March 2016 CPN

CPN

Community Pharmacy News – March 2016

Campaign gathers momentum Pharmacy pulls together to raise awareness of the potential threat to community healthcare

SCR rollout checklist | Local commissioning support | Prescriber codes guidance

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Campaign to protect community pharmacy's future Work continues to prevent the Government plans from damaging patient care. Here we update community pharmacy teams on the latest developments in the sector’s campaigning work.

Following the Government’s announcement of its plans for the future of community pharmacy, PSNC has worked with the other national pharmacy organisations and its public affairs agency, Luther Pendragon, to launch a campaign to protect the sector and ultimately patients.

In the first phase of the campaign, PSNC has been coordinating activity with other pharmacy organisations and providing information and resources to help LPCs and contractors get behind the campaign. PSNC has been warning about the threats posed to pharmacy, and hence to patients and the public, as well as pointing out the problems and risks with the proposals and asking for more clarity on them.

Collaboration with others In January, the pharmacy organisations agreed to establish a steering group including representatives from PSNC, Pharmacy Voice, the National Pharmacy Association (NPA), the Royal Pharmaceutical Society (RPS), the Association of Independent Multiple Pharmacies and the Company Chemists’ Association.

The steering group oversees the communications and public affairs work related to the response to the proposed changes to community pharmacy. It monitors ongoing and planned work, helping to ensure that all work is as coordinated as possible as it is really important that pharmacy's response to the proposals is consistent.

As well as the steering group, the communications and public affairs leads from all the pharmacy organisations are working very closely together. The group has worked together on a range of campaign activities including agreeing the wording of

the paper petition against the changes; aligning social media activity; setting up email signatures and campaign resource hubs; and preparing for the action day on 24th March (see page opposite).

Political lobbying A key focus for all the pharmacy organisations has been the lobbying of MPs about the proposed changes, and pharmacy teams and LPCs have a vital role to play in helping this work at a constituent level.

To help with this PSNC has produced a range of resources including a template briefing for MPs. PSNC can also give advice to pharmacy teams and LPCs to help with this work.

PSNC has also been lobbying particular MPs and peers at a national level; with a series of meetings arranged to talk them through our concerns and service proposals, and to suggest ways in which they might be able to help. This has led to a number of MPs asking Parliamentary questions, writing letters to pharmacy minister Alistair Burt and supporting the campaign in other ways.

PSNC and LPCs also worked hard to brief a number of MPs ahead of a Parliamentary debate on pharmacy in Westminster Hall on 23rd February. A summary of this very constructive debate is available as PSNC Briefing 016/16 at: psnc.org.uk/briefings.

In March, PSNC, Pharmacy Voice and the RPS will jointly host evening briefings with Conservative and Labour MPs to discuss the changes and their thoughts on them in more detail. The three organisations are also working to align party conference activity later in the year.

PSNC’s public responses PSNC has now issued a number of public statements on the changes.

These are summarised here.

17th December: Initial statement saying that the announcement has delivered a financial blow to community pharmacy; highlighting the efficiencies consistently made by contractors; and stressing the impact that cutting funding will have in directing more people to GPs and urgent care.

2015 2016 December

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January

15th January: PSNC response to 17th December letter published.

The letter sets out a number of concerns and questions about the proposed changes. The letter states that the Government appears to have settled on a course of action that runs counter to its stated ambition to develop a clinically focussed community pharmacy service. And the letter confirms that PSNC will not enter into negotiations until the Government has shared further details of its plans.

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Getting involved in the campaign What others have been doing Representatives from across the sector were making the case for community pharmacy to the public in London last month. On 26th February, PSNC staff and committee members joined LPC members, community pharmacy contractors and NPA and Pharmacy Voice representatives at an action day organised by the NPA. The team hosted a stand at the Elephant and Castle shopping centre, using it to speak to members of the public about community pharmacy’s future and to gain signatures for the paper petition. Signatures collected were then presented to the Department of Health. To find out more about the petitions visit: psnc.org.uk/campaign.

What you can do 1. Show your support by adding a promotional piece to your email signature. Find the template created by PSNC and the other national pharmacy bodies on the "How can you help?" page of PSNC’s campaign hub (psnc.org.uk/campaign).

