June 2016 CPN

CPN

Community Pharmacy News – June 2016

Community pharmacy: beyond the consultation As the community pharmacy consultation comes to an end, PSNC briefs contractors and MPs on the latest developments

Smartcard management | Aspiring pharmacy leaders | Preventing prescription returns

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Contractor update on funding negotiations The Chair of PSNC’s Funding and Contract Subcommittee issues a statement preparing contractors for what may lie ahead in the remainder of 2016/17.

Since the publication of the Government’s 17th December letter, PSNC has been working, both with the other national pharmacy organisations and in discussions with the Department of Health and NHS England, to convince policy makers of the need to make better use of community pharmacy. This work included putting a counter proposal to the NHS, setting out how community pharmacy could be used to make the £170 million savings while also improving care for patients.

The full PSNC Committee met last month to review the outcome of our discussions and agree next steps. Peter Cattee, Chair of PSNC’s Funding and Contract Subcommittee and CEO of PCT Healthcare, made the following statement: “In our meetings with the Department of Health and NHS England it has become clear that they have little interest in commissioning additional national community pharmacy services or in our constructive proposals to make better use of community pharmacy to help the NHS to make savings. The Government appear unshaken in their determination to remove a sum of £170m from community pharmacy funding this year, and to do so via reductions in fees and allowances. As a committee of contractors PSNC is

extremely concerned about this and we continue to work with the other pharmacy organisations seeking to persuade policy makers of the value of community pharmacy and the dangers in implementing a funding reduction of this nature.

In addition to this we realise there was a major over delivery of margin in 2015/16, and the Drug Tariff changes also announced begin a programme by the Department of Health to recover that margin from community pharmacy [see box below]. Combined with the determination to remove £170m from community pharmacy in October, this financial year will be very difficult for the sector. We strongly advise all contractors to make whatever provisions they can for the funding reductions. Earnings from the first half of this financial year will be adversely affected by the Category M price reductions, but will still be significantly above those expected for the second half.

We will continue working with our colleague organisations to find new ways to convince policy makers of the value of our current services.

The Committee are very pessimistic about the outcome of the consultation on community pharmacy’s future. We are also very concerned that the NHS and Government have not been clear about their aims, for example, on hub and spoke dispensing and the community pharmacy access scheme. We will continue our work seeking the best possible outcome for contractors and will continue working with our colleague organisations to try to find new ways to convince policy makers at both a national and local level of the value of our current services, and the opportunities for the NHS to make better use of community pharmacy.”

Category M price reduction The Department of Health (DH) has announced reductions to Category M prices which will apply to prescriptions between June and September 2016.

The reduction is intended to reclaim excess margin that DH believes was delivered to contractors in 2015/16 above the agreed allowed £800m. PSNC accepts margin levels were high during the period, but has not agreed to the reduction.

PSNC responds to 17th December letter PSNC has published its response to the Government’s letter from 17th December 2015 entitled “Community pharmacy in 2016/17 and beyond”.

underpinning the letter have not been based on analysis of the likely consequences or costs to the public as patients, members of our communities, or taxpayers.

Within the response, PSNC makes clear that the proposals contained in the letter represent a major threat to the future availability of accessible healthcare, support and advice from community pharmacies. We are concerned that this threat has not been made clear to the public, and that the policies

The response also highlights that whilst PSNC is willing and keen to work collaboratively to achieve change, proper, informed negotiations have been made impossible by the lack of clarity, detail or analysis of the issues raised. To read PSNC’s response to the letter in full, please visit: ow.ly/bmeQ300xfmi

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MPs briefed as pharmacy consultation ends PSNC and the other national pharmacy organisations held a briefing event for MPs in the House of Commons to highlight the value of community pharmacy and the potential damage to patient care if Government plans go ahead.

As the consultation on changes to community pharmacy in 2016/17 and beyond came to a close on Tuesday 24th May 2016, community pharmacy representatives were in Westminster briefing MPs and their teams about community pharmacy services and presenting a patient petition to Downing Street.

Around 50 MPs and a further 10 Parliamentary researchers attended a Pharmacy health checks and speed briefing event in Westminster to hear about the vital work that community pharmacies do for their patients and concerns about the proposed funding cut for the sector. MPs heard how the plans are putting some pharmacy services at risk and the impact that could have on patients.

