August 2016 CPN

CPN

Community Pharmacy News – August 2016

Pharmacy gets ready for flu Community pharmacists and their teams prepare for the launch of this year’s national Flu Vaccination Service

Capita concerns escalated | Flu Vaccination Service poster | Specials endorsing guide

services and commissioning

The healThcare landscape

lpcs

Flu Vaccination Service launches 1st September The launch of the national community pharmacy Flu Vaccination Service 2016/17 is planned for 1st September 2016. Here we outline the key points of this year's service that community pharmacy contractors need to be aware of.

Duration of service

GP notification form

Signing up to deliver the service

This year the service will be commissioned for an extra month, until 31st March 2017 (last year the service was commissioned until the end of February) – however, focus should still be given to vaccinating eligible patients between 1st September and 31st January in order to maximise the impact.

The GP notification form will require contractors to include the reason why the patient was eligible for the Flu Vaccination Service (if the patient is eligible for more than one reason, the reason the patient was initially identified as being eligible should be selected).

Contractors must complete the form on the NHS BSA website prior to provision of the service to notify NHS England that they intend to provide the service for 2016/17. This must be done annually.

Therefore even if a contractor provided the service in 2015/16 they must complete this sign-up process again. Contractors need to complete this form for all their pharmacies from which the Flu Vaccination Service will be offered. If the form is not completed before provision of the service, claims for payment will not be accepted by the NHS BSA.

Patient questionnaire Patients will still need to be asked to complete a survey after they have been vaccinated but there will be an NHS England website available to contractors to support collation and submission of the data. Further details on the website will be made available by NHS England in due course.

Payment claims deadline Payment claims for vaccinations administered during March 2017 must be submitted to the NHS BSA by 5th April in line with the FP34C submission document process. Late claims will not be processed and contractors will not receive payment for vaccinations claimed.

Patient Group Direction (PGD)

Differences from last year

A separate PGD will be available for the community pharmacy Flu Vaccination Service this year (last year the PGD was not community pharmacy specific and was used by a number of healthcare professionals).

Flu Vaccination Service webinar PSNC is due to hold a webinar on getting ready for the service at the end of August. On the night Alastair Buxton, Director of NHS Services at PSNC, and Sunil Kochhar, PSNC Regional Representative and community pharmacist, will explain how the Flu Vaccination Service works, showing you how to ensure that you and your team are ready to make the most of the opportunity. A recording of the PSNC webinar will be made available to watch at: psnc.org.uk/webinar

Training requirements for the national Flu Vaccination Service Face-to-face training Face-to-face training is required for both injection technique and basic life support every two years. A list of organisations that provide vaccination training for pharmacists can be found at: psnc.org.uk/flutraining. We also suggest contacting your LPC to see if they have organised training in your area.

Declaration of Competence (DoC) Pharmacists also need to complete the NHS seasonal influenza vaccination ADVANCED Declaration of Competence (DoC) selfassessment framework and statement of declaration (available on the Centre for Pharmacy Postgraduate Education website) every two years.

An A3 poster promoting the national community pharmacy Flu Vaccination Service is available in the centre of this month’s edition of CPN. It’s double-sided so it can be displayed on a window. Translated posters are available at: psnc.org.uk/flu

2 Community Pharmacy News – August 2016

psnc’s work

funding and sTaTisTics

conTracT and iT

dispensing and supply

PSNC seeks remedial action over PCS service levels PSNC escalates concerns about Capita’s delivery of PCS services to NHS England and demands action to improve the situation.

In a letter to NHS England's National Director: Operations and Information, PSNC has escalated concerns about Capita’s Primary Care Support (PCS) England operation and is seeking remedial action from NHS England.

The letter set out a number of areas in which both community pharmacy contractors and LPCs have been experiencing poor service from PCS England. These include: • Serious delays in delivery of vital controlled stationery (e.g. EPS tokens); • Staff who are confused and lack knowledge about practices and processes; and • Delays, incomplete letters and failures to issue the required notifications around market entry provisions.

