March 2019 CPN

CPN

Community Pharmacy News – March 2019

Funding maintained as interim measure

• Levels will remain at £2.592bn per year • PSNC expects substantive negotiations for future funding to begin shortly Brexit and medicines supply | Roll-out of CDs in EPS | PSNC EPS claims factsheet

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Chief Executive’s blog PSNC Chief Executive Simon Dukes uses this section of CPN to provide an update on PSNC’s work.

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The Minister and NHS England stressed their desire to make the most of community pharmacies

Simon Dukes

PSNC Chief Executive Earlier this month, PSNC hosted its annual National Meeting of LPCs, bringing together LPCs from across England for an update on work at a national level and the chance to network and make progress on local issues. On one of the big standing agenda items, negotiations on pharmacy funding, there was little detail to give as they have not yet begun. We expect them to begin very shortly and pharmacy must not take the delay personally – the Government is currently fully engaged with the most complex economic and political issue it has had to deal with in decades; it is inevitable that other work is feeling the effects of that.

But although the official conversations have not yet begun, we are working closely with all those that will be involved in them and at the meeting LPCs heard from both NHS England and the Minister, Steve Brine MP, who addressed them via a video presentation. Both the Minister and NHS England stressed their desire to make the most of community pharmacies and I do believe they are genuine. They want us to help with prevention and to support our local primary care colleagues, and a first step in that will be taking on the management of minor conditions to free up capacity in urgent care. If we show that we can do that effectively, then other roles, such as management of people with long-term conditions, may follow.

My message to the NHS and Minister has

2 Community Pharmacy News – March 2019

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been that community pharmacy is ready for that, but that there is nothing more that can be squeezed out of this sector.

We must have a multi-year settlement to enable businesses to plan and to change in the ways that they want. They seem to agree, and I look forward to starting our negotiations with them.

When I started at PSNC I wanted to improve our transparency and the way we communicate with you. However, those of you who have been watching the progress of the UK’s exit from the European Union will have seen that negotiating in the public eye is quite tricky. I too will be reticent about sharing too much detail about our conversations as they unfold. I know this is frustrating, but please be reassured that the both I and my team understand just how critical these negotiations are for your businesses and livelihoods. We must get them right. We will have the support of an expert Negotiating Team who will be bringing the concerns of contractors – because they are contractors – to the table, and that we will tell you as much as we can, as soon as we can.

A note on Primary Care Networks One of the trickier topics of the day at the National Meeting of LPCs was Primary Care Networks (PCNs). It is no

overstatement to say that PCNs, which are in various early states of formation at the moment, will be the building blocks of the primary care service of the future. With GPs at their heart, the networks are being tasked, with the help of an injection of GP contract funding, with delivering a range of new services and health improvements.

The message from NHS England has been clear: while GPs are being tasked with forming these networks, GPs won’t be able to do all of the work alone and they will need to partner with other healthcare professionals and providers

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PCNs:GPs will need to partner with other healthcare professionals and providers to deliver them

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such as community pharmacies to deliver the progress set out in the NHS Long Term Plan. But the leaders of the PCNs won’t necessarily come knocking at our doors, and it is up to us to engage with them. With the networks covering neighbourhoods of around 30-50,000 patients, these really will be community level organisations, and it will be for individual pharmacies to engage with PCNs directly. We and the LPCs will support and guide (and help when things go wrong), but pharmacy businesses must be forward footed, and that will involve working together not just with GPs, but with other pharmacies – however challenging that might seem. You can expect more guidance from us on PCNs as and when we get better clarity from NHS England.

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

Interim funding arrangements agreed • The current community pharmacy funding arrangements will continue on an interim basis • Category M prices will increase by £10m per month from 1st April 2019 • Contractors can provide a maximum of 200 MURs in the first six months of the year • We hope that negotiations on future funding will conclude in time for changes to the CPCF to be made from October 2019

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Statements on the interim arrangements

This interim funding arrangement will protect current funding levels for pharmacies and we welcome the £10m monthly increase in Category M prices.

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Community pharmacy funding levels will remain the same from 1st April 2019, set to deliver the current agreed funding envelope of £2.592 billion per year.

At the same time Category M prices will increase by £10 million per month, as the reductions to recover excess margin come to an end.

PSNC and the Department of Health and Social Care (DHSC) have agreed this as an interim arrangement pending the start of substantive negotiations on future pharmacy funding. The arrangement will apply until the negotiations have concluded.

Use Reviews (MURs) from 1st April to 30th September 2019. This is because further discussions about the service will form part of the wider negotiations which we expect to begin in the next month.

No discussions have taken place on the future of the Quality Payments Scheme, so contractors do not need to do any work for a checkpoint until further notice. The future of the scheme will again be a part of the upcoming negotiations.

