January 2017 CPN

CPN

Community Pharmacy News – January 2017

Pharmacy’s place in the NHS The campaign for community pharmacy continues as review sets clinical services direction

Quality Payment resources | e-Repeat Dispensing factsheet | Cashflow changes guide

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A message from Sue Sharpe, PSNC Chief Executive Officer PSNC’s CEO talks about how far the sector has come since the Government’s 17th December 2015 letter and what happens next.

“In the campaign, community pharmacy pulled together like never before.”

Although traditionally a time for looking forwards, many of us in community pharmacy will also this month be reflecting on the year that has just passed. 2016 was dominated by the unprecedented public announcement of funding cuts and other proposals that threatened the sector. For the first time this century negotiations on funding failed, and both PSNC and the NPA are seeking judicial reviews of the Government’s decision to impose cuts and other changes.

In the campaign that followed the December 2015 announcement, community pharmacy pulled together like never before. Pharmacy teams, local representatives and national leadership organisations lobbied together, and strong new evidence emerged such as the PricewaterhouseCoopers (PwC) study undertaken for PSNC, which demonstrated powerfully the ‘added value’ of the community pharmacy

service: more than £3 billion a year for twelve specific services. The impact of this combined effort was evident in everything from the petition – the largest ever in healthcare – to the countless Parliamentary discussions and national media coverage. Thank you to all the pharmacies and LPCs who helped.

Yet despite all this, community pharmacy still now finds itself threatened by funding cuts and other changes. The decision by PSNC to take legal action over the consultation on those cuts was not made lightly. The most productive relationships are collaborative and we must ensure that once the legal action is concluded we build a strong basis for working with our NHS colleagues in the future. This will be a major policy objective for 2017. We are also reviewing our governance, to ensure that PSNC has the structure that best equips it to promote and represent the sector.

The recently published Murray Review and the Community Pharmacy Forward View will both feature prominently in community pharmacy’s advocacy work in

High Court grants permission for PSNC Judicial Review The High Court has granted PSNC permission for a Judicial Review of the Secretary of State’s October decision to implement cuts to community pharmacy funding and other changes.

The hearing is to be expedited and will be heard in the week commencing 6th February 2017.

The Judge has indicated that if the Secretary of State seeks a later hearing date, the question of whether there should be a delay in the implementation of the legislation will arise.

As reported in last month’s CPN, PSNC sought permission to apply for the Judicial Review on the grounds that it believes the Secretary of State failed to carry out a lawful consultation.

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early 2017. Both documents set out visions for service development and we must continue to campaign, as a sector, to ensure that the NHS takes these forward, and that community pharmacy is properly used to deliver greater capacity to primary care. Every pharmacy has a role to play in this: with their patients, with local GPs, social care providers and other stakeholders. When these relationships work well and pharmacies are seen as important partners, it is easier to move forward. But when they are patchy, when some pharmacies do not get involved, commissioners can be reluctant to depend on the sector.

2017 will be another testing year for us all. We are working in an increasingly hostile environment and the financial stringencies biting across the whole of the public sector will continue for several years. During the difficult times in 2016 I was reminded of the quotation by Benjamin Franklin 240 years earlier: “We must, indeed, all hang together, or assuredly we shall all hang separately”.

We managed it last year; let us continue to fight, together and united, this year.

Parliament shows support for community pharmacy A House of Lords debate has led to calls from peers for an enhanced community pharmacy role.

During the debate initiated by Baroness Cumberlege, ViceChair of the All-Party Pharmacy Group, peers urged the Government to invest in further use of pharmacies, referring to the PricewaterhouseCoopers (PwC) report on ‘The value of community pharmacy’, and querying the cut in funding.

Also, the Parliamentary Health Select Committee has announced it will hold a one-off evidence session on community pharmacy in 2017. The session will hear from both ministers and pharmacy representatives following the outcome of PSNC’s legal action.