The drop-in speed briefing session, hosted by Sir Kevin Barron MP and Michael Dugher MP, gave Parliamentarians and their staff the opportunity to find out what is happening in pharmacy, as well as the chance to receive a health check from a front-line pharmacist.

Pharmacists and national representatives were on hand to brief MPs and their staff on the important contribution which pharmacies make to their local communities, and to discuss how they could do more to support the overstretched NHS. Also on 24th May, pharmacy teams and patients took their concerns to Downing Street, presenting the Prime Minister with a public petition in support of local pharmacies across the country. The petition has so far been signed by more than 1.8 million people who value their local pharmacies and want to save them from the plans to significantly cut their funding.

What’s happening now?

PSNC is continuing to make the case for community pharmacy by developing relationships with key influential MPs. Following the Westminster event, we sent these MPs an infographic style briefing detailing alternative ways that community pharmacy could save the NHS money, the current funding situation and the potential for pharmacy teams to do more.

LPCs are also continuing to work hard on behalf of their contractors by securing a significant amount of local press coverage and supporting the campaign for community pharmacy’s presence on social media.

PSNC responds to ‘Hub and Spoke’ consultation PSNC has published its response to the consultation on ‘hub and spoke’ dispensing.

Following confirmation from the Department of Health that the draft regulations, if implemented, would permit hub and spoke dispensing between “relevant clinical entities” which it is proposed would include hospitals and surgeries, PSNC became concerned that this could potentially bypass registered pharmacy premises.

While changes to the Medicines Act 1968 or Human Medicines Regulations 2012 do not change NHS provisions (and doctors have always been able to supply medicines to their patients), these changes, if implemented, would provide an entirely new legislative framework for the retail supply of medicines on which there has been no consultation.

Read PSNC’s response in full at: ow.ly/VzPt300uEqz

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Gathering evidence of community pharmacy’s social value An independent assessment of the social value of community pharmacy is being carried out on behalf of PSNC. Data has been pouring in from across England and analysis is now underway.

Community pharmacy teams across England have been getting involved in a PSNC project to assess the social value of community pharmacy.

PSNC has appointed PricewaterhouseCoopers (PwC) to carry out the independent assessment to provide a robust evidence base to use in discussions with stakeholders and in future negotiations.

Pharmacy teams have been taking part in: 1. A survey on the number of additional activities that they have provided in relation to dispensing prescriptions, for example, delivery of medicines and provision of monitored dosage systems; and 2. Data collection of how many times in a week advice on self-care or on the use of over-the-counter (OTC) medicines has been provided.

NHS England to recommission flu vaccination service NHS England has announced it will recommission the Community Pharmacy Seasonal Influenza Vaccination programme in 2016/17. The terms and fees for the recommissioned service will remain the same as in 2015/16.

Further guidance will be issued to community pharmacy contractors once legislation and associated documents have been updated to take into account the recommissioning of this service. These will be added to PSNC’s dedicated pharmacy flu vaccination service hub: psnc.org.uk/flu

Automated dispensing research PSNC has published a paper examining the research around dispensing errors and automated dispensing in pharmacy.

The paper was written in response to Chief Pharmaceutical Officer, Dr Keith Ridge, commenting that dispensing errors in community pharmacy occur in around 3% of all items dispensed, whilst large-scale automated dispensing would reduce the error rate to 0.00001%.

As CPN went to press, more than 800 pharmacy teams had responded to the first activity and PwC were in the process of analysing the data received. Further information will be published on the PSNC website in due course.

Healthcare news in brief NHS sets out local NHS funding NHS England has announced that it will invest around £112m in 2016/17 in the vanguard projects around the country. It will also help local NHS and care leaders develop their Sustainability and Transformation Plans, to demonstrate how they will implement the NHS Five Year Forward View in their locality.

New model yields positive results A few months after the Primary Care Home model pilot started, several test sites have reported seeing a positive impact on care and services. Many of the test sites are focussing on common themes, including an emphasis on co-location of community staff within GP services and developing joined-up IT systems to better share data and resources.

Quality checks for NHS services NHS England has announced it will employ people with a learning disability to help improve NHS services ranging from dentistry to acute care. The NHS Quality Checkers programme will ask them to inspect local NHS services and give feedback on how they can better meet their needs.