What to do if you experience issues 1. Contact PCS England using the form on their website or via email to PCSE.enquiries@nhs.net 2. Email daily until a response is received, keeping a record of your emails.

3. If no response is received within three working days, please copy all the emails to info@psnc.org.uk explaining the current position so we can assist.

PSNC has asked NHS England to review the criteria by which PCS England is assessed, to postpone any plans for Capita to take on further work involving community pharmacy until they are able to manage the current work, and to give assurance that any losses incurred by pharmacies relating to Capita’s management of market entry provisions will be dealt with speedily and fairly by NHS England.

The Committee has also asked NHS England to take action to ensure that PCS England’s processes for the delivery of controlled stationery are fit for purpose, to give assurances that contractors unable to fulfil their Terms of Service due to lack of controlled stationery are not penalised, and to ensure that Capita has sufficient numbers of appropriately trained staff to manage market entry provisions.

PSNC elections notice Two PSNC election processes are in progress. The first is for a West Midlands regional representative, following Rajesh Morjaria’s resignation; he now operates more than nine pharmacies so is no longer eligible to be an independent Chemist representative. The second is for a Multiple Chemist representative, following Kirit Patel’s untimely death. Please visit the PSNC website for more information.

Practice Payment changes The August Drug Tariff includes a reduced practice payment. The lower rate of 43.8 pence per item will be paid for August and September prescriptions, and will rise to 52.2 pence per item from October.

The previous practice payment had been on track to over-deliver on the fee budget, so a correction was needed. The PSNC Committee considered carefully how best to do this, in light of the difficult and uncertain financial environment contractors are facing. It concluded that a lower rate in August and September to recover the overdelivery, before moving to a fee that reflects the right rate for distribution of fee income based on current volume forecasts, was the best approach.

Q. How much over-delivery of fees has there been?

A. PSNC and the NHS agreed that without changes to the current fee there would be an over-delivery of fees amounting to around £44 million by the end of March 2017.

Q. Why has that over-delivery happened?

A. In 2015/16 practice payment fees were raised in September and November, to address a projected under-delivery by the year end.

Q. Why did we not have advance notice of this reduction in practice payment?

A. This was first raised in a meeting with DH and NHS England in early July, and discussed by PSNC at its July meeting.

Ministerial approval of the proposals was

required so there was no opportunity for earlier notice to be given to contractors.

Q. How much will this affect businesses?

A. Businesses are already facing reduced reimbursement prices to repay excess delivery of margin income in 2015/6. This is a further reduction, but the Committee decided it was important to address the over-delivery as soon as possible to avoid a higher level of cut later in the year.

Q. Why has PSNC agreed to this reduction – wouldn’t it be better to have a smaller cut over a longer period of time?

A. This alternative option was given careful consideration by the Committee and they decided it was better to correct the over-delivery early.

psnc.org.uk 3

psnc’s work

funding and sTaTisTics

conTracT and iT

Tributes paid to former PSNC Vice Chairman PSNC's CEO leads the pharmacy sector in celebrating the work of Kirit Patel, Day Lewis Chief Executive and PSNC Vice Chairman, following his untimely death last month.

Tributes from across the pharmacy world followed the news of the sudden death on 16th July of PSNC’s Vice Chairman, Kirit Patel MBE. PSNC Chief Executive Sue Sharpe: “A key member of the PSNC Committee, Kirit founded the Day Lewis Group of pharmacies and remained Chief Executive of the family business until his death. Kirit was passionate about community pharmacy and in 2005 was awarded an MBE by her Majesty the Queen for his contribution to pharmacy and public service.

From his initial investment to buy his first pharmacy, Kirit had an affinity with the independent sector that stayed with him throughout his life in pharmacy. Even when he had built Day Lewis into the largest privately owned pharmacy chain he would say he was an independent at heart, and many of his closest friends were independent pharmacy owners. With them, and colleagues from all parts of pharmacy and associated businesses, he enjoyed gatherings and holidays, his extrovert, fun-loving personality making him the life and soul of whatever was going on. As a host his hospitality was legendary, his generosity unbounded.

