December 2017 CPN

CPN

Community Pharmacy News – December 2017

Shortages hit the headlines

Pharmacy’s struggle to get hold of vital medicines for patients is recognised in the national media NHS to stop prescribing 18 medicines | EPS urgent care pilot | Flu Vaccination Service FAQs

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Drug shortages featured in national press As community pharmacy contractors continue to wait to hear about November price concessions, the impact of these drug shortages on patients is now making headlines in the national press.

On Thursday 7th December, the front cover of The Times featured an article raising concerns about patients not being able to get hold of vital medicines due to drug shortages.

The Times reported that cancer patients and people with severe mental illness are being particularly affected by the shortages, which have cost the NHS £180 million in the last six months due to substantial price increases. The article went on to state that at least 100 drugs have been affected by supply problems, forcing health officials to approve temporary price rises of up to 4,000% to boost stocks.

Community pharmacy contractors and their teams will be all too aware of the current generic supply situation. PSNC Committee Member and independent contractor Mark Burdon is quoted in the article referencing the difficult situation that pharmacy teams were being put in trying to explain the situation to patients whilst they were “scratching around” for crucial supplies.

As CPN went to press, the team at PSNC continue to press urgently for a decision on the outstanding November price concession applications and we have been assured by the Department of Health (DH) that this is a priority. We hope to receive a reply soon and well before November prescription pricing is finalised. As soon as any announcement is made we will inform contractors via our website (psnc.org.uk/ncso) and email news alerts (you can sign up for these at: psnc.org.uk/enews).

PSNC is making applications for December as usual. We have made DH aware of the hardship the situation is imposing on contractors, coming as it does on top of the recent funding cuts and margin recovery, and ultimately of the risks for patients who may struggle to access vital medicines.

We base our applications for price concessions on feedback from contractors, and information provided by suppliers. DH then undertakes its own investigations and sets price concessions using the information they have gathered. The resulting prices are often less than the prices at which individual contractors can purchase medicines.

PSNC is continuing to work to ensure that the DH understands the problems and risks if pharmacies are not able to obtain medicines for patients in a timely manner, and to press for better systems to address the impact of high price rises.

Mike Dent, Director of Pharmacy Funding at PSNC, said: “We are receiving unprecedented numbers of calls from community pharmacy teams who cannot get hold of certain medicines that patients need despite their best efforts; or who are having to pay prices many times more than the NHS reimbursement price. This has been going on for many months. When we request price concessions, the Department of Health always makes its own inquiries following reports from us to validate the availability and prices around the country.”

One-off 12ppi increase made to December 1st advance payments Community pharmacy contractors received an increase in their December 1st advance payments (made for services provided in October) of 12p per prescription item (ppi).

This was a one-off increase, implemented in the same way as the one-off 15ppi increase that was given for November 1st advance payments.

PSNC had continued to press for urgent intervention to offer some relief for contractors, and this latest measure was taken in recognition of the continuing extraordinary cashflow challenges being faced by contractors.

2 Community Pharmacy News – December 2017

The increase was once again confirmed for one month only, and full and final payment for services provided in October will be reconciled as usual at the end of December.

This means that contractors will not receive any additional funding overall; this measure was designed to help smooth cashflow.

Contractors should note that last month’s increase of 15ppi has been recovered as full and final payment for services provided in September were reconciled as usual at the end of November.

LPCs

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Prescribing restrictions agreed for low value medicines NHS England agrees prescribing restrictions for low value medicines whilst also announcing its intention to run a full consultation on NHS provision of overthe-counter (OTC) products in the New Year.

NHS England has issued guidance to GPs and Clinical Commissioning Groups to “remove ineffective, unsafe and low clinical value treatments, such as some dietary supplements herbal treatments and homeopathy, and restricting the use of a further 11, saving up to £141 million a year.” It also decided a full consultation should be held in early 2018 on a proposal that the prescribing of OTC products, currently prescribed at NHS expense, should be restricted in the future.

Low value medicines The announcement on low value medicines follows a consultation held earlier this year on a list of 18 treatments which were proposed as items which should not be routinely prescribed in primary care.