2. Use #lovemypharmacy on social media to share stories of how you and your pharmacy team have gone out of your way to help patients.

3. Collect case studies that demonstrate where you have offered exceptional care to patients. These can be emailed to campaign@psnc.org.uk.

4. Ask your patients to sign the paper petition (which can be downloaded from the supportyourlocalpharmacy.org website) and to contact their MP. Upcoming work – 24th March The cross pharmacy steering and communications group is jointly working on a raft of activity to take place during the week beginning 21st March. This includes press work and a day of action taking place on Thursday 24th March (the day before Good Friday). The action day will see a real push in community pharmacies to gain signatures for the campaign petition as well as increased social media activity to gather case studies of exceptional community pharmacy care.

Further resources PSNC has set up a campaign hub (psnc.org.uk/campaign) and a campaign email address (campaign@psnc.org.uk) in order to give contractors and LPCs easy access to information and resources and a place to ask questions and share positive stories and case studies. A flyer highlighting the value of community pharmacy and including information on PSNC’s service development proposals has also been produced (PSNC Briefing 018/16 at psnc.org.uk/briefings), plus guidance is under development for LPCs on organising local campaigning events.

Next steps PSNC is continuing with the programme of meetings with MPs and peers to build support for community pharmacy and for our concerns about the proposals for changes. PSNC will also continue to support LPCs in their local activity and to keep them updated on developments. PSNC is in discussion with Pharmacy Voice and the NPA about which patient organisations to approach for additional support, as well as to decide how to collate case studies and use them to best effect to help make the sector’s case.

Prescription Charge Card 2016 Each year PSNC provides a Prescription Charge Card for community pharmacies in England which is designed to be used as a poster. At the time Community Pharmacy News (CPN) went to press the Department of Health had not confirmed what the charge would be from April 2016; we hope to have this finalised in time to include the poster with CPN, but look out for updates at: psnc.org.uk

22nd January:

9th February:

24th February:

PSNC published an update for contractors following a number of developments including the publication of the Department of Health's briefing presentation on the changes and the comment from pharmacy minister Alistair Burt that as many as 3,000 pharmacies could close. PSNC set out its response to the individual proposals, stating that it could not accept proposals that will jeopardise the services and supplies that pharmacies provide to their patients.

PSNC service proposals published. These set out a plan for community pharmacy services including the introduction of a care package, which would see repeat dispensing becoming a default option where medicines are needed on a long-term basis, patient registration at pharmacies, and pharmacies offering enhanced medicines optimisation services. PSNC's proposals can be found at: psnc.org.uk/campaign.

PSNC held the first of two contractor events, in Birmingham, to give contractors information about the proposals and the response to them; and to encourage them to get involved in the campaign. The second event was held in London on 10th March.

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Summary Care Record update The rollout of Summary Care Records (SCR) to community pharmacies across England continues. At the beginning of March 2016, over 430 pharmacies had completed rollout and had SCR access.

How can you get SCR access in your community pharmacy?

In order to go live with SCR, at least one person from each community pharmacy must attend a face to face ‘Implementation Briefing Session’. Please note this requirement is per community pharmacy, not per contractor/company.

Other requirements are mentioned within the implementation checklist on the page opposite.

The following contractors are providing Implementation Briefing Sessions internally within their company, with details of the sessions being sent directly to their pharmacies: Lloydspharmacy, Boots, Tesco, Safedale Ltd, Manor Pharmacy, Dean & Smedley, Knights, Cohen’s Group, Superdrug, Morrisons, H.I Weldrick Ltd and Kamsons.

The Health & Social Care Information Centre (HSCIC) has advised that Day Lewis and Rowlands have already completed briefing sessions for their pharmacies.

For staff who work in all other community pharmacies, the Implementation Briefing Sessions will be provided on a local, geographical basis, and you will be informed of these through local communication channels (generally via your LPC and local NHS England team).

