November 2016 CPN

CPN

Community Pharmacy News – November 2016

Pharmacy funding imposition Community pharmacy continues to make its voice heard in the wake of impending cuts

Essential EPS Checklist | Your u queries answered | How to endorse prescriptions

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A message from Sue Sharpe, PSNC Chief Executive Officer

“This is a short-sighted approach when constructive alternatives have been put forward.”

The Government’s decision to impose a two-year funding package on community pharmacy is extremely disappointing but does not come as a surprise; it became apparent some time ago that the Government was unshaken in its determination to make a massive cut to community pharmacy funding by reducing fees and allowances.

PSNC could not accept a funding offer which was damaging to the sector and which will adversely affect the ability of pharmacies to provide patient care (see PSNC’s rejection letter at: ow.ly/cMwp305HMuH).

In response to the consultation on changes to community pharmacy, PSNC set out the need for the Government to make decisions about community pharmacy services based on a number of principles that put the needs of patients and communities, as well as evidence, at the heart of the process.

PSNC’s CEO responds to the Government’s decision to impose a funding package on community pharmacy which includes a £113m reduction for 2016/17.

Sadly, this has not been the case, and we are instead now seeing the implementation of a decision for which no evidence has been produced and which many people, including patient and GP groups, have warned will have a detrimental effect on patient care and lead to further pressure on other healthcare services. This is a short-sighted and ill-judged approach to take, particularly when alternative constructive proposals that would address the need for the NHS to make cash savings have been put forward by PSNC. The lack of real consultation and clarity has been a common theme throughout the consultation period.

PSNC will study the Government’s decision carefully to inform our own decisions about next steps.

The funding cut, combined with the previously announced reductions to Category M prices following a significant over-delivery of margin last year, will have a significant and negative impact on contractors’ businesses. We would strongly advise contractors to make

whatever provisions they can for the funding reductions. These will be very challenging times.

PSNC remains keen to work with the NHS on changes to the Community Pharmacy Contractual Framework that will allow the development of clinical community pharmacy services so that patients and the NHS can get the most benefit and best value from community pharmacy.

Call to fund minor ailments service During November’s LPC Conference, PSNC Chief Executive Sue Sharpe called on the Department of Health to use the cuts from the community pharmacy funding budget to fund a minor ailments service in 2017.

Mrs Sharpe told delegates: “A national minor ailments service could create significant savings for the NHS by ensuring patients use pharmacies when they have minor conditions, preventing unnecessary GP appointments and A&E attendances.”

The funding package A two-year funding package has been imposed on community pharmacy after PSNC unanimously rejected it. Details are as follows:

There will be a £113 million (4%) reduction in funding in 2016/17.

This year’s reduction will be squeezed into just 4 months so on average income will fall by 12% compared with current levels.

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A further reduction in 2017/18 will see funding levels drop by around 7.5% compared with current levels.

There will be changes to the way in which funding is distributed, introducing Quality Payments and a Pharmacy Access Scheme.

An Urgent Medicine Supply Service pilot has also been announced (see psnc.org.uk/umss for more information).

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Information and resources for contractors published Following the Government imposing a two-year funding package on community pharmacy, PSNC has been working to publicise information and create resources for contractors. Here we outline all available materials and where to find them.

Information briefing for contractors PSNC has published a briefing summarising the changes to the CPCF in 2016/17 and 2017/18 as announced by David Mowat MP on 20th October 2016.

The briefing includes detailed information on changes to the way in which funding is distributed, arrangements for an Urgent Medicine Supply Service pilot, details of a Pharmacy Access Scheme and criteria for new Quality Payments.

Read and download PSNC Briefing 057/16: Information for Contractors from: ow.ly/rIQg305sU1W Indicative income calculations PSNC has published a set of tables to illustrate the indicative income levels that could be expected by an average pharmacy for Essential Services provided under the CPCF from 1st December 2016.

We have also created a calculator which allows contractors to easily view an estimated income simply by entering the number of items dispensed per month. It includes Quality Payments and an option for those eligible for the Pharmacy Access Scheme.

Both of these resources can be found at: ow.ly/4OUB305sNQx CPCF changes hub launched A new hub page that will provide community pharmacy contractors and their teams with access to the most up to date information on the changes to the Community Pharmacy Contractual Framework (CPCF) in 2016/17 and 2017/18 is now live on the PSNC website.