GP collaboration case studies

PSNC welcomes a recent clarification of these comments from Dr Ridge in which further detail is given about where he acquired his figures and he acknowledges that it was not appropriate to draw a direct comparison between the two.

The Royal College of General Practitioners has published a report, The Future of GP Collaborative Working, which showcases innovative schemes designed to improve the integration of patient care. It highlights seven case studies covering a wide range of GP-led services across the UK.

Read PSNC’s paper and Dr Ridge’s subsequent clarification at: ow.ly/DXS63008qxX

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

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Does your team know how to manage Smartcards?

Smartcards are used by community pharmacy team members to access NHS IT systems such as EPS and the Summary Care Record (SCR).

Smartcards provide security measures to protect patient data. The controlled access these provide ensures only those people who are directly involved in patient care, and have a legitimate reason to access patient medical information can do so. Each pharmacy team member whose role requires a Smartcard should have one. Smartcards should not be shared.

Smartcard management and support There is a system in place to support pharmacy teams with the maintenance of their Smartcards.

The Care Identity Service (CIS) is the online portal which can be used to carry out Smartcard management activities by a variety of people. Pharmacy staff without admin or Sponsor rights can use it to renew their own Smartcards or update their contact/ passcode information (see below).

Administrators, Sponsors and Registration Authority staff provide support for pharmacy users. They also use CIS to manage Smartcards: Description

CIS rights

Local Smartcard Administrators (LSAs)

PSNC recommends that each pharmacy premises has someone with the LSA rights so that they can support staff. Read more at: psnc.org.uk/lsa

LSAs can support pharmacy team members with renewing Smartcard certificates and unlocking Smartcards.

Sponsors

Advanced Smartcard users or support staff may request Sponsor powers. Read more at: psnc.org.uk/scsponsor

Sponsors have the LSA rights plus a few additional ones, e.g. they are able to help with requests for a new Smartcard, or a change to a staff member’s roles.

Registration Authority (RA)

The local RA manage local Smartcard issues: e.g. assigning roles and sites onto new ones. Contact details are available from psnc.org.uk/ra (but if RA issues need escalating, please visit: psnc.org.uk/scescalation)

The RA staff have all of the LSA and Sponsor rights plus many additional ones such as authorising applications and requests and applying changes to Smartcards.

More information is available in our ‘Quick reference guide’ over the page.

Using the Care Identity Service (CIS) Ensure you can access CIS: it can be selected from the NHS Spine Portal: https://portal.national.ncrs.nhs.uk/portal/dt (Smartcard required) Requirements for access: an N3 connection and a Smartcard are necessary.

Where you cannot access the NHS Spine portal, this may relate to software/Java settings and therefore your IT helpdesk can be contacted (e.g. your IT department if you have one, and/or your system supplier) to ensure your system is setup to run CIS as well as all of the other programs the pharmacy will need. Read more at: psnc.org.uk/wes

How to access CIS

Training: The Health & Social Care Information Centre (HSCIC) has published a screen-by-screen guide to explain how it can be used: tinyurl.com/cisguide Improving CIS: pharmacy staff who would like to make suggestions for CIS improvement can contact HSCIC: tinyurl.com/cisimprove

Why use CIS? Using CIS will enable pharmacy teams to resolve many of the common Smartcard issues more speedily because there may be no need to contact the RA. Additionally, the RA will be able to place more focus on critical tasks such as issuing new Smartcards.

Locating 'Manage Smartcard' section

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Managing your Smartcard: Quick reference guide This guide explains how you can self-manage your Smartcard.

