February 2019 CPN

CPN

Community Pharmacy News – February 2019

Health service transformation

• Primary Care Networks to deliver joined up care • Community pharmacy must develop strong links with

these networks CEO Blog | Clinical governance deadlines | Pregabalin and gabapentin reclassification

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Chief Executive’s blog PSNC Chief Executive Simon Dukes provides an update on PSNC’s work. affect everyone working in primary care; community pharmacies included. PCNs are merely local networks with GP practices at the heart; but they bring together a range of other healthcare professionals to deliver patient-focused care and we must all work to ensure that community pharmacies are involved and integrated with them.

Simon Dukes

PSNC Chief Executive The PSNC Committee held the first of its new-style quarterly meetings this month.

In a packed agenda, we discussed the NHS Long Term Plan, Brexit contingency planning, price concessions, service updates, and of course the commitment to Primary Care Networks (PCNs) made in the GP funding deal. We also had a guest speaker: Julie Wood, CEO of NHS Clinical Commissioners. The Long Term Plan highlights the desire by our principal customer (NHS England) to develop an integrated local healthcare system. CCGs and community pharmacy’s relationship could not be more key, and it was great to hear Julie’s views on this.

The new contract for GPs paves the way for unprecedented changes that will

“

We expect funding negotiations to commence before Easter.

”

As a sector, achieving this will require not only working closely with GP colleagues, but also collaborating with one another, and embracing and delivering some of our own changes to help free up community pharmacists’ time to focus more on clinical services.

Encouragingly, we have seen a number of positive statements from the NHS confirming that this is a direction of travel in which they wish to support us. The Long Term Plan promised to make better use of community pharmacists’ clinical skills; we have had assurances that community pharmacists could provide some of the clinical pharmacy services that the PCNs will need to offer; and an extension of

the Digital Minor Illness Referral Service (DMIRS) service is likely to see GPs referring to pharmacies, in due course. All of which are clear signals that people on the other side of the negotiating table are keen for community pharmacies to offer more in the future.

Of course, it won’t have escaped your notice that community pharmacy funding negotiations have not yet begun. These have been delayed, as have many things,

by HM Government’s work preparing for Brexit. But we expect them to commence before Easter, and we will issue a short statement when they do. If we are going to truly integrate with these multi-disciplinary networks, then it makes sense for the NHS to commit to a deal that runs parallel to that agreed with GPs, and contractors should have no doubt that we will be pushing for that during our negotiations.

Outside of the negotiations our immediate next steps are to begin working with NHS England and LPCs to help facilitate local engagement to ensure that community pharmacy is at the heart of the developing plans; and to start collating evidence that may help to make the case for community pharmacy service development and integration within PCNs. You can read more about this and our workplan for 2019 in the summary of the PSNC meeting which is available at: ow.ly/17gC30nJLNH

PSNC webinars on-demand PSNC regularly holds online events to make information accessible; here are details of two of our recent webinars.

Completing your IG return workshop On 30th January we held an online workshop about the Data Security and Protection (IG) Toolkit, and an ondemand recording is now available.

98% found it useful, with one pharmacy manager commenting: “The information was very clear, reassuring and the speakers have made the toolkit feel less burdensome. I still have a lot to do but it seems more ‘doable’ now.”

Exemptions and switching webinar PSNC and the NHS Business Services Authority (NHSBSA) held a ‘Prescription charge exemptions and switching’ webinar last month, and a recorded version of this webinar is now available.

87% said they would recommend watching it to others, with one pharmacist commenting: “Clear delivery and great as more convenient than face to face sessions.”

Please visit psnc.org.uk/webinar for details of how to watch these on-demand.

2 Community Pharmacy News – February 2019

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Pharmacists vital to transforming primary care • GP funding deal to revolutionise primary healthcare services • Pharmacists will become part of core general practice teams • Referrals from GP practices to community pharmacies to be piloted

“

Multi-disciplinary teams will work together at a local level to deliver joined up care

”

NHS England has announced a £4.5bn funding package for GPs in a five-year deal that is designed to transform local healthcare systems, and pharmacists will have a vital part to play in that transformation.

The plans for PCNs include pharmacists becoming part of core general practice teams – enabling patients to access expert advice about medicines much more quickly – and the community pharmacy sector will develop strong links with these networks.

The deal includes funding that will help to fund the widespread development of Primary Care Networks (PCNs), which will be multi-disciplinary teams of healthcare professionals working together at a local level to deliver joined up patient care.

Each PCN will cover around 30-50,000 GP registered patients.