Following consideration of the responses to the consultation, the NHS England Board agreed that the following treatments should no longer be routinely prescribed: • Homeopathy – no clear or robust evidence to support its use; • Herbal treatments – no clear or robust evidence to support its use; • Omega-3 Fatty Acid Compounds (fish oil) – essential fatty acids which can be obtained through diet, low clinical effectiveness; • Co-proxamol – had its marketing authorisation withdrawn due to safety concerns; • Rubefacients (excluding topical NSAIDS) – limited evidence; • Lutein and Antioxidants – used to treat the eye condition age related macular degeneration, low clinical effectiveness; and • Glucosamine and Chondroitin – used for joint pain, low clinical effectiveness.

A joint clinical working group considered the responses to the consultation and agreed that the recommendations for the 18

products consulted on should either remain unchanged (13 products) or be modified or clarified in five cases (Liothyronine, Travel Vaccines, Lidocaine Plasters and Immediate Release Fentanyl).

OTC medicines Proposals for the consultation on OTC medicines include stopping the routine prescribing of products that can be purchased over the counter and treat a condition that is considered to be self-limiting or which could be managed by self-care.

NHS England says it will continue its work alongside NHS Clinical Commissioners to further develop these proposals, and identify scenarios where exemptions may be necessary.

PSNC Chief Executive Sue Sharpe said: “As the NHS grapples with its funding crisis, it is becoming more important than ever that we develop support for self-care, so that people can manage their health without the need to visit their GP or hospital. The NHS looks to community pharmacies to do this, promoting them as a first port of call and a place for patients to go for advice and self-care treatments.

But those looking to transfer the burden from GP practices and urgent care towards pharmacy must acknowledge that without proper resourcing, community pharmacy will also not be able to manage. The current financial pressures facing community pharmacies mean their ability to soak up winter pressures on the health service is already faltering. Many are struggling to survive.

Community pharmacies can do much more to help, but they are not an infinite resource.”

Budget 2017: Chancellor pledges £10 billion for STPs An extra £2.8 billion will be made available to the NHS in England over the next three years, Chancellor Philip Hammond confirmed in his Budget speech last month. £350 million will be given immediately to assist with winter pressures, with a further £1.6 billion being delivered in 2018/19 and the remainder in 2019/20. Acknowledging that the service “remains under pressure”, the Chancellor announced this additional

resource as an exception because it falls outside the usual Spending Review process.

Reconfirming the Government’s commitment to Sustainability and Transformation Partnerships (STPs), the Chancellor also pledged £10 billion to investing in “an NHS which is fit for the future” and he expressed his hope that STPs will make the NHS more resilient.

PSNC Chief Executive Sue Sharpe said: “Sustainability and Transformation Plan

leaders must now make the right decisions to make the most of the investment announced and ensure the sustainable future that the Government wants. That means working with the parts of primary care that have the most contact with patients, and it means investing in services that improve the health of local populations.

We hope that the additional funding will be spent wisely, on services that we know can help patients and wider public services, and which make full use of the network of community pharmacies.”

psnc.org.uk 3

CONTRACT AND IT

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

EPS to be piloted in urgent care settings Trial of the Electronic Prescription Service (EPS) by prescribers in urgent care settings to start shortly as NHS Digital organises pilot scheme.

NHS Digital and partners will shortly begin trialling use of EPS by prescribers in urgent care settings.

will not affect existing nominations for the patient’s ‘regular’ prescriptions.

A pilot will take place for selected users of the Adastra system, the clinical software used in many urgent care settings. Care settings will include NHS 111, GP out of hours services, Clinical Assessment Services (CAS), Walk-in Centres, Minor Injuries Units and Urgent Care Centres.

Prescribers will identify a pharmacy that is open and accessible for the patient using similar processes as used for paper FP10s and, as EPS cannot indicate the urgency of the prescription, prescribers have been asked to ensure that the pharmacy is contacted to alert them that the electronic prescription is available for them to dispense.

Prescribers within the pilot sites will be able to use EPS to prescribe medicines in the same way as EPS prescriptions are currently issued

by GP practices. As patients can get their prescriptions dispensed from any NHS community pharmacy in the country, all pharmacy staff (including locums) should familiarise themselves with the details of the pilot.

The prescriptions will be downloaded by the contractor’s PMR system in the normal way. Pharmacies that are open out of hours and that regularly receive paper prescriptions written by prescribers from urgent care providers may want to consider reviewing how frequently they download prescriptions from the central NHS Spine, so that any prescriptions sent by urgent care services are downloaded promptly. The prescription message will contain the contact details of the prescribing site in case there are any queries for the prescriber. The existing EPS dispense/claim message sending processes are unaffected.

