July 2015 CPN

CPN

Community Pharmacy News – July 2015

Looking to pharmacy’s IT future ➢ £7.5 million for care records access ➢ More than 1,350 tune in for PSNC’s endorsing webinar ➢ Making the most of the electronic script tracker Temporary Smartcard access | NMS reminder poster | Latest Drug Tariff FAQs

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NHS England gives go-ahead for roll out of Summary Care Record (SCR) to pharmacies Health and Social Care Information Centre (HSCIC) project backed by funding and set to launch in autumn 2015 Following a successful proof of concept trial, NHS England has commissioned HSCIC to help give all community pharmacies in England access to the SCR. Pharmacy minister Alistair Burt announced last month that a fund of £7.5 million would be available to support the roll out, and we expect implementation to begin in autumn 2015.

The SCR access trial

The SCR provides key clinical information about a patient, sourced from the GP record. It is used by authorised healthcare professionals, with the patient’s consent, to support their care and treatment. Community pharmacists and pharmacy technicians will be provided with secure approved and monitored access to the SCR which will allow them to support patients with better informed and tailored care.

140 pharmacies across five geographical areas were given SCR access in late 2014

More than 96% of the population have an SCR and it is already being successfully used in many settings across the NHS, such as A&E departments, hospital pharmacies, NHS 111, GP out of hours services and walk in centres.

Community pharmacy has been pressing for access to the records for a number of years as they will give pharmacy teams more information about patients and so help them to improve the care they can offer. National pharmacy bodies have welcomed the roll out of the SCR in a joint statement from PSNC, the Royal Pharmaceutical Society (RPS) and Pharmacy Voice which can be found at: dld.bz/dHAqK Get the latest PSNC and community pharmacy news deliered to your inbox: psnc.org.uk/email

92%

of the time when pharmacists accessed the SCR they did not need of pharmacists to signpost surveyed agreed or patients to strongly agreed that other care SCR access reduced the need for them to contact the patient’s GP

85%

18%

In of SCR access encounters the risk of a prescribing error was avoided’

NHS practice pharmacy initiative unveiled NHS England has announced a £15 million scheme to fund, recruit and employ clinical pharmacists in GP practices.

The pharmacists will offer a range of clinical care including helping patients to manage long-term conditions, giving advice on medications, managing repeat prescription requests and developing bespoke medicine plans for patients.

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The three-year initiative will focus on areas where GPs are under greatest pressure and is intended to ease GP workload and improve communication with other healthcare providers including community pharmacies.

Responding to the announcement, PSNC Chief Executive Sue Sharpe made the following statement: “We are pleased that NHS England recognises the medicines expertise of pharmacists and the role that they can play to better support patients in their treatment plans. Pharmacists working in GP practices to supplement and support the care already given by GPs and community pharmacists could be a real advance, bringing clinical benefits to many patients.

Community pharmacy teams are the most accessible healthcare professionals and

often the ones who are seen most regularly by patients. They have shown how they can help patients and we must build on this potential, with pharmacists in other settings collaborating closely with them to ensure patients are receiving joined up and consistent care. We hope that this project will give community and other pharmacists a chance to explore new ways of working, and perhaps training, together to offer the best possible care to patients.”

PSNC has also encouraged LPCs to try to ensure that the new posts actively support use and development of community pharmacy services and a collaborative approach between general practice and community pharmacists. More information is included in LPC News and LPCs needing further support can contact the office.

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PSNC Endorsing and Submission Good Practice Workshop: now available on-demand More than 1,350 people tuned into a live webinar covering the dos and don’ts of endorsing in June. Catch up now if you missed it at psnc.org.uk/webinar Community pharmacy teams can now access an online recording of PSNC’s recent webinar on the dos and don’ts of endorsing and submitting prescriptions.

More than 1,350 people tuned into the webinar on 30th June when PSNC’s inhouse Drug Tariff experts (Head of Pricing, Harpreet Chana, and Head of Dispensing and Supply, Komal George) conducted the live workshop.

Attendees had first worked through a series of prescription examples from PSNC’s Pricing Audit Centre and Harpreet and Komal talked through these, explaining how to endorse and sort them correctly whilst highlighting the most common errors made and how to avoid them.

Did you miss the webinar?

An on-demand recording of the webinar is now available to watch at: psnc.org.uk/webinar. To view the recording you will need to register (or input the email address you registered with previously).

