June 2017 CPN

CPN

Community Pharmacy News – June 2017

The General Election

What next for pharmacy and the NHS as Jeremy Hunt stays on as Health Secretary?

CPAF screening begins | Leadership Academy update | Dispensing FAQs answered

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

A message from Sue Sharpe, PSNC Chief Executive Officer PSNC’s CEO responds to the ruling given on PSNC’s Judicial Review of the Secretary of State’s decision to impose a pharmacy funding cut.

“There are serious criticisms of the consultation process and of the Department of Health made in the judgment.”

PSNC was disappointed that the High Court ruled on 18th May that the funding reduction imposed on community pharmacies and the consultation relating to it were not unlawful and cannot be quashed.

Our lawyers felt that we had a good case; and there are serious criticisms of the consultation process and of the Department of Health made in the judgment. Unfortunately, the fact that the Secretary of State has very wide powers to decide what is relevant to his decisions, coupled with the Department withdrawing reliance on analysis they had undertaken, means that we failed to establish that the inadequacies in the process were sufficient to make it unlawful.

A critical point was the Department’s conduct regarding its analysis of Companies House data which led to a figure of a 15% operating margin for community pharmacies. PSNC first saw this figure

when the impact assessment was published alongside the imposition on 20th October 2016. The report has since been discredited by experts at PricewaterhouseCoopers.

Extraordinarily, although the Minister emphasised this study when announcing the imposition and it was repeatedly used in briefing papers disclosed in the litigation, counsel for the Department stated that no reliance was placed on it.

A mass of information regarding the policy behind the funding cuts was disclosed through the legal proceedings allowing us, at last, to see the masterplan behind the 17th December 2015 letter which was devised in mid-2015 and which the Department denied existed.

Had we seen this when the letter was published, we would have had the opportunity to interrogate and challenge the Department’s thinking, and the consultation period would have been very different. But it was withheld from us.

High Court Judge Mr. Justice Collins noted the ‘hardships’ that would inevitably be suffered with any reduction in remuneration. We know that the impact on pharmacies and their patients could be severe in some cases, and we will continue

to highlight this, as well as the impact on wider health and social care services and livelihoods. As the Judge noted, there is a real concern about the unintended consequences of the imposition in increasing pressure on GPs and A&E departments.

On the issue of pharmacy closures, the Judge found that these were a recognised and desired consequence but not the specific intention of the funding cut, noting comments made by the Chief Pharmaceutical Officer about there being too many pharmacies. PSNC could not and still cannot predict the number of closures that will result from the changes – contractors, as any business owners, will do anything they can to avoid closures and they will all seek to find ways to survive by reducing costs and services.

Our priority now is to ensure that the valuable contribution that pharmacies make to local communities and the NHS is never again disregarded as it so clearly was in the process leading up to the letter of 17th December 2015.

Further information on the judgment can be found at: ow.ly/XP4p30ck3N2

What the PSNC Committee says “I share the anger of many contractors at the way in which the Department of Health has conducted itself, and everyone on PSNC will be disappointed with the Judge’s ruling. But it was important for us to challenge the decision, to ensure that we are getting the best possible funding arrangements for contractors.

The past 18 months have been important both in building support for the sector, and finding out where we stand when it comes to the need to make savings. We hope that the Department will take on board the findings of this hearing, and that we can return to more open discussions without delay.”

Garry Myers, Independent Contractor and Member of PSNC’s Negotiating Team

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“I’m very disappointed that we were not able to meet the very high threshold needed to prove that the Department’s actions were unlawful and needed review. Of course any legal process costs money, but the sums of money involved, although large, are nothing in comparison with the cuts that we were seeking to prevent.

We felt that we needed to challenge the conduct of the Department, in particular its reliance on a 15% operating margin figure for community pharmacy and withholding information from us, in order to do our best to support the interests of contractors. ” Mark Burdon, Independent Contractor and Chair of PSNC’s Resource, Development & Finance Subcommittee

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

General Election result PSNC issues statement on what the outcome of the 2017 General Election held on 8th June means for the community pharmacy sector.

The 2017 General Election resulted in a hung Parliament, with no party having a clear majority, but Prime Minister Theresa May has said that she intends to form a Government with support from the Democratic Unionist Party (DUP).

