July 2016 CPN

CPN

Community Pharmacy News – July 2016

Pharmacy gains third party support Healthcare workers and MPs back plans for the development of community pharmacy clinical services

The beneďŹ ts of SCR | Pharmacists reducing GP workload | Out of pocket claims guide

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Support for community pharmacy builds Politicians and healthcare professionals have been declaring their support for the use and development of pharmacy in local communities.

New NHS Alliance supports greater role in LTC care The New NHS Alliance has called for “more proactive action” from the NHS to commission a new model of community pharmacy led care and to support a greater role for pharmacy in self-care, management of minor ailments and care for people with long-term conditions (LTCs).

In a report published in June the alliance of professionals from across both health and social care said it was disappointed that the NHS had failed to make best use of the expertise of community pharmacists.

The report, Supporting the Development of Community Pharmacy Practice within Primary Care, said community pharmacy must be given a clear strategy to deliver its potential.

The New NHS Alliance called for: • Patients with acute self-limiting illnesses to be diverted to community pharmacy; • GPs to support the commissioning of minor ailments services; • GPs to identify elements of care that could be self-care opportunities for delivery within pharmacy; • GPs to identify opportunities for the care of certain conditions to be transferred to community pharmacy; and • Commissioners to develop local plans to support community pharmacy to deliver consistent public health messages.

Community pharmacy is an “underutilised asset”, the New NHS Alliance said, and too little progress has been made in developing the possible clinical roles of community pharmacists. “It is time for more proactive action,” the report declared.

MPs call on Government to develop new clinical services The All Party Pharmacy Group (APPG) has called on the Government to develop new community pharmacy clinical services, building on the supply of medicines as a platform for health interventions.

The report published in June by the cross-party group of MPs said pharmacy funding must incentivise clinical services for the benefit of patients and the NHS, building on the dispensing service. But they warned that the Government’s proposals for the future of community pharmacy did “the opposite”.

The APPG’s report of its Inquiry into Primary and Community Care, How can service improvements be achieved and where does pharmacy fit?, called on the Government to reach agreement with community pharmacy about the future and to address concerns about pharmacy closures.

The APPG requested a view from Government on PSNC’s community pharmacy service proposals saying PSNC’s plans merited “a detailed response”. The Group also said the Government should use the ongoing review into community pharmacy services to consider the potential for new services, and the report called on the Government to recommence negotiations on a national Minor Ailments Advisory Service.

The APPG made the following recommendations: • The future of community pharmacy should be secured by investing in technology, developing professionalism in pharmacy and integrating pharmacy into primary care; • Community pharmacy must continue to develop clinical services, using the supply of medicines as a platform for health interventions; and • The Government must address concerns about pharmacies closing due to funding cuts.

PSNC Chief Executive Sue Sharpe said: “These reports show that both politicians and healthcare professionals from a wide range of backgrounds are as disappointed as we are by the NHS ignoring the value of community pharmacy services and have serious doubts about the Government’s plans for the sector.

The MPs not only support the important role that community pharmacy plays in supporting local populations, but they want the Government to expand that role in the future to help support both patients and the NHS. Whilst the New NHS Alliance’s report recommends that the NHS should make use of community pharmacies for self-care, minor ailments and the management of long-term conditions. These echo proposals that PSNC has put forward to the Government and NHS England on many occasions.

We hope they will take note of the New NHS Alliance and the APPG on this issue.”

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‘Hub and spoke’ plans are postponed Government announces the postponement of its ‘hub and spoke’ plans to allow time to re-engage with PSNC and other stakeholders before proceeding with legislation.

The Government has announced that it will further engage with PSNC and other stakeholders before making changes to medicines legislation on ‘hub and spoke’ dispensing.

Responding to a Parliamentary Question last month, pharmacy minister Alistair Burt said the Department of Health would like to “explore in more detail with stakeholders’ representatives before progressing any legislation”. He said the Department did not now envisage changes to the legislation commencing on 1st October 2016.

Mr Burt said the responses to the consultation had “raised issues” around removing the bar on ‘hub and spoke’ dispensing between retail pharmacies that are not part of the same business.

PSNC responded forcibly to the consultation, pointing out the many fundamental flaws in the proposals and consultation

process; crucially, that the narrative of the consultation did not match the proposals in the draft legislation. We are delighted that the Government has acknowledged some of the issues and hope that in these further discussions it will recognise all of the shortcomings in its proposals.