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Clinical Services Review sets direction for community pharmacy Report recommends making better use of community pharmacists’ skills by integrating them into care pathways and developing existing services.

NHS England has published the report of the Community Pharmacy Clinical Services Review carried out by Richard Murray, Director of Policy at the King’s Fund.

The review was informed by a steering group, but was carried out independently.

The report concludes that there needs to be “renewed efforts to make the most of the existing clinical services that community pharmacy can provide and to do so at pace”.

It sets out how the skills of community pharmacists and their teams can be used to help people to manage long-term conditions and to embed medicines optimisation within care pathways. This may require national action through the Community Pharmacy Contractual Framework, as well as local progress on integrating pharmacies into evolving models of care, the report states.

The report also called for NHS England to set out how it intends to deliver on its commitment to ensure that minor ailments services are commissioned across England by April 2018. It stressed the need for community pharmacy to share information with clinical records held by other healthcare professionals, and said pharmacy technicians should be able to work under Patient Group Directions to improve use of the skill mix within pharmacies.

The report sets out a number of recommendations for the future development of community pharmacy services including: • Incentivising use of electronic repeat dispensing so that this becomes the default for repeat prescribing; • A redesign of MURs to develop them into full clinical reviews including ongoing monitoring and follow-up of patients, consideration of prescription duration, and utilising independent prescribing as part of the care pathway; • Consideration of making smoking cessation services an element of the national contractual framework; • Use of the Vanguard programmes to develop the evidence base for community pharmacists, including integrating community pharmacists into long-term condition management pathways, involving them in case finding programmes, and using new ways of contracting that mitigate any perceived conflicts of interest; • Support from NHS England and national partners to help STP leads to integrate community pharmacy into their plans and local commissioners to contract for services; and • Joint work by PSNC, the Royal Pharmaceutical Society and national GP representatives to explore what practical steps can be taken to unravel professional boundary issues and ensure closer working between community pharmacists and GPs. The report recommends that a formal group be established, including representatives of community pharmacy, to have oversight of progress and recommend further action where needed.

PSNC has issued a briefing summarising the main elements of, and recommendations given within, the report: ow.ly/G31s307fyX6

Over 800k flu vaccinations administered More than three quarters of a million NHS flu vaccinations have been administered so far during this season’s Community Pharmacy Flu Vaccination Advanced Service.

Data from PharmOutcomes and Sonar Informatics has confirmed that pharmacy teams had exceeded the 800,000 mark by the end of December 2016, although the total number will be even higher as some pharmacy teams are not using these systems to record administration of vaccines.

See the latest data and statistics reports at: psnc.org.uk/flustats Community pharmacy contractors can monitor their payments for delivering flu vaccinations using Check34 – find out more at: psnc.org.uk/check34

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Support for the Quality Payments Scheme Guidance and resources are now available to help community pharmacy contractors to meet the necessary criteria for the Quality Payments Scheme.

A Quality Payments Scheme framework and an asthma referrals service tool have been created on PharmOutcomes to support contractors.

This support is available to all contractors as PSNC has agreed to use its PharmOutcomes licence to provide access to the Quality Payments Scheme framework and asthma referrals tool on PharmOutcomes.

Contractors who own multiple pharmacies can set up complementary viewer accounts within PharmOutcomes which enable an administrator/manager to view the progress that each of their pharmacies are making towards achieving the Quality Payment criteria.

By using their LPC viewer login, LPCs are also able to view the progress contractors are making towards achieving the Quality Payment criteria. This will help to identify additional support that contractors require.

The framework enables contractors to track their overall progress in achieving the Quality Payment criteria, containing links to the PSNC website to provide additional information on each criterion and links to other PharmOutcomes services to assist contractors with collating evidence.

The asthma referral tool assists specifically in meeting that particular criterion, providing contractors with a

The Quality Payments Scheme framework tool on PharmOutcomes. simple method of recording and sending a referral directly to a patient’s GP practice, if a secure email address is held for that GP practice within PharmOutcomes (NB. a notification can be printed to send where a GP practice has not provided a secure email address).

