December 2019 CPN

CPN

Community Pharmacy News – December 2019

Pharmacy Quality Scheme

Nearly 11,000 community pharmacies meet NHS website and Directory of Services criteria General Election Statement | IT access for CPCS | EPS declaration errors factsheet

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Chief Executive’s blog This month PSNC Chief Executive Simon Dukes describes what a new Government means for the negotiator and those it represents.

Simon Dukes

PSNC Chief Executive Finally, after months of impasse, one party has a majority in the House of Commons and a legislative mandate. The focus of the Government over the coming weeks will be to deliver the Withdrawal Agreement and embark on a legislative programme: in part trying to catch-up on work that was shelved because of Brexit planning and the resulting political stalemate; but also looking to deliver on some ambitious (and expensive) manifesto pledges.

The NHS was a hot topic throughout the election period, and PSNC has to tread a careful path by not commenting on specific party political declarations regarding the health service – as the negotiator, we have to work with which ever party is in power – but needing to get key messages across about community pharmacy and the current pressures we are under as a sector. Hopefully you spotted the pharmacy manifesto we collaborated on with the other national pharmacy organisations – if not, you can still see it at votepharmacy.uk. It sets out the policies that we want the new Government to work with us on. A number of candidates contacted us about this #votepharmacy initiative, and our attention is now focused on taking forward some of those policy objectives with the MPs that have been elected.

With 140 new MPs elected to Parliament, unsurprisingly pharmacy lost a number of friends in this election – including Sir

2 Community Pharmacy News – December 2019

Kevin Barron who had chaired the All-Party Pharmacy Group (APPG) for some 20 years.

But we’re delighted to welcome back many MPs who have backed pharmacy in the past, and we’re now working on engaging with some new faces. Our public affairs work is closely aligned with that of the RPS, NPA, CCA and AIM, and in particular we are now all focused on persuading more MPs to support the APPG, which we all jointly fund. The Group has been a voice for the sector across Parliament and the House of Lords for the past two decades, investigating key issues such as medicines shortages, and helping us to showcase the value of potential of community pharmacy and pharmacists. The Group’s mission will be unchanged by the result of the election: a group of supportive MPs who are willing to stand up for us in Parliament and to scrutinise pharmacy policy.

Similarly, the new Government doesn’t change PSNC’s approach in the short term. Several contractors have been in touch already pointing out that PSNC must ensure pharmacy gets a share of any new cash for the NHS. All political parties promised lots of things to get elected, and we will want to wait to see whether any new money is actually going to be forthcoming for healthcare, and if so where it might be headed. In the past year, the term ‘NHS’ has referred to hospitals and GP/nurse recruitment and that is likely to be where any new money is destined.

Rest assured however, PSNC will be doing all it can to argue the case for further investment in our sector. Returning Secretary of State Matt Hancock has already said in his first speech since the election that he is committed to ‘unleashing the potential’ of pharmacies, making them the first port of call for patients with minor illnesses over the next five years. That’s great to hear, but as you will have heard me say on more than one occasion: it is the capacity and costs of doing more in community pharmacy

that will be the barriers to this vision. I look forward to working with this new Government over the coming months and years to overcome them.

A lot can still happen during the lifetime of this unprecedented five-year Community Pharmacy Contractual Framework (CPCF) given the inevitable political and economic change to come. When we negotiated the CPCF in July 2019, we had no idea what political colour the Government would be in 2020, and although that point has now been clarified we still have no idea how Brexit trade deals (when eventually secured) will affect the wider economy let alone medicine supply; what the impact of the dissatisfaction of Scottish voters will have on England; and who will be Heath Secretary and/or Pharmacy Minister after the PM’s anticipated major reshuffle in the New Year. The five-year deal provides us with economic certainty in the midst of all these variables, but it also gives us the platform to argue our case for additional funding – and that is exactly what we will be doing.

