December 2018 CPN

CPN

Community Pharmacy News – December 2018

Brexit contingency planning • PSNC working with Ministers and MPs to minimise impact on medicines supply chain • Pharmacies and patients warned not to stockpile PSNC’s plans for 2019 | Support for Quality Payments | Drug Tariff distribution notice

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Chief Executive’s blog PSNC Chief Executive Simon Dukes uses this section of CPN to provide an update on PSNC’s work. unclear about why they have been treated as they have. For their part, the Government and NHS – our paying customers – also appear bruised; they have not been able to get all that they want out of the pharmacies they fund, and constructive dialogue when I arrived had reached a standstill.

Simon Dukes

PSNC Chief Executive The end of the year, whatever your faith or beliefs, is often a time of reflection – both on the twelve months that have passed and the year to come. For community pharmacy there is much to think about as we look back over an eventful year; all pharmacies have been busy juggling the complexities of this year’s flu vaccination service, implementing GDPR, managing medicines supplies and shortages, working towards Quality Payments and offering all the local clinical services that so many of you do.

Since joining PSNC seven months ago I have seen a sector working incredibly hard to serve their local patients and communities; but I have also met business owners who are battling for survival, feeling frustrated and

The good news is that there is now willingness from both sides to engage.

We saw evidence of this once again earlier this month when the Chief Executives of the national pharmacy organisations (the RPS, AIM, CCA, NPA and PSNC) had a meeting with NHS England. Discussion centred on the relationships between community pharmacy, the NHS and other healthcare providers, and we explored the principles behind the integration of community pharmacies as part of Primary Care Networks, and how the Pharmacy Integration Fund could enable future integration. We will meet again in early 2019 to discuss further within the context of the NHS Long Term Plan.

That we now have constructive dialogue in place is positive – community pharmacy cannot be at odds with its customer. But that is not to say that the coming year, and all those beyond, are going to be easy. The tests ahead were all too apparent at PSNC’s planning meeting in November at which we discussed such topics as pharmacy

funding distribution and how community pharmacies must embrace technology to enhance their relationship with patients and the service that they can offer.

There will be big challenges for community pharmacy in 2019, both sector specific and related to the wider economic picture and the drive to control costs across the health service. As pharmacy’s future is shaped by the NS Long Term Plan and the 2019/20 funding negotiations, community pharmacies will need to be open to making changes in how we work and to the core services that pharmacies offer on behalf of the NHS. That will not be easy, and I would encourage all of you as you make choices for the year ahead to consider the ability that your businesses will have to adapt to these changes. For our part, it is increasingly important that PSNC supports community pharmacy owners and LPCs and we will continue to focus on how best we can do that.

I know that many of you will be working over the holiday season – yet another demonstration of the important role that community pharmacies have in the healthcare of this country – but I hope all of you will manage to get a break of some sort, and to recharge the batteries in preparation for an inevitably busy year to come.

PSNC Annual Planning Meeting Report PSNC has published a summary of its annual planning meeting at which the committee explored some of the most important policy areas that PSNC and community pharmacy will need to influence through 2019.

PSNC considered three broad topics which will be at the heart of its 2019 work: • The needs of LPCs and how PSNC might best support them; • Technology and how community pharmacy can best take advantage of it to meet the needs of both patients and Government; and • Pharmacy funding and numbers.

Further research and discussion on many of the topics will be required through 2019 and PSNC will continue to work closely with the other pharmacy organisations to represent pharmacies. We will also be seeking views from LPCs on the future and the support that they would like from PSNC. A summary report of the PSNC Planning Meeting can be viewed at: ow.ly/RRmg30mYdTg

2 Community Pharmacy News – December 2018

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Preparing for Brexit • Planning to ensure the supply of medicines post-Brexit has been stepped up this month • The Health Secretary has provided an update for healthcare professionals • PSNC has shared its position on Brexit with the Health and Social Care Committee

National clinical audit 2018/19 The data collection period for the 2018/19 national community pharmacy clinical audit ended on 16th December and contractors are reminded of the requirement to submit their audit data by midnight on 30th December 2018.

The pharmacy’s collated data should be submitted to NHS England using the webbased form at: https://pharmacy-flu2018. nhsdatacollection.org/ (Please note, this portal is the same one used to submit flu vaccination patient questionnaire responses.)

“

PSNC and others are considering what measures may be needed in addition to the six-week stockpile of medicines”

Once submitted, contractors should consider whether they could make any changes to improve provision of advice on flu vaccination.

”

Community pharmacy teams may have seen national media coverage about the ongoing contingency planning that is taking place in preparation for the UK’s exit from the European Union.

