June 2019 CPN

CPN

Community Pharmacy News – June 2019

Serious Shortage Protocols (SSPs)

Regulatory changes to introduce SSPs into the NHS pharmacy terms of service from 1st July 2019

PSNC meeting summary | PCN engagement resources | Schedule of Payments factsheet

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Chief Executive’s blog PSNC Chief Executive Simon Dukes explains the challenge of Primary Care Networks.

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The first challenge is to accept that PCNs are here to stay.

Simon Dukes

PSNC Chief Executive In his speech to the NPA Conference in Manchester last month, Ed Waller, who is Director of Primary Care Strategy at NHS England and NHS Improvement, said: “The idea of a Primary Care Network is not that people compete with each other … in some places this is going to be uncomfortable.”

On 1 July 2019, 1,259 Primary Care Networks (PCNs) became operational across England, which could mean a lot of discomfort if the aim is for us all to leave behind competition within them.

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It will be uncomfortable for some, but it’s not impossible.

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For community pharmacies the first challenge must be to understand and accept that PCNs are here to stay. The good news is that they should also in the future be a source of potential funding for some services that community pharmacies can provide. To tap into this, we need to start to identify ways that we – as a sector – can work together more and, in turn, engage and work in partnership with other healthcare providers in our local PCNs. What does this mean in practice?

PSNC has provided a useful guidance document ow.ly/CfKN50uQxqL, but

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essentially it means in the first instance knowing which other community pharmacies are in your PCN and getting together with them – ideally with a member of your LPC present. You’ll need to identify what your collective community pharmacy coverage looks like: some things like patient numbers and what services you already offer, down to how many consulting rooms you have collectively, and what difficulties you think there might be in working in partnership. Getting a sense of your collective value will in turn help the lead GPs in your PCN understand how you can help them to meet their service objectives and, ultimately, persuade them that you should be paid for doing so.

You will also need a ‘lead’ community pharmacist to be the point of contact with the PCN and ensure that your LPC is informed of your progress every step of the way. LPCs will have a vital role in making sure that contractors have the guidance and advice they need to engage with PCNs, but also to be there to help where disputes arise or engagement is not working as it should. LPCs are also the route through which you can escalate issues to PSNC. There is much detail still to be worked out on PCNs, so don’t feel frustrated if you feel that you are behind the curve (many GPs are too).

Importantly, all this costs money: coming together to talk as a community pharmacy group within a PCN and, in time, talking to other healthcare providers too. I have been asked by many of you to negotiate a funding pot to help with this engagement, and I am not breaking any confidentiality if I say that it is absolutely on the PSNC list of requirements.

In Manchester last month, I gave a response to Ed Waller’s presentation by outlining the most common reasons (according to PwC) as to why business partnerships fail. Lack of vision (or clarity) on what we are trying to do; involving the wrong people; focusing on detail rather than the bigger picture; lack of trust; and poor decision-making processes were amongst the top. We have a vision for how PCNs will operate and the detail is emerging as to how they will work, and LPCs are already gearing-up to help pharmacies to engage with them. The one thing that only front-line pharmacists can do is ensure that we have the right people engaging with the PCNs, and that we all enter in to this new way of working in a spirit of mutual trust.

Waller is right: it will be uncomfortable for some – but it’s not impossible. Successful engagement with PCNs could bring significant benefits for local community pharmacies – whether providing clinical pharmacists to GPs or provision of subcontracted services. And don’t forget that in addition to the £4+bn routed to PCNs, there is an additional £3bn to CCGs for primary medical services. Collaborative and effective community pharmacy partnerships within PCNs could be a valued and trusted supplier for CCGs – benefiting the community, patients and the NHS.

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

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

FreeStyle Libre Sensors to be exempt from discount deduction Following PSNC representations, DHSC have agreed to the addition of the FreeStyle Libre Sensors to the DND list FreeStyle Libre Sensors will enter the Drugs for which Discount is Not Deducted (DND) list (Part II of the Drug Tariff) from 1st July 2019. The assumed level of discount normally applied when community pharmacy contractors dispense medicines and appliances will no longer be applied to FreeStyle Libre Sensors. This follows negotiations between PSNC making representations to the Department of Health and Social Care (DHSC) about the difficult position that contractors have found themselves in when trying to source this appliance.

Since extra NHS funding was made available for the prescribing of Freestyle Libre Sensors in April 2019, there has been seen a surge in the number of prescriptions dispensed by community pharmacies for this item. The sensors can only be ordered directly from the manufacturer, Abbott Ltd, and contractors have reported to PSNC that they were dispensing each pack at a loss because there is no discount available, yet the item was subject to the discount deduction scale.