An audit report is also created alongside referrals being sent that can be used to review activity and as evidence of activity if required.

For more information, including how to obtain login details for PharmOutcomes, please visit: ow.ly/w1t9307R0Lw NHS England guidance Additionally, NHS England’s guidance on the gateway criteria for the Quality Payments Scheme has also been published. The document provides detailed information on the four criteria that contractors must meet to be eligible to collect the points necessary to claim the Quality Payment.

Get involved with PHE campaigns Public Health England (PHE) has launched three new campaigns and is encouraging community pharmacy teams to support the campaigns.

The campaigns are: • One You: New Year, New You; • Smokefree January; and • Sepsis.

PHE has developed toolkits for pharmacy teams which can be ordered by calling 0300 123 1019. The order line will be open Monday to Friday, from 8am to 6pm, until March 2017 or whilst stocks last.

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PharmOutcomes asthma referral tool for the relevant Quality Payment criterion.

However, contractors should note that this guidance does not cover the announcement made regarding the process required to apply for an NHSmail account (see article opposite). For the purposes of the 28th April 2017 review point, contractors are required to have evidence that they applied for an NHSmail account for their pharmacy by 1st February 2017.

The guidance can be downloaded from: ow.ly/wjeC307uMZa

Repeat Dispensing factsheet In support of NHS Digital’s current campaign to increase the use of electronic Repeat Dispensing (eRD), PSNC has created a two-page factsheet for community pharmacy teams.

One side contains key phrases to help advise patients on the benefits of eRD, whilst the other side provides a list of questions to ask patients collecting a repeat prescription. You can find the factsheet on pages 7/8.

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Final SCR briefing events announced NHS Digital announces the final free face-to-face training sessions on using the Summary Care Record (SCR) for community pharmacy teams.

Whilst the latest statistics from NHS Digital revealed that around half of community pharmacies in England (almost 6,000) have accessed the SCR, it also highlighted that 10% of community pharmacies have not yet sent a representative to attend SCR training. Before a pharmacy can begin accessing SCR, one member of staff needs to have attended an NHS Digital approved briefing event.

Once the pharmacy has gone live, it then becomes eligible for a one-off SCR allowance of £200. Community pharmacy contractors only have until 31st March 2017 to start accessing SCR in order to trigger this £200 payment. So, if your pharmacy hasn’t yet sent a representative to an approved SCR event, make sure you send someone as the final round of events are now being organised.

Accessing SCR has also been included as one of the criteria in the new Quality Payments Scheme: increased usage could be worth up to £640 in 2017/18. PSNC will shortly release a calculator to assist contractors in determining their usage of SCR.

SCR usage in numbers The current status of community pharmacy’s use of SCR. Data courtesy of NHS Digital, correct as of December 2016.

90% of community pharmacies have participated in briefing sessions to support their implementation of SCR. SCR has now been accessed by around half of community pharmacies in England.

20,000 pharmacy professionals have completed online SCR training.

The most active pharmacies are accessing SCR up to 50 times a week.

NHS Digital has announced they are holding sessions throughout January and February 2017 across the Midlands, East, Lancashire and Yorkshire regions. Approved locally organised events are also scheduled for London, the South, Halton and Essex.

Pharmacy Postgraduate Education (CPPE) SCR module, and the Acceptable Use Agreement form. The checklist can also be used as a reference after attending the event to help complete the golive process.

Before attending an event, it is useful to ensure you have completed all of the items possible on the SCR implementation checklist (psnc.org.uk/SCRlist) – in particular the Centre for

Please refer to psnc.org.uk/SCRtraining for more information and links to the training dates and venues. Information will be updated as more dates are added by NHS Digital.

