January 2019 CPN

CPN

Community Pharmacy News – January 2019

NHS ten-year plan published

• Plan describes how extra NHS funding will be used • Commitment to make greater use of community pharmacists’ skills IG support materials | Quality Payments declaration | Price concession flow chart

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Chief Executive’s blog PSNC Chief Executive Simon Dukes uses this section of CPN to provide an update on PSNC’s work. have been calling for and one which we must embrace. The plan also states that community pharmacists will be used to offer more tests such as blood pressure checks; again, this is a role we have asked for and must show that we can deliver.

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Our commissioner recognises the skills of community pharmacists

Simon Dukes

PSNC Chief Executive Last week saw the publication of the much-anticipated NHS Long Term Plan, and for community pharmacy, if you are to believe the media reports, some good news and some uncertainty.

The first piece of good news is that community pharmacy gets more than one mention – this has not always been the case with big picture NHS planning documents. NHS England’s statement that it will “work with Government to make greater use of community pharmacists’ skills and opportunities to engage patients” is perhaps the biggest positive; it shows that our commissioner recognises the skills of community pharmacists and wants to make better use of them.

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We will need to prove at each stage that we are ready and competent

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The plan talks about referring patients from NHS 111 directly to pharmacies and this workstream will also include a pilot of GP referrals to pharmacies.

Taken together, these represent a move towards community pharmacies becoming the key healthcare location for people with minor conditions – this is a role we

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The question now is how we achieve all of this, and of course this means some difficult conversations about how we free up pharmacists’ time to allow them to offer these services (whether through using technology or enhancing the skills of the wider pharmacy team) and how we pay for them in an environment in which there is no more money (including considering the number of pharmacies that the NHS currently pays for). We also need to upskill both our pharmacists and their teams.

All of which is what NHS England is likely referring to when it talks about ‘exploring efficiencies’.

Since the publication of the plan, Minister Steve Brine has confirmed that the reference to reform of reimbursement and wider supply arrangements means his Department will take forward reforms that they had agreed to previously, and which PSNC supports. They include making changes to reimbursement for ‘non Part VIII’ and Category M products; changes

to the Margin Survey; and ‘splitting the discount’. We hope that this commitment means that NHS England are looking to improve systems which pharmacy has been unhappy with for some time, and along with the Minister’s confirmation that he is seeking to renegotiate the Community Pharmacy Contractual Framework, will all help to move community pharmacy in the direction that we want.

The Long Term Plan also talks about ‘clinical pharmacists’ which have been a source of contention in the past, with some asking what makes pharmacists working in GP practices more ‘clinical’ than other pharmacists? NHS England, our customer, is committed to these pharmacists and to increasing their numbers, and so our strategy will be to try to find ways to make this work for us; ultimately we want to try to get community pharmacists doing some of what the NHS has designated the ‘clinical’ roles, alongside their many other patient facing services.

So I hope that you will begin the year feeling positive about the Long Term Plan and what it could mean for community pharmacy. That is not to say that the coming years are going to be easy – there will be much change for community pharmacies which will be challenging; and we will need to prove at each stage that we are ready and competent to deliver what comes next. But I think with the commitments set out in the plan and the community pharmacy organisations working closely together to help you and LPCs to deliver it, we can afford a little optimism.

Make sure you get all the latest Community Pharmacy News delivered to your inbox, by signing up at psnc.org.uk/email

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

The NHS Long Term Plan Ten-year healthcare plan reveals how the NHS will use its £20 billion a year funding increase to improve patient care, with a key focus on prevention.

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Reshaping the NHS around the needs of patients

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NHS England has this month published the NHS Long Term Plan, setting out its priorities for healthcare over the next ten years and showing how the NHS funding settlement will be used.

The plan was unveiled by NHS England Chief Executive Simon Stevens and Prime Minister Theresa May, who said it was about “reshaping the NHS around the needs of patients”.

For community pharmacy, the plan states: • NHS England will work with Government to make greater use of community pharmacists’ skills and opportunities to engage patients; • NHS England and the Government will explore further efficiencies through reform of reimbursement and wider supply arrangements; • NHS England will work with community pharmacists and others to provide opportunities for the public to check their health, through tests for high blood pressure and other high-risk conditions; and • From 2019, NHS 111 will start direct booking into GP practices across the country, as well as referring on to community pharmacies who can support urgent care and promote patient self-care and self-management.