Region

Likely month of first sessions

Central Midlands (Northampton and Milton Keynes), Greater Manchester

Commenced in January

North Midlands (Shropshire), South Central, South February East, South West, Wessex, Central Midlands (Luton, Bedfordshire and Leicestershire), West Midlands (Wolverhampton, Solihull, Worcestershire) Central Midlands (remaining areas to start), North Midlands (Staffordshire), Cheshire & Merseyside Cumbria & North East, East Midlands, West Midlands (remaining areas to start), Yorkshire & Humber, Lancashire

March

London

April

North Midlands (remaining areas to start)

May

Each contractor will need to nominate a person responsible for monitoring SCR activity; this person is termed the Privacy Officer.

Training on this role and how to access reports will also be provided locally. Pharmacy Voice have recently issued a briefing paper on the role of the Privacy Officer (tinyurl.com/scrprivacyoff) and further guidance is available on the HSCIC website (tinyurl.com/hscicscrpo).

For further information on SCR and the implementation approach, as well as confirmed timescales for the briefing sessions, please visit the HSCIC website (tinyurl.com/hscicscr).

Funding for rollout of SCR access The March 2016 Drug Tariff notified community pharmacy contractors that to support the implementation of the Summary Care Record (SCR) to community pharmacies, they will be paid an allowance of £200 from 1st March 2016, subject to certain conditions being met.

The £200 allowance will be triggered when the pharmacy contractor has submitted the SCR in Community Pharmacy Usage Agreement to the Health & Social Care Information Centre (HSCIC) and accessed the SCR. The allowance will only be paid once, irrespective of any subsequent premises merger, sale or relocation. The allowance will be timelimited and cease on 31st March 2017.

The relevant regulations which contractors must adhere to are set out in Schedules 4 4 Community Pharmacy News – March 2015

In order to receive the allowance pharmacy contractors must fulfil a number of requirements; these are specified within the checklist on the page opposite.

and 7 of the National Health Service (Pharmaceutical and Local Pharmaceutical Services (England) (Amendment) Regulations 2016.

PSNC comment on the SCR funding “The costs that pharmacy contractors will incur if they choose to rollout SCR access will vary depending on the individual pharmacy; the £200 payment to pharmacy contractors included in the March 2016 Drug Tariff represents a contribution to those costs. When the Secretary of State for Health provided funding to NHS England to enable SCR access in community pharmacies, he made this conditional on pharmacy contractors sharing the cost of rollout with the NHS.” Find out more about community pharmacy access to SCR at: psnc.org.uk/scr

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Summary Care Record (SCR) implementation checklist Smartcard roles are set up* – Staff accessing the SCR should have specific Smartcard roles enabling access to the SCR. Locums who regularly work at a particular pharmacy can request the specific site pharmacy role is added to their Smartcard (please visit: psnc.org.uk/sc) Standard operating procedure (SOP) is in place* – The pharmacy team need an SCR SOP. A template is available at: tinyurl.com/scrsop. SCR access could also be integrated into other SOPs. Standard system settings are compliant* – The system must be compliant with the HSCIC Warranted Environment Specification (WES), please visit: psnc.org.uk/wes

Face-to-face training event has been attended* – One person per site to have attended a HSCIC or HSCIC approved face-to-face implementation briefing.

CPPE online training has been completed* – All pharmacists and pharmacy technicians who will access the SCR must have completed the Centre for Pharmacy Postgraduate Education (CPPE) online SCR training module prior to accessing the SCR. Privacy Officer has been appointed* – The Privacy Officer is responsible for auditing and reviewing the SCR access.

Information Governance (IG) Toolkit has been submitted* – An IG Toolkit submission must have been made within the last 12 months.

N3 connection is present* – If you are EPS-live this will be present already.

Trigger the payment of the allowance after confirming that the above steps have been completed – Once the requirements above have been fulfilled a declaration (tinyurl.com/scragreement) is made that the contractor and their team agree to comply with the ongoing requirements for access to the SCR.

Access has been checked using test patient – The pharmacy team should check they can access the SCR using the test NHS Numbers provided (these can be found in the sample SOP at: tinyurl.com/scrsop).