Due to the unique nature of FreeStyle Libre Sensors and its restricted ordering system, PSNC requested that it be considered for addition to the DND list to help mitigate against any further losses incurred by contractors when dispensing this appliance. PSNC, with the support of Abbott Ltd, made its representations to DHSC, who agreed to the addition of FreeStyle Libre Sensors to the DND list.

Bharat Patel, an independent community pharmacy contractor and PSNC Regional Representative for the East and Vice Chair, said: “When a product like Freestyle Libre is not exempt from discount deduction, it puts contractors like me in an awkward position. We know how this appliance can help transform the lives of patients living with diabetes and so are keen to dispense it, but we could not continue to cover the difference between the purchase and reimbursement prices out of our own pockets. I am therefore delighted that DHSC has recognised and addressed the issue in a timely manner.”

PSNC May Meeting The PSNC Committee met in May, with a significant portion of the meeting allocated to detailed discussions to inform the community pharmacy funding negotiations. The Committee heard a confidential briefing on the Community Pharmacy Contractual Framework (CPCF) negotiations and later considered its positions on particular topics that are due to be addressed in those negotiations. PSNC’s May meeting was held on the 22nd and 23rd of the month, and other key agenda items included: consideration of remuneration for Serious Shortage Protocols; reviewing pharmacy vaccination provision; NHS IT updates on EPS Phase 4 and Real-time Exemption Checking; current funding issues; LPC support, including the creation of a data dashboard; and public affairs work, in particular the development of ‘policy asks’. Read a summary of the meeting at: ow.ly/qU5I50uQMgw

NHS workforce plan to support pharmacy The NHS has published an Interim People Plan, which sets out how it will support the workforce to deliver the care that the NHS needs.

Long Term Plan, will be published after the Government’s next Spending Review.

PSNC Director of NHS Services, Alastair Buxton, said: “With prevention and urgent care high on the NHS Long Term Plan’s list of priorities, we are pleased to see that the Interim People Plan picks out community pharmacy as one of the sectors that will benefit from workforce development.

When the NHS Long Term Plan was published in January 2019, it was recognised that changes would need to be made to the healthcare workforce to help fulfil the plan’s ambitions. The interim plan addresses the immediate actions required in the coming year.

The plan prioritises urgent action on nursing shortages, but also outlines intentions to develop the workforce by making the NHS an employer of excellence, creating a culture that delivers better care, offering new types of roles, and utilising new technologies.

freedom to deliver more clinical care, the introduction of a common foundation programme for all newly registered pharmacists, and new training to support community pharmacy teams in delivering care. A Briefing on Future Plans for the Pharmacy Workforce can be viewed at: ow.ly/AOH030oTevh

Actions for the pharmacy workforce include giving community pharmacists greater

A full five-year People Plan, alongside a detailed implementation plan for the NHS

PSNC has recently recommended to pharmacy teams that they take all opportunities to update their skills to help them meet the future needs of the NHS. The interim plan shows that the NHS also recognises its role in making sure the right training and support is available to help community pharmacy deliver the services of the future; we look forward to investment in upskilling the pharmacy workforce featuring in the full People Plan.” psnc.org.uk 3

CONTRACT AND IT

Quality Payments data 10,678 contractors declared and were validated as meeting the gateway criteria for the February review point of the Quality Payments Scheme.

Declaration data from the NHS Business Services Authority (NHSBSA) shows that more than 10,000 contractors met each of the Dementia Friends, patient safety report and asthma clinical effectiveness quality criteria. It also indicates that 9,535 pharmacies met the Health Living Pharmacy quality criterion.

NHSBSA’s full data breakdown can be found at: ow.ly/VeuA50uHRbJ

NHS England Primary Care Prescribing Guidance Update Following a public consultation held between 28th November 2018 and 28th February 2019, the NHS England and NHS Improvement Boards have agreed that previous guidance issued for CCGs on items that should not be routinely prescribed in primary care (first published in November 2017), should be updated to include guidance on the following treatments: • Aliskiren – used to treat blood pressure • Amiodarone – used to treat abnormal heart rhythms • Dronedarone – used to treat atrial fibrillation • Minocycline – used to treat acne • Needles for pre-filled and reusable insulin pens for diabetes which cost more than £5 per 100 needles • Bath and shower emollient preparations • Silk garments The recommendation on rubefacients has also been updated so that capsaicin cream can be prescribed in line with NICE guidance.