Finally, don’t forget there are plenty of naysayers still out there: politicians, civil servants, and other healthcare professionals who will take every opportunity to talk our sector down. So, it is not solely the responsibility of PSNC (nor indeed NPA, CCA, AIM, PDA and RPS) to make the case for pharmacy. We all need to highlight the good work pharmacies are doing locally and shout loudly where community pharmacy has changed and saved lives (and the Community Pharmacist Consultation Service gives us a great opportunity to do this). So let’s make 2020 the year of community pharmacy: we are saving the NHS from itself – helping to ease the pressures in GP surgeries and reduce A&E waiting times by taking on more clinical services as well as promoting selfcare and healthy living to 1.6m people per day. Let’s make sure this new Government knows it.

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

PSNC’s General Election Statement PSNC responds to the outcome of the December 2019 General Election, describing how the organisation will continue to promote community pharmacy.

The Conservative Party has won a majority in the 2019 General Election and will form the next Government. The Conservatives won 365 seats and so Boris Johnson will remain Prime Minister.

It is expected that the leadership of other parties may be subject to change but that won’t impact on PSNC’s plans to reach out to individual MPs to attempt to gain or reaffirm their support. Many new MPs will be entering Parliament and we look forward to working with them to promote the pharmacy sector and all that it has to offer. We will also continue to help LPCs engage with their new and returning MPs, with updated resources and guidance to be published in the new year.

Whilst a number of key existing community pharmacy supporters have retained their seats, the Shadow Community Health Minister responsible for pharmacy and long-time advocate for the sector, Julie Cooper, lost her seat in Burnley.

Research reveals mental health concerns in pharmacy Almost three-quarters of pharmacists say their training or working life has had an impact on their mental health or wellbeing at some point, new research has revealed.

The Royal Pharmaceutical Society (RPS) and the independent charity Pharmacist Support have announced the results of a recent survey of over 1,300 pharmacists, which will be used to campaign to extend NHS-funded wellbeing support to pharmacists.

Significantly, 80% of respondents said they were at high or very high risk of burnout due to exhaustion, with more than half stating they felt they didn’t spend enough time with family and friends and had considered a change of career.

Reasons identified by respondents included a lack of support staff and worrying about making mistakes.

More detailed analysis of the data will be published in Spring 2020, but you can find out more about the Workforce Wellbeing campaign at: ow.ly/B1mg30q3la5

Both Health Secretary Matt Hancock and Pharmacy Minister Jo Churchill did retain their seats as MPs, but a Cabinet reshuffle is likely in early 2020 and we will keep you updated on their ministerial roles.

Pharmacy Manifesto The General Election presented a great opportunity for the sector to be recognised as a valuable health and wellbeing asset, and so the NPA, RPS and PSNC worked together to create a shared ‘pharmacy manifesto’.

The manifesto sets out our ambitions for community pharmacy and we will be asking the new Government to commit to it.

See votepharmacy.uk for more details.

Overcoming self care barriers The Proprietary Association of Great Britain (PAGB) has published a report entitled ‘Overcoming the Barriers to Self Care’.

The report analyses the barriers preventing wider adoption of self care policies and identifies current NHS structures and a riskaverse culture as key challenges that need to be overcome.

PAGB’s analysis looks at three policy initiatives which would support and empower more people to self care but have not yet been widely implemented. It examines the potential barriers to implementation and highlights case studies where local innovation has overcome these.

The policy initiatives are: 1. The use of recommendation prescriptions so GPs can refer patients to self care and their local pharmacy for advice; 2. Enabling community pharmacists to refer directly to other healthcare professionals, fast-tracked as appropriate; and 3. Providing community pharmacists with ‘write’ access to patient medical records and the ability to update details of medication or advice in real time.

Read the PAGB report in full at: ow.ly/mWtp50xD3Nm

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SERVICES AND COMMISSIONING

PQS: NSAID quality criterion PSNC has highlighted several points on the non-steroidal anti-inflammatory drug (NSAID) quality criterion of the Pharmacy Quality Scheme (PQS) of which community pharmacy contractors should be aware.

These include: • implementing the findings and recommendations from the 2018/19 Quality Payments Scheme NSAID audit report; • an update to the Specialist Pharmacy Service (SPS) NSAID audit; and • sharing anonymised patient data with NHS England and NHS Improvement.

Read the PSNC news story detailing this important information at: ow.ly/j2O030q3Exu

PSNC resources for PQS A new PSNC Briefing provides a list of all the PSNC resources available to assist community pharmacy contractors with meeting the gateway and quality criteria of the 2019/20 PQS. PharmOutcomes services and assessments, which are relevant for the PQS, are also listed in this Briefing as PSNC has agreed to use their licence to provide access so all contractors can use these free of charge.

