April 2018 CPN

CPN

Community Pharmacy News – April 2018

Pharmacy funding levels maintained

Interim arrangements agreed to protect current funding distribution systems prior to negotiations Getting to grips with GDPR | Care Plan evaluation | Prescription penalty resources

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

Interim Funding Arrangements agreed for 2018/19 Single Activity Fee stays the same whilst there are some changes to the gateway criteria for the Quality Payments Scheme.

Community pharmacy fees and allowances will remain unchanged from April as part of interim funding arrangements, the Department of Health and Social Care (DHSC) has confirmed.

• Opening hours on NHS Choices must include Bank Holidays; and • The requirement for the pharmacy to be able to send and receive NHSmail should be from a shared NHSmail account.

The arrangements have been agreed to protect current funding distribution systems pending the start of substantive negotiations with PSNC on community pharmacy funding for 2018/19.

Contractors must read the briefing on these two changes here: ow.ly/MzbJ30jaRpJ

For now, funding levels will be maintained at the 2017/18 level, with no changes to the Single Activity Fee (SAF), Establishment Payments or Pharmacy Access Scheme (PhAS) payments.

This means that the SAF will remain unchanged at £1.29, and pharmacies receiving PhAS payments will continue to do so with monthly payments from April 2018 the same as those made in the last financial year.

NHS England is, however, making two changes to the gateway criteria for Quality Payments:

As previously announced, NHS England has confirmed that the Community Pharmacy Seasonal Influenza Vaccination Advanced service will be re-commissioned for 2018/19.

Further information will be posted on the PSNC website as soon as it is available.

NHS England and DHSC also wish to have discussions with PSNC about moving forwards with the implementation of EPS Phase 4. It is expected that a pilot will commence in Autumn 2018.

The interim arrangements have been put in place because the DHSC and NHS England are not yet in a position to begin negotiations for 2018/19. PSNC has put forward proposals about how it wishes to develop future community pharmacy

services, and we hope to begin formal negotiations soon.

PSNC discussed the DHSC’s proposals for interim arrangements at its January meeting, noting that many of the elements had formed part of the imposition to which PSNC remained opposed.

PSNC Chief Executive Sue Sharpe said: “We hope to commence negotiations with the NHS for 2018/19 community pharmacy funding very shortly, and we hope this will include discussion on PSNC’s proposals for the development of community pharmacy services. As yet we cannot speculate on the negotiations, but our objective will be to agree arrangements that will safeguard the future of this invaluable network of healthcare providers.”

Quality Payments: the 2017/18 reconciliation payment The 2017/18 Quality Payments Scheme included the potential for a reconciliation payment at the end of the year, which would distribute any remaining money from the £75m funding to contractors that had participated in the scheme.

PSNC has audited the Pricing Authority’s payments to contractors for the scheme and calculated the likely value of the reconciliation payment as £7.71 per point achieved, meaning that the full value of each point within the scheme would be £71.71. The reconciliation payment will be paid automatically in the full payment for March 2018’s submission to the Pricing Authority; contractors do not have to claim it.

Quality Payments: Edit or validate your NHS Choices entry now For the June 2018 Quality Payments review point, community pharmacy contractors are required to edit or validate the three sections of their pharmacy’s NHS Choices profile between 0:00 on 9th April 2018 and 11.59pm on 29th June 2018 to meet the gateway criterion.

Contractors must validate their profile even if it is correct otherwise they will not meet the gateway criterion and will therefore not be entitled to claim for a Quality Payment.

2 Community Pharmacy News – April 2018

Contractors must edit or validate: • their opening hours, including for Bank Holidays (new); • the facilities the pharmacy provides e.g. consultation room, parking etc; and • the services the pharmacy provides e.g. Medicines Use Reviews (MURs), New Medicine Service (NMS), etc.

Further information, including details of the process for distance selling pharmacies, can be found at: psnc.org.uk/QPNHSChoices

SER

RVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

PSNC’s WORK

GDPR guidance for community pharmacies PSNC publishes a series of guidance documents, alongside other support materials, to assist community pharmacy contractors in working towards GDPR compliance.

A series of guidance documents has been published to assist community pharmacy contractors in working towards General Data Protection Regulation (GDPR) compliance.

The materials, created by the cross-sector Community Pharmacy GDPR Working Party of which PSNC is a member, discuss each of the different elements of the GDPR and how they apply to community pharmacy.

They consist of: Guidance for Community Pharmacy (Part 1): this should help contractors to understand the GDPR requirements, and it sets out the steps they will need to take to comply.