The NHS Urgent Medicine Supply Advanced Service (NUMSAS) pilot will continue to be commissioned until 30th September 2019, ahead of discussions on this service.

The Single Activity Fee (SAF) will be set to continue to deliver £2.592 billion in funding annually; the level of the SAF is still under discussion with DHSC and as such may be adjusted later this year.

Pharmacies currently receiving Pharmacy Access Scheme (PhAS) payments will continue to do so with monthly payments from April 2019 being the same as those made in the last financial year.

During the interim period, contractors will be paid for a maximum of 200 Medicines

The interim arrangements have been put in place to cover the period from April

PSNC Chief Executive Simon Dukes said: “We are pleased that DHSC and NHS England expect to be in a position to begin negotiations on community pharmacy shortly and we are looking forward to exploring with them developments that will ensure that community pharmacies can play a key part in the developing primary care systems for the benefit of patients.

In the meantime, this interim funding arrangement will protect current funding levels for pharmacies and we welcome the £10 million monthly increase in Category M prices.”

Pharmacy Minister Steve Brine said: ”I look forward to discussions with PSNC on how the Community Pharmacy Contractual Framework can support community pharmacy’s further integration into primary care networks and enable us to better utilise the skill set and reach of pharmacy teams.”

until negotiations on future pharmacy funding have concluded. We expect to begin these negotiations before Easter and hope that any substantive changes to the Community Pharmacy Contractual Framework (CPCF) will be agreed in time to be implemented from October 2019.

10,383 contractors validated for Quality Payments The NHS Business Services Authority (NHSBSA) gateway criteria report published on 19th March shows that 10,383 community pharmacy contractors have now been validated as meeting the five gateway criteria of the Quality Payments Scheme.

Contractors who have been validated will be paid a Quality Payment based on the quality criteria they declared they met when they completed their declaration. This payment will

be made as part of the full payment for their March 2019 submission to NHSBSA (which contractors will receive at the start of June 2019).

Any contractor who has not been validated, but made a declaration for the February review point, has until 29th March 2019 to take corrective action. Learn more at: ow.ly/5Rhq30o2Pyw

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CONTRACT AND IT

Serious Shortage Protocols briefing In early 2019, changes to legislation were started to permit the Government to use Serious Shortage Protocols (SSPs) in the event of a serious shortage of a medicine. The final legislative changes are expected to be passed before Easter.

The briefing below explains how we expect SSPs to work, including the many safeguards in place to ensure that this legislation is implemented safely and for the benefit of patients.

Download the SSP stakeholder briefing: ow.ly/i7ba30nY7Dk

Have you completed your pharmacy’s IG return?

Community pharmacy contractors are reminded that they must complete the Data Security and Protection (IG) Toolkit

by Sunday 31st March 2019.

Whilst 75% of pharmacy contractors have already registered to use the Toolkit, only half of those have published the assessment* which is required as part of their Terms of Service. (*Correct as of 20th March.)

Contractors are encouraged to use PSNC’s question-by-question guidance to complete the mandatory questions, including the technical ones. Further information, including this guidance, can be found at: ow.ly/p8ea30o8DER

FMD alert messages updated SecurMed, the organisation which runs the UK Falsified Medicines Directive (FMD) hub, has changed the wording of the eleven alert messages and one related system message produced by the hub when the data on the pack of a medicine gives cause for concern for its authenticity.

Both the “Description” and “Short Description” have been amended to make them more understandable to users of the system; this change follows discussions between SecurMed, the UK FMD Working Group for Community Pharmacy and some FMD system suppliers. View the revised messages at: ow.ly/akZ930o0ZPT

4 Community Pharmacy News – March 2019

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

Brexit and the medicine supply chain • DHSC provides further information on its contingency planning work • Patient information and FAQs have been published to support healthcare providers • PSNC’s Brexit Forum becomes formal route of communication between community pharmacy and DHSC

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DHSC has analysed the supply chains of 12,300 medicines and put a comprehensive plan in place

The Government issued an update on its contingency planning for a no-deal Brexit at the end of February.

With around three-quarters of medicines given to UK patients coming from or via the EU, the Department of Health and Social Care (DHSC) has analysed the supply chains of 12,300 medicines and put a comprehensive plan in place to minimise potential disruption.

DHSC’s approach involves a diverse range of measures including: • Securing additional roll-on, roll-off freight capacity for goods to continue to come into the UK; • Building up buffer stocks and stockpiling (by DHSC and industry) in the UK before 29th March; • Buying extra warehouse space to hold additional stock; • Booking space on aeroplanes for products with short shelf-life or specific storage conditions; • Making changes to regulatory requirements so companies can continue to sell their products in the UK; and • Strengthening the processes and resources used to deal with shortages.