NHS England has confirmed that PCN pharmacists will not necessarily need to be employed by GP practices, but they will need to work as part of the integrated care team that makes up the PCN. In the latest Pharmacy and Medicines Bulletin, Chief Pharmaceutical Officer, Dr

February PSNC meeting At the first of PSNC’s meetings for 2019, the Committee held important discussions on a wide range of issues and agreed its strategic plan for 2019/20.

As well as discussing topical issues such as the NHS Long Term Plan and Brexit preparations, PSNC members considered funding and the margins survey, reimbursement and price concessions, and PSNC guidance materials for contractors and their teams.

During the February meeting, PSNC’s 2019/20 Plan was also agreed. The plan pulls together all of the work streams being undertaken by PSNC’s six subcommittees – Service Development; Legislation and Regulatory Affairs; Funding and Contract; LPC and Contractor Support; Communications and Public Affairs; and Resource, Development and Finance.

Further information is available in our summary of the February PSNC meeting: ow.ly/17gC30nJLNH

Keith Ridge, recognises the need to utilise the clinical skills of community pharmacy professionals as NHS England works towards making the Long Term Plan a reality.

Dr Ridge states that “subject to contract negotiation, the Digital Minor Illness Referral Service may be extended” and pilot referral services from GP practices to community pharmacies will begin in several PCN areas.

The funding comes into effect from April 2020, and the changes are expected to amount to a transformation in general practice and primary healthcare services.

PSNC’s 2019/20 Plan The Committee agreed to: Develop PSNC’s support for local service development Establish a Community Pharmacy Technology Working Group Maximise the benefits from forthcoming proposals from the DHSC on reimbursement Carry out a strategic influencing programme

psnc.org.uk 3

CONTRACT AND IT

Interim guidance on FMD alerts published The final phase of the Falsified Medicines Directive (FMD) implementation began on 9th February 2019. FMD is a huge project and in the initial phase many “false positive” alerts are expected. This does not necessarily indicate a falsified medicine, and in most cases it will be appropriate to dispense the medicine, subject to the normal checks.

The UK FMD Working Group for Community Pharmacy has published interim guidance for pharmacy teams on dealing with FMD alerts generated when products are scanned. All the latest information and resources on FMD are available at: fmdsource.co.uk

NHS App begins public rollout Patients across England can now download the NHS App which will allow them to order repeat prescriptions, check their patient record or book and manage GP appointments.

GP practices will need to review some of their IT system settings to enable patients to access the app’s full range of functions.

The Community Pharmacy IT Group (CPITG) has been working with NHS Digital on features that could be added which would support better use of community pharmacies; one such option would be for patients to be able to set their EPS nomination using the NHS App.

Requested features include touchscreen functionality, more compatibility with other systems, compatibility with hand-held devices, and affordable business continuity options.

The list is intended to assist pharmacy teams discussing future development of systems with their suppliers or selecting a system supplier.

4 Community Pharmacy News – February 2019

SERVICES AND COMMISSIONING

Clinical governance deadlines fast approaching PSNC’s Regulations and Support Team reminds community pharmacy teams of the actions required by 31st March 2019 to meet their contractual obligations.

“

Our guide to contractual requirements due by the end of the financial year.

”

The end of the financial year (31st March) is fast approaching and community pharmacy contractors are reminded of four key deadlines relating to the clinical governance aspects of their terms of service.

PSNC urges contractors to ensure they have completed, or are working towards completing, the clinical governance requirements highlighted below to meet the end of year deadline.

Summary of actions to be completed by 31st March 2019 Topic

Requirements

By when?

Data Security and Protection Toolkit

To complete and submit the Data Security and Protection (formerly Information Governance) Toolkit.*

31st March 2019

*Find PSNC’s guidance to support submission of the new Toolkit: psnc.org.uk/ig

CPPQ

To conduct an annual Community Pharmacy Patient Questionnaire (CPPQ) and publish the results.

31st March 2019

Clinical audit

To conduct two audits each year: one on a topic of your choice* and one nationally determined by NHS England (this was the flu vaccination audit conducted at the end of 2018).

Pharmacy’s own audit deadline: 31st March 2019

*Please note, the non-steroidal antiinflammatory drug (NSAID) audit for the Quality Payments Scheme cannot be used as the pharmacy’s own audit.

Wish list of pharmacy IT system suggested features published The CPITG has published a list of features that pharmacy teams would like their patient medication record (PMR) IT systems to include: ow.ly/27Vz30nDfA3

DISPENSING AND SUPPLY

A fourth clinical governance requirement, whilst not due by 31st March, should be completed shortly afterwards and as such it is best to begin work towards achieving this alongside the requirements listed above.