Download the PSNC Briefing: ow.ly/1I7k30q1C2m

PQS evidence checklist Another PSNC Briefing provides community pharmacy contractors with examples of suggested evidence, in a checklist format, that they can use to confirm they have the necessary evidence ready to make their PQS declaration between 9am on 3rd February 2020 and 11.59pm on 28th February 2020.

The examples provided as suggested evidence are not exhaustive; other evidence may also be suitable.

Download the PSNC Briefing: ow.ly/8J8z30q1BVN

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THE HEALTHCARE LANDSCAPE

LPCS

Almost 11,000 contractors meet first PQS deadlines The majority of community pharmacy contractors have met the NHS website and DoS criterion of the Pharmacy Quality Scheme – but are you one of them?

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Use NHSBSA’s PQS validation data to check that you have met these criteria

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Following the deadline of 11.59pm on 30th November 2019 for community pharmacy contractors to meet the NHS website gateway criterion and the Directory of Services (DoS) quality criterion of the Pharmacy Quality Scheme (PQS), nearly 11,000 contractors met both of these deadlines.

The latest data from the NHS Business Services Authority (NHSBSA) shows that 10,970 contractors met the NHS website gateway criterion and 10,903 contractors met the DoS quality criterion.

Contractors are strongly encouraged to check the latest NHSBSA PQS validation data to confirm if they are showing as having met both of these criteria. If contractors are showing as green for these criteria on the data spreadsheet, they can be confident that they have met the criteria.

If a contractor is not showing as green, but believe they have met the NHS website gateway criterion or both of the criteria, they are advised to take action as soon as possible so the data can be reviewed ahead of the PQS declaration period.

Contractors wishing to query data in the spreadsheet should email the NHSBSA Provider Assurance Team at nhsbsa.pharmacysupport@nhs.net with the following information: • If querying not meeting the NHS website gateway criterion, send screenshots of the three sections of your NHS website profile, showing the date when the sections were updated or validated. (Distance Selling Pharmacies should forward the email and attachment they originally sent to the NHSBSA Provider Assurance Team.)

• If querying not meeting the DoS quality criterion, forward the confirmation email you received after updating your pharmacy’s DoS profile.

Further advice for contractors on the PQS validation data can be found at: ow.ly/iNng30q1zUl

PQS information hub As has been the case for previous Quality Schemes, the PSNC Services Team has pulled together all the information on the new PQS so it can be accessed from one location. The PQS information hub includes guidance and resources on varying aspects of the Scheme from how to achieve the individual criteria to where and when to claim payment. Visit the PQS hub: psnc.org.uk/PQS

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

IT access for CPCS Have you planned how to get IT access in your consultation room for CPCS? Here’s what you need to have in place by 1st April 2020.

Pharmacies providing the Community Pharmacist Consultation Service (CPCS) must have IT equipment accessible within the consultation room to allow contemporaneous records of the CPCS consultations to be made within the CPCS IT system (PharmOutcomes or Sonar) from 1st April 2020.

This means that pharmacists providing the service in the consultation room will need access to a desktop computer, laptop or tablet device with, as a minimum, access to the internet. This will enable access to the web-based CPCS IT systems, so records can be made while talking to the patient.

If the pharmacist is to access the NHS Summary Care Record (SCR) in the consultation room, the computer equipment will also need to have a Smartcard reader. If that is not possible, while not ideal, the patient’s SCR could be checked prior to the

consultation starting at another computer in the pharmacy which does have SCR access.

If a consultation room is now being used to provide CPCS and there is no IT equipment that can be used within it, contractors should now start to plan how they will provide access to such equipment by 1st April 2020.

Your pharmacy IT supplier may be able to provide advice on how to enable IT access within the consultation room. Don’t underestimate the time it may take to put such arrangements in place, particularly if a wired network point needs to be installed in the consultation room or you need a secure Wi-Fi network setup within the pharmacy.

Further information on CPCS can be found at: psnc.org.uk/cpcs

CPCS clinical skills workshops The Centre for Postgraduate Pharmacy Education (CPPE) is offering skills workshops to support pharmacists providing the new Community Pharmacist Consultation Service.