Obtaining or replacing a Smartcard: Contact your Registration Authority (RA) to obtain a new Smartcard. A face-to-face meeting and identity check will be required. If a Smartcard is lost or stolen contact your RA immediately. Read more at: psnc.org.uk/scobtain Changing your Smartcard roles: Smartcard ‘roles’ control what a pharmacy team member can do and what they can see. Appropriate roles are applied by an RA or Sponsor and are dependent upon the tasks the pharmacy team member needs to perform. Read more at: psnc.org.uk/scrole Changing your Smartcard sites: A pharmacy staff member who regularly works at four local pharmacies, will have had those four premises added by the RA to their Smartcard. Locums who work at five or more sites at short notice may have the multi-site ‘FFFFF’ code for use when necessary, but should also have their regular premises added to their Smartcard. Read more at: psnc.org.uk/scmultisite

Unlocking your Smartcard: If a Smartcard passcode is accidentally entered incorrectly three times, the smartcard can become locked. Where two readers are present, Local Smartcard Administrators (LSAs) or Sponsors can use the Care Identity Service (CIS) to unlock a Smartcard. Alternatively, the RA may support the unlocking. Read more at: psnc.org.uk/scunlock Renewing your Smartcard: Without action Smartcards expire after two years, for Information Governance (IG) purposes. When the expiry date approaches you will be prompted at each login to renew your own card using the CIS in good time.

LSAs/Sponsors/RAs may also assist where needed. You can only self-renew twice – the third time requires an RA, and another identity check. Read more at: psnc.org.uk/screnew Smartcard expiry: If a Smartcard is not renewed within the two-year period (see above), it will expire and be permanently locked. A face-to-face meeting with the RA is required to make the Smartcard usable again. Read more at: psnc.org.uk/scexpiry Passcode / contact detail updating: The process involves logging into ‘My Profile’ of the CIS to enter-in the information. Read more at: psnc.org.uk/scupdate

Change site or cancel: If a member of staff is leaving, the pharmacist or pharmacy manager should advise the RA who will make the necessary changes. Leavers with no intention of working at another pharmacy will have their Smartcard revoked. Read more at: psnc.org.uk/sccancel

Smartcard and CIS top tips • Check you are aware of how to contact your local RA in case you need to in an emergency: psnc.org.uk/ra • Regular locums should have regular premises added to their Smartcard rather than relying only on the generic locum FFFFF code.

• Do not let your Smartcard reach expiry: Renew it yourself using CIS when you are prompted.

• Test your CIS access using the link above: Add it as a favourite and desktop shortcut.

• Smartcard readers: At least one terminal could be setup with two Smartcard readers to make the best use of the CIS. If you need extra Smartcard readers speak to your IT system supplier.

• Ensure someone on the premises requests LSA rights: as described above.

Find out more at: psnc.org.uk/sc and http://systems.hscic.gov.uk/rasmartcards

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On the path towards leadership PSNC’s leadership development programme for LPCs is now well underway and here we find out what two aspiring leaders have been up to so far.

Claire Dickens

Lauren Seamons

Manchester LPC’s Claire Dickens holds a rare position in the pharmacy world – a non-pharmacist LPC Chief Officer. And whilst Claire has been with the LPC for five years now, there has been a steep learning curve and PSNC’s Leadership Academy seemed like the next logical step.

Despite gaining a considerable amount of experience during her time at Norfolk LPC, Lauren Seamons had not had any formal leadership training until she joined PSNC’s Leadership Academy.

As a former member of a Strategic Health Authority (SHA), Claire knew her strength lay in her planning skills, but looked to the Academy programme to support her in acquiring a wider skillset.

Claire has found her fellow aspiring leaders to be a good support network who have helped her develop new ways of thinking.

Lauren found the practical, problem-solving style of the programme to be especially useful as it was easier to apply it to her role. She also appreciated that course leader Rachel was responsive to the needs of the group, encouraging the aspiring leaders to interact with the different elements of the training along the way.

The coaching sessions with course leader Rachel Harrison have given Claire more confidence and helped her to recognise what she has achieved. The one-to-one nature provided an environment that was reassuring, allowing Claire to open up and providing motivation for the future.

She commented that working from a home office can sometimes feel isolated, so Lauren’s one-to-one coaching was particularly beneficial. It helped changed her mindset by putting things into perspective and keeping her focussed on the positive, giving Lauren the confidence she needed to deliver a winning pitch on recommissioning Norfolk’s involvement in the Healthy Living Pharmacy (HLP) programme.

Claire has also shared some of the materials from the programme with her fellow LPC officers and is looking forward to embracing collaboration with the other Greater Manchester LPCs as part of their work on the DevoManc project.

Lauren now recognises that she needs to delegate to others more, as well as to know when to ask for help. Also, the LPC has begun to change its communication style by increasing use of social media and trialling staff meetings via Skype.