Complaints report

To prepare an annual report each year and send a copy to the local NHS England team.

As soon as practicable after 31st March 2019

To help support contractors in meeting the above requirements, PSNC’s Regulations and Support Team has also produced a quick reference guide identifying the actions to be completed by 31st March 2019, as well as details of ongoing clinical governance requirements. Download the Briefing from: ow.ly/DuGR30nuBfe

TH

HE HEALTHCARE LANDSCAPE

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

Quality Payments declaration

VaxigripTetraTM vaccine added to flu claim forms

Having now passed the February review point for the Quality Payments Scheme, the PSNC Services Team guides contractors through the declaration process.

Following the recent entry of VaxigripTetraTM (quadrivalent influenza vaccine) to the UK supply chain, the NHS Business Services Authority (NHSBSA) has listed this vaccine on the digital claim form and on a new paper claim form (V2) so that contractors can claim for it accordingly.

“

Have you submitted your declaration yet?

”

Community pharmacy contractors have until Friday 1st March 2019 at 11.59pm to make a declaration for a Quality Payment for the 15th February 2019 review point of the Quality Payments Scheme.

For this review point, claims can be made by one of two routes, the Snap Survey tool (as used for previous declarations) or the Manage Your Service (MYS) application.

Contractors should not submit a declaration via both routes and pharmacy teams are advised to check with their business owner or head office which route they should use.

The table below details the main advantages and disadvantages of both routes to assist contractors with deciding on which route they would prefer to use.

Route

Advantages

Disadvantages

Snap Survey

• Familiar process.

• Registration is not required.

• Does not provide real time confirmation of meeting the gateway criteria.

• The ODS code is added manually so there is a risk of submission under an incorrect ODS code.

MYS application

• Provides real time confirmation of meeting the gateway criteria.

• Registration removes the risk of entering an incorrect ODS code.

• There are also longer-term benefits outside of the Quality Payments Scheme; further information can be found on the NHSBSA website.

• Contractors using MYS will also be able to take part in pilots enabling them to submit and view prescription and services information digitally.

• New process to follow.

• Registration is required.

PSNC support

Further information on how to make a declaration and the validation process for the gateway criteria can be found in a PSNC Briefing: ow.ly/sq9z30nFCcr It may also be useful to refer to PSNC’s evidence checklist (see ow.ly/heij30nFCdi) which provides examples of what constitutes acceptable evidence for meeting the gateway and quality criteria. It is important that contractors have this evidence to assure themselves that they meet the necessary requirements; as well as to be able to provide this evidence to the NHSBSA provider assurance team that will undertake verification checks.

NHSBSA has confirmed that contractors can still use the previous form if they are not claiming for VaxigripTetraTM vaccine. Download the new form: ow.ly/iMlb30ntyAv

Flu vaccines for 2019/20 NHS England has published an update on vaccines for the 2019/20 Flu Vaccination Service. As stated in previous communication, the vaccines recommended for the 2018/19 season continue to be recommended for the 2019/20 season.

Additionally, the cell grown quadrivalent vaccine (QIVc), Flucelvax® Tetra, is now licensed for use and contractors can consider ordering this for 2019/20 Flu Vaccination Service.

NHS England has determined that the high-dose trivalent vaccine (TIV-HD) will not be commissioned or reimbursed for use in the Flu Vaccination Service.

New GP2Pharmacy service A new, innovative service has been launched in South Tyneside, which involves collaborative working between community pharmacy teams and GP practice teams.

The ‘GP2Pharmacy’ service enables GP reception staff to book fixed time appointments for suitable patients at their local pharmacy to have a consultation with the pharmacist. The service also supports other planned appointments such as check-ups and long term condition management.

The pilot scheme runs until September 2019, offering 8,000 appointments at around 30 locations in South Tyneside, including some weekend appointments. Learn more about the service at: ow.ly/UoM730nFDor

psnc.org.uk 5

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

All you need to know about: Pregabalin and gabapentin reclassification Here we explain the prescribing and dispensing changes that will need to take place when pregabalin and gabapentin become Schedule 3 Controlled Drugs.

“

How these medicines becoming Controlled Drugs will affect your patients’ prescriptions

”

Emergency supplies: Schedule 3 CDs cannot be supplied in an emergency without a valid prescription, except for phenobarbitone or phenobarbitone sodium for epilepsy.