Guidance for Community Pharmacy (short version) (Part 2): this has been made available to assist with staff training.

Workbook for Community Pharmacy (Part 3): this contains a set of editable templates that contractors can use to show that they are meeting all the GDPR requirements.

FAQs for Community Pharmacy (Part 4): this provides simple answers to key questions on the GDPR. All the guidance documents can be downloaded from: psnc.org.uk/GDPR Contractors should be reassured that whilst the GDPR brings a new approach to data protection, much of what becomes mandatory has been good practice in the

past and pharmacy teams are used to managing personal data and are subject to considerable information governance (IG) requirements already.

To keep things as straightforward as possible, the new guidance is underpinned by the mnemonic DATAPROTECTED, giving 13 steps as the route to compliance: 1. Decide who is responsible 2. Action plan 3. Think about and record the personal data you process 4. Assure your lawful basis for processing 5. Process according to data protection principles 6. Review and check with your processors 7. Obtain consent if you need to 8. Tell people about your fair processing notice 9. Ensure data security 10. Consider personal data breaches 11. Think about data subject rights 12. Ensure privacy by design 13. Data protection impact assessment As everybody is still getting to grips with the GDPR, there is much still to be clarified both before and after the 25th May 2018; in her blog, the Information Commissioner Elizabeth Denham admits that “GDPR compliance will be an ongoing journey”. Therefore, this guidance should be considered a starting point and we will update it as issues are clarified.

The working party is also happy to accept questions, which may be sent to any of the member organisations and selected questions with answers will be added to the FAQs document.

Further PSNC support GDPR webinar now on-demand More than 600 people tuned in to PSNC’s recent webinars on complying with the GDPR and community pharmacy contractors can now access an online recording at: psnc.org.uk/GDPRwebinar During each webinar PSNC Director of Operations and Support, Gordon Hockey, explained what the GDPR means for the average pharmacy business, outlined the steps contractors will need to take to comply, and highlighted the templates that PSNC has developed as part of the cross-sector GDPR working group.

Getting to grips with GDPR A series of articles, written by PSNC Director of Operations and Support Gordon Hockey, has been developed to provide further support for contractors and accompanies the GDPR guidance and contractor workbook.

A new article will be published each week and links to all the articles will be available at: psnc.org.uk/GDPR

PSNC presses for DPO exemption for smaller pharmacies PSNC, the National Pharmacy Association, the British Dental Association and the Optical Confederation have written an open letter to the Government requesting that NHS primary care providers, including community pharmacies, are exempted from a section of the UK Data Protection Bill which will accompany the GDPR.

Currently the Bill will require all primary care providers to appoint a Data Protection Officer (DPO), but PSNC considers the requirement for a DPO to be inappropriate for smaller pharmacy businesses, where the costs of engaging a DPO are likely to be disproportionate to the benefits. Read the joint letter at: ow.ly/s1U930j5VK2

psnc.org.uk 3

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

Care Plan service demonstrates significant benefits Evaluation shows Care Plan service can deliver significant clinical and economic benefits to both patients and the NHS. A research paper on the Community Pharmacy Future Pharmacy Care Plan service has been published in Research in Social & Administrative Pharmacy.

The paper details the evaluation and cost-effectiveness of the service and concludes that the service increases levels of patient activation, self-reported adherence to their medication and selfreported quality of life. The study and its results show that this new patient-centred model of care, is cost-effective, empowers patients to manage their own condition, and supports the NHS self-care agenda.

The service was a demonstrator pilot which took place in community pharmacies in West Yorkshire, aimed at patients with long-term conditions. Each eligible patient had one-to-one discussions with a pharmacist to explore and identify personalised health goals and agree on actions, as well as discussing optimisation of the use of their medicines.

The service used validated clinical tools to support the provision of care to the patient, such as the Patient Activation Measure (PAM), which assesses the knowledge, skill and confidence a person has in managing their own health and health care.

The health economic analysis results suggest that the service can be considered to be cost effective. NICE refers to a cost effectiveness threshold value of £20-30k per QALY with an ICER of below £20k being considered value for money; the ICER for the service was estimated to be £8,495 per QALY suggesting that it is a cost-effective solution for the NHS.

Pharmacists beat last year’s flu vaccinations total Community pharmacy teams have proved they can deliver yet again by administering at least 240,000 more flu vaccinations under the national Flu Vaccination Service in 2017/18 than in the previous year, as well as exceeding the one million vaccinations mark.