PSNC Chief Executive Sue Sharpe said: “The proposals in the ‘hub and spoke’ consultation have been ill thought out and the effect of the proposed legislation has not been made clear to pharmacy or the public.

We have seen a similar approach throughout the wider proposals laid out in the Government’s 17th December letter on ‘Community Pharmacy in 2016/17 and beyond’, but as yet there has been no indication from the Department of Health that it will be prepared to grapple with the real issues or acknowledge the failings of that wider consultation process.”

Pharmacy minister to leave in September Pharmacy minister Alistair Burt has announced his intention to step down from his ministerial post in September.

During a Health Questions session Mr Burt told Parliament: “A few weeks ago I made it clear to the Secretary of State and to the Prime Minister and the Chief Whip that I wouldn't, after the referendum, be seeking a post in what I expected to be a reshuffled government.”

Following the election of a new leader of the Conservative Party, and therefore Prime Minister, a reshuffle of ministerial posts is to be expected, but with this announcement Mr Burt has made clear his intention not to continue in his ministerial post in this Government.

PSNC Chief Executive Sue Sharpe said: “This announcement from Alistair Burt comes at a critical moment for community pharmacy. MPs of all parties across the country have become concerned about the wisdom of the Treasury-driven demand for the radical and damaging community pharmacy funding cut, which has been opposed by more than two million patients who signed a petition supporting pharmacy. With a new ministerial team, this policy must be reviewed. It cannot be right to press ahead with an ill-informed decision before the incoming team is able to fully grasp both the damage of the proposals and the opportunities for using community pharmacy more effectively in future. The NHS must work with us to protect and develop the community pharmacy service that patients value and need and to ensure that pharmacy can play a greater role in reducing pressure on other parts of health and social care."

NHS fraud checking notification Community pharmacy teams are reminded that, from 1st July 2016, the Terms of Service requires them to advise anyone claiming an exemption from the NHS prescription charge, where evidence is required but not provided, that checks take place to verify exemptions in an attempt to prevent fraud and inappropriate exemption claims.

To help pharmacy teams comply with this new requirement, PSNC has produced a Briefing explaining the key things that should be considered. Download Briefing 032/16 from our Briefings Database: psnc.org.uk/briefings

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New materials highlight benefits of SCR Community pharmacy teams are reminded of the benefits of accessing the Summary Care Record before they miss the opportunity to attend free training events in their area.

The Health & Social Care Information Centre (HSCIC) has developed a series of materials highlighting the benefits of Summary Care Record (SCR) access.

55 million patients have an SCR and accessing it can help pharmacists treat patients more efficiently and effectively with less need to contact GPs, even out-of-hours. Plus, for a limited period, pharmacy staff can receive free training and a payment of £200 once the pharmacy has gone live. HSCIC and PSNC are eager to see all community pharmacies taking up the opportunity whilst the funding is available (until 31st March 2017).

The new materials created by HSCIC include: • A pharmacy case study describing how SCR access works in practise; • Storyboards giving examples of scenarios in which accessing the SCR could be beneficial; and • Factsheets highlighting key statistics, examples of when to access the SCR and the role of the Privacy Officer.

Visit the dedicated section of PSNC’s website for links to HSCIC’s materials, as well as general guidance on SCR access: psnc.org.uk/SCR

SCR training

Using SCR

Prior to SCR usage one person per site is to have attended an HSCIC or HSCIC approved face-to-face implementation briefing. These SCR briefing events are taking place across the country for a limited period.

After attending a training event, remember to begin using the SCR.

PSNC recommends that all pharmacists and pharmacy technicians take part in the nearest scheduled event before training finishes in their area. If necessary, pharmacy professionals may also apply to attend an event in a neighbouring area.

Events run for a limited period in each area, so book online before it’s too late! Details of local training events can be found at: psnc.org.uk/SCRevents

Privacy Officer training The Health & Social Care Information Centre (HSCIC) is running free webinars about the role of Privacy Officer in overseeing use of the Summary Care Record (SCR).

The webinars are being offered to support learning and share experiences. However, they are aimed at those who have some knowledge of the role, so you should only register if you have already completed local Privacy Officer training.

