsalazine 250mg capsules (112) is changing to Category A • Olsalazine 500mg tablets (60) is changing to Category A • Oxprenolol 20mg tablets (56) is changing to Category C AMCo • Phenindione 10mg tablets (28) is changing to Category C AMCo • Phenindione 25mg tablets (28) is changing to Category C AMCo • Phenoxybenzamine 10mg capsules (30)

is changing to Category C AMCo • Sulfinpyrazone 100mg tablets (84) is changing to Category C AMCo • Sulfinpyrazone 200mg tablets (84) is changing to Category C AMCo • Tramadol 100mg/ml oral drops SC (10ml) is changing to Category C AMCo 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 price paid in future. * This pack only (others already available) • * Morphine sulfate 30mg/1ml solution for injection ampoules (5) Category A • Testosterone 30mg modified-release muco-adhesive buccal tablets (60) Category C Striant SR • Tragacanth powder (500g) Category C J M Loveridge 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.

• Coloplast Ltd Self-Cath plus (Male) (USCC10M-USCC16M) CH 10-16 (Female) (USCC8F-USCC16F) CH 8-16 • MANUKApli (15g) • Eyezin (10ml) preservative free bottle • Coloplast Ltd S Triform Leg Bags 350ml short tube 5350 750ml short tube with soft backing 5751 • CliniMed Ltd Soft-end Ties White 9760 30Hollister Ltd Moderma Flex with Lock ‘n’ Roll Closure Beige comfort backing on both sides 20mm 28120 (30) • Hollister Ltd Maxi - Conform 2 with Lock'n'Roll Closure Transparent with comfort backing on body side only N 35mm 23860 (30)

Need to know if an item can be dispensed on an FP10? Check on our database at: psnc.org.uk/FP10database

psnc.org.uk 11

Pricing Factsheet: Checking Your Prescriptions Before Submission

During the dispensing process, pharmacy teams should make sure that prescriptions meet certain requirements to ensure that the items on the prescription will be reimbursed correctly. This guide includes details of how prescriptions are scanned and tips on useful checks pharmacy teams can make.

Additional guidance 1. Determining whether a prescription form is valid: psnc.org.uk/prescriptionforms 2. Identifying prescribing rights: psnc.org.uk/prescribing 3. Checking eligibility for exemption from the prescription charge: psnc.org.uk/charges 4. Getting your prescription bundle ready to send: psnc.org.uk/submission

There MUST be a valid signature present on the form if the patient is exempt and there is no printed age/DOB.

A numeric entry in part 2 can cause inadvertent switching. Try to keep this box clear if the patient is exempt.

If the patient does not have any evidence of their exemption, ensure this box is ticked.

If there is no printed age or DOB, ensure the appropriate age exemption box or the correct exemption box is ticked.

The red highlighted areas below are the only parts of the prescription that are read by the Intelligent Character Recognition (ICR) software at the Pricing Authority once the form has been scanned. To ensure accurate payment please follow these tips and ensure that these areas are kept clear.

If using “Quadrant” checking stamps in this area, ensure they do not cover the age/DOB or NHS number of the patient.

Ensure your pharmacy stamp does not cover the age/DOB as this can affect switching.

All endorsements must be kept in this column and not encroach on the middle part of the form.

If the prescriber’s signature encroaches on any item on the form, it must be placed in the red separator.

Ensure that there is a Prescriber Cost Code present.

This number is now being read by the ICR; ensure it is filled in correctly.

The token and prescription illustrations are reproduced here with permission from the Department of Health. Subject to Crown copyright. They were the correct version as at the date of publication (April 2015), but medical professionals should check which versions are valid and in use at any given time and should not assume the versions printed are still valid.