Patient information is available – The pharmacy team may choose to make patient information materials (posters, leaflets) available at the pharmacy and on the pharmacy website (tinyurl.com/scrdocs)

SCR web address has been added to favourites – The pharmacy team may choose to add the SCR URL to their desktop/favourites to make future access quick and easy. The URL required to access the SCR is: https://portal.national.ncrs.nhs.uk/portal/dt (please note a Smartcard is required).

Begin using the SCR – Pharmacy teams report that the SCR can be used as an alternative to contacting the GP practice in some scenarios. The Royal Pharmaceutical Society has published a one-page factsheet which explains the scenarios in which to use the SCR (tinyurl.com/scrscenarios). The decision as to when to use SCR is a professional one. *These are required to be completed before a community pharmacy contractor can receive the £200 SCR allowance.

For further details on SCR implementation please contact your regional SCR implementation manager North: richard.oliver5@hscic.gov.uk

Midlands: michele.hulme@hscic.gov.uk

London & South: harpreet.shergill@hscic.gov.uk

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Local commissioning support PSNC supports LPCs in their work to get local services commissioned for pharmacy contractors in their area. Here we highlight some of our recent resources which help promote the work community pharmacy can do.

Essential facts, stats and quotes A new section on Essential facts, stats and quotes has been added to the PSNC website.

Please note this section is a work in progress; however, we have decided to publish it so that LPC members can start to use it. New topics will continue to be added, and new facts, stats and quotes will also be added to the individual topics.

Useful shortlinks are: • psnc.org.uk/essentialfacts – this takes you directly to the page; and • psnc.org.uk/pharmacyfacts – this takes you directly to the page, which contains key facts about community pharmacy and pharmacy professionals.

New service prospectuses published At the time of going to press, we have published 11 service prospectuses, with more to be published over the coming weeks. The prospectuses are intended to showcase community pharmacy services to encourage local commissioners to consider commissioning them.

The prospectuses have been added to our Think Pharmacy webpage (psnc.org.uk/thinkpharmacy) and included in our Commissioners Portal (psnc.org.uk/commissioners), but Word versions are also available in the LPC Resources Centre so LPCs can add their own contact details in the footer.

Community pharmacy’s value in delivering public health services is recognised BMJ Open has published the results of a systematic review focussed on public health interventions delivered by community pharmacies, which concludes that commissioners should consider using community pharmacies to help deliver public health services.

Nineteen studies, which explored the effectiveness of community pharmacy-delivered interventions for weight management, smoking cessation and the misuse or excessive consumption of alcohol were included in the review.

The review concluded that community pharmacy is an appropriate and feasible setting to deliver a range of public health interventions and that given the potential reach, effectiveness and associated costs of these interventions, community pharmacy should be considered by commissioners to help deliver public health services.

The Zika virus: guidance for pharmacy teams Public Health England has issued a guidance document on the Zika virus for healthcare professionals, produced in conjunction with the Royal College of General Practitioners and the British Medical Association.

The guidance provides a summary of background information on the Zika virus including risks of transmission and symptoms, its risk of harm to foetuses as well as general advice and recommendations for travellers. It also issues specific advice to women who are pregnant, or planning to become pregnant.

The information in the guidance can be used by pharmacy teams when giving advice or responding to patients’ queries, including pregnant women, who are travelling to or retuning from countries which have been affected by the Zika outbreak.

To read and download the guidance, please visit: dld.bz/emDfm

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Polypharmacy learning campaign The Centre for Pharmacy Postgraduate Education (CPPE) has sent out materials on polypharmacy to every registered pharmacy professional in England for their spring 2016 learning campaign.

We are launching a range of learning on Polypharmacy, including a national campaign of learning, a “distance learning programme and a focal point workshop.

Over the past decade, the average number of items prescribed for each person per year in England has increased significantly. For many patients, it might be entirely appropriate to be taking multiple medicines. However, evidence suggests that some patients may be taking unnecessary or problematic medicines. This can put patients at risk of harm, increasing risk of hospital admission and leading to poor therapeutic outcomes. This makes polypharmacy an important topic for all health and social care professionals.

Layla Fattah Senior Pharmacist, Learning Development

CPPE is aiming to raise awareness of polypharmacy, and highlight the important role that pharmacy professionals have in supporting patients taking multiple medicines. The learning materials look at practical steps that you can take in your practice to identify problematic polypharmacy and address this by working with your patients and colleagues in a patient-centred way.