Assuming a successful pilot, the EPS functionality for urgent care settings will be rolled out nationally.

How will the pilot work?

The pilot will use a new type of ‘one-off nomination’ to send the prescription to the pharmacy that the patient has selected; this

For more information on the EPS pilot in urgent care settings, please visit: psnc.org.uk/EPSurgentcare

NHS Choices to trial improved Find a Pharmacy service The NHS Choices website is to trial an improved ‘Find a Pharmacy’ service. This new search service will allow website visitors to find the nearest pharmacy to them which is open at the time of the search.

The current pharmacy search on NHS Choices will identify nearby pharmacies, but it does not identify which are open at the time of the search. Research on the way NHS Choices visitors use the current pharmacy search suggests that most of them are looking for an open pharmacy in the out of hours period. The new search functionality is possible following the recent widespread updating of NHS Choices pharmacy profiles, including opening hours, as part of the Quality Payments Scheme.

Assuming the new search performs as expected during the trial period, there will be a gradual transition of visitors to this search, with the majority being directed to the new search by the end of January 2018.

Pharmacy teams share their views on preferred EPS enhancements NHS Digital ran a survey in September to gather the views of community pharmacy teams about which enhancements to the Electronic Prescription Service (EPS) they would like to see prioritised.

Around 1,000 pharmacy team members took part by completing the online survey, and the most requested EPS enhancements were: • High priority prescriptions: ability for prescribers to add alerts to urgent EPS prescription; • One-off nomination: to manage a patient’s request for the one-off use of a pharmacy while ensuring that future prescriptions return to the original nominated dispenser; and • Automatic downloads: ability to choose to automatically have prescriptions appear in the dispensing system inbox throughout the day without manual download requests.

The full results will be analysed in detail by NHS Digital, PSNC, and the Community Pharmacy IT Group to further inform workplans.

4 Community Pharmacy News – December 2017

TH

HE HEALTHCARE LANDSCAPE

LPCs

PSNC’s WORK

FUNDING AND STATISTICS

Answered: Your vaccination of social care workers FAQs Publication of new service documentation enables community pharmacists to administer NHS flu vaccinations for social care workers. Here we answer your queries on the new cohort.

Q

What is different about the updated Flu Vaccination Advanced Service?

The only change to the 2017/18 Flu Vaccination Advanced Service is the addition of care home and domiciliary care workers to the eligible group of patients that can be vaccinated. Therefore, the following documents have been updated due to this change: • service specification; • Patient Group Direction (PGD); • GP notification form; • patient questionnaire; and • record and consent form.

Please note that the term for this group on the above documentation appears as “social care worker”.

Pharmacy teams should dispose of the superseded forms and documentation and use the updated materials from 20th November 2017.

Q

Which care home and domiciliary care workers are eligible to receive the Flu Vaccination Advanced Service?

Only health and social care staff (aged 18 years and over) employed by a registered residential care/nursing home or registered domiciliary care provider who are directly involved in the care of vulnerable patients/clients who are at increased risk from exposure to influenza, meaning those patients/clients in a clinical risk group or aged 65 years and over, are eligible to be vaccinated by community pharmacies.

Q

Can the community pharmacy provide vaccinations to care home and domiciliary care workers at their place of work?

No. Flu vaccinations must be administered to care home and domiciliary care workers at the community pharmacy premises.

There is no provision within the service specification to vaccinate care home and domiciliary care workers at their place of work.

Community pharmacies can continue to vaccinate patients in care homes by following the outlined process in the service specification.

Q

Do pharmacists providing the service need to sign a new Patient Group Direction (PGD)?

Yes. If the community pharmacy wishes to provide the Flu Vaccination Service to care home and domiciliary care workers, community pharmacists must sign the new PGD, alongside a signature from an authorising manager. The old PGD will still be valid but does not include care home and domiciliary care workers, so this cohort will not be able to be vaccinated as part of the Flu Vaccination Advanced Service unless the new PGD is signed.

Q

If a person presenting is a care home and domiciliary care worker but is also eligible to receive the Flu Vaccination Advanced Service at the community pharmacy because they are part of an ‘at risk’ group, under which risk category should they be recorded?

The person presenting should be recorded under their ‘at risk’ group for their eligibility for the Flu Vaccination Advanced Service.

Q

Does the care home and domiciliary care worker need to provide evidence that they work within a relevant organisation?