More than just convivial, he would be as generous with his advice. With his quick and wide-ranging mind, and the kick he got from seizing a problem and exploring possible solutions to arrive at a way forward, he was for many not just a role model but a mentor.

We benefitted from this hugely at PSNC. In recent years Kirit had scaled down his involvement in pharmacy organisations, but he recognised the importance of PSNC to the contractors he cared about, and wanted to use his skills to support our work. As our vice chair for four years, any criticism was always constructive, all advice and ideas – and there were many of them – were to help us do the best possible job for the whole of community pharmacy.

Kirit was at the PSNC meeting just three days before he died, and was as full of life and fun as ever. That is how we will remember him.

In all the tributes, three words recur constantly: generous, innovative, mentor. He was all of these to us and we are very grateful.”

Umesh Patel MBE, Chair of the Review and Audit Panel at PSNC: “I first met Kirit 18 years ago at a PSNC conference dinner, when he was a relatively unknown person in the pharmacy world, and then saw his steady rise to be a king among community pharmacy owners in the years that followed.

His advice, kindness and generosity will be remembered by everyone in the world of community pharmacy across the globe. We have had tributes from as far away as Australia.

The celebration of his life at his home on July 23rd was attended by over 3,000 people which showed just how popular he was. His sense of humour and his energetic participation in the day to day business of PSNC will be remembered by all of us.

During my last private meeting with Kirit in late June, the main thing he emphasised was that we need unity and all bodies should work with PSNC to secure the best funding and services for all of us. He knew that any other approach would lead to ‘Divide and Rule’ and this could be ruinous: we need to move away from fighting for our own personal gains.

I personally have lost a very good friend and a brother. Pharmacy has lost a great champion.”

4 Community Pharmacy News – August 2016

dispensing and supply

services and commissioning

The healThcare landscape

lpcs

Pilot of EPS Phase 4 approved Electronic prescriptions as the default prescribing method in GP practices makes its debut during a limited pilot.

A limited pilot of Phase 4 of the Electronic Prescription Service (EPS) was approved during the July 2016 PSNC meeting. EPS Phase 4 is the point at which electronic rather than paper prescriptions become the default. This will be tested initially in a small number of pilot GP practices later in 2016.

What you need to know

PSNC and NHS Digital (formerly HSCIC) will provide further updates as work towards preparation of the pilot continues, and these will be published at: psnc.org.uk/pilot PSNC Director of NHS Services Alastair Buxton said: “The pilot of EPS Phase 4 will help community pharmacy and the NHS test the move to ‘full’ EPS in order to make sure the systems are right before any full roll-out of this is considered. Identifying issues that need to be addressed before full roll-out is critical, in addition to NHS Digital and others completing the actions already identified which need to take place before Phase 4.

EPS and paper prescribing systems currently coexist and this drives complexity and costs for pharmacy teams; successful implementation of Phase 4 will shift the balance to the majority of scripts being electronic, which in turn will remove the inefficiency of the current dual system.

The pilot is therefore very important and we hope that pharmacy teams close to the pilot GP practices will be willing to participate fully in it, sharing their experiences and feedback, both good and bad.”

CPAF: what happens next?

97% of community pharmacy contractors completed the Community Pharmacy Assurance Framework (CPAF) screening survey. PSNC has produced the following FAQs to explain what happens next.

Q. I submitted the CPAF screening questionnaire by the closing date; what happens next?

A. During September/ October 2016, NHS England will visit c.2% of pharmacies to validate the answers given to the screening survey.

This selection will include some who have scored 3s for all questions and some who have scored a mixture of 2s and 3s. The aim is for NHS England to observe areas of good practice and also identify any situation where the answers are inconsistent with the evidence available.

Q. Will I need to complete the full questionnaire?

A. In November 2016, the full CPAF questionnaire will be available for selected pharmacies to complete. NHS England will decide which pharmacies are invited to complete the full CPAF questionnaire.

