February 2016 CPN

CPN

Community Pharmacy News – February 2016

Joint campaign for community pharmacy PSNC works with the other national pharmacy organisations on national communications

Reconciling EPS prescriptions | Leadership Academy update | Payment reports portal

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PSNC publishes service development proposals PSNC is working with the other national pharmacy organisations to prevent the Government plans from damaging patient care.

PSNC has published a set of service proposals that describe how community pharmacy services could develop in the future within the context of Government drives for efficiency.

meet the NHS and Government's stated aims for patient care, and PSNC will undertake further development work on them subject to the response they receive from DH and NHS England.

The proposals include the introduction of a care package, which would see repeat dispensing becoming a default option where medicines are needed on a longterm basis, patient registration at pharmacies, and pharmacies offering enhanced medicines optimisation services.

The proposals are set out in three phases, in recognition of the need to allow the wider NHS and community pharmacy to adopt them in a controlled manner that also allows time for other enablers, such as IT, to be put in place. The box opposite summarises the first phase of PSNC’s proposals; the full proposals can be viewed on our campaign page: psnc.org.uk/campaign

The document comes as part of the discussions with the NHS following the 17th December open letter in which the Government announced a number of plans for community pharmacy including a £170m reduction in funding. The Government highlighted the need for efficiencies but also stated that it wanted to develop a clinically focussed community pharmacy service.

We recognise that implementing these service development proposals would have substantial implications for DH's planned restructuring of funding delivery and this would require detailed consideration.

The Department of Health (DH) and NHS England have no specific proposals on how to develop that clinically focussed community pharmacy service, so they invited PSNC to propose service development options for discussion.

The proposals offer a possible way to develop the pharmacy service in order to

Proposals: Phase 1 a) Transfer from Repeat Prescribing to eRepeat Dispensing (eRD) and develop a community pharmacy care package for patients. b) Offer of an inhaler technique check and coaching session to patients prescribed inhalers. c) Prescription interventions to be clearly recorded using a standard classification system and the data to be centrally collated. d) Post-discharge Medicines Use Reviews (MURs) to continue. e) To effectively implement a Minor Ailments Advice Service and an Emergency Supply Service. f) Public Health England (PHE) and NHS England should agree up to six national campaign topics each year, running within pharmacies for up to two months.

The campaign PSNC and the other national pharmacy organisations have begun the coordinated campaign on the future of community pharmacy. Tactics include sending Parliamentary briefings and meeting with MPs, as well as media work.

Everyone can help in the following ways.

• Follow us online and on social media. Please visit the dedicated website at: supportyourlocalpharmacy.org and look out for #lovemypharmacy updates on Twitter.

• Share your stories – you can use #lovemypharmacy to share stories of how you and your pharmacy team have gone out of your way to help your patients.

• Collect case studies that demonstrate where you have

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offered exceptional care to patients. These can be emailed to campaign@psnc.org.uk. See the guidance at: psnc.org.uk/campaign.

• Sign up to the e-petition at: tinyurl.com/supportyourlocalpharmacy and then commit to getting your patients to sign the paper petition coming soon.

• Talk to patients – tell them about the campaign and ask for their support, for instance through the petition, social media, or by contacting their MP. Read the guidance at: psnc.org.uk/campaign for more help and information.

• Contact your MP – write a personalised letter to your MP setting out your concerns. The key messages at: psnc.org.uk/campaign will help you with this.

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LPC leaders discuss Government proposals PSNC last month hosted a meeting of LPC Chairs and Chief Officers to discuss its response to the Government plans.

Within days of the 17th December announcement PSNC had called a special meeting of LPC Chairs and Chief Officers. The meeting held on 20th January had representatives from 75 LPCs to get the latest information from PSNC, hear about national plans and work together to discuss how LPCs can play their part.

PSNC Chief Executive Sue Sharpe identified the specific threat to community pharmacy, the government’s aims and objectives, PSNC’s position on specific elements of the Government’s plans, PSNC’s strategy, and the campaign to win hearts and minds.

Sue emphasised that this was not a short campaign – it was for at least two years and the impact on patients is the main concern.

NPA Chair Ian Strachan spoke passionately and personally about his disbelief on first hearing about the plans and his commitment to work collaboratively with other national bodies to fight the proposals to protect the services patients need and value.

LPCs agreed that working together with the national

organisations on a coordinated campaign was vital. Through group discussions they identified how locally LPCs can lobby MPs, use social media, collect patient stories on the value of their contractors' pharmacies, organise local meetings and engage patients and customers in the pharmacy in high impact ways.