PSNC is continuing to work closely with officials at the Department of Health and Social Care (DHSC), as well as with the other pharmacy organisations via the Brexit Forum, to try to minimise the impact of Brexit on the medicines supply chain.

DHSC is consulting with members of the Brexit Forum on a number of possible measures, including the ability for community pharmacists to make substitutions in certain situations. Whilst most of the proposals do not need any change to legislation, one that would require legislation change is the establishment of a national ‘serious shortage protocol’, which DHSC is proposing to introduce whether there is a Brexit deal or not. The protocol would provide dispensers with more flexibility in case of serious shortages of Prescription-Only Medicines (POMs).

PSNC broadly supports the DHSC proposals. Where actual shortages of branded medicines occur, our preferred option would be to allow pharmacies to generically substitute certain medicines. However, the feasibility of enabling this within a short space of time means that, in the short term, it makes sense to relax the NHS Terms of Service obligation on pharmacists to allow them to refuse supply if necessary. This would allow pharmacies to avoid dispensing drugs at a significant loss and incurring costs that their business could not survive, as well as to manage the demand for medicines better and to prioritise stock for patients who need it most in a shortage situation.

Updated guidance Health Secretary Matt Hancock has written to frontline healthcare professionals, stressing the need to avoid local stockpiling of medicines. He said they should advise their patients against stockpiling medicines as well and restated that there is no need for clinicians to write longer NHS prescriptions.

LPCS

PSNC engagement with politicians PSNC has written to Dr Sarah Wollaston, MP for Totnes and Chair of the Health and Social Care Committee, to set out our position on Brexit and medicines supply. As well as highlighting our ongoing work, the letter describes a number of measures that could help minimise the impact of Brexit on medicines supply, pharmacies and patients.

For further information on our work with DHSC, please visit: psnc.org.uk/Brexit

Community care to receive extra funding Prime Minister Theresa May has pledged a funding boost for primary and community healthcare worth £3.5 billion a year in real terms by 2023/24. Part of this funding will be used for a scheme where healthcare professionals, including pharmacists, are assigned to care homes.

PSNC Chief Executive Simon Dukes said: “We agree that providing an alternative to hospital is better for patients and the NHS, however we are surprised that the network of community pharmacies seems to have been overlooked. PSNC will be speaking with Health Ministers to address this.”

EPS Phase 4 pilot begins NHS Digital is now piloting EPS Phase 4, which allows electronic prescriptions to be used for patients without an EPS nomination. Upon receiving a Phase 4 token, the pharmacy team can scan the barcode and dispense as they would any other electronic prescription.

The first sites in Greater Manchester, Essex, south-east London and Devon began piloting at the end of November.

Feedback from community pharmacies, GP practices, PSNC and other stakeholders will be used to refine the process prior to further roll-out.

psnc.org.uk 3

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Quality Payments: February 2019 review point The second review point for the 2018/19 Quality Payments Scheme is fast approaching. Here is a round-up of the latest information and resources available for community pharmacy contractors.

Check your HLP status Contractors are reminded that if their pharmacy was accredited as a Healthy Living Pharmacy (HLP) Level 1 locally or through the profession led self-assessment process this accreditation is only valid for two years. If a pharmacy was accredited before 16th February 2017, contractors will need to re-accredit their pharmacy as an HLP Level 1 to meet the first part of the HLP quality criterion.

Learn more at: psnc.org.uk/QPhlp

Updating your NHS website entry Contractors are required to edit or validate their pharmacy’s NHS website (formerly known as NHS Choices) profile by 11:59pm on 15th February 2019 to meet this gateway criterion. Contractors must edit or validate: (1) their opening hours, including Bank Holidays; (2) the facilities the pharmacy provides; and (3) the services the pharmacy provides.

Find out more at: psnc.org.uk/QPNHSwebsite

Guide for the CPPQ criterion The NHS website team has published an updated user guide for uploading the Community Pharmacy Patient Questionnaire (CPPQ) results onto a pharmacy’s NHS website profile. Contractors should ensure they follow the naming convention correctly as this helps during the validation process for the CPPQ gateway criterion. See further guidance at: psnc.org.uk/QPcppq

Contractors will need to access the Summary Care Record (SCR) portal from their pharmacy to validate whether their pharmacy meets the Warranted Environment Specification (WES) gateway criterion. NHS BSA will send an email to each contractor’s shared premises NHSmail account in December 2018, which will detail whether NHS Digital has been able to validate the pharmacy. If contractors have not accessed the SCR since 14th November 2018, they are encouraged to do this as soon as possible. Find out more at: psnc.org.uk/QPwes

NHS England guidance

Key points

Updated patient safety report resources PSNC and the Community Pharmacy Patient Safety Group have updated the patient safety report resources. The monthly and annual patient safety report templates have been updated to include the additional requirement for contractors to actively identify and manage the risks associated with specified look-alike sound-alike (LASA) errors. Completed monthly and annual patient safety report examples and the resource which explains how contractors can use the monthly and annual template patient safety reports to meet the quality criterion have also been updated.