A copy of our new Polypharmacy distance learning programme, a leaflet sharing our weekly challenges and a letter outlining how you can use the programme have been sent to all pharmacy professionals.

Keep an eye on our dedicated webpage for updates: www.cppe.ac.uk/polypharmacy.

”

Latest support from CPPE The “Prioritising services, improving outcomes” e-learning programme aims to explain the underlying principles of patientcentred pharmacy services and to help participants identify and overcome the main barriers to effective service delivery.

Find out more at: dld.bz/epuHU

A new consultation skills floor has been added to theLearningpharmacy.com to complement CPPE’s other work in this area. Online learning platform theLearningpharmacy.com is a free virtual community pharmacy that offers interactive bite-sized challenges for the whole pharmacy team.

Find out more at: dld.bz/eqdmk

The third edition of the consultation skills for pharmacy practice (CSfPP) newsletter describes new work that CPPE is currently undertaking, such as the ‘Do you say…?’ leaflet campaign and the distribution of consultation skills cards for pharmacy teams, as well as relevant publications and e-learning programmes.

Find out more at: dld.bz/eqQ7A

Charity Focus: British Lung Foundation The British Lung Foundation (BLF) is the only charity in the UK with a mission to look after the nation’s lungs. Their aim is to improve care – and to prevent, treat and cure lung conditions. They are involved in research, campaigns and offer support to people with lung conditions.

as chronic obstructive pulmonary disease, lung cancer, mesothelioma, pulmonary fibrosis and tuberculosis; • a web community, which allows people to chat to others who are in a similar situation, ask questions or just have a look at what is being discussed; and • a local support finder, which assists with finding out what local support groups are available.

BLF has a number of free resources that community pharmacy teams can supply patients with or signpost patients to on the BLF website, including: • easy-to-understand information about lung conditions; • advice on how people can get the most out of life with a lung condition; • a range of leaflets, booklets and other resources on topics such

Additionally, healthcare professionals with a special interest in respiratory care can become a BLF Professional, which includes a number of benefits such as regional study days, networking and opportunities to shadow other services.

You can read the full article on what BLF has to offer both patients and healthcare professionals at: dld.bz/erY3K

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PSNC regularly receives questions from LPCs and pharmacy contractors about what is going on in the wider health and care landscape beyond community pharmacy. For a more comprehensive round-up, please visit: psnc.org.uk/hclbriefings

...and public dissatisfaction rose by 8% to 23%

Public satisfaction with the NHS fell by 5% in 2015 to 60%...

Men and women can now expect to live for a further 20 years on average at age 65 Evaluations and statistics • A survey of more than 2,000 people showed that public satisfaction with the NHS fell by 5% in 2015 to 60% and dissatisfaction rose by 8% to 23%.The three main reasons that people gave for being dissatisfied with the health service were long waiting times, staff shortages and lack of funding.

• The latest quality monitoring report from The King’s Fund found that just over half (53%) of NHS trust finance directors said that quality of care in their local area has worsened in the past year, and nearly two-thirds (64%) of trusts are reliant on extra financial support from the Department of Health (DH) or drawing down their reserves.

• NHS England has published the results of the NHS 2015 Staff Survey involving approximately a quarter of the permanent NHS workforce. Despite showing significant improvements in key areas such as staff engagement, employee health and wellbeing and prioritisation of patient care, the survey still reveals a number of challenges being faced such as stress, staffing levels and discrimination.

• According to a report by Public Health England (PHE), men can now expect to live for a further 19 years at age 65 and women can expect to live for a further 21 years.

• The Health & Social Care Information Centre has revealed that the proportion of women aged 50-70 screened for breast cancer after their first invite decreased to 63.3% in 2014/15, down from 70.1% in 2004/05.

Resources • PHE has published Making Every Contact Count (MECC): implementation guide, a guide to support people and organisations to aid local implementation of MECC activity.

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An independent report identifies ways to save £5bn over the next three to four years MECC encourages conversations based on behaviour change, empowering healthier lifestyle choices and exploring the wider social determinants that influence people’s heath.