The online ‘WebEx’ training sessions available are: • Tuesday 2nd August 2016, 11am – 12noon • Thursday 6th October 2016, 1pm – 2pm • Thursday 8th December 2016, 2pm – 3pm If you would like to join one of these sessions, please email scrpharmacy@nhs.net for registration details. Find out more about the Privacy Officer role at: psnc.org.uk/scrpo

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Payment of the one-off £200 SCR allowance will be triggered when the contractor has submitted the SCR in Community Pharmacy Usage Agreement to HSCIC and accessed the SCR. Making use of the SCR helps show that community pharmacy needs write access.

PSNC has created an implementation checklist to help pharmacy teams get started: psnc.org.uk/SCRlist

Healthcare news in brief Reduction in antibiotic prescriptions Efforts made by NHS Improvement, Public Health England and NHS England have reduced the number of antibiotics prescribed by GPs by 2.6m (7.3%) in one year.

Digital healthcare report The policy institute Reform’s report, The future of public services: digital patients, looks at the role of wearable and app technology and the opportunities they can bring to healthcare.

Health and care integration A new report from health and care commissioners discusses how integration can meet the requirements of individuals with complex and chronic health needs.

For more information on any of these stories, please see the monthly updates available at: psnc.org.uk/hclbriefings

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Contract Factsheet: Pharmacy opening hours in 2017 Are you aware of the pharmacy opening hour requirements in the terms of service? Here we explain all you need to know for the public holidays in 2017.

PSNC’s Regulations and Support Team are often asked questions about the requirements in the terms of service relating to opening hours. We have therefore produced this quick reference guide for 2017.

Day of the week

Covered by the Regulations?

Can the pharmacy close without giving notice?

1st January 2017

Sunday

New Year’s Day 2017 (substitute day)*

2nd January 2017

Monday

Good Friday

14th April 2017

Friday

Easter Sunday

16th April 2017

Sunday

Easter Monday*

17th April 2017

Monday

Early May Bank Holiday*

1st May 2017

Monday

Spring Bank Holiday*

29th May 2017

Monday

Summer Bank Holiday*

28th August 2017

Monday

Christmas Day

25th December 2017

Monday

Boxing Day*

26th December 2017

Tuesday

7 3 3 3 3 3 3 3 3 3

7 3 3 3 3 3 3 3 3 3

Name of holiday

Date in 2017

New Year’s Day 2017

*These dates are not specifically mentioned by name but because they are official “bank holidays” they will be covered by the Regulations.

Frequently Asked Questions 1. Can I close my pharmacy on bank holidays?

Yes. Community pharmacy contractors can close their pharmacies on days which are specifically mentioned in the Regulations (namely Christmas Day, Good Friday and Easter Sunday) or a day which has been designated as a “bank holiday”, unless directed to open by NHS England.

2. What about my core contractual hours?

A pharmacy will be treated as having been open for its usual hours on that day for the purpose of counting the core contractual hours that week. Therefore the contractor can close their pharmacy on the days indicated without giving notice or making an application to change their core hours.

3. Are there exceptional circumstances when I must open on these days?

Yes. If a pharmacy contractor has been directed to open their pharmacy by NHS England.

4. Can I close my pharmacy early any other time?

Sometimes pharmacy contractors may wish to close an hour or so earlier than usual on a particular day for any reason. If the hours that the contractor wishes to close early are supplementary hours, then notice of that intention should be given at least three months in advance. If the hours are core hours, then an application is needed, and the contractor would have to be able to satisfy NHS England that there have been changes to the needs of people in the area, otherwise the application is likely to be refused.

Unless you have notified NHS England of changes to your supplementary hours at least three months before the date, or applied successfully for amendment of core hours, the contractor will not be able to close early.

5. Do I need to notify NHS England of opening intentions on Bank Holidays?

Contractors are encouraged to inform NHS England whether their premises will be open on bank holidays.

This information is of critical importance to NHS England in order that it is able to plan pharmacy provision during holiday periods.

If NHS England is not able to determine the opening hours of pharmacies with a high degree of certainty after consulting the LPC, its only option may be to issue directions to one or more pharmacies requiring them to open.

This clearly is not in the best interests of pharmacies if there are other suitable pharmacies that would have been open; so PSNC recommends that all pharmacies notify their intentions and then open as they have notified.