Some of those suggestions are now built into the campaign and LPCs side by side with the pharmacy bodies are gearing up to fight the threats to community pharmacy and patients.

Further details emerge on Government plans for pharmacy A number of details have emerged in recent weeks about the Government’s plans for community pharmacy in 2016/17 and beyond; here's a round-up of the additional details that have now emerged: • A Department of Health presentation/briefing document providing further information on their proposals; • PSNC has stated it cannot accept proposals that will jeopardise the services and supplies that pharmacies provide to their patients; • At a meeting with the All-Party Pharmacy Group, pharmacy minister Alistair Burt suggested that between 1,000 and 3,000 community pharmacies could close; and • The Government responded to an online petition seeking to stop the community pharmacy funding reduction for 2016/17, restating its belief that efficiencies can be made in the sector.

Community pharmacy contractors and LPCs may want to read these documents in full to ensure they are fully informed of the current situation. Links to the documents and further information are available from: psnc.org.uk/campaign

PSNC Leadership Academy update There was a great response to the invitation to apply to be part of PSNC’s leadership development programme for LPCs, designed to develop leaders for the future.

We received applications from numerous excellent candidates, more than double the number of places available, which made the selection process all the more difficult.

Congratulations to all the successful candidates; we will track the development of the group and keep LPCs updated with news of their progress.

The successful candidates, and their LPCs, are: 1. Andrew Beardshall – Barnsley 2. Sarah Wood – Bury & Rochdale 3. Nicholas Thayer – Cheshire & Wirral 4. Tom Kallis – Devon 5. Penny Woodgate – East Sussex 6. Altaf Vaiya – Leicestershire & Rutland 7. David Sanchez – Liverpool 8. Claire Dickens – Manchester 9. Lauren Seamons – Norfolk 10. Stephen Blackman – North of Tyne 11. Elissa Pateman – North Staffordshire & Stoke 12. Sandie Hall – Tees

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EPS costing study An independent study of EPS, involving 200 randomly selected community pharmacy teams, has taken place to assess the impact of the Electronic Prescription Service on contractors.

PricewaterhouseCoopers (PwC) has recently undertaken an independent study, commissioned by government, to assess the costs and benefits of the Electronic Prescription Service (EPS).

The study, which began in late January, involved PwC visiting a sample of community pharmacies from across the country in order to assess the impact of using EPS compared to paper prescriptions.

Following the agreement in the 2015/16 community pharmacy funding settlement for this work to be undertaken, PwC was selected to obtain and use independent evidence to assess the benefits and dis-benefits of using EPS to community pharmacies, in particular the difference in time, costs and workload required for handling electronic compared to paper prescriptions.

Pharmacies were selected to take part in the work in order to reflect the range of pharmacy types (e.g. locations, script volumes and ownership type), extent of use of EPS and the range of Patient Medication Record (PMR) systems in use across England.

The views and experiences of other community pharmacy teams were also canvassed through an online survey held earlier this month.

Don't miss out on the free EPS masterclasses in your area this year!

To help pharmacy teams get the most out of EPS, over 800 training events are being held throughout England with at least one event per PMR system in each LPC area taking place before June 2016.

The events are being organised by the EPS Team at the Health and Social Care Information Centre (HSCIC), in conjunction with LPCs, dispensing system suppliers and the Pricing Authority (PA).

The free training will focus on: 1. dispensing system training, tailored specifically to your PMR system, covering how to use EPS Release 2; 2. business process change and how to get the best out of EPS, including business continuity; and 3. a claiming and endorsing masterclass by the PA. Where possible the whole pharmacy team should attend the events to ensure they can get the most out of EPS, understand their PMR capability, and are prepared for the future development of EPS. Pharmacy teams should consider how to further optimise their processes following their session and attendance can count towards Continuing Professional Development.

James Wood, pharmacist at Wicker Pharmacy, commented: “The events are a good way to ensure the whole pharmacy team can

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- minimum events per LPC area

over 800

- number of events across the country

2 hours

- length of each event

3

- number of sessions at each event

get to know their PMR and maximise their use of EPS. They’ll provide a great introduction for those who haven’t used EPS very much to date, and staff will be able to raise their questions.”

Most pharmacy teams will be able to find events in their area because more than 75% of the planned events are now listed on the HSCIC website. Sign up for events at: tinyurl.com/traineps or read more at: psnc.org.uk/epstraining

IG toolkit reminder It’s just over a month to go before the deadline to submit Information Governance (IG) returns (31st March 2016). Don’t forget pharmacies are no longer exempt from requirement 319 and therefore contractors need to have a business continuity plan in place. Guidance on developing a plan can be found in the clinical governance section of the PSNC website: psnc.org.uk/IG319

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Want to reconcile your EPS prescription figures?