Find the button opposite on the website homepage for an easy way to visit the hub.

Information available via the hub includes links to individual pages on the different elements of the changes as well as to PSNC Briefings on those topics. As further information on the changes becomes available, it will be added to the hub pages.

PSNC webinar series We have been holding a series of webinars in November to help community pharmacy contractors to understand the imposition of funding and other changes recently made by the Government.

The webinar series covers what changes are being made from and how contractors may be affected, as well as giving the opportunity to ask members of the PSNC team questions. Ondemand versions will be made available at: psnc.org.uk/webinar Raising awareness PSNC and the other national pharmacy organisations are continuing to work to ensure that the media and politicians are aware of the imposition announcement and the ongoing concerns about community pharmacy. LPCs have also been contacting local MPs and other stakeholders.

As well as substantial coverage on TV, radio and national newspapers, 2nd November saw an Opposition Day debate held in the House of Commons on community pharmacies where numerous MPs representing constituents right across the country showed their support for the sector.

How can you help?

PSNC will be going through the announcement and impact assessment in more detail and working with the other pharmacy organisations to develop more detailed plans for the next phase of our campaign for community pharmacy, but for now you may like to consider the following actions: • Tweet the link to the Government imposition announcement on the PSNC website, perhaps using our template tweets to engage local politicians (you can find these at: ow.ly/G3sq305sQyJ).

• If you receive any requests for media comments, please speak to your LPC in the first instance.

• Send your case studies about how your pharmacy is helping your local community and how it may be affected by cuts to your LPC or campaign@psnc.org.uk Let us know about any media or MP successes you have by emailing campaign@psnc.org.uk

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SCR webinar now available on-demand Community pharmacy teams can now access an online recording of the recent PSNC webinar on accessing the Summary Care Record (SCR).

94%

would recommend it to others

70%

found it very useful

77%

said it was very good on ideas of how to use SCR more often

96%

will use what they have learned in their day to day work

More than 200 people tuned in to the 60-minute webinar in October when NHS Digital’s Community Pharmacy Lead for SCR, Harpreet Shergill, highlighted the value that regularly accessing SCR can bring. Harpreet explained how SCR can help improve the day to day running of a pharmacy and shared examples of life-saving interventions that could not have happened without it.

Following Hapreet’s presentation and a video interview with Pharmacy Manager Shaheen of P&S Chemist Ltd, PSNC’s Daniel Ah-Thion chaired an informative question and answer session covering a range of questions from who can have access to scenarios when SCR could be used.

The webinar is a valuable resource for community pharmacists and technicians considering using SCR or those about to go live, as well as those who have already begun using SCR. Did you miss out or do you just want to watch again?

An on-demand recording of the webinar is now available to watch at: psnc.org.uk/SCRwebinar. To view the recording, you will need to register (or input the email address you registered with previously).

SCR Part 2 A second webinar, hosted by the National Pharmacy Association (NPA), was held a few days later and covered information governance requirements, liability issues, permission-to-view (consent), and how to easily and appropriately deal with privacy and audit. You can also watch that webinar on-demand by clicking on the link available at: psnc.org.uk/SCRwebinar

Contract monitoring next steps In December 2016, NHS England will make arrangements to visit some community pharmacies in England for contract monitoring purposes early next year.

NHS England’s upcoming pharmacy visits follow on from some pharmacies being invited to complete the full Community Pharmacy Assurance Framework (CPAF) questionnaire this month.

The contract monitoring visits are expected to take place between January and March 2017 based on the full questionnaire responses, or in cases where a pharmacy was invited to complete the full questionnaire but did not do so by the deadline, i.e.

4th December 2016.

For further information and the latest news on contract monitoring, please visit: psnc.org.uk/CPAF

New PSNC Vice Chair and Committee Members Independent community pharmacy contractor Bharat Patel has been elected as PSNC’s Vice Chair.

Bharat has been a member of PSNC since 2004. He is currently PSNC Regional Representative for the East Region and a member of the Negotiating Team.

Since qualifying from the Liverpool School of Pharmacy in 1979 Bharat has been a

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passionate advocate for community pharmacy. He has been a member of Essex LPC since 1982 and has most recently been campaigning for the sector by joining PSNC staff at the political party conferences.

PSNC is also pleased to announce the election of Jay Patel of Day Lewis Plc and Jas Heer of Coventry LPC to the Committee. Jay Patel becomes a Multiple

Chemist Representative, whilst Jas Heer joins as Regional Representative for the West Midlands.