Q. I completed the full CPAF questionnaire; does this mean my pharmacy will definitely have a contract monitoring visit?

A. Not necessarily. In December 2016, NHS England will decide which pharmacies will be visited for contract monitoring purposes – it may be that NHS England decide not to visit a pharmacy following their more in depth response i.e. the full CPAF questionnaire.

• Phase 4 of EPS will mean the majority of prescriptions will be signed and sent electronically, even for patients who have not set a nomination.

• Patients without a nomination will be given a paper token by their GP practice to take to any pharmacy in England. Pharmacy staff will need to scan the token’s barcode to download the prescription.

• Any patients that are part of a prescription collection service, but haven’t set a nomination, will have a token printed (instead of a paper FP10) for their pharmacy to collect.

• As patients are free to choose any pharmacy to get their medicines dispensed from, all pharmacy teams will need to be ready and know what to do should a patient present a non-nominated token in their pharmacy.

• But if your local GP practice is taking part in the pilot, your pharmacy will be contacted directly by NHS Digital so that you and your team can receive additional support.

Latest pharmacy guidance HLP self-assessment criteria published The Pharmacy and Public Health Forum’s Healthy Living Pharmacy (HLP) task group has introduced a new profession-led self-assessment process for achieving HLP level 1 status. The self-assessment guide, which sets out the quality criteria that must be met to gain level 1 status, can be downloaded from: ow.ly/cw6I302nVNb Updated Prescribing Competency Framework The Royal Pharmaceutical Society (RPS) has published a new, updated single Prescribing Competency Framework containing a common set of key competencies to help healthcare professionals practise as safe and effective prescribers. Find out more about the framework at: ow.ly/laIC302lHnL New guide for working in care homes The RPS has published a new guide, aimed at pharmacists working in or with care homes. The guide provides support, comprehensive signposting and an overview of the different roles pharmacists may have in care home service provision. Find out more about the guide at: ow.ly/ScT6302IPQB

psnc.org.uk 5

services and commissioning

The healThcare landscape

lpcs

New health ministerial team takes shape

As the new Prime Minister forms her new Government, PSNC takes advantage of the opportunity the ministerial changes provide.

Jeremy Hunt MP remains in his role as Secretary of State for Health whilst David Mowat, the MP for Warrington South, has become the new minister with responsibility for pharmacy. This news comes following a government reshuffle by new Prime Minister Theresa May. Mr Mowat is a chartered accountant by background and has worked extensively on Treasury and industrial issues since his election to Parliament in 2010. As well as primary care, Mr Mowat also now has ministerial responsibility for adult social care, carers, community services, cancer, dementia and learning disabilities.

PSNC will be writing to Mr Mowat urgently to ask him to consider the future of community pharmacy.

PSNC Chief Executive Sue Sharpe said: “PSNC would like to welcome the minister to his new role in health and we look forward to beginning constructive dialogue with him. We hope very much that the new team will take a fresh

approach to community pharmacy, revisiting the nonsensical proposals set out last year and instead working with us to ensure that the NHS and patients can get the most benefit possible from community pharmacies.

As the minister gets to grips with his new New pharmacy minister, brief we will be encouraging him to look David Mowat MP carefully at the ill-considered proposals that led to 2.2m people signing a petition supporting pharmacies, thousands of letters sent to MPs and a host of arguments put forward at both local and national level since publication of the December 17th letter. We will also ask him to examine carefully the thinking and analysis that underpinned those proposals and whether they have any sound basis. We have seen nothing.

We will seek to meet with the minister very early, and we hope to be able to work constructively with him and officials.”