Yes. A care home and domiciliary care worker to be vaccinated under the Flu Vaccination Advanced Service should present evidence that they are eligible – they’ll have been told by their employer to bring some evidence with them. The types of appropriate evidence accepted could be an ID badge or payslip from their place of work. A letter on the employer’s letterhead would also be acceptable evidence. As with all patients who present for a vaccination, it’s up to the pharmacy to decide if they are satisfied that the patient is eligible under the advanced service.

PSNC has provided a template that pharmacies can give to local care provider organisations for them to add to their letterhead and provide to staff. (Download the template from psnc.org.uk/flucareworkers)

For more information, including links to the updated documentation and new PSNC resources, please visit psnc.org.uk/flucareworkers

psnc.org.uk 5

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

Local service enables pharmacists to administer children’s flu vaccines Leicestershire community pharmacies are providing a children’s nasal flu vaccination ‘mop-up’ service following a successful pilot.

2015/16 pilot evaluation More than 1,000 letters offering the service were sent to parents 33% responded to the invite letters Learn more about the service at: ow.ly/5jN530gURJS Community pharmacy teams in Leicestershire have been taking part in a ‘catch-up’ programme allowing them to vaccinate children in school years 1-6 against influenza. After a successful pilot during the 2015/16 flu season, the service was re-commissioned during the 2016/17 flu season and again in 2017/18.

Although children’s nasal flu vaccines are normally administered in schools, there are occasions where children are unable to have this done at school on the day set for vaccinations, for example, if they have a severely blocked nose, fever, wheeze or if they are homeschooled or absent on that day.

Leicestershire Partnership NHS Trust had previously utilised local clinics to vaccinate those children that missed out on being vaccinated at school, however there were a limited number of locations where the clinics operated and they did not provide much flexibility for access outside of school times.

It was therefore decided that community pharmacies would be utilised to provide second opportunities for children to have the Fluenz/nasal flu vaccine due to their accessibility and existing provision of other vaccinations, which means that their teams are already familiar with provision of such services.

In the community pharmacy service, parents are invited to present at a local pharmacy for their child to be vaccinated. When the parent and child attend the pharmacy, the child will undergo a clinical check by the pharmacist to determine whether they are suitable to receive the vaccine. If the child is eligible for vaccination, the vaccine will then be administered.

As the key aim behind the service was to ensure patients and their parents have convenient access to the Fluenz/nasal flu vaccine, it

6 Community Pharmacy News – December 2017

240 children received the nasal flu vaccine at a community pharmacy 14 community pharmacies took part in the pilot was very positive when the 2015/16 pilot evaluation found that all parents stated that they found it easy to have their child vaccinated in the community pharmacy.

A total of 1,050 letters were sent out to parents offering them a second opportunity to have their child vaccinated; 344 parents responded giving a 33% response rate. Out of those that responded, 240 children (70% of those that responded to the invitation letter and 23% of the full cohort of patients invited) then went on to have the vaccine administered at one of fourteen community pharmacies participating in the pilot.

Parents rated the experience as extremely good and said that they would definitely use the service again if the opportunity was available.

Top tips for LPCs Luvjit Kandula, Chief Officer of Leicestershire and Rutland LPC, shares her tips for other LPCs who wish to implement a similar service in their area: • talk to your public health childhood immunisation team and find out the percentage of children who missed out on their school flu vaccination and discuss how pharmacies may increase uptake through a mop-up programme; • use the service specification and evaluation from the Leicestershire service to build on its success and demonstrate community pharmacy’s potential; and • get the workforce on board: identify pharmacies who are willing to get engaged with the service and inform them in advance of what you are proposing to do.

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

NHS 111 refer patients with low acuity conditions to community pharmacies A pilot in the North East integrates community pharmacy into NHS 111 referral pathways for people suffering from minor conditions.

A new pilot service is enabling NHS 111 to refer patients requiring advice and/or treatment for certain conditions to community pharmacies across the North East of England.

The Community Pharmacy Referral Service (CPRS) pilot will see NHS 111 call handlers referring patients with ‘low acuity’ conditions to community pharmacies for face-to-face consultations using PharmOutcomes or NHSmail. The conditions eligible for the service include rashes, constipation, diarrhoea, vaginal discharge, sore eye, mouth ulcer, failed contraception, vomiting, scabies and ear wax.