All of these resources can be found at: psnc.org.uk/safetyreport

4 Community Pharmacy News – December 2018

Completing the WES gateway criterion

This guidance document, updated for the February review point, provides information on how to meet the revised gateway and quality criteria requirements. It also details the new declaration process via the NHS Business Services Authority (NHS BSA) Manage Your Service application and highlights the new process for validation of the gateway criteria. Find the guidance at: psnc.org.uk/quality

Risk review resources PSNC and the Community Pharmacy Patient Safety Group have produced some resources to assist community pharmacy contractors with meeting the risk review part of the risk management quality criterion. The resources are comprised of a template risk review and a completed example of a risk review.

Both of these resources can be found at: psnc.org.uk/riskmanagement

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

The impact of Drug Tariff changes • Changes to pharmacy funding were made in November 2018 Drug Tariff • Pricing time-lag means pharmacy payments aren’t affected straight away • Contractors advised to take note of how and when this will affect cashflow

“

The end of January payment is the point at which the impact on contractors will be most significant

Gluten-free foods As of 4th December 2018, the prescribing of gluten-free (GF) foods on the NHS in England is restricted to bread and mixes only. As such, revisions have been made to Part XV (the ‘ACBS list’) and Part XVIIIA (the ‘Blacklist’) of the December 2018 Drug Tariff to reflect this change in GF prescribing.

If a patient presents a prescription for any restricted GF foods, they will need to be referred back to the prescriber to discuss suitable alternatives.

”

For more details see CPN page 9 for responses to your questions around gluten-free foods.

Community pharmacy contractors should be aware of when their payments will be impacted by the reductions in Category M prices and the Single Activity Fee implemented in the November Drug Tariff.

At the end of December, a pharmacy would receive an advance payment for the dispensing month of November. This is an estimated payment, taking into account the pharmacy’s number of declared items for November, and the pharmacy’s average item value (AIV) from dispensing month of October. Because AIV will have dropped in November in line with the reductions in Category M prices and the Single Activity Fee in that month, the advance is likely to overstate the value of November’s prescriptions.

Subsequently at the end of January, the pharmacy will receive the balancing payment for November, and the advance payment will be recovered. This means that the end of January payment is the point at which the impact on contractors will be most significant as the balance for November will be lower than the recovery of the advance.

Below is a table illustrating payment timelines for upcoming months: Payments made end of month

Recovery of advance from

Total of account for

Advance for

November

September

September

October

December

October

October

November

January

November

November

December

February

December

December

January

A worked example is illustrated below for an average volume pharmacy, whose AIV is reduced by 15p per item from dispensing month of November: Dispensing/SOP Month

Oct-18

Nov-18

Dec-18

Jan-19

Feb-19

AIV

£8.70

£8.55

£8.55

£8.55

£8.55

£8.55

Items Dispensed

7,000

7,000

7,000

7,000

7,000

7,000

Items Submitted for Payment

DISPENSING AND SUPPLY

Mar-19

7,000

7,000

7,000

7,000

7,000

7,000

Advance Payment

£60,900

£60,900

£60,900

£59,871

£59,871

£59,871

Advance Recovered

-£60,900

-£60,900

-£60,900

-£60,900

-£59,871

-£59,871

Total value of account

£60,900

£60,900

£60,900

£59,871

£59,871

£59,871

Total payment

£60,900

£60,900

£60,900

£58,841

£59,871

£59,871

PSNC strongly advises contractors to analyse the impact on their finances. A PSNC Briefing and a cashflow calculator to support planning are available at: psnc.org.uk/incometables

Adrenaline supply levels update Adrenaline 150microgram autoinjectors are no longer subject to additional validation processes.

Community pharmacy teams are, therefore, now permitted to dispense the total number of adrenaline 150microgram auto-injectors prescribed to each patient. However, whilst stock filters through the supply chain, some wholesalers may still apply a restriction to ordering levels.

PSNC will continue to monitor the supply of adrenaline auto-injectors and will support the Department of Health and Social Care and NHS England in their efforts to ensure the return to normal dispensing runs smoothly.

Voluntary scheme for branded medicines pricing and access The Department of Health and Social Care (DHSC) have published the outline terms agreed between DHSC and the Association of the British Pharmaceutical Industry (ABPI) for a new voluntary scheme to control pricing of branded medicines.