Dates for the diary Self Care Conference 2016 Community pharmacy teams, other healthcare professionals and commissioners are welcome to attend the annual Self Care Conference on 26th September, which will showcase awardwinning self care initiatives being implemented in the community to improve people's health. Find out more at: ow.ly/J0Zc3023CWl BOPA annual symposium 2016 The British Oncology Pharmacy Association (BOPA) is reaching out to community pharmacy professionals and inviting them to attend their annual symposium, which includes a workstream on ‘Care of cancer patients in the community’. Find out more about the symposium on 14-16th October at: ow.ly/3QeI302eTn2 Antibiotic Guardian roadshows 2016 Public Health England is running two antibiotic awareness workshops aimed at pharmacy teams and other healthcare workers. The events will highlight how you can help tackle antibiotic resistance and support on how to inform patients. Find out more at: ow.ly/CJOR302o5ED E-courses from CPPE Whether you are just starting out in the sector, or are a more experienced pharmacy professional, the Centre for Pharmacy Postgraduate Education (CPPE) has a number of e-courses beginning in the autumn. New medicine service: improving quality and getting it right begins on 19th September, whilst a Life skills e-course is starting on 10th October.

CPPE has courses scheduled stretching into 2017, including Healthy living pharmacies – developing your services and Mental health. To book on to an e-course, visit: cppe.ac.uk/programme-listings/ecourses 6 Community Pharmacy News – August 2016

Back to school asthma alert Did you know that children aged 14 and under are almost three times as likely to be admitted to hospital with asthma in September compared to August? Asthma UK believe this is partly because many children slip out of their usual medicine routine during the summer holidays. They lose the protective benefits of their preventer inhaler so are more likely to react to triggers when they go back to school.

Three ways you and your pharmacy team can help: 1. When parents collect an inhaler prescription for their child or ask for any advice, talk to them about the importance of making sure their child takes their preventer inhaler even when they’re well. You can explain that while it doesn’t work immediately, like their reliever inhaler, the effects build up to prevent their child’s airways reacting to triggers, helping to reduce their risk of having a potentially life-threatening asthma attack.

2. Point out the other benefits of ensuring their child takes their medicine as prescribed. You could explain it will help stop asthma symptoms spoiling summer activities – and give parents peace of mind, knowing their child’s asthma is well managed.

3. Advise parents on ways to ensure their child keeps taking their medicine as prescribed when the family may be out of their usual routine.

For more tips on managing asthma in children, you could direct parents towards Asthma UK’s all-new section for parents: asthma.org.uk/advice/child

psnc’s work

funding and sTaTisTics

conTracT and iT

dispensing and supply

Changes to Part VIIIB of the Drug Tariff Changes to the Drug Tariff impact on reimbursement so it is important for community pharmacy teams to take note when products are added, removed or amended.

Deletions The following products have been deleted from Part VIIIB (specials and imported unlicensed medicines) of the Drug Tariff as of 1st August 2016: • Amiodarone 100mg/5ml oral solution 100ml • Atropine 500micrograms/5ml oral solution 125ml • Sodium phenylbutyrate 625mg/5ml oral solution 200ml Please note that unlicensed medicines which are not listed in Part VIIIB of the Drug Tariff and which are sourced under a manufacturer’s specials/ importer’s licence issued by the MHRA, must be endorsed with the following: • Amount dispensed over pack size used; • Invoice price per pack size from which the order was supplied less any discount or rebate; • Manufacturers’/importers’ MHRA licence number; • Batch number of the product supplied; and • SP.

Additions Some products were also added to Part VIIIB of the Drug Tariff as of 1st August: • Enalapril 10mg/5ml oral suspension 100ml • Tranexamic acid 250mg/5ml oral suspension 60ml Please note that unlicensed medicines which are listed in Part VIIIB of the Drug Tariff must be endorsed ‘SP’ for products sourced under an MHRA specials licence.

See our Endorsement Guidance on page 9 of this month’s CPN for more on dispensing and endorsing unlicensed specials and imports.

More information can be found at: psnc.org.uk/specials August 2016 Drug Tariff print error Due to a technical error Ethinylestradiol 20 microgram / Drospirenone 3mg tablets were omitted from Part XVI, section 10, of the August Drug Tariff. The Pricing Authority have taken steps to ensure this does not affect reimbursement.

Sending EPS tokens to the Pricing Authority The Pricing Authority has brought to our attention that a number of community pharmacy teams are incorrectly sending all of their EPS tokens in with their monthly bundles.