NHS England has published template forms which can be used for notification of opening intentions; these are available at: tinyurl.com/zwtgvrc For more information, including a comprehensive list of FAQs, please visit: psnc.org.uk/hours

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Community pharmacists reduce workload for GPs in Sheffield 1,375 hours of GPs’ time has been saved by community pharmacists taking part in a joint working pilot in Sheffield.

Evaluation highlights 95.5% of the activities completed by

1,375 hours of GPs’ time was released by community pharmacists’ work in this pilot.

pharmacists would have otherwise been dealt with by the GP.

33.5% of work undertaken by community pharmacists was reconciliation of medicines after patients were discharged from hospital.

Further data on a community pharmacy service pilot designed to develop joint working with GP practices has shown that pharmacists were able to save 1,375 hours of GPs’ time.

This joint working pilot ran between December 2014 and April 2015; however, a bid for funding under the Prime Minister’s Challenge Fund was successful, allowing roll out of the scheme across the city from October 2015, commissioned by Sheffield Clinical Commissioning Group (CCG).

The service involves community pharmacists undertaking a number of different tasks, dependent on the needs of the GP practice. These include medicines data analysis; triage (medicines related queries); long-term condition reviews (for asthma, COPD), blood pressure checks; medication reviews; actions arising from hospital To Take Out (TTO) paperwork; support around medication content of care plans; and cost effective medication changes.

89%

of patients were successfully managed by a pharmacist without the need for referral.

Read the article in full at: ow.ly/BAlT301qLgr The level of joint-working is flexible, dependent on the needs of the GP practice, with variations including a specific time agreed as to when the pharmacist would be based in the practice and domiciliary patient visits on a weekly basis.

The original evaluation had already shown that positive outcomes had been achieved, but new data (see opposite) has led the CCG to conclude that the pilot has helped to raise the profile of community pharmacy as part of the primary care team. The project has demonstrated that closer working between community pharmacists and GPs can enhance patient care as it resulted in greater understanding of each other’s perspectives.

More information on this service, including how the service was set up and the evaluation, can be found on the PSNC Services Database: psnc.org.uk/database (LPC member log-in required to view documents)

Award success for LPCs

Cycling to support pharmacists

Two LPCs had success at the Chemist + Druggist Awards held in Cardiff last month.

Former PSNC Director of Regulation and Support Steve Lutener has been made a trustee of Pharmacist Support.

Community Pharmacy Sheffield won the GP Partnership of the Year Award for the Sheffield GP and Pharmacy Joint Working Service (see above), which sees community pharmacists working closely alongside local GPs for up to two sessions each week.

In celebration of the charity’s 175-year anniversary, Steve will be taking part in a cycle ride to help Pharmacist Support raise much needed funds to help pharmacists, former pharmacists and their families and pharmacy students.

Community Pharmacy West Yorkshire also won an award, scooping the Public Health Initiative of the Year Award for their Making Time Project. The Making Time Project was developed to ensure that people with learning disabilities get the maximum benefit from services offered by local community pharmacies.

The Prudential Ride London 46 takes place on 31st July.

Anyone wishing to support Steve is asked to donate via his Just Giving webpage: justgiving.com/STEPHEN-LUTENER

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Find out more about the charity at: pharmacistsupport.org

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Supporting medicines use in care homes The new learning programme from the Centre for Pharmacy Postgraduate Education (CPPE) gives community pharmacy professionals the necessary skills to provide support to people living in care homes. to Age UK there were 426,000 elderly and disabled people living in residential care in “theAccording UK in 2014. Residents are living longer, with multiple health conditions and taking many medicines.

We have developed an e-learning programme on Care homes: supporting people, optimising medicines.

This programme aims to update your knowledge about working with care homes, the multidisciplinary teams involved in looking after care home residents, as well as the roles and responsibilities of the pharmacy team in helping residents living in care homes to get the most from their medicines.

Caroline Barraclough

We also consider legal issues, guidance and regulations surrounding medicines in care homes.

Through practice-based and interactive activities the programme supports you to use that knowledge in care homes you are working in.

Regional Manager, East Midlands

There is a need to improve services and support for care homes residents to ensure safe and effective use of medicines, to reduce waste and to ensure the whole healthcare team works together for the benefit of the resident.

The community pharmacy team can provide valuable support through medicines reviews, advising on prescriptions and training care home staff on the safe use and monitoring of medicines. The support provided by community pharmacists will be different from practice-based primary care support pharmacists.