The pilot covers the geographical area of Durham, Darlington, Tees, Northumberland and Tyne and Wear which is covered by ten Clinical Commissioning Groups and contains a population of approximately 2.6 million. Up to 618 pharmacies are eligible to sign up to provide the service across the region.

Running from 4th December 2017 until 31st March 2018, the pilot service is intended to increase capacity and relieve pressure on existing urgent care services, delivering care closer to home and resulting in cash savings. The Pharmacy Integration Fund is providing funding to support the pilot and its evaluation.

NUMSAS pilot extended for a further six months At NHS England’s Pharmacy Integration Fund event on Thursday 16th November 2017, it was announced that the NHS Urgent Medicine Supply Advanced Service (NUMSAS) would continue to be commissioned for a further six months beyond the end of March to allow a proper evaluation of the service to be completed; therefore, the service will run until the end of September 2018.

In October, NHS England shared a slide set giving an update on the NUMSAS pilot. This highlights that NHS England will be conducting an interim evaluation report with data analysis this Autumn, and will undertake a qualitative review of the service in Spring 2018. As part of this work, NHS England is also inviting community pharmacy contractors and their teams to provide feedback on NUMSAS. Find out more at: ow.ly/7yZA30fVXbJ

Launch of Substance use and misuse programme New e-learning modules now available from the Centre for Pharmacy Postgraduate Education (CPPE).

“ We are delighted to announce a new four-module package on substance use and misuse.

Pharmacy teams often see people who misuse substances more than any other healthcare professional, and are therefore ideally placed to provide support to this group. This e-learning programme will help you to advise Alison Fryer those who misuse substances at any Learning development point during their journey, including pharmacist, CPPE signposting to further support, providing needle and syringe programmes and supervising the consumption of prescription medicines.

Substance use and misuse provides an overview of substances of

misuse, harm reduction strategies, holistic care and information on communicating with different patient groups, as well as the provision of services including supervised administration and needle exchange.

This programme will be useful for those who are completing Declaration of Competence (DoC) for needle and syringe programmes (NSPs).

The four modules in Substance use and misuse have been repurposed from work created by the Welsh Centre for Pharmacy Professional Education (WCPPE). Thanks to our colleagues at WCPPE for allowing access to this programme, which has been updated to refer to English legislation.

You can find further information and access Substance use and misuse on the CPPE website: tinyurl.com/CPPEsubstancemisuse

”

psnc.org.uk 7

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

All you need to know about: Universal Credit and prescription charges Our Dispensing and Supply Team explains which Universal Credit recipients qualify for free NHS prescriptions and the process for claiming their exemption from the prescription charge.

Note: If someone is part of a couple then the net earning threshold applies to their combined net earnings.

Universal Credit (UC) is being introduced in stages across the UK meaning more pharmacies are encountering patients eligible for free NHS prescriptions who are getting UC. UC does not automatically entitle patients to help with their health costs. This guide has been created to help ensure community pharmacy teams understand what recipients of UC are entitled to and how they can claim it.

Eligibility criteria An individual qualifies for free NHS prescriptions if, on the date they claim help with health costs: • they receive UC and either had no earnings or had net earnings of £435 or less in their last UC assessment period or • they receive UC, which includes an element for a child, or they (or their partner) had limited capability for work and work-related activity, and they either had no earnings or net earnings of £935 or less in their last UC assessment period

Claiming exemption Step 1: When the patient is asked to declare their exemption on the back of the prescription form, pharmacy staff must check that the patient has a valid UC award letter notice bearing the patient’s name (either as the recipient or because they are a partner or child of the recipient) as evidence of valid entitlement.

If a patient is unsure whether they are entitled to free prescriptions, pharmacy staff should advise the patient to pay for their prescription and provide them with an FP57 form with information on how to claim a refund at a later date.

Step 2: Where patients do not have evidence or where there is doubt over whether the evidence provided is appropriate, the “Evidence not Seen” box on the back of the prescription should be marked with an X by pharmacy staff.

Pharmacy staff need not refuse to dispense items on the basis that the patient does not provide evidence of their entitlement to free prescriptions.

Step 3: Pharmacy staff should ask the patient to tick the appropriate exemption box and sign the declaration. In the absence of a UC box ask the patient to tick the “income-based Jobseeker’s Allowance” exemption, until the prescription forms are updated.

Step 4: Remind the patient that they should make sure they are still eligible each month, i.e. in case their circumstances change or check if their earnings are still within the threshold limits during their most recent monthly assessment period.