• A report published by the Commonwealth Fund evaluates the findings of an analysis of smartphone apps targeting individuals with chronic illnesses and the extent of usefulness of these apps in patient engagement. The authors also developed a framework consisting of a set of general criteria to evaluate apps on the basis of patient engagement, quality and safety.

The criteria can be used when judging whether or not an app should be recommended to patients.

Future plans • DH has outlined its vision and commitment to provide the highest quality and most compassionate health and care services in the world in its Shared delivery plan: 2015 to 2020.

The plan includes a commitment to focus as much on the prevention of poor health as it does on treating illnesses.

• Building on the agenda set out in the Five Year Forward View, NHS England has launched a new three year programme to support social movements in health and care, supported by the Transformation Funding. The programme will work with six new vanguards across England and aims to: identify and develop exemplar social movements; demonstrate what works effectively; and support spread to enable local approaches to be adapted in other communities.

• An independent report, Operational productivity and performance in English NHS acute hospitals: Unwarranted variations, gives 15 recommendations that need to be acted upon to deliver a £5bn saving for the NHS over the next three to four years.

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

New oral anticoagulants toolkit

Pfizer has published an oral anticoagulants toolkit to support community pharmacy teams to deliver Medicines Use Reviews (MURs) and the New Medicine Service (NMS).

PSNC and Pharmacy Voice have both endorsed the toolkit.

The toolkit includes a brief overview of anticoagulants, advice on starting to provide MURs and NMS for patients taking anticoagulants, and eight key points to discuss with every patient taking an oral anticoagulant.

To find out more, including how to order hard copies of the toolkit, please visit: dld.bz/emPrJ

Rebalancing medicines legislation

The Department of Health has publis hed the outcome of the rebalancing medic ines legislation and pharmacy regulation consultati on – read the outcome in full at: dld.bz/en3K2 It mentions that a separate repo rt will be published on the responses to the consultation questions on the Pharmacy (Prepara tion and Dispensing Errors) Order 2016, but there is no indication of when this will happen.

ls GPhC fees to remain at current leve cil (GPhC) governing The General Pharmaceutical Coun pharmacists, for levels fee ed council has decid premises will macy phar and s nician tech pharmacy 17 financial year.

2016/ remain at current levels for the enr5m dld.bz/ visit: e pleas n, For further informatio

MHRA issues materials and advice relating to valproate ucts The Medicines and Healthcare prod d new issue has A) (MHR Regulatory Agency ase incre to rials mate ation communic s of the awareness and support discussion of les risks of valproate, with fema childbearing potential and during pregnancy.

let The MHRA has produced a book as nals essio for healthcare prof well as a checklist for patients and prescribers. There is also a patient card and a patient guide available.

To find out more, please visit: dld.bz/epTF3

Adult public health campaign

Public Health England has called on community pharmacy teams to support its new adult health behaviour change programme, One You, which is designed to help adults live longer, healthier and happier lives.

As the NHS Five Year Forward View made very clear, the nation has to get serious about prevention. Without such a focus, recent improvements in tackling life expectancies will stall and health inequalities will deepen.

A toolkit has been developed to help pharmacy teams promote health and wellbeing messages, providing a great platform for teams to initiate conversations about lifestyle behaviours.

You can place an order for a toolkit by calling 0300 123 1019. The order line will be open Monday to Friday, from 8am to 6pm, until 8th May 2016 or while stocks last.

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The importance of checking for prescriber codes Community pharmacy teams are required to check NHS prescriptions for prescriber codes at the point of dispensing. Here we explain why they are important and where to find them on a prescription.

Prescriber codes enable the Pricing Authority to recharge the costs of prescriptions to the appropriate area. It is really important that community pharmacy contractors check NHS prescriptions contain a prescriber code, and attempt to identify and insert codes where any are missing. Prescriptions missing the prescriber code (with the exception of forms issued by a Dental Practitioner which do not need to have a code) may be returned to the contractor as a referred back form. This could lead to a delay in payment for that prescription.