Both took up committee membership immediately and will serve the remaining portion of PSNC’s term of office ending 31st March 2018.

PSNC is delighted to welcome Bharat, Jay and Jas to their new roles.

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The Essential EPS Checklist: Part 1 of 2 Share this checklist with your pharmacy team and complete it together to ensure the whole team is getting the most out of EPS Release 2. Look out for part 2 next month.

Know when your local GPs are going live • GPs must give at least 8 weeks’ notice prior to EPS go-live so all have time to prepare.

• Your LPC can advise you of local GP practice go-live dates, and may be able to delay go-live if pharmacies are not ready.

• Local deployment: An online list and map reveal which practices are live, and which are not (see psnc.org.uk/epsstats).

Meet with GPs Take part in EPS business process change sessions at the GP practice, or ask your local GP practice staff for a meeting alongside other local pharmacies. LPCs and LMCs may assist (see psnc.org.uk/epsmeetgp for more on meeting and working with GPs).

Ensure staff are trained in both EPSR2 and your PMR system • Check and take part in PMR system training opportunities: E.g. one-to-one staff training, webinars, training videos, user manuals, quick reference guides, desk aids and help menus (see tinyurl.com/trainingeps).

• Plan the training so that all staff are fully trained: The most effective training will take place shortly before staff start to deal with large quantities of electronic prescriptions (see psnc.org.uk/epstraining).

• Update and refine SOPs to incorporate EPS. • Appoint an 'EPS champion' who staff can go to for support and troubleshooting advice.

• Learn how to quickly sort and filter different prescriptions within your PMR system.

• Make provision for the training of part-time staff and locums.

Gather nominations • Fully explain EPS to patients: Consider using patient leaflets, signs and online videos (see psnc.org.uk/nomcore).

• Read nomination guidance: Ensure staff gathering nominations are familiar with this (see tinyurl.com/epsnom).

• Are re-confirmations needed? Nominations collected on paper but not adjusted on the EPS system within 6 weeks need re-confirmation prior to updating on the NHS Spine.

Check your Smartcards are all working correctly • Obtain R2-ready Smartcards with the appropriate roles assigned for each team member dealing with prescriptions (dispensing technicians, pharmacists etc.) and test these work (see psnc.org.uk/smartcards).

• Check passcodes: Are these known? Can all staff use their smartcards or are any locked?

• Get Sponsor/LSA role: Someone in the pharmacy could request the Sponsor or Local Smartcard Administrator role so that they can support others with Smartcard issues (see psnc.org.uk/SCroles).

• Know your Local Registration Authority (RA): Your RA is responsible for providing cards and dealing with card issues. Favourite the link to contact details (see psnc.org.uk/ra).

• Bookmark and test Care Identity Service: This is the online Smartcard admin portal. Add https://portal.national.ncrs.nhs.uk/portal/dt (card required) as a favourite and desktop shortcut. Also see psnc.org.uk/managingsmartcards.

Check your NHS Choices profile Are your NHS Choices details correct? If patients ask the GP practice about live pharmacies, they must provide a list of local pharmacies R2-enabled, based on information from the NHS Choices website (see psnc.org.uk/choices). psnc.org.uk 5

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Answered: Your top flu queries The team at PSNC has received a number of queries on the national Flu Vaccination Service since the service went live. Below are some of the questions asked in recent weeks:

1

I am unsure whether a patient is eligible to receive a vaccine under the Flu Vaccination Service because their condition is not specifically mentioned in the service specification. What is the best way to proceed?

Pharmacists will need to make a clinical decision as to whether an individual patient falls into an eligible group based on the information in the service specification and consider that eligible groups offered the flu vaccination are those that are most at risk of the complications of flu. If a pharmacist is unsure if a patient is eligible for an NHS flu vaccination, the patient should be referred to their GP.

2

Would people living in supported accommodation such as sheltered accommodation be eligible for an off-site flu vaccination?

People living in supported accommodation such as sheltered accommodation would not fall under the eligible group ‘people living in long-stay residential care homes or other long-stay care facilities’ and would therefore not be eligible for an off-site flu vaccination.

However, they may be eligible for an NHS flu vaccination if they fall into one of the other eligible groups for the Flu Vaccination Service and if so, could have a flu vaccination at the pharmacy.