The information published so far can be viewed on the GOV.uk website: ow.ly/7lTB30mNrRC PSNC is pleased that DHSC and ABPI have come to an agreement and look forward to receiving more details when they become available.

psnc.org.uk 5

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Extension of NHS 111 referral pilot • Service integrating community pharmacy into NHS 111 referral pathways • Successful pilot in North East of England so rolling out to additional areas • This project is being undertaken as part of the Pharmacy Integration Fund Following a successful initial pilot in the North East, NHS England is now extending the Digital Minor Illness Referral Service (DMIRS) pilot to London, Devon (and eventually Somerset) and the East Midlands.

Part of a work programme under the Pharmacy Integration Fund (PhIF), the aim is to integrate community pharmacy into NHS 111 referral pathways for people suffering from minor conditions. It is hoped that this will increase capacity and relieve pressure on existing urgent care services, deliver care closer to home in the community and potentially result in savings for the NHS. The service enables NHS 111 call handlers to digitally refer patients requiring advice and/or treatment for low acuity conditions to community pharmacies for face-to-face consultations. The conditions eligible for the service include rashes, constipation, diarrhoea, vaginal discharge, sore eye, mouth ulcer, failed contraception, vomiting, scabies and ear wax.

All pilots are currently set to run until 31st March 2019 with the evaluation timed to inform any future commissioning for 2019/20.

Sanjay Ganvir, Superintendent Pharmacist at Green Light Pharmacy Group and Chair of Camden & Islington LPC said: “The community pharmacy network is the biggest walk-in service in the NHS so it’s great to see the NHS using the huge potential of community pharmacies to help to ensure that GP and A&E care will be more available for those who need it most.”

North East pilot

Over 390 pharmacies currently taking part across the North East Minor illness cases being referred to GPs from NHS 111 fell from 70% to 40%

11,900 referrals made to community pharmacists Half of those referrals were managed in the pharmacy

22% of referrals were signposted to other health services Learning from the North East for other pilot areas Community pharmacy teams working in areas where DMIRS has already gone live have adopted new working practices, particularly checking their NHSmail inbox regularly so that they are aware of referrals received from NHS 111.

Pharmacy teams have also made sure they are attuned to red flags symptoms, including the signs of sepsis and meningitis.

PSNC’s minor illnesses resource hub (psnc.org.uk/minorillnesses) contains links to a range of resources that can help pharmacy teams providing DMIRS.

NHS funding of ‘low priority’ items NHS England has launched a consultation on proposals to extend the list of products that primary care prescribers are recommended not to routinely prescribe.

The intention is to update the November 2017 national guidance for Clinical Commissioning Groups (CCGs) on Items which should not to be routinely prescribed in primary care.

Following a review of the CCG guidance by a clinical working group, views are now being sought on adding a list of eight products/types of products which are considered to be of ‘low priority’ for NHS funding (see list opposite).

Interested parties have until 28th February 2019 to respond via the public consultation on the NHS England website.

Further information is available at: ow.ly/TnG230mYdrV PSNC will consider the consultation proposals and our response over the coming weeks.

6 Community Pharmacy News – December 2018

Items considered to be of low clinical effectiveness: • Amiodarone • Emollient bath and shower preparations for dry and pruritic skin conditions • Dronedarone • Minocycline for acne • Silk garments

Items where more cost-effective products are readily available: • Aliskiren • Blood glucose testing strips for people with type 2 diabetes that cost >£10 for 50 strips • Needles for pre-filled and reusable insulin pens that cost >£5 per 100 needles

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

Joint LPC/LMC campaign to increase flu vaccination uptake Pharmacy and GP practice representatives in Wessex collaborate on flu vaccination campaign to increase uptake in the area.

Local Medical Committees (LMCs) and Local Pharmaceutical Committees (LPCs) in Wessex are working collaboratively to encourage patients to get a flu vaccination either at their GP practice or local pharmacy and are currently running a ‘Flu Free Wessex’ campaign.

Following analysis of previous years’ flu vaccination uptake figures in Wessex, the LMCs and LPCs recognised that more needed to be done to encourage patients to have a flu vaccination and that there was potential for both GP practices and pharmacies to increase the number of flu vaccinations provided.

Before the flu season started, a joint letter was issued by the LMCs and LPCs to all GP practices and pharmacies highlighting the joint work and the benefits of the collaborative campaign for patients as well as for GP practices and pharmacies.

The ‘Flu Free Wessex’ campaign is being run on social media; a

Facebook page along with Twitter and Instagram accounts have been created, as well as use of local media to get flu messages out to patients and the public.

In September the campaign provided general messages to encourage eligible patients to have a free NHS flu vaccination, in October it targeted patients with long-term conditions and in November it focussed on encouraging uptake amongst the 65 and over age group.