A copy of the updated guidance can be found at: ow.ly/cyA550uRFzQ

NHSmail password changes NHSmail users’ passwords will become valid for 365 days instead of the current 90-day expiry. This change follows PSNC, on behalf of the Community Pharmacy IT Group (CP ITG), lobbying NHS Digital about its approach to frequent forced password changes.

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

SSPs to enter pharmacy terms of service Regulatory changes provide detail about the considerations for pharmacists if a Serious Shortage Protocol is approved by the Health Secretary.

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Pharmacists will be required to consider SSPs, but will not be forced to use them

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On 1 July 2019 legislation came into force allowing the Department of Health and Social Care (DHSC) to issue Serious Shortage Protocols (SSPs).

SSPs are a potential way to help pharmacies to manage any serious shortages of medicines that may occur, without needing to refer patients back to prescribers. Any SSPs issued will specify an alternative product or quantity that may be supplied (an alternative strength or formulation, or generic or therapeutic alternative or less of the product) by community pharmacies, along with any restrictions or other points that pharmacists need to consider.

SSPs will only specify changes to specific medicines that medical experts believe to be appropriate; and pharmacists will always have the professional discretion not to supply an alternative to any individual patient.

If an SSP is issued, community pharmacy contractors must, under their Terms of Service, consider the SSP, so it is important that contractors are aware of the legislation and the new requirements. To help contractors to do this, PSNC has issued a briefing: ow.ly/9LS650uQx7r. The briefing explains the legislation and what pharmacies should do if an SSP is issued, including a flowchart diagram to help contractors follow the process required.

Funding for the consideration and implementation of SSPs by contractors is still under discussion with DHSC. It is important to note that although legislation will permit the issuing of SSPs from July 1st, an SSP will only be considered

by DHSC and issued if there is a serious shortage of a specific medicine. PSNC will notify contractors of any SSPs that are issued, and in practice, we do not expect this to happen immediately.

PSNC to hold SSP webinar PSNC Director of Operations and Support, Gordon Hockey, will be hosting a webinar about SSPs on Thursday 18th July at 7.30pm During the webinar Gordon will explain what an SSP is, clarify situations when they may be used, describe what they may involve, and talk you through the decisions you may need to make when one is in place.

Please sign up at: psnc.org.uk/webinar

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HE HEALTHCARE LANDSCAPE

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

Primary care collaboration

A range of support has recently been made available to help LPCs and community pharmacies prepare to engage with Primary Care Networks (PCNs).

NHS England guidance

Pharmacy guide for GPs

NHS England and NHS Improvement have published two key documents for community pharmacy.

The emergence and ongoing development of PCNs will mean that it is increasingly important for GP and community pharmacy teams to understand each other’s profession and the roles they undertake.

Firstly, an informative pharmacy briefing containing key background information on PCNs: their structure, function, the role of clinical directors and how they fit in the NHS. Secondly, LPC guidance, published in partnership with PSNC and other stakeholders, outlines a recommended four-step process for LPCs to support contractor engagement with PCNs.

To help with this, PSNC has recently updated The community pharmacy – A guide for general practitioners and practice staff and is collaborating with the British Medical Association to promote this guide among the GP and pharmacy professions.

Find both documents at: ow.ly/B92Z30oY0Zo

Download the guide from: ow.ly/1tcX30oQAJA

PCN Roadmap

Service prospectuses

We have developed a roadmap for LPCs describing the journey to integration with Primary Care Networks (PCNs).

The PSNC Think Pharmacy prospectuses have been reviewed and updated. A number of new prospectuses have also been published to add to the range of services covered.

During this initial phase, it is recommended that LPCs first ensure they work to mobilise our contractors to be prepared for the need to engage with PCNs in the near future.

The prospectuses provide introductions to specific pharmacy services and they have been designed to help LPCs and others to make initial service pitches to local commissioners and stakeholders. Each one highlights a healthcare challenge and explains how community pharmacy can provide a solution.

Read the briefing at: ow.ly/OlnS50uJJnX

View the Think Pharmacy webpage: psnc.org.uk/thinkpharmacy

Fully funded postgraduate courses Community pharmacists are reminded of a number of postgraduate courses, funded by the Pharmacy Integration Fund until March 2020.

Learners can choose from a range of courses and modules to develop their clinical practice.