NHS England has also pledged to offer Primary Care Networks a new ‘shared savings’ scheme so they can benefit from actions taken such as to reduce avoidable A&E attendances and delayed discharge and to reduce over-medication through pharmacist review.

The plan also aims to make digital health services a mainstream part of the NHS, so that in five years’ time, patients in England will be able to access online GP consultations.

How PSNC fed into the plan During the development stage, PSNC worked closely with the other national pharmacy organisations to coordinate pharmacy’s input into the plan, and, as part of that work, submitted briefings to some of the plan’s working groups.

Later, PSNC’s used its response to the NHS Long Term Plan consultation to highlight the valuable contributions that community pharmacies can make in many key areas of healthcare. The response included a number of case studies and evidence of the success of pharmacy services, and called for further commissioning of services.

LPCS

Long Term Plan: PSNC Summary The Plan includes several mentions of pharmacists, in particular noting the role that they will play in local Primary Care Networks. Pharmacists may be involved in helping to identify and treat people with high-risk conditions, educating patients on the correct use of inhalers, and offering medicine reviews to care home residents.

PSNC has published a briefing which summarises the aspects of the Plan which are most relevant to community pharmacy and LPCs. PSNC Briefing 002/19: A summary of the NHS Long Term Plan can be found at: ow.ly/DuSR30ng51b Further information on the Plan is available on our dedicated webpage: psnc.org.uk/NHSLongTermPlan

Long Term Plan: Priorities A key theme of the plan is prevention, as NHS England says it believes 500,000 lives could be saved over the next ten years by focusing on prevention and early detection. The NHS will focus on its aim to make the population ‘fit for the future’ by: • Enabling everyone to get the best start in life; • Helping communities to live well; and • Helping people to age well.

NHS England will also recruit tens of thousands more doctors, nurses and other health professionals, although its full workforce plan is not expected until later this year.

Long Term Plan: Next Steps The Plan describes 2019/20 as a transitional year, in which the local NHS and its partners will have a chance to shape local implementation. Local plans will be brought together in a detailed national implementation programme by the autumn.

The NHS and partners will also be moving to create Integrated Care Systems everywhere by April 2021, bringing together local organisations to deliver the ‘triple integration’ of primary and specialist care, physical and mental health services, and health and social care.

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CONTRACT AND IT

FMD: one month to go There is now just under a month to go until the Falsified Medicines Directive (FMD) comes into force on 9th February 2019. Key resources include: • The UK FMD Working Group for Community Pharmacy’s website (managed by PSNC) – containing detailed guidance and links to system suppliers offering an FMD solution.

Visit now: fmdsource.co.uk • PSNC’s quick guide for the pharmacy team – answering common questions about the practicalities of complying with the FMD legislation. Download from: ow.ly/b7Ec30mRuLv • PSNC’s FMD webinar – explaining what community pharmacy contractors need to do to prepare. Watch now: psnc.org. uk/FMDwebinar

Latest Brexit news Draft legislation on Serious Shortage Protocols has been laid before Parliament and should come into force in early February 2019. The protocols, for use in the event of a serious shortage of a medicine, may give community pharmacies the ability to dispense less, give a different strength or pharmaceutical form or provide an alternative product.

This is just one of a series of measures and guidance materials that have been issued in recent weeks as part of the Department of Health and Social Care’s work to ramp up preparations for a possible no-deal Brexit. PSNC has gathered together all the latest information and advice on our Brexit webpage: psnc.org.uk/Brexit

Priority Services Register Contractors can now sign up for the Priority Services Register, run by the UK’s utility companies, to boost their business continuity arrangements. Inclusion on this register should mean your pharmacy has priority access to electricity, water and gas supplies.

Your utility bills may explain how to sign-up and provide contact details.