Commenting on the initiative, Deborah Crockford, Chief Officer at Community Pharmacy South Central said: “Working with our LMC on the promotion of flu vaccinations this year has been a very positive and constructive experience which we intend to continue into other projects. This season, we are all focused on ensuring the maximum availability and uptake of flu vaccinations within our communities, emphasising that the important point is to actually get vaccinated, rather than worry about where you go to get that vaccination.”

Flu vaccine ordering for 2019/20 Public Health England (PHE) has advised that both of the vaccines that were recommended for the 2018/19 season (quadrivalent inactivated vaccine and adjuvanted trivalent inactivated vaccine) will continue to be recommended for next year.

PHE also anticipates that two further products will be licensed within the ordering window for the 2019/20 flu season.

Find out more at: ow.ly/eNO430mHG5q

Falls prevention workshops We are pleased to announce that we “have launched our new Falls prevention workshops.

Caroline Barraclough regional manager, CPPE

Falls can affect everyone in the healthcare system and pharmacy professionals are perfectly placed to play a part in helping to prevent falls and support those at risk. In all sectors, pharmacy teams can provide information about managing the risk of falls, contribute to the optimisation of medicines and signpost patients to additional sources of information.

This two-hour workshop aims to help you identify the factors that can lead to an increased risk of falls and provide solutions

to reduce this risk , help you utilise your knowledge in falls prevention to better support your patients and help you to provide educational advice on promoting good bone health and medicines for osteoporosis.

Our Falls prevention workshop includes a presentation from an expert speaker on falls risk and will also provide you with the opportunity to work through a case study and a series of activities with fellow pharmacy professionals in a friendly and supportive environment. This learning is suitable for pharmacists, pharmacy technicians and pre-registration trainees across all sectors and can be used to support revalidation and your continuing professional development (CPD). The workshop will also encourage you to consider what extra steps you can take to extend your learning.

For more information and to apply for the workshop, visit the CPPE website: www.cppe.ac.uk/programmes/l/falls-w-01

”

psnc.org.uk 7

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Drug Tariff distribution notice Community pharmacies must opt-in to continue to receive paper Drug Tariffs in 2019, or go online.

NHS England has announced that it will stop automatically sending monthly printed copies of the Drug Tariff to community pharmacies after the January 2019 edition.

As part of NHS England’s sustainable development strategy and commitment to make services available online where possible, community pharmacy contractors will only receive the printed copy of the Drug Tariff if they have requested to do so.

Pharmacy teams are being encouraged to make use of the online versions of the Drug Tariff which can be accessed on the NHS Business Services Authority website (try our shortlink: psnc.org.uk/dt). Also, PSNC publishes a monthly ‘Drug Tariff Watch’ article in CPN magazine and on our website, which can help contractors prepare for upcoming changes.

How can I opt-in to receive the paper Drug Tariff?

To continue receiving the monthly printed copy, an email request must be sent to DTBsurvey@nhs.net before the 10th January 2019 deadline.

Review into overprescribing

In your email please state that you wish to opt-in to receive the monthly hard copy Drug Tariff from 2019 and provide: • Your name • Your business name and address • F-code/ODS code* • Any days you are not open and alternative delivery instructions for those days *This code appears at the top of your monthly FP34 Schedule of Payments.

Any pharmacy choosing not to opt-in will still receive one paper Drug Tariff each year (in January).

Primary Care Support England (PCSE) has distributed a flyer containing information about this change to all pharmacy branches along with the December Drug Tariff.

Any queries should be directed to pcse.enquiries@nhs.net or 0333 014 2884.

Health Secretary Matt Hancock has announced a review into over-prescribing in the NHS, which will be led by Chief Pharmaceutical Officer Dr Keith Ridge.

The review will form an important part of the Department of Health and Social Care’s prevention strategy and will look at patients who take multiple medicines, to ensure they are receiving the most appropriate treatments. Mr Hancock said he wanted to empower doctors and pharmacists to ensure that patients get the medicines they need and stop taking those that no longer benefit them. Learn more about the review at: ow.ly/wWyq30mXl0j

Can it be dispensed on an FP10?

When community pharmacy teams receive NHS prescriptions, they must check whether the items prescribed are allowed on the NHS before dispensing otherwise the contractor may not be paid for them. Below are 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

Bio-freeze gel

No

n/a

Yes

No

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

CCS footcare cream

No

No

No

Yes

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

Biotene Oralbalance gel

Yes

n/a

Yes

Yes

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

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

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

8 Community Pharmacy News – December 2018

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Ask PSNC: Gluten-free foods The PSNC Dispensing and Supply Team answers your questions on dispensing gluten-free products following changes to NHS prescribing regulations in England.

