April 2016 CPN

CPN

Community Pharmacy News – April 2016

Pharmacy gets behind the campaign Find out how community pharmacies across England have been helping the campaign for pharmacy’s future

How to report EPS issues | Ask PSNC | Next stage of Leadership Academy

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On the campaign trail LPCs and community pharmacy teams across the country have been working hard to support the campaign for the sector’s future. Here are details of just some of the work we’ve heard about.

Consultation period extended The Department of Health (DH) has confirmed its consultation on community pharmacy in 2016/17 and beyond is extended until 24th May 2016. Pharmacy minister Alistair Burt said the extension of the consultation would give more time for DH to develop its proposals working with PSNC and informed by other stakeholders. The extension is welcomed by PSNC who are seeking to understand more about the plans and to ensure that community pharmacy’s role is recognised and developed.

The national picture 350,000 signatures for the Downing

Over 100 patient case studies

Street petition

recorded by the National

by 1st April

Pharmacy Association

161 radio stations covered the story on the campaign media day

10,000 tweets were sent using the #pharmacy24 hashtag during the social media

(22nd March)

action day (24th March)

RE NU M BE RS

OS TS SIG NATU COMMUNIT Y SPIRIT BO n in support of ed the Downing Street petitio

ady sign ll Nearly 2,000 people have alre outh. Pharmacist Nat Mitche & Sons Pharmacy in Cockerm son Alli at ices serv cy nity rma mu pha ir local com support from patients and the and his team have found the overwhelming. petition,” says Nat, who rmacy specifically to sign the “People have come into the pha n from their friends, are hearing about the campaig goes on to explain that locals te to the local newspaper wro even a regular patient who was It urs. hbo neig and s relative piece on it. station, ITV Border, running a which led to the regional TV we’re doing a good job and ation “frustrating as we think Whilst Nat has found the situ reness of the work awa e rais ised that the key is to real has he ” s, pen hap this n the ients. He has arranged to talk do behind the scenes for pat community pharmacy teams rmers to try and highlight the previously spoken to sixth-fo to a business group and has role of pharmacy. community centre; for some t the pharmacy is more like a Patients often tell the team tha that. Nat is clear that e and you can’t put a pric on life, ial soc ir the of t par a it’s of them, s all community pharmacy y rely on us,” so he encourage “we rely on patients just as the g them in the campaign. to their patients and engagin teams to fight back by talking

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Press coverage helps secure local council support After reading about the plight of local pharmacies in The Yorkshire Post, one councillor was determined to get behind the campaign and, at the end of March, Leeds City Council passed a motion in support of community pharmacies, promising to defend this vital resource from ‘counter-intuitive’ Government proposals.

It was Councillor Stewart Golton who put forward the motion after visiting Garners Pharmacy in the Rothwell area of Leeds. During his visit Cllr Golton was shown how the Department of Health’s plans would affect pharmacy and patients. He also spoke to Community Pharmacy West Yorkshire’s Chief Officer Robbie Turner about the ‘Support Your Local Pharmacy ’ campaign.

Leeds City Council now plans to respond to the Government's consultation and write to the

pharmacy minster to set out its specific concerns. Council members are also calling on Leeds MPs and other local government teams to join them in their mission to protect this vital service.

Cllr Golton said: “As a member of the local Health and Wellbeing Board with a keen interest in the prevention of ill health, I think local pharmacies are the key to the future of public health. Pharmacy should be the first port of call as it is the most accessible healthcare provider.

But when I read about these plans, I thought they were counter-intuitive: whilst on the one hand saying local pharmacies having an important role, these proposals will take them out of the very communities that rely on them.

This is the same as what happened with the post offices – it’s a death knell for the high street.”

Working with CCG creates promotional opportunity

When Northern, Eastern and Western Devon Clinical Commissioning Group (CCG) wanted to create a newsletter article reminding the public about community pharmacy services available over Easter, they turned to Devon LPC. Keen to make the most of this opportunity, Boots representative Tom Kallis worked with the CCG to develop a ‘day in the life of a pharmacist’ piece.

their communities inspired the idea to further bring attention to the work involved in community pharmacy. He decided he wanted to outline exactly what a ‘typical’ day might look like for a pharmacist so people would understand what they would miss if their pharmacy was no longer there. The article has since been published on the CCG’s website (dld.bz/eyc2c), leading to further attention via social media.