Theresa May is seeking to form an agreement with the DUP and, as CPN went to press, she has begun making ministerial appointments.

It has been announced that Jeremy Hunt MP will remain in his role as Secretary of State for Health, but we await news of who is to take on the pharmacy minister role.

A number of key community pharmacy supporters in Parliament from across all parties have held their seats, and we look forward to continuing to work with them to promote the sector and all that it has to offer.

The campaign for community pharmacy over the past 18 months has been extremely strong, and PSNC was pleased to note the inclusion of pledges on community pharmacy in many of the manifestos. We will be working with the new Parliament to try to ensure that the value and potential of community pharmacies are fully recognised.

PSNC will also continue to work closely with LPCs to build and make the most of Parliamentary support for community pharmacy.

PSNC Chief Executive Sue Sharpe said: “Congratulations must go to all our new and returning MPs, who we look forward to working with to realise their manifesto ambitions for community pharmacies. We are pleased to see that many MPs who we have been working very constitutively with in the past 18 months have returned to Parliament.

Now that Jeremy Hunt has been given the opportunity to re-engage with those who work in the health and care system, we hope that he will take the time to reflect on the benefits of using pharmacy to help in the crisis confronting the NHS and seek to work differently with the sector going forward. PSNC will want to meet with Mr Hunt and the health minister responsible for pharmacy at the earliest opportunity, to ensure they develop policies that develop the community pharmacy service and secure a strong future for community pharmacy.

We do know that the hard work put in by community pharmacy teams, LPCs and the national organisations last year led to pharmacy being specifically mentioned in many of the parties’ manifestos. This is a first, and something we can build on over the coming months to increase the support we have for the sector.”

Community pharmacy appears in party manifestos During the election campaign PSNC was pleased to note that the manifestos of the three major political parties all made specific pledges about community pharmacy.

The Conservatives’ manifesto said the party would support community pharmacies in rural areas and ensure pharmacies can play a “stronger role to keep people healthy outside hospital”. Labour said it would halt the cuts to pharmacy funding. And the Liberal Democrats said they would ensure any changes did not “leave local areas without reasonable access to a community pharmacist”.

This shows the positive impact that the campaign to promote community pharmacy had last year, and PSNC will continue that work to promote the sector to politicians and more widely.

PSNC CEO Sue Sharpe to leave at end of 2017 During PSNC’s May meeting, Chief Executive Sue Sharpe informed the PSNC committee that she intends to resign from her current position at the end of 2017.

PSNC Chair Sir Mike Pitt said: “It has been a pleasure to work with Sue and the team at PSNC since I was appointed as Chair two years ago. Sue has been an exceptional advocate for community pharmacy, working tirelessly to promote the sector on behalf of PSNC and all the contractors it represents. She will be a very hard act to follow.”

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PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

CPAF screening process begins This year’s contract monitoring survey is available to community pharmacy contractors until 9th July. The short screening survey removes the need for all contractors to complete the full CPAF questionnaire.

The 2017/18 Community Pharmacy Assurance Framework (CPAF) screening questionnaire is available for completion for four weeks from Monday 12th June 2017 until Sunday 9th July 2017.

Now in its third year, the process asks all NHS community pharmacy contractors to complete a short screening questionnaire consisting of 10 questions; NHS England will then select a small number of pharmacies for a monitoring visit and/or to complete the full CPAF questionnaire.

Level 2 is the minimum standard expected to demonstrate compliance with the terms of service. Last year’s CPAF screening process revealed that the prescription-based interventions and signposting questions on the screening questionnaire may have been misunderstood by some contractors. It is important that these questions are properly understood as CPAF does not require that records are made of all prescription-linked, signposting and self-care interventions, but that records are made ‘as appropriate’.

The NHS Business Services Authority (NHS BSA) carries out the administration of CPAF at a national level on behalf of NHS England and this has been facilitated by a secure on-line portal for contractors to complete their screening questionnaires. Contractors should have already received an email from NHS England informing them of the CPAF process. If you have not yet received an email, please contact NHS BSA at: nhsbsa.cpaf@nhs.net

On 12th June 2017, contractors were sent a link to the screening questionnaire and asked to complete it. Please remember to complete the screening questionnaire accurately, because once it has been submitted, you will not be able to make any amendments.

If you do not receive this second email by 13th June 2017, you should contact the NHS BSA at the same email address.