3

Are pharmacy team members eligible for flu vaccinations under the Flu Vaccination Service?

No. Employers may wish to offer pharmacy staff flu vaccinations as part of their occupational health arrangements, but this cannot be undertaken as part of the Advanced Service. If a pharmacy team member is eligible for an NHS flu vaccination and falls into one of the eligible patient groups for the Advanced Service, they would be able to use the service at the pharmacy.

Resources round up Toolkit for promoting to local charity support groups PSNC has produced a resources toolkit to help LPCs to promote the national Flu Vaccination Service to local charity support groups. It includes a list of groups, a template email, and a template Powerpoint presentation which could be used at an event. The toolkit can be downloaded from: ow.ly/Lnau305yBkv

Carers and the flu jab It can be difficult to identify carers who may be eligible for an NHS flu vaccination under the national Flu Vaccination Service. PSNC has highlighted some resources to assist pharmacy teams in identifying carers here: ow.ly/qs6L305k8Nn

4

Can any brand of flu vaccine be used for the Flu Vaccination Service?

No. Public Health England’s annual flu letter contains more information about which vaccines to use and who supplies them for the Flu Vaccination Service (see tinyurl.com/fluplan201617). Please note, the community pharmacy Flu Vaccination Service does not include the intradermal vaccine (Intanza) or the nasal spray (Fluenz Tetra).

5

Can distance selling pharmacies provide the Flu Vaccination Service?

Yes. A distance selling pharmacy may provide Advanced and Enhanced Services, as long as any Essential Service which forms part of the Advanced or Enhanced Service is not provided to persons present at the premises. The distance selling pharmacy must fully meet the requirements for the provision of the Flu Vaccination Service, which includes the consultation room requirements.

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

Pharmacy teams beat last year’s NHS flu vaccination total Pharmacy teams surpassed the total number of NHS flu vaccinations delivered during last year in less than eight weeks.

Last year the total number of vaccines administered in community pharmacies under the national Flu Vaccination Service was 595,467. Data from PharmOutcomes and Sonar Informatics has confirmed that pharmacy teams had exceeded the 600,000 mark by the end of October, although the total number will be even higher as some pharmacies are not using these systems to record administration of vaccines.

The latest statistics can be viewed at: psnc.org.uk/flustats

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Epilepsy focal point New learning programme from the Centre for Pharmacy Postgraduate Education (CPPE) focuses on pharmacy’s role in supporting patients with epilepsy.

We have launched our latest focal point programme on epilepsy, with workshops now available “across England.

Epilepsy is the most common neurological condition in the UK, and according to the Joint Epilepsy Council of the UK and Ireland, it affects around 600,000 people. This is equivalent to approximately one in 103 people.

Clare Smith Programme developer and senior pharmacist, CPPE

Epilepsy is a long-term condition, and we know that the management of epilepsy can be complex; but with the right support, around 70% of patients have the potential to be seizure free. Pharmacy teams are ideally placed to be able to support patients and their relatives and carers as part of the wider multidisciplinary team.

The Epilepsy focal point considers: • the incidence, definition and diagnosis of epilepsy; • the pharmacological and non-pharmacological management of epilepsy; • ways in which to support woman considering starting a family, from pre-conception through to pregnancy; and • signposting patients living with epilepsy and/or their carers to useful resources.

The learning programme gives you key information regarding the management of epilepsy while encouraging you to identify your own learning needs. Then, through the use of case studies and clinical vignettes, you have the opportunity to apply what you have learnt, and think about how that relates to your own area of practice.

As well as an update on epilepsy and its management, the workshop provides lots of information to help pharmacy professionals support patients, including information about risk assessment, driving regulations and contraception.

Latest support from CPPE Learning disabilities distance learning A new distance learning programme from CPPE aims to help learners respond more effectively to the needs of people with a learning disability and those who look after them. Find out more at: ow.ly/JsSx3056Zcg

Our focal points bring you up to date with expertly written material and learning with colleagues in a relaxed, friendly, supportive environment. Book your place at a local workshop at: www.cppe.ac.uk

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Pharmacy service news Lower rate of readmissions for patients using post-discharge scheme The evaluation of a post-discharge scheme indicates that patients who receive a follow-up consultation with a pharmacist may have lower rates of readmissions and shorter hospital stays if they are readmitted.