If you receive a referred back form which is missing a prescriber code, and you are able to identify the code, the code should be added to the form and returned to the Pricing Authority in the next month’s submission. If you have been unsuccessful in identifying the code, the prescription should be endorsed to that effect and then returned. In either case, when resubmitted, the prescription will be paid in line with the Drug Tariff for the month the prescription form is resubmitted.

Please also see the FAQs on the page opposite.

Example 1 – standard prescriber details

The prescriber code will be a numerical code located at the top of the box containing the prescriber’s details and close to their name. It is often in bold and slightly larger than the rest of the text in this box.

Example 2 – independent prescriber details

There are usually two codes – one for the prescriber and one for the medical centre they are affiliated to. The prescriber code will be the top code, next to the prescriber’s name. It is often slightly larger than the rest of the text in this box.

Example 3 – hospital prescriber details

The prescriber code will be located at the top of the box containing the prescriber’s details. Hospital codes will contain letters as well as numbers. It is often in bold and slightly larger than the rest of the text in this box.

Experiencing supply issues?

Pharmacy teams who experience problems in obtaining medicines (generic or branded) or appliances are reminded to feed this back to our Dispensing and Supply Team, to support PSNC’s ongoing representation of issues in the supply chain.

PSNC passes a monthly summary of the feedback received to the Department of Health to support their monitoring of the situation. This information is also used as an evidence base in discussions with manufacturers on manufacturer-specific problems, for example, highlighting problems with contingency arrangements and promoting solutions.

Please make sure you let us know about any supply issues by using our online feedback forms at: psnc.org.uk/feedback 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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Endorsing prescriptions for appliances For an appliance prescribed generically and only listed generically in the Drug Tariff, the only endorsement required is the pack size where multiple pack sizes of the product are available. In the case of elastic hosiery and trusses, a description of the generic product must be provided.

For an appliance prescribed generically but listed by brand or manufacturer’s name in the Drug Tariff, endorse the brand or manufacturer’s name as listed in the Drug Tariff. The pack size need only be endorsed where there are multiple pack sizes of the product listed.

For an appliance prescribed by brand or manufacturer’s name, the only endorsement required is pack size where there are multiple pack sizes of the product listed.

Distributed for PSNC by:

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

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Ask PSNC The PSNC Dispensing and Supply Team can give pharmacy teams support and advice on a range of topics related to the Drug Tariff and reimbursement. Questions asked in recent months have included: 1. I have received a prescription which contains a prescriber code, I don’t know if it is the individual's prescriber code. Do I need to verify this code is correct?

No. Community pharmacy contractors are only expected to ensure that a code is present. Sometimes, in the case of hospital prescriptions, the code may be related to a hospital unit rather than an individual prescriber. Pricing Authority staff will check during the recharging process that the code is correct.

3. A patient has presented a prescription for a generic drug. They have requested the brand version and say they are willing to pay the pharmacy the difference in cost between the generic and brand. Is this allowed?

No. NHS services are provided free of charge at the point of delivery (unless otherwise indicated, e.g. if an NHS prescription charge is applicable).

As the contractor is not expected to perform any extra work by attempting to validate codes, prescriptions will not be returned to the pharmacy if a code is later identified as being incorrect.

These prescriptions will still be paid as normal within the usual timeframes. However, if a contractor suspects the prescription is not a genuine order for the person named on the prescription (e.g. they believe it has been stolen or forged), they should refuse to dispense for that reason.

2. I have received a dental prescription which does not contain a prescriber code, do I need to contact the prescriber to find it out?

No. The Pricing Authority has confirmed that dental prescriptions do not have prescriber codes; therefore contractors can dispense and submit these prescriptions without needing to identify or endorse a prescriber code.

You can, if you so choose, dispense a brand for a prescription written generically, provided you do not receive any additional payment for dispensing the branded drug. The choice of which product dispensed would be that of the pharmacist and any additional costs incurred should not be passed on to the patient.

Please note that for products prescribed generically and listed in Part VIIIA or Part VIIIB of the Drug Tariff, reimbursement is based on the Drug Tariff price. For a product prescribed generically which is not listed in Part VIIIA of the Drug Tariff, reimbursement is based on the manufacturer’s list price of the endorsed product.