Data received from PharmOutcomes, Sonar Informatics and Healthi has confirmed that this season pharmacy teams have administered almost 1.2 million vaccinations, although the total number of vaccinations administered will be even higher as some pharmacy teams have not used the electronic systems to record administration of vaccines.

4 Community Pharmacy News – April 2018

What does the evaluation show?

38 community pharmacies involved

93% agreed one or more health goals with the pharmacist

378 patients supported through the service

Nearly 40% of those patients achieved one or more of their health goals

The research was conducted by the Community Pharmacy Future group (Boots UK, LloydsPharmacy, Rowlands Pharmacy and Well) and academics from the University of East Anglia. The Pharmacy Care Plan is an evolution of the two successful support services evaluated in 2013/14 that evidenced significant improvements in quality of life and medicines adherence, with health economic benefits.

Further details on the previous research is available at: communitypharmacyfuture.org Alastair Buxton, Director of NHS Services at PSNC said: “The publication of this research supports PSNC’s development proposals for the contractual framework, which we have recently submitted to DHSC and NHS England. A Community Pharmacy Care Plan service sits at the centre of our proposals, which is based on the approach taken in the Community Pharmacy Future II project. This research takes us one step closer to making the proposals set out in the Murray Review and the Community Pharmacy Forward View a reality.”

Flu Vaccination Service 2018/19 orders Earlier this year, NHS England advised that for the 2018/19 flu vaccination campaign adjuvanted trivalent influenza vaccine (aTIV) (Fluad, Seqirus) should be offered to all those aged 65 and over.

Seqirus, the manufacturer of aTIV, has said that deliveries to both pharmacies and general practices will need to be phased with 4 million doses available for delivery in September, 2 million in mid-October, and 3 million in early November.

To ensure all pharmacies and general practices receive at least some of their order of aTIV early in the season, all orders (from pharmacies and general practices) will be re-phased with the aim of giving all customers split deliveries across September, October and November. PSNC supports this arrangement which should ensure that pharmacies, general practices and most importantly, patients will have equitable access to the vaccine.

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

National rollout for EPS in urgent care settings Rollout of the Electronic Prescription Service (EPS) to urgent care prescribers to reduce administrative burden for community pharmacy teams. include: NHS 111, GP out of hours, Clinical Assessment Services (CAS), Walk-in Centres, Minor Injuries Units and Urgent Care Centres.

Following a successful pilot, NHS Digital is now rolling out EPS access to all integrated urgent care providers using the Advanced Adastra prescribing system.

This means community pharmacies across the country may start to receive electronic prescriptions from integrated urgent care providers. Integrated urgent care providers

Electronic prescriptions from these services should be dispensed and claimed for as normal but, as most urgent care providers operate out of hours, contractors should consider: • checking staffing rotas to make sure at least one Smartcard-holding pharmacy team member is always available during opening hours; • whether further staff require an EPS Smartcard; and • adjusting when and how regularly electronic prescriptions are downloaded during the out of hours period (where pharmacies are open during this period).

Due to the acute nature of prescriptions issued in urgent care, prescribers have been advised to consider whether it is necessary to contact dispensers to notify them they are issuing an EPS prescription to advise it needs to be dispensed promptly.

Prescribers will use the Directory of Services (DoS) to identify an open pharmacy close to the patient, so contractors may want to ensure their pharmacy’s details are correctly recorded in the DoS; the Quality Payments Scheme will provide an opportunity to update this information.

Other urgent care software providers are developing EPS functionality within their systems, so further pilots using these systems are expected in due course.

DHSC publishes report reviewing pharmacy regulations The Department of Health and Social Care (DHSC) has published its report following a post implementation review of the NHS (Pharmaceutical and Local Pharmaceutical Services) 2013 Regulations. Such reviews are now routine to ensure legislation remains fit for purpose, but any proposed changes would need to be consulted on separately.

PSNC gives a cautious welcome to the report, which confirms that the Regulations remain important to ensure the provision of stable, safe and effective NHS pharmaceutical services in England, for the benefit of the public.

There is recognition that the special arrangements for Distance Selling Premises (which by definition provide a national pharmaceutical service) should be adhered to and that efforts should be made to address the direction of prescriptions, among other issues.

PSNC will consider and explore the review recommendations with DHSC, but we are pleased that many of the recommendations adopt proposals and submissions from PSNC. Read the report in full at: ow.ly/iQ6V30jhH89

SCR calculator for June 2018 review point NHS Digital has updated the Summary Care Record (SCR) calculator webpage for the June 2018 review point of the Quality Payments Scheme. This includes a new, more user-friendly format calculator.