Tom’s prior involvement with a BBC Radio Devon show discussing what the cuts will mean for local pharmacies and

Leading on from the success of the article, LPC Chief Officer Sue Taylor has organised a visit to a pharmacy in Chagford, central

Devon, with a local BBC journalist to go one stage further and show them a ‘day in the life of a community pharmacy’, with an emphasis on how their day to day work supports their rural community.

Tom has seen first-hand how useful local media can be as a campaigning tool and his top campaign tip for LPCs is to build a relationship with your local media providers. In particular, Tom suggests learning their news cycles as experience has taught him, “they willt be hungry for press releases during their quieter periods”.

Keep up the good work!

PSNC and the other national pharmacy organisations would like to thank community pharmacy teams and LPCs for all their hard work so far, but please continue to raise awareness by:  Backing the Downing Street petition: ask patients to sign the petition and direct them to supportyourlocalpharmacy.org (materials can be download from that website).  Sharing case studies: collect examples that demonstrate where you have offered exceptional care to patients. These can be emailed to your LPC or campaign@psnc.org.uk.  Posting on social media: share anything you like to show how much of a positive difference you are making to your patients and don’t forget to use the hashtag #lovemypharmacy.

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Community pharmacy regulations update The regulations governing the NHS community pharmacy contract must be followed by all contractors so it is important to be aware of any amendments made and when they come into effect.

Pharmacy premises standards The Pharmacy (Premises Standards, Information Obligations, etc) Order 2016 came into effect on 12th April 2016. This enacted a number of changes surrounding the setting of standards for the safe and effective practice of pharmacy, and for the enforcement of those standards.

Key amendments to The Medicines Act 1968 and Pharmacy Order 2010 include: • the removal of the requirement for the General Pharmaceutical Council (GPhC) standards for registered pharmacy premises to be set in rules; • applying the standards to the delivery of pharmacy services as well as to pharmacies; • revising the sanctions which the GPhC may use where pharmacy owners breach the standards; • introducing the use of interim suspension orders by the GPhC against pharmacy owners when that is in the public interest; • changes to the GPhC’s powers to gather information from pharmacy owners; and • clarity as to what information the GPhC may publish in its reports of pharmacy inspections*. *The GPhC can publish reports of the inspections and other visits that its inspectors make, and these reports may include an account of the outcomes of such inspections and visits.

Changes to incorporate SCR access and NHS fraud checking Community pharmacy contractors should be aware of the following amendments to the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013: Summary Care Record From 1st April 2016, the Terms of Service require community pharmacists who have access to the Summary Care Record (SCR) to access this if they consider, in their clinical judgment, that it is in the best interests of the patient to do so.

Guidance on accessing the SCR can be found at: dld.bz/eus2v Prescription charge exemption anti-fraud measures From 1st July 2016, anyone who does not produce evidence of their entitlement to exemption from NHS prescription charges must be informed by a member of the community pharmacy team that NHS checks are routinely undertaken to verify exemptions.

Hub and Spoke consultation launched The Department of Health and the Medicines and Healthcare products Regulatory Agency (MHRA) have launched a consultation on changes to the Human Medicines Regulations and the Medicines Act. The consultation, which runs until 17th May 2016, seeks views on allowing independent pharmacies to make use of 'hub and spoke' dispensing models. Additionally, the consultation seeks views on publishing the price of medicines on dispensing labels. It also seeks to clarify the current dispensing label requirements for monitored dosage systems and medicines supplied under Patient Group Directions.

Find out more about the consultation at: dld.bz/ew9kk

NHS stationery ordering portal Primary Care Support England's (PCSE) online portal for ordering NHS stationery has gone live, and all community pharmacy contractors should have received registration letters. If any queries arise, the PCSE website has a number of helpful FAQs: pcse.england.nhs.uk/help One query that has been raised a number of times is "Will I be charged for my order?" This question has arisen because the online ordering portal includes prices for many of the items. As stated in the relevant FAQ, contractors will not be charged for standard orders made using the portal. PCSE is committed to ensuring NHS England supplies are ordered responsibly and for this reason, prices for items are included to help contractors make an informed decision about what they need. (Note, there may be a charge for urgent supplies.)

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Reporting EPS issues Community pharmacy teams will sometimes experience issues with the Electronic Prescription Service Release 2 (EPS R2) system. Here we explain all you need to know about reporting these issues.