The Fund will cover the tuition fees for chosen modules, up to a maximum of 60 credits in a year (this can be for a Postgraduate Certificate, Diploma or CPD for revalidation).

All courses are designed with flexibility in mind, allowing you to study at work or in your own time, with minimal or no face to face time. Participating universities will be able to guide you through the registration process and help you select the modules that are best for you, based on your career stage and aspirations.

Act now to secure your place: ow.ly/X4tK30oQC5v Keep an eye on psnc.org.uk/pcnresources for the latest updates. psnc.org.uk 5

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Flu vaccination figures announced

NHSBSA figures show that more than 1. 4 million NHS flu jabs were provided in community pharmacies during the 2018/19 flu season.

Community pharmacists in England administered 1,431,538 flu vaccinations to patients under the national NHS Flu Vaccination Service in 2018/19.

The NHS Business Services Authority (NHSBSA) has published the Advanced Service Flu Report 2018/19*, detailing the community pharmacy contractors who signed up to provide the service, as well as the NHS England area, vaccines administered, and drug and fee costs.

The number of community pharmacies which provided the national NHS Flu Vaccination Service in 2018/19 was 9,071 (78.2% of all community pharmacies in England).

The average number of vaccinations carried out by each participating pharmacy was 158, although five contractors greatly exceeded this by completing over 1,000 vaccinations each, with one administering over 2,500 vaccinations. *Whilst the NHSBSA has published this data now, please note that contractors have until September 2019 to submit their claims, so the final figure could increase.

9,071 community pharmacies provided the Flu Vaccination Service in 2018/19 A total of 1,431,538 vaccinations were carried out under the NHS pharmacy Flu Vaccination Service 158 was the average number of flu vaccinations per participating pharmacy But the most proficient pharmacy provided more than 2,500 flu vaccinations

Accuracy checking pharmacy technician programmes Our Accuracy checking pharmacy “technician (ACPT) programme is designed to support pharmacy technicians develop the knowledge, skills and behaviours required to safely and effectively provide the final accuracy check of dispensed medicines and products.

Joanne Nevinson

The programme develops leadership skills Lead Pharmacy in order to supervise the work of others, Technician, CPPE support the team and drive performance, as well as enabling you to develop skills that contribute to the learning of others following the identification of dispensing errors. Our ACPT programme directs you to exercise professional judgement in making decisions and prioritising and delegating work.

What does the programme involve?

The ACPT programme is a comprehensive package which offers a blended approach to learning including resources for self-directed study, e-learning, practice-based activities, professional discussion and comprehensive assessment. Throughout the programme, you will collect a portfolio of evidence using an online learning platform called Canvas.

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Our ACPT programme provides you with support from a workplace-based education supervisor who you can meet with regularly, and who aims to support you to learn, develop and achieve competency in the skills, knowledge and behaviours required for the responsibility of the accuracy checking pharmacy technician role.

The programme is flexible to suit different pharmacy settings and takes between 3-12 months to complete. The learning is traineeled with support of a CPPE tutor throughout. The programme also provides an opportunity for revalidation activities to be completed, including a professional discussion with a CPPE tutor.

Who can apply?

The ACPT programme is open to pharmacy technicians in England who are registered with the General Pharmaceutical Council (GPhC).

If you are interested in enrolling onto the ACPT programme, have a look at the Accuracy checking pharmacy technician pages on the CPPE website, where you will find lots more information, including the entry criteria and frequently asked questions: www.cppe.ac.uk/career/acpt

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PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Schedule of Payments webinar now on-demand

Feedback on the webinar

Webinar session from PSNC and NHSBSA helps contractors to better understand their monthly payments schedule.

83% found it useful

89% found the content relevant

Community pharmacy contractors can now access an online recording of PSNC and NHS Business Services Authority’s (NHSBSA) recent Schedule of Payments webinar.

Over 700 people registered for the webinar presented by Jack Cresswell (PSNC Funding Strategy Manager), Suraj Shah (PSNC Drug Tariff and Reimbursement Manager), Claire Latimer (NHSBSA Customer Payments Team Manager) and Andrew Grey (NHSBSA Customer Payments Team Member).

During this webinar viewers were guided through how your pharmacy’s monthly FP34 Schedule of Payments is put together, potential discrepancies between the FP34c and FP34 were highlighted, NHSBSA also described the different sections of the schedule.

PSNC illustrated why monthly payments for contractors may fluctuate and how to use your Schedule of Payments to monitor performance.

