August 2018 CPN

CPN

Community Pharmacy News – August 2018

Flu Vaccination Service changes • PSNC negotiates payment increase • Registration requirement removed • Patients can be vaccinated at home First CEO blog | Category M increase | FMD update | Exemptions factsheet

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Chief Executive’s blog Starting from this month, in each issue PSNC Chief Executive Simon Dukes will use this section of CPN to provide an update on PSNC’s work.

I am pleased to say that all three are well underway, and I will talk about my strategic plans in future blogs.

As someone new to the world of community pharmacy, I also have two immediate observations.

Simon Dukes

PSNC Chief Executive Welcome to my first CPN blog.

On arriving as CEO of PSNC, I set myself three priorities that are crucial to my role in negotiating on behalf of community pharmacy: (i) to speak to every PSNC Committee Member and visit as many community pharmacies and LPCs as my diary would allow to listen to the challenges being faced on the front line; (ii) to rebuild the relationship with HM Government in preparation for a new round of negotiations later in the year; and (iii) to reach out to, and work more closely with, the CEOs of the NPA, CCA, AIM, RPS and PDA to explore new opportunities for the sector.

Aside from the very difficult economic situation for many community pharmacies, there’s a lot going on in the outside world too: we have a new Secretary of State with a clear digital agenda which will bring challenges and opportunities; we still have the outcome of the Judicial Review appeal hanging over us; there’s a raft of legislation slowly making its way through Parliament which will impact pharmacy (Healthcare (Local Accountability) and Local Health Scrutiny Bills, as well as the NHS Bill); and of course there’s Brexit.

PSNC has an increasingly important role to play in strategic influencing to ensure that these external factors have a positive impact on pharmacies. We are engaging with HM Government on many fronts to represent all aspects of community pharmacy in England – from discussing the implications of Brexit on medicines supply to the Falsified Medicines Directive (FMD) to the NHS Long Term Plan. We are at the table on all these issues and we are working collaboratively

with the Government as well as other pharmacy groups to get the best outcomes for pharmacies and your patients.

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We are working collaboratively to get the best outcomes for pharmacies and patients

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Which leads me on to the second observation. PSNC needs to do more to communicate better with community pharmacy, and you will notice a number of initiatives over the coming weeks aimed at addressing this, including this blog.

Your day-to-day dealings with patients and suppliers, NHS/CCG/STPs and other healthcare providers can seem miles away from the strategy, lobbying and negotiating of PSNC, and I want to make community pharmacy better informed about what we are doing on your behalf. The quid pro quo is that we need to hear your views too: through the Committee itself, via LPCs or directly to me at: chiefexec@psnc.org.uk There is much important work to be done, but I look forward to updating you on our progress.

Committee blogs coming soon

Meet PSNC’s CEO

PSNC will be launching a blog section on its website where community pharmacy teams can hear directly from our members. Check the website for details of the launch.

First up is Sian Retallick who was appointed PSNC South Western Regional Representative earlier this year.

PSNC Chief Executive Simon Dukes will be holding a webinar to discuss his plans for the future of community pharmacy and answer questions from contractors.

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Community pharmacies are finding things very challenging indeed at the moment so I wanted to join PSNC to find out more about funding and what the vision and plan for pharmacy is; we can’t do this on our own.

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The webinar, scheduled for Thursday 20th September at 7.30pm, will provide an opportunity for contractors to hear about the direction that Simon wants PSNC to take.

Register for the CEO’s webinar at: psnc.org.uk/webinar

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Category M reimbursement price increase • PSNC has negotiated a £15m increase in Category M prices from August 2018 • The increase comes as DHSC ceases margin recovery for now, recognising the impact on contractors’ cashflow • This decision is positive and reflective of the collaborative working relationship between DHSC and PSNC • Further excess margin earned in 2016/17 will need to be recovered at a later date and PSNC and DHSC will discuss this further before the October Drug Tariff

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These reductions had been in place since August 2017 and had been set to continue.

This was because the latest Margins Survey results from 2016/17 suggest that there was over-delivery of margin in that financial year, with some excess yet to be recovered

by DHSC. The decision to cease the Category M price reductions to recover margin now was a result of negotiations with PSNC in which we raised concerns about the impact of price reductions on contractors’ cash flow.

However, underlying Category M prices will continue to be based on manufacturers’

PSNC has set up a Brexit forum involving the Chief Executives of the pharmacy representative bodies and stakeholders from across the medicines supply chain.

The forum will liaise with the DHSC and support their work to ensure that the supply of medicines to community pharmacy patients is maintained. It also provides a platform for stakeholders to share thoughts and compile advice for community pharmacy teams.