From 1st April 2019, amendments to the Misuse of Drugs Regulations 2001 and the Safe Custody Regulations 1973 come into force which mean that pregabalin and gabapentin will be reclassified as Schedule 3 Controlled Drugs (CDs). But how will this affect prescriptions?

Prescription requirements From 1st April 2019, all gabapentin and pregabalin prescriptions will be subject to the following prescription writing requirements for Schedule 3 CDs: • Patient name and address • Prescriber’s address • Prescriber’s signature • Date of prescriber’s signature • Drug name, strength and formulation • Dose (Note: ‘as directed’ is NOT acceptable; ‘one as directed’ is acceptable) • Total quantity (in both words and figures) Validity: Prescriptions for Schedule 3 CDs are valid for 28 days after the appropriate date on the prescription.

Storage and record-keeping requirements Pregabalin and gabapentin will be included in the list of “exempted drugs” in the safe custody regulations which means that they will not be required to be kept in the CD cabinet.

Schedule 3 CDs are also exempt from record-keeping requirements.

Changes to prescribing systems GP clinical systems will be updated ahead of 1st April 2019, when pregabalin and gabapentin will be classified as CDs. NHS England has informed PSNC that EMIS has already implemented updates, meaning paper prescriptions will replace those previously sent by EPS.

should be checked, assessed for clinical appropriateness (taking into account the length of time that the prescription or owing has been awaiting collection), and where necessary, the prescriber should be contacted for a replacement prescription.

Community pharmacy teams should also check all NHS repeat dispensing prescriptions that they currently hold for gabapentin and pregabalin, ensuring that all batch issues dispensed prior to the 1st April are claimed for no later than the 5th April. Any remaining issues from the batch which have not been dispensed should be returned to the prescriber/spine and a replacement prescription requested as repeat dispensing prescriptions will not be valid after 1st April 2019.

If a patient’s other prescription items are issued via EPS, there is a risk that the paper script for pregabalin or gabapentin may not be collected from the GP practice; pharmacy teams should be alert to this risk.

Repeat dispensing: Following the change, it will be illegal to supply pregabalin and gabapentin through repeat dispensing.

EPS: Some GP practices are piloting EPS CDs, so you may receive and dispense a mix of EPS/paper prescriptions for gabapentin and pregabalin.

Advice for pharmacy teams Prescriptions and owings awaiting collection from before 1st April 2019

Further information PSNC has issued a briefing on gabapentin and pregabalin’s reclassification as Controlled Drugs, which includes a set of FAQs to outline what to do in certain scenarios: ow.ly/2oD030nKQpy NHS England has issued a briefing note on Rescheduling of Gabapentin and Pregabalin as Schedule 3 Controlled Drugs: ow.ly/wyrp30nKQqQ

Summary Requirements for gabapentin and pregabalin from 1st April 2019 are as follows: Controlled Drug Gabapentin Pregabalin

Prescription requirements

Prescription validity

Safe custody requirements

Entry in CD register

Emergency supplies

Repeat dispensing

3 3

28 days

7 7

7 7

7 7

7 7

6 Community Pharmacy News – February 2019

28 days

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

Book now for PSNC’s Price Concessions Webinar Upcoming PSNC webinar will guide viewers through process of negotiating price concessions and describe what we are doing to try to improve it.

“

We will explain how the system operates and outline our work in this area

”

Mike Dent (Director of Pharmacy Funding) and Suraj Shah (Drug Tariff and Reimbursement Manager) will be hosting a PSNC webinar about price concessions on Tuesday 5th March at 7.30pm.

The webinar will address the following questions: • How are price concessions negotiated?

• What is the impact of price concessions on overall funding?

• What are the current challenges in setting price concessions?

• How is PSNC working to improve the price concession system?

During the webinar viewers will be guided through the price concession process; from applying for a price concession to how prices are finalised and then communicated to pharmacy contractors and their teams.

Mike and Suraj will also explain how price concessions are measured in the Margin Survey and the impact this has on the overall funding envelope. Finally, they will explore the challenges of the current price concession system and discuss the principles of a fair system agreed by the PSNC Committee. There will also be an opportunity for viewers to ask questions.

So if you want to better understand how the price concession system works and PSNC’s work in this area, attending this webinar will provide some useful insights.

Join us for the webinar

CONTRACT AND IT

Changes to proof of exemption As part of the NHS Business Services Authority (NHSBSA) service improvement programme, paper certificates are replacing plastic cards.

NHSBSA envisage it taking up to five years for the plastic cards to be fully phased out. During this transition period pharmacy teams may be presented with plastic, paper and digital certificates as proof of exemption from NHS charges.