So, if you want to better understand the payments your pharmacy receives from the NHS, watching this webinar may provide some useful insights.

Watch the on-demand webinar at: psnc.org.uk/FP34webinar

Important supply update Diamorphine 5mg injections: Out of stock until w/c 5th August 2019. It is expected that there will be sufficient supplies of Diamorphine 10mg injections via usual wholesalers.

Microgynon 30 tablets: Out of stock until w/c 8th July. This is due to capacity constraints at their manufacturing site in Germany.

Ovranette tablets: Out of stock until August 2019. This is due to capacity constraints.

Both Microgynon 30 and Ovranette contain ethinylestradiol 30microgram/ levonorgestrel 150microgram, but the Department of Health and Social Care advises that there are sufficient alternatives available to meet demand.

Further details, including advice for prescribers and dispensers, can be found at: ow.ly/Q7cA30oQAV6

DISPENSING AND SUPPLY

New PSNC resource: Appliance Watch A three-month period of notice is issued by the NHS Business Service Authority (NHSBSA) on all appliances due to be deleted from Part IX of the Drug Tariff. However, an appliance flagged with a two-or three-month notice of deletion may not always be easy to identify as they are not listed separately in the Preface section.

To assist pharmacy teams and provide full visibility of all appliances due to be deleted in the coming month(s), PSNC will publish the list of appliances that have been deleted from the current month’s Drug Tariff and compile lists of the appliances flagged with a notice of deletion of up to three months.

To view the appliances due to be deleted from upcoming months, go to our page: psnc.org.uk/appliancedeletions

Yellow Card Scheme videos The Medicines and Healthcare products Regulatory Agency (MHRA) has produced two videos which highlight the Yellow Card Scheme to patients, and community pharmacy teams are being asked to share them.

The videos have been developed to help increase the reporting of side effects or problems that may occur when patients take medicines or use medical devices.

Watch and share the videos from: ow.ly/xrLe50uE4Cv

AstraZeneca distribution change From 1st July 2019, AAH Pharmaceuticals Ltd will be the solus distributor for all AstraZeneca products to pharmacies in the UK. If you have questions regarding the change to AstraZeneca’s distribution, please contact the Supply Chain team on supply.chain@astrazeneca.com If you do not already have an AAH account, you can contact AAH via their website (www.aah.co.uk) or by calling 0344 561 2008.

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Ask PSNC

The PSNC Dispensing and Supply Team provides pharmacy teams with support and advice on a range of topics related to the Drug Tariff and reimbursement. Questions asked in recent months include:

Q. How is my AIV calculated?

A. Your Average Item Value (AIV) is calculated using the total figures from the first page of your Schedule of Payments, as follows.

Q. Is it possible to claim top-ups for Establishment Payments, for the month of April 2019?

Drug and Appliance costs plus fees less the value of MURs, AURs and NMS divided by the total number of professional fees.

Total of drug and £56,802.12 appliance costs Total of all fees £10,634.06

Other fees Medicine use reviews £84.00 Appliance use reviews £0.00 carried out at patients home Appliance use reviews £0.00 carried out at premises

AIV = (Drugs & Appliance cost + fees) – (MUR, AUR & NMS value) Total number of items Total of items, for which a fee is paid 7418

For example: Drug and Appliance costs plus fees = £67,436.18 Total value of MURs, AURs and NMS = £84.00 Total number of professional fees = 7418 £67,436.18 - £84.00 = £63,3438.18 divided by 7418 = £9.08 Please note, where contractors have not submitted for three months previously, a national average is applied.

Q. Can the NHSBSA please send copies of switched prescriptions for pharmacy team training purposes?

A. No. The mechanism for claiming top-ups for Establishment Payments and Practice Payments was removed for English pharmacies when the Government imposed the funding reduction and associated Drug Tariff changes in December 2016.

The last period that was eligible for claims for English pharmacies was April - November 2016.

A. The NHS Business Services Authority (NHSBSA) Services can only send out copies the first time that they are requested per account, and for training purposes only.

To request a copy of switched prescriptions, you must submit the recheck request form available on our website: psnc.org.uk/recheck Please note that if NHSBSA can see on their records that you have had copies for a previous month, they will not be able to send copies for another month. If this is the case, then you will need to contact your local NHS England Team who are required to provide pharmacy contractors with reasonable facilities for examining all or any of their prescription forms.

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 email info@psnc.org.uk).

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LPCS

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Using Your Schedule of Payments to Monitor Performance PSNC’s Dispensing and Supply team explain how to analyse your monthly Schedule of Payments to help you understand and manage your NHS pharmacy business more effectively.