Look out for more frequently asked questions next month…

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

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?

Does it have a ‘CE’ mark?

Is it in the blacklist?

Can it be dispensed on an FP10?

Additional information

Cura-Heat Back Pain heat packs

No

Yes

n/a

No

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

Dermol Wash cutaneous emulsion

Yes

No

No

Yes

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

Haleraid-120

No

Yes

n/a

No

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

Optrex ActiMist eye spray

No

Yes

n/a

No

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

Oilatum soap

Yes

No

Yes

No

This item is listed in Part XVIIIA (the ‘blacklist’) of the Drug Tariff.

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

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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 April 2016. You may also wish to see our Dispensing Factsheet: The Drug Tariff Preface at psnc.org.uk/dtresources SC Special Container R Item requiring reconstitution Part VIIIA additions Category A Additions: • Aripiprazole 10mg orodispersible tablets sugar free (28) • Aripiprazole 15mg orodispersible tablets sugar free (28) • Orphenadrine 50mg/5ml oral solution sugar free (150ml) Category C Additions: • Co-amoxiclav 125mg/31mg/5ml oral suspension R (100ml) – Mylan Ltd • Co-amoxiclav 250mg/62mg/5ml oral suspension R (100ml) – Mylan Ltd

• Co-careldopa 25mg/100mg modifiedrelease tablets (60) – Half Sinemet CR • Co-careldopa 50mg/200mg modifiedrelease tablets (60) – Sinemet CR • Lidocaine 2% cream SC (30g) – Vagisil • Mesalazine 250mg suppositories (20) – Asacol • Mesalazine 500mg suppositories (10) – Asacol • Tramadol 50mg modified-release tablets (60) – Zydol SR Part VIIIA amendments • Mupirocin 2% cream SC (15g) is changing to Category C Bactroban

Part VIIIA deletions If a medicinal product has been removed from Part VIIIA and has no other pack sizes listed, it can continue to be dispensed as long as the product does not appear in Part XVIIIA (the ‘Blacklist’)–but it will need to be endorsed fully (i.e. brand or supplier name from whom the product was purchased and the pack size from which the item was dispensed).

• Liquid paraffin / Magnesium hydroxide oral emulsion sugar free (150ml) Category C – JM Loveridge Ltd • Zaleplon 10mg capsules (14) Category C – Sonata • Zaleplon 5mg capsules (14) Category C – Sonata

Part IX deletions It is important to take careful note of removals from Part IX because if you dispense a deleted product, prescriptions will be returned as disallowed and therefore payment will not be made for dispensing the item.

Product

HME filter cassette

Trachi-Naze Nasal Restoration System

Size and type

Product code

Normal (Normal breathing resistance)

7242

Normal Tinted

7242Cv

HiFlow (Lower resistance for sport and first time users)

7243

HiFlow Tinted

7243C

Blue Filter (Night filter)

LANNZ 0001A

Green Filter (Day filter)

LANNZ 0002A

Orange Filter (Active filter)

LANNZ 0003A

Baseplate - Hydrocolloid (small)

LANNZ 0004A

Baseplate - Hydrocolloid (large)

LANNZ 0005

Non-Woven Adhesive (large)

LANNZ 0006

Clear Adhesive Waterproof Film (round)

LANNZ 0007

Hands Free Valve ‘Type A’

LATNV 1001

Hands Free Valve ‘Type B’

LATNV 2001

Occlusion Cap

LATNV 3001

Changes to prescribing rights On 1st April 2016, a number of changes to the Human Medicines Regulations 2012 come into effect, including new prescribing rights for therapeutic radiographers, dietitians, orthoptists and midwives. Find out more at: dld.bz/erY36

PSNC website For up to date information and news on community pharmacy issues, visit the PSNC website at psnc.org.uk PSNC Community Pharmacy News is published by: The Pharmaceutical Services Negotiating Committee, Times House, 5 Bravingtons Walk, London N1 9AW Community Pharmacy News is edited by: Melinda Mabbutt who can be contacted at the above address or by email at: mmabbutt@psnc.org.uk PSNC Office: 0844 381 4180 or 0203 122 0810

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