The calculator is designed to assist community pharmacy contractors in monitoring their SCR usage to meet the SCR quality criterion, which requires contractors to be able to demonstrate on the day of the review (29th June 2018): • a total increase in access to SCR from period 1 to period 2 as defined below; or • to have accessed the SCR 100 times or more in both period 1 and period 2.

The periods for the June 2018 review point have been defined as: For 29th June 2018 review point

Period 1

Period 2

Monday 1st May 2017 to Sunday 26th November 2017

Monday 4th December 2017 to Sunday 1st July 2018

Check your SCR usage now: tinyurl.com/SCRcalculator

psnc.org.uk 5

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

NHS England issues final OTC guidance for CCGs Guidance recommends OTC medicines for 35 minor health conditions should no longer be routinely prescribed on the NHS, but restrictions do not apply to people with long-term conditions.

NHS England has published its final guidance for Clinical Commissioning Groups (CCGs) following a public consultation on the prescribing of over the counter (OTC) medicines.

The aim of the guidance is to create a consistent, national approach for CCGs to follow when considering restricting the prescribing of OTC medicines.

The CCG guidance lists 35 minor health conditions for which it is now recommended that OTC medicines should no longer be routinely prescribed.

Vitamins, minerals and probiotics are also included in the restrictions as items of limited clinical effectiveness.

NHS England and NHS Clinical Commissioners worked together to produce the guidance for CCGs and will be developing a range of national resources to support local implementation. However, it will be individual CCG boards who determine the timescale for their local areas.

However, the guidance also makes clear that these restrictions do not apply to people with long-term conditions, nor should they be applied to patients who the prescriber considers unable to selfcare due to medical, mental health or significant social vulnerability.

PSNC responded to NHS England’s initial consultation on the proposals and was pleased to see significant revisions made, including to focus the guidance on prescribing for specific minor illnesses and not to limit the prescribing of medicines for the treatment of long-term conditions.

The OTC guidance can be viewed in full at: ow.ly/KSlm30jhHpn PSNC Director of NHS Services, Alastair Buxton, said: “This guidance is a significant step for the NHS to take as it looks to find ways to tackle its affordability challenge. While it is likely to lead to a reduction in prescription volume and the de-commissioning of some minor ailments schemes, it could also present an opportunity for community pharmacy to build on its existing role in educating patients to help them to self-care.”

Utilising community pharmacists to reduce prescribing waste The full evaluation of a medicines optimisation pilot in Bath and NorthEast Somerset has been published in Prescriber.

It shows that, over four months, the service has received 300 entries from community pharmacies with 187 so far being implemented by the practice support pharmacist which has resulted in changes to the patient’s record. This represents a total annual net saving of £18,384 and a CCG return on investment of

£4.28 for every £1 spent in fees. The pilot’s success has meant that the project has been opened up to all 40 pharmacies in BANES CCG. The evaluation concludes that by harnessing a community pharmacists’ extensive medication knowledge and patient contact time, this project puts them at the forefront of community-based medicines optimisation and presents a novel way for CCGs to work with their community pharmacy colleagues.

Learn more at: ow.ly/enTg30jcsp4

NHS England announces pharmacist support for care homes NHS England has announced plans to recruit 180 WTE (whole time equivalent) pharmacists and 60 WTE pharmacy technicians to support medicines optimisation in care homes.

NHS England will roll out the programme, funded by the Pharmacy Integration Fund, by recruiting the pharmacists and pharmacy technicians in April, with posts taken up by early summer. Local planning for the programme will be undertaken by Integrated Care Systems/Sustainability and Transformation Partnerships (STPs), generally with a lead Clinical Commissioning Group in each STP area.

Pharmacists and pharmacy technicians will be supported by a CPPE training programme, which for pharmacists, will include training to become an independent prescriber.

6 Community Pharmacy News – April 2018

NUMSAS service update A minor amendment has been made to the service specification and Directions for the NHS Urgent Medicine Supply Advanced Service (NUMSAS) to allow referrals to be made from Integrated Urgent Care hubs, but no action is required by contractors and pharmacy teams.

Learn more at: ow.ly/k0g330j4Bs5

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

STP Engagement: Survey shows progress made by LPCs Community pharmacy representation in STP structures has improved by a fifth in the past year with 9% of LPCs having presented to the STP Board.