More than 96% of pharmacies completed the screening questionnaire in 2015/16 and 2016/17, but it is hoped that this could be improved upon in 2017/18 which should help contractors avoid facing unnecessary monitoring visits.

For further information, please visit PSNC’s contract monitoring page at: psnc.org.uk/cpaf

Update affecting all contractors receiving PhAS payments The Department of Health (DH) has written to all pharmacies receiving Pharmacy Access Scheme (PhAS) payments with corrected payments due to them under the scheme.

The PhAS was introduced on 1st December 2016 and community pharmacy contractors were informed at the end of March 2017 that PSNC had identified issues with the PhAS payments. The extent of the problems has now become clear.

The problems arose because DH had not calculated PhAS payments in accordance with the Drug Tariff and this has led to inaccurate payments being made to contractors. DH has now reviewed all PhAS payment calculations and has indicated that it is correcting errors in its methodology to make its calculations consistent with the provision in the Drug Tariff. The correct PhAS payments will be made from the month of March 2017 onwards.

DH identified that in the three months before March 2017 under-payments were made to some contractors and over-payments were made to others. DH has said it will calculate an adjustment payment for any contractor who has been underpaid in these months, to make up the shortfall; and it will not seek to recover any overpayments made in these months.

Additionally, NHS England has confirmed that it has responded to the majority of contractors who asked for their eligibility for PhAS to be reviewed, with 71 additional pharmacies now due to receive payments under the scheme. Find out more at: ow.ly/r6br30cy3SH

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PSNC guidance on consolidations PSNC’s Regulations and Support Team has produced a briefing providing information on the Consolidation Amendment Regulations.

As well as detailing the three main consolidation options and the procedural steps for an application, it also outlines the statutory protection from subsequent applications seeking to replace the closing pharmacy.

Visit psnc.org.uk/briefings to read it in full.

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

Handling cybersecurity risks Following a recent cyber attack on the NHS, PSNC provides community pharmacy teams with guidance on helping keep their IT systems secure.

Pharmacy teams will be aware from media reports that NHS computers and IT systems were part of a larger group of organisations across the world affected by a ransomware attack. NHS Digital worked closely with the National Cyber Security Centre, the Department of Health and NHS England to help restore normal working order quickly.

However, the Electronic Prescription Service (EPS), the NHS Summary Care Record (SCR) and NHSmail were unaffected, allowing pharmacy staff to show their resilience and support during times of crisis.

In light of this recent cyber attack, PSNC advises contractors to do the following: 1. Familiarise yourself with our new webpage on cybersecurity This section of the PSNC website provides information and guidance on how to prevent ransomware attacks and what to do if your system does get infected.

Visit the page now: psnc.org.uk/cybersecurity 2. Read the Information Commissioner’s Office (ICO) findings on community pharmacy This ICO report was compiled following a survey undertaken last year. It is intended to promote good practices and make recommendations about how to further improve data protection and security within community pharmacies (see key recommendations opposite). With the expansion of services being offered by the community pharmacy sector, it is important for pharmacy contractors to consider best practices related to information governance and security.

3. Implement new standard operating procedures regarding IT Ensure that all pharmacy staff know to be suspicious of unsolicited emails and to be especially cautious of attachments or visiting website links within unsolicited emails.

Contractors should also regularly check that their systems are operating with the latest software updates. Pharmacy system suppliers usually manage the application of software patches for pharmacy computers and contractors should therefore seek advice from their system supplier before installing any software patches.

Key recommendations from ICO report Good practices and practical tips were highlighted within the ICO report on community pharmacies, including: • Provision of regular and ongoing training for staff who handle sensitive information; • The importance of regularly updating software on computers which are processing sensitive personal data; • There should be a mechanism, such as “Safe Haven” procedures, in place to maximise the secure use of fax machines; • Individual user logons should be used for all systems that contain patient identifiable data; • Smartcards should only be used by the registered holder; and • Procedures should be easily available so staff can refer to them when necessary.

Read the full report at: ow.ly/KpW630bWfv2

Answered: Your NUMSAS queries Q. How should patients or their representatives complete the NUMSAS patient questionnaire?

The questionnaire can be completed either online or by paper.