PSNC encourages contractors to conduct their own internal audits by checking their Schedule of Payments as soon as possible after receipt to identify any unusual trends or potential errors. The following highlights sections of your account you may wish to check (please note this is not exhaustive):

1. What checks can I make to monitor monthly payments?

Monitoring the net payment figure alone is insufficient.

Looking at your monthly net payment figure solely is not an ideal parameter for understanding changes to patterns of payment over a period of time, since these figures are distorted by changes to the average item value (AIV) and by the advances which are issued and recovered each month.

Over time, monitoring the relevant totals and subtotals within the ‘Drug and Appliance Costs’ section, and ‘Professional Fees’ section, will provide a better understanding of any changes to pharmacy payments. As reimbursement prices for drugs and appliances can vary monthto-month, pharmacy drug/appliance purchasing costs may follow a similar pattern and it may be useful to compare the trend of procurement costs against the total of drugs and appliances reimbursed.

The AIV is calculated using the total of drugs and appliance costs plus fees and less any MUR, AUR and NMS values; this figure is then divided by the total number of items for which a fee is paid. The AIV figure is important as it is used to calculate the Advance payment.

2. Was there anything unusual/different about the dispensing month this schedule refers to?

When looking at a Schedule of Payments it is important to think back to the actual dispensing month it relates to. For example, the total number of items dispensed may have been lower due to a Bank holiday that month or it was it a shorter dispensing month due to fewer working days. Perhaps, it was during a month when some of the regular patients were away on holiday and had collected their items in the preceding months.

3. Has your average item value (AIV) changed?

A range of factors can affect the AIV including: • a change to the profile of drugs dispensed; for example, if a regular patient with expensive items no longer visits the pharmacy • local deprescribing initiatives reducing the total number of items dispensed by a pharmacy • expiry of patents for high-volume or high-cost drugs • prescribers requesting fewer or lower-value expensive items or, conversely, a high number of expensive items dispensed in a particular month • a local change such as a competitor that has just opened or closed their business, or relocation of local GP practice • changes to Category M prices (see our page Retained margin (Category M)) • Pharmaceutical Price Regulation Scheme (PPRS) branded medicine price changes • a change to period of treatment (i.e. 28 versus 56-day prescriptions) Data on national AIV trends can be found on the PSNC website (psnc.org.uk/statistics).

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PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

4. Are there higher than normal levels of prescription switching on your account?

Prescription switching statistics for each account can usually be found on page 3 of the Schedule of Payments. It is important to monitor this closely, to identify any staff training needs particularly if the pharmacy prescription switching figures are high. To avoid switching of prescriptions between exempt and chargeable groups, ensure that the prescription receipt SOPs are being followed by pharmacy staff, exemption checks and declarations are completed correctly where required, and that paper prescriptions are sorted and submitted in the correct group (exempt or chargeable) at the end of the month.

PSNC’s Prescription Switching Factsheet contains tips on how to prevent prescriptions from being switched.

5. Are there any expensive items with a net ingredient cost (NIC) of over £100 missing from the itemised list on your schedule?

PSNC recommends, where possible, keeping a record of all expensive lines submitted to the NHSBSA every month and then reconciling these items with your Schedule of Payments; this might be done by keeping copies of such prescriptions.

Please note: If a broken bulk claim has been made for an expensive item, the schedule will only show the value of the prescribed quantity, even where the pharmacy has been paid for the full pack under the broken bulk arrangements.

6. What’s the best way to double-check for inputting errors?

PSNC advises contractors to check that: • Dispense and claim notification messages are sent on time considering the EPS 5-day window (PSNC’s Claiming for EPS prescriptions on time factsheet explains how EPS 5-day window affects timing of payment).

• The correct number of items are declared on your FP34C. PMR systems can generate reports showing the correct number of EPS and paper items to include on the FP34C. • Any figures declared on the FP34C are clearly legible.

• It is advisable to photocopy your FP34C before sending it to NHSBSA. • There is no significant discrepancy between the number of forms/items declared on the FP34C document and your Schedule of Payments (paying particular attention to your submitted EPS figures). The number of items used to calculate the Advance payment* should match the number of items declared on the FP34C for the relevant dispensing month.

• The number of FP57 refunds match your declaration.