Step 5: Pharmacy staff should inform the patient that it is their responsibility to determine the accuracy of the declaration they make. NHS Protect have a responsibility to check for prescription charge exemption fraud and patients found to have wrongly claimed for free prescriptions, could face a penalty charge, the prescription charge required and in some cases prosecution.

Useful links PSNC’s webpage on exemptions from the prescription charge: psnc.org.uk/chargeexemptions The NHS Business Service Authority’s guide to UC: tinyurl.com/ universalcredithelp

PSNC responds to consultation on additional NHS supply information PSNC has responded to the Department of Health (DH) consultation on Proposed legal requirements to provide information about health service products by asking DH to re-think the applicability and scope of the proposed information requests to community pharmacy.

Amongst PSNC’s concerns is why DH needs any additional information from community pharmacy contractors, arguing that the current arrangements for managing pharmacy remuneration, namely the Margins Survey, are sufficient, and there are proposals to obtain quarterly information from manufacturers and wholesalers. Read the response in full at: ow.ly/yaw930gKGcw

8 Community Pharmacy News – December 2017

Normal hours

Normal hours

09:00-16:30

08:30-12:00

09:00-13:00

08:30-16:30

09:00-16:00

Normal hours

Aspen

Astellas

BoehringerIngelheim

BMS

Britannia pharmaceuticals

Daiichi-Sankyo

Eli Lilly

GSK

Normal hours

09:00-16:30

Normal hours

Normal hours

09:00-16:00

Normal hours

Movianto

Novartis

Novo Nordisk

Pfizer

Roche

Sanofi

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Tue 26th Dec

Normal hours

09:00-16:00

Normal hours

Normal hours

09:00-16:00

Normal hours

Normal hours

For customer service contact details and manufacturer contingency arrangements see psnc.org.uk/mca

Normal hours

09:00-16:00

Normal hours

Normal hours

09:00-16:00

Normal hours

Normal hours

Closed

09:30-16:00 (Main number, see below for specific team times)

09:30-16:00 (Main number, see below for specific team times) Closed

09:00-16:00

Closed

09:00–midday

10:00-14:00

09:00-16:00

Normal hours

Normal hours

Normal hours

08:30-17:00

Thurs 28th Dec

09:00-16:00

Closed

09:00–midday

10:00-14:00

09:00-16:00

Normal hours

Normal hours

Normal hours

08:30-17:00

Wed 27th Dec

Normal hours

09:00-16:00

Normal hours

Normal hours

09:00-16:00

Normal hours

Normal hours

Closed

09:30-16:00 (Main number, see below for specific team times)

09:00-16:00

Closed

09:00–midday

10:00-14:00

09:00-16:00

Normal hours

Normal hours

Normal hours

08:30-14:00

Fri 29th Dec

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Mon 1st Jan

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

09:00-17:00

Normal hours except for Livingston (closed)

Normal hours

Normal hours

08:30-17:00

Tue 2nd Jan

FUNDING AND STATISTICS

For order cut off/delivery schedules, please visit ow.ly/ongD30gKHQ2

Normal hours

Merck

Closed

Normal hours

Alliance

Bank Holiday

Mon 25th Dec

PSNC’s WORK

Lundbeck

08:30-14:00

Accord

Fri 22nd Dec

At this busy time of year, manufacturers are working closely with wholesalers to ensure that sufficient stock is available for the festive period. A summary of customer service desk opening hours can be found below. Please note these times may vary according to staffing levels.

Manufacturer & Wholesaler Christmas Opening Hours 2017 LPCs CONTRACT AND IT

psnc.org.uk 9

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Ask PSNC: Prescription charge exemptions The team at PSNC provides pharmacy teams with support and advice on a range of topics related to dispensing and NHS IT. Questions asked in recent weeks have included: Q. How can I use my PMR system to check and amend EPS Release 2 exemptions to avoid switches and payment issues?

Q. A patient does not have evidence of their eligibility to claim exemption from the prescription charge with them. Do I need to do anything else apart from ticking the “evidence not seen” box on the prescription?

A. You can check the paid/exemption category currently applied onto an electronic prescription using your PMR system. PMR systems should assist users by (1) preventing prescriptions being sent to the Pricing Authority unless an exemption category option has been selected; and/or (2) where needed, asking whether either, the ‘paid’ status is right, or, if instead, the category needs adjusting.