All EPS system issues need to be reported to pharmacy system suppliers. In some cases, the problem may be resolved over the phone, for example, if it is a training or local IT system configuration problem. In other cases, the supplier may need to add it on to their work-plan as a future development.

TOP TIP: When reporting an EPS issue to your system supplier, ask for a helpdesk reference number. If the supplier does not resolve the problem in a satisfactory way, the reference number is required to escalate the problem via other routes.

Where the supplier is unable to resolve a problem due to it being outside of their control – for example, if it is an issue with the GP system or with national IT infrastructure – the pharmacy supplier should: (a) escalate the issue to the Health and Social Care Information Centre (HSCIC)'s National Service Desk (NSD) to co-ordinate resolution; and (b) report progress back to the pharmacy, including providing the HSCIC national incident number (NIN).

This diagram illustrates how the EPS service model operates:

GP system supplier

Higher Severity Services Incident (HSCIC Service Bridge) NSD coordinates with relevant parties EPS issues

Pharmacy team need to report EPS national/local or system issue

ic Electron ion Prescript Service

Pharmacy System supplier – note helpdesk reference number

National Service Desk (NSD)

HSCIC Spine team

Escalation and complaints Message handler of pharmacy system supplier

nhs.uk

Smartcard issues

Problems with accessing services from your Registration Authority (RA) see psnc.org.uk/ra

N3

How to identify issues with the national EPS systems PSNC recommends pharmacy staff use the following three EPS tools: Alerts Register to receive text or email alerts in the event that the national HSCIC systems supporting EPS are experiencing issues at: tinyurl.com/Spinealerts

Checker Visit the HSCIC service status checker webpage (Smartcard required) for the status of national systems at: tinyurl.com/EPSchecker

Tracker Find information on the status of individual prescriptions using the EPS Prescription Tracker at: tinyurl.com/EPStracker

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The first step towards leadership PSNC’s leadership development programme for LPCs began last month and here we find out what two trainees have been up to so far.

Andy Beardshall

Sarah Wood

Vice Chair of Barnsley LPC, Andy Beardshall, hopes that the PSNC Leadership Academy programme will guide him on how to make the most of his role so he can better represent community pharmacy contractors.

When the PSNC Leadership Academy programme was announced, Bury and Rochdale LPC’s Sarah Wood was intrigued and – with a little encouragement from her LPC Chair and Chief Officer – she applied.

Compared to some LPCs, Barnsley is quite small so Andy has found it difficult to bounce ideas off others and is therefore eager to use this opportunity to gain insight and help drive him, and his LPC, forward.

During the first training session on 3rd March, Andy says he was inspired by the others in the group and has already taken forward an idea for LPC members to visit contractors prior to each LPC meeting.

Course leader Rachel Harrison has also given Andy personalised support and helped him to develop a strategy plan as part of his one-to-one coaching session in preparation for the next training session later this month. Andy’s goal is to become an LPC Chair or Chief Officer and, one day, hopes to be elected a PSNC Regional Representative.

Sarah found comparing different leadership styles during the training session really useful and found it reassuring to discover that, whilst every LPC was different, they were all facing the same challenges.

Public speaking is an area Sarah has identified as needing improvement and she has begun looking for opportunities to practice. Sarah’s first step was to give a talk about her pharmacy career at a University of Manchester alumni event and she was delighted to receive positive feedback, including the event organiser posting an endorsement on her LinkedIn page.

During her one-to-one session, Sarah found course leader Rachel’s coaching style helped her consider what she needed to do to achieve her goals and create a plan, making her feel more confident in her own abilities. Sarah sees herself moving into an LPC leadership role in the next year or two.

138 patients helped by anticoagulant service in 6 months Six months after the launch of Swindon’s New Medicine Service (NMS) anticoagulant referral service with Great Western Hospital, 138 patients have been referred into the service.

When Fiona Castle, Chief Officer of Swindon and Wiltshire LPC, delivered a presentation to GPs promoting the role of community pharmacy teams in supporting patients prescribed anticoagulants, it served to highlight that many were not receiving an NMS because they were not being referred by the hospital team. Fiona approached Great Western Hospital about this and the LPC worked closely with the hospital team to develop an NMS referral service for patients who were prescribed anticoagulants.

In 15 cases so far, the pharmacist reported that the interaction had improved the patient’s knowledge, confidence or ability to continue taking their medicine and nearly all of the pharmacies involved have found the referral process useful.