Try using our handy nine step process!

PSNC recommends contractors use the steps below to help reconcile the number of electronic prescriptions sent by their pharmacy with the amount paid by the Pricing Authority (PA).

1. Consider the five day window when counting EPS totals: E.g. Prescriptions with dispense messages sent in August (1st-31st) are included in the August dispensing month only if the claim messages are sent by the end of 5th September.

If both the dispense message and the claim message are sent within the first five days of September, these will be included in the September dispensing month as shown in this example.

August 28

29

September 30

31

Dispense notification sent on 29th August

August 28

29

30

31

August 29

2

3

4

5

6

1

2

3

4

5

6

31

= September Payment

Electronic claim message received after midnight on 5th September

September 30

= August Payment

Electronic claim message received before midnight on 5th September

September

Dispense notification sent on 29th August

28

1

1

2

3

4

5

6

= September Payment

Dispense notification Electronic claim message received sent on 1st September before midnight on 5th September

2. Send EPS dispense and claim messages at the right time: Consider (a) sending all dispense and claim messages by the end of the month and (b) not sending claim messages between 1st-5th of the next month, given five day window logic, if this can ease your counting.

3. View PMr monthly totals report: This can help with completing the FP34C submission form as the PMR report may summarise and break down your EPS totals for the month.

5. Manually note EPS totals onto top of FP34C form: See image below. This will help in reconciling with your FP34 Schedule of Payment.

4. Complete FP34C form: Tick the EPS box, and enter the totals into the boxes provided i.e. paper plus electronic overall forms and items.

PrESCriPTioN DATA

6. Take a copy and then send the FP34C form: Send it via a track and trace method with your prescriptions, by the 5th of the month following dispensing.

Total forms received (including electronic prescription)

3,391

Total electronic prescription forms received

1,587

Total electronic prescription items received

3,502

7. Compare EPS totals on the FP34C form copy to EPS totals listed on the Schedule of Payment as soon as you can*: The totals are in the PRESCRIPTION DATA section typically found on page 2 or 3 – see image above.

9. Still worried?

If you are still concerned you may want to ask the PA to re-count the forms/items in the prescription bundle via the recheck form (psnc.org.uk/epsreconcile).

8. Spotting a discrepancy: Small differences, like that seen above, are common and usually caused by: the five day logic (see step 1); suppliers’ totals reports requiring refining; methadone instalments; elastic hosiery items; or multiple strengths/flavours.

*EPS items are removed from the spine six months after the dispense claim has been sent so reconciliation must be completed as soon as possible. psnc.org.uk 5

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New payment transparency reports Community pharmacy contractors registered with the NHSBSA’s Information Services Portal can now access detailed prescription payment reports.

PSNC has been lobbying the Department of Health for many years for community pharmacy contractors to have full transparency of their payments from the NHS. Work commenced in 2012 on a joint programme between PSNC and NHS Business Services Authority (NHSBSA) to deliver this transparency over three phases (see tinyurl.com/nhsbsa-isp for details of Phase III).

Phase I delivered the introduction of NHSBSA’s Information Services Portal (ISP) in 2015 (to access the ISP go to: tinyurl.com/NHSBSAportal), which gives all registered users access to their FP34 Schedules of Payment.

Phase II sees the delivery of a new detailed prescription item payment report that has been made available to all contractors who have registered for the ISP. This report allows contractors for the first time, to see a full breakdown of every payment made to their business, at individual prescription item level. See below for a mock-up of the new report. (Please note that this report is just an extract using fictitious data, some columns have been removed and the data contained may not be wholly accurate.)

Each report will detail the OCS code and dispensing month relating to the information.

OCS Code

This is the form number that has been printed onto the prescription by the Pricing Authority

Dispensing Form Item Month Number Number 201509 1132 201509 1134 201509 1143 201509 1146 201509 1150 201509 1150 201509 1151 201509 1152 201509 1160 201509 1160

This is the order of which the item appeared on the prescription

2 1 1 1 2 3 2 1 2 3

Information relating to the charge status of the item (and how it was submitted)

This is the unique code of the product that has been reimbursed.