We are delighted to announce the “launch of the new workshop, NHS

knowledge to real life scenarios.

Community Pharmacist Consultation Service: clinical assessment – essential skills.

The workshop will introduce learners to clinical examination skills in order to demonstrate the scope of what pharmacists can perform within their community pharmacy. The focus of the clinical assessment skills will be to support clinical consultations held with patients referred to the pharmacy as part of the CPCS.

The Community Pharmacy Contractual Framework introduced in 2019 includes of learning development, and Joanne Lane, regional a plan to nationally roll out the NHS manager, CPPE Community Pharmacist Consultation Service (CPCS). This brings together the DMIRS and NUMAS services that previously existed in certain areas of the country.

Lesley Grimes, head

The aim of these workshops is to support pharmacists to develop the knowledge, skills and confidence needed to undertake effective consultations, communications and clinical assessments in order to provide the CPCS. This is a full-day workshop and includes various activities on physical examinations, history taking and clinical transfers and safety netting. Participants will also have the opportunity to work through several case studies so that they can apply their

After completing these workshops, pharmacists should be able to apply tools and techniques to demonstrate a structured personcentred approach to clinical history taking and apply evidencebased practice and relevant guidance to support clinical reasoning and engage the person in shared decision making, such as NICE Clinical Knowledge Summaries.

Please note these workshops are available where commissioned locally and by Health Education England (HEE) to support the delivery of the NHS CPCS by community pharmacists.

To book a place on the workshop or for more information, visit: www.cppe.ac.uk/programmes/l/cpcs-w-01

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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.

Pharmacy applications go online

) has launched the first stage of Primary Care Support England (PCSE ation process. applic digitising the pharmacy market entry ations will see the replacement of This new approach for pharmacy applic application, accessible via the multiple paper forms with one single online ‘PCSE Online’ portal.

ed group of pharmacies will be the As part of a managed rollout, a select a limited number of forms being first to make applications online with only available at first. w of the system which provided PSNC previously helped facilitate a previe ue to work with PCSE on the contin vital early testing and feedback and will portal’s development.

uppliers’ Christmas opening hours S

Following the summary of customer servic e desk opening hours for manufacturers and wholesalers over the Christmas period published in November’s CPN magazine, some additional information has been added to the online version. These include the opening hours and delivery schedules for AAH and Alliance.

For the latest information and order cut off/delivery schedules, please visit: ow.ly/ 5jEA3 0pXy ZK

Use of antiviral medicines against influenza

Due to increasing flu levels in the community, GPs and other prescribe rs working in primary care in England may now prescribe antiviral medicines for the prophylaxis and treatment of flu at NHS expense.

Community pharmacy teams who receive FP10 NHS prescriptions, written generically or by brand, for oseltamivir (Tamiflu) or zanamivir (Relenza) , are reminded that prescriptions for these products must be endorsed SLS. If the SLS endorsement is missing, the prescription should not be dispensed and will not be passed for payment by the NHS Business Services Authority.

6 Community Pharmacy News – December 2019

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Dispensing and Supply News Our Dispensing and Supply Team highlights the latest news, information and guidance that community pharmacy teams should be aware of.

Parallel export ban update Additions have been made to the list of medicines which must not be parallel exported from the UK. These include: • Colestyramine sachets • Fluticasone nasules The Department of Health and Social Care (DHSC) and the Medicines and Healthcare products Regulatory Agency (MHRA) have added these products to the list to ensure their continued supply to meet the needs of UK patients.

The full list can be viewed at: ow.ly/AFzd30q1zjK Experiencing supply issues?

If your pharmacy is finding it difficult to obtain a medicine or appliance, please report this to PSNC. We send a monthly summary of the feedback received to DHSC to support its monitoring of the supply chain. This information is also used as an evidence base in discussions with manufacturers, for example highlighting problems with contingency arrangements.

Please make sure you let us know about any supply issues by using our online feedback forms at: psnc.org.uk/feedback

Medicine shortages The DHSC Medicine Supply Team provides a monthly update on potential supply issues affecting both primary and secondary care.