Along with paper prescriptions, some prescribing/ dispensing tokens from the Electronic Prescription Service (EPS) also need to be sent to the Pricing Authority. Tokens sent to the Pricing Authority are for audit purposes only. Payment is made using only the electronic claim message sent by the pharmacy team once the prescription has been dispensed and submitted for payment.

Which tokens should be sent with the prescription bundle?

• Tokens which were used to capture the exemption signature (where the patient is exempt for reasons other than age or is exempt by age and the patient’s date of birth is not included in the electronic prescription message); or • Tokens where the patient has paid a prescription charge.

• Tokens that don't require a signature; or • Tokens where the patient is exempt by age and the patient’s date of birth is included in the electronic prescription message.

Please note: Contractors are not required to keep those tokens which do not need to be sent to the Pricing Authority. These can be disposed of in accordance with the Data Protection Act and the pharmacy team’s processes. See our webpage ‘Sorting your prescriptions prior to submission’ for more information: psnc.org.uk/sorting

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.

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.org.uk 7

dispensing and supply

services and commissioning

The healThcare landscape

Warning: Fraudulent invoice and endorsement claims for specials Please note the following information relating to claiming payment for the sourcing and dispensing of unlicensed medicines and imports.

PSNC has received an allegation that some specials manufacturers are offering to issue false invoices to disguise a lower actual price paid for unlicensed or imported medicines. An arrangement in which a false invoice is used to claim a higher amount from the NHS than the true net sum paid, would constitute fraud by the person who claims payment on the basis of an inflated invoice.

Community pharmacy teams are strongly advised not to deal with companies that offer invoices and other documentation that seek to disguise discounts or rebates, or which do not allow them to claim accurately for specials that have been procured. Fraud of this nature could lead to imprisonment, and to a lifetime disqualification from providing services under the NHS. Part VIIIB of the Drug Tariff sets out the arrangements for claiming payment for specials. For those products listed in Part VIIIB, the pharmacy will receive payment based on the price listed in the Drug Tariff.

For products not listed in Part VIIIB of the Drug Tariff, the contractor is entitled to payment of the net price – that is, the price paid after any discounts/ rebates have been deducted.

See our Endorsement Guidance on page 9 of this month’s CPN for further information on correctly endorsing and submitting specials.

Further information can also be found on our website at: psnc.org.uk/specials

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 community pharmacy 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?

Is it Does it in the have a ‘CE’ blacklist?* mark?

Can it be dispensed on an FP10?

Additional information

Proshield Foam & Spray skin cleanser

Yes

n/a

Yes

Yes

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

Boston Simplus contact lens solution

No

n/a

Yes

No

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

Sorbsan sterile plastic medical probe 125mm

No

n/a

Yes

No

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

Quattro multifunctional contact solution

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 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

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 8 Community Pharmacy News – August 2016

© PSNC

conTracT and iT

funding and sTaTisTics

dispensing and supply

services and commissioning

Endorsement guidance for unlicensed specials and imports NOT listed in the Drug Tariff

How to endorse Non-Part VIIIB unlicensed specials and imports For an unlicensed medicine which is not listed in Part VIIIB of the Drug Tariff and which has been sourced under a manufacturer’s specials/importer’s licence issued by the Medicines & Healthcare products Regulatory Agency (MHRA), you must endorse: • Amount dispensed over pack size used; • Invoice price per pack size from which the order was supplied less any discount or rebate; • Manufacturers’/importers’ MHRA licence number (see figure 1 below); • Batch number of the product supplied; and • SP. Figure 1: Endorsement examples for using importers’ MHRA licence number or manufacturers’ MHRA licence number Number of days’ treatment N.B. Ensure dose is stated

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

NHS Number:

Endorsements

60/60 £x.xx/pack Importer ABC Batch 00 SP

NHS Number:

Endorsements

Melatonin 1mg caps 60 capsules 1 at night

or

500ml/500ml £x.xx/pack Manufacturer AB123 Batch 00 SP

Sotalol 40mg/5ml oral suspension 10ml BD 500ml

You should ALWAYS clearly endorse the ACTUAL price paid per pack, minus any discounts or rebates.