By developing this multi-layered approach,

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the Government is confident that the supply of medicines and medical products should be uninterrupted in the event of exiting the EU without a deal.

Information for patients The NHS.UK website now contains information for patients on how they will be able to access their medicines and medicinal products in the event of a no-deal Brexit. Pharmacy teams may like to signpost patients to this information.

NHS England has also published a series of FAQs and an accompanying message for healthcare providers. Find links to these in our Brexit hub (see below).

The Brexit Forum DHSC has asked PSNC’s Community Pharmacy Brexit Forum to be a formal route of communication between the sector and DHSC. Accordingly, contractors, pharmacists and pharmacy team members are asked to bring any relevant Brexit issues to one of their respective organisations – this could be done via the LPC, in the first instance.

The issues could relate to workforce and operational readiness as well as supply; but any requests for concession prices should be made to PSNC in the usual way.

New Brexit hub PSNC’s revamped Brexit and Community Pharmacy pages bring together updates from the Government and contractor guidance alongside PSNC’s work leading the Community Pharmacy Brexit Forum. Visit the Brexit hub at: psnc.org.uk/Brexit

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HE HEALTHCARE LANDSCAPE

LPCS

PSNC’S WORK

National roll-out of EPS CD prescriptions Provision for the prescribing of Schedule 2 and 3 Controlled Drugs (CDs) via the Electronic Prescription Service (EPS) is now being rolled out across the country.

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Pharmacy teams may find it useful to check when their local GP practices are due to go live on the roll-out schedule

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The national roll-out of CDs in EPS has begun with implementation for TPP SystmOne, Vision and EMIS GP practices.

This means that the number of CD prescriptions that pharmacies receive via EPS will increase significantly as more GP practices have the functionality switched on.

It is therefore important that all pharmacy staff, including locums, are aware of the rollout and are prepared to dispense an electronic prescription for a Schedule 2 or 3 CD. If you receive a prescription for a Schedule 2 or 3 CD via EPS, you should dispense it as you would any other electronic prescription.

Pharmacy teams may find it useful to check when the GP practices local to you are going live by checking on the roll-out schedule on the NHS Digital website: ow.ly/yDdX30o0Hv0 It will take a few weeks to complete the roll-out to all practices in England using these sytems, and switch on dates will depend on the prescribing system and the Clinical Commissioning Group (CCG) area of the general practice.

At GP practices where roll-out has occurred, CD prescriptions (except for instalment FP10MDAs) can be processed electronically for all patients that use EPS for their existing prescriptions. For GP practices that are also taking part in the EPS Phase 4 pilot, CDs will be prescribed electronically for both patients with and without an EPS nomination.

The national roll-out dates for other GP systems will be announced by NHS Digital in due course.

Further information is available at: psnc.org.uk/epscds

Gabapentin and pregabalin changes From 1st April 2019, pregabalin and gabapentin will be reclassified as Schedule 3 CDs. With many GP practices expected to have gone live with EPS CD functionality by this date, pharmacy teams may receive a mix of EPS and paper prescriptions for gabapentin and pregabalin before and after the schedule changes occur on 1st April.

See CPN page 7 for some FAQs on these changes, plus PSNC’s briefing provides even more information: ow.ly/sIre30o0RhZ

FUNDING AND STATISTICS

Prescription charge increase The Government has announced that the NHS prescription charge will rise to £9.00 per item from 1st April 2019.

The cost of prescription pre-payment certificates (PPCs) has remained the same for a further year, with the price of a three-month PPC at £29.10 and a 12-month PPC at £104.00. PPCs offer savings for those needing four or more items in three months or more than 12 items in one year.

PSNC has published a Prescription Charge Card for community pharmacies.

Download your copy from: psnc.org.uk/chargecard

Topiramate oral solution Effective from March 2019, Topiramate oral suspension (both 100mg/5ml and 50mg/5ml) has been deleted from Part VIIIB (unlicensed specials and imports) of the Drug Tariff. This is because licensed alternatives (listed below) now appear in Part VIIIA: • Topiramate 100mg/5ml oral suspension SF (Rosemont Pharmaceuticals Ltd) • Topiramate 50mg/5ml oral suspension SF (Rosemont Pharmaceuticals Ltd) Any changes to Part VIII of the Drug Tariff impacts reimbursement so it is important to take note when amendments are made to product listings.

Increased access to Freestyle Libre for type 1 diabetes patients From 1st April 2019, community pharmacy teams may see an increase in prescriptions for Freestyle Libre sensors following a growth in funding which will allow access to flash glucose monitoring throughout the country.

See our website for the full story: ow.ly/LbjE30obgYX Please note, the obligation to dispense an appliance arises only if the pharmacist supplies for such products ‘in the normal course of his business’.