Feedback on the workshop Early indications from our feedback survey are:

97

found it ‘useful’ or ‘very useful’

91

said they would ‘change their practice’ as a result

92

said they would ‘recommend to others’

%

%

They also gave a run-down of their top tips and the last section of the webinar was dedicated to viewers’ questions.

This workshop would be a valuable resource for anyone involved in dispensing and end of month processes.

To get the most out of the workshop you may first like to carry out the preworkshop quiz which can be printed out from the web page as well. You can then test your knowledge and understanding as our experts work through the answers.

%

“I learnt lots, maybe we endorse too much. Looking forward to more practice prescriptions.”

Tracy Robinson, Dispensing Assistant “This was my first PSNC webinar and it will not be my last. I found it very informative and well thought out.”

Hazel Hughes, Locum Pharmacist “I found it very useful; it reinforced my understanding and also I was able to pick up a couple of tips.”

Margaret Clement, Community Pharmacist

Update: Schedule 2/3 Controlled Drugs and EPS

Although legislation came into force from 1st July 2015 allowing Schedule 2 and 3 Controlled Drugs to be prescribed and dispensed using the Electronic Prescription Service (EPS) release 2 messages, the date at which pharmacy teams will start to receive such prescriptions has yet to be confirmed.

EPS release 2 prescriptions for Schedule 2 and 3 Controlled Drugs will need to satisfy the usual prescription writing requirements including the need to express the total quantity in words and figures. In PSNC’s response to the consultation on allowing Schedule 2 and 3 Controlled Drugs to be prescribed via EPS, we suggested that this requirement should not apply to electronic prescriptions, but the Home Office concluded that the requirement should remain.

The Health and Social Care Information Centre (HSCIC) has issued all GP and community pharmacy system suppliers with the technical requirements to implement Controlled Drugs prescribing via EPS,

including the requirement for ‘words and figures’. All dispensing systems must be updated and fully deployed across all pharmacy sites, before it is possible to enable the new functionality. This is to avoid the possible risk of a prescriber sending a prescription for a Controlled Drug to a pharmacy which can’t then dispense it.

Suppliers have been asked by HSCIC to consider when they will be able to implement the changes and until all suppliers provide this feedback, a decision can’t be made regarding implementation timescales.

Turn over for our latest EPS factsheet on the EPS Prescription Tracker

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EPS Prescription Tracker: How it can help in your day to day work The EPS Prescription Tracker has recently been updated and this factsheet tells you all you need to know about the changes and how it can help The EPS Prescription Tracker is an online tool provided by the NHS that provides community pharmacy teams with an additional means of viewing the status of electronic prescriptions on the NHS Spine.

What information does the tracker provide?

It provides basic information about a prescription. Initially the status, issue date and prescription treatment type (acute, repeat prescribing or repeat dispensing) will be presented. You can then choose to look at the GP practice who issued the prescription, the patient’s NHS number and the event history of that electronic prescription. Contact details for prescribers and dispensers are also provided.

The tracker does not provide patient demographic or prescribed medication details.

What can I use it for?

The most likely reason for using the tracker will be when a patient says they are expecting to collect a prescription, but you can’t see it on your dispensing system.

By searching the patient’s NHS number, or the prescription ID if they have a prescribing token, you will be able to check on the status of their prescription.

The information provided will enable you to take appropriate action. This might be to remind the patient that they have nominated a different pharmacy, or to confirm that there is a system issue and the prescription has not yet downloaded to your dispensing system.

Tip: If you cannot find a prescription in your dispensing system, you can cut and paste the Prescription ID into your dispensing system and use it to ‘pull down’ the prescription from the Spine.

Note: You can only do this if the patient wants the prescription to be dispensed at your dispensing site.

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How do I use it?

You can search for specific prescriptions by entering the prescription ID. Tip: if you have a barcode scanner, then click on the prescription ID input box and scan the barcode.

Or you can search for all prescriptions for your pharmacy or for a particular patient, by specifying a date range of your choice.

You will need the patient’s NHS number to use this search.

Pharmacy teams are expected to use the tracker when there is a valid reason to do so, e.g. to verify that a prescription exists or its status during the prescribing and dispensing process.

What is the ‘my site’ search option?