The Transfer of Care Scheme shows the support that community pharmacy teams can provide to patients recently discharged from hospital.

Find out more, and read the evaluation in full, at: ow.ly/cV3S305tzbx

NICE launches food allergy and anaphylaxis e-learning tool A new online learning tool on the management of food allergies and anaphylaxis has been launched by the National Institute for Health and Care Excellence (NICE).

The tool helps healthcare professionals, including pharmacy professionals, implement NICE guidance in a practical way.

Find out more about this free tool, developed by the Centre for Pharmacy Postgraduate Education, at: ow.ly/KuLl305CAWk

Pharmacy teams reach out to people with diabetes Community pharmacy teams in Wiltshire have been taking part in a project designed to reach out to young people (aged 16-40) with type 1 or type 2 diabetes.

An evaluation of the project has shown that, after the pharmacist's intervention, 31% of patients had completed the additional care processes and 19% made an active change in their lifestyle and diabetes management.

Find out more, and read the evaluation in full, at: ow.ly/NKB6304Xt3K

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Are you endorsing your prescriptions correctly?

Our Dispensing and Supply Team outlines the endorsement terms required to make claims for additional fees – and which terms to avoid.

It has been brought to the attention of PSNC that some prescriptions are being incorrectly endorsed for claims for additional fees. For example, when endorsing prescriptions to claim for Broken Bulk the words “Broken Bulk” are being endorsed and this is incorrect. Part II, clause 11 of the Drug Tariff states that the appropriate endorsement to be used is “BB” only.

Category

Endorsement

Broken Bulk

“BB” and amount dispensed over pack size used (more information at psnc.org.uk/bb).

Extemporaneously Dispensed

“ED” (more information at psnc.org.uk/specials).

Hosiery

Compressions class, article style, quantity, knit, “made to measure” if appropriate.

For paper prescriptions – pharmacy staff should endorse “BB” in the left hand endorsement column.

Instalment Dispensing

For EPS Release 2 prescriptions – pharmacy staff should use their PMR system to insert the “BB” endorsement to the electronic message.

Not Dispensed

“ND” and score through the item in the prescribing area.

Out of Pocket Expenses

“OOP” or “XP“ on paper prescriptions and only “XP” on EPS R2 prescriptions, name or description of the charge, price paid (more information at psnc.org.uk/oop).

Packaged Doses (for oral liquid methadone) Prescriber Contacted

“PD” followed by the number of additional doses packaged separately (more information at psnc.org.uk/methadone).

“PC” and the missing information, date and initials.

Prescriber Not Contacted

“PNC” and the missing information, date and initials.

Trusses

Single or double, position, type.

Unlicensed Specials and Imports

“SP” (more information at psnc.org.uk/specials).

Date, quantity, pharmacist initials for each instalment (more information at psnc.org.uk/mda).

Measured and Fitted “MF”

This is also the same for out of pocket expense claims where prescriptions endorsed with the wording “Out of Pocket Expenses” will not be eligible for payment. Instead, paper prescriptions should be endorsed with "OOP" or "XP" and EPS Release 2 prescriptions should only use "XP".

Pharmacy staff are reminded to check for an item’s eligibility before making a claim for additional fees. Applying the appropriate endorsements will ensure correct reimbursement by the Pricing Authority.

Opposite is a quick guide to the most commonly used endorsements. For full details of all possible endorsements, see our guide, An Alphabetical Guide to Prescription Endorsement, which is available on our website at: psnc.org.uk/endorsement

For more information on endorsing prescriptions correctly, please see ‘Dispensing Factsheet: Prescription endorsements’ on page 9.

Can it be dispensed on an FP10?

When pharmacy teams receive NHS prescriptions, they must check whether the items prescribed are allowed on the NHS before dispensing otherwise the pharmacy contractor may not be paid for them. Below is a list of some products that we have recently received queries about.

Product

Is the item listed in the Drug Tariff?

Is it Does it in the have a ‘CE’ blacklist?* mark?

Can it be dispensed on an FP10?

Additional information

Confidence Gold Colostomy bag Standard CTNW32 32mm Transparent

No

n/a

Yes

No

This item is a medical device (CE marked) and has recently been removed from the Drug Tariff.

Tegaderm Film dressing 10cm x 12cm

No

n/a

Yes

No

This item is a medical device (CE marked) and does not appear in the Drug Tariff.