Last chance to request NHSmail account Community pharmacy contractors that wish to take part in the Quality Payments Scheme must: 1. have an NHSmail account for their pharmacy by the review points (28th April 2017 and 24th November 2017) at which they wish to make a Quality Payments Scheme claim; or 2. for the purposes of the 28th April 2017 review point, have evidence that they have applied for an NHSmail account by 1st February 2017.

NHS England and NHS Digital announced on 21st December 2016 that contractors that wish to apply for an NHSmail account for their pharmacy, to meet the requirement in point 2 above, can do so by emailing the following information to nhspharmacy.registration@nhs.net (by 1st February 2017):

• Trading name of pharmacy; • Owner’s name; • Address, including postcode (for the premises the NHSmail address will apply to); • Pharmacy ODS code (F code); • Pharmacy telephone number; and • Current pharmacy email address.

Contractors with multiple pharmacies may submit this information via one email, providing details for each pharmacy premises; a spreadsheet template is available on the PSNC website for collating the information on individual pharmacies within a group.

Make sure you don’t miss the 1st February 2017 deadline!

Further information on NHSmail can be found at: psnc.org.uk/nhsmail

IG toolkit submission Community pharmacy contractors are reminded that the deadline for submitting this year’s information governance (IG) toolkit is 31st March 2017.

Contractors are encouraged to complete the IG toolkit sooner rather than later and to use this as an opportunity to comprehensively review their IG processes.

Further guidance and support is available from: psnc.org.uk/ig

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Pharmacy service case studies PSNC regularly receives examples of LPCs, community pharmacists and their teams delivering high quality care. Here we look at some recent cases.

Devon’s co-ordinated flu vaccination campaign

HIV testing being offered in Cumbrian pharmacies

Contractors in Devon have been working in partnership with the Beacon Medical Group to ensure as many eligible patients receive their flu vaccinations as possible.

Community pharmacies in Cumbria are now offering an HIV testing service after OutREACH Cumbria secured funding for a pharmacy-based service.

Devon LPC and the general practice group realised that GP practice staff and local community pharmacy teams needed to work together to achieve the World Health Organization’s aspirational target of flu vaccination coverage.

The pilot project is funded by Public Health England through the National HIV Prevention Innovation Fund, and is one of 13 successful voluntary-led projects selected from 102 applications that offer new and innovative ways of delivering HIV prevention.

In addition to co-designing posters to ensure a consistent message, GP practices advised patients who were unable to attend their walk-in flu clinics to have their vaccination at a local pharmacy instead. Pharmacy teams would also actively refer patients to the practices if they could not vaccinate a patient for a clinical or other reason.

A proposal to commission a fully partnered service in the South West is being considered. Find out more at: ow.ly/dHjK307kJ5S

OutREACH Cumbria has worked in collaboration with Cumbria Partnership Foundation Trust and Cumbria LPC to set up the pharmacy service, which is being provided by Healthy Living Pharmacies in areas with higher levels of high-risk groups.

Further details on this service, and other blood-borne virus screening services, can be found on the PSNC Services Database at: psnc.org.uk/database

Updated Apps for pharmacy guide think will be useful for community pharmacists and their teams. Some are sources of information, some can be used during consultations with patients and some are for signposting to support healthy lifestyles and self-care.

Liz Reid

The guide is divided into three sections: 1. Professional apps and information sources for pharmacy staff; 2. Service-related and healthy lifestyle apps; and 3. Self-care apps for patients. learning development pharmacist, CPPE

For this edition, we have reviewed, replaced and updated information about new apps in all three sections. We have provided large, clear icons and new apps are clearly indicated –

so if you have used this guide before you can easily pick out new apps to look at. For professionals, some of the new apps include the Oxford Medical Dictionary, Chemist + Druggist and NHS apps on child health and safeguarding.

Section 2 has evolved to suggest apps for use alongside providing pharmacy services and to promote healthy lifestyles.