MPs learn impact of drug pricing

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The increase is because DHSC has agreed to cease the £15 million per month reduction in prices that had been in place to recover estimated excess margin delivered to pharmacies in 2015/16 and 2016/17.

Community Pharmacy Brexit Forum

PSNC will provide updates from the forum’s work in due course.

We will work to ensure that any future mechanisms to correct margin delivery are as manageable as possible in terms of cash flow

Category M reimbursement prices will increase by £15 million a month from August 2018, the Department of Health and Social Care (DHSC) has confirmed.

LPCS

data so prices will still reflect the lower purchase prices that led to the additional reduction in prices seen in the July Tariff.

Category M prices have been uplifted by an average of 16% which equates to an increase in Average Item Value (AIV) of between 19 and 20 pence per item on all items. This increase is reflected in the August 2018 Drug Tariff.

PSNC Director of Pharmacy Funding, Mike Dent said: “The decision to cease margin recovery in the short-term in light of PSNC’s representations about contractors’ cash flow is very positive and reflective of the collaborative relationship that we are trying to rebuild with the DHSC. PSNC will be working, through the negotiations on funding and in discussions with the Department, to get the best possible deal for contractors and to ensure that any future mechanisms to correct margin delivery are as manageable as possible in terms of cash flow.”

FAQs A series of Frequently Asked Questions have been developed to further explain what this means for contractors. These are available from: ow.ly/e92z30l1BK1

Mark Burdon, PSNC Regional Representative for the North East and Cumbria, gave evidence to an investigation by the Public Accounts Committee (PAC) into price increases in generic medicines.

He told MPs about the thousands of reports that PSNC had received about shortages and described the work that community pharmacies had done to ensure that no patients were harmed.

The PAC also heard evidence from representatives of the the DHSC, the MHRA and NHS England. A report of the inquiry will be published in the autumn.

MPs report on Capita contract The PAC has recognised a number of problems with the Primary Care Support England (PCSE) services delivered to pharmacies and other healthcare providers by Capita.

The Committee said that service failures following the outsourcing of the contract were disruptive to thousands of primary care practitioners and put patients at risk of serious harm.

PSNC submitted written evidence to the PAC to highlight the additional workload that community pharmacy teams have had to endure, but also continues to work with both Capita and NHS England to address these issues.

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SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Flu Vaccination Service: Your ‘at a glance’ guide • PSNC secures Flu Vaccination Service payment increase to £9.48 • Requirement to register with NHS Business Services Authority (NHS BSA) removed • Improvements to payment processes and training requirements, and pharmacy’s patients can be vaccinated at home PSNC has worked with NHS England to agree some key improvements to the community pharmacy Flu Vaccination Service for 2018/19.

This ‘at a glance’ guide has been created to outline the changes.

Consent form Documentation for patient consent and record-keeping has been separated into two different forms. If requested by the NHS BSA, contractors will only need to submit the consent form for the purposes of post payment verification. The new forms are available from psnc.org.uk/flu

Training requirements

Funding and payment

Pharmacists providing the service now only need to undertake face-to-face training for injection technique and basic life support every three years. Also, a new Vaccination services Declaration of Competence (DoC) has been published, which combines the previously separate frameworks for the national and locally commissioned services. PSNC has published a series of FAQs which explain the DoC requirement in more detail: ow.ly/uEc230kUbHG

The fee for vaccination has been increased to £7.98 per administered dose of vaccine plus an additional fee of £1.50 per vaccination. Also, this year, contractors will have the option to submit their payment claims electronically via an NHS BSA webform.

Over-65s vaccine NHS England has advised that for the 2018/19 flu vaccination season, adjuvanted trivalent influenza vaccine (aTIV) (Fluad, Seqirus) should be offered to all those aged 65 and over. Contractors are advised to read the guidance issued by NHS England (and supported by PSNC and the British Medical Association), which can be found at: ow.ly/gS0n30lpO9p

Sign-up requirement

Changes to the service

Eligible patient groups This year, hospice care workers have been added as an eligible ‘at-risk’ group. This includes staff members employed by a voluntary managed hospice provider who are directly involved in the care of vulnerable patients/ clients who are at increased risk from exposure to influenza.

Social care workers who were added as an eligible group in November 2017 continue to be eligible for the service.

Contractors no longer need to submit a declaration form on the NHS BSA website to start providing the service. The monthly flu vaccinations claim form (both the electronic and paper form) will now contain the appropriate declaration which contractors sign prior to submission.

Off-site vaccinations Contractors can for the first time undertake vaccinations in a patient’s home (where there is an existing clinical relationship with the patient) in addition to vaccinating patients in a long-stay care home or residential facility.

Contractors need to notify their local NHS England team and, when vaccinating patients in a long-stay residential care home or other long-stay care facility, also the patient’s GP practice.