Find out more at: ow.ly/EVi130nGGya

Phasing out paper certificates As part of work to phase out paper prescription prepayment certificates (PPCs), the NHSBSA is encouraging pharmacy teams to register to sell PPCs or direct patients on how to obtain a PPC. Pharmacy teams can register to sell PPCs by complete the form at: https://apps. nhsbsa.nhs.uk/pharmacy-ppc/login Or they can direct patients to obtain a PPC from www.nhsbsa.nhs.uk/ppc or by calling 0300 330 1341.

Part VIIIB Drug Tariff changes From February 2019, the following unlicensed (special) products have been deleted from Part VIIIB of the Drug Tariff: • Clobetasone 0.05%/Oxtetracycline 3%/ Nystatin 100,000units/g cream • Clonidine 50micrograms/5ml oral solution • Clonidine 50micrograms/5ml oral suspension Licensed alternatives for these products have been added to Part VIIIA: • Clobetasone 0.05%/Oxytetracycline 3%/Nystatin 100,000units/g cream (Trimovate Cream) • Clonidine 50micrograms/5ml oral solution sugar free (Thame Laboratories Ltd)

Book your place now: psnc.org.uk/webinar Find out more at: ow.ly/2bcL30nzGjE Even if you are unable to attend the webinar live, it is still worth registering for the event so that you will be sent a link to the recorded version of the webinar as soon as it becomes available.

You may wish to read PSNC Briefing 067/18: How the price concession system operates in advance of the webinar, which can be found at: psnc.org.uk/concessionsbriefing

Carbagen tablets There is currently a shortage of Carbagen 200mg and 400mg immediate release (IR) tablets and 200mg and 400mg prolonged release (PR) tablets. As stocks might not return to normal until late 2019, patients may need to be switched to Tegretol.

psnc.org.uk 7

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Help Us Help You Pharmacy campaign underway This initiative to promote use of community pharmacies to the public is one of pharmacy’s six public health campaigns for the year.

“

Encouraging public use of pharmacies for help managing minor illnesses.

NHS England launched a promotional campaign on 4th February 2019 focused on encouraging the public to use their local pharmacy as their first port of call for managing minor illness.

The campaign aims to increase public recognition of community pharmacies as the appropriate choice of healthcare setting for managing minor illnesses such as coughs, colds, stomach upset, and aches and pains.

Following on from the successful ‘Stay Well Pharmacy’ campaign last year, this

”

campaign will sit under the wider ‘Help Us Help You’ brand.

PSNC and NHS England have agreed that this will count as one of community pharmacy’s six public health campaigns for the year, so participation in the campaign by displaying the materials is mandatory. Please ensure all members of the pharmacy team are briefed about this campaign.

All community pharmacies in England were sent a resources pack at the end of January. Packs included a

Minor illnesses resource hub Community pharmacy teams may wish to familiarise themselves with PSNC’s one-stop resources hub, which links to all the most upto-date clinical resources on managing minor illnesses, and identifying red flag symptoms: psnc.org.uk/minorillnesses

campaign briefing sheet, doublesided window sticker, shelf wobblers, poster, information cards and a leaflet dispenser.

Additional resources, including digital and social media assets, are available to order or download from Public Health England’s Campaign Resource Centre: campaignresources.phe.gov.uk

Just Ask: Could it be Sepsis?

UK Sepsis Trust highlights how important it is for all healthcare professionals to be able to recognise the signs and symptoms of sepsis.

“ I’d like to introduce you to my one-year

Melissa Mead MBE National Project Coordinator, UK Sepsis Trust

old son William. This photo was taken in October 2014, his first nursery photo.

At the time William had just developed a cough, it sounded fairly self-limiting, systemically he was well, but he just couldn’t shake this chesty cough. We took William to the doctors where he was examined and found to be suffering with a viral cough, no treatment was needed, as we suspected.

Over the coming weeks we returned to the doctors with William several times as the cough persisted, nothing new, we were told. Just a virus. When William begun to vomit we sought a second opinion from another doctor; ‘it’s just viral, his chest is clear’. The end of November came and we celebrated William’s first birthday. Just a few short days later on Friday 12th December William started to run a temperature at nursery, despite administering paracetamol his temperature continued

8 Community Pharmacy News – February 2019

to rise. We collected him immediately and took him to the emergency doctor. We had to sit and wait until the end of the day, William was examined. Despite his temperature of 40.1C, the persistent cough and vomiting we were assured William was fine, his chest and ears were clear. He just had a viral infection and would get better without treatment.