New apps in this section include Diabetes UK Professionals, NHS 24 MSK help and NHS Stroke Prevention. And for patients, new apps include the My Local NHS app to support people to choose the best option for their urgent care needs in their local area.

This is the perfect resource if you got a new phone or tablet for Christmas and you were wondering what to download!

Download our apps guide now: www.cppe.ac.uk/programmes/l/apps-g-04w

“

“ Our new guide is full of apps that we

Consultation Skills newsletter The winter edition of CPPE’s Consultation Skills for Pharmacy Practice (CSfPP) newsletter includes information on what’s new and what’s on the horizon for CSfPP. 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.

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.

This issue highlights the training and resources currently available, as well as looking at upcoming learning programmes. Find out more at: ow.ly/eWKv307bSUi

Distributed for PSNC by:

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

The benefits of electronic repeat dispensing eRD is hassle-free…

“Your medicines can be synchronised, so you can collect all your medicines at the same time.”* “Since prescriptions are electronic, there is no paper prescription to carry around or to hand in at the pharmacy.”

eRD can save you time…

“There is no need to order your repeat prescription from the pharmacy or surgery so often (depending on how many batch prescriptions are issued by your GP, you may only need to order your repeat prescription once every 12 months).”* “Since we can download your prescription seven days before your medicines are due, we can order your medicines in advance. This reduces the chance of your medicine being out-ofstock/us owing you medicines, and you having to return to the pharmacy.”

“The process is simple, once your GP surgery has enrolled you on electronic repeat dispensing then they can send your prescriptions to us electronically. You can just turn up at the pharmacy and we’ll have your medicines ready.”*

eRD can reduce medicines waste…

“Since we’ll be having a chat with you about your medicines before you collect them, we can identify together if there’s any medicines that you don’t need. This will reduce the chance of you having unwanted or unneeded medicines at home.”

eRD is responsive to your needs…

“If you’re going away on holiday, we can get your medicines ready in advance, as eRD allows us to access your prescription early for these types of situations.”

“If you are away on holiday and have forgotten to collect your medicines, eRD allows you to collect your medicines from another pharmacy.”

eRD gives you the opportunity to ask questions about your medicines…

“When you collect your medicines, we’ll just need to ask you a few questions to make sure it’s still appropriate for us to supply you with medicines. Why not use this opportunity to ask us any questions you have about your medicines?”

* Some medicines, for example, Schedule 2 or 3 Controlled Drugs will not be suitable for eRD so patients may need to be advised that not all their medicines can be supplied through eRD.

Questions to ask patients before supplying an electronic repeat dispensing prescription Are you still taking/ using all these items?

Are there any items on your repeat prescription that you don’t need this month?

Have you been having any problems with your medicines/ appliances or have you been experiencing any side effects?

Have you recently stopped taking/ using or started taking/ using any new medicines or appliances, either on prescription or that you have bought yourself?

Have you seen any health professionals (for example, your GP, nurse or hospital doctor) since you had your last repeat prescription?

Have there been any changes to your health since you got the last prescription?

If a patient answers ‘yes’ to any of these questions, the pharmacist may need to speak to the patient to decide if a supply can be made or whether the patient will need to be referred to their prescriber.

Remember: When the patient collects the final issue of their eRD prescription, a pharmacy team member should inform the patient to contact their prescriber to order another eRD prescription. GP practices will often schedule a patient review to coincide with the end of an eRD batch.

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All you need to know about: Dispensing optional extras with lymphoedema garments Our Dispensing and Supply Team answers some frequently asked questions on prescriptions that include optional extras for lymphoedema garments.

A common query regarding the endorsing of optional extras for lymphoedema stockings is whether the Pricing Authority (PA) will process optional extras that over-spill onto additional FP10s (or EPS dispensing tokens), as seen in the image opposite.

The PA will still process these as the optional extras are recognised individually by their own unique product codes and processed in their own right. Therefore, there is no need to have a new prescription written.