Community pharmacy teams can watch a PSNC webinar which further explains these changes to the 2018/19 Flu Vaccination Advanced Service via psnc.org.uk/fluwebinar 4 Community Pharmacy News – August 2018

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Court of Appeal upholds High Court decision on pharmacy funding cuts Appeal Judges dismiss case against judgment that the funding reduction and other changes were not unlawful.

The Court of Appeal has upheld the High Court ruling that the reduction in funding imposed on community pharmacies in October 2016 was not unlawful.

the funding changes unlawful, “even if a reduction in the numbers [of community pharmacies] was expected”.

PSNC and the National Pharmacy Association (NPA) both brought Judicial Reviews cases following the Secretary of State’s decision to impose a funding reduction in 2016. Following an unsuccessful outcome at the High Court, PSNC and the NPA decided to appeal.

The Appeal cases were heard by three Court of Appeal Judges – Lord Justice Irwin, Lord Justice Hickinbottom and Sir Jack Beatson – and their judgment was handed down on Thursday 23rd August.

The three Court of Appeal judges upheld the initial High Court judgment, agreeing that the funding cuts and consultation relating to them were not unlawful. In dismissing the Appeals, the Judges said that, “there is no principle of law” which would render

Responding to PSNC’s concern about the Department of Health’s (DH’s) reliance on an assumed 15% operating margin, the Judges agreed: “It was regrettable that the process was not more open.” But found that, “since no such margin was treated as a critical point in the decision, the point could not render the process unfair.”

Future funding We expect that funding negotiations for 2018/19 will begin shortly. The process of rebuilding relationships with Government has been an early priority for PSNC’s new CEO, Simon Dukes.

For more information, including statements from PSNC and a summary of the judgment, please visit: ow.ly/gJQc30ltKue

MPs turn out for pharmacy PSNC, working with LPCs and other pharmacy organisations, held a busy briefing event in Parliament last month, which 35 MPs attended to learn about how community pharmacy teams can support people with long-term conditions.

The MPs, along with seven representatives from other MPs’ offices, were briefed on how pharmacy teams can identify and treat longterm conditions in the community, help to keep people healthy and out of hospital, and reduce pressure on GPs and other parts of the health service. Many of them expressed support for the sector and PSNC and LPCs will be following up with them over the summer.

Photos and videos taken at the event have already been shared on social media, and a selection of these can also be viewed at: ow.ly/BLuV30l2x9s

DISPENSING AND SUPPLY

Health Secretary sets out priorities New Health and Social Care Secretary Matt Hancock has announced that prevention, technology and the healthcare workforce are to be the top priorities for the health service.

Mr Hancock said that the NHS needs to take more of a holistic approach to prevention and “to make the investment in primary care and community pharmacies so people don’t need to go to hospital”.

PSNC Chief Executive Simon Dukes said: “We are pleased to hear the new Secretary of State acknowledging the need for investment in community pharmacies so that they can do more to help ease pressure on hospitals.

This is in line with PSNC’s ambitions – pharmacies are ideally placed to help people to stay healthy and avoid visits to hospital.”

July PSNC meeting summary At the meeting of PSNC held last month in Crewe, key agenda items included: • The significant financial pressure that contractors are currently experiencing; • Potential amendments to NUMSAS that would help to improve the service; • The 2018/19 flu vaccination service; • Ongoing support for LPCs; and • Parliamentary lobbying activity.

A summary for contractors can be downloaded from: ow.ly/vFGj30l4nyJ Further details regarding PSNC’s ongoing work will be shared on the website as soon as possible.

PSNC at the Pharmacy Show Registration is now open for this year’s Pharmacy Show, where there will be an opportunity to see presentations on innovative and unique services taking place in community pharmacies across the country at the PSNC Pharmacy Services Innovation Theatre.

The Pharmacy Show takes place on 7th and 8th October 2018 at The NEC in Birmingham. Register for your free place at: ow.ly/8hra30kMFaf

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CONTRACT AND IT

Overpayment recovery appeals Community pharmacy contractors now have a route to appeal against an NHS England decision to recover overpayments as part of the Pharmacy Provider Assurance Programme.

New Directions plug a gap in the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 which refer to an appeal option for contractors but provide no mechanism for the appeal.

At PSNC’s request, NHS England agreed not to seek to recover overpayments until an appeal mechanism was in place.

Find out more at: ow.ly/X1nl30lbdlu

Pharmacy regulation consultation PSNC has submitted its response to the General Pharmaceutical Council’s (GPhC) consultation on developing its approach to regulating registered pharmacies, highlighting concerns about the proposal to move to unannounced inspections.