One of the new features is the introduction of a ‘my site’ option. This allows you to search for all prescriptions for your pharmacy.

What else is new?

One of the new features is the visibility of actioned or pending cancellation requests. You’ll be able to see if the cancellation applies to the whole prescription or one of the prescribed items on it. You’ll also be able to see the cancellation reason.

Who can use it?

Pharmacy teams, appliance contractor staff and GP teams are the main users.

All users will need a Smartcard.

Further information • The Tracker has an integrated help function, but if you have any problems accessing the Prescription Tracker, you should contact your IT support (e.g. your IT department if you have one or your system supplier helpdesk).

• More information about the tracker is available at: psnc.org.uk/tracker

Note: This type of search will not return any results for users logged on using a Virtual Local Pharmacy (FFFFF) user role profile as no prescriptions are associated with that virtual organisation.

Where can I find the Prescription Tracker?

You can find the tracker at tinyurl.com/epsr2tracker (Smartcard required)

Electronic Prescription Service

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Pharmacy notice board In this section of Community Pharmacy News we have highlighted some key notices for you and your team to be aware of in the coming weeks and months

ing programme Transfer of care e-learn either an error or 30–70% of patients have r medicines when thei to nge unintentional cha this can result in their care is transferred; idable readmission death, serious harm or avo to hospital. s can play their Community pharmacy team ents an MUR pati g erin off by ding part inclu m fro hospital. following their discharge Postgraduate cy The Centre for Pharma e-learning new a has Education (CPPE) cy teams to rma pha ble ena to e programm ive transfer of facilitate safe and effect care for patients.

Programme details: d l d.bz /dG DF A

Looking for repeat dispensing resources?

A Repeat Dispensing Referral Form has just been added to

the Repeat Dispensing section of our website to help you refer patients to GP practices.

You can also access NHS England’s new guidance Electronic Repeat Dispensing – Guidance which you may like to share with CCGs and local practice teams.

Visit

psnc.org.uk/repeatdispensing

Reminder: Mandatory logo for selling medicines online As of 1st July 2015, any person or organisation in the UK selling medicines online to the public must be registered with the Medicines and Healthcare products Regulatory Agency (MHRA) and display the new European Union (EU) common logo.

This is separate from the voluntary logo scheme run by the General Pharmaceutical Council (GPhC) as it is a legal requirement across Europe.

The penalty for not being registered or displaying the logo is up to two years in prison or a fine, or both.

Logo registration: https://pclportal.mhra.gov.uk

Temporary Access Smartcard guidance

Temporary Access Cards (TACs) are ‘blank’ Smartcards with a pre-defined set of access rights. If a Smartcard is lost or stolen, TACs can be activated by the Smartcard sponsor or Local Smartcard Administrator.

HSCIC has issued guidance for pharmacy teams recommending that those with few Smartcard users should consider discussing TACs or what other options may be available to them with their local Registration Authority (RA) team.

If a Smartcard is lost or stolen:

Report to the local RA as soon as possible;

Activate and securely store your TACs; and Once the pharmacy team member has

received a permanent replacement card, restore the TAC to a blank state.

Further information about Smartcards: psnc.org.uk/smartcards

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Important notice: Boxing Day 2015 Community pharmacy contractors should be aware of pharmacy opening hours requirements and how they apply to Boxing Day 2015 This year Boxing Day, 26th December, falls on a Saturday and this means the Boxing Day bank holiday moves to the next available weekday, i.e. Monday 28th December. This change to the bank holiday has an impact on the opening hours requirements for community pharmacies.

If the pharmacy would normally open on a Saturday, it must open as usual on Saturday 26th December, unless it acquires permission from the local NHS England team to change any core opening hours (but see note below). Note, if the Saturday opening hours are supplementary hours only, these can be amended by giving at least 90 days’ notice – permission to close is not required.

NHS England has issued the following statement: “NHS England considers community pharmacy to be an important part of our system resilience. We have been promoting community pharmacy to the public as a first stop for self-care and professional advice to elderly people who are ‘feeling under the weather’. In order to

support this we will be asking all primary care contractors whose contracted hours include Saturdays to open their normal hours on 26th December 2015. Local arrangements will be put in place to ensure adequate pharmaceutical services are available on the Boxing Day bank holiday on 28th December 2015.”