Alternatively, identify who your energy supplier is at the Energy Networks Association’s website or search for ‘Priority Service Register’ on your utility company websites. Find out more at: ow.ly/2iVe30naJq9

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

PSNC guidance on meeting IG requirements • Comprehensive guidance on completing this year’s information governance return is now available • A new toolkit incorporating new data standards (e.g. GDPR) must be completed • PSNC has secured modifications to the declaration toolkit to significantly reduce workload for contractors

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The Data Security and Protection Toolkit must be completed no later than 31st March 2019

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PSNC has developed a series of guidance documents to assist community pharmacy contractors as they work towards their information governance (IG) declaration for 2018/19. Previously known as the IG Toolkit, this year contractors must complete the new ‘Data Security and Protection Toolkit’ no later than 31st March 2019.

PSNC and NHS Digital have been working together on the development of the Toolkit and NHS Digital has informally endorsed the information in the Toolkit completion: Overview.

As part of this work PSNC achieved agreement with NHS Digital in key areas which will significantly reduce the work contractors need to do to complete the Toolkit. Firstly, any contractor who completed our General Data Protection Regulation (GDPR) Workbook last year can simply tick a box to confirm this and around half of the questions will be auto-

completed. Secondly, with support from a number of PMR suppliers, many contractors will have access to information to help answer up to 12 technical questions.

PSNC recommends that contractors register now, take a look at our guidance documents and start to get familiar with the new Toolkit. However, some contractors may consider it beneficial to finish the Toolkit questions after: a) their PMR supplier may have added some relevant information against some technical questions (scheduled for mid-January 2019); or b) the batch submission feature (for owners of multiple pharmacies) has been made available (early 2019).

Please note, community pharmacies are expected to meet all mandatory evidence requirements which means that all questions marked as mandatory must be completed.

PSNC guidance documents Toolkit completion: Overview – this outlines six steps to complete the Toolkit.

Toolkit completion: Question-by-question guidance (mandatory questions) (PDF version) – this can be used to work your way down the Toolkit questions from top to bottom completing the mandatory questions not already marked completed.

Toolkit completion: Question-by-question guidance (all) – this Excel spreadsheet, covering all mandatory and optional questions, provides an alternative to using the PDF. Representatives from PSNC and NHS Digital will be available to talk you through the new Toolkit in our workshop on 30th January. Sign up at: psnc.org.uk/webinar PSNC’s guidance documents and further information is available at: psnc.org.uk/ig

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HE HEALTHCARE LANDSCAPE

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

Quality Payments: New declaration process Contractors given new option on how to make their Quality Payments declaration for the 15th February 2019 review point.

The NHS Business Services Authority (NHS BSA) last month sent an email to pharmacy shared NHSmail accounts detailing changes to the process of claiming for a quality payment. When the declaration window opens on Monday 4th February 2019, community pharmacy contractors will be able to claim for a quality payment either via the Manage Your Service (MYS) application or a SNAP survey tool (as used for previous declarations).

Pharmacy teams should check with their business owner or head office which route they should use to make a declaration before completing the MYS registration form.

1. Manage Your Service application

2. SNAP survey tool

The MYS application can provide contractors, at the time of making their declaration, with confirmation that their pharmacy has been assessed against national datasets as either meeting or not meeting the gateway criteria. This means if contractors have not met the five gateway criteria, they have the opportunity to take corrective action before they make their declaration.

The SNAP survey tool will be available as an alternative option similar to previous Quality Payment Scheme declarations. If contractors decide to use this option, verification of the gateway criteria cannot be confirmed in real time, thus reducing the possible time for corrective action.

If contractors choose to use this option, they are encouraged to register with the MYS application as soon as possible, to ensure the registration process is complete before the declaration period.

Contractors will however be able to check the status of their compliance with the gateway criteria by accessing a report on the NHS BSA website.

Contractors will have their gateway criteria verification confirmed by email within a week of their SNAP submission.

The Quality Payment Scheme declaration within the MYS application and the SNAP survey tool will both open for declarations on Monday 4th February 2019 at 9am and will close on Friday 1st March 2019 at 11.59pm.

Weekly gateway criteria reports Community pharmacy contractors are now able to view a gateway criteria report on the NHS Business Services Authority (NHS BSA) website, which details contractors who have been assessed, using national datasets, as meeting four of the five gateway criteria.

This weekly report – updated by close of business every Friday – means contractors can check whether their pharmacies meet the four gateway criteria and are therefore confident of this, when they complete their declarations for the February review point.

Contractors are therefore encouraged to check this report to see if the national datasets show they have met the four gateway criteria as detailed above and if not, take corrective action as soon as possible to ensure they meet the criteria by the review point.