This update is uploaded on the Specialist Pharmacy Services (SPS) website: sps.nhs.uk If you are not already registered on the SPS website, we recommend you sign-up to ensure you are informed on the latest supply issues.

To register, you will need an NHS email address. Once set up and logged in, you will be able to access it online.

Metformin safety update The MHRA has been made aware that outside of the UK very low amounts of an impurity, N-nitrosodimethylamine (NDMA), have been found in some metformin diabetes medicines.

MHRA has advised that patients in the UK should continue to take their metformin medicines as usual and stated that the risks from not having adequate diabetes treatment far outweigh any possible effects of low levels of NDMA seen in metformin medicines outside the UK. The levels of NDMA appear to be within the range that people would be normally exposed to from other sources including food or water, but the European Medicines Agency are investigating. View the last update at: ow.ly/5YM230q2CZj

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

Compact testing strips

No

n/a

Yes

No

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

iHealth testing strips

No

n/a

Yes

No

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

BD Micro-Fine + lancets 0.20mm/33 gauge

No

n/a

Yes

No

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

BD Micro-Fine + lancets 0.30mm/30 gauge

No

n/a

Yes

No

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

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

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

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

SSPs: Your FAQs answered PSNC’s Dispensing and Supply Team answer some common queries on endorsement and submission of prescriptions subject to Serious Shortage Protocols (SSPs).

Q. When endorsing a prescription for an SSP, do I have to endorse the pack size?

A. Community pharmacy teams should endorse the prescription or token in line with the endorsement requirements specified in the protocol.

It may be beneficial to endorse the pack size to remove any ambiguity and aid processing at the NHS Business Services Authority (NHSBSA), if the free text ‘Dispensed Additional Information’ field can accommodate the extra characters.

Q. How should I submit an SSP claim if my PMR system does not appear to support all the required endorsements to submit a valid SSP claim electronically?

Q. How can I ensure that the paper prescriptions and tokens with SSP claims are seen by an exception handler at NHSBSA? A. All paper prescriptions and tokens with SSP claims must be placed in the red separator on top of the monthly prescription bundle before submitting to the NHSBSA in the usual way.

Q. When endorsing a prescription for an SSP, does the SSP number need to be included?

A. No. The SSP number is not required as the originally prescribed drug and the presence of an ‘NCSO’ endorsement against it will help identify the protocol that was used to make a supply.

A. In order to remove any ambiguity and avoid the risk of incorrect endorsement, the NHSBSA advises that all the required SSP endorsements should be present within the free text ‘Dispensed Additional Information’ field, where possible.

If the SSP endorsements cannot be accommodated on the EPS claim message (for example, due to character limit restrictions), pharmacy teams are advised to submit the SSP claim using the corresponding EPS token instead. When making a submission using a token, always remember to mark the electronic claim message as ‘not dispensed’ or ‘ND’.

Additionally, as there are limited character spaces in the free text ‘Dispensed Additional Information’ field, keeping endorsements minimal is ideal.

For more information on endorsing SSPs see psnc.org.uk/SSPfactsheet Look out for more frequently asked questions next month…

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

SSP02 for Fluoxetine 30mg capsules The Serious Shortage Protocol (SSP) for Fluoxetine 30mg capsules expired at 23.55pm on Wednesday 18th December 2019.

The Department of Health and Social Care (DHSC) has confirmed that sufficient stock is now available to supply normal demand for dispensing against prescriptions for Fluoxetine 30mg capsules. SSP02 is therefore not valid for use after 18th December 2019.

8 Community Pharmacy News – December 2019

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Drug Tariff Watch

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

Below is a quick summary of the changes due to take place from 1st January 2020.