Almost two thirds of LPCs say that community pharmacy is represented at some level on local Sustainability and Transformation Partnerships (STPs), a survey has shown.

Out of 43 LPCs responding, 27 said that community pharmacy was represented on STP working groups or other structures.

While 12% of LPCs said they were not involved with the local STP, 42% had met with people involved in the STP, 9% had presented to the STP Board, and two LPCs have a community pharmacy representative at STP Board level.

But despite these obstacles 55% of LPCs felt that STPs’ understanding of community pharmacy was now ‘reasonable’ or ‘quite good’. Common barriers to engagement with STPs included that LPCs had been unable to find the right people to talk to, or that STPs had not been interested in or invited community pharmacy to participate.

the contribution of the community pharmacy sector had not been fully explored during the development of the 44 STPs.

The STPs were set up in 2015 to drive forward the aims of the NHS Five Year Forward View (5YFV) and they are considering all aspects of local healthcare delivery. LPCs have been working hard to ensure that community pharmacy is included as part of the evolving plans.

A survey of LPCs was carried out in January 2018 by Pharmacy Business magazine, working closely with PSNC.

Alastair Buxton, Director of NHS Services at PSNC, said: “These survey results confirm once again that STPs have a lot of priorities to juggle, but that hard work from LPCs to engage with them has really been paying off in some areas. We’re pleased to see that so many LPCs have managed to get some engagement with STPs, and this makes sense as community pharmacy has a huge amount to contribute to many key local health priorities.”

The findings suggest that some progress has been made since December 2016, when an integration survey carried out by PSNC, Pharmacy Voice and the Royal Pharmaceutical Society found that

For more information on STPs, including a new STP engagement leaflet, webinars and further best practice examples, please visit: psnc.org.uk/STP

NHS long-term plans must make better use of pharmacies Additional NHS funding of £760 million has been announced to help 40 NHS hospitals and community services to modernise and transform services. The funding, announced by Health Secretary Jeremy Hunt, will be spent on programmes to meet local demand, such as new urgent care centres and the refurbishment of mental health facilities. The Government is also releasing £150 million to support the NHS in becoming more efficient.

PSNC Director of NHS Services Alastair Buxton said: “The NHS must recognise the value of the community pharmacy network of healthcare locations, and in future we would like to see community pharmacies playing a central role in helping people to stay healthy, to self-care and to manage their long-term conditions, thereby reducing some of the immense pressure that we know GPs and hospitals are still under.”

In that survey, just 5% of LPCs rated their engagement with STPs as ‘high’ with 33% saying they had no engagement at all, and 28% rating engagement as very low.

NHS turns 70: how pharmacy teams can get involved 2018 marks 70 years since the NHS came into being and events are being planned throughout the year to celebrate this milestone.

NHS England has created a resources centre to help NHS healthcare organisations to get involved and, as an integral part of the NHS, community pharmacy teams are encouraged to join in by holding a local event, nominating colleagues for an award, or sharing positive patient outcomes on social media.

For ideas and resources for pharmacy teams, please visit: ow.ly/E10M30jhI0G

psnc.org.uk 7

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

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.

PSNC Representatives elected Following invitations for nominations for candidates to become representatives on PSNC, elections have been held.

Prakash Patel has been re-elected as PSNC’s London North Thames regional representative and Sian Retallick, a member of Devon LPC, has been elected as PSNC’s South Western regional representative.

A ballot was also conducted for Multiple Chemist (non-CCA) representatives. Jay Patel of Day Lewis Plc, Peter Cattee of PCT Healthcare Ltd, and Has Modi of Jardines (UK) Ltd were all elected.

Fire hazards video: Paraffin-based skin products

West Yorkshire Fire and Rescue Service, with support from PSNC’s Yorkshire Regional Representative, David Broome, and other members of Community Pharmacy West Yorkshire, has produced a YouTube video aimed at healthcare professionals and carers, to highlight the potential fire hazards associated with paraffin-based skin products.

Watch the video at: ow.ly/VI6230 jps3R

March PSNC meeting

At PSNC’s March meeting , discussions were held on potential new funding models, proposals for the development of the Community Pharma cy Contractual Framework, and support materials for GDPR com pliance.