Whilst PSNC supports the GPhC’s overall intention to move towards an inspection model more similar to that of the Care Quality Commission (CQC), it considers the proposal to make all inspections unannounced both unnecessary and undesirable. Although it was recognised that unannounced visits in appropriate circumstances could help to establish patient confidence in the GPhC.

CPAF monitoring process continues Community pharmacy contractors responded positively to this year’s Community Pharmacy Assurance Framework (CPAF) screening questionnaire, with 98% completing the survey by the closing date.

The next stage of the CPAF monitoring process will involve NHS England visiting up to 2% of pharmacies to validate the answers given in the screening questionnaire. The aim is to observe areas of good practice and also identify any situation where answers provided appear inconsistent with the evidence available.

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

FMD: Six months to go • PSNC is working as part of the UK Community Pharmacy FMD Group • Pharmacists have been advised by the Group to consider their FMD IT systems very carefully • A list of potential IT suppliers is now available • PSNC is working with the other national negotiators to cost FMD compliance for contractors

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We are mandated to comply so we must proceed, albeit with caution

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The UK Community Pharmacy Falsified Medicines Directive (FMD) Working Group is advising that uncertainties related to Brexit mean that all pharmacies need to carefully consider which systems they choose to verify the authenticity of the medicines they supply. Authentication of medicines under FMD will start from 9th February 2019.

Arvato, part of the Bertelsmann group, has recently signed a contract with SecurMed UK to provide the UK FMD system. Community pharmacies should be able to start getting connected to the system from September this year. The UK system will connect to the central EU FMD hub.

Commenting after a recent meeting of the working group, Chairman and NPA Board member Raj Patel, said: “Given continued Brexit uncertainties, we recommend that whatever system pharmacies choose, they ensure that termination of the contract without penalties is possible, in the remote possibility there is no workable UK FMD repository.”

Meanwhile, the Department of Health and Social Care and MHRA have launched a consultation on some aspects of implementing FMD in the UK, which contains a section on sanctions for non-compliance.

Mr Patel continued: “With a lack of certainty as to just how long the FMD system will be needed for, combined with the financial squeeze on community pharmacy, and the lack of any announcement on government

funding for this regulation, it is hard to justify the investment. However, we are mandated to comply so we must proceed, albeit with caution.”

One of the key requirements of FMD is the ‘decommissioning’ of a medicinal product before a supply is made to a patient. IT solutions will be available which will include standalone FMD systems or FMD capability integrated into patient medication record (PMR) systems. The working group has published a list of FMD IT system suppliers to help contractors to consider their options.

Each of the four national community pharmacy negotiators, including PSNC, is working to ensure that contractors’ FMDrelated costs are recognised in future NHS funding settlements. Some of the costs involved include initial set-up, IT, both software and hardware, plus ongoing operational costs.

FMD Source website PSNC has, on behalf of the working group, refreshed the FMD Source website to add additional content and make it more easily navigable. As well as explaining what FMD is, the site includes detailed guidance on what pharmacies need to do and links to system suppliers who are known to be offering an FMD solution.

Visit it now: fmdsource.co.uk

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HE HEALTHCARE LANDSCAPE

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

Evaluation of GP pharmacists pilot published • Pharmacists working in GP practices shown to have positive impact • A study was undertaken as part of phase 1 of NHS England’s pilot to invest in GP pharmacists • PSNC pleased to see some GP pharmacists have actively engaged with community pharmacies The University of Nottingham has published an evaluation of NHS England’s initiative to integrate pharmacists into general practice, as originally outlined in the General Practice Forward View.

The research team investigated the role and impact of the newly created pharmacist roles from the perspectives of the pharmacists, their work colleagues, stakeholders and patients. The evaluation also considers the activities they have introduced to enhance collaborative working with other healthcare providers, such as community pharmacy, hospital pharmacy and Clinical Commissioning Groups.

Read the evaluation report at: ow.ly/ZbH530lbeBh

PSNC Chief Executive Simon Dukes said: “PSNC is pleased but not surprised to see that pharmacists have had a positive impact on GP capacity and workload. Patients value spending time with pharmacists and there is much evidence that this interaction can improve people’s understanding and use of medicines.

All pharmacists have the knowledge to offer extensive medicines support and advice to patients. We would like to see community pharmacists fully empowered to use their clinical skills in this way, working closely with pharmacists in all other settings. We are keen to work with NHS England to explore how community pharmacies can be better integrated with general practice for the benefit of patients and the NHS.”

Apply for Foundation pharmacist training pathway for “thisApplications year’s Foundation

Clare Smith CPPE Senior Pharmacist, Learning Development

pharmacist training pathway are now open.

This course from the Centre for Pharmacy Postgraduate Education (CPPE) supports newly qualified pharmacists to develop skills in community pharmacy practice.