NHSmail gateway criterion Due to the need for active accounts to meet the NHSmail gateway criterion, contractors are advised to review the report regularly to ensure that their pharmacy continues to meet all four gateway criteria. A PSNC Briefing is now available to support contractors in meeting the NHSmail criterion: ow.ly/UPg130neh1L

Reviewing your results 1. The report can be found at nhsbsa.nhs.uk/qualitypaymentsscheme, in the ‘Datasets for gateway criteria’ section.

2. Open the spreadsheet and search for your pharmacy’s ODS code (F code).

3. The spreadsheet will display either a green or red box for NHS website opening times, NHS website services and NHS website facilities columns. The dates in these boxes denote when this particular section was last edited or validated.

If all three boxes are green, the NHS website criterion is deemed to be met.

4. The spreadsheet also displays a green tick if the pharmacy has been assessed as meeting the gateway criterion or a red cross if the pharmacy has not in the NHS website, Advanced Services, CPPQ and NHSmail columns of the report.

5. For cyber security reasons, confirmation of meeting the fifth gateway criterion – compliance with the NHS Digital Warranted Environment Specification (WES) – was sent

by NHS BSA to each contractor’s shared NHSmail account on 16th January, 2019 (please note this has been delayed from December).

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SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

2019/20 Public Health campaigns The Public Health Essential Service campaign topics and timescales have now been set for the upcoming year.

As part of the Community Pharmacy Contractual Framework, each year pharmacies are required participate in up to six campaigns at the request of NHS England.

Previously, these campaigns were determined at a local level by NHS England teams, however PSNC recently agreed with NHS England to set these campaigns at a national level so that all community pharmacy contractors participate in the same campaigns thus having a greater exposure to the target groups.

To provide some local flexibility, there will be two different types of campaigns: • Campaigns that appear in black: these campaigns have been developed nationally; and • Campaigns that appear in red: these campaign topics have been agreed nationally but allow flexibility for local NHS England teams to consider the

specific patient populations that they might target these campaigns at (e.g. the Stoptober campaign materials will be used, but pharmacy teams may be asked to target pregnant women who smoke). *The antimicrobial resistance campaign (which appears in green) has the potential to fall between either of the above groups

as there is other central NHS England/ Public Health England work that is being developed which could inform the focus of the campaign.

Further information on all the above campaigns, including which resources will be provided to pharmacies, will be available in due course.

DATE

TOPIC

Mid-February to mid-March 2019

Help Us Help You Pharmacy campaign (formerly Stay Well Pharmacy)

Mid-May to mid-June 2019

Children’s oral health/Smile Month (in line with the training currently being incentivised by the Quality Payment Scheme)

September 2019

Antimicrobial resistance*

October 2019

Stoptober

November/December 2019

Help Us Help You main Winter campaign (formerly Stay Well this Winter)

January 2020

Alcohol

Return to prescribing course Enabling pharmacist prescribers to redevelop their prescribing skills.

We are pleased to announce that “Centre for Pharmacy Postgraduate

Dianne Bell Education supervisor, CPPE

Education’s (CPPE) Return to prescribing course is back by popular demand.

This three-day programme is delivered in two blocks over a three-month period and is open to any registered pharmacist prescriber in England who has been out of prescribing practice for over a year.

The aim of the course is to support you to regain the confidence and competence to prescribe by helping you to acquire the necessary knowledge, skills and networks. This will be achieved through a variety of learning methods including individual learning, group activities, discussions and sharing of best practice. The content of the course is mapped onto the prescribing competency framework and will help you build a library of reliable, evidence-based information sources to ensure that you feel ready to return to your prescribing role.

6 Community Pharmacy News – January 2019

The course will also help you to identify your learning needs and create an action plan which will address these needs, in order to build prescribing confidence.

There is no fee to attend our Return to prescribing course as it is fully funded by Health Education England.

As well as being great CPD and a significant step to developing your practice, this is an opportunity to collect evidence for your RPS Faculty application by providing evidence for the expert professional practice cluster. You will also benefit from peer review, which may contribute towards your revalidation submission.

The next available course is on 9th and 10th February, and 21st May 2019 in Manchester.