In light of the above statement it is unlikely that NHS England will give permission for changes in core hours. Pharmacy contractors that do wish to amend core hours for Saturday 26th December should make their applications without delay, and will need to provide such information as is reasonably requested by NHS England in respect of any changes to the needs of the people in its area, or other likely users of the pharmacy, for pharmaceutical services.

It should also be noted that in previous years appeals against refusals have been unsuccessful.

Monday 28th December Pharmacy contractors may close on Monday 28th December as this is the declared public holiday, unless they have

been directed to open by NHS England or they are bound by conditions imposed when they applied for inclusion in the pharmaceutical list.

However, although most pharmacies are entitled to close, LPCs and contractors may wish to work with NHS England to ensure the availability of adequate pharmaceutical services, through a locally commissioned Enhanced service.

For further details about opening hours see our Opening Hours page at: psnc.org.uk/hours

PSNC regularly receives questions from LPCs and pharmacy contractors about what is going on in the wider health and care landscape beyond community pharmacy. In this round-up we cover the latest news from the past month.

Manchester plan includes 7-day service Seven-day GP services will be rolled out across the whole of Greater Manchester after a local pilot scheme was found to reduce A&E attendances by up to 8%.

a seven-day GP service pilot scheme was found to reduce A&E attendances by up to 8% 6 Community Pharmacy News – July 2015

Care.data restarts The Care.data project, which aims to link patients’ GP and hospital records, restarted in June with the project being piloted in four areas: Blackburn with Darwen, Somerset, West Hampshire and Leeds. The NHS England led project had been delayed by concerns about patient confidentiality.

Five Year Forward View update The seven principal national health bodies have published Five Year Forward View: Time to Deliver (dld.bz/dJt3W). The report

looks at the progress made so far towards delivering the Five Year Forward View, and sets out the next steps. £200m cut to public health budgets Council controlled public health budgets may be slashed by £200m as the Department of Health (DH) is set to consult on an in-year cut worth 7.4% of the annual budget.

More than one in 10 born to smokers New figures published by the Health and Social Care Information Centre (HSCIC)

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Study calls for better asthma support Pharmacists urged to help people at risk of attack due to unsafe prescribing A year on from the National Review of Asthma Deaths (NRAD), which highlighted prescribing errors in nearly half of asthma deaths in primary care, new analysis from Asthma UK has revealed that unsafe prescribing is putting the lives of more than 120,000 people at risk.

Data from over 500 GP practices showed that over 22,000 people with asthma in the UK, including 2,000 children, have been prescribed medicines (long-acting reliever inhalers) in a way that is so unsafe they have a ‘black box warning’ in the USA due to the risk they pose. This error occurs when a dangerous monotherapy including long-acting beta agonists (LABA) and/or a long-acting muscarinic antagonists (LAMA) are prescribed without an inhaled corticosteroid (ICS).

In addition, Asthma UK’s research indicates that almost 100,000 people with asthma have been prescribed too many short-acting reliever inhalers (more than 12 in a year) without the British Thoracic Society/Scottish Intercollegiate Guidelines Network (BTS/SIGN) national clinical guidelines being followed, leaving them at risk of asthma attacks.

show that 11.4% of pregnant women were recorded as smokers at the time of giving birth in 2014/15. This latest figure continues the steady decline from 2006/07 (15.1%) to become the lowest on record.

11.4% of pregnant women were recorded as smokers at the time of giving birth in 2014–15 New vaccination programmes Public Health Minister, Jane Ellison, has announced the introduction of two new vaccination programmes in England: MenACWY and MenB vaccines. The MenB programme means that England is the first country in the world to begin

500

GP practices provided data for the study

Almost 100,000 people with asthma have been prescribed more than 12 shortacting reliever inhalers within a year

22,000

people with asthma in the UK have been prescribed medicines in an unsafe and potentially lifethreatening manner

90,000 people in England

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have uncontrolled asthma which is not being monitored by healthcare professionals

The charity’s report, along with practical guidance for healthcare professionals, can be found at: asthma.org.uk/prescribing-safety Asthma UK has called on healthcare professionals to review their systems and recall patients who have been prescribed long-acting relievers on their own without a steroid preventer, or not as a combination inhaler.