LPCs supported by PSNC media training As the campaign for community pharmacy digs in for the long term, LPCs need to use the media effectively to keep up the pressure and maintain interest – as well as responding quickly when approached for an interview or comment.

To help make sure LPCs have the necessary skills to handle media and get the best coverage for contractors, PSNC commissioned leading communications agency Luther Pendragon to provide training specific to running and managing a local campaign. During February and March, training was held in the north of England, the Midlands and London.

For the latest news on the work your LPC is doing to support your interests in this challenging time, check out your LPC website via our portal: lpc-online.org.uk

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The Mental Capacity Act The Centre for Pharmacy Postgraduate Education (CPPE) is working to guide and advise pharmacy professionals in supporting patients who lack capacity to make particular decisions.

We have developed a new workshop – The Mental Capacity Act 2005 and covert administration of medicines.

“

The General Pharmaceutical Council (GPhC) Guidance on Consent states ‘Every adult is presumed to have capacity to make their own decisions (that is, they are competent) and to give consent for a service or treatment unless there is evidence to suggest otherwise.’

Paula Higginson Lead Pharmacist, Learning Development

However, some adults may permanently or temporarily lack capacity to make these decisions. The Mental Capacity Act 2005 provides a legal framework for people who lack capacity to make decisions for themselves. It sets out who can take decisions, in which situations, and how they should go about this. The Act is intended to be enabling and supportive of people who lack capacity, not restricting or controlling of their lives. It aims to protect people who lack capacity to make particular decisions, but also to maximise their ability to make decisions, or to participate in decision-making, as far as they are able to do so.

Pharmacy professionals and their teams in the community might encounter situations concerning mental capacity during their practice and an area where this can be challenging and discussions can be difficult is the covert use of medicines.

Our new workshop The Mental Capacity Act 2005 and covert administration of medicines will offer you the opportunity to work through various covert administration scenarios where patients may have permanent or temporary lack of capacity. You will have the opportunity to discuss these scenarios with your peers and also to be given guidance from a local expert.

If you are not familiar with the five statutory principles that underpin and your responsibility to comply with the Mental Capacity Act 2005 you would benefit from attending one of our local workshops. You can book your place on our website: www.cppe.ac.uk.

”

Pharmacy services: recently published resources NHS Standard Contract 2016/17 NHS England has published the following documents which may be of interest: • NHS Standard Contract 2016/17; • NHS shorter-form Contract 2016/17 (for use in defined circumstances); • NHS Standard Contract 2016/17 Technical Guidance (providing an overview of the key changes which have been made); • Sanctions reporting template; • Sustainability and Transformation Fund Service Development Improvement Plan template; and • Equality Impact Analysis.

LGA highlights role of pharmacy The Local Government Association (LGA) has published The community pharmacy offer for improving the public’s health, a briefing for councillors and commissioners, describing the increasing role of community pharmacy in public health and explains councils’ roles and duties.

A number of case studies are included within the briefing that demonstrate the variety of collaborative approaches taken by community pharmacies working with councils and other community partners, as well as key information on Healthy Living Pharmacies (HLPs) and the approach of Making Every Contact Count to improve health and reduce health inequalities.

Find out more at: tinyurl.com/NHScontract201617

The briefing can be downloaded from: dld.bz/ewNWy

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:

Healthy Living Pharmacy infographics Public Health England (PHE) has published a set of infographic slides to illustrate the role of HLPs in the health and care system.

The three infographic slides aim to explain what an HLP is by highlighting the features that make up an HLP, using statistics to demonstrate the impact that they are having across the country, and providing the total number of HLPs and qualified health champions across England.

The infographics can be downloaded from: dld.bz/ewNyF and further information on HLPs can be found at: psnc.org.uk/hlp

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

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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. For a more comprehensive round-up, please visit: psnc.org.uk/hclbriefings

20,000 places to be made available nationwide in NHS Diabetes Prevention Programme

Alcohol-specific deaths have decreased by 3% between 2012 and 2014 In the news • The NHS Diabetes Prevention Programme, the world’s first such scheme, is due to start its first wave.

Across 27 areas, there will be 20,000 places available, rising to an expected 100,000 places to be made available across the whole country in subsequent years.

• Public Health England (PHE) is supporting the creation of ten ‘healthy new towns’ as test sites across the country, potentially covering 170,000 residents from more than 76,000 new homes.