Part VIIIA additions Category C: • Aprepitant 80mg capsules (2) - Zentiva • Baclofen 10mg/20ml solution for infusion ampoules  (1) - Lioresal Intrathecal • Baclofen 10mg/5ml solution for infusion ampoules  (1) - Lioresal Intrathecal • Baclofen 50micrograms/1ml solution for injection ampoules  (1) - Lioresal Intrathecal • Evolocumab 140mg/1ml solution for injection pre-filled disposable devices (2) – Repatha SureClick • Glatiramer acetate 20mg/1ml solution for injection pre-filled syringes (28) – Copaxone • Glatiramer acetate 40mg/1ml solution for injection pre-filled syringes (12) – Copaxone

• Lidocaine 7.5mg/actuation / Prilocaine 2.5mg/actuation cutaneous spray  (5ml) - Fortacin • Memantine 5mg/10mg/15mg/20mg orodispersible tablets initiation pack sugar free  (28) – Valios • Prasterone 6.5mg pessaries (28) – Intrarosa • Rivaroxaban 15mg tablets and Rivaroxaban 20mg tablets  (49) – Xarelto • Rotavirus vaccine live oral suspension 1.5ml tube  (1) – Rotarix • Zidovudine 300mg / Lamivudine 150mg tablets (60) – Combivir Part VIIIA amendments • Lorazepam 500microgram tablets (28) – Advanz Pharma is changing to Category A • Nifedipine 10mg modified-release

tablets (56) – Adalat retard is changing to Nifedipress MR 10 • Propiverine 15mg tablets (56) – Detrunorm is changing to Category A • Ropinirole 1mg tablets (84) – ReQuip is changing to Category A • Rupatadine 10mg tablets (30) – Aspire Pharma Ltd is changing to Category A Part VIIIA deletions • Estradiol 1mg / Drospirenone 2mg tablets (84) – Angeliq • Glucosamine hydrochloride 625mg tablets (60) – Alateris • Nedocromil 2% eye drops (5ml) – Rapitil • Rotavirus vaccine live oral suspension 1.5ml pre-filled syringes (1) – Rotarix • Valsartan 80mg tablets (28) – Macleods Pharma UK Ltd.

Part IX deletions Product Nélaton Catheter (‘ordinary’ cylindrical Catheter) – Unomedical Ltd Nélaton Catheter (‘ordinary’ cylindrical Catheter) Single use – Wellspect HealthCare LoFric Insti-Cath – (Tiemann)

Additional information (e.g. size, product code, etc.)

All types and sizes (821200) 12Ch

Foley Catheter – 2 Way For Long Term Use – Adult – Medasil (Surgical) Ltd – All Silicone

All types and sizes

Foley Catheter – 2 Way Long Term Use – Paediatric – Medasil (Surgical) Ltd – All Silicone

(83P) 5ml, 8-10Ch

Hydrogel Dressing – Sterile – Askina Gel

15g

Soft Polymer Wound Contact Dressing with Polyurethane Foam Film Backing Impregnated with Antimicrobial Agents – UrgoCell Silver

All sizes

LYMPHOEDEMA GARMENTS – Sigvaris Coton – (15-20mmHg)

All types and sizes

LYMPHOEDEMA GARMENTS – Sigvaris Expert – (20-36mmHg)

All types and sizes

SPACER/HOLDING CHAMBER DEVICES – Vortex

All types (with and without masks)

Soft Silicone Fixation Tape – Hypafix gentle touch

All sizes

COLOSTOMY BAGS – Softima Convex with filter – Beige – pre-cut

25mm (43026E) and 40mm (43041E)

COLOSTOMY BAGS – Dansac NovaLife TRE 1 – with viewing option – Maxi cut-to-fit

25-55/70mm (3007-25) 30-55/70mm (3007-30) 25-70/90mm (3005-25) 30-70/90mm (3005-30)

ILEOSTOMY (DRAINABLE) BAGS – Dansac NovaLife TRE 1 – Midi Clear cut-to-fit

25-55/70mm (3024-25) 30-55/70mm (3024-30) 35-55/70mm (3024-35)

ILEOSTOMY (DRAINABLE) BAGS – Dansac NovaLife TRE 1 – with viewing option Midi Clear cut-to-fit

40-55/70mm (3023-40)

ILEOSTOMY (DRAINABLE) BAGS – Dansac NovaLife TRE 1 open convex – Mini Clear cut-to-fit

15-24mm (3042-24)

ILEOSTOMY (DRAINABLE) BAGS – Dansac NovaLife TRE 1 open convex – Midi Clear cut-to-fit

30-37mm (3042-30)

TWO PIECE OSTOMY SYSTEMS – Softima Key Convex Flexible Baseplate – pre-cut

50/200mm (63054E)

UROSTOMY BAGS – Softima Uro Silk Convex Urostomy Bag Beige – cut-to-fit

15-25mm (43916E)

UROSTOMY BAGS – Softima Uro Silk Convex Urostomy Bag Beige – pre-cut

25mm (43921E) and 30mm (43923E)

Chemical Reagent – eBchek

n/a

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Reducing errors arising from ‘paid’ or ‘exempt’ status declaration using EPS It’s important to ensure that patient exemption/paid status is accurately populated prior to submitting your electronic claim message. This factsheet will help you to identify possible sources of errors and tips to help prevent them from occurring.