Element Prescriber Charges Id Code Payable Product Description 1 944380 0 NovoRapid Penfill 10 1 930740 0 Tramadol 100mg mo 1 337804 0 Renvela 800mg table 1 923553 0 Benzoyl peroxide 5% 1 871613 0 Tramadol 50mg caps 1 871613 0 Buprenorphine 70mi 1 871613 0 Hibiscrub 4% solution 1 920962 0 Metolazone 2.5mg ta 1 871613 0 Humulin S 100units/ 1 871913 0 Lantus 100units/ml s

Details relating to the prescriber can help reconcile information back to your PMR system

Shows which products were paid 10p payment for containers

LB denotes the £20 sourcing fee for specials and the next column gives the total value of £20 fees paid

Payment Snomed Unit Of Pack Basic Payment for for Code Quantity Measure Price Pack Size Price* Consumables Containers* NB SC-32794 25 cartridge 28.31 5 141.55 0.0124 0 SC-10403 84 capsule 14.47 60 28.94 0.0124 0.1 NB SC-18291 180 tablet 167.04 180 167.04 0.0124 0 SC-93422 1 gram 21.89 50 21.89 0.0124 0 SC-10531 200 capsule 4 100 8 0.0124 0 SC-10367 26 patch 31.6 4 205.4 0.0124 0.1 SC-34025 500 ml 5.25 500 5.25 0.0124 0 SC-24502 8 tablet 0 1 7.54 0.0124 0 SC-33114 15 cartridge 19.08 5 57.24 0.0124 0 SC-32845 15 cartridge 41.5 5 124.5 0.0124 0

Product information giving the total quantity paid, the pack size used for reimbursement and the final basic price paid.

Products which are zero discounted (i.e. discount is not deducted)

ZD ZD ZD ZD ZD ZD ZD ZD ZD ZD ZD

Unique item level identifier for EPS prescriptions

Unlicensed Expensive NHS Meds Fee Item Fee Dispensing Patient LB Value* UID Value* Number 0 2.83 0 0 0 3.34 0 0 0 0 0 4.11 0 0 LB 20 0 0 0 0 2.49

All items that have been paid an expensive item fee

Partially redacted NHS number can help with reconciling back to your PMR records.

* The totals of these columns should equal the figures found on the FP34 Schedule of Payment.

Contractors will be able to reconcile the values on their payment schedules with those on the new item payment report to a certain degree, but there will be some manipulation required in order to do this. There is a variety of supporting documentation available to help assist contractors and any feedback on these documents should be made to psnc@psnc.org.uk

If you have not yet registered for access to the ISP please go to: tinyurl.com/NHSBSAportal

Whilst the new item payment report will offer a level of better transparency, PSNC will continue to work with NHSBSA to ensure

For more information regarding the portal please contact NHSBSA by calling 0191 203 5050 or emailing nhsbsa.help@nhs.net

that contractors are given more meaningful transparency through access to prescription images, which will help reconcile any individual payment back to the pharmacy’s internal records.

Primary care support services online portal coming soon Primary Care Support England (PCSE) is currently developing a new online portal through which all community pharmacy teams in England will be able to order NHS stationery.

The portal will initially provide a quick and easy way for ordering and tracking supplies including pre-printed forms, Electronic Prescription Service (EPS) tokens and other NHS stationery. The portal will replace the channels pharmacy teams currently use to order supplies from PCSE. At the time of writing, PCSE will shortly invite all pharmacies in England to pre-register (with full details of how to do so) for the portal with the aim of it being available to all English pharmacies from 29th March 2016. Further information is available from: psnc.org.uk/marketentry, but if pharmacy teams have further queries about registering on the portal, or about the new process, please get in touch with PCSE by emailing PCSE.enquiries@nhs.net

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How to pass the CSfPP assessment The Centre for Pharmacy Postgraduate Education (CPPE) last month released support materials to help pharmacy professionals complete their Consultation Skills for Pharmacy Practice (CSfPP) assessment.

“We know that developing the necessary skills to communicate with patients clearly and effectively can help to improve patient outcomes, and empower them to manage their own health and wellbeing. This is why we have released support materials for the CSfPP assessment.

Latest support from CPPE

The materials were provided in a four-week breakdown to correspond with the four sections of the assessment, providing a range of hints and tips for pharmacists and pharmacy technicians. The support concluded with a #CSACselfie day when successful participants posted photos with their pass certificates on social media. We also saw the pass percentage rate of each section, and the overall assessment, increase across the board during the month.

A new consultation skills resource has been sent out to all community pharmacies in England this month. The resource consists of a set of learning cards, each covering a separate topic with key learning points, top tips and links to videos. Find out more at: dld.bz/embJX

The assessment is a core competency of the Declaration of Competence system which must be completed by pharmacists who wish to carry out various locally commissioned services and the Seasonal Influenza Vaccination Advanced Service.