“

To access the programme, visit: tinyurl.com/carehomesupport

Latest support from CPPE The fourth edition of the consultation skills for pharmacy practice (CSfPP) newsletter describes new work that CPPE is currently undertaking in this area, which this month includes the addition of more videos to the CSfPP assessment and published research articles relating to consultation skills in pharmacy. Find out more at: ow.ly/Z4Mz301reHF

Public health news Declaration of Competence relaunch

Be Clear on Cancer campaign

The Declaration of Competence (DoC) system has been relaunched by the Community Pharmacy Competence Group (CPCG) in a new easier to use framework.

Public Health England (PHE)’s latest Be Clear on Cancer campaign highlights the respiratory symptoms of a persistent cough and inappropriate breathlessness. The campaign runs between 14th July and 16th October 2016.

The DoC system, which is used for the national Seasonal Influenza Vaccination Advanced Service as well as many locally commissioned services, is a self-assessment tool for pharmacy professionals to assure commissioners that they are ready to provide services, and that they have the skills, knowledge and behaviours required to provide them in a high quality and competent manner.

Feedback from pharmacy professionals who had completed the previous DoC system suggested that some found the process to be time-consuming and complex. The CPCG has therefore simplified the paperwork and put more emphasis on the key DoC principles of reflection and assuring competence.

Find out more about the improvements made at: ow.ly/VaGJ301c0EX

By encouraging people with these symptoms to go to their doctor earlier, the campaign aims to improve earlier diagnosis of heart disease and lung disease, including lung cancer and COPD. PHE has produced a toolkit to support the campaign which includes resources for both patients and pharmacy staff. The free toolkits are available to order now by calling the PHE pharmacy order line on 0300 123 1019 and using the code BCOCRESPPHARMKIT. The order line is open Monday to Friday, from 8am to 6pm.

The Be Clear on Cancer series aims to improve early diagnosis of cancer by raising awareness of the signs of cancer and encouraging people to visit their GP without delay.

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The guiding principles of patient nomination Nomination is a key part of the Electronic Prescription Service (EPS) and so it is important for community pharmacy teams to understand and follow the principles of nomination to protect patient choice.

1. Explain how EPS works

2. Do not influence the patient

Ensure patients are fully informed about EPS before setting their nomination (they must “opt-in”).

Ensure all pharmacy staff are able to explain EPS and nomination to patients.

Tell patients they can change or cancel their nomination at any time, including to switch to another dispenser.

Tell patients nomination is not mandatory, so they can choose not to set a nomination if they wish.

If the patient’s GP practice has not yet gone live, do explain to the patient they will continue to receive paper prescriptions until their GP practice begins using EPS.

Do not automatically nominate patients.

Do not add nomination requests that have been gathered on paper more than six weeks previously without reconfirming with the patient first.

It is not acceptable to change a nomination for a patient without their consent, so do not adjust a patient’s nomination unless they request it.

Do not persuade or influence patient choice or provide any inducements or incentives.

Although nominations do not expire, don’t forget they cannot be changed or removed unless at the request of the patient.

The four principles of nomination

3. Update nomination details as soon as possible

To be followed by all pharmacy staff

Nominations can be set by any EPS user with a Smartcard, e.g. staff at GP practices, pharmacies or appliance contractors.

Enter nominations onto your system in a timely manner and on a regular basis (most pharmacies do this at the end of each day).

Ensure all staff know how to set, change and remove a nomination using the pharmacy system.

4. Create a Standard Operating Procedure

Whilst consent for nominations doesn't have to be in writing, make sure you have an auditable process; most EPS users do this by using paper template forms (psnc.org.uk/nomconsentforms).

Although patient nominations don’t need to be reconfirmed when a GP practice goes live, it is best practice to regularly confirm a patient’s nomination with them.

Have patient leaflets and posters available in the pharmacy to help patients understand the process better. NHS England has requested all pharmacies and GP practices display the Your prescription: your choice poster (psnc.org.uk/patientchoiceposter).

FAQs Q. Which patients are suitable for EPS? EPS is suitable for most patients, although those on regular repeats and who use the same pharmacy will see the most benefit. Why not speak to all the patients using your prescription collection service and ask them to nominate you?

Q. Where can I find out how my pharmacy is doing? The Health & Social Care Information Centre (HSCIC) and PSNC now publish the number of nominations for every pharmacy in England.