The 12-month, fully-funded programme provides a comprehensive mix of online tutor-supported learning activities, workshops, assessment and work-based support through a designated workplacebased CPPE education supervisor. It will support you to develop the necessary knowledge, skills, behaviours and experience to deliver excellent patient care.

Our Foundation pharmacist training pathway is mapped to the Royal Pharmaceutical Society (RPS) Foundation practice framework and aims to support you to be capable and competent in your role, ensuring quality of care during the first stage of your foundation training.

Any pharmacist that is newly qualified, returning to community practice after a career break, or working as a locum for at least three days a week, is eligible to apply. The deadline for applications is 14th October 2018, with the course due to start on 5th November 2018.

If you are a newly qualified pharmacist and are interested in CPPE’s Foundation pharmacist training pathway, you can find out more information and apply for a place at: www.cppe.ac.uk/career/ foundation-prog

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NMS for hypertension does not increase GP workload Research which examined referrals for patients with hypertension from community pharmacies to GPs as part of the New Medicine Service (NMS) concludes that additional pharmacist involvement does not increase GP workload.

PharmOutcomes data from 131,419 patients, provided to the researchers

by PSNC, showed that only 4.5% of patients were referred back to a GP within the first two weeks, and most patients did not require a referral.

The research also suggested that an extended prescribing role for community pharmacists could reduce referrals of routine cases to GPs.

Diabetes service improves patient outcomes Community pharmacy teams in Hertfordshire have been participating in a small pilot to provide extra support to patients with diabetes.

During the delivery period from midJanuary to April 2018, 60 interactions were recorded, with 45% of those receiving follow-up consultations.

The patient evaluation found that 90% felt more empowered to manage their diabetes and 95% had time to discuss concerns around their diabetes management.

It concludes that value is being provided to patients with diabetes particularly in identifying atrisk patients at an earlier stage and preventing their condition deteriorating.

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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.

PhIF funded community pharmacy leadership train ing

Community pharmacists and pharmacy technicians are being encouraged to apply for free leadership training.

Fully funded through the Pharmacy integration Fund (PhIF), Health Education England (HEE) is offering a range of training course s to help community pharmacy professionals improve their clinical and leaders hip skills.

Find out more about the training at: ow.ly/O lDi30lk 8VT

Blood in Pee campaign

Community pharmacy teams can now obtain a free toolkit for the Be Clear on Cancer Blood in Pee campaign which is running until 23rd September 2018.

Find out more, including how to order your toolkit, at: ow.ly/S BAG30 lk8Ty

Appeals Unit Name change for renamed Unit has been Services Appeal The Family Health . ice re Appeals serv as the Primary Ca come into Contractors may service, for contact with the armacy’s ph a example, when its core e ang ch request to ned tur is s ur ho opening gland.

En S NH by wn do Learn more at: B2 ow .ly/ cL 0a 30 l2w

S hare your views on SCRs with additional information

NHS Digital has launched a survey to assess the benefits and disadvanta ges of ‘Additional Information’ being available for those healthcar e staff who view Summary Care Records (SCR).

If this additional information is availa ble to community pharmacists and pharmacy technicians, this is likely to have benefits for patient care provided by community pharmacies.

Complete the online SCR additional information survey before 28th September to have your say: ow.ly /Lzy o30lj JUO

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Endorsing Webinar: Your Questions Answered Following PSNC’s endorsing webinar in June, our Dispensing and Supply Team is working to respond to the questions you posed on the night but they didn’t have time to answer.

Q. Could you explain in more detail the difference between an unlicensed/imported special and a special obtain? How can I check if the product I have ordered is an unlicensed special?

A. Below we will define what each are and how to check the classification of a product.

licence number or an importer’s licence number on the accompanying paperwork.

Unlicensed specials/imports Unlicensed specials are unlicensed medicinal products manufactured in the UK for human use and are made to order to meet the individual need of a patient.

To identify an unlicensed special, pharmacy staff should look for the wholesalers’ MHRA specials licence number on the Certificate of Conformity/Certificate of Analysis (COC/COA) supplied with the product.

Special obtains products often include, gluten-free foods and other borderline substances, certain dressings, stoma and incontinence appliances. Do not assume that all special obtains items are unlicensed specials or imported lines.

An imported medicine is licensed in the country of origin but is not licensed in the UK. For imports, an importer’s licence number can be found on the accompanying paperwork.

Special obtains Wholesalers typically categorise products as being either a “standard lines” or “special obtains” item. Items classified as ‘special obtains’ are infrequent, low volume products which are not normally stocked by mainline wholesalers who then source these products on a bespoke, ad-hoc basis to meet demand. As ”special obtains” products often have reference to the word ‘special’ in their description, there is a common misconception that these items are to be treated as unlicensed specials.