For anyone who missed the weekly support, we have published a unified version of our support videos which can be viewed at: vimeo.com/130327306. To access and complete the assessment, go to: tinyurl.com/j3pvmgy.”

Consulting with people living with dementia aims to help learners successfully involve people with dementia and their family members and/or carers in consultations and decisions about their treatment.

Find out more at: dld.bz/ekb8f

Services news

50%

of users would have gone without their medicine if it weren’t for a pharmacy emergency supply service

Emergency supply evaluation published An NHS funded community pharmacy emergency repeat medication supply service (PERMSS) evaluation discovered that, in the absence of this service, 50% of patients would have missed their medicines until they saw their GP whilst a further 46% of patients would have accessed another out of hours service.

The evaluation, published by British Medical Journal Open, agrees with recent calls for emergency supplies to be provided by community pharmacies in order to reduce the burden on the wider NHS. To read the evaluation in full, please visit: dld.bz/ekwM3

9.4%

of eligible patients in a community pharmacy pilot showed a positive test result for coeliac disease

Early detection of coeliac disease project The results of a community pharmacy project, focussed on the early detection of people with undiagnosed coeliac disease, show that 9.4% of eligible patients who took part had a positive test result for coeliac disease and 7.2% tested positive for IgA deficiency.

Patient feedback from the project, commissioned by Coeliac UK and published by the National Association of Primary Care, also indicated that community pharmacies were the ideal place for this type of service to be offered. To read the results in full, please visit: dld.bz/ekb8A

Don’t forget to submit your flu vaccination claims The national community pharmacy flu vaccination service 2015/16 finishes on the 29th February 2016; community pharmacy contractors are therefore reminded of the need to submit payment claims for those vaccinations administered during February with their prescription bundle at the beginning of March.

The Service Specification for the seasonal influenza vaccination service states: “Payment claims for those vaccinations administered during February must be submitted to the NHS BSA by the 5th of March in line with the FP34C process.”

Failure to comply may result in contractors not being paid for vaccinations administered during February.

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PSNC regularly receives questions from LPCs and pharmacy contractors about what is going on in the wider health and care landscape beyond community pharmacy. For a more comprehensive round-up, please visit: psnc.org.uk/hclbriefings News • The Department of Health (DH) has launched a public consultation to seek views on proposed recommendations to limit the consumption of alcohol to minimise health-related risks.

• The Care Quality Commission has appointed Dame Eileen Smith as the country’s first national guardian to support healthcare staff in speaking out about concerns over patient safety.

• The Prime Minister has announced almost a billion pounds of investment to enhance mental health services across the country.

• NHS England is aiming to widen the personal health budgets scheme to more patients with complex needs and multiple longterm conditions by 2020.

innovation • A trial conducted by Imperial College, DH and Barts NHS Trust has shown that text messages informing the patient about the specific waste to the NHS of not attending reduced missed appointments by 23% compared to the standard message.

• Newham’s diabetes webcam appointments scheme has saved approximately £27 in clinician time per consultant appointment and, overall, it showed better health outcomes and a reduction in A&E admissions for young people with diabetes.

• Simon Stevens has launched the first wave of Innovation Test Beds which will involve the NHS collaborating with innovators such as Verily, Philips and IBM to utilise technology to address complex issue facing patients and the health service.

resources • DH has issued guidance which sets out how the Better Care Fund (BCF) will be implemented in 2016/17.

• A series of hypertension profiles and a new dementia profile have been launched by Public Health England (PHE) enabling comparisons between local authorities and CCGs. • NICE has published a quality standard, Obesity in adults: prevention and lifestyle weight management programmes, covering ways of preventing adults from becoming overweight or obese and the provision of lifestyle weight management programmes.

Almost £1bn to be invested in mental health services

Webcam appointments for diabetes patients save approximately £27 in clinician time 1 in 27 NHS Health Checks identify a new case of high blood pressure Evaluations and statistics • The first major evaluation of the NHS Health Check service found that the checks identified 7,844 new cases of high blood pressure (1 new case in every 27 checks), but the study didn’t distinguish between those conducted in GP practices and community pharmacies.

• The latest PHE figures on chronic obstructive pulmonary disease (COPD) show that more than one million people are living with COPD. • PHE’s evaluation of the shingles vaccination programme indicates that uptake of the vaccine was down by almost 3% on the previous year.

• The National Diabetes Audit (NDA) 2014-2015 highlighted that those aged under 40 were less likely to receive all eight care processes recommended by NICE, ranging from 24.8% to 80.6% across CCGs and Local Health Boards.

Primary care and neurodegenerative conditions Last month, the UCL School of Pharmacy held their New Year lecture on Pathways to Neurodegeneration, focusing on the search for Alzheimer’s Disease treatments.