Q. Which gluten-free (GF) products are allowed on an FP10 after 4th December?

Q. What should I do if a patient comes in with a prescription for a GF product which is no longer allowed?

A. If you receive an NHS prescription for a disallowed GF food (i.e any except for gluten free breads and mixes or products which are gluten free and low protein or low protein products which are prescribed for phenylketonuria) which has been issued after 4th December 2018, PSNC recommends informing the patient of the changes to NHS rules and advising that they speak to their GP if they wish to discuss this further. You may also wish to contact the prescriber to make them aware of the situation.

A. A list of the GF breads and mixes that are permitted on NHS prescription in England from 4th December 2018 can be found in Part XV of the Drug Tariff (see pages 861-862 December Drug Tariff).

Please note the prescribing regulations do not exclude GF breads and mixes or gluten free and low protein and low protein products prescribed for phenylketonuria not specified on the ACBS list; these will continue to be reimbursed if dispensed.

Q. I ordered and prepared a prescription for a patient for GF foods in November 2018, but the patient didn’t come to collect the items until mid-December; the products ordered are now disallowed, can I submit this prescription and will I be reimbursed?

A. Whilst GF foods other than bread and mixes should not be prescribed on or after 4th December 2018, any prescriptions for GF foods (except for GF foods previously blacklisted) will continue to be reimbursed until June 2019 as prescriptions are valid for six months after they have been issued.

Q. One of our patients purchased a pre-payment certificate (PPC) to cover the cost of their GF prescriptions; now they will only be able to access a limited range of products.

Are they able to obtain a refund for the PPC?

A. No. A PPC cannot be refunded because of the amendments to the prescribing regulations of GF foods. Changes to GF prescribing were announced in February 2018 giving patients and NHS services an extended period of notice before the amended regulations came into force in December 2018.

Pre-payment certificates cover all prescription medicines and not just GF food so can continue to be used until they expire.

Further information More guidance is available in our PSNC Briefing: psnc.org.uk/GFbriefing Or you can speak to the PSNC Dispensing and Supply Team on 0203 1220 810 or by emailing info@psnc.org.uk

Patients can only claim a refund of a PPC if they become entitled to free NHS prescriptions.

More information is available at: https://www.nhsbsa.nhs.uk/ help-nhs-prescription-costs/free-nhs-prescriptions

psnc.org.uk 9

Manufacturer & Wholesaler Christmas Opening Hours 2018

BoehringerIngelheim

Astellas

Alloga (Concordia)

Alliance

08:30-12:00

09:00-16:30

See Alliance delivery schedule

Normal hours

Normal hours

Mon 24th Dec

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Tues 25th Dec

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Wed 26th Dec

10:00-14:00

09:00-16:00

See Alliance delivery schedule

Normal hours

Normal hours

Thurs 27th Dec

09:00-12:00

10:00-14:00

09:00-16:00

See Alliance delivery schedule

Normal hours

Normal hours

Fri 28th Dec

09:00-12:00

10:00-14:00

09:00-16:00

See Alliance delivery schedule

Normal hours

Normal hours

Mon 31st Dec

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Bank Holiday

Tues 1st Jan

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Normal hours

Wed 2nd Jan

A summary of customer service desk opening hours for the Christmas period.