Head of the Asthma UK Helpline, Sonia Munde, said: “Community pharmacists can play an important role by helping to

identify patients who have been prescribed a LABA and/or LAMA with no inhaled corticosteroid and flag this back to their GP or asthma nurse. Another way pharmacists can help people with asthma is to make them aware hay fever can make them at increased risk of an attack.”

PSNC has a range of resources on asthma.

See psnc.org.uk/asthma

national and publicly funded MenB immunisation.

the Committee will be nominated by the House in the coming weeks.

‘New deal’ for general practice Secretary of State for Health, Jeremy Hunt, has set out the first steps in his ‘new deal’ for general practice. Part of the deal will require GP practices to improve the quality and continuity of care for vulnerable patients and delivering better access, 7 days a week, for everyone.

He reiterated the election commitment to increasing the primary care workforce by at least 10,000 and focusing more effort on recruiting new GP trainees, as well as ensuring all medical students have experience in general practice.

MERS update Chief Medical Officer, Professor Dame Sally Davies, has written to healthcare professionals outlining the latest information on the MERS Coronavirus outbreak in South Korea, stating that whilst the risk to the UK is currently low, she expects healthcare teams to remain vigilant.

If a patient presents with sudden and unexplained febrile illness, pharmacy teams should obtain details of their travel history and, if they have travelled from any of the affected countries, advice should be sought from the local infection disease clinician. The supporting algorithm (dld.bz/dJt4a), published by Public Health England, provides further guidance.

Health Committee chair re-elected Dr Sarah Wollaston has been re-elected as Chair of Parliament’s Health Select Committee. The remaining members of

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Hunt sets personal responsibility challenge Health Secretary plans to include indicative prices on medicines packs to encourage people to reduce waste and improve adherence The Government has called on patients to take more responsibility for their own health and for reducing waste in the NHS. Speaking to local authority representatives Health Secretary Jeremy Hunt said people needed to feel ‘firmly in the driving seat for their own health outcomes’.

Highlighting the roles that factors such as smoking and obesity still play in driving up health costs, he added: “The best person to manage a long-term condition is the person who has that long-term condition.”

Hunt also set out plans to publish indicative medicines costs to the NHS on the packs of all medicines costing more than £20. This would reduce waste and improve patient care by improving adherence, he said.

Responding to the announcement, Sue Sharpe, PSNC Chief Executive, outlined pharmacy’s vital role in helping patients.

“Pharmacy’s role in supporting personal responsibility can and should be far more extensive, including helping to minimise unnecessary use of GP time and visits to urgent care centres,” she stressed.

Sue added that any system for noting the cost of medicines would be “far from straightforward to implement” as the costs of prescribed medicines vary depending on a wide range of factors. “We will explore these with the NHS as it progresses this policy,” she said.

Read Sue Sharpe’s full statement at psnc.org.uk

LPC News and Resources CPWY Ramadan support videos Community Pharmacy West Yorkshire (CPWY) has worked with a local imam and a film production company to create some really useful videos explaining how community pharmacy teams can advise Muslim patients on their medicines use during the Holy Month of Ramadan.

Three videos were produced: information for patients (to be used in local mosques); information for pharmacy teams (the original highlights video); and a final video to explain how pharmacy teams are being trained and supported in advising Muslim patients during Ramadan. All three are now freely available on YouTube at: tinyurl.com/ RamadanPharmacyVideos

PSNC commissioners portal PSNC has developed a new 'Commissioners Portal' which was launched to coincide with the Health Service Journal (HSJ) and Local Government Chronicle (LGC) supplement on community pharmacy services. Now the portal is fully up and running LPCs may like to direct their local commissioners to it; and also to ask them to sign up for the commissioners mailing list using the form on the main page. LPCs have been sent copies of the HSJ/LGC supplement to help in their local conversations and should look out for these. The portal can be found at: psnc.org.uk/commissioners

Devon LPC features on web TV channel David Bearman and Mark Stone of Devon LPC have appeared on a web TV channel to highlight the importance of community pharmacy. TV channel Hiblio interviewed the pair as part of a programme which aimed to make the public more aware of the services and advice available from their local pharmacy team.