These nomination reports, plus further information about EPS nomination, are available at: psnc.org.uk/nomination

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Q. How are nomination issues dealt with? Patients or EPS users with concerns about particular nomination issues should contact their local NHS England team (psnc.org.uk/nhse). They are responsible for nomination monitoring and investigating complaints.

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.

Social value research PSNC wants to say a big thank you to all the community pharmacy teams who participated in our project to assess the social value of community pharmacy.

Findings from this work will provide a robust evidence base to use in discussions with stakeholders and in future negotiations. Nearly 1,500 pharmacy teams have submitted details of the advice they provide to patients.

The independent assessor, PricewaterhouseCoopers (PwC), is currently in the process of analysing the data received. Further information will be published on the PSNC website in due course.

Have you seen PSNC’s updated prescribing rights webpage?

The PSNC Dispensing and Supply Team is currently in the process of updating their section of the PSNC website. The updated ‘Who can prescribe what?’ page contains information on the prescribing rights for different types of prescribers.

Head over there now and see the new look page with easy to use drop-downs: psnc.org.uk/prescribing

New medicines disposal agreement NHS England recently launched a new national framework agreement for the collection and disposal of unwanted medicines from pharmacies.

Following a procurement process, five suppliers have been chosen and will be invited to "bid" for contracts in local areas when current contracts expire.

Find out more at: ow.ly/KtTy300SWKe

Updated specials prescribing guidance

The Royal Pharmaceutical Soc iety (RPS) has updated its professio nal guidance for the prescribing of specials.

The guidance is endorsed by the Royal College of GPs, the Academy of Med ical Royal Colleges and the Royal College of Nurs ing.

Find out more at: ow.ly/kC6i3 01m6h2

Pharmacy Show 2016

The Pharmacy Show, now in its 10th year, will return to the NEC, Birmingham on Sunday 25th and Monday 26th September 2016 and registration for the event is now open.

The show includes the PSNC Pharmacy Services Innovation Theatre, which will showcase a number of presentations on innovative and unique services taking place in community pharmacies across the country.

Registration for the two-day event is free and pharmacy contractors and their teams, and other healthcare and allied healthcare industry professionals are able to register for the event at: www.thepharmacyshow.co.uk/psnc

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All you need to know about: Out of pocket expenses Our Dispensing and Supply Team shows you how to identify items eligible for out of pocket expenses and explains the process of making claims.

What is an out of pocket expenses claim?

An out of pocket (OOP) expenses claim allows community pharmacy contractors to claim payment where additional expenses have been incurred in obtaining an eligible product (see chart below), and where the product is not required to be frequently supplied by the contractor.

When can I claim OOP? The products on which OOP expenses can be claimed are as follows: • Part VIIIA Category C • Readily available medicinal products outside of Part VIIIA (including ACBS) • Part IXB • Part IXC

• Part VIIIA Category A and M • All unlicensed specials and imports, including those in Part VIIIB* • Part IXA • Part IXR

* The ‘SP’ fixed fee for dispensing unlicensed specials and imports is a separate arrangement (see Part IIIA of the Drug Tariff). More information can be found on our webpage: psnc.org.uk/specials Only actual costs incurred during the process of obtaining the item for which you are making the claim can be claimed such as; postage and packaging; handling; and cost of phone calls to manufacturers or suppliers to order products. Contractors may wish to keep a log

of all OOP claims for audit purposes.

How do I endorse and submit the prescription?

To make a claim for ‘OOP’, contractors must endorse: • ‘OOP’ or ‘XP’ for paper prescriptions; • ‘XP’ for electronic prescription submissions; • Details of the claim being made (e.g. postage and packaging); and • The total amount being claimed (see example below).

Number of days’ treatment N.B. Ensure dose is stated

NHS Number:

Endorsements

10/10 OOP Postage £x.xx

Enoxaparin sodium 100mg/1ml solution for injection pre-filled syringes Quantity: 10

Prescription forms with OOP expense claims need to be separated and placed in the red separator before submission.

For more information on ‘OOP’, such as minimum thresholds and VAT, see our webpage: psnc.org.uk/oop and, for relevant FAQs, see this month’s Ask PSNC on the page opposite.

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

Rapilose OGTT solution

No

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.