To find out more about the course and to apply, visit our dedicated webpage on the CPPE website: www.cppe.ac.uk/career/return-prescribing

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PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

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.

Health Harms campaign returns

on 28th December 2018 The Smokefree Health Harms campaign launched 2019. y and will run throughout Januar g in the new year, by The campaign encourages smokers to stop smokin a cigarette is smoked. highlighting the immediate personal harm every time gn toolkit, at: Find out more, including how to order the free campai ow.ly/IG Ps30n3 seX

2019 Patient Safety Group priorities

acy Patient The Community Pharm lished its pub has Safety Group these are of ny Ma . ties ori 2019 pri us years vio pre carried over from group’s the e driv and will continue to ety saf ient pat e rov imp principles to more at: arn Le m. har uce and red g/2 019 -pr ior itie s pha rm acy saf ety .or

Oral lidocaine-containing products hange in the legal status of C newly manufactured stock of oral lidocaine-containing products for teething in children from general sale (GSL) to pharmacy (P). xisting ‘GSL’ labelled packs E should only be supplied under the supervision of a pharmacist. ind out more at: F ow.ly/LAYX30n3vk2

F lu fighter awards nomination s

Nominations are open for the annual NHS Employers flu fight er awards which take place in March. The awards celebrate the success of flu teams across the NHS and social care sector, recognising all the hard work that has gone into local campaigns.

Pharmacists, pharmacy team s and LPCs are invited to find the category that most suits them and ente r before nominations close on Mon day 21st Janu ary 2019 .

Details of how to enter can be found at: ow.l y/T9 Fq3 0nb GYf

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DISPENSING AND SUPPLY

Pregabalin and gabapentin to be controlled drugs From 1st April 2019, pregabalin and gabapentin will be classified as Schedule 3 Controlled Drugs (CDs).

Community pharmacy teams should note that whilst pregabalin and gabapentin will be subject to the usual prescription writing requirements for Schedule 3 CDs, they will be exempt from the safe custody regulations. This means that pharmacies will not be required to keep these drugs in their CD cabinet.

This follows representations from PSNC and others that the usual storage arrangements for Schedule 3 CDs would not be practical for pharmacies to comply with considering the significant number of prescriptions for these drugs.

Experiencing supply issues?

Pharmacy teams who experience problems in obtaining medicines (generic or branded) or appliances are reminded to feed this back to the PSNC Dispensing and Supply Team.

PSNC reports the feedback received to the Department of Health and Social Care to support their monitoring of the situation.

It is also used in discussions with manufacturers, for example, highlighting problems with contingency arrangements.

Please report using our online feedback forms: psnc.org.uk/feedback

Use of antiviral medicines against influenza Due to increasing flu levels in the community, the Department of Health and Social Care (DHSC) has advised 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 oseltamivir (Tamiflu) or zanamivir (Relenza) must be endorsed ‘SLS’ by the prescriber.

8 Community Pharmacy News – January 2019

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Book now for our Prescription charge exemptions and switching webinar Latest PSNC and NHS BSA webinar will guide viewers through the exemption declaration process and explain how prescription switching can affect pharmacy payments.

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We will outline the different exemptions and give you tips to prevent switching.

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PSNC and the NHS Business Services Authority (NHS BSA) will be holding a ‘Prescription charge exemptions and switching’ webinar on Tuesday 22nd January at 7.30pm.

Are you interested in learning about: • How to determine a patient’s eligibility for exemption from the NHS prescription charge?

• How to ensure that the backs of prescription forms and EPS tokens are completed correctly?

• Tips on how to avoid prescriptions being switched from exempt to chargeable (and vice versa)?

If you answered “yes” to any of these questions, sign up to our webinar where Suraj Shah and Mitesh Bhudia, from PSNC’s Dispensing and Supply Team, and Alison O’Brien, from the NHS BSA, will provide the answers. During the 60-minute webinar, there will also be an opportunity for viewers to ask their own questions.

Exemptions from the prescription charge is consistently one of our most popular webpages and, to complement NHS BSA’s recent Check Before You Tick campaign, PSNC is keen to help make sure that community pharmacy contractors and their teams are fully equipped to discuss exemptions with patients as well as recognising the importance of filing prescriptions into the ‘paid’ and ‘exempt’ bundles correctly for processing and payment.