Hiblio was created by the South Devon Healthcare NHS Foundation Trust to bring local health and wellbeing information to a wider audience. Watch the programme ondemand at: vimeo.com/129416089

Think Pharmacy events A briefing has been created to provide all the materials LPCs need to organise and run a Think Pharmacy event. Think Pharmacy is a brand that has already been successfully used by many LPCs to engage their local commissioners. Rather than going to commissioners individually, an LPC Think Pharmacy event brings everyone together to learn more about community pharmacy and showcase pharmacy services. Find the briefing at: psnc.org.uk/briefings

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New Medicine Service – condition/therapy areas If a patient is newly prescribed a medicine listed in the chapters/sub-headings of the British National Formulary (BNF) as detailed below then they will be eligible to receive the New Medicine Service (NMS), subject to the pharmacist being able to determine that the medicine is being used to treat one of the below conditions/therapy area The patient’s newly prescribed medicine is listed in one of the following BNF chapters/sub-sections:

The patient has been newly prescribed the medicine for hypertension

2.2.1 Thiazides and related diuretics 2.4 Beta-adrenoceptor blocking drugs 2.5.1 Vasodilator antihypertensive drugs 2.5.2 Centrally acting antihypertensive drugs 2.5.4 Alpha-adrenoceptor blocking drugs 2.5.5 Drugs affecting the renin-angiotensin system 2.6.2 Calcium-channel blockers

The patient’s newly prescribed medicine is listed in one of the following BNF chapters/sub-sections: 2.8.2 Oral anticoagulants 2.9 Antiplatelet drugs

The patient’s newly prescribed medicine is listed in one of the following BNF chapters/sub-sections:

The patient has been newly prescribed the medicine as antiplatelet or anticoagulant therapy

The patient has been newly prescribed the medicine for asthma or COPD

3.1.1 Adrenoceptor agonists 3.1.2 Antimuscarinic bronchodilators 3.1.3 Theophylline 3.1.4 Compound bronchodilator preparations 3.2 Corticosteroids 3.3 Cromoglicate and related therapy, leukotriene receptor antagonists and phosphodiesterase type-4 inhibitors

The patient’s newly prescribed medicine is listed in one of the following BNF chapters/sub-sections: 6.1.1.1 Short acting insulins 6.1.1.2 Intermediate and long acting insulins 6.1.2 Antidiabetic drugs

The patient has been newly prescribed the medicine for Type 2 diabetes

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

Questions asked in recent months have included: 1. How long do NCSO/price concessions last?

PSNC needs to apply/re-apply for concessions on a monthly basis.

Therefore a concession only lasts until the end of the month in which it was granted. If there is an on-going supply problem, it is possible that a new concession will be granted by the Department of Health (DH) the following month, however this is not guaranteed.

The ‘OOP’ or ‘XP’ endorsement cannot be used on prescriptions for unlicensed specials and imports. Instead contractors are entitled to claim a fixed sourcing fee of £20, which is to cover the additional costs associated with procuring both Part VIIIB and nonPart VIIIB listed specials. The fee is paid when the prescription has been endorsed with ‘SP’ (or ‘ED’ for extemporaneously dispensing the item).

2. Why aren’t NCSO/price concessions granted on the first day of each month?

If there is an ongoing supply problem, PSNC needs to make a fresh concession application at the start of every month. The DH then take time to undertake checks and make a decision. In some cases, there is a need for negotiation between PSNC and the DH on an individual product’s circumstances. This can take time. PSNC would like to see changes to the arrangements that would allow contractors to have certainty over what they will be reimbursed, much earlier in the month.

4. How do I endorse a licensed medicine not in the Drug Tariff?

For licensed medicines not included in the Drug Tariff, endorse the quantity dispensed over the pack size used, and if the prescription has been issued generically, also endorse the brand name or the name of the supplier (see picture).

The Pricing Authority reimburses using the NHS-listed reimbursement price, but if this is not known by them (i.e. the supplier does not list the product/price on the NHS database, dm+d*) then they will need to use your endorsed price (N.B. the following must be included: the pack size, and total net price for that pack before discount and ex VAT). It is important to only include the necessary information in line with the endorsement requirement as any additional information could risk misinterpretation which could lead to an incorrect payment being made. *For more information on dm+d, please visit: psnc.org.uk/dmd

want to be alerted to price concessions as they are agreed? sign up to our email alerts at psnc.org.uk/email 3. How can I claim extra charges for unlicensed specials and imports?

Reimbursement of charges related to the sourcing of unlicensed specials and imports falls under the arrangements for payment of specials and imported unlicensed medicines introduced in November 2011 (Part VIIIB of the Drug Tariff).