It is important to note that the optional extras must be prescribed as individual items on the prescription, as shown in the image. If they do not appear in the correct format, then the pharmacy will not be reimbursed for supplying them. Incorrectly written prescriptions should be returned to the prescriber for amendment.

As long as the necessary endorsements are next to the appropriate items, there will be no processing complications. However, incorrect endorsement may result in the forms being referred back for the missing information or being reimbursed incorrectly.

Additionally, optional extras appearing on their own on a prescription do not incur additional prescription charges as these are classed as no charge items. More information about prescription charges can be found on our 'What does the patient pay?' page: psnc.org.uk/charges

DH permits use of antiviral medicines against influenza Due to increasing flu levels in the community, the Department of Health (DH) has issued a letter advising that the prescribing of antiviral medicines for the prophylaxis and treatment of flu at NHS expense is now permitted. 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 at: ow.ly/kXpk307R3WJ

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 in the have a ‘CE’ blacklist?* mark?

Can it be dispensed on an FP10?

Additional information

LimbO waterproof protector – Adult full leg

No

n/a

Yes

No

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

FITLEGSTM anti-embolism stockings

No

n/a

Yes

No

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

Selsun Blue anti-dandruff deep cleansing 1% shampoo

No

No

No

Yes

This item is a toiletry and does not appear in Part XVIIIA (the ‘blacklist’) of the Drug Tariff.

Juzo gauntlet with thumb stub

Yes

n/a

Yes

Yes

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

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

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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 February 2017.

Part VIIIA additions Category A: • Amitriptyline 10mg/5ml oral solution sugar free (150ml) • Dexamethasone 3.3mg/1ml solution for injection ampoules (10) • Heparin sodium 200units/2ml patency solution ampoules (10) • Heparin sodium 50units/5ml patency solution ampoules (10) • Levothyroxine sodium 12.5microgram tablets (28) • Levothyroxine sodium 75microgram tablets (28) • Prednisolone 1mg gastro-resistant tablets (30) • Voriconazole 200mg tablets (28) • Voriconazole 50mg tablets (28) Category C: • Calcium chloride 10% solution for injection 10ml pre-filled syringes SC (1) – Martindale Pharmaceuticals Ltd • Dapoxetine 30mg tablets (3) – Priligy • Dapoxetine 30mg tablets (6) – Priligy • Dapoxetine 60mg tablets (3) – Priligy • Dapoxetine 60mg tablets (6) – Priligy • Diclofenac potassium 25mg tablets (28) – Actavis UK Ltd • Haloperidol 500microgram tablets (28) – Crescent Pharma Ltd • Lamivudine 150mg tablets (60) – Epivir • Lamivudine 300mg tablets (30) – Epivir • Meropenem 1g powder for solution for injection vials (10) – Fresenius Kabi Ltd • Meropenem 500mg powder for solution for injection vials (10) – Fresenius Kabi Ltd Part VIIIA amendments • Docusate 50mg/5ml oral solution sugar free (300ml) Category C – Docusol is changing to Category A • Ethanol 90% including duty (100ml) is changing to Category C – J M Loveridge Ltd • Levonorgestrel 1.5mg tablets SC (1) Category C – Levonelle 1500 is changing to Category A • Loperamide 2mg tablets (30) Category C – Norimode is changing to Category A • Quinagolide 75microgram tablets (30) Category C – Norprolac is changing to Category C – Aspire Pharma Ltd • Dexamethasone 2mg tablets (50) Category A is changing to Category M • Lemecycline 408mg capsules (28) Category A is changing to Category M • Nefopam 30mg tablets (90) Category A is changing to Category M

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

• Paroxetine 10mg tablets (28) Category A is changing to Category M Part IX deletions Product AproDerm Emollient Cream

Size and product code 45g

Heritage sheath collar pack (Salts Healthcare)

30 (code: ZL0022)