Patients can access the questionnaire online by visiting numsas.nhsdatacollection.org or using a QR code to access via their smartphone. Pharmacy teams can print off personalised compliment slips for patients which include the web address and the QR code at: pharmacy-numsas.nhsdatacollection.org A paper copy of the questionnaire can be printed out from the pharmacy section of the IT platform. Please note, when patient questionnaires are completed on paper, contractors should utilise the functionality to submit patients’ responses on the IT platform; questionnaires should not be sent to the Pricing Authority.

Q. Do I need to complete an FP10DT EPS dispensing token for each referral I receive from NHS 111?

An FP10DT EPS dispensing token must be completed as stated in the service specification for each referral received from NHS 111; the required information should not be submitted to NHS BSA on any other forms or on a blank piece of paper.

Q. Does the exemption declaration on the back of the FP10DT EPS need to be completed when a supply is being made?

When a supply of a medicine or appliance is being made, all patients should be asked to complete the back of the FP10DT EPS unless their date of birth is computer generated on the front of the token and the patient is under 16 years of age or aged 60 years or over. If the reverse of the token is not completed, it will be assumed that the patient is not exempt and has therefore paid for their items.

Still got questions? Check out our FAQ database at: psnc.org.uk/numsasfaqs

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SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

SCR calculator for November review point SCR usage tool now updated for community pharmacy contractors to check progress in meeting the SCR quality criterion at the November review point.

NHS Digital has updated the Summary Care Record (SCR) usage calculator tool for the November 2017 review point of the Quality Payments Scheme.

The SCR calculator is designed to assist contractors in monitoring and increasing their SCR usage to meet the SCR quality criterion, which requires contractors to be able to demonstrate on the day of the review, a total increase in access to SCR from period 1 to period 2 as defined below.

For 24th November 2017 review point

Period 1

Period 2

Monday 3rd October 2016 to Sunday 30th April 2017

Monday 1st May 2017 to Sunday 26th November 2017

Relevant resources The following resources provide guidance and examples for pharmacy professionals on when they could consider accessing a patient’s SCR (with the patient’s consent), which may assist contractors with increasing their SCR usage ahead of the next review point:

The calculator will show contractors the number of times their pharmacy has viewed the SCR in both period 1 and period 2 so a comparison can easily be made.

FAQs Q. How often is the SCR calculator updated?

The SCR calculator is updated weekly on Thursdays (with the previous week’s viewing figures).

Q. How can I practice using SCR so that I can learn how to use it quickly for patients under my care?

You can practice using SCR by using the test patient NHS numbers that NHS Digital has provided; this will allow you to access example records and help you become more familiar with the process. Details of the test NHS numbers plus further information on this process can be found at: psnc.org.uk/usingSCR Q. Does the SCR usage calculator tool include test patients when it calculates the number of times a pharmacy has viewed the SCR in period 1 and period 2?

Yes. The SCR usage calculator tool is not able to differentiate between test patients and real patients therefore both are included in the calculation of how many times a pharmacy has accessed the SCR.

Resource

How to access

PSNC on-demand SCR webinar: Getting started and using efficiently

Watch it at: psnc.org.uk/ SCRwebinar

Centre for Pharmacy Postgraduate Education (CPPE) workshop: SCRs making the most of them

Register at: tinyurl.com/ CPPESCRcourse

NHS Digital guidance: Benefits and uses of SCR in community pharmacy

Read it at: tinyurl.com/ y7ws3a3c

National Pharmacy Association (NPA) webinar: Breaking down the barriers

Watch it at: tinyurl.com/ y98k3g43

Phenomenal engagement with Quality Payments Scheme The first declaration period for the Quality Payments Scheme closed on 12th May, marking the end of a period of hard work by community pharmacy teams and LPCs across England. We understand that over 11,000 pharmacies completed a declaration for the first review period, which means the vast majority of the sector took on the challenge of meeting the various quality criteria.

Contractors who did not make the necessary declaration between 10th April 2017 and 12th May 2017 will not be entitled to a Quality Payment for the

6 Community Pharmacy News – June 2017

April review point, whilst contractors who did make a claim within the required timeframe should receive their payment at the end of June 2017 (as part of the April 2017 submission payment).

Commenting on this high level of engagement, Alastair Buxton, PSNC Director of NHS Services, said: “Congratulations to pharmacy teams and LPCs on the hard work and phenomenal

engagement with the Quality Payment Scheme which we have seen in the first review period.