Quattro multifunctional contact lens solution

No

n/a

Yes

No

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

TauroLock Hep500

No

n/a

Yes

No

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

Mucodis Mouthwash

No

n/a

Yes

No

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

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

Please note: If the prescription is an FP10CN or FP10PN (community nurse prescriber), an FP10D (dental prescriber) or an FP10MDA (instalment dispensing), please visit psnc.org.uk/prescriptionforms for more information.

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.

10 Community Pharmacy News – July 2016

Distributed for PSNC by:

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

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Ask PSNC – OOP special The PSNC Dispensing and Supply Team can provide pharmacy teams with support and advice on a range of topics related to the Drug Tariff and reimbursement. Questions asked in recent months have included: Q. What should I do if I can’t obtain a Part IXA appliance without extra charges?

A. Community pharmacy contractors will not be reimbursed for out of pocket (OOP) expenses incurred in obtaining products listed in Part IXA of the Drug Tariff.

Where a Part IXA appliance is not available from wholesalers without additional charges, we recommend contacting the manufacturer directly to find out how you can obtain the product without extra charges.

If a product appears to be unavailable without additional charges from either the manufacturer or the wholesaler, please report this to the PSNC Dispensing and Supply Team using our online form (psnc.org.uk/feedback) and we will investigate the issue.

For further information, please visit: psnc.org.uk/oop

Q. I have obtained a product from another pharmacy. This was sent by taxi – can I claim OOP expenses for this cost?

Q. Can I claim OOP expenses for unlicensed specials and imports?

A. Yes. Where, in exceptional circumstances, products need to be obtained from another pharmacy to support patient care, the expenses incurred can be claimed using the endorsement 'OOP'. This may include taxi fares or postage and packaging. For more information on 'OOP', see our webpage: psnc.org.uk/oop

A. The ‘OOP’ or ‘XP’ endorsement cannot be used on prescriptions for unlicensed specials and imports.

Contractors are however entitled to claim a fixed fee (£20 per item) for each unlicensed special or import dispensed, to cover the costs of postage, handling and delivery etc. which may be incurred when obtaining the product. The fee is paid when the prescription has been endorsed with ‘SP’ (or ‘ED’ for extemporaneously dispensing the item).

Prescriptions forms for unlicensed specials and imports should be separated from the rest of the bundle and placed in the red separator for submission.

Information on endorsing unlicensed specials and imports can be found on our webpage: psnc.org.uk/specials

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).

Experiencing supply issues?

Pharmacy teams who experience problems in obtaining medicines or appliances are reminded to feed this back to our Dispensing and Supply Team.

PSNC reports the feedback received to the Department of Health 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

Naproxen 125mg/5ml oral suspension sugar free Naproxen 125mg/5ml oral suspension has been removed from Part VIIIB of the Drug Tariff. This is because a licenced alternative, Naproxen 125mg/5ml oral suspension sugar free, is now available and has been added to Part VIIIA effective from 1st July 2016.

Changes to the Drug Tariff impact on reimbursement so it’s important to take note when amendments are made to product listings.

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

© PSNC

psnc.org.uk 11

dispensing and supply

services and commissioning

The healThcare landscape

Drug Tariff Watch Below is a quick summary of the changes due to take place from 1st August 2016.

Part VIIIA additions Category C Additions: • Aclidinium bromide 396micrograms/dose / Formoterol 11.8micrograms/dose dry powder inhaler SC (60 dose) – Duaklir Genuair • Co-danthrusate 50mg/60mg/5ml oral suspension sugar free (200ml) – A A H Pharmaceuticals Ltd • Diazepam 2mg/5ml oral suspension (100ml) – Sandoz Ltd • Diltiazem 90mg modified-release tablets (56) – Tildiem Retard • Diltiazem 120mg modified-release tablets (56) – Tildiem Retard • Diltiazem 360mg modified-release capsules (28) – Viazem XL • *Erythromycin ethyl succinate 500mg/5ml oral suspension sugar free R (140ml) – Erythroped Forte • Estradiol 1mg tablets (84) – Elleste Solo • Estradiol 2mg tablets (84) – Elleste Solo • Ethinylestradiol 20microgram / Drospirenone 3mg tablets (84) – Eloine • Glycopyrronium bromide 55microgram inhalation powder capsules with device SC (30) – Seebri Breezhaler • Insulin detemir 100units/ml solution for injection 3ml cartridges (5) – Levemir Penfill • Linaclotide 290microgram capsules SC (28) – Constella • Lithium citrate 1.018g/5ml oral solution (150ml) – Li-Liquid • Lithium citrate 509mg/5ml oral solution (150ml) – Li-Liquid