Riemann P20 Once a Day Sunfilter lotion SPF 50

No

No

No

Yes

This item is a cosmetic product and does not appear in Part XVIIIA (the ‘blacklist’) of the Drug Tariff.

HydroSil Go catheter female 12Ch 71812v

Yes

n/a

Yes

Yes

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

*n/a is because medical devices are not listed in the blacklist.

Please note: If the prescription is an FP10CN or FP10PN (community nurse prescriber), an FP10D (dental prescriber) or an FP10MDA (instalment dispensing), please visit psnc.org.uk/prescriptionforms for more information.

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Dispensing Factsheet: Prescription endorsements This is a quick reference guide to the prescription endorsements which pharmacy teams may need to use. Accurate endorsement is vital to ensuring correct payment from the Pricing Authority.

1. General endorsements — The guidance below is intended as a quick reference only.

Prescribed item

Required endorsement

A generic medicine listed in Part VIIIA of the Drug Tariff.

For Part VIIIA products, the only endorsement required is the pack size where there are multiple pack sizes listed.

A generic medicine listed in Part VIIIB of the Drug Tariff.

There is no endorsement required for Part VIIIB listed products (apart from claiming the sourcing fee with “SP” or “ED” where appropriate).

A generic medicine which is not listed in Part VIIIA of Endorse with the brand name or manufacturer/supplier as well as pack size the Drug Tariff. where there are multiple pack sizes available.

If the product does not have a price listed in the Dictionary of Medicines and Devices (dm+d)*, the net price before discount and exc. VAT should also be endorsed.

An unlicensed medicine (or special) which is not Endorse: listed in Part VIIIB of the Drug Tariff and has been • Amount dispensed over pack size used; sourced under a manufacturer’s specials/ importer’s • Invoice price per pack size from which the order was supplied less any discount or rebate; licence** issued by the MHRA. • Manufacturers’/ importers’ MHRA licence number; • Batch number of the product supplied; • SP (for costs incurred in obtaining the item) (more information at psnc.org.uk/specials) An unlicensed medicine (or special) which is not Endorse the names, quantities and cost of the ingredients used in preparing listed in Part VIIIB and has been manufactured under the product plus “ED” for costs incurred in dispensing a product prepared the Section 10 exemption from the Medicines Act under the Section 10 exemption (more information at psnc.org.uk/specials).

1968 (either by the contractor or a third party).

A branded medicine.

The only endorsement required is the pack size.

If the product does not have a price listed in the dm+d, the net price before discount and excluding VAT should also be endorsed.

A generic appliance which is only listed generically in The only endorsement required is the pack size where multiple pack sizes are Part IX of the Drug Tariff. available.

Additionally, ensure elastic hosiery prescriptions indicate: • the total quantity to be supplied; • a description of the article (e.g. circular knit, below knee); • the compression class A generic appliance which is listed by brand or manufacturer in Part IX of the Drug Tariff.

Endorse with a brand or manufacturer’s name as listed in the Tariff. Only endorse the pack size where there are multiple pack sizes listed in the Tariff.

Please note: some appliances have default prices, listed at the beginning of the relevant Drug Tariff section, which are used for pricing in this situation.

These are: catheters, elasticated tubular bandages, absorbent perforated plastic film faced dressings, permeable non-woven synthetic adhesive tape BP 1988, and peak flow meters.

To be reimbursed for any of the above products which may be priced higher than the default price, the prescription must be returned to the prescriber for amendment to include a specific brand name as listed in the Drug Tariff.

A branded appliance which is listed by brand or manufacturer in Part IX of the Drug Tariff.

The only endorsement required is pack size where there are multiple pack sizes listed.

* The Dictionary of Medicines and Devices is the database used by the NHS to standardise the language used to describe medicines within the NHS. This database also contains information regarding the price of medicines. Pharmacy staff can access this database by visiting dmd.medicines.org.uk ** The manufacturer’s specials/importer’s licence number can be found on the invoice or CoC/CoA for the product.

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

© PSNC

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2. Specific endorsements Below are the most commonly used endorsements, but pharmacy staff will need to check for an item’s eligibility. For full details of all possible endorsements, you may find the joint guide, An Alphabetical Guide to Prescription Endorsement (available from psnc.org.uk/endorsement), useful.

Category

Endorsement

Broken Bulk

“BB” and amount dispensed over pack size used (more information at psnc.org.uk/bb).