Check34 roll out begins Nearly 20% of all independent pharmacies in England now have access to the Check34 prescription data analysis tool. Independent contractor registration for Check34 is being managed by the National Pharmacy Association (NPA) who reported that 430 members, totalling 1,100 pharmacies, have registered.

Independents outside NPA membership can also register through them. Developed by PSNC, Check34 is an online software solution that helps pharmacies to assess their prescription business performance. Access Check34 at check34.com

All details correct at time of printing.

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

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

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Look out for more frequently asked questions next month.

If you would like more information on any of the topics covered, the PSNC Dispensing and Supply Team will be happy to help (0844 381 4180 or 0203 1220 810 or e-mail info@psnc.org.uk).

Have you seen?

Have you seen our webpage ‘Completing Your FP34C Submission Document & Dispatching Your Prescription Bundle’?

It details the dos and don’ts of completing your FP34C and information about dispatching your bundle. You will also find a link to our prescription submission factsheet.

Head over to psnc.org.uk/interactive-fp34c for more information.

Distributed for PSNC by:

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

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Changes to Part VIIIB of the Drug Tariff July 2015 changes: products moving to Part VIIIA The listings for the following products are moving from Part VIIIB (specials and imported unlicensed medicines) to Part VIIIA, as these products are now available as licensed medicines. This change is annotated in the Preface of the July 2015 Drug Tariff.

• Amlodipine 10mg/5ml oral solution • Amlodipine 5mg/5ml oral solution • Amlodipine 10mg/5ml oral suspension • Amlodipine 5mg/5ml oral suspension Reminder: June 2015 removals from Part VIIIB Pharmacy teams are reminded that a number of lines were removed from Part VIIIB (specials and imported unlicensed medicines) of the June 2015 Drug Tariff. Therefore, prescriptions for these products now require additional endorsement to ensure correct payment.

Acetylcysteine 10% eye drops Folic acid 5mg/5ml oral suspension Acetylcysteine 5% eye drops preservative free Furosemide 5mg/5ml oral solution/suspension Amisulpride 25mg/5ml oral solution/suspension Haloperidol 1mg/5ml oral solution/suspension Amitriptyline 10mg/5ml oral solution/suspension Midazolam 10mg/ml oral solution Chloral hydrate 200mg/5ml oral solution/suspension Phenobarbital 50mg/5ml oral solution/suspension Ciclosporin 0.06% eye drops Phosphate 0.98mmol/ml / Sodium 0.78mmol/ml oral suspension Ciclosporin 2% eye drops preservative free Pregabalin 75mg/5ml oral suspension Dexamethasone 0.1% eye drops preservative free Tacrolimus 2.5mg/5ml oral suspension Diazepam 10mg/5ml oral suspension Tacrolimus 5mg/5ml oral suspension Dipyridamole 100mg/5ml oral suspension Trihexyphenidyl 2mg/5ml oral solution/suspension Unlicensed medicines which are not listed in Part VIIIB of the Drug Tariff and are sourced under a manufacturer’s specials/importer’s licence issued by the MHRA, must be endorsed with the following: • Amount dispensed over pack size used • Invoice price per pack size from which the order was supplied less any discount or rebate • Manufacturer’s/importer’s MHRA licence number • Batch number of the product supplied • SP Further information on dispensing and endorsing unlicensed specials and imports can be found at: psnc.org.uk/specials

Can it be dispensed on an FP10?

When pharmacy teams receive NHS prescriptions they must check whether the items prescribed are allowed on the NHS before dispensing. If they are not allowed, the pharmacy may not be paid for them. Pharmacy teams may wish to check PSNC’s ‘Dispensing on an FP10 database’ (available at: psnc.org.uk/FP10database) for more information on whether an item can be dispensed on an FP10, and we have listed some products below that we have recently received queries about.

Product

Is the item listed in the Drug Tariff?

Does it have a ‘CE’ mark?

Is it in the blacklist?

Can it be dispensed on an FP10?