The evening lecture was given by Professor John Hardy of the UCL Institute of Neurology who recently won the Breakthrough Prize in Life Sciences for his research into neurodegenerative conditions.

A press conference was held earlier in the day to explore some of the key issues with relevant stakeholders in primary care, including representatives from PSNC, Pharmacy Voice and the Royal Pharmaceutical Society.

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During the conference, Professor David Colin-Thomé, former national clinical director for primary care, discussed his recent publication Primary Care in the Twenty First Century which explores the need for and provision of good quality health and social care for people affected by conditions such as dementia.

Professor Colin-Thomé stated, “In future community pharmacists may, in addition to winning extended roles in early stage dementia detection and personal care, also play more useful parts in the delivery of preventive care via enabling more people to adopt healthy lifestyles and use medicines to best effect in contexts such as vascular disease prevention.”

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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.

DH permits use of antiviral medicines against influenza

Due to an increase in flu virus activity, the Department of Health (DH) has issued a letter advising that GPs and other prescribers working in primary care in England may now prescribe antiviral medicines for the prophylaxis and treatment of influenza at NHS expense.

Community pharmacy teams are reminded that prescriptions for these products must be endorsed ‘SLS’ by the prescriber. If the SLS endorsement is missing, the prescription should not be dispensed and will not be passed for payment. Find out more, and read the letter in full, at: dld.bz/egGDC

New diabetes e-learning tool

A new online learning tool has been launched by the National Institute for Health and Care Excellence (NICE) to help healthcare professionals understand how to support adults with type 1 diabetes.

The free tool has interactive features and case studies to help learners implement their knowledge of NICE guidelines and is aimed at healthcare professionals across primary and secondary care as well as service commissioners for type 1 diabetes.

Find out more about what support the tool can offer at: dld.bz/ehxWf

Research funding available to pharmacists

Pharmacy Research UK is calling for funding applications from pharmacists who wish to develop their skills and experience in research.

The funding is aimed at researchers who are novices and at an early stage in their career.

The deadline for applications is 4th May 2016.

Further information, including details of how to apply, are available from: dld.bz/eg7dc

Pharmacy Show 2015 presentations available

Recordings and slides from all the presentations made during Pharmacy Show 2015 have now been made available online at: tinyurl.com/pharmacyshow15 PSNC supported the Local Pharmacy Innovation Theatre with Christine Burbage, Chair of PSNC’s LPC and Implementation Support Subcommittee, chairing the theatre on the first day and Director of NHS Services Alastair Buxton on the second day.

A number of LPC Chief Officers and LPC members presented on locally commissioned services over the two days; the recordings and slides of these are available under the ‘Local Pharmacy Innovation Theatre’ section (when prompted the password is pharmacy15).

Which GP practice do your prescriptions come from? ...How are you doing with EPS nominations? ...How many flu jabs have you been paid for this winter so far?

Find out with THREE NEW KPIs at: www.check34.com

Understand your NHS business better with Check34 Not yet got an account? Email check34admin@psnc.org.uk for more information.

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Drug Tariff news: Hydroquinone and Mesalazine Changes to the Drug Tariff impact on reimbursement so it is important for community pharmacy teams to take note when amendments are made to product listings.

Hydroquinone 4% Cream The Department of Health has confirmed that there was an incorrect listing in Part VIIIA for Hydroquinone 4% cream 1g in the December 2015, January and February 2016 Drug Tariffs.

Hydroquinone 4% cream 30g is correctly listed in Part VIIIB under ‘Arrangements for payment for specials and imported unlicensed medicines’. The Pricing Authority has confirmed that the listing of this product has not affected reimbursement; prescriptions for Hydroquinone 4% cream have been and will continue to be reimbursed under the Part VIIIB arrangements.

Mesalazine 400mg Gr tablets In the February 2016 Drug Tariff, changes were made to the Mesalazine 400mg gastro-resistant tablets listing in Part VIIIA. There are now two listings for Mesalazine 400mg gastro-resistant tablets: • Reimbursement for the pack size of 90 tablets is now based on Octasa 400mg MR gastro-resistant tablets; and • A pack size of 84, with reimbursement based on Asacol 400mg MR gastro-resistant tablets, has been added.

For Part VIIIA Category C products where there are multiple pack sizes listed, endorsement of the pack size is needed to ensure correct reimbursement.

Find out more about these Drug Tariff changes at: dld.bz/ekyA8

NHSBSA’s Hints & Tips

Experiencing supply issues?

The Pricing Authority produces a quarterly newsletter called Hints & Tips for dispensing contractors.