For more information on dispensing appliances, please visit: psnc.org.uk/appliances

psnc.org.uk 5

SERVICES AND COMMISSIONING

Severe weather survey How well prepared is your pharmacy for severe weather?

Please answer a quick national survey by 19th April, with an opportunity to win £100 for a local charity of your choice. This will help the NHS and Public Health understand how to reduce risks to health and care services.

Find out more at: ow.ly/DwuG30nVmVm

Clinical Entrepreneur Programme The NHS Clinical Entrepreneur Programme is now open to applications for 2019.

The educational workforce development programme, managed jointly by NHS England and Health Education England, has been designed for clinicians and NHS staff who want to develop and scale their most innovative ideas for patient benefit.

The curriculum covers all aspects of setting up and running a small business, including attracting investors, applying for funding, and ensuring appropriate corporate governance.

Support on the programme includes mentoring, practical sessions, customer matching, and possible entrepreneurial placements.

Learn more and find out how to apply at: ow.ly/3dM530o2LDf (closes 29th March)

NHS Parliamentary Awards The NHS Parliamentary awards celebrate and give national recognition to staff who go above and beyond the call of duty.

Nominations for the 2019 awards are now open, and LPCs and those working in community pharmacy may like to nominate a particular pharmacist or pharmacy team to their local MPs. There are 10 categories in which you can put forward nominations – and you can do so in as many as you like.

Make a nomination via: ow.ly/WSKQ30o2Lng (closes at midnight on 26th April)

6 Community Pharmacy News – March 2019

THE HEALTHCARE LANDSCAPE

LPCS

ENT & eye service highly valued Community pharmacy service commissioned across Staffordshire and Shropshire receives positive feedback from patients.

About two-thirds of patients received a POM via PGD 408 patients accessed the service between December 2017 and March 2018 96% of patients reported being very Only 5% of patients needed to be satisfied or satisfied with referred onwards the service An evaluation of a new community pharmacy service for ear, nose and throat (ENT) and eye conditions, which has demonstrated a high level of patient satisfaction, has been published in the International Journal of Pharmacy Practice.

The Pharmacy First Extended Care Service for ENT and eye conditions directs patients seeking GP appointments with specified conditions to a participating pharmacy, where they are offered a consultation with a community pharmacist who has undergone service specific training.

What does the service involve?

The service allows patients with the following conditions to be referred to see

the pharmacist: bacterial conjunctivitis, bacterial sinusitis, otitis externa with suspected secondary infection, otitis media, chronic sinusitis, and sore throat.

The pharmacist provides self-care advice, and, where clinically appropriate, supplies medicines or specific prescription-only medicines (POMs), including antibiotics, under a Patient Group Direction (PGD).

Patients receive a follow-up call from the pharmacist five days later to check how the patient is getting on and answer any questions the patient may have.

Learn more about the service at: ow.ly/pXWD30nRLQf

Atrial fibrillation e-learning We are pleased to “introduce our brand new e-learning programme, Atrial fibrillation detection in community pharmacy: what you need to become service ready. Atrial fibrillation is the most Clare Smith common form of cardiac CPPE Senior Pharmacist, arrhythmia and results in Learning an abnormally fast and Development irregular heart rate, and an increased risk of stroke.

This e-learning programme aims to help you explore current atrial fibrillation detection services in community pharmacy and support you to consider your learning and development needs for you to become service ready. As part of the programme,

you will be signposted to other learning resources that will cover the clinical aspects of atrial fibrillation, such as how it is diagnosed and managed.

You will also look at how you can support patients through the service by reflecting on your current consultation skills. Finally, you will have the opportunity to watch video examples of the atrial detection service being carried out in community practice.

This e-learning programme is an interactive, self-study resource that is intended to take around two hours of study time and it is open to all pharmacy professionals and pre-registration trainees.

For more information, visit the CPPE website: ow.ly/v4f530o5FF9

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PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

Ask PSNC: Pregabalin and gabapentin The PSNC Dispensing and Supply Team answers your questions on the reclassification of pregabalin and gabapentin as Schedule 3 Controlled Drugs (CDs).

Q. Will gabapentin and pregabalin need to be stored in the CD cabinet?

A. No, because they will be exempt from the safe custody requirements.

Q. A patient has presented a gabapentin prescription in April 2019, but it was issued before 1st April – how long is it valid for?

A. The new legislation will apply to prescriptions dispensed after 1st April 2019, so these prescriptions will only technically be valid for 28 days from the appropriate date.

Q. Can gabapentin and pregabalin be prescribed on NHS repeat dispensing prescriptions?

A. Schedule 2 and 3 CDs cannot be prescribed as part of the NHS Repeat Dispensing scheme. As of 1st April 2019, this means they will no longer be eligible for repeatable prescriptions.