Do not endorse…

• Discount not deducted (DND) — the community pharmacy contractor will have no discount deduction applied to their prescription price endorsed as contractors endorse the price after any discount is applied.

• Broken bulk (BB) — cannot be claimed on these items.

• Out of pocket expenses (XP or OOP) — as the SP endorsement of £20 covers costs incurred in obtaining the item.

How to endorse Non-Part VIIIB unlicensed specials that have been extemporaneously dispensed For an unlicensed medicine which is not listed in Part VIIIB of the Drug Tariff and has been manufactured under the Section 10 exemption from the Medicines Act 1968 (either by the contractor or a third party), endorse: • the names, quantities and cost of the ingredients used in preparing the product; • ED – for costs incurred in dispensing a product prepared under the Section 10 exemption; and • BB – can be claimed on the ingredients used to make the product.

Do not endorse…

• DND — the contractor will have no discount deduction applied to their prescription price endorsed as contractors endorse the price after any discount is applied.

• XP or OOP — as the SP endorsement of £20 covers costs incurred in obtaining the item.

Endorsement examples Take a look at the endorsement examples below to see how endorsements should look on a prescription and how they will be used to calculate the correct reimbursement price. Please note we have used an import in all the examples below, if you dispensed an unlicensed special you would need to substitute the importers MHRA number for the specials manufacturer’s MHRA number.

You should ALWAYS clearly endorse the ACTUAL price paid per pack minus any discounts or rebates.

Example 1: where less than a full pack size is dispensed Number of days’ treatment N.B. Ensure dose is stated

NHS Number:

Endorsements

15/30 £30/pack Importer ABC Batch 00 SP

Example 2: where the quantity dispensed Example 3: where more than one pack is falls between pack sizes dispensed Number of days’ treatment N.B. Ensure dose is stated

NHS Number:

Melatonin 1mg caps 15 capsules 1 nocte

Reimbursement calculation: £30 is for pack of 30, so pro-rata that is – £15 paid for dispensing 15 capsules.

45/30 £30/pack Importer ABC Batch 00 SP

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

NHS Number:

Endorsements

Endorsements

Melatonin 1mg caps 45 capsules 1 nocte

Reimbursement calculation: £30 is for a pack of 30, so pro-rata that is – £45 paid for dispensing 45 capsules.

60/30 £30/pack Importer ABC Batch 00 SP

Melatonin 1mg caps 60 capsules 1 nocte

Reimbursement calculation: £30 is for pack of 30, so pro-rata that is – £60 paid for dispensing 60 capsules. psnc.org.uk 9

dispensing and supply

services and commissioning

The healThcare landscape

Drug Tariff Watch Below is a quick summary of the changes due to take place from 1st September 2016.

Part VIIIA additions Category A Additions: • Co-trimoxazole 40mg/200mg/5ml oral suspension sugar free SC (100ml) • Co-trimoxazole 80mg/400mg/5ml oral suspension SC (100ml) • Dexamethasone 6.6mg/2ml solution for injection ampoules (5) • Ergocalciferol 300,000units/1ml solution for injection ampoules (10) • Imipramine 25mg/5ml oral solution sugar free (150ml) • Isotretinoin 5mg capsules (56) • Morphine sulfate 50mg/50ml solution for infusion vials SC (1) • Promazine 25mg tablets (100) • Promazine 50mg tablets (100) • Ranitidine 50mg/2ml solution for injection ampoules (5) • Sodium chloride 0.9% nebuliser liquid 2.5ml unit dose ampoules (20) Category C Additions: • Apomorphine 30mg/3ml solution for injection pre-filled disposable devices (5) – APO-go PEN • Apomorphine 50mg/10ml solution for infusion pre-filled syringes (5) – APO-go • Apomorphine 50mg/5ml solution for injection ampoules (5) – APO-go