Pharmacy teams who experience problems in obtaining medicines (generic or branded) or appliances are reminded to feed this back to our Dispensing and Supply Team, to support PSNC’s ongoing representation of issues in the supply chain.

We would like to draw your attention to the latest edition (Issue 22) which contains some really useful information and advice regarding: • Free EPS masterclass training; • Guidance on endorsing your FP10MDA forms correctly; • Transparency of payment information; and • How to endorse a brand and/or pack size in EPS Release 2.

All published editions of the Hints & Tips newsletter can be found on the the Pricing Authority’s website: www.nhsbsa.nhs.uk/3191.aspx

PSNC passes a monthly summary of the feedback received to the Department of Health to support their monitoring of the situation. This information is also used as an evidence base in discussions with manufacturers on manufacturer-specific problems, for example, highlighting problems with contingency arrangements and promoting solutions.

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

EPS prescription process changes go live As highlighted on page 4 of January’s CPN, changes to EPS repeat dispensing timing logic and prescriber cancellation are due to take place this month. As this edition of CPN went to press, these changes were given a go-live date of Thursday 18th February.

The most up-to-date information on these changes can be found at: dld.bz/ekwPz All details correct at time of printing.

No part of this publication may be reproduced without the written permission of PSNC. Produced for PSNC by Communications International Group. ©. PSNC. Colour repro and printing by Truprint Media, Margate.

The publishers accept no responsibility for any statement made in signed contributions or in those reproduced from any other source.

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Distributed for PSNC by:

Communications International Group Linen Hall, 162-168 Regent Street, London W1B 5TB Tel: 020 7434 1530 Fax: 020 7437 0915

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Ask PSNC The PSNC Dispensing and Supply Team give pharmacy teams support and advice on a range of topics related to the Drug Tariff and reimbursement.

Questions asked in recent months have included: 1. I have been presented with a prescription for a generic product but there is no generic available, only the brand. I have asked the prescriber if they would be prepared to reissue the prescription for the branded product instead but they have refused. Do I have to dispense the brand?

Yes, the current Terms of Service require community pharmacy contractors to dispense drugs with “reasonable promptness” (Terms of Service, paragraph 5) therefore, supply cannot be withheld on cost grounds.

However, where you become aware that a generic is not available to purchase or is not available at the Drug Tariff price, it is essential that you inform PSNC via the online feedback form on our website (psnc.org.uk/feedback). Information received from pharmacies helps feed into our market surveillance and subsequent discussions on Drug Tariff changes with the Department of Health (DH). It is imperative that PSNC is kept informed about such pricing anomalies, so that we can act to secure fair reimbursement for contractors.

Updates on price concessions will be shown on our website at: psnc.org.uk/generic-shortages 2. Why aren’t price concessions granted on the first day of each month?

If there is an on-going supply problem, PSNC needs to make a fresh concession application at the start of every month. DH then take time to undertake checks and make a decision. In some cases, there is a need for negotiation between PSNC and DH on an individual product’s circumstances. This can take time. PSNC would like to see changes to the arrangements that would allow contractors to have certainty over what they will be reimbursed much earlier in the month, a point which we have raised with DH. 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 (0844 381 4180 or 0203 1220 810 or e-mail info@psnc.org.uk).

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. If they are not allowed, the contractor may not be paid for them.

Pharmacy teams may wish to check PSNC’s ‘Dispensing on an FP10 database’ (available at: psnc.org.uk/FP10database) for more information on whether an item can be dispensed on an FP10. Below is a list of some products that we have recently received queries about.

Product

Is the item listed in the Drug Tariff?

Does it have a ‘CE’ mark?

Is it in the blacklist?

Can it be dispensed on an FP10?

Additional information

Flivasorb Adhesive dressing 15cm x 25cm rectangular

Yes

Yes

n/a

Yes

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

Ilex skin protectant paste IP51

Yes

Yes

n/a

Yes

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

OpSite film spray dressing 100 ml

No

Yes

n/a

No

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

MGDRx EyeBag

Yes

Yes

n/a

Yes

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

Sidestream disposable nebuliser with adult mask and tubing

No

Yes

n/a

No

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

Please note: If the prescription is one of the following, pharmacy staff will need to check the relevant sections of the Drug Tariff/PSNC website: • FP10CN or FP10PN (community nurse prescriber) – Part XVIIB of the Drug Tariff • FP10D (dental prescriber) – Part XVIIA of the Drug Tariff • FP10MDA (instalment dispensing) – psnc.org.uk/mda