Additional information

Cutimed Protect Cream

Yes

Yes

n/a

Yes

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

Vaniqa Cream

Yes

No

No

Yes

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

Hycosan 0.1% eye drops

No

Yes

n/a

No

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

Ichthopaste (6/2%)

Yes

Yes

n/a

Yes

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

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

psnc.org.uk 11

dispensing and supply

services and commissioning

The healThcare landscape

Drug Tariff Watch The first section of the Drug Tariff is the Preface. This contains valuable information relevant for both the current edition and the next. It lists additions, deletions and any other alterations to the Drug Tariff. The Preface should ideally be checked each month to identify products which are entering or being removed from the Tariff as well as those products changing between categories or in the case of Category C items, changes to the brand used for pricing.

It is also important to know the category of an item when claiming certain payments (e.g. OOP expenses) as these are not allowed for some categories. For more information visit psnc.org.uk/oop

It is especially important to note which are Drug Tariff listed products as well as which category products are entering and the

Below is a quick summary of some the changes due to take place from 1st August 2015.

Part VIIIA Additions Category A Additions: • Glycopyrronium bromide 200micrograms/1ml solution for injection ampoules (10) • Pericyazine 10mg tablets (84) • Pericyazine 2.5mg tablets (84) • Sulfadiazine 500mg tablets (56) Category C Additions: SC Special Container • Amiloride 5mg/5ml oral solution sugar free (150ml) – Amilamont • Ibuprofen 5% / Levomenthol 3% gel SC

pack sizes being included in these entries, as reimbursement will be based on this classification and its endorsement requirements.

Incorrect endorsement can lead to incorrect payment for items.

(30g) - Deep Relief • Ibuprofen 5% / Levomenthol 3% gel SC (50g) - Deep Relief • Ibuprofen 5% / Levomenthol 3% gel SC (100g) - Deep Relief Part VIIIA Amendments SC Special Container • Betamethasone valerate 0.1% / Neomycin 0.5% cream SC (30g) is changing to Category A • Betamethasone valerate 0.1% / Neomycin 0.5% cream SC (100g) is changing to Category A

• Betamethasone valerate 0.1% / Neomycin 0.5% ointment SC (30g) is changing to Category A • Betamethasone valerate 0.1% / Neomycin 0.5% ointment SC (100g) is changing to Category A • Glycerol 1g suppositories (12) is changing to Category C Martindale Pharmaceuticals Ltd • Torasemide 10mg tablets (28) is changing to Category C Torem • Torasemide 5mg tablets (28) is changing to Category C Torem

Part VIIIA Deletions If a medicinal product has been removed from Part VIIIA and has no other pack sizes listed, it can continue to be dispensed, but it will need to be endorsed fully (i.e. brand or supplier name from whom the product was purchased and the pack size from which the item was dispensed) and price paid in future.

• Carbocisteine 125mg/5ml oral solution (300ml) Category C - Mucodyne syrup • Cefixime 100mg/5ml oral suspension (100ml) Category C - Suprax • Rupatadine 10mg tablets (30) Category C - Rupafin Part IX Deletions It is important to take careful note of removals from Part IX because if you dispense a deleted product, prescriptions will be returned as disallowed and therefore payment will not be made for dispensing the item.

• IryPump S (B Braun Medical) IryPump Container - 29240E • Molnlycke System 4 - multi-layer compression bandage kit - 18-25cm System 4 kits contain a combination of the following components: Softexe (layer #1) - listed on page 202 10cm x 3.5m (unstretched) Setocrepe (layer #2) - listed on page 196 10cm x 4.5m (stretched) Elset (layer #3) - listed on page 197 10cm x 8m (stretched) K Meban Self-Adherent Bandage (layer #4) 10cm x 6m (stretched) • HumaPen Memoir (Lilly) 3.0ml - 1 unit (1-60 units)

• Pelican Healthcare Ltd Eakin Closed bag Clear 32mm - 839130 - 20 45mm - 839131 - 20 64mm - 839132 - 20 • Pelican Healthcare Ltd Eakin Closed bag Large 32mm - 839120 - 20 45mm - 839121 - 20 Small 32mm - 839110 - 20 45mm - 839111 - 20 64mm - 839112 - 20 • ConvaTec Ltd Esteem Synergy+ Closed Pouch with Filter Small Clear 48mm - 416780 - 30 • ConvaTec Ltd Drainable Pouch with Invisiclose outlet and no filter Standard - Clear 35mm - 416797 - 10 Need to know if an item can be dispensed on an FP10?

Check on our database at: psnc.org.uk/FP10database

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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