A summary for contrac tors can be downloaded from: ow. ly/7 7Fd 30jw YP1

Supply issues

phate Tablets 10mg Disruptions to the supply of Menadiol Diphos sed verisons of these and Trimovate Cream mean that only unlicen teams will therefore acy Pharm products are currently available. with ‘Unlicensed Special’ ted annota are s need to ensure prescription reminded to follow the or ‘Special Order’. Pharmacy teams are ce and place prescriptions non-Part VIIIB special endorsement guidan submission. month of in the red separators for the end ting these products can Full details about the supply issues affec Menadiol) and here: be found here: ow.ly/ OcMK 30jcr Sh (for vate) ow.ly/ PJy93 0jcrV I (for Trimo

The Primary Care and Public Health con ference

Registration is now open for the 28th annua l Primary Care and Public Health conference, which will be taking place on 16th and 17th May, at the NEC, Birmingham.

Presentations to look out for include those from: PSNC’s Director of NHS Services Alastair Buxton, Michael Lennox (Somerset LPC), Richard Brown (Avon LPC), Ade Williams (Bedminster Pharmacy) and Tom Wedgbury (Birmingham LPC).

Book your place here: www .prima rycar eandp ublich ealth.c o.uk

8 Community Pharmacy News – April 2018

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

Help your patients avoid penalty charges Pharmacies will soon receive new resources on how to ‘Help your patients avoid penalty charges’ from the NHS Business Services Authority (NHS BSA).

In 2017, over a million people received a penalty charge notice after claiming free prescriptions. With checks increasing, the NHS BSA has recently updated their guidance to help patients understand their entitlement to free NHS prescriptions and the consequences of making an incorrect claim.

Over the next few weeks all pharmacies will receive a copy of a new A3 poster and 10 copies of a booklet for patients.

Copies of these new resources, along with a factsheet for dispensers titled ‘Help your patients avoid penalty charges’, can be downloaded from tinyurl. com/BSAfreeprescriptions (see under ‘Resources for dispensers’) Pharmacy teams can help their customers to avoid receiving penalty charge notices by: • Displaying the new resources somewhere visible; • Encouraging patients to check their entitlement prior to making a claim/ completing the declaration on the prescription; • Asking to see evidence of patients’ entitlement and checking the expiry

date on any certificates presented.

REMEMBER: If a patient can’t provide proof, mark the ‘Evidence not seen’ box on the prescription; • Informing the person claiming exemption from payment of NHS prescription charges (where evidence

is required but not provided) that NHS checks are routinely undertaken to verify their entitlement, as part of arrangements for preventing or detecting fraud or error. Patients who claim free prescriptions that they’re not entitled to may have to pay a penalty charge of up to £100, as well as the original prescription charges; • Advising patients who are unsure of their entitlement to pay for their prescription(s) and provide them with an FP57 receipt with information on how to claim a refund (within three months) if they can later confirm that they are entitled. Further information for patients can be found at www.nhs.uk/healthcosts; and • Signposting patients currently paying for their prescriptions that they may benefit from buying a prescription prepayment certificate or applying for the NHS Low Income Scheme, where appropriate.

If you have any comments or would be interested in ordering additional supplies, please email: nhsbsa.communicationsteam@nhs.net

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 otherwise the pharmacy contractor may not be paid for them. 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 Does it Can it be in the have a ‘CE’ dispensed blacklist?* mark? on an FP10?

Additional information

Vizulize dry eye mist

No

n/a

Yes

No

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

Vizulize Hypromellose 0.3% eye drops

Yes

n/a

Yes

Yes

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

Vizulize Intensive 0.3% eye drops

Yes

n/a

Yes

Yes

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

Hyabak UD 0.15% eye drops 0.4ml unit dose

No

n/a

Yes

No

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

*n/a is because medical devices are not listed in the blacklist.

Please note: If the prescription is an FP10CN or FP10PN (community nurse prescriber), an FP10D (dental prescriber) or an FP10MDA (instalment dispensing), please visit psnc.org.uk/prescriptionforms for more information.

psnc.org.uk 9

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

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 submit age exempt EPS tokens with my end of month bundle?

A. No, community pharmacy contractors should not submit age exempt Electronic Prescription Service (EPS) tokens with their end of month prescription bundles.

The tokens which should be sent to the Pricing Authority are those where: • the exemption status has been captured (other than were the patient is age exempt, i.e. aged under 16 or over 59); or • if the patient has paid a charge.

With exception for the NHS Urgent Medicine Supply Advanced Service (NUMSAS), tokens are not used for payment, reimbursement is made against electronically submitted EPS Release 2 claim messages and the exemption category applied to that message. Tokens are submitted for audit purposes only.