Over the weekend we contacted more doctors and were told on each occasion the best place for William was at home with plenty of rest and fluids. “Goodnight sweetheart, I love you” were the words I whispered to William when I tucked him in to bed on Saturday 13th December. These were the last words my son would ever hear. On Sunday morning when I went in to check on him, I found that William had passed away. Despite a paramedic’s best efforts, William had already left us.

”

Early recognition, diagnosis and treatment dramatically improves outcomes from sepsis. Improve your knowledge of sepsis by reading the full version of this article at: ow.ly/rfb030nMwbJ

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

Understanding the Single Activity Fee PSNC’s Dispensing and Supply Team explain what the Single Activity Fee is and provide examples of items that are eligible for multiple fees as well as those that attract no fee.

It is important to be aware of how many fees an item attracts to ensure you are claiming the appropriate number of fees for each prescription submitted for payment, and to declare the correct number of item totals on your end of month submission form (FP34C).

What is the Single Activity Fee? In December 2016, the Department of Health and Social Care introduced the Single Activity Fee (SAF) consolidating a range of payments into one single fee (see image below). A SAF is paid automatically for all eligible items meaning no additional endorsement is required.

Professional fee (also known as dispensing fee)

Single Activity Fee (SAF)

Practice payment Repeat dispensing payment EPS monthly allowance

What is the current value of a SAF and why does it change?

Since its introduction in December 2016, the SAF rate has fluctuated up and down. The change in SAF is based on the forecast of the total number of items dispensed to ensure that the fee delivery remains within the agreed funding envelope for the year. Currently, the SAF for items dispensed from November 2018 onwards is set at £1.26 per item.

Do certain item attracts multiple SAFs? Some items for example certain combination drugs automatically attract multiple SAFs. For example, a prescription for Femoston 1/10mg tablets attracts two SAFs as it contains two types of tablets – one containing Estradiol 1mg only, and the other a combination of two active ingredients, Estradiol 1mg and Dydrogesterone 10mg.

Changes in SAF since its introduction £1.35 £1.29

£1.30 £1.25

£1.25

£1.26

£1.20 £1.15 £1.13

£1.10 Dec - 16 Jan - 17 Feb - 17 Mar - 17 Apr - 17 May - 17 Jun - 17 Jul - 17 Aug - 17 Sep - 17 Oct - 17 Nov - 17 Dec - 17 Jan - 18 Feb - 18 Mar - 18 Apr - 18 May - 18 Jun - 18 Jul - 18 Aug - 18 Sep - 18 Oct - 18 Nov - 18 Dec - 18 Jan - 19 Feb - 19

Do any items attract no SAF? Whilst lymphoedema garments attract one SAF per pair, any additional options for base garments ordered on the same or a separate prescription form do not attract a separate SAF. No additional fees are payable other than those applicable to the base garment as all that is being dispensed is the base garment with optional modifications.

It is important to keep track of the number of SAFs that can be claimed on each prescription; this can be made easier by recording the figure per prescription in the box provided on the bottom left hand corner of an FP10 prescription.

Completing the ‘For dispenser No. of Prescriptions on form’ box (circled) is good practice as it will make counting item totals easier for completion of the FP34C submission document at the end of the month. Please note this figure is not used by NHSBSA when processing your bundle so it is vital that your FP34C is completed accurately.

psnc.org.uk 9

DISPENSING AND SUPPLY

Multiple SAFs apply if the following are on the same prescription: • Different drugs, types of dressings or appliances are supplied; • Different formulations, strengths or presentations of the same drug or preparation are prescribed and supplied (including combination packs); • For each interaction / “pick-up” for prescriptions for oral liquid methadone or other items prescribed and supplied on an instalment prescription (FP10MDA) • Multiple flavours are prescribed and supplied – where a prescription orders multiple, assorted, various or mixed flavours one SAF can be claimed for each flavour supplied and endorsed. With EPS prescriptions an ‘AF’ endorsement needs to be added by the prescriber in the prescriber endorsement field to receive a separate SAF for each flavour supplied. In order to receive the appropriate amount of fees it is best practice for pharmacy teams to endorse exactly which flavours have been dispensed and make a note of the number of items dispensed on the prescription in the box provided in the bottom left hand corner of the prescription. When totalling up your items figures and entering onto your FP34C ensure one item is claimed for each flavour dispensed and endorsed (see example below) Please note, if the prescription states ‘flavour not specified’ or specifies a named flavour for example, ‘strawberry’, the pharmacy will only be paid one SAF for the prescribed item. If multiple flavours are dispensed against a prescription stating ‘flavour not specified’, the pharmacy will only receive one SAF regardless of endorsement.