On the night the presenters will outline the different exemptions from the prescription charge, including the evidence needed to prove eligibility, and how the declaration process varies between paper and electronic prescriptions.

This will be followed by details of why prescriptions are switched and how this affects pharmacy payments, as well as providing top tips on how to make sure switching isn’t a problem in your pharmacy.

Join us for the webinar Book your place now: psnc.org.uk/webinar. 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 Dispensing Factsheet: Prescription Switching in advance of the webinar, which can be found at: psnc.org.uk/witchingfactsheet

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Ask PSNC: Price concessions special The PSNC Dispensing and Supply Team answers the most commonly asked questions about the price concession system.

A. PSNC is required to make a fresh application for price concessions at the start of each month.

The Department of Health and Social Care (DHSC) then takes time to undertake their own checks to reach a proposal. The price concession updates are announced as soon as they are agreed.

In some cases, there is a need for ongoing negotiation between PSNC and DHSC, particularly on drugs where we are far apart on prices; this can take time. The final monthly update is often released late in the month as these include new drug applications submitted mid-month and any drugs where PSNC and DHSC have been unable to agree, resulting in imposed prices.

Q. Why isn’t the full list of price concessions released earlier each month?

PSNC would like to see changes to the arrangements that would allow community pharmacy contractors to have certainty over what they will be reimbursed, much earlier in the month; but this must be balanced with the need to negotiate with DHSC where PSNC feels the offered price is not sufficient.

Q. Can you tell me where the drug is available to purchase at the stated concessionary price?

Q. If a price concession is granted in one month and is still a problem in the next month, why doesn’t the price just roll over?

A. Unfortunately, competition law prevents us from directing pharmacies to purchase drugs from a specific wholesaler or manufacturer.

A. Price concessions only apply for the month in which they are granted.

Because the market fluctuates on a regular basis in terms of stock levels and prices it would not be appropriate to roll the price over from one month to the next.

We do often see prices for drugs vary quite significantly between different mainline wholesalers and also via short-line wholesalers, and therefore we advise contractors to check with multiple suppliers before ordering to make sure they are purchasing at the best possible price.

PSNC regularly monitors the market through contractor reports and communications with wholesalers. As stock levels and prices can vary across the country, we rely on contractor reports to help feed into our market surveillance and our discussions with DHSC. It is also important to note that the DHSC may not act on something unless contractors have reported it.

Q. Why does the price concession for a drug not reflect the price I’m having to purchase it at?

A. PSNC and DHSC negotiate price concessions and try to agree on a price that both parties feel is reflective of the market. Whilst this may not be the price that you have purchased at, PSNC only agrees when we believe that the price is one that most contractors can obtain the drug for.

However, there are also times when an agreement cannot be reached and DHSC decides to impose a price concession instead. The decision to grant a concession ultimately lies with DHSC so they have the power to impose a price if they feel unable to agree to PSNC’s requested prices.

Q. How do I report supply issues to PSNC? A. Please get in touch with us to report any supply issues by using the online reporting form at psnc. org.uk/genericreport. Alternatively, you can report any concerns about drug availability at Drug Tariff-listed prices by contacting us via telephone on 0203 1220 810 or by emailing info@psnc.org.uk.

You can email in copies of wholesaler invoices as evidence to medicines.shortages@psnc.org.uk or fax 0207 278 1127.

Look out for more frequently asked questions next month…

If you would like more information on any of the topics covered, the team at PSNC will be happy to help (0203 1220 810 or e-mail info@psnc.org.uk). psnc.org.uk 9

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Monthly price concession flow chart This factsheet shows how price concessions are set on a monthly basis.

Learn more about the process at: psnc.org.uk/concessionsbriefing Contractor sends report to PSNC via email/phone/website if a drug is unavailable to purchase at Drug Tariff price

PSNC requests information from main-line wholesalers

DHSC gathers pricing and stock information from manufacturers and wholesalers using Information Disclosure Regulations

PSNC reviews any further contractor reports and any new wholesaler data

Week 1 PSNC collates all contractor reports and information from wholesalers to submit initial request for price concessions to Department of Health and Social Care (DHSC)

Week 2 & 3 DHSC sends proposed prices to PSNC

PSNC reviews proposed prices to determine whether they are acceptable

Agree

Price concession update published jointly on PSNC and NHS BSA websites

Disagree

DHSC obtain further data from manufacturers and wholesales

PSNC submits acceptable prices to DHSC

DHSC consider PSNCs prices and may propose revised prices

PSNC deides if any revised prices are acceptable. Prices which cannot be agreed to are subject to Ministerial approval process

Disagree

This timeline above is for illustration purposes only.