BMS

09:00-12:00

Normal hours

Bank Holiday

Bank Holiday

Normal hours

Bank Holiday

See Alliance, AAH & Phoenix delivery schedules

Bank Holiday

Normal hours

09:00-12:30

See Alliance, AAH & Phoenix delivery schedules

Closed

Bank Holiday

Normal hours

Britannia pharmaceuticals

Closed

Closed

Bank Holiday

Normal hours

Normal hours

Closed

Closed

Closed

Bank Holiday

Normal hours

Bank Holiday

Bank Holiday

Closed

Closed

Normal hours

Bank Holiday

08:00-20:00

09:00-15:30

Bank Holiday

Bank Holiday

Closed

Normal hours

08:30-16:00

Bank Holiday

Normal hours

09:00-17:00

09:00-17:00

Bank Holiday

Bank Holiday

Normal hours

09:00-16:00

08:00-20:00

Bank Holiday

Normal hours

09:00-17:00

Kyowa Kirin Closed

Bank Holiday

Bank Holiday

09:00-16:00

08:00-20:00

Normal hours

Bank Holiday

Normal hours

Bank Holiday

Lundbeck Closed

Bank Holiday

Bank Holiday

08:00-20:00

Normal hours

Normal hours

Bank Holiday

Normal hours

Bank Holiday

Merck Serono

Normal hours

Bank Holiday

Bank Holiday

Normal hours

Normal hours

Normal hours

Bank Holiday

09:00-15:30

Movianto

08:30-16:00

Bank Holiday

Bank Holiday

Normal hours

Normal hours

Normal hours

Eli Lilly

Novartis

08:00-20:00

Bank Holiday

Bank Holiday

Normal hours

Normal hours

Bank Holiday

Novo Nordisk

Normal hours

Bank Holiday

Bank Holiday

Normal hours

Bank Holiday

Pfizer

Normal hours

Bank Holiday

Bank Holiday

GSK

Roche

Normal hours

Bank Holiday

See Alliance, AAH & Phoenix delivery schedules

Sanofi

Normal hours

See Alliance, AAH & Phoenix delivery schedules

Sigma

For order cut off/delivery schedules, please visit: ow.ly/XM0E30mKPe5

10 Community Pharmacy News – December 2018

THE HEALTHCARE LANDSCAPE SERVICES AND COMMISSIONING DISPENSING AND SUPPLY

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

Drug Tariff Watch: January 2019 Part VIIIA additions • *Diclofenac potassium 50mg tablets (28) – Category A • Apremilast 30mg tablets (56) – Otezia • Aripiprazole 400mg powder and solvent for suspension for injection: o pre-filled syringes  (1) – Abilify Maintena o vials  (1) – Abilify Maintena • Aztreonam 75mg powder and solvent for nebuliser solution vials with device  (84) – Cayston • Betaine oral powder  (180g) – Cystadane • Calcium acetate 435mg / Magnesium carbonate heavy 235mg tablets (180) – Osvaren • Cinnarizine 20mg / Dimenhydrinate 40mg tablets (100) – Arlevert • Dasatinib 100mg tablets (30), 140mg tablets (30), 20mg tablets (60), 50mg tablets (60) and 80mg tablets (30) – Sprycel • Deflazacort 6mg tablets (60) – Calcort • Dexamethasone 0.1% eye drops preservative free  (6ml) – Eythalm • Dexamfetamine 20mg tablets (30) – Amfexa • Diclofenac 75mg/ml solution for injection ampoules (5) – Akis • Enzalutamide 40mg capsules (112) – Xtandi • Flucloxacillin powder for solution for injection vials: o 1g (10) – Bowmed Ibisqus Ltd o 250mg (10) – Bowmed Ibisqus Ltd o 2g  (1) – Bowmed Ibisqus Ltd o 500mg (10) – Bowmed Ibisqus Ltd • Granisetron 3.1mg/24hours transdermal patches  (1) – Sancuso • Haloperidol decanoate solution for injection ampoules: o 100mg/1ml (5) – Haldol Decanoate o 50mg/1ml (5) – Haldol Decanoate • Heparin calcium 5,000units/0.2ml solution for injection ampoules (10) – Wockhardt UK Ltd • Heparin sodium solution for injection ampoules: o 1,000units/1ml (10) – Wockhardt UK Ltd o 10,000units/10ml (10) – Wockhardt UK Ltd o 20,000units/20ml (10) – Wockhardt UK Ltd o 25,000units/1ml (10) – Wockhardt UK Ltd o 25,000units/5ml (10) – Wockhardt UK Ltd

o 5,000units/0.2ml (10) – Wockhardt UK

CONTRACT AND IT

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

Ltd o 5,000units/5ml (10) – Wockhardt UK Ltd

• Heparin sodium solution for injection vials: o 25,000units/5ml (10) – LEO Pharma o 5,000units/5ml (10) – LEO Pharma • Hepatitis B (rDNA) vaccine suspension for injection pre-filled syringes: o 20micrograms/0.5ml  (1) – Fendrix o 5micrograms/0.5ml  (1) – HBVAXPRO • Hexetidine 0.1% mouthwash sugar free (200ml) – Oraldene • Ibuprofen oral suspension 5ml sachets sugar free: o 100mg/5ml (8) and (16) – Nurofen for Children Singles o 100mg/5ml (12) – Calprofen • Ibuprofen 200mg / Codeine 12.8mg tablets (24) and (32) – Nurofen Plus • Insulin lispro biphasic 25/75 100units/ml suspension for injection 10ml vials  (1) – Humalog Mix25 • Insulin soluble human 100units/ml solution for injection 10ml vials  (1) – Humulin S • Ketotifen 250micrograms/ml eye drops 0.4ml unit dose preservative free (30) – Ketofall • Lanreotide 30mg powder and solvent for suspension for injection vials  (1) – Somatuline LA • Lenalidomide 10mg capsules (21), 15mg capsules (21), 2.5mg capsules (21), 20mg capsules (21), 25mg capsules (21), 5mg capsules (21) and 7.5mg capsules (21) – Revlimid • Mercaptamine 150mg capsules  (100) and 50mg capsules  (100) – Cystagon • Mesalazine 1g gastro-resistant tablets (90) – Salofalk • Nitisinone 20mg capsules (60) – Orfadin • Oseltamivir 6mg/ml oral suspension sugar free SLS  (65ml) – Tamiflu • Pantoprazole 40mg powder for solution for injection vials: o  (1) – Sun Pharmaceuticals UK Ltd o (5) – Bowmed Ibisqus Ltd • Paracetamol 250mg/5ml oral suspension 5ml sachets sugar free (12) – Calpol Six Plus • Phentolamine 2mg/0.35ml / Aviptadil 25micrograms/0.35ml solution for injection ampoules (5) – Invicorp • Pholcodine 10mg/5ml linctus strong (200ml) – Bell, Sons & Co (Druggists) Ltd • Pilocarpine nitrate 2% eye drops 0.5ml