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Prescription includes an additional instruction to dispense ‘various flavours’

Multiple flavours have been endorsed, a SAF will be received for each flavour endorsed.

A note has been made of the number of items dispensed, this will help when calculating your end of month totals

Item declaration on FP34C It is important to be aware of the number of SAFs an item attracts and keep a note of this when dispensing; this will help to ensure accurate completion of your end-of-month submission document. It is important your FP34C submission document is completed accurately with the total number of SAFs declared in your total items figures section. The declared item totals are used to calculate your pharmacy Advance payment which can affect pharmacy cashflow if the total number of items declared are lower than the actual total number of items (or SAFs).

The NHS Business Services Authority (NHSBSA) applies a 5% tolerance for differences between your declared and NHSBSAs received item figures. If the figures are above this 5% tolerance, they will contact you to re-confirm your figures.

PSNC’s useful links • Refer to our Methadone dispensing (FP10 and FP10MDA) page for guidance on endorsement and applicable fees: psnc.org.uk/methadone • See our Dispensing Factsheet: No Charge and Multi-Charge Items for information on items which incur either single multiple or no patient charges: psnc.org.uk/multichargesfactsheet • See our Prescription Submission Factsheet for guidance on the endorsing and submission of prescriptions: psnc.org.uk/submissionfactsheet • Use the NHS medicines database (dm+d) to view reimbursement information. See our page for guidance on using dm+d: psnc.org.uk/dmd

10 Community Pharmacy News – February 2019

LPCS

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. ct recipient ax messages received by incorre F

ed by a n Governance team has been notifi NHS England’s Corporate Informatio tly sent to erten inadv been have to ar appe s hotel group that a number of faxe unity pharmacies. them by GP practices and comm they are not using the numbers in Pharmacy teams should check that of the healthcare system. Any breaches question as they are not part of can nt incide the should be reported so that information governance security where necessary. be investigated and learning shared ow.ly /T4M Z30n zHdm More information can be found at:

Improving detection of CVD A new coalition led by Public Health England (PHE) and NHS England has announced the first ever national ambitions to improve the major causes of cardiovascular disease (CVD).

People aged between 40 and 74 are also being urged to get their free NHS Health Check, which helps detect the early warning signs of CVD. Learn more at: ow.ly/S sc430 nHnhB

Hints & Tips newsletter s NHS Prescription Service sletter new ly rter qua a es duc pro ensing called “Hints & Tips for disp contractors”.

The latest edition (Issue 34) rmation contains some useful info on time ing and advice on sav checking exemption from on, rati inist adm n prescriptio ring your pharmacy for NHS charges, and registe ate (PPC) applications tific online pre-payment cer Tips newsletter can be All editions of the Hints & k/3 191.a spx found at: ww w.n hsb sa.n hs.u

Pharmacists Versus Arthritis

Versus Arthritis is inviting applications to its Muscul oskeletal (MSK) Champions leadership development programme. Together with Ashridge Executive Education, the charity has created a bespoke leaders hip initiative, which will support you to become a Champion of MSK healthc are.

If your application is successful, you will be suppor ted and coached to develop your personal leadership skills and drive forward a service improvement project on MSK care, with either a local or national focus.

If you would like to find out more please visit www.v ersusa rthritis .org/m skcham pions or email champ ions@v ersusa rthritis .org

psnc.org.uk 11

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

Drug Tariff Watch: March 2019 Part VIIIA additions Category A: • *Danazol 100mg capsules (28) • *Danazol 200mg capsules (56) • Valganciclovir 450mg tablets (60) Category C: • Adefovir 10mg tablets  (30) – Hepsera • Benzocaine 1.5mg/dose oromucosal spray sugar free  (60 dose) – AAA • Colistimethate 1,662,500unit inhalation powder capsules (56) – Colobreathe • Dexpanthenol 5% ointment  (100g) – Bepanthen Nappy Care • Dimethyl fumarate 120mg gastroresistant tablets (90 &180) – Skilarence • Dimethyl fumarate 30mg gastro-resistant tablets (42) – Skilarence • Diphenhydramine 10mg/5ml oral solution (150ml) – Histergan • Ephedrine hydrochloride 15mg / Chlorphenamine 10mg tablets (10) – Haymine • Gentamicin 80mg/2ml solution for injection vials (5) – Cidomycin Adult Injectable • Ketorolac 30mg/1ml solution for injection ampoules (5) – Toradol • Lidocaine 0.05% / Chlorhexidine 0.2% oromucosal spray sugar free  (30ml) – Covonia Sore Throat