• NHS England has allocated £55 million to reward GPs and hospitals to make digital referrals by 2018 and end the practice of referring via post. At the moment, around 50% of patients are referred for hospital appointments electronically, but it is intended for this to increase rapidly to 100% by 2018.

Evaluations and statistics • PHE’s latest figures show that alcoholrelated deaths such as heart disease and certain cancers, have increased from the years 2012 to 2014, but alcohol-specific

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£55 million allocated

by NHS England to encourage GPs and hospitals to make digital referrals by 2018

Antibiotic prescribing has fallen by 2 million since the introduction of financial incentives

deaths have decreased by 3%. This data comes from PHE’s Local Alcohol Profiles for England (LAPE) tool.

• The introduction of financial incentives in April 2015 by NHS England and PHE has seen antibiotic prescribing fall by two million, in comparison to the same period in 2014.

• The research paper, Estimating the population impact of e-cigarettes on smoking cessation in England, suggests that 2.5% of the smokers who used an ecigarette in their quit attempt succeeded, would have failed if they had used nothing or used a licensed nicotine product.

Useful resources • The National Institute for Health and Care Excellence (NICE) has published its Medicines optimisation quality standard (dld.bz/ewMRg). NICE quality standards describe high-priority areas for quality improvement in a defined care or service area, drawing on existing guidance, which provides an underpinning, comprehensive set of recommendations.

• PHE has published its fourth edition of

Health Matters (dld.bz/ewMRq), focussing on midlife approaches for reducing the risk of dementia. The PHE resource includes a wealth of information, plus a pack of infographics to help when highlighting the risks of dementia in local areas.

• The House of Commons Library has published a briefing, The structure of the NHS in England (dld.bz/ewMRB), which provides an overview of the funding and accountability relationships under the new system, and an introduction to the roles of key organisations.

• NICE has published a guideline covering community engagement approaches (dld.bz/ewMR3) to reduce health inequalities, ensure health and wellbeing initiatives are effective and to help local authorities and health bodies meet their statutory obligations.

• PHE has published Child Health Profiles 2016 (dld.bz/ewMR7) to present data across 32 key health indicators of child health and wellbeing. They are designed to help local authorities and health services improve the health and wellbeing of children and tackle health inequalities.

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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.

Error with some EPS R1 prescriptions

PSNC has been made aware of an error with the Electronic Prescription Service (EPS) that allowed some GP practices to send Schedule 2 and 3 Controlled Drug orders via Release 1 (barcoded) prescriptions, which should not occur.

The relevant GP system has implemented a fix, but if you are presented with an affected prescription:

dispense the prescription as if it had been a paper one – the paper element is the legal one and both words and figures appear on the physical prescription; and avoid scanning the barcode, but if you do, this will not cause an issue.

Want to share something from PSNC's website with your colleagues?

Look out for the se buttons

Our new social media buttons make it so much easier

Useful links for NHS IT information

Popular factsheets

The following are PSNC’s most popular factsheets. Community pharmacy teams may find these useful to print them out for future reference:

psnc.org.uk/sc

Checking Prescription Exemption Status (dld.bz/d9pYc)

National target Groups for MUR s (dld.bz/ewZTR)

NMS Medicines List (dld.bz/ewZT W) Community Pharmacy Value Flyer (dld.bz/esSkb)

ins This section of the PSNC website conta nts geme arran a summary of the national n about for NHS Smartcards and informatio . them ister admin how to psnc.org.uk/scrlist

This links straight to PSNC’s Summary Care Record implementation checklist. psnc.org.uk/epstime

ding the This links straight to PSNC’s “Understan heet. facts EPS payment schedule”

Do you report your dispensing figures to your accountants each month?

Set them up on Check34 and let their fingers do the walking.

Set up a regular financial report for your business 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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Changes regarding prescription pre-payment certificates Community pharmacy teams should be aware that the change to the NHS prescription charge also has an impact on PPCs; patients may ask you about what this means for them.

Following last month’s announcement that the NHS prescription charge will increase to £8.40 per item from 1st April 2016, the April 2016 Drug Tariff also highlights a change regarding prescription pre-payment certificates (PPCs).

Although the cost of a PPC remains at £29.10 for three months and £104 for 12-months, the Drug Tariff (Notes on Charges) now states: “They are worthwhile for anyone requiring 13 or more items in 12 months or 4 or more items in three months. For the convenience of patients, pharmacists are asked to hold PPC application forms FP95 (which are also available from 0300 123 0849).”