Finoderm Release Non Sting Medical Adhesive Remover Wipe – Sterile (H&R Healthcare Ltd) Finoderm Release Non Sting Medical Adhesive Remover Spray – Sterile (H&R Healthcare Ltd) Finoderm Protect Foam Applicator 1ml – Sterile (H&R Healthcare Ltd) Finoderm Protect Spray – Sterile (H&R Healthcare Ltd) Finoderm Protect Wipes – Sterile (H&R Healthcare Ltd) Atmocol Pocket Spray (Ecolab)

30 wipes (code: FD15030) 50ml (code: FD152-50)

Vanilla Bean Drops (Respond Healthcare Ltd)

50ml (code: VBN50)

Colorimetric Cassette – Mobile

100

5 (code: FD154-05) 50ml (code: FD153-50) 30 (code: FD151-30) 25ml (code: 785911)

Ask PSNC: EPS tokens EPS tokens have been a popular topic for queries, so here is some useful information from our Dispensing & Supply Team.

The tokens contractors need to send to the Pricing Authority (PA) include: • Those used to capture exemption status and signature (for non-age related exemptions only); or • Those where the patient has paid a charge.

Although EPS tokens are scanned, they are not used by the PA to determine endorsements or reimbursement. They assist only in the event of queries in relation to an exemption category such as an investigation into a possibly fraudulent patient exemption claim.

During the usual pricing of your monthly bundle, the PA determines the exemption category for EPS prescriptions not by looking at tokens but instead by reviewing the exemption category which the pharmacy has applied onto the electronic prescription using their PMR system.

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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declared item figures for the month x

average item value (AIV*) for previous month

* The AIV is calculated using the total of drug and appliance costs plus fees, less the value of MURs and AURs, divided by the total number of professional fees (now known as the Single Activity Fee)

See overleaf for a summary of cashflow for 2017

• Once the month has been priced at the NHSBSA, the advance is recovered and balance settled three months following dispensing i.e. the December 2016 advance payment will be recovered with a balancing payment made by 1st March 2017

• The December 2016 advance payment will be calculated based on November’s AIV

Advance Payment

• Advance payments: these are payments made two months following the dispensing date i.e. December 2016 prescriptions will have a 100% advance paid by 1st February 2017

On this page you will find some background on pharmacy payments.

Following the Government’s decision to impose a new funding package on community pharmacy for 2016/17, PSNC has published this guidance and chart to show what impact the cuts will have on cash flow for community pharmacy contractors from December 2016.

Important pharmacy cashflow changes

1st Apr 17

May 17

1st Jul 17

Aug 17

Note: this payment is only made twice a year with April and November's balancing payments

For eligible pharmacies the first Quality Payment will be made in July 2017

Jun 17

Funding cut £95m Further reduction in Establishment Payment by 40% Slight increase in Single Activity Fee @ rate of £1.24 per item Reduction in average Pharmacy Access Scheme payment Introduction of Quality Payments Margin recovery of £12m pcm ends

Summary of funding changes & pharmacy cashflow impact Funding cut £113m Reduction in Establishment Payment by 20% Introduction of Single Activity Fee @ rate of £1.13 per item Introduction of Pharmacy Access Scheme Ongoing margin recovery of £12m pcm

1st Mar 17

Jan 17 advance payment

1st Feb 17

Dec 16 advance payment

Dec 16 balancing payment

Jan 17

Oct 16 advance payment

Nov 16 balancing payment

1st Dec 16

Sept 16 balancing payment

Dec 16 advance payment will be inflated as it is based on November’s AIV

• Dec 16 balance payment will be less than the value of the advance payment

• Jan 17 advance payment will be lower as the AIV calculation will take into consideration the reduction in fees

Big Impact Month

No changes to payments for contractors apart from usual fluctuations in AIV

Try the PSNC’s Cashflow & Indicative Income Calculator to see how these changes will impact your pharmacy by visiting psnc.org.uk/fundingchanges and clicking on the ‘Impact on contractor income’ dropdown