Q. Will prescriptions for gabapentin and pregabalin need two signatures on the reverse of the prescription?

A. It is good practice to ask individuals, at the point that Schedule 2 or 3 CDs are handed to them, to sign the back of the prescription form (or EPS token reverse) as confirmation of collection, alongside the exemption/ charge paid declaration. When the CD is supplied, it is a requirement to mark the prescription with the date of supply at the time the supply is made.

See psnc.org.uk/CDvalidity for further information.

Q. Can I dispense a prescription for ‘pregabalin 20mg/ml oral solution sugar free’ requesting less than 30 days’ supply if the product is in a special container with a pack size exceeding 30 days’ supply?

A. Where the quantity ordered by the prescriber does not coincide with that of an original pack (or sub-pack when the special container status is placed on the sub-pack) and the product is considered a special container, contractors are required to supply the special container or combination of containers nearest to the quantity ordered and endorse the prescription form with the number and size of these containers.

Should a prescription be issued for ‘pregabalin 20mg/ml oral solution sugar free’ the pharmacy would still be reimbursed for the full pack size as per existing special container rules even if this exceeds the recommended 30 days’ supply.

Q. Will pharmacies be remunerated for the Schedule 3 CD fee if prescriptions issued before 1st April comply with the CD regulations?

A. Irrespective of the date of issue, payment relates to the month in which a prescription is submitted for payment. For example, if a pregabalin or gabapentin prescription is submitted with the bundle prepared in early April (for the March dispensing month) then a Schedule 3 CD fee would not be paid, but if the prescription is submitted for payment with the bundle prepared in May (for the April dispensing month) then a Schedule 3 CD fee would be paid.

Q. Can I make a supply of these drugs under NUMSAS if I receive a request to do so?

A. No, you will not be able to supply gabapentin or pregabalin under NUMSAS from the 1st April 2019. If you receive a NUMSAS request for a Schedule 2 or 3 CD via an NHS 111 referral for a patient on or after 1st April 2019, you should follow the guidance in the NUMSAS Service Specification and either refer the patient to their GP or contact the local GP OOHs provider to discuss a solution, and if necessary request that the patient be contacted by an appropriate healthcare professional.

The NUMSAS referral should be claimed for in the normal way; i.e. recording the name of the item requested and endorsing the reason for no supply, using the code ‘NoSupp A’ in this scenario.

Q. Will exemption for emergency supply to people with epilepsy be in place?

A. No, community pharmacy teams will not be permitted to provide emergency supplies of pregabalin or gabapentin. Whilst an exception has been made for phenobarbital, no such exception exists for these drugs.

Look out for more frequently asked questions next month…

If you would like more information on any of the topics covered, the team at PSNC will be happy to help (0203 1220 810 or e-mail info@psnc.org.uk).

psnc.org.uk 7

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.

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Flu vaccines for 2019/20

Diabetes Prevention Week toolkit

Type 2 Diabetes Prevention Week (1st-7th April) aims to raise awareness of Type 2 diabetes, complications associated with the condition, at-risk groups and how to prevent it.

Pharmacy teams can order a free toolkit which contains posters, leaflets, ‘How do you measure up?’ tape measures and more.

Order the toolkit: ow.ly/2 rTV30n VzPc

NHS England has published an upda te on vaccines fo Service. As stated r the 2019/20 Flu in previous comm Vaccination unication, the vacc 2018/19 season co ines recommende ntinue to be reco d for the mmended for the 2019/20 season.

Additionally, the ce ll grown quadrivale nt vaccine (QIVc), contractors can Flucelvax® Tetra, consider orderin is now licensed fo g this for 2019/20 r use and Flu Vaccination Se rvice.

NHS England has determined that the high-dose triva reimbursed for lent vaccine (TIV-H use in the Flu Va D) will not be comm ccination Service issioned or .

8 Community Pharmacy News – March 2019

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Claiming for EPS prescriptions on time In this factsheet we explain how to reduce the risk of delays to payment caused by timing issues with electronic prescriptions.

EPS submission The following steps can help you and your pharmacy team to make sure that all of your EPS prescriptions are processed for payment in a timely manner.

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Claims should be sent to the NHS Business Services Authority (NHSBSA) no later than the 5th day of the month following that in which supply was made (Drug Tariff Part I, Clause 5A).

Send claims frequently throughout the month. If all claims are submitted at the end of the month, there is a risk of delayed payments if a technical issue prevents the successful transmission of claims.

Claim soon after the final dispense notification (DN) has been sent, and before the 180-day (six months) prescription claiming deadline*.

After 180 days, the prescription cannot be priced by NHSBSA.