Pharmacy teams may want to highlight this information when discussing PPCs. Find out more at: psnc.org.uk/externalresources

Experiencing supply issues?

Pharmacy teams who experience problems in obtaining medicines (generic or branded) or appliances are reminded to feed this back to our Dispensing and Supply Team, to support PSNC’s ongoing representation of issues in the supply chain.

PSNC passes a monthly summary of the feedback received to the Department of Health to support their monitoring of the situation. This information is also used as an evidence base in discussions with manufacturers on manufacturer-specific problems, for example, highlighting problems with contingency arrangements and promoting solutions.

Please make sure you let us know about any supply issues by using our online feedback forms at: psnc.org.uk/feedback

Establishment and Practice Payments The current Establishment and Practice Payment levels have been extended until 30th June 2016.

Pharmacies dispensing more than 2,500 items per month will continue to receive an Establishment Payment plus a Practice Payment of 56.4p per item.

Find out more at: dld.bz/exnBh

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 allowed, the contractor 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. Below is a list of some products 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

XLS-Medical Fat Binder Tablets

No

Yes

n/a

No

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

Allergenics Skin lotion

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.

Oralieve moisturising mouth gel

Yes

Yes

n/a

Yes

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

Acticoat Absorbent dressing 10cm x 12.5cm rectangular

No

Yes

n/a

No

This item is a medical device and is no longer 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 provide 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. A patient has presented a prescription for two items but says they only one; how should I mark the item Not Dispensed?

Where an item is not dispensed, it must be clearly annotated to ensure prescriptions are correctly priced by the Pricing Authority.

For paper prescriptions — endorse “ND” in the left hand endorsement column and score through the item in the prescribing area completely (see diagram below). Please note that if the item is not scored through completely it could potentially be read by the Pricing Authority's intelligent character recognition software, which could lead to an overpayment. Any overpayments made could be recovered from your account if it is re-checked or audited.

Number of days’ treatment N.B. Ensure dose is stated

NHS Number:

Endorsements

ND

Omeprazole 20mg dispensible gastro-resistant tablets 28 tablets Take one daily

For EPS Release 2 prescriptions — use your PMR system to apply the “ND” endorsement to the electronic message. If you are unsure how to do this, you should speak with your system supplier. Please note that it is not correct practice to mark a dispensed quantity of zero, and mark such an item as dispensed.

2. A patient has presented a prescription for '28 x 5mg tablets'.

The 5mg strength is unavailable as it is in short supply; however, I do have '56 x 2.5mg tablets' in stock. As this is the same amount of drug i.e. 5mg which can be administered at the prescribed dose by doubling the number of tablets; can I dispense 56 x 2.5mg tablets against this prescription instead?

No. It is part of the Terms of Service that community pharmacy

contractors must, with reasonable promptness, “provide drugs so ordered” once a prescription has been presented. “Drugs” includes medicines e.g. the tablets. In this scenario, the patient has presented a prescription for 28 x 5mg tablets and therefore supplying 56 x 2.5mg tablets would not be providing the drugs “so ordered”.

If you intend to dispense 56 x 2.5mg tablets then the prescription would need to be amended or a new prescription would need to be issued by the prescriber at the prescriber’s discretion. It would also be essential to ensure the patient understands the different dosage to be taken if there were an amendment to their prescription.

3. I have received a prescription for Sando-K effervescent tablets which comes as a pack of 100 in tubes of 5 x 20 tablets. If I receive a prescription for 20 tablets can I claim broken bulk for the 100 tablets?

No; Sando-K effervescent tablets have a special container status, and as such, you cannot claim broken bulk (BB) on special containers. In this scenario, the sub-pack of 20 is a special container and falls under the special container rules therefore, you will be reimbursed for 20 tablets.

4. How do I make a broken bulk claim on an EPS R2 prescription?

Your pharmacy system should enable you to make a broken bulk (BB) claim through manual endorsement against the item during the dispensing process. If you are unclear on how to do this, refer to your pharmacy system manual or speak with your pharmacy system supplier for guidance.

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 (0844 381 4180 or 0203 1220 810 or e-mail info@psnc.org.uk).

Removal from Part VIIIB Sodium chloride 292.5mg (1mmol/ml) oral solution has been removed from Part VIIIB of the Drug Tariff as of 1st March 2016.