Contractors are not required to keep those tokens which do not need to be sent to the Pricing Authority. These can therefore be disposed of in accordance with the Data Protection Act and the pharmacy team’s own processes.

For more information on submitting EPS tokens see psnc.org.uk/epstokensubmission

Q. If a prescription was dispensed before the 1st April but the patient didn’t collect it until after the 1st April, should the patient pay the old or the 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 PMR record.

Please note that for EPS prescriptions any claim message received by the Pricing Authority 5th April 2018 or after will be charged at the new prescription charge rate irrespective of the date on which the dispense notification was sent.

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. How many prescription charges should be levied if both carbamazepine 200mg tablets and carbamazepine MR 200mg tablets are prescribed on the same FP10 prescription?

A. Where different formulations or presentations of the same drug or preparation are prescribed and supplied, multiple prescription charges are payable (see Part XVI, Clause 11.2 of the Drug Tariff). In this example, as standard tablets and modified-release tablets are different formulations, two prescription charges would be payable unless the patient was entitled to exemption or remission from the charge.

Look out for more frequently asked questions next month…

If you would like more information on any of the topics covered, the team at PSNC will be happy to help (0203 1220 810 or e-mail info@psnc.org.uk).

Dispensing errors in registered pharmacies As of 16th April 2018, legal defences are available for inadvertent errors made by community pharmacies and pharmacy technicians.

The Pharmacy (Preparation and Dispensing Errors – Registered Pharmacies) Order 2018 makes provision for a defence to prosecution under section 63 and section 64 of the Medicines Act 1968 in cases where medicines are prepared or dispensed by a registered pharmacist or pharmacy technician, or someone acting under the supervision of a registered pharmacy professional.

It is anticipated that further information will be available from the Department of Health and Social Care in due course.

10 Community Pharmacy News – April 2018

LPCs

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

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 2018.

Part VIIIA additions Category A: • Imatinib 100mg tablets (60) Category C: • Acetylcysteine 2g/10ml solution for infusion ampoules (10) – Martindale Pharmaceuticals Ltd • Adrenaline (base) 150micrograms/0.3ml (1 in 2,000) solution for injection pre-filled disposable devices SC (1) and (2) – EpiPen Jr. • Bimatoprost 300micrograms/ml / Timolol 5mg/ml eye drops 0.4ml unit dose preservative free (30 (6xSC5)) – Ganfort • Cefuroxime 125mg/5ml oral suspension R (70ml) – Zinnat • Diltiazem 120mg modified-release capsules (28) – Adizem-XL • Diltiazem 120mg modified-release capsules (56) – Adizem-SR • Diltiazem 180mg modified-release capsules (28) – Adizem-XL • Diltiazem 180mg modified-release capsules (56) – Adizem-SR • Diphtheria / Tetanus / Poliomyelitis (inactivated) vaccine (adsorbed) suspension for injection 0.5ml pre-filled syringes SC (1) – Revaxis • Enoxaparin sodium 300mg/3ml solution for injection vials SC (1) – Clexane • Estradiol 500micrograms / Dydrogesterone 2.5mg tablets (84) – Femoston-conti • Glucose powder for oral use BP 1980 (500g) – Thornton & Ross Ltd • Hepatitis A (inactivated) / Hepatitis B (rDNA) vaccine (adsorbed) suspension for injection 1ml pre-filled syringes SC (1) – Ambirix • Insulin degludec 100units/ml / Liraglutide 3.6mg/ml solution for injection 3ml pre-filled disposable devices (3) – Xultophy • Insulin lispro biphasic 50/50 100units/ml suspension for injection 3ml cartridges (5) – Humalog Mix50 • Insulin soluble human 100units/ml solution for injection 3ml cartridges (5) – Humulin S • Methotrexate 12.5mg/0.5ml solution for injection pre-filled syringes SC (1) – Zlatal • Methotrexate 15mg/0.6ml solution for injection pre-filled syringes SC (1) – Zlatal • Methotrexate 17.5mg/0.7ml solution for injection pre-filled syringes SC (1) – Zlatal • Methotrexate 20mg/0.8ml solution for injection pre-filled syringes SC (1) – Zlatal • Methotrexate 22.5mg/0.9ml solution for injection pre-filled syringes SC (1) – Zlatal • Methotrexate 25mg/1ml solution for injection pre-filled syringes SC (1) – Zlatal • Methotrexate 7.5mg/0.3ml solution for injection pre-filled syringes SC (1) – Zlatal • Nifedipine 20mg modified-release tablets (28) – Adalat LA