Special obtains products would not be supplied with a COC/COA and will not have any details of a manufacturer’s specials

It is important to double check the classification of the product you are ordering, as an incorrect endorsement, could mean you will miss out on the relevant fees such as ‘OOP’/’XP’ for ‘special obtains’ and ‘SP’ for unlicensed specials/ imports.

PSNC TOP TIP

How can you check the classification of a product?

A good resource for checking whether a product is an unlicensed special is the Dictionary of Medicines and Medical Devices. Here you can check if a product is classed as a ‘Drug Tariff Special Order’, a non-Drug Tariff ‘Special Order’ or an ‘Imported’ product. Find the dictionary at: dmd.medicines.org.uk

If you would like more information on this topic, the PSNC Dispensing and Supply Team will be happy to help (0203 1220 810 or email info@psnc.org.uk).

Watch the webinar View an on-demand version of the webinar at: psnc.org.uk/endorsingwebinar.

This page also contains a downloadable version of the slide pack used in the webinar.

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Drug Tariff Watch The first section of the Drug Tariff is the Preface. The Preface lists additions, deletions and alterations which may affect reimbursement and endorsement requirements.

Each month PSNC provides a summary of the changes due to take place. For the changes due to take effect from 1st September 2018, please visit: ow.ly/YonG30lnCbE You may also wish to see our Dispensing Factsheet: The Drug Tariff Preface at: psnc.org.uk/dtresources

Reporting fraudulent prescription forms Community pharmacy contractors are advised to note the change of contact details for the reward scheme for fraudulent prescription forms, as listed in Part XIVA of the Drug Tariff.

Pharmacists who are eligible to claim a reward under the scheme should contact: NHS Counter Fraud Authority Skipton House 80 London Road London SE1 6LH Freephone: 0800 028 4060 Tel: 0207 895 4500 Website: www.cfa.nhs.uk

Supply issues Community pharmacy teams who experience problems in obtaining medicines or appliances are reminded to feed this back to PSNC’s Dispensing and Supply Team.

PSNC reports the feedback received to the Department of Health and Social Care to support their monitoring of the situation.

It is also used in discussions with manufacturers, for example, highlighting problems with contingency arrangements.

Please report using our online feedback forms: psnc.org.uk/feedback

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Dispensing Factsheet: Exemptions from the prescription charge Our Dispensing and Supply Team guides you through the categories of exemptions from the NHS prescription charge and the proof required for each.

Eligible reasons for exemption Exemption category Who is exempt?

Proof required

A. Under 16 years of age

Birth certificate, passport or medical card Please note: Prescriptions with computer-generated dates of birth (DOB) do not require proof of age.

B. Full-time students aged 16, 17 or 18

C. 60 years of age or over

Children under 16 years of age

Must be aged 16, 17 or 18 and in full-time education from an establishment such as a school, college or university or similar, such as home tutored.

Please note: Apprenticeships are not eligible. (However, patients may qualify for a HC2 certificate under the NHS Low Income Scheme tinyurl.com/ybal3auu)

Proof of age can be found on a child benefit award letter, or birth certificate /passport/medical card and proof they are a full-time student can be obtained from the patient’s school, college, university or local education authority (LEA).

Any patient who is 60 years of age or over.

Birth certificate, passport or medical card Please note: Prescriptions with computer-generated DOB do not require proof of age.

How to apply for exemption

N/A

N/A

N/A

D. Maternity Exemption

Expectant mothers and those who have given birth to a child (including a still-born child) in the last 12 months.

Possession of a valid Maternity Exemption (MATEX) certificate.

Please note: Prescription Services are currently trialing digital maternity exemption certificates. Pharmacies may be presented with one of the following types of exemption certificate: • Digital certificate • Printed copy of the certificate • Plastic exemption card More information can be found on the Prescription Services website tinyurl.com/y7olj84w

Patient must complete a FW8 form available from GPs, midwives or health visitors.

These professionals then sign the form and send it off to Prescription Services who then issue a certificate.

Maternity exemption certificate helpline: 0300 330 1341

E. Medical Exemption

Patients with certain medical conditions or physical disability as listed in Part XVI of the Drug Tariff tinyurl.com/ycpw9m78

Possession of a valid Medical Exemption Certificate.

Please note: Patients with qualifying conditions alone are not entitled to exemption without a valid certificate.

Patients must complete an FP92A form available from GPs. The GP will then send the form to Prescription Services who will issue a certificate.

Medical exemption certificate helpline: 0300 330 1341

F. Prescription Prepayment Certificate (PPC)

Patients in possession of a valid PPC at the point of dispensing.