2016/17 Flu Plan published Details have been published outlining the influenza vaccination programme for winter 2016/17. The plan – published by the Department of Health, NHS England and Public Health England – sets out a coordinated and evidence-based approach to planning for, and responding to, the demands of influenza across England.

The only change this year is the addition of the offer of the flu vaccination to children of school year 3. Also, as in previous years, there is an expectation for all frontline health workers to be offered flu vaccination by their employer.

A supporting letter for healthcare professionals, issued in conjunction with the Flu Plan, has also been published and both are available from: ow.ly/nMGy300Bzec

Healthcare news in brief People’s involvement in their care The Care Quality Commission (CQC) has published Better care in my hands, which examines patients’ involvement in their own care. The report provides examples of good practice, as identified by CQC inspectors.

Public health report QualityWatch has published a report on public health outcomes, discussing the impact of recent financial and legislative developments. It includes quantitative data and interviews with public health professionals.

Place-based services of care Public Health England has produced a web feature on the place-based approach to care, providing an illustration of how health and care is integrated within a local community and explaining the background to the approach.

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

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

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Evolving your consultation skills The Centre for Pharmacy Postgraduate Education (CPPE) has a wealth of guidance and resources available to support community pharmacy teams in developing their consultation skills.

Every time you speak with a patient you have an opportunity to make a difference, whether that is “helping them with a healthcare issue or supporting them with their medicines. CPPE are committed to supporting the pharmacy profession in developing the patient-centred consultation skills to move practice from counselling to true consultation.

The www.consultationskillsforpharmacy.com programme provides a six-step learning and development pathway.

The portfolio of learning supports a range of experience and skills – from core skills learning through to more advanced programmes such as Consulting with children and young people. Good communication skills are important for the whole pharmacy team and you may have seen our new consultation skills training resource which was sent to every pharmacy in England earlier in 2016.

Lesley Grimes

Our most recent e-learning programme – Consultation skills: what good practice looks like – takes a video wall approach showcasing consultation skills experts demonstrating some of the skills needed to meet the national practice standards for pharmacy consultations. The standards in the Consultation Skills for Pharmacy Practice (CSfPP) pathway (step 2) outline the key skills and behaviours expected of all pharmacy professionals in a patient-facing role.

Lead Pharmacist, Learning Development

And if that wasn’t enough, we also run a number of events, including Confidence in consultation skills and Consulting with older people.

All this is designed to support you in successfully completing the CSfPP e-assessment.

Take a look at the www.consultationskillsforpharmacy.com programme to reflect on your practice and find out how you can advance your consultation skills today.

Care homes e-learning programme CPPE has released its latest programme for pharmacy professionals, Care homes: supporting people, optimising medicines.

The e-learning programme serves as an update for those who are looking to refresh their knowledge, but can also support those who are looking to develop new skills in this area.

Find out more about this course at: ow.ly/nueA3008xbo

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Healthcare news in brief New series of leaflet guides

Improving carer wellbeing

The scale of the LTCs challenge

Public Health England has published a series of leaflets explaining important issues for women who have had a positive screening result for hepatitis B, syphilis or HIV. The leaflets can be used by healthcare professionals to refer to when discussing results and follow-on care.

As part of its ongoing Commitment to Carers, NHS England has published a carers toolkit, which is designed to help health and social care organisations to work together in identifying, assessing and supporting the wellbeing of carers and their families.

NHS England has updated its long term conditions (LTC) infographic, highlighting the prevalence of LTCs and their effects on the healthcare system in England. The infographic also outlines what is already being done to drive improvements.

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

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 8 Community Pharmacy News – June 2016

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NHS stationery for community pharmacy obtainable from the PCSE portal This guide highlights which pharmacy resources are now managed by Primary Care Support England (PCSE).

Resource

Description

HC1 Application Form

Low Income Scheme application form /Claim for Help with Health Costs.

HC1(LP) Application Form

Low Income Scheme Application Form (Large Print).

HC1(SC) Application Form

Low Income Scheme application form Special Circumstances.

HC12 Guide

A quick guide to help with health costs (including dental, charges and optical voucher values).

HC12LP Guide

A quick guide to help with health costs including charges and optical voucher values (Large Print).

HC20 Guide

Paying NHS Prescription Charges.