Timings may change each month.

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DHSC finalise prices for outstanding requests based on the process agreed to by Ministers and send a letter to PSNC of their decision

Agree

Price concession update published jointly on PSNC and NHS BSA websites

Week 4 - end of the month Final prices published jointly on PSNC and NHS BSA websites

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

Drug Tariff Watch: February 2019 Part VIIIA additions • Bupivacaine 25mg/10ml (0.25%) / Adrenaline (base) 50micrograms/10ml (1 in 200,000) solution for injection ampoules (10) – Advanz Pharma • Bupivacaine 50mg/10ml (0.5%) / Adrenaline (base) 50micrograms/10ml (1 in 200,000) solution for injection ampoules (10) – Advanz Pharma • Buprenorphine 16mg / Naloxone 4mg sublingual tablets sugar free (28) Suboxone • Buprenorphine 2mg oral lyophilisates sugar free (7) - Espranor • Buprenorphine 8mg oral lyophilisates sugar free (7) - Espranor • Dolutegravir 10mg tablets (30) - Tivicay • Dolutegravir 25mg tablets (30) - Tivicay • Dolutegravir 50mg tablets (30) - Tivicay • Fentanyl 37.5microgram/hour transdermal patches (5) - Mezolar Matrix • Fidaxomicin 200mg tablets (20) - Dificlir • Hepatitis A GMB strain (adsorbed) / Typhoid polysaccharide vaccine suspension for injection 1ml pre-filled syringes  (1) - ViATIM • Hepatitis A vaccine (inactivated, adsorbed) suspension for injection 1ml pre-filled syringes  (1) - Havrix Monodose • Hypromellose 0.32% eye drops 0.5ml unit dose preservative free (30) - Artelac Single Dose Unit • Ingenol mebutate 150micrograms/g gel (1.41g (3x  0.47g)) - Picato

• Ingenol mebutate 500micrograms/g gel (0.94g (2x  0.47g)) - Picato • Insulin isophane biphasic human 25/75 100units/ml suspension for injection 3ml pre-filled disposable devices (5) Insuman Comb 25 SoloStar • Insulin isophane biphasic human 30/70 100units/ml suspension for injection 10ml vials  (1) - Humulin M3 • Insulin lispro 200units/ml solution for injection 3ml pre-filled disposable devices: o (5) - Humalog KwikPen • Levocarnitine 1g/10ml oral solution unit dose vials sugar free (10) - Carnitor • Levonorgestrel 19.5mg intrauterine device  (1) - Kyleena • Medroxyprogesterone 104mg/0.65ml suspension for injection pre-filled disposable devices  (1) -Sayana Press • *Mesalazine 500mg suppositories (30) Salofalk • Phytomenadione 2mg/0.2ml solution for injection ampoules (5): o - Konakion MM Paediatric • Rifampicin 100mg/5ml oral suspension (120ml) - Rifadin • Ticagrelor 90mg orodispersible tablets sugar free (56) - Brilique • Tobramycin 28mg inhalation powder capsules with device  (224) - Tobi Podhaler • Tramadol 100mg/2ml solution for injection ampoules (5) - Zydol

CONTRACT AND IT

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

• Water for injections 10ml vials (25) Hameln Pharmaceuticals Ltd • Water for injections 20ml ampoules (20) - Water for injections Mini-Plasco Part VIIIA deletions • Dexibuprofen 400mg tablets (60) Seractil • Diamorphine 500mg powder for solution for injection vials (5) - Teva UK Ltd • Diltiazem 60mg modified-release capsules (56) - Dilzem SR 60 • Erythromycin 250mg gastro-resistant capsules (28) - Erymax • Hypromellose 1% eye drops (10ml) Isopto Alkaline • *Mesalazine 500mg suppositories (10) Asacol • Miconazole 1.2g vaginal capsules (1) Gyno-Daktarin • Pergolide 1mg tablets (100) • Pergolide 250microgram tablets (100) • Pindolol 10mg / Clopamide 5mg tablets (28) - Viskaldix • Timolol 0.5% eye drops 0.2ml unit dose preservative free (30) - Timoptol For a full list of the upcoming Drug Tariff changes, please visit: ow.ly/MEVg30ngds0