A. Yes. From 1st July 2016, the Terms of Service were amended to require community pharmacy contractors, before supplying the drug or appliance, to advise the person who has been asked to provide the evidence of entitlement to exemption that NHS checks are routinely undertaken to verify that persons are exempt from payment of NHS prescription charges as part of the relevant arrangements for preventing or detecting fraud or error.

EPS prescriptions should also be able to have their exemption status amended at any time after claim notification has been sent, and the EPS prescription has been sent to the Pricing Authority, as long as the prescription’s relevant ‘5th of the month’ pricing deadline has not passed. NHS Digital has made amendments to the Spine to allow this functionality to be implemented and one PMR system already has this functionality available to users according to NHS Digital information.

Q. Does the Pricing Authority use the EPS tokens I submit to determine exemption status for the purpose of pricing our pharmacy’s prescriptions?

A. No. Tokens created by the Electronic Prescription Service (EPS) are not used to price pharmacies’ prescriptions, they are used for audit purposes, i.e. to check for patient charge exemption fraud. Exemption information recorded by the patient onto either dispensing tokens (pharmacy-issued) or prescribing tokens (GPissued) is solely used to assist with this.

Watch our latest #PSNCtalk video on submitting payment claims via EPS at: psnc.org.uk/PSNCtalk

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

Dermabond ProPen

Yes

n/a

Yes

Yes

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

Finger Cots

Yes

n/a

Yes

Yes

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

Hycosan 0.1% eye drops

No

n/a

Yes

No

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

Hycosan Extra 0.2% eye drops

No

n/a

Yes

No

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

Hycosan Plus eye drops

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.

10 Community Pharmacy News – December 2017

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 January 2018.

Part VIIIA additions Category A: • *Co-codamol 8mg/500mg capsules 100 Category C: • Betaxolol 0.25% eye drops 0.25ml unit dose preservative free (50) – Betoptic • Bimatoprost 300micrograms/ml eye drops SC (3ml) – Aspire Pharma Ltd • Brimonidine 3mg/g gel SC (30g) – Mirvaso • Brivaracetam 50mg/5ml oral solution sugar free (300ml) – Briviact • Chlorhexidine gluconate 5% solution (5000ml) – HiBiTane Plus • Chloroquine phosphate 80mg/5ml oral solution (75ml) – Malarivon • Cholera vaccine oral suspension and vehicle (2 dose) – Dukoral • Cinchocaine 0.5% / Hydrocortisone 0.5% ointment SC (30g) – Proctosedyl • Cinchocaine 5mg / Hydrocortisone 5mg suppositories (12) – Proctosedyl • Clobetasol 500micrograms/g foam SC (100g) – Clarelux • Dequalinium chloride 10mg vaginal tablets (6) – Fluomizin • Dexamethasone 40mg tablets (10) – Neofordex • Diclofenac 0.1% eye drops SC (5ml) – Voltarol Ophtha Multidose • Diclofenac 0.1% eye drops 0.3ml unit

dose preservative free (5) – Voltarol Ophtha • Diclofenac 0.1% eye drops 0.3ml unit dose preservative free (40) – Voltarol Ophtha • Dorzolamide 20mg/ml / Timolol 5mg/ ml eye drops preservative free SC (5ml) – Eylamdo • Dorzolamide 20mg/ml eye drops preservative free SC (5ml) – Eydelto • Glycerol 40% cream SC (100ml) – Neutrogena Norwegian Formula • Hydrocortisone 20mg modified-release tablets (50) – Plenadren • Hydrocortisone 5mg modified-release tablets (50) – Plenadren • Imiquimod 3.75% cream 250mg sachets (28) – Zyclara • Leuprorelin 22.5mg powder and solvent for suspension for injection vials SC (1) – Lutrate • Leuprorelin 3.75mg powder and solvent for suspension for injection vials SC (1) – Lutrate • Levetiracetam 1g granules sachets sugar free (60) – Desitrend • Levetiracetam 250mg granules sachets sugar free (60) – Desitrend • Levetiracetam 500mg granules sachets sugar free (60) – Desitrend • Levetiracetam 500mg/5ml solution for

Part IX deletions Take careful note of removals from Part IX because if you dispense a deleted product, prescriptions will be returned as disallowed.