Claim for any partially-dispensed items. All prescription items must be marked as either fully dispensed or not dispensed before you submit a claim notification (CN). If a prescription has multiple items and one of the items is no longer required, by the patient, mark the item as ‘not-dispensed’ so that you are able to submit CNs for any other items dispensed on the same prescription.

EPS message types There are two key EPS notifications sent to the NHS Spine using your PMR system: 1. Dispense notification (DN) message: This message is submitted once a prescription has been dispensed via EPS. Sending the DN may also be referred to as ‘dispensed’, ‘collected’ or ‘complete’ depending on the PMR system used.

2. Claim notification (CN) message: This is the final claim message that should be sent after the DN has been submitted by the pharmacy.

The CN message includes endorsements and the charge status of the prescription. The CN may be referred to as an ‘electronic reimbursement claim’, ‘prescription claim message’, or similar, depending on the PMR system used.

Take into account the five-day EPS window (explained overleaf).

Ensure that Schedule 2, 3 and 4 Controlled Drug (CD) prescriptions are marked as ‘dispensed’ and claimed for in a CD timely manner. The law sets out that actual dispensing of the Schedule 2, 3 and 4 CDs must take place within 28 days of the appropriate date. Aim to ensure that any DNs and CNs are sent within the same period. Your system supplier should not prevent the DNs and CNs from being submitted later for example, where the actual dispensing took place within 28 days, but the DNs and CNs were submitted later due to a technical outage on day 28. *Ensure that all electronic Repeat Dispensing (eRD) prescriptions are claimed within 365 days of the prescriber’s original signature date because DNs and CNs cannot be submitted beyond this point.

Using your PMR system Your PMR system may have functionality to help ensure your EPS prescriptions are sent on time. Why not consider learning how to: • Filter and display prescriptions within your PMR system that still need DNs and CNs to be sent.

• Set up PMR system alerts to notify you of any unclaimed prescriptions marked as ‘dispensed’ and approaching their 180-day claiming deadline; or downloaded from the Spine but not yet dispensed.

• Use the EPS Tracker to identify prescriptions which have not been submitted. The tracker allows you to search by entering a prescription ID or NHS number plus a date range. Find out more at: psnc.org.uk/tracker • Use the claim amend feature (if your PMR system has it) to make any necessary changes if the 5th deadline has not yet passed.

• Deal with planned or unexpected system updates as these may temporarily disrupt the submission of CNs.

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

How does the EPS five-day window work?

THE HEALTHCARE LANDSCAPE

% of EPS prescriptions with DN sent during the dispensing calendar month and CN sent on 6th or after in the following month:

The dispensing month in which an EPS prescription is submitted and counted for payment is determined by two key dates: the DN date and the CN date.

9%

When a DN is sent before midnight on the last day of the dispensing calendar month, the CN must be received by the NHSBSA before midnight on the 5th of the following month to be counted towards the total items for the actual dispensing month. However, if the CN is submitted later than the 5th of the following month, the item will NOT be counted towards the actual dispensing month.

*

Tip: Submit DNs and CNs in a timely manner because the prices paid for a medicine/appliance can vary from month to month, e.g. when a price concession in granted one month but not the next.

Examples of the five-day window

*data from the twelve months ending October 2018.

Read more about this data at: psnc.org.uk/timeEPS

The four scenarios outlined below explain how this works in practice.

Scenario 1: Both DN and CN sent before the end of the dispensing month The example shows a DN sent on 29th March and the CN sent on 31st March. This claim will therefore be processed as part of the March dispensing month bundle.

Scenario 2: DN sent in dispensing month and CN sent between days 1-5 of the following month A DN was sent on 29th March and the CN on 4th April (before the 5th April deadline). This claim will therefore be processed as part of the March dispensing month bundle.

Scenario 3: DN sent in dispensing month and CN sent after day 5 of the following month The example shows a DN submitted in March, but a CN is sent on 6th April. This claim will therefore be processed as part of the April dispensing month bundle.

Scenario 4: Both DN and CN sent between days 1-5 of the following month Both the DN and CN have been sent in the first five days of the month, so this prescription will be processed as part of that dispensing month (in this case, April).

March 28

29

April 30

31

Dispense notification sent 29th March

March 28

29

30

31

March 29

31

March 29

3

4

5

6

= March dispensing month

1

2

3

4

5

6

Electronic claim message received before midnight on 5th April

= March dispensing month

April 30

Dispense notification sent 29th March

28

2

April

Dispense notification sent 29th March

28

1

Electronic claim message received before midnight on 5th April

1

2

3

4

5

6

Electronic claim message received after midnight on 5th April

= April dispensing month

April 30

31

Dispense notification sent 1st April

1

2

3

4

5

6

Electronic claim message received before midnight on 5th April

= April dispensing month

Note: For scenarios 3 and 4, these EPS prescription claims will NOT be included in your payment for prescriptions dispensed in March, even if it was inadvertently declared in your FP34C submission document for the March dispensing month bundle.