• Payment for Advanced Services (MUR/NMS/AUR/NUMSAS) match your declaration. * Discrepancies between the declared item totals and the actual items received by the NHSBSA total will have an impact on your Advance payment and balancing payment. This could lead to cashflow issues that may take time to stabilise. The correct declaration of items will help with prescription reconciliation.

For more information on Advance payments and how balancing payments are calculated, visit psnc.org.uk/schedule The Manage Your Service (MYS) application (currently in pilot testing phase) offers a digital alternative to the current paper-based submission processes followed by contractors. To reduce risk of inputting errors, MYS has built-in validation to improve the accuracy of submissions.

If you believe there is an issue with your monthly payment (for example due to item count, charges count, expensive items, out of pocket expenses, switching etc), this should be reported to the NHSBSA and a re-check of a month or specific months’ prescriptions can be requested in writing by completing the NHSBSA’s prescription pricing enquiry form. Further information can be found at psnc.org.uk/rechecks.

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Drug Tariff Watch: July 2019 Part VIIIA Category C additions: • Abacavir 600mg / Lamivudine 300mg tablets (30) - Lupin Healthcare (UK) Ltd • Alirocumab solution for injection prefilled disposable devices: ° 150mg/1ml (2) - Praluent ° 75mg/1ml (2) - Praluent • Amlodipine 5mg/5ml oral suspension s/f (150ml) - Essential Pharmaceuticals Ltd • Amphotericin B 50mg powder for solution for infusion vials  (1) Fungizone Intravenous • Bethanechol chloride 10mg tablets (100) and 25mg tablets (100) - Myotonine • Bilastine 20mg tablets (30) - Ilaxten • Cetrorelix 250µg powder and solvent for solution for injection vials  (1) - Cetrotide • Ciprofloxacin 3mg/ml / Fluocinolone acetonide 0.25mg/ml ear drops 0.25ml unit dose preservative free (15) Cetraxal Plus • Citric acid 17.79g / Magnesium carbonate 11.57g effervescent powder sachets s/f (10) - Citramag • Econazole 1% cream  (15g) - GynoPevaryl and  (30g) • Filgrastim 30million units/1ml solution for injection vials (5) - Neupogen • Fluocinolone acetonide 0.025% / Neomycin 0.5% ointment  (30g) - Synalar N • Flurbiprofen 0.03% eye drops 0.4ml unit dose preservative free  (40) - Ocufen • Hamamelis water 13% eye drops  (10ml) - Optrex Sore Eyes • Hydrocortisone 0.1% topical emulsion  (100g) - Locoid Crelo • Hydrogen peroxide: ° 3% (200ml) - Thornton & Ross ° 6% (200ml) - Thornton & Ross ° 9% (200ml) - Thornton & Ross • Inosine acedoben dimepranol 500mg tablets (100) - Imunovir

• Japanese encephalitis vaccine (inactivated, adsorbed) suspension for injection 0.5ml pre-filled syringes  (1) - Ixiaro • Latanoprost 50µg/ml / Timolol 5mg/ml eye drops 0.2ml unit dose preservative free (30 (6x  5)) - Fixapost • Lidocaine 0.66% / Aminoacridine 0.05% oromucosal gel s/f  (8g) - Iglu • Lidocaine 1% / Hydrocortisone 0.2% spray  (30ml) - Perinal • Measles, Mumps and Rubella vaccine (live) powder and solvent for solution for injection 0.5ml pre-filled syringes  (1) - Priorix • Meglumine amidotrizoate 3.3g/5ml / Sodium amidotrizoate 500mg/5ml oral solution s/f (1000ml (10x  100)) Gastrografin • Mepyramine 2% cream  (25g) - Anthisan • Oseltamivir 30mg capsules SLS (10), 45mg capsules SLS (10) and 75mg capsules SLS (10) - Tamiflu • Paracetamol 80mg suppositories (10) Phoenix Labs Ltd • Patiromer calcium oral powder: ° 16.8g sachets (30) - Veltassa ° 8.4g sachets (30) - Veltassa • Pentosan polysulfate sodium 100mg capsules (90) - Elmiron (Consilient Health Ltd) • Pneumococcal polysaccharide vaccine solution for injection 0.5ml pre-filled syringes (1) - Pneumovax 23 • Pseudoephedrine 30mg/5ml oral solution (100ml) – Sudafed Decongestant liquid • Salbutamol 100µg/dose dry powder inhalation cartridge with device  (200 dose) - Salbulin Novolizer • Salbutamol 5mg/5ml solution for infusion ampoules (10) - Ventolin