Many elements of the scheme, such as use of the NHS Summary Care Record and NHSmail, provide a very useful foundation for future community pharmacy service developments. The fabulous level of engagement with the scheme demonstrates that pharmacy teams are committed to continuously improving the quality of the services they provide to patients and the public and I hope that this is acknowledged by DH and NHS England.”

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

On the road to success PSNC’s 2017 leadership development programme for LPCs has begun and here we find out what two of the trainees have been up to so far.

Myra Battle The requirement to teach others as part of her role at Suffolk LPC helping with the development of Health Living Pharmacies (HLPs) is what first led Myra Battle to apply for PSNC’s Leadership Academy programme.

Myra has found joining the Leadership Academy to be an enlightening experience. She is not a pharmacist and felt intimidated during the first Academy training session, but when course leader Rachel Harrison said, “everyone has baggage, but only you can see your own,” it was a real eye-opener for Myra.

The programme is building Myra’s confidence to push herself and expand her boundaries; she’s even booked on to PSNC’s coaching and mentoring course to help further develop her skills in that area. Myra has begun carefully planning what she will do during her pharmacy visits before going to do them and hopes, in time, to be able to adapt her leadership style to suit her audience.

Myra hopes to empower those she’s teaching to motivate others; she has already inspired one of her HLP pharmacy students to quit smoking simply due to her infectious enthusiasm for healthy living. Myra wants to make a difference and her ultimate goal is to do so on a national scale.

She is looking forward to building on her experience to lead the health of the British public to a brighter future through her work with the LPC.

Amit Patel Chief Executive of Pharmacy London, Amit Patel is still relatively new to the world of pharmacy, but has taken on a lot of responsibilities in a short space of time. As such Amit hopes to use his place on the Leadership Academy programme to develop himself and his board, who will then be able to share those skills with the 13 London LPCs who make up the joint workgroup.

Amit values the opportunity to learn from other LPCs around the country and has found the networking opportunity provided by the Academy to be “phenomenal”, and describes the sheer volume of ideas being shared as “amazing”.

During his one-to-one coaching session, course leader Rachel Harrison not only provided Amit with the chance to reflect on his work, but she also gave him ideas on how to improve. Amit says he has “been on a journey of mindset change” and now wants to implement positive thinking alongside colleagues to generate more positive outcomes.

Amit believes pharmacy needs leaders with a media-savvy voice to get the sector’s messages across and take up key roles. His plan going forward is to create a three to five-year plan to help take community pharmacy in his area on to bigger and better things: “there’s a lot more to come from Pharmacy London”.

PSNC will be catching up with more of the candidates later on in their training.

Safeguarding children and vulnerable adults

Karen Wragg Programme developer and regional manager, CPPE

Under the patient safety domain of the “Quality Payments criteria, 80% of registered

safeguarding issues with fellow pharmacy professionals and hear how others have handled situations in the past.

pharmacy professionals are required to have achieved level 2 safeguarding status for children and vulnerable adults within the last two years.

If you haven’t yet achieved level 2 safeguarding status required for Quality Payments, you will be in a much better place to complete the assessment after attending this workshop.

Running throughout June and July, and later in the year, Safeguarding children and vulnerable adults is a two-hour workshop designed to give pharmacy professionals the skills, knowledge and confidence to deal professionally with safeguarding issues.

During the workshop, you’ll hear from a local safeguarding expert to ensure you understand the policies, legislation and procedures in your area.

You will also have the opportunity to discuss a number of

Aside from the obvious benefit in relation to quality payments, the workshop will also help you convey the importance of the pharmacy team increasing their awareness of suspected abuse, neglect and child sexual exploitation (CSE).

Therefore, you will be better prepared to develop ways in which to work with other healthcare professionals to promote best practice to deal with situations involving suspected abuse, neglect or CSE. You can book your place on one of the workshops today by visiting: www.cppe.ac.uk/programmes/l/safegrding-w-05

”

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PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

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.

NHS BSA webinars: Submitting MUR/NMS quarterly information

The NHS Business Services Authority (NHS BSA) is holding webinars on various dates in June and July on the process to follow for reporting quarterly information to NHS England on the Medicines Use Review (MUR) service and the New Medicine Service (NMS).