FP1010 Book

Peak Flow Meter Charts.

FP92A Pad

Application for prescription charge exemption (medical).

FP95 Form

Application for certificate of prepayment of prescription charges.

IPD Pack

Insulin Passport for Diabetics information booklet.

Lithium Books Pack

Lithium Record Books – in addition to those in the packs.

Lithium Alert Card Pack

Lithium Alert Card (Red) – in addition to those in the packs.

Lithium Info Book Pack

Lithium Info Book – in addition to those in packs.

Lithium Pack

Collation of Info Book, Record Book and Alert Card.

MTB Book

Methotrexate Treatment Booklets.

OAT Info Book

Information Book for oral anticoagulant patients – in addition to those in packs.

OAT Alert Card

OAT Alert Card – card only.

OAT Book

OAT Record Booklet – in addition to those in packs.

OAT PACK

OATPACK collation of all 5 OAT products.

PPAEXENV (RE26) Envelope

PPA Return Exemption manilla Envelope.

RD1 Form

Patient Agreement /Consent Form (for sharing information on repeat dispensing).

RD2 Leaflet

Repeat Dispensing Patient Leaflet.

STC Card

Steroid Treatment Card.

FP57 Form

Receipt and Refund form for patients claiming reimbursement for prescription charges.

Note: 1 unit is 100 pads of 10.

FP10CDF Form

Controlled Drug Requisition form for use where the Controlled Drugs will be ordered from a community pharmacy/another practice. Requisitions not received on the new mandatory form after 30th November 2015 cannot be processed by the Pricing Authority, as they are not legally valid.

The new mandatory form can also be obtained online from the Pricing Authority’s website. They can be downloaded, completed online, printed and signed in wet ink. Find out more at: psnc.org.uk/cd

FP10DT Token

Electronic Prescription Service (EPS) Release 2 Dispensing Token.

Drug Tariff

Copies of the Drug Tariff are sent out every month to all pharmacy contractors in England.

Some pharmacy teams find it useful to use the online version which can be accessed from the Pricing Authority’s website. We have created a shortlink for quick access: psnc.org.uk/dt

Useful links: • The portal can be accessed via the PCSE website: pcse.england.nhs.uk/pharmacies • A step-by-step guide to ordering supplies can also be found on the PCSE website: pcse.england.nhs.uk/howtoorder - all supplies orders will be delivered by CitySprint, operating on planned daily routes on a weekly schedule.

• For further help or information, please visit their FAQ page: pcse.england.nhs.uk/help • Alternatively, you can contact PCSE by emailing PCSE.enquiries@nhs.net or via their website: pcse.england.nhs.uk/contact • If your enquiry is urgent, you can telephone the PCSE customer service centre on 0333 014 2884.

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How to avoid prescription returns PSNC’s Dispensing and Supply Team explains how community pharmacy teams can avoid prescriptions being returned for clarification.

Approximately 0.16% of prescriptions are returned by the Pricing Authority to pharmacy teams each month for clarification. The majority of these prescriptions are returned because of insufficient or unclear endorsements. To try and help reduce the number of returned items, we have compiled a list of common issues for pharmacy staff to be aware of (Please Note: this list is not exhaustive).

Issue

Examples of the issue

How to avoid them

A branded product is marketed by multiple suppliers

Dianette tablets are manufactured by Bayer Plc but are supplied to Mylan under third party livery. When a prescriber issues a branded prescription for Dianette tablets, a pharmacist can dispense either the Bayer or Mylan product.

Endorse the name of the supplier as per the packaging. Go to our page psnc.org.uk/returns for a list of products known to be affected by this issue.

Please note: If the prescription is resubmitted without the required endorsement, reimbursement will be made based on the branded product with the lowest price (as per Part II Clause 7C of the Drug Tariff).

Generic prescription for inhalers which include a trademarked name e.g.

Accuhaler or Easibreathe

• Fluticasone propionate 100micrograms/dose dry powder Accuhaler • Beclometasone 100micrograms/dose breath actuated Easi-Breathe inhaler

The pharmacy should dispense the proprietary product which meets this description and endorse the prescription accordingly.