Background When using the Electronic Prescription Service (EPS), patients are required to sign an EPS token to declare that they have paid the relevant number of prescription charges or to declare an exemption other than an age exemption (under 16 years of age or 60 years and over). An electronic claim message cannot be submitted to the NHS Business Services Authority (NHSBSA) without selecting an EPS message code to identify the patients exempt or charge paid status.

The declaration made on the electronic claim message is used by the NHSBSA to calculate the prescription charge deduction amount. If a ‘paid’ declaration is submitted electronically, the relevant number of prescription charges linked to the claim message are deducted by the NHSBSA. It has come to PSNC’s attention that some community pharmacy teams are inadvertently submitting electronic claim messages as ‘paid’ despite patients being in possession of a valid exemption and having completed the corresponding EPS token declaring their exemption.

What happens if the wrong EPS message code is selected?

If the wrong EPS message code (except for age-exempt patients) is selected, discrepancies may arise between the number of charges collected and declared on the FP34C submission document by the pharmacy and the number of charges deducted by the NHSBSA. If EPS prescriptions are erroneously marked as ‘paid’, this can have a significant impact on the pharmacy payments (both monthly Advance and balancing reconciliation payments). This issue has led to some contractors losing thousands of pounds each month (see Case Study below).

It is important that pharmacy teams ensure that the correct patient information regarding exemption or charge status has been populated on every electronic claim message prior to submission. Pharmacy teams should accurately populate the Patient Medication Record (PMR) using the declaration made on the EPS token by the patient or their representative and ensure that this is correctly applied to the dispense notification message before it is transmitted as part of the electronic claim message.

Case Study PSNC analysed data from six pharmacies that reported discrepancies in their payments showing significant differences between the number of charges deducted by the NHSBSA compared to the contractor’s end of month submission.

Looking at Schedule of Payments data over 16 months between April 2018 and July 2019, PSNC found that for the six pharmacies: • A total of 34,000 items were declared as paid (this would include a combination of the current £9.00 NHS prescription charge and the old charge rates of £8.80 and £8.60).

• NHSBSA recovered charges for over 43,000 items (this would include any paper prescriptions switched from exempt to paid).

• The difference of 9,200 paid items works out to £81,000 more prescription charges deducted by the NHSBSA than were declared by the pharmacies.

• Across the six pharmacies, this equates to an average discrepancy of -£13,500 per pharmacy during the period.

Overall, PSNC’s prescription pricing audit work reveals a high degree of accuracy in processing by the NHSBSA. This suggests that the issues may reside at a local level depending on the systems and processes used by individual contractors.

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LPCS

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

What could be contributing to the incorrect patient declarations?

We have identified some possible sources of errors below to help identify and understand what could be driving some of these errors or discrepancies: Possible pharmacy errors: • FP34C transcribing error – counting/declaring incorrect ‘paid’ and ‘exempt’ totals on the FP34C submission document. In some cases, we have come across instances where the ‘Number of patient charges paid’ declaration section has been left blank by pharmacy teams.

• Human error – electronic claim messages for exempt patients inadvertently being marked as ‘paid’.

• Inaccurate PMR information – pharmacy teams not checking and updating patient declarations on the PMR and electronic claim message before submission.

• Claim message transcribing error – inaccurate capturing and transferring of the patient declaration from token to the electronic claim message.

• Totalling errors – pharmacy teams manually counting EPS tokens instead of using system totals to declare total paid/ exempt items on the FP34C declaration.

System checks: • Does your dispensing system default to the EPS message code ‘paid’ status if no code is selected by the pharmacy before submitting an electronic claim message?