Extemporaneously Dispensed

“ED” (more information at psnc.org.uk/specials).

Hosiery

Compression class, article style, quantity, knit, “made to measure” if appropriate.

Instalment Dispensing

Date, quantity, pharmacist initials for each instalment (more information at psnc.org.uk/mda).

Measured and Fitted

“MF”

Not Dispensed

“ND” and score through the item in the prescribing area.

Out of Pocket Expenses

“OOP” or “XP” on paper prescriptions and only “XP”on EPSR2 prescription, name or description of the charge, price paid (more information at psnc.org.uk/oop).

Packaged Doses (for oral liquid methadone)

“PD” followed by the number of additional doses packaged separately (more information at psnc.org.uk/methadone).

Prescriber Contacted

“PC” and the missing information, date and initials.

Prescriber Not Contacted

“PNC” and the missing information, date and initials.

Trusses

Single or double, position, type.

Unlicensed Specials and Imports

“SP” (more information at psnc.org.uk/specials).

3. Prescriber endorsements Below is a list of the endorsements which only a prescriber can add to a prescription item.

Endorsement

What it means for dispensing

ACBS

No impact on dispensing.

If an item which is found on the Borderline Substances list (Part XV of DT) has not been endorsed by the prescriber, this product can still be dispensed as it isn’t a compulsory requirement (but the prescriber may be questioned by the local NHS England team later).

If required, this endorsement must have been made by the prescriber before dispensing.

If a medicine which is found in the Selected List Scheme (Part XVIIIB of DT) has not been endorsed by the prescriber, the prescription would need to be returned to the prescriber for amendment – pharmacy staff cannot make this endorsement themselves.

SLS

Either “OC”, “CC” or “♀”

No patient charge is payable for this item.

This endorsement is the prescriber declaring that it is to be used for contraceptive purposes.

Bulk Prescription

No patient charge is payable for this item.

This endorsement is the prescriber declaring that the criteria for issuing bulk prescriptions have been met.

4. Frequently asked questions Q. With electronic prescriptions (EPS Release 2), can I endorse the token?

A. Tokens are not used for pricing, so endorsements on them would not be considered. Reimbursement for electronic prescriptions are based on the electronic claim message. Pharmacy teams will need to use their pharmacy system to ensure they make accurate endorsements electronically.

Q. Will the Pricing Authority (PA) allow me to amend a prescription (e.g. adjust an endorsement) after I have already sent it to them for pricing?

A. A paper prescription cannot be amended after the PA has received it for pricing.

However with electronic prescriptions, it may be possible to make a change (such as amending an incorrect endorsement or adjusting the patient exemption category) after the prescription claim message has been sent to the PA. This is subject to the following criteria: • your PMR system supplier must have added the functionality required to recall claim messages; and • it must be before the deadline of the 5th day of the month following that in which supply was made. After this time the PA’s pricing process will begin and the prescription can no longer be recalled.

If these criteria are met, your PMR system can allow you to recall, correct, and then resend the electronic script to the PA.

For the most up to date information on endorsements, please visit the PSNC website: psnc.org.uk/endorsement 10 Community Pharmacy News – November 2016

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Ask PSNC The PSNC Dispensing and Supply Team can provide pharmacy teams with support and advice on a range of topics related to the Drug Tariff and reimbursement. Questions asked in recent months have included: Q. A patient has presented a prescription from Northern Ireland; the patient says they do not pay for their prescription however they have not produced a valid exemption. Does this patient need to pay the prescription charge?

A. No. As of 1st April 2010, prescription charges were abolished in Northern Ireland and an agreement was put in place which means no prescription charges should be collected if presented to a pharmacy in England. Please note, no such agreement is in place for Scottish or Welsh prescriptions.

For more information on when you should collect a prescription charge, see our ‘What does the patient pay?’ page (psnc.org.uk/patient-charges).

Q. I have just found EPS prescriptions on our system that have been dispensed with the dispensed notification sent, however no claim message has been sent. The dispensed notifications were sent over 180 days ago; can payment still be claimed from the Pricing Authority for these items?

Q. A patient has recently had a miscarriage. Is she still entitled to use her Maternity Exemption Certificate?

A. No. All electronic claim messages must be sent within 180 days of the dispense notification message being sent. This time is known as the ‘claim reconciliation period’. At this point, the Pricing Authority receives a no-claim message, which means it has been removed from the Spine and can no longer be priced by the Pricing Authority.