Part IX deletions Product

Size, Type, Product Code

Flivasorb dressing

Square and Rectangular (all sizes)

Venturi wound sealing kit

Channel Drain

Silk Garments - Baby Grow

Premature

Provox HME Stomafilter with Regular Plus adhesive

7330

Provox HME Stomafilter with regular adhesive

Oval (7252) and Round (7251)

Tracheostomy Cleaning Devices - Hei-Clean brush

All sizes

Tracheostomy Cleaning Devices - Hei-Clean Soft brush

All sizes

DEODERANTS - Independence Odour Eliminator Lemon & Lime Pump Spray

59ml (PR310)

ILEOSTOMY (DRAINABLE) BAGS - Impression with Convex wafer - Transparent

19mm (3610), 25mm (3612), 44mm (3618)

ILEOSTOMY (DRAINABLE) BAGS - Premium - Transparent

25mm (3662)

TWO PIECE OSTOMY SYSTEMS - Esteem Synergy - Drainable Pouch with InvisiClose outlet and Filter - Opaque - Standard - Right (30.8cm)

13-35mm barrier (S1210F)

TWO PIECE OSTOMY SYSTEMS – Conform - Drainable Pouch - Transparent

55mm (25600)

AMCo name change Contractors should note the manufacturer name change of AMCo to Advanz Pharma from the January 2019 Drug Tariff onwards.

psnc.org.uk 11

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

PSNC resources library In this section of Community Pharmacy News we have provided details of some of the resources that PSNC has produced this month.

PSNC Briefings PSNC Briefing 064/18: Completing the Data and Security Protection (IG) Toolkit This briefing and its related documents may assist community pharmacy contractors in completing the new Data Security and Protection Toolkit (previously known as the Information Governance, or IG, Toolkit).

Download from: psnc.org.uk/igtoolkit PSNC Briefing 065/18: Quality Payments – Evidence checklist This PSNC Briefing provides contractors with examples of what is acceptable evidence, in a checklist format, that can be used to confirm they have the necessary evidence to meet the gateway and quality criteria for the February 2019 review point.

Download from: ow.ly/E5An30nbF5O PSNC Briefing 066/18: Quality Payments – PSNC resources This PSNC Briefing provides a list of all the PSNC resources available to assist contractors with meeting the gateway and quality criteria of the Quality Payments Scheme for the February 2019 review point.

Download from: ow.ly/hCWu30nbF8o PSNC Briefing 067/18: How the price concession system operates In this briefing our Dispensing and Supply Team explain how the price concession system works, as well as answering some common queries received from contractors and their teams.

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

Other resources Quality Payments video This recorded presentation provides updated information on the Quality Payments Scheme and the resources which are available from PSNC and on PharmOutcomes to assist contractors with meeting the requirements of the Scheme.

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

Email news alerts PSNC guidance on meeting IG requirements now available (19th December) This email alert informed contractors that PSNC had published new guidance documents outlining the steps to complete the Data and Security Protection Toolkit for their information governance (IG) declaration for 2018/19.

Read now: ow.ly/LSr130nbFBx Quality Payments: Have you updated your NHS website profile? (3rd January) A reminder to contractors of the need to edit or validate three sections of their NHS website (formerly NHS Choices) profile before the February review point to meet this Quality Payments gateway criterion.

Read now: ow.ly/55Cu30nbFEw Not receiving our emails? Sign up now at: psnc.org.uk/enews PSNC website For up to date information and news on community pharmacy issues, visit the PSNC website at psnc.org.uk PSNC Community Pharmacy News is published by: The Pharmaceutical Services Negotiating Committee, 14 Hosier Lane, London, EC1A 9LQ Community Pharmacy News is edited by: Melinda Mabbutt who can be contacted at the above address or by email at: mmabbutt@psnc.org.uk PSNC Office: 0203 122 0810

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