Please note: A PPC is valid for either 3 months or 12 months, depending on the type of PPC purchased.

Possession of a valid PPC. Please note: Prescription Services are working to phase out plastic cards and move towards digital certificates for PPCs. For more information see our website tinyurl.com/ybuh8ye2

Patients can complete an FP95 form, available from pharmacies and purchase in store (for pharmacies registered to sell PCCs) or via post (postage details can be found on the FP95).

Patients can also purchase a PPC online from Prescription Services tinyurl.com/ybqfhapr or by contacting the PPC helpline 0300 330 1341

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LPCS

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

How to apply for exemption

Exemption category Who is exempt?

Proof required

G. War Pension Exemption

Patients holding a War Pension Exemption Certificate and the prescription is for their accepted disablement.

Possession of a War Pension Exemption Certificate.

Patients can write to: The Treatment Group, Veterans UK, Norcross, Thornton-Cleveleys, FY5 3WP Veterans UK helpline: 0808 1914 218

L. HC2 Charges Certificate

Anyone qualifying for full help with health costs through the NHS Low Income Scheme tinyurl.com/ybal3auu

Possession of a valid HC2 Charges Certificate.

Please note: A partner and dependent children under 19 years named on the claim will also be entitled to free prescriptions while the certificate is valid.

Patients must complete the HC1 form, available from Jobcentre Plus Office, forms may also be available from pharmacies, NHS hospitals, dentist, optician or GP surgery. Pharmacies can obtain HC1 forms from PCSE via their online portal. tinyurl.com/ybkrwtm6 NHS Low Income Scheme helpline: 0300 330 1343

X. Free-of-charge contraceptives

Patients in possession of a prescription for a contraceptive substance(s) and/or listed contraceptive appliances for women (as referenced in Part XVI Clause 10 of the Drug Tariff tinyurl.com/ycpw9m78) prescribed on FP10 or any of its variants.

No charge is payable for contraceptive substances and listed contraceptive appliances for women (as referenced in Part XVI Clause 10 of the Drug Tariff tinyurl.com/ycpw9m78) prescribed on FP10 or any of its variants.

Please note: Prescriptions for any other drug not included in the list of contraceptive drugs to be dispensed free of charge must be annotated by the prescriber with ‘CC’, ‘CU’, ‘OC’ or the female symbol ♀. In the absence of such an endorsement by the prescriber and where the patient does not have another valid exemption, the normal prescription charge will apply to that item.

H. Income Support (IS) OR Income-related Employment and Support Allowance (ESA) K. Income-based Jobseeker’s Allowance (JSA) OR Universal Credit (UC)

N/A

Patients in receipt of IS or those included in (this could be the partner of or any dependent young people under 20) an award for IS.

Possession of an IS award notice

Patients can speak to their Jobcentre Plus Office or contact Jobcentre Plus helpline: 0800 169 0310

Patients in receipt of income-based ESA or those included in an award for ESA - this could be the partner of or any dependent young people under 20.

Possession of an ESA award notice

Patients can speak to their Jobcentre Plus Office or contact Jobcentre Plus helpline: 0800 169 0310

Patients in receipt of income-based JSA or those included in an award for JSA - this could be the partner of or any dependent young people under 20.

Possession of a JSA award notice

Patients can speak to their Jobcentre Plus Office or contact the Jobcentre Plus helpline: 0800 169 0310

Patients in receipt of UC.

Possession of a Universal Credit statement.

Patients can apply online via the GOV.UK website tinyurl.com/khunvvu or contact the Universal Credit full service: 0800 328 5644 Universal Credit live service: 0800 328 9344

Please note: UC does not automatically entitle patients to help with their health costs. To qualify, patients must be included in a UC award and their earnings during their most recent assessment period must be: • £435 or less • £935 or less if their UC includes an element for either a child or limited capability for work

Please note: Patients should tick the box K for ‘income-based JSA’ on the patient declaration until the prescription form is updated to include an exemption category for UC.

‘Most recent assessment period’ means the assessment period that ended immediately before the date a patient claims a free NHS prescription. It runs for a calendar month.

psnc.org.uk 11

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

Exemption category Who is exempt?

Proof required

M. NHS Tax Credit Exemption

Patients (including any partner and/or young person(s) included in the claim) receiving tax credits, who have been sent ‘NHS Tax Credit Exemption Certificate’ by Prescription Services.

Please note: To be entitled to a Tax Credit Exemption certificate, the patient and their partner (if applicable) must: have a combined annual income for Tax Credit assessment purposes of £15,276 or less, and; be in receipt of Child Tax Credit and/or receive a disability element of Working Tax Credit* *Receiving Working Tax Credit alone (no disability element included) does not entitle patients to help with health costs, regardless of their annual income.