• Loperamide 2mg / Simeticone 125mg tablets (6) – Imodium Plus Comfort • Loperamide 2mg / Simeticone 125mg tablets (12) – Imodium Plus • Menotrophin 1,200unit powder and solvent for solution for injection vials  (1) – Menopur • Menotrophin 150unit powder and solvent for solution for injection vials (10) – Menopur • Menotrophin 600unit powder and solvent for solution for injection vials  (1) – Menopur • Menotrophin 75unit powder and solvent for solution for injection vials (10) – Menopur • Miconazole 2% vaginal cream  (78g) Gyno-Daktarin • Pitolisant 18mg tablets (30) – Wakix • BPitolisant 4.5mg tablets (30) – Wakix • Pseudoephedrine 60mg Acrivastine 8mg capsules (12) – Benadryl Allergy Relief Plus Decongestant • Ruxolitinib 10mg tablets (56) – Jakavi • Ruxolitinib 15mg tablets (56) – Jakavi • Ruxolitinib 20mg tablets (56) – Jakavi • Ruxolitinib 5mg tablets (56) – Jakavi • Selenium 100micrograms/2ml oral solution unit dose ampoules (20) – Selenase • Water for infusion polyethylene bottles  (1) – Polyfusor W

THE HEALTHCARE LANDSCAPE

KEY:  Special container * This pack only (others already available) SLS Selected List Scheme Part VIIIA deletions • *Danazol 100mg capsules (60) – Danol • *Danazol 200mg capsules (60) – Danol • Emedastine 0.5mg/ml eye drops (5ml) – Emadine • Glycerol 40% cream (100ml) - Neutrogena Norwegian Formula • Oxprenolol 20mg tablets (56) - Advanz Pharma • Oxprenolol 40mg tablets (56) - Advanz Pharma • Terbutaline 500micrograms/dose dry powder inhaler (100 dose) - Bricanyl Turbohaler • Timolol 0.25% eye drops 0.2ml unit dose preservative free (30) - Timoptol Unit Dose • Verapamil 120mg modified-release capsules (28) - Univer • Verapamil 180mg modified-release capsules (56) - Univer • Verapamil 240mg modified-release capsules (28) - Univer For a full list of the upcoming Drug Tariff changes, including amendements, please visit: ow.ly/2dl130nKCJp

Part IX deletions Product

Size, Type, Product Code

MelMax dressing, Rectangular

All sizes

Spirit 2mm Silicone Adhesive Non Border Hydro Foam dressing

10cm x 10cm

Spirit 5mm Silicone Adhesive Non Border Hydro Foam dressing

All sizes

Spirit Silicone Adhesive Border Hydro Foam dressing

All sizes

TRACHEOSTOMY AND LARYNGECTOMY APPLIANCES - Blom-Singer HME Cartridge

BE1055

DEODORANTS - Peak Medical Ltd - Auricare Odour Eliminator

All sizes

ILEOSTOMY (DRAINABLE) BAGS - Hollister Ltd - Compact Drainable Pouch, Clear

13-64mm (3250)

ILEOSTOMY (DRAINABLE) BAGS - Hollister Ltd - Impression “C” with convex wafer, Beige

35mm (3265)

TWO PIECE OSTOMY SYSTEMS - ConvaTec Ltd - Combihesive Natura with filter

All sizes

TWO PIECE OSTOMY SYSTEMS - ConvaTec Ltd - Combihesive Natura no filter, Standard size - Opaque

All sizes

TWO PIECE OSTOMY SYSTEMS - ConvaTec Ltd - Esteem Synergy with InvisiClose outlet, small right, Opaque

13-48mm (S1236N)

TWO PIECE OSTOMY SYSTEMS - ConvaTec Ltd - Natura+ no filter, Standard Size - Opaque

All sizes

UROSTOMY BAGS - ProSys International Ltd - Apuro 1 piece urostomy activity pouch

UP10

PSNC website For up to date information and news on community pharmacy issues, visit the PSNC website at psnc.org.uk PSNC Community Pharmacy News is published by: The Pharmaceutical Services Negotiating Committee, 14 Hosier Lane, London, EC1A 9LQ Community Pharmacy News is edited by: Melinda Mabbutt who can be contacted at the above address or by email at: mmabbutt@psnc.org.uk PSNC Office: 0203 122 0810

© PSNC