Declaration of end-of-month totals CNs should be sent on time and the correct number of items declared on your FP34C submission document. PMR systems can generate reports showing the correct number of EPS and paper items to include on the FP34C. Do not count dispensing tokens when totalling EPS figures; use the reports generated by your PMR system.

Discrepancies between the declared item total and the actual item total will have an impact on your advance payment and balancing payment. This could lead to cashflow issues that take time to stabilise. Making an accurate declaration will also help with prescription reconciliation.

Further information Find out more by visiting the following PSNC resources.

Claiming EPS scripts in time webpage: psnc.org.uk/timeEPS Reconcile EPS prescription figures factsheet: psnc.org.uk/reconcileEPS

10 Community Pharmacy News – March 2019

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

Drug Tariff Watch: April 2019 Part VIIIA additions • Baricitinib 2mg tablets (28) and 4mg tablets (28) - Olumiant • Budesonide 200µg/dose dry powder: o inhalation cartridge  (100 dose) – Budelin Novolizer o inhalation cartridge with device  (100 dose) – Budelin Novolizer • Capecitabine 150mg tablets (60) and 500mg tablets (120) – Dr Reddy’s Laboratories (UK) Ltd • Chlorhexidine gluconate 2% / Isopropyl alcohol 70% solution: o 0.67ml applicators (200) – ChloraPrep o 1.5ml applicators (20) – ChloraPrep o 10.5ml applicators (25) – ChloraPrep o 26ml applicators (25) – ChloraPrep o 3ml applicators (25) – ChloraPrep • Choriogonadotropin alfa 250µg/0.5ml solution for injection: o pre-filled disposable devices  (1) – Ovitrelle o pre-filled syringes  (1) – Ovitrelle • Desmopressin 150µg/dose nasal spray  (25 dose) - Octim • Diptheria (low dose) / Tetanus / Pertussis (acellular component) / Poliomyelitis (inactivated) vaccine(adsorbed) suspension for injection 0.5ml pre-filled syringes  (1) – Repevax • Doxepin 5% cream  30g – Xepin • Doxylamine 10mg / Pyridoxine 10mg gastro-resistant tablets (20) – Xonvea • Emtricitabine 200mg / Tenofovir 245mg tablets (30) – Truvada • Ertapenem 1g powder for solution for infusion vials  (1) – Invanz • Felodipine 2.5mg MR / Ramipril 2.5mg tablets (28) – Triapin • Fluocinolone acetonide 0.025% / Clioquinol 3% cream  15g and ointment  15g – Synalar C

• Haemophilus type b / Meningococcal C conjugate vaccine powder and solvent for solution for injection 0.5ml vials  (1) – Menitorix • Human papillomavirus (type 6, 11, 16, 18) vaccine (adsorbed) suspension for injection 0.5ml pre-filled syringes  (1) – Gardasil • Human papillomavirus (type 6, 11, 16, 18, 31, 33, 45, 52, 58) vaccine (adsorbed) suspension for injection 0.5ml pre-filled syringes  (1) – Gardasil 9 • Hydromorphone 1.3mg capsules (56) and 2.6mg capsules (56) – Palladone • Hydromorphone 16mg MR capsules (56), 24mg MR capsules (56), 2mg MR capsules (56), 4mg MR capsules (56) and 8mg MR capsules (56) – Palladone SR • Hyoscine hydrobromide 150µg chewable tablets SF (12) – Joy-rides • Interferon alfa-2a solution for injection pre-filled syringes: o 3million units/0.5ml  (1) – Roferon-A o 4.5million units/0.5ml  (1) – Roferon-A o 6million units/0.5ml  (1) – Roferon-A • Ketoconazole 200mg tablets (60) – Category A: • Ketotifen 1mg tablets (60) – Zaditen • Linezolid 100mg/5ml oral suspension  (150ml) – Zyvox • Macrogol compound oral liquid 25ml sachets NPF SF (30) Movicol Ready to Take • Methadone 10mg/ml oral solution SF (150ml) and 20mg/ml oral solution SF (150ml) – Methadose • Nafarelin 200µg/dose nasal spray  (60 dose) – Synarel • Olanzapine embonate powder and solvent for suspension for injection vials: o 210mg  (1) – Zypadhera o 300mg  (1) – Zypadhera o 405mg  (1) – Zypadhera • Omeprazole 40mg powder for solution