No pharmaceutical form listed on the prescription

• Paracetamol 120mg/5ml sugar-free – this could be requesting either oral solution or suspension • Metronidazole 200mg PO – this could be requesting either tablets or suspension

Speak to the prescriber to confirm the form to be supplied and endorse the prescription accordingly using the “PC” endorsement.

Please note: If a Schedule 2 or 3 Controlled Drug prescription item has no form, this must be returned to the prescriber for amendment.

Total quantity not stated but clear from dosage instructions

A prescription which states ‘Take 1 tablet TDS for Endorse the total quantity dispensed. one week’ but does not include a total quantity Please note: If a Schedule 2 or 3 Controlled Drug prescription item has no total quantity stated, this must be returned to the prescriber for amendment.

Endorsement of non-Part VIIIA generic products

A prescription calls for Diltiazem 120mg modified-release capsules and Adizem was dispensed against this; the endorsement will need to specify whether Adizem-SR or AdizemXL capsules are being dispensed as both meet this generic description.

Endorse the following information: • pack size used to dispense from; • brand name or the name of the manufacturer or supplier from whom the product was purchased; • if the product is less common, the purchase price before discount (ex VAT).

Dypiridamole 200mg/5ml oral suspension deleted from Part VIIIB

Have you seen our updated external resources webpage?

Dypiridamole 200mg/5ml oral suspension has been removed from Part VIIIB of the Drug Tariff. This is because a licenced alternative, Dypiridamole 200mg/5ml oral suspension sugar free, is now available and has been added to Part VIIIA effective from 1st June 2016.

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

The PSNC Dispensing and Supply Team is currently in the process of updating their section of the PSNC website.

The updated ‘Where to obtain external resources’ page outlines how to source commonly required resources for community pharmacy teams.

Head over there now: psnc.org.uk/external-resources Also, a list of NHS stationery for community pharmacy obtainable from the Primary Care Support England (PCSE) portal is on page 9.

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Ask PSNC 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. I heard new prescription charge exemption checks are coming in soon what do I need to do?

A. From 1st July 2016, the Terms of Service will require community pharmacy teams to inform patients claiming exemption from prescription charges without presenting any evidence of entitlement about the exemption checks and action on inappropriate claims that the NHS takes.

Look out for more information on the PSNC website: psnc.org.uk/exemption

Q. I have received a prescription for two items, one is a tablet and the other an eye drop but the prescriber has not written the quantity on the prescription. However, there are directions on the prescription, can I use these to calculate what quantity to dispense?

Q. When resubmitting returned prescriptions, how do I record them on my FP34c and where in my bundle should they be placed?

A. For the tablets, you can calculate the exact quantity using the directions, e.g. take one tablet twice a day for a month = 84, and endorse accordingly. You will be paid based on your endorsement.

For the eye drops, you will have to use your professional judgement to decide how many bottles would be appropriate to meet the requirement. Again, reimbursement would be based on your endorsement.

N.B. a month's supply is taken as 28 days unless indicated otherwise.

A. The number of returned forms and items being resubmitted should be declared with the current month’s figures, in the relevant boxes in Part 1 of the FP34c Submission Document. When resubmitting in the next month’s prescription bundle, these returned forms should be sorted at the top of the ‘exempt’ or ‘charge paid’ group as appropriate.

Please remember only the number of items returned for clarification should be declared on the submission document. This is because payment will already have been received for any other items on the returned forms.

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

Canespro fungal nail treatment set

No

n/a

Yes

No

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

SteriSets Newcastle Urine Collection Pack

No

n/a

Yes

No

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

Bladder irrigation syringe 100ml

Yes

n/a

Yes

Yes

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

Lemon Glycerin swabsticks 75 sachet

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.

psnc.org.uk 11

Dispensing anD supply

services anD commissioning

the healthcare lanDscape

Drug Tariff Watch The Preface lists additions, deletions and alterations to the Drug Tariff.

Below is a quick summary of the changes due to take place from 1st July 2016.