Possession of a valid NHS Tax Credit Exemption Certificate.

Please note: Prescription Services are working to phase out plastic cards and move towards digital certificates.

In the interim pharmacies may be presented with one of the following types of exemption certificate: • Double-sided A4 paper certificates • Plastic exemption cards

Patients or their partners in receipt of PCGC.

Possession of a PCGC award notice.

S. Pension Credit (Guarantee Credit) paid on its own, or Pension Credit (Guarantee Credit with Savings Credit)

THE HEALTHCARE LANDSCAPE

How to apply for exemption Certificates are automatically issued to eligible patients.

Tax Credit helpline: 0345 300 3900

For more information see our website tinyurl.com/ybuh8ye2

Patients can speak to their Jobcentre Plus Office.

Pension Service helpline: 0800 731 0469

Other exempted persons/categories Prisoners on Release

Prisoners on release and those released from secure accommodation (e.g. courts, training areas or children’s home) who present an FP10 or FP10(MDA) with the letters ‘HMP’ computer printed in the practice address box.

The letters ‘HMP’, the prison/secure accommodation address, contact number, prescribing code and cost centre code must be computer printed in the box provided for the practice address.

Please note: if the above is handwritten, it cannot be accepted as automatically exempt.

N/A

If the necessary information is on the prescription then the patient is classed as automatically exempt and does not need to sign or tick the declaration on the back of the form.

Ineligible reasons for exemption Those in receipt of the following benefits are not eligible to claim for exemption from prescription charges in England: • Contribution-based Jobseeker’s Allowance and Employment and Support Allowance paid on its own; • Pension Credit (Savings Credit), paid on its own; • HC3 certificate for limited help with health costs; • Any benefit paid on its own and not listed on the back of a prescription (such as Disability Living Allowance, Personal Independence Payment or Incapacity benefit); and

• Asylum seekers – instead supported by the National Asylum Support Service (NASS) who will automatically send an NHS Low Income Scheme HC2 certificate entitling them to help with health costs including free prescriptions. Alternatively, patients can apply for support using the HC1 application form.

For a full list of benefits that do not entitle patients to exemption from the prescription charge see Prescription Services website tinyurl.com/ybunwhcm.

‘Check Before You Tick’ campaign

During September 2018, a new nationwide campaign, ‘Check Before You Tick’, will be launched to help patients understand their eligibility for free NHS prescriptions, and to highlight the possible consequences of making an incorrect claim.

NHS England will be posting a toolkit of materials to pharmacies to help prompt patients and offer guidance.

Community pharmacy contractors and their teams already play a key role in the prescription exemption checking process, but further information and resources which may help with this campaign are available from ow.ly/NaRj30loFmD

12 Community Pharmacy News – August 2018

LPCS

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 034/18: Information and disclosure regulations This briefing describes how The Health Service Products (Provision and Disclosure of Information) Regulations 2018 applies to community pharmacy contractors. It also includes brief details on the requirements relating to wholesalers, as some community pharmacies have wholesale dealer’s licences.

Download from: ow.ly/tMaU30ljKXF PSNC Briefing 036/18: Contract Factsheet – Pharmacy opening hours in 2019 PSNC’s Regulations and Support Team are often asked questions about the requirements in the terms of service relating to opening hours. This briefing contains a quick reference guide for 2019.

Download from: ow.ly/jhfe30ljKTY PSNC Briefing 038/18: Change of pharmacy circumstance guide: ODS codes and planning required should your ODS code change This briefing explains pharmacy ODS (F) codes and those actions needed if your pharmacy circumstances are going to change (e.g. location or ownership). It focuses on mitigating IT/Electronic Prescription Service (EPS) impacts where such changes are planned.

Download from: ow.ly/fGvy30ljKR9 See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources Flu Vaccination Service webinar A recording of PSNC’s webinar on the Flu Vaccination Advanced Service is now available. During the webinar Alastair Buxton, Director of NHS Services at PSNC, explains how the service differs for the 2018/19 flu season, highlighting some important changes community pharmacy teams need to be aware of.

Watch now: psnc.org.uk/fluwebinar PSNC CEO webinar Discussing his first impressions of the sector, the key issues and how he plans to move forward, this webinar will give an insight into the PSNC Chief Executive’s ambitions for the next few years.

Register now: psnc.org.uk/webinar t Look out for additional resources as you explore our website: psnc.org.uk

Email news alerts Category M reimbursement prices to increase from August 2018 (19th July) This email provided information on the announcement that PSNC had negotiated a £15 million a month increase in Category M prices from August 2018 with the Department of Health and Social Care.

Read now: ow.ly/JSCA30ljKAr 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

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