• Is your system generated end-of-month total report configured to take account of the EPS five-day window (see psnc.org.uk/5daywindow for more information) and any Not Dispensed items?

How do I prevent such discrepancies from arising in future?

• Pharmacy teams should ensure that accurate exemption/ prescription charge declarations are populated on the electronic message before submitting the dispense notification and claim notification.

• Always check that the information on your PMR matches the patient declaration made on the EPS token before populating the EPS message – patient exemption status can change monthly so always ensure you check against the patient declaration on the reverse of the EPS token.

• Always ensure you select an exempt/paid status (as applicable) on the electronic message – If your system automatically defaults selection to the charge ‘paid’ EPS message code, please speak to your system supplier to identify a fix.

• DO NOT count EPS tokens – use system generated reports for declaring your end of month EPS and paper item totals.

Configure your system-generated end of month reports accurately to represent the EPS and paper (paid and exempt) item totals by taking into account EPS-5 day window, Not Dispensed items and the relevant EPS message codes selected on electronic prescriptions – speak with your system supplier if you suspect any inaccuracies with the reporting.

• Contact your system supplier to find out the most efficient way to deal with non-age exempt patients – what prompts and flags can be put in place to ensure all declarations are completed accurately before submission?

• The facility to amend a claim within the reimbursement period is now available from several system suppliers, check if your system supplier offers this feature. The claim amend functionality allows you to ‘correct’ a claim that has been accidently submitted as paid instead of exempt or vice versa as long as it’s within the ‘reimbursement period’, i.e. before the end of the fifth day of the month after it was dispensed (dispense notification sent).

• Contractors can now complete their FP34C submission document electronically using the Manage Your Service (MYS) portal accessed via the NHSBSA website (see psnc.org.uk/MYS for more information). The MYS pharmacy submission form splits the declaration for EPS and paper item totals which can help with reconciliation against your Schedule of Payments and Prescription Item reports.

Useful resources PSNC factsheet Number of Items – getting your declaration right explains how to accurately complete your FP34C to ensure you receive the correct level of Advance payment: psnc.org.uk/itemsdeclarationguide PSNC factsheet Claiming for EPS prescriptions on time explains how the five-day window works and the impact it can have on your end-of-month totals: psnc.org.uk/EPSclaimguide

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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 044/19: CP ITG – Preparing for Windows 7 and Windows 10 transition From 14th January 2020, Microsoft will end its free support for the Windows 7 operating system. This Community Pharmacy IT Group (CP ITG) briefing has been compiled for those supporting pharmacy IT who may be involved in supporting the transition from Windows 7 to Windows 10.

Download from: ow.ly/V7sx30q0Da9 PSNC Briefing 051/19: CPCF Services – Important dates and checklist A checklist of important dates which relate to services including the Community Pharmacist Consultation Service; Flu Vaccination Service; Medicines Use Reviews; New Medicine Service; Pharmacy Quality Scheme and contractual public health campaigns.

Download from: ow.ly/A7fW30q0D4B PSNC Briefing 057/19: NHS CPCS – Early learnings and tips for contractors Guidance for pharmacy contractors on some elements of providing the Community Pharmacist Consultation Service (CPCS). It contains suggestions on how to better manage service provision based on reports from the first few weeks of the service going live.

Download from: ow.ly/fQ7S30q0D1c PSNC Briefing 059/19: Pharmacy Quality Scheme – PSNC resources This briefing provides a list of all the PSNC resources available to assist community pharmacy contractors with meeting the gateway and quality criteria of the Pharmacy Quality Scheme (PQS) 2019/20.

Download from: ow.ly/or7A30q0CZt See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources November PSNC Meeting Summary The PSNC Committee met on the 27th and 28th of November, with key discussions around progress with new services alongside concerns around funding and capacity pressures. Further information is available in our summary document.

Read now: ow.ly/aYXa30q0DoH Look out for additional resources as you explore our website: psnc.org.uk

Email news alerts CPCF Checklist 30. CPCS: Plan how to get IT access in your consultation room (28th November) Reminding contractors planning to provide the Community Pharmacist Consultation Service (CPCS) of the need to have IT access in their pharmacy’s consultation room and describing what needs to be in place by 1st April 2020.

Read now: ow.ly/6BhI30q0Dx2 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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