LPCS

KEY:  Special container * This pack only (others already available) SLS Selected List Scheme • Semaglutide solution for injection 1.5ml prefilled disposable device: ° 0.25mg/0.19ml  (1) - Ozempic ° 0.5mg/0.37ml  (1) - Ozempic • Semaglutide 1mg/0.74ml solution for injection 3ml pre-filled disposable device  (1) - Ozempic • Silver nitrate caustic applicators: ° 75% (100) - Avoca ° 95% (100) - Avoca • *Sodium alginate 225mg/dose / Magnesium alginate 87.5mg/dose oral powder sachets s/f (30) - Gaviscon Infant • Sodium chloride 0.18% / Glucose 4% infusion 500ml polyethylene bottles  (1) - Polyfusor T • Sodium valproate 400mg powder and solvent for solution for injection vials  (1) - Epilim Intravenous • Testosterone 20mg/g transdermal gel (23mg per actuation)  (85.5g) - Testavan • Tetanus immunoglobulin human 250unit solution for injection vials  (1) - Bio Products Laboratory Ltd • Tioguanine 40mg tablets (25) - Aspen Pharma Trading Ltd • Tolnaftate 1% liquid spray  (150ml) Scholl Athlete’s Foot • Toremifene 60mg tablets (30) - Fareston • Triamterene 50mg / Chlortalidone 50mg tablets (28) - Kalspare • Zinc oxide 283.5mg / Lidocaine 13.2mg suppositories (12) and (24) - Germoloids • Zinc oxide 6.6% / Lidocaine 0.7% cream  (25g) and  (55g) – Germoloids For a full list of changes, please visit: ow.ly/MQ2Y50uD63R

Part IX deletions Product

Size, type, product code

Vaginal Contraceptive Diaphragm Premierfilm Plus dressing Venturi MiNO Slim Foam Weekly Therapy Wound Care Set – Portal Drain Venturi MiNO Gauze Weekly Therapy Wound Care Set – Portal Drain

All products All sizes 10cm x 15cm x 1.5cm 15cm x 17cm

Rocket IPC Catheter – 1000ml Bottle and Mini dressing pack Rocket IPC Catheter – Mini Dressing Pack and Bottle Limb Protector – buddy – Isolated wounds Limb Protector – buddy – Legs MacGregor Healthcare Ltd – Qufora Self Adhering Silicone Urisheath – Standard & Short MacGregor Healthcare Ltd – Qufora Sterile Leg Bags – direct inlet Q Flow Lever Tap MacGregor Healthcare Ltd – Qufora Sterile Leg Bags – direct inlet T-tap

R54411-00-PP R54400-00-PP CC/XS20/20 and CC/S30/20 LL/XXS/30 and LL/XS/40 All sizes 12161704 and 12361704 12151704 and 12351704 psnc.org.uk 11

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

PSNC resources library PSNC Briefings PSNC Briefing 018/19: A summary of the Network Contract Directed Enhanced Service (DES) 2019/20 This PSNC Briefing summarises the Network Contract DES specification which enables general practices to take a leading role in Primary Care Networks (PCNs).

Download from: ow.ly/hSol30oVXv7

PSNC Briefing 021/19: CPAF screening process for 2019/20 With the Community Pharmacy Assurance Framework (CPAF) screening questionnaire now underway, this PSNC briefing describes the updates to this year’s questionnaire and provides guidance on the other sections.

Download from: ow.ly/jlro30oVXuy PSNC Briefing 022/19: Serious Shortage Protocols As Serious Shortage Protocols (SSPs) are introduced into the pharmacy Terms of Service, this PSNC Briefing explains the considerations that pharmacists will have to make if an SSP is approved by Government.

Download from: ow.ly/9LS650uQx7r See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources Understanding your Schedule of Payments webinar In this webinar, PSNC and the NHS Business Services Authority (NHSBSA) talk viewers through the different sections of the monthly FP34 Schedule of Payments, and explain how to use it to monitor performance.

Watch now: psnc.org.uk/FP34webinar Appliance Watch: Notice of Deletion PSNC’s new webpage includes the list of appliances to be deleted from the Drug Tariff, giving contractors full visibility of all appliances due to be deleted in the coming month(s). The page will be updated each month.

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

Email news alerts Feedback on our Future of Pharmacy Animation (21st May) An email requesting feedback on our ‘future of pharmacy’ animation to make sure that it is useful and asking whether PSNC should create more animations going forwards.

Read now: ow.ly/NOHl30oVXHr 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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