• Coal tar 4% shampoo S (150ml) – Polytar Scalp • Colecalciferol 2,740units/ml oral drops sugar free SC (25ml) – Fultium-D3 • Darifenacin 15mg modified-release tablets (28) – Emselex • Dexamethasone 20mg/5ml oral solution sugar free (50ml) – Focus Pharmaceuticals Ltd • Fenofibrate 145mg / Simvastatin 20mg tablets (30) – Cholib • Fenofibrate 145mg / Simvastatin 40mg tablets (30) – Cholib • Gentamicin 20mg/2ml solution for injection vials (5) – Gentamicin Paediatric • Ibuprofen 200mg orodispersible tablets sugar free (12) – Nurofen Meltlets • Metronidazole 0.75% gel SC (40g) – Metrogel • Naproxen 250mg effervescent tablets sugar free (20) – Stirlescent • Paracetamol 500mg/5ml oral solution sugar free (200ml) – AMCo • Pentazocine 50mg capsules (28) – Mylan Ltd • Pimozide 4mg tablets (100) – Orap • Prednisolone 10mg/ml oral solution sugar free SC (30ml) – Focus Pharmaceuticals Ltd • Pregabalin 20mg/ml oral solution sugar free SC (473ml) – Lyrica

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

• Quinagolide 75microgram tablets (30) – Norprolac • Salbutamol 2.5mg/2.5ml / Ipratropium bromide 500micrograms/2.5ml nebuliser liquid unit dose vials (60) – Combivent • Sodium fluoride 0.05% mouthwash sugar free (250ml) – Endekay • Stiripentol 250mg oral powder sachets (60) – Diacomit Part VIIIA Amendments • Acamprosate 333mg gastro-resistant tablets (168) is changing to Category A • Fludrocortisone 100microgram tablets (30) is changing to Category A • Gentamicin 0.3% ear/eye drops SC (10ml) is changing to Category A Part VIIIA Deletions • Benzoyl peroxide 2.5% gel (40g) – PanOxyl 2.5 Aquagel • Benzoyl peroxide 5% cream (40g) – PanOxyl 5 • Povidone-Iodine 1.14% dry powder spray (50ml) – Savlon Dry

Part IX deletions Product Qufora All Silicone Catheter: -Male, Balloon Size (ml) 5-10 Gauge (Ch) 20-26 -Female, Balloon Size (ml) 5-10 Gauge (Ch) 16-26 -Paediatric, Balloon Size (mL) 1-1.5 Gauge (Ch) 6 -Paediatric, Balloon Size (mL) 2-3 Gauge (Ch) 8 -Paediatric, Balloon Size (mL) 3-5 Gauge (Ch) 10

Product code

Qufora All Silicone Suprapubic Catheter – Balloon Size (mL) 5-10, Gauge (Ch) 22-24 InsuJet Nozzle Pack InsuJet 3ml Cartridge Adaptor Pack InsuJet 10ml Vial Adaptor Pack Qufora Sterile Leg Bags: -350ml, direct inlet Q Flow Lever Tap -350ml, long tube Q Flow Lever Tap -350ml, direct inlet T-tap -350ml, long tube T-tap -350ml, short tube Q Flow Lever Tap -350ml, short tube T-tap

34230222-34230224 012070GB15 012071GB1503 01207GB1510

Biotrol Elite colostomy bag with filter – Beige Biotrol Integrale colostomy bag with filter – White (35mm) Biotrol Almarys Optima colostomy bag with filter – Beige (50mm) OstoMart OstoZyme Odour Neutralising Lubricating Gel sachets (90 x 80ml) Biotrol Almarys Optima ileostomy bag (starter hole) Moderma Flex ilesotsmy bag with filter and Lock ‘n’ Roll closure, Mini – Beige (40mm) Biotrol Almarys Twin + two piece ostomy system ileostomy bag with filter – Transparent (50mm) Softima Key two piece ostomy system ileostomy bag with Filter and Flow Control – Beige (50mm)

34220520-34220526 34240516-34240526 34210506 34210508 34210510

12061704 12061504 12051704 12051504 12061804 12051804 Starter hole = 36-810 45mm = 36-845 50mm = 36-850 32-435 F008650E TCB3-90 Transparent = F018710E Beige = F008710E 28140 038750E 63350E