There is now a listing for a licensed alternative, Sodium chloride 292.5mg (1mmol/ml) oral solution sugar free 100ml which can be found in Part VIIIA as a Category C line.

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

© PSNC

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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 May 2016. You may also wish to see our Dispensing Factsheet: The Drug Tariff Preface at psnc.org.uk/dtresources Part XVI – Notes on charges Please see the article about prescription pre-payment certificates on page 10.

Part VIIIA additions SC Special Container Category A Additions: • Midazolam 10mg/2ml solution for injection ampoules (10) Category C Additions: • Aripiprazole 1mg/ml oral solution (150ml) – Abilify • Denosumab 60mg/1ml solution for injection pre-filled syringes SC (1) – Prolia • Ibuprofen 200mg capsules (30) – Nurofen Express • Lidocaine 2.5% / Prilocaine 2.5% cream SC (30g) – Emla • Lithium carbonate 400mg modifiedrelease tablets (100) – Priadel • Propranolol 10mg/5ml oral solution sugar free (150ml) – Syprol

• Propranolol 40mg/5ml oral solution sugar free (150ml) – Syprol • Propranolol 5mg/5ml oral solution sugar free (150ml) – Syprol • Propranolol 50mg/5ml oral solution sugar free (150ml) – Syprol • Sodium alginate 500mg / Potassium bicarbonate 100mg chewable tablets sugar free (60) – Gaviscon Advance • Sodium valproate 100mg modifiedrelease granules sachets sugar free (30) – Epilim Chronosphere • Sodium valproate 1g modified-release granules sachets sugar free (30) – Epilim Chronosphere • Sodium valproate 1g modified-release granules sachets sugar free (100) – Episenta • Sodium valproate 200mg modifiedrelease tablets (100) – Epilim Chrono • Sodium valproate 250mg modifiedrelease granules sachets sugar free (30) – Epilim Chronosphere • Sodium valproate 300mg modifiedrelease tablets (100) – Epilim Chrono

• Sodium valproate 500mg modifiedrelease granules sachets sugar free (30) – Epilim Chronosphere • Sodium valproate 500mg modifiedrelease granules sachets sugar free (100) – Episenta • Sodium valproate 750mg modifiedrelease granules sachets sugar free (30) – Epilim Chronosphere • Tamoxifen 10mg/5ml oral solution sugar free (150ml) – Soltamox • Verapamil 40mg/5ml oral solution sugar free (150ml) – Zolvera 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’)–but it will need to be endorsed fully (i.e. brand or supplier name and the pack size from which the item was dispensed).

• Co-phenotrope 2.5mg/0.025mg tablets (100) Category C – AMCo

Part IX deletions Remember, if you dispense a deleted appliance, payment will not be made for dispensing the item.

Product HydroSil rose catheter Acticoat Absorbent dressing Tegaderm Hydrocolloid dressing Tegaderm Contact dressing Cutimed Sorbact Hydroactive B dressing Duratouch dressing Accuseal leg bag extension tube Biotrol Elite colostomy bag with filter Biotrol Elite Petite colostomy bag with filter Biotrol Integrale colostomy bag with filter Biotrol Almarys Preference colostomy bag with filer Biotrol Almarys Quiet colostomy bag with filter Welland FreeStyle Flushable colostomy bag with Dual-Carb filter Biotrol Almarys Optima Drainable bag Biotrol Almarys Optima Drainable bag with filter Biotrol Elite ileostomy bag

Size, type and product code Female, CH8 (71408) 2cm x 30cm Square, 15cm x 15cm 7.5cm x 20cm 20cm x 20cm 5cm x 7cm, 8cm x 10cm and 12cm x 15cm S455 Transparent, 30mm (30-830) and White, 60mm (32-860) Beige, 30mm (37-330) and 40mm (37-340) White, 30mm (32-430) Beige, 35mm (F008335E) Beige, 45mm (F008145E) and 60mm (F008160E) All sizes Beige, 30mm (F008730E), 35mm (F008735E) and 40mm (F008740E) Beige, 25mm (F009525E) Beige, 50mm (38-850) and White, 40mm (34-840) and 45mm (34-845)

Biotrol Elite Petite ileostomy bag Beige, 25mm (37-725) Softima drainable pouch with filter Beige, 32mm (043732E), 36mm (043736E) and 45mm (043745E) Softima Key two piece ostomy system (Drainable Pouch with filter) Transparent, 40mm (63440E) and 60mm (63460E)