CONTRACT AND IT

KEY:  Special container  Item requiring reconstitution for infusion vials (5) – Bowmed Ibisqus Ltd • Paracetamol 250mg orodispersible tablets SF (12) (24) – Calpol Six Plus Fastmelts • Paricalcitol 1µg capsules (28) and 2µg capsules (28) – Zemplar • Potassium aminobenzoate 3g oral powder sachets (40) – Potaba • Progesterone 8% vaginal gel 1.125g applicators (15) – Crinone • Rifampicin 150mg / Isoniazid 100mg tablets (84) – Rifanah • Rifampicin 300mg / Isoniazid 150mg tablets (56) – Rifanah • Sodium phenylbutyrate 940mg/g granules SF (266g) – Ammonaps • Sodium polystyrene sulfonate powder SF (454g) – Resonium A • Sodium valproate 150mg MR capsules  (100) – Episenta • Spironolactone 50mg / Furosemide 20mg capsules (28) – Lasilactone • Tacrolimus 1mg MR tablets  (30), 4mg MR tablets  (30) and 750µg MR tablets  (30) -Envarsus • Terbutaline 500µg/dose dry powder inhaler  (120 dose) – Bricanyl Turbohaler • Urea [13-C] breath test kit SF: o 100mg soluble tablets  (1) – Pylobactell o 45mg oral powder  (1) – Helicobacter Test INFAI for children o 75mg oral powder  (1) – Helicobacter Test INFAI • Urea 5% scalp application  (100ml) Eucerin DermoCapillaire Calming For a full list of the upcoming Drug Tariff changes, including amendements, please visit: ow.ly/J7Vm30o7zdf

Part IX deletions Product

Size, Type, Product Code

WOUND MANAGEMENT DRESSINGS - Tegaderm Superabsorber

Rectangular, 10cm x 20cm

WOUND MANAGEMENT DRESSINGS - Topical Negative Pressure System Accessories - Gauze wound dressing (Smith & Nephew)

5cm x 17cm

EYE DROPS - Hypromellose - Vizulize Hypromellose 0.3%

10ml bottle

EYE DROPS - Sodium Hyaluronate - Vizulize 0.1%

10ml bottle

EYE DROPS - Sodium Hyaluronate - Vizulize Intensive 0.3%

10ml bottle

INDWELLING PLEURAL CATHETER DRAINAGE SYSTEMS - Rocket IPC - Drainage Line

R544 10-00-DL

INDWELLING PLEURAL CATHETER DRAINAGE SYSTEMS - Rocket IPC - Valve Cap

R544 10-00-CP

TRACHEOSTOMY AND LARYNGECTOMY APPLIANCES - Tracheostomy Tube Holders - Primus-Plain

71-0029-00

CHEMICAL REAGENTS - Biosensor Strips - GlucoRx Evolve Glucose Test Strips

50 strips

CHEMICAL REAGENTS - DETECTION STRIPS, BLOOD FOR KETONES (Beta-Hydroxybuterate) - GlucoRx Evolve Ketone Test Strips

10 strips

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 005/19: Key actions for pharmacy contractors to prepare for a no-deal exit from the EU The Department of Health and Social Care (DHSC) issued EU Exit Operational Readiness Guidance in late 2018. This briefing highlights those aspects of the guidance that are of most relevance to community pharmacy contractors.

Download from: ow.ly/H3UV30nXeCv PSNC Briefing 008/19: A five-year framework for GP contract reform to implement the NHS Long Term Plan NHS England’s five-year framework for GP services implements changes to the GP contract. This briefing summarises the key aspects of the framework that are of most relevance to community pharmacy teams and LPCs.

Download from: ow.ly/SHuR30nXeLr PSNC Briefing 010/19: Reclassification of gabapentin and pregabalin as CDs This briefing has been compiled to support community pharmacy teams as the reclassification of pregabalin and gabapentin as Schedule 3 Controlled Drugs (CDs) comes into force on 1st April 2019.

Download from: ow.ly/e30X30nXeYp PSNC Briefing 012/19: An Introduction to Serious Shortage Protocols In early 2019, changes to legislation were started to permit the Government to use Serious Shortage Protocols (SSPs) in the event of a serious shortage of a medicine. This interim briefing describes how we expect that SSPs might operate.

Download from: ow.ly/biGL30nXpfq See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources Brexit and Pharmacy hub This section of the PSNC website brings together updates from the Government and contractor guidance alongside PSNC’s work leading the Community Pharmacy Brexit Forum. There is also now a page on the Serious Shortage Protocols.

Visit now: psnc.org.uk/Brexit Price concessions webinar We explain how the price concession system works and describes what PSNC does behind the scenes for community pharmacy contractors.

Watch now: psnc.org.uk/concessionswebinar Data Security and Protection (IG) Toolkit Workshop Representatives from PSNC and NHS Digital talk viewers through the new Toolkit for completing their pharmacy’s 2018/19 Information Governance (IG) return.

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