Part VIIIA additions Category A additions: • Desmopressin 360micrograms/ml oral solution SC (15ml) • Dexamethasone 2mg soluble tablets sugar free (50) • Dexamethasone 4mg soluble tablets sugar free (50) • Dexamethasone 8mg soluble tablets sugar free (50) Category C Additions: • Colecalciferol 1,000unit / Calcium carbonate 2.5g chewable tablets (28) – Calci-D • Colecalciferol 1,000unit tablets (28) – Stexerol-D3 • Colecalciferol 25,000unit tablets (12) – Stexerol-D3 • Edoxaban 15mg tablets (10) – Lixiana • Edoxaban 30mg tablets (28) – Lixiana • Edoxaban 60mg tablets (28) – Lixiana • *Fludroxycortide 4micrograms/square cm tape 7.5cm SC (20) – Haelan • Fluticasone furoate 184micrograms/dose / Vilanterol 22micrograms/dose dry powder inhaler SC (30 dose) – Relvar Ellipta • Fluticasone furoate 92micrograms/dose / Vilanterol 22micrograms/dose dry powder inhaler SC (30 dose) – Relvar Ellipta • Fluticasone propionate 50micrograms/dose / Azelastine 137micrograms/dose nasal spray SC (120 dose) – Dymista • Lidocaine 4% cream SC (30g) – LMX 4 • Lisdexamfetamine 20mg capsules (28) – Elvanse • Lisdexamfetamine 40mg capsules (28) – Elvanse

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

• Lisdexamfetamine 60mg capsules (28) – Elvanse • *Selegiline 10mg tablets (100) – Eldepryl • *Selegiline 5mg tablets (100) – Eldepryl • Ticagrelor 60mg tablets (56) – Brilique • Umeclidinium bromide 65micrograms/dose / Vilanterol 22micrograms/dose dry powder inhaler SC (30 dose) – Anoro Ellipta • Vortioxetine 10mg tablets (28) – Brintellix • Vortioxetine 20mg tablets (28) – Brintellix • Vortioxetine 5mg tablets (28) – Brintellix Part VIIIA amendments - additions to Category A • Lisinopril 5mg/5ml oral solution sugar free (150ml) • Zonisamide 100mg capsules (56) • Zonisamide 25mg capsules (14) • Zonisamide 50mg capsules (56)

Part VIIIA deletions • Bilastine 20mg tablets (30) Category C – Ilaxten • Cimetidine 200mg tablets (60) Category A • Erythromycin ethyl succinate 500mg/5ml oral suspension sugar free R (100ml) – Category A • *Fludroxycortide 4micrograms/square cm tape 7.5cm SC (200) Category C – Haelan • Hydroxyzine 10mg/5ml oral solution (200ml) Category C – Ucerax • *Selegiline 10mg tablets (30) – Category A • *Selegiline 5mg tablets (60) – Category A

Part IX deletions Product

Type and size

Product code

Nélaton Catheter (‘ordinary’ cylindrical Catheter) Single use Wellspect HealthCare LoFric Plus (non PVC)

Male 10-18 Gauge (Ch) Female 8-18 Gauge (Ch) Female 15cm 10-16 Gauge (Ch) Paediatric 30cm 8-10 Gauge (Ch)

904000-904800 943800-944800 984000-984600 993800-994000

Bioclusive dressing

10.2cm x 12.7cm

n/a

Exufiber dressing

Rectangular 2cm x 50cm

n/a

Unilet General Purpose Superlite lancets (Owen Mumford Ltd)

0.66mm/23 gauge 100 & 200

n/a

Urethral Rochester Medical Ltd FemSoft Insert for female stress incontinence Standard Length (35mm) Long Length (45mm)

Size 1 (16CH) Size 2 (18CH) Size 3 (20CH) Size 1 (16CH) Size 2 (18CH) Size 3 (20CH)

71201 71202 71203 72201 72202 72203

B. Braun Medical Biotrol Elite colostomy bag with filter, skin protector adhesive, fabric backing - White

starter hole 30 50mm 30

32-815 32-850

B.Braun Medical Softima drainable pouch with filter, skin protector, protective cover and "Flow Control" soft outlet - Beige

40mm 30

043740E

B. Braun Medical Almarys Twin + Drainable pouch with filter, protective cover and "Flow Control" soft outlet - Beige Transparent

40mm 30 50mm 30 60mm 30 40mm 30 60mm 30

038840E 038850E 038860E 038740E 038760E

ConvaTec Ltd Consecura Low Profile Closed Pouch with Filter Standard Size Clear for:

35mm flange 30

S630LP

CozyLab S7 testing strips

50

n/a