• Metronidazole 0.75% vaginal gel SC (40g) – Zidoval • Sacubitril 24mg / Valsartan 26mg tablets (28) – Entresto • Sacubitril 49mg / Valsartan 51mg tablets (56) – Entresto • Sacubitril 97mg / Valsartan 103mg tablets (56) – Entresto • Sodium valproate 300mg modifiedrelease capsules SC (100) – Episenta • Sodium valproate 500mg modifiedrelease tablets (100) – Epilim Chrono • Theophylline 200mg modified-release tablets (56) – Uniphyllin Continus • Theophylline 300mg modified-release tablets (56) – Uniphyllin Continus • Tinzaparin sodium 10,000units/0.5ml solution for injection pre-filled syringes (10) – Innohep • Tinzaparin sodium 12,000units/0.6ml solution for injection pre-filled syringes (10) – Innohep • Tinzaparin sodium 14,000units/0.7ml solution for injection pre-filled syringes (10) – Innohep • Tinzaparin sodium 16,000units/0.8ml solution for injection pre-filled syringes (10) – Innohep • Tinzaparin sodium 18,000units/0.9ml solution for injection pre-filled syringes (10) – Innohep • Tinzaparin sodium 2,500units/0.25ml solution for injection pre-filled syringes (10) – LEO Pharma • Tinzaparin sodium 20,000units/2ml solution for injection vials (10) – Innohep

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

• Tinzaparin sodium 3,500units/0.35ml solution for injection pre-filled syringes (10) – LEO Pharma • Tinzaparin sodium 4,500units/0.45ml solution for injection pre-filled syringes (10) – LEO Pharma • Tinzaparin sodium 40,000units/2ml solution for injection vials SC (1) – Innohep • Tinzaparin sodium 8,000units/0.4ml solution for injection pre-filled syringes (10) – LEO Pharma • Triptorelin acetate 11.25mg powder and solvent for suspension for injection vials SC (1) – Decapeptyl SR • Triptorelin acetate 3mg powder and solvent for suspension for injection vials SC (1) – Decapeptyl SR • Triptorelin embonate 22.5mg powder and solvent for suspension for injection vials SC (1) – Decapeptyl SR Part VIIIA amendments • White soft paraffin 50% / Liquid paraffin 50% ointment (500g) is changing to Category C – Alliance Healthcare (Distribution) Ltd Part VIIIA deletions • Estradiol valerate 2mg / Norethisterone 700microgram tablets (84) – Climesse • Sulfinpyrazone 100mg tablets (84) – AMCo • Sulfinpyrazone 200mg tablets (84) – AMCo

Part IX deletions Product

Type and size

Product code

Nélaton Catheter ('ordinary' cylindrical Catheter) Rusch Soft Rubber Jaques

8-14 Gauge (Ch), pack of 1

DT5143-1

Nélaton Catheter (‘ordinary’ cylindrical Catheter) Single use Wellspect HealthCare LoFric (Tieman Tip) Wellspect HealthCare LoFric Primo with integrated water pocket (Tieman Tip)

10-18 Gauge (Ch), pack of 25 961000-961800 10-18 Gauge (Ch), pack of 30 9661000-9661800

kliniderm Foam Silicone Heel Border

12.5cm x 20cm

n/a

Permeable Non-Woven Synthetic Adhesive Tape BP 1988 -Transpore

1.25 cm x 5m

n/a

SpiroTect HME SystemSpiroTect Antibacterial Cassette Duo SpiroTect Baseplate Duo Oval SpiroTect Baseplate Duo Round

Pack of 30 Pack of 20 Pack of 20

PTC1007 PTW600 PTW601

Medicareplus International Ltd Medi Lifteez non sting medical adhesive remover

75ml aerosol

60314

Medicareplus International Ltd Medi Gelsorb Sachets

30 100

60369 61052

Medicareplus International Ltd Medi Derma-S Non Sting Medical Barrier Film Aerosol

75ml

60291

ConvaTec Ltd Consecura Low Profile Stomahesive Locking Flange

100m, pack of 5

S594LP

Detection Strips, Blood for Determination of International Normalised Ratio (INR) ProTime 3 cuvettes

6 25

49006000 49005000