psnc.org.uk 11

Dispensing anD supply

services anD commissioning

the healthcare lanDscape

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 March 2016. You may also wish to see our Dispensing Factsheet: The Drug Tariff Preface at psnc.org.uk/dtresources Part ViiiA additions SC Special Container Category A Additions: • Dihydrocodeine 10mg/5ml oral solution (150ml) • Isocarboxazid 10mg tablets (56) • Procyclidine 10mg/2ml solution for injection ampoules (5) Category C Additions: • Aclidinium bromide 375micrograms/dose dry powder Inhaler SC (60 dose) – Eklira • Adapalene 0.1% / Benzoyl peroxide 2.5% gel SC (45g) – Epiduo • Alendronic acid 70mg effervescent tablets sugar free SC (4) – Binosto • Alogliptin 12.5mg tablets (28) – Vipidia • Alogliptin 25mg tablets (28) – Vipidia • Alogliptin 6.25mg tablets (28) – Vipidia • Alogliptin 12.5mg / Metformin 1g tablets (56) – Vipdomet • Aminophylline hydrate 225mg modified-release tablets (56) – Phyllocontin Continus • Aminophylline hydrate 350mg modified-release tablets (56) – Phyllocontin Forte Continus • Atenolol 50mg / Nifedipine 20mg modified-release capsules (28) – Tenif • Coal tar extract 5% shampoo SC (250ml) – Alphosyl 2 in 1 • Colecalciferol 10,000units/ml oral solution sugar free SC (2.5ml) – Thorens • Colecalciferol 10,000units/ml oral solution sugar free (10ml (4xSC2.5ml)) – Thorens

• Colecalciferol 10,000units/ml oral drops sugar free SC (10ml) – Thorens • Colecalciferol 50,000units/1ml oral solution unit dose ampoules sugar free (3) – InVita D3 • Diclofenac 2.32% gel SC (30g, 50g & 100g) – Voltarol 12 Hour Emulgel P • Dronedarone 400mg tablets (20) – Multaq • Granisetron 2mg tablets (5) – Kytril • Magnesium hydroxide 415mg/5ml oral suspension sugar free (200ml) – Phillips' Milk of Magnesia • Solifenacin 6mg / Tamsulosin 400microgram modified-release Tablets (30) – Vesomni • Urea hydrogen peroxide 5% ear drops SC (8ml) – Otex Part ViiiA deletions If a medicinal product has been removed from Part VIIIA and has no other pack sizes listed, it can continue to be dispensed, but it will need to be endorsed fully (i.e. brand or supplier name, pack size and price paid) in future.

• Co-danthrusate 50mg/60mg/5ml oral suspension sugar free (200ml) – Normax • Erythromycin 2% solution (50ml) – Stiemycin • Orphenadrine 50mg tablets (250) – Disipal • Rimexolone 10mg/ml eye drops (5ml) – Vexol • Salbutamol 95micrograms/dose dry powder inhaler (200 dose) – Asmasal Clickhaler • Salbutamol 200micrograms/dose dry powder inhaler (100 dose) – Pulvinal Salbutamol

Part iX deletions It is important to take careful note of removals from Part IX because if you dispense a deleted product, prescriptions will be returned as disallowed and therefore payment will not be made for dispensing the item.

Product name and description

Sizes affected

Hollister InstantCath Protect (Nélaton Intermittent Catheter with introducer tip and urine bag)

10 Ch (9692) and 16 Ch (9695)

Vacuskin (Vapour-permeable Adhesive Film Dressing)

6cm x 7cm, 10cm x 12cm, 10cm x 25cm, and 15cm x 20cm

TS-A Safety insulin syringe (Minsmed)

1ml (0.33mm/29G)

Sigvaris Coton (20-36mmHg), Below Knee Closed Toe Female

Long and Normal in S, M, L, and XL

Sigvaris Coton (20-36mmHg), Thigh High Hold Up Closed Toe Female

Long and Normal in S, M, L, and XL

Ring pessary, Polythene, Specification 20 (ii)

7.5mm thick, 110mm diameter

Filmated Gauze Swab BP 1988 Non Sterile (Gauze Type 13 Light BP 1988 8-ply)

10cm x 10cm

PSNC website For up to date information and news on community pharmacy issues, visit the PSNC website at psnc.org.uk PSNC Community Pharmacy News is published by: The Pharmaceutical Services Negotiating Committee, Times House, 5 Bravingtons Walk, London N1 9AW Community Pharmacy News is edited by: Melinda Mabbutt who can be contacted at the above address or by email at: mmabbutt@psnc.org.uk PSNC Office: 0844 381 4180 or 0203 122 0810

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