Product

Size, type and product code

Keratin Dressing – keragel

20g tube

Keratin Dressing – keragelT

5g tube

Multiclix (Roche Diabetes Care Ltd)

0.3mm/30 gauge, 204 lancets

OstoMart OstoSEAL Protective 25g (ABP1) Powder (Respond Healthcare Ltd) Conform 2 two piece ostomy system – Drainable Pouch with Filter – anatomical shape – Transparent (Hollister Ltd)

45mm (24820) and 55mm (25820)

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

infusion ampoules (10) – Desitrend • Loratadine 10mg oral lyophilisates sugar free (10) – Clarityn Rapide Allergy • Magnesium aspartate (magnesium 10mmol) oral powder sachets (10) – Magnaspartate • Memantine 10mg orodispersible tablets sugar free (28) – Valios • Memantine 20mg orodispersible tablets sugar free (28) – Valios • Nicotine 6mg medicated chewing gum sugar free (105) – Nicorette Fruitfusion • Nicotine 6mg medicated chewing gum sugar free (210) – Nicorette Fruitfusion • Olmesartan medoxomil 20mg / Amlodipine 5mg tablets (28) – Sevikar • Olmesartan medoxomil 40mg / Amlodipine 10mg tablets (28) – Sevikar • Olmesartan medoxomil 40mg / Amlodipine 5mg tablets (28) – Sevikar • Simeticone 125mg capsules (20) – Wind-eze • Simeticone 42mg/5ml oral drops (100ml) – Dentinox Infant colic drops • Ulipristal 30mg tablets SC (1) – EllaOne • White soft paraffin 10% spray SC (250ml) – Dermamist Part VIIIA amendments • Co-codamol 8mg/500mg capsules (32) – Paracodol is changing to Category A

AeroChamber Plus* with adult mask available only through AAH Due to a supply issue, AeroChamber Plus* adult mask will be available exclusively through AHH Pharmaceuticals from 8th December 2017.

Please note that GSK will continue to supply other products in the range until 3rd January 2018.

Trudell Medical UK Ltd (TM-UK) have announced that as of 3rd January 2018 they will become the UK distributor, distributing exclusively through AAH for the full AeroChamber Plus* range, the Aeronike OPEP device and other speciality chambers.

For ordering information, please contact the AAH Customer Service Team on 0344 561 6699 and, for product queries, call 01256 338 400 or email info@trudell medical.co.uk

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 082/17 and 083/17: Regional Representative and (non-CCA) Multiple Chemist election guides Election proceedings for 13 Regional Representatives and three non-CCA Multiple Representatives to the PSNC Committee will begin early in the New Year. These briefings provide information about the election process, including actions required for those seeking to stand or vote in the elections.

Download from: ow.ly/SD2z30gsTJa PSNC Briefing 085/17: A summary of changes to the Flu Vaccination Service 2017/18 documents NHS England and Public Health England (PHE) have added care home and domiciliary care workers to the groups of people eligible for NHS flu vaccination. This PSNC Briefing outlines the changes that have been made to the patient group direction (PGD) and service specification for the NHS Community Pharmacy Flu Vaccination Advanced Service following the addition of this cohort.

Download from: ow.ly/trzz30h08yC PSNC Briefing 086/17: Features of higher quality health apps and how to give app feedback This briefing provides pharmacy contractors and pharmacy teams with information about health apps which may be used by patients or health and care workers. It explores the features of higher quality apps and explains how pharmacy teams or patients can provide feedback about apps.

Download from: ow.ly/1LDg30h08Ox See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources #PSNCtalk video: EPS submission and payment The latest video in the #PSNCtalk series from PSNC and pharmacyTALK sees Daniel Ah-Thion, Community Pharmacy IT lead at PSNC, discussing how the submission process works for electronic prescriptions and explaining the importance of the five day payment window. He also clarifies which tokens need to be sent to the Pricing Authority, as well as highlighting useful resources on the PSNC website.

Watch now: psnc.org.uk/PSNCtalk Flu Vaccination Service: Care home and domiciliary care workers PSNC has created a new webpage for guidance and resources relating to the addition of care workers and domiciliary care workers as an eligible group to the community pharmacy NHS Flu Vaccination Advanced Service 2017/18.

Visit now: psnc.org.uk/flucareworkers EPS use in urgent care settings NHS Digital and partners are working to give prescribers in urgent care settings the ability to prescribe electronically using the Electronic Prescription Service (EPS). This new page of the PSNC website outlines the details of a pilot due to take place shortly.

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

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