KEY: SC Special container R Item requiring reconstitution * This pack only (others already available)

• Nifedipine 20mg modified-release tablets (56) – Adalat retard • Somatropin (rbe) 10mg powder and solvent for solution for injection vials SC (1) – Zomacton • Somatropin (rbe) 4mg powder and solvent for solution for injection vials SC (1) – Zomacton • Somatropin (rmc) 8mg powder and solvent for solution for injection vials SC (1) – Saizen • Timolol 2.5mg/ml eye drops preservative free SC (5ml) – Eysano • Timolol 5mg/ml eye drops preservative free SC (5ml) – Eysano • Ulipristal 5mg tablets (28) – Esmya Part VIIIA amendments • Imatinib 400mg tablets (30) – Glivec is changing to Category A • Pramipexole 1.05mg modified-release tablets (30) – Mirapexin is changing to Category A • Pramipexole 1.57mg modified-release tablets (30) – Mirapexin is changing to Category A • Pramipexole 260microgram modified-release tablets (30) – Mirapexin is changing to Category A • Pramipexole 2.1mg modified-release tablets (30) – Mirapexin is changing to Category A • Pramipexole 2.62mg modified-release tablets (30) – Mirapexin is changing to Category A • Pramipexole 3.15mg modified-release tablets (30) – Mirapexin is changing to Category A • Pramipexole 520microgram modified-release tablets (30) – Mirapexin is changing to Category A Part VIIIA deletions • Emulsifying ointment 50% / Liquid paraffin 50% ointment (100g) – Emulfin 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.

Product

Type, Size, Product code

WOUND MANAGEMENT DRESSINGS - Tielle Xtra

Square (11cm x 11cm and 15cm x 15cm) and Rectangular (15cm x 20cm)

URINAL SYSTEMS - Bard Ltd - 600532 Maguire adaptor & tubing BELTS - AMI Medical Ltd Corsinel Suportx Abdominal Tube, White

X Small (74-82cm) - CRL243W Small (78-90cm) - CRL244W Medium (86-98cm) - CRL245W Large (94-106cm) - CRL246W X Large (102-116cm) - CRL247W

psnc.org.uk 11

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

PSNC resources library In this section of Community Pharmacy News we have provided details of some of the resources that PSNC has produced this month.

PSNC Briefings PSNC Briefing 016/18: The interim Quality Payments Scheme 2018/19 – A summary of changes to the Scheme As part of the interim funding arrangements, the Quality Payments Scheme will continue with a June 2018 declaration. This PSNC Briefing outlines the small number of minor changes that have been made.

Download from: ow.ly/5Y5F30js3wP PSNC Briefing 017/18: What can pharmacy do to help transform local care? – a leaflet for STPs PSNC has produced a draft leaflet which LPCs may wish to use as a discussion aid when engaging with local STPs. A Word version is also available, so that LPCs can edit and align it with their STPs’ specific healthcare priorities.

Download from: ow.ly/n7q530js3yi PSNC Briefing 020/18: Quality Payments – Referrals for asthma reviews This PSNC Briefing provides contractors with updated guidance for the June 2018 review point on meeting the ‘referrals for asthma review’ quality criterion.

Download from: ow.ly/jvtU30js3Eb PSNC Briefing 021/18: Quality Payments – How to become a Dementia Friend This PSNC Briefing provides an overview of how to achieve the Dementia Friends criterion of the Quality Payments Scheme.

Download from: ow.ly/rbKk30js3HK See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources Prescription Charge Card 2018 Following the NHS prescription charge increase to £8.80 per prescription item, PSNC has designed a downloadable Prescription Charge Card for community pharmacies. The card is now available on the PSNC website.

Download now: psnc.org.uk/chargecard The General Data Protection Regulation (GDPR) GDPR represents an overhaul of data protection legislation. This webpage brings together information, guidance and resources to support community pharmacy contractors on making sure they comply by 25th May 2018.

Visit now: psnc.org.uk/GDPR Look out for additional resources as you explore our website: psnc.org.uk

Email news alerts Quality Payments: Edit or validate your NHS Choices entry now (9th April) Informing community pharmacy contractors that the editing and validation period for NHS Choices profiles has now opened and describing the changes since the November 2017 review point.

Read now: ow.ly/61HN30js4es Not receiving our emails? Sign up now at: psnc.org.uk/enews 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, 14 Hosier Lane, London, EC1A 9LQ 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: 0203 122 0810

© PSNC