In 2016/17 a new process was rolled out with NHS BSA taking on the role of collecting the completed electronic reporting MUR and NMS templates for community pharmacy contractors, on behalf of NHS England. The NHS BSA webinars will provide contractors with insight and guidance on how to submit the templates.

For webinar dates and timings, please visit the NHS BSA website: tinyurl.com/B SAwebinars

Supporting patients with ME information Action for M.E. has published an teams macy phar resource for community ic myalg on n matio containing key infor encephalomyelitis (ME).

logical The guide covers the pharmaco polypharmacy with s issue ME, management of iding pharmacy prov when ider cons to s and point ws to Revie services such as Medicines Use people with ME.

View the resource at: y-and -me www .actio nfor me.o rg.uk /pha rmac

Urgent and emergency care guidance

The Royal Pharmaceutical Socie ty (RPS) has published a guide to support pharmacists working in or with urgent and emergency care , which includes a section on comm unity pharmacy.

The guide includes information on community pharmacy urgent and emergency care roles , practical guidance, the legal and regulatory framewor k, professional guidance and ethical issues, as well as clinical guidance and support tools.

You can view the RPS guide at: tinyu rl.co m/n5 rqhk 9

Healthcare news in brief Here’s a round-up of what is going on in the wider health and care landscape beyond community pharmacy.

For more information on any of these stories, please see the monthly updates at: psnc.org.uk/hclbriefings 39% of people in the UK are failing to meet recommendations for physical activity, putting them at risk of heart and circulatory disease.

A report from NHS Digital shows that hospital admissions related to alcohol consumption have risen by 22% in the past decade.

8 Community Pharmacy News – June 2017

Children and young people under 25 years of age typically attend A&E more frequently than the adult population.

A House of Commons committee report concluded there remains too much reliance on seeing GPs, rather than nurses, mental health professionals and other staff.

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

Dispensing and Supply news Our Dispensing and Supply Team highlights the latest news, information and guidance that community pharmacy contracts should be aware of.

Removal from Part VIIIB of the Drug Tariff The listings for Magnesium glycerophosphate 5mmol/5ml oral suspension and solution plus Quetiapine 100ml/5ml oral suspension have been removed from Part VIIIB of the Drug Tariff.

Unsolicited calls claiming to be from Pricing Authority The NHS Business Services Authority is warning all community pharmacy contractors that it has received reports of pharmacists being contacted by someone falsely claiming to be from the ‘PPA’ or ‘Prescription Services’.

This is because there are alternatives now available and these have been added to Part VIIIA effective from 1st June 2017. The alternatives are Magnesium glycerophosphate (magnesium) 121.25mg/5ml (5mmol/5ml) oral solution and Quetiapine 100mg/5ml oral suspension sugar free.

The unsolicited callers are requesting bank details after telling the contractor they are due a refund or there is a problem with a banking mandate. If the request is complied with, this could allow the caller to make a deduction from the contractor’s account.

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

If you receive such a call, please report it to the National Fraud and Cyber Crime Reporting Centre, Action Fraud, on 0300 123 2040.

Hints & Tips newsletter The Pricing Authority produces a quarterly newsletter called Hints & Tips for dispensing contractors. We would like to draw your attention to the latest edition (Issue 27) which contains some really useful information and advice regarding: • Endorsing the correct price on EPS messages; • The Community Pharmacy Quality Payments Scheme; • Referred Back (returned) items explained; and • Universal Credit – claiming free NHS prescriptions.

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.

All published editions of the Hints & Tips newsletter can be found on the Pricing Authority’s website: tinyurl.com/dispensinghints-tips

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

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.

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 Can it be in the have a ‘CE’ dispensed blacklist?* mark? on an FP10?

Additional information

Amielle Comfort vaginal dilator

Yes

n/a

Yes

Yes

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

Cathejell Lidocaine C

Yes

n/a

Yes

Yes

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

LimbO Finger Plaster Cast and Dressing Protector

No

n/a

Yes

No

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

SafetyGel absorbent powder

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.

*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.

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

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 have a prescription for a patient who was 59 when his prescription was written; however, the patient did not handover the prescription to be dispensed until they were 60. Is the patient age exempt from paying a prescription charge?