unit dose preservative free (20) – Minims • Piracetam 1.2g tablets (60) and 800mg tablets (90) – Nootropil • Simeticone 100mg capsules (8) and (24) – WindSetlers • Sirolimus 1mg/ml oral solution sugar free  (60ml) – Rapamune • Sodium aurothiomalate solution for injection ampoules: o 10mg/0.5ml (10) – Myocrisin o 50mg/0.5ml (10) – Myocrisin • *Sodium chloride 30% solution for infusion 50ml vials  (1) – Martindale Pharmaceuticals Ltd • Sodium dihydrogen phosphate dihydrate 18.1% / Disodium hydrogen phosphate dodecahydrate 8% 133ml enema  (1) – Cleen Ready-to-use • Somatropin (epr) solution for injection pre-filled disposable devices: o 10mg/1.5ml  (1) – Norditropin NordiFlex o 15mg/1.5ml  (1) – Norditropin NordiFlex o 5mg/1.5ml  (1) – Norditropin NordiFlex • Teicoplanin powder and solvent for solution for injection vials: o 200mg  (1) – Targocid o 400mg  (1) – Targocid • Tetracosactide suspension for injection ampoules: o 1mg/1ml  (1) – Synacthen Depot o 250micrograms/1ml  (1) – Synacthen • Tiagabine 10mg tablets (100), 15mg tablets (100) and 5mg tablets (100) – Gabitril • Tocilizumab 162mg/0.9ml solution for injection pre-filled disposable devices (4) – RoActemra • Tolcapone 100mg tablets (100) – Tasmar • *Tranexamic acid 500mg/5ml solution for injection ampoules (5) – Bowmed Ibisqus Ltd • Urea [13-C] 50mg tablets breath test kit  (1) – diabect UBT • Vancomycin powder for solution for infusion vials: o *1g  (1) – Bowmed Ibisqus Ltd o *500mg  (1) – Bowmed Ibisqus Ltd For a full list of the upcoming Drug Tariff changes, please visit: ow.ly/NZxI30mXxLQ

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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 058/18: Getting ready for FMD – a quick guide for the pharmacy team In this briefing we answer common questions about the practicalities of complying with the Falsified Medicines Directive (FMD) legislation.

Download from: ow.ly/b7Ec30mRuLv PSNC Briefing 060/18: Quality Payments – Asthma referrals This PSNC Briefing provides contractors with updated guidance for the February 2019 review point on meeting the ‘referrals for asthma review’ quality criterion of the Quality Payments Scheme.

Download from: ow.ly/o7cm30mRuNI PSNC Briefing 061/18: Changes to the availability of gluten-free foods on NHS prescription This briefing has been compiled to support community pharmacy teams as changes to the availability of glutenfree foods on NHS prescription in England come into effect from 4th December 2018.

Download from: ow.ly/n9Bv30mRuQg See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources PSNC CEO appears on BBC radio show PSNC Chief Executive Simon Dukes appeared on BBC Radio 5 Live’s ‘Wake Up to Money’ programme to discuss how preparations for a no-deal Brexit may be exacerbating ongoing medicine supply issues.

Listen now: www.bbc.co.uk/sounds/play/m0001mqm Falsified Medicines Directive (FMD) webinar This on-demand webinar explains how the introduction of FMD will affect the day-to-day working of community pharmacy teams and what they need to do to prepare.

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

Email news alerts EPS Phase 4 pilot to begin shortly (21st November) NHS Digital’s pilot for EPS Phase 4 was announced. The first sites in Greater Manchester, Essex, south-east London and Devon began piloting at the end of November and additional GP practices are due to join the pilot in subsequent weeks.

Read now: ow.ly/jOOe30mS9TS Quality Payments: NHS England guidance published for February 2019 review point (27th November) This email alert informed contractors that the NHS England guidance to support the second Quality Payments Scheme for 2018/19 was now available. Contractors are advised to read the guidance to ensure they understand how to meet the requirements.

Read now: ow.ly/AsEc30mSa7E See all our PSNC Briefings in our database at: psnc.org.uk/briefings 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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