A. Yes, subject to the prescription still being within the period of validity. The reverse of a prescription says that entitlement to prescription exemption is based on the patient’s circumstances on the day they are asked to pay. In this case, as the patient was over 60 when they entered the pharmacy to have their prescription dispensed, they would therefore be age exempt from paying a prescription charge.

For paper prescriptions, where the patient’s age is shown on the front of the prescription as “59” they would only be exempt if their 60th birthday has taken place between the time of being provided with the prescription and making their declaration of exemption. The patient should sign the back of the prescription form to declare that they are indeed over the age of 60 on the day they are asked to pay.

For EPS prescriptions, your EPS system may auto-suggest an exemption category but you may need to override this, e.g. systems might use the date the Dispense Notification (DN) was sent and compare this with the patient’s date of birth or certificate validity period recorded on the PMR. However, the date the DN was sent may be different to the date the patient was asked to pay, causing the need to override the exemption category suggested by the system. Please note, the printed patient’s ‘age’ on a prescription token or dispensing token may show the age at the time of the printing.

You can check the paid/exemption category currently applied onto an electronic prescription using your PMR system.

For further information on EPS exemptions, see psnc.org.uk/epsexemption

Q. How long does a price concession last?

A. If a price concession is granted, it is only valid until the end of the month in which it is granted. PSNC then needs to apply once again the following month if it is an on-going issue. This also means that pharmacies will need to re-submit pricing issue reports (forms can be found here: psnc.org.uk/feedback) every month.

Q. Are young people aged 16, 17 or 18 on apprenticeships automatically exempt from prescription charges?

A. No. Whilst there is an exemption for those who are 16, 17 or 18 in full-time education, NHS Help with Health Costs has confirmed that apprenticeships do not qualify for free prescriptions. Full-time education means you must be receiving full-time instruction from a recognised educational establishment, such as a school, college or university.

However, patients aged 16, 17 and 18 undertaking an apprenticeship who are on a low income are able to apply for help with their health costs using the HC1 form. If they are successful with their application, they will receive an HC2 certificate which would entitle the patient to receive free prescriptions.

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

A. If there is an on-going supply problem, PSNC needs to make a fresh concession application at the start of every month.

DH then take time to undertake checks and make a decision. In some cases, there is a need for negotiation between PSNC and 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, a point which we have raised with DH.

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 (0203 1220 810 or e-mail info@psnc.org.uk).

10 Community Pharmacy News – June 2017

LPCs

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Drug Tariff Watch This is a summary of changes effective from 1st July 2017.

Part VIIIA additions Category A: • Amiodarone 300mg/10ml solution for injection pre-filled syringes SC (1) • Naproxen 250mg/5ml oral suspension (100ml) Category C: • Colecalciferol 25,000unit capsules (3) – InVita D3 • Colecalciferol 400unit capsules (28) – InVita D3 • Colecalciferol 5,600unit capsules (4) – InVita D3 • Colecalciferol 50,000unit capsules (3) – InVita D3 • Hydrocortisone 0.25% / Crotamiton 10% cream SC (15g) – Eurax Hc • Methotrexate 10mg/0.4ml solution for injection pre-filled disposable devices SC (1) – Nordimet • Methotrexate 12.5mg/0.5ml solution for injection pre-filled disposable devices SC (1) – Nordimet

• Methotrexate 15mg/0.6ml solution for injection pre-filled disposable devices SC (1) – Nordimet • Methotrexate 17.5mg/0.7ml solution for injection pre-filled disposable devices SC (1) – Nordimet • Methotrexate 20mg/0.8ml solution for injection pre-filled disposable devices SC (1) – Nordimet • Methotrexate 22.5mg/0.9ml solution for injection pre-filled disposable devices SC (1) – Nordimet • Methotrexate 25mg/1ml solution for injection pre-filled disposable devices SC (1) – Nordimet • Methotrexate 7.5mg/0.3ml solution for injection pre-filled disposable devices SC (1) – Nordimet • Ranitidine 75mg tablets (48) – Zantac 75 • Ursodeoxycholic acid 500mg tablets (100) – Ursofalk Part VIIIA amendments • Ethosuximide 250mg/5ml oral solution

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

(200ml) Category C – Zarontin is changing to Category A • Sodium chloride 292.5mg/5ml (1mmol/ml) oral solution sugar free (100ml) Category C – Viridian Pharma Ltd is changing to Sodium chloride 292.5mg/5ml (1mmol/ml) oral solution (100ml) Category C – Viridian Pharma Ltd Part VIIIA deletions • Sodium chloride 0.9% nebuliser liquid 2.5ml unit dose vials (20) – Saline Steripoules Part VIIIB deletions • Magnesium glycerophosphate (magnesium 121.25mg/5ml (5mmol/5ml)) oral solution • Magnesium glycerophosphate (magnesium 121.25mg/5ml (5mmol/5ml)) oral suspension • Quetiapine 100mg/5ml oral suspension

Part IX deletions Take careful note of removals from Part IX because if you dispense a deleted product, prescriptions will be returned as disallowed.

Product

Size, type and product code

Uriflo Catheterisation Pack

Short (FCP001-S), Long (FCP001-L)

Advadraw

All sizes

Advadraw Spiral

0.5cm x 40cm

Surgihoney

10g

Mepilex Border Lite

10cm x 10cm

Elave Intensive Cream

All sizes

NovoPen 3 Demi

3ml cartridge 0.5 unit dial up / range 1-35 units

NovoFine

12mm/28 gauge

Uriflo sterile drainable night drainage bag with slide T tap

2 litre (F2000)

Uriflo single use non-sterile drainable night drainage bag with slide T tap

2 litre (FSU2)

Uriflo non-drainable night drainage bag

2 litre (F2)

Uriflo elasticated cotton leg bag strap

F10LS

Uriflo catheter retaining strap

FCS-05

Option Connect 2 two piece ostomy system ileostomy bag with filter, to fit up to 45mm Stoma

JH300

Option Connect 2 two piece ostomy system ileostomy bag with filter, Midi, to fit up JH200 to 45mm Stoma Option Connect 2 two piece ostomy system ileostomy bag with filter, Mini, to fit up JH100 to 45mm Stoma Option two piece ostomy system colostomy bag with filter, Opaque

50mm (CA50K) psnc.org.uk 11

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

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

PSNC Briefings PSNC Briefing 030/17: Dispensing Factsheet – Checking Prescription Exemption Status The Dispensing and Supply Team often receive queries about the proof required by patients for exemption from the prescription charge and where patients can obtain proof from. This briefing outlines which documents are required and how patients can go to get them.

Download from: ow.ly/1LUt30ck4qy PSNC Briefing 031/17: Summary of the Judicial Review Judgment This briefing summarises the judgment in PSNC’s Judicial Review Case which was handed down on Thursday 18th May 2017. There are also a selection of Frequently Asked Questions about the judgment.

Download from: ow.ly/XP4p30ck3N2 PSNC Briefing 032/17: Update on the Health and Care Landscape (May 2017) This briefing is part of a series issued regularly by PSNC to inform pharmacy contractors and LPCs of developments in the wider health and care landscape beyond community pharmacy.

Download from: ow.ly/qd8D30ck417 See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources HLP health promotion ideas PSNC’s Services Team have been busy adding to and updating the ‘health promotion ideas for pharmacy teams’ hub.

In particular, they have added more public health topics and more links to useful resources. Pharmacy teams can use this section for inspiration for the Health Living Pharmacy (HLP) Health Promotion Zone.

Visit now: psnc.org.uk/healthpromotion Dealing with recent cybersecurity risks This PSNC webpage was created following the recent cyber attack on NHS computers and IT systems. It provides information and guidance on how to prevent ransomware attacks and what to do if your system gets infected.

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

Email news alerts High Court rules pharmacy funding cut was not unlawful (18th May 2017) Here we shared the verdict given on PSNC’s Judicial Review of the Secretary of State’s decision to impose the funding reduction on community pharmacies. The Judge remarked that it was with regret that he could not quash the decision.

Read now: ow.ly/Klfn30ck5EX Not receiving our emails? Sign up now at: psnc.org.uk/enews PSNC website For up to date information and news on community pharmacy issues, visit the PSNC website at psnc.org.uk PSNC Community Pharmacy News is published by: The Pharmaceutical Services Negotiating Committee, 14 Hosier Lane, London, EC1A 9LQ Community Pharmacy News is edited by: Melinda Mabbutt who can be contacted at the above address or by email at: mmabbutt@psnc.org.uk PSNC Office: 0203 122 0810

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