For more information, see our ‘How long is a prescription valid for?’ page (psnc.org.uk/period-of-validity).

A. A patient in receipt of a Maternity Exemption Certificate who has a miscarriage, abortion/termination of pregnancy or stillborn birth is entitled to use their Maternity Exemption Certificate for NHS Prescriptions until the certificate expires.

For more information, see our ‘Exemptions from the prescription charge’ page (psnc.org.uk/exemptions).

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).

Hints & Tips for dispensing contractors

Switching insulin delivery devices The Medicine and Health products Regulatory Agency (MHRA) has issued a medical device alert about patients changing their insulin delivery device.

The latest issue (number 25) of the Pricing Authority’s Hints & Tips for dispensing contractors newsletter contains some really useful information on: • the national Flu Vaccination Service; • Electronic Repeat Dispensing; • viewing Summary Care Records; • how to claim additional fees and other payments; and • common reasons for referring back prescription items.

Patients are being warned that if they are contacted directly by a manufacturer or other organisation to try using a different insulin therapy system, they should first discuss this with their diabetes specialist to avoid risk of hyperglycaemia, hypoglycaemia or diabetic ketoacidosis.

You can read issue 25 at: www.nhsbsa.nhs.uk/3191.aspx

Additional key drug notice information can be found in the latest MHRA Drug Safety Update available from: ow.ly/NVkI305fUck

Read the alert in full at: ow.ly/MUOk305y2Lu

psnc.org.uk 11

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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 December 2016.

Part VIIIA additions Category A Additions: • Pyridoxine 10mg tablets (28) • Sodium bicarbonate 600mg tablets (100) Category C Additions: • Beclometasone 100micrograms/dose / Formoterol 6micrograms/dose dry powder inhaler SC (120 dose) – Fostair NEXThaler • Beclometasone 200micrograms/dose / Formoterol 6micrograms/dose dry powder inhaler SC (120 dose) – Fostair NEXThaler • Beclometasone 200micrograms/dose / Formoterol 6micrograms/dose inhaler CFC free SC (120 dose) – Fostair • Budesonide 200micrograms/dose / Formoterol 6micrograms/dose inhaler CFC free SC (120 dose) – Symbicort • Buprenorphine 15micrograms/hour transdermal patches (4) – BuTrans • Calcipotriol 50micrograms/g / Betamethasone diproprionate 500micrograms/g foam SC (60mg) – Enstilar • Cinacalcet 60mg tablets (28) – Mimpara • Cinacalcet 90mg tablets (28) – Mimpara • Co-codamol 12.8mg/500mg tablets (20) – Solpadeine Max • Co-codamol 12.8mg/500mg tablets (30) – Solpadeine Max • Colecalciferol 1,000unit capsules (30) – Aviticol • Colecalciferol 4,000unit tablets (70) – Desunin • Dalteparin sodium 10,000units/0.4ml solution for injection prefilled syringes (5) – Fragmin • Dalteparin sodium 10,000units/1ml solution for injection prefilled syringes (5) – Fragmin • Dalteparin sodium 12,500units/0.5ml solution for injection prefilled syringes (5) – Fragmin • Dalteparin sodium 15,000units/0.6ml solution for injection prefilled syringes (5) – Fragmin • Dalteparin sodium 18,000units/0.72ml solution for injection prefilled syringes (5) – Fragmin • Dalteparin sodium 2,500units/0.2ml solution for injection prefilled syringes (10) – Fragmin • Dalteparin sodium 5,000units/0.2ml solution for injection prefilled syringes (10) – Fragmin • Dalteparin sodium 7,500units/0.3ml solution for injection prefilled syringes (10) – Fragmin • Diphenhydramine 50mg tablets (20) – Nytol One-A-Night • Haloperidol 5mg/1ml solution for injection ampoules (10) – AMCo • Mesalazine 1g/application foam enema SC (14 dose) – Salofalk

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.

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.

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

• Podophyllotoxin 0.5% solution SC (3ml) – Warticon • Podophyllotoxin 0.5% solution SC (3.5ml) – Condyline • Rufinamide 40mg/ml oral suspension sugar free SC (460ml) – Inovelon • Senna 15mg tablets (48) – Senokot Max Strength • Zinc sulfate 220mg capsules (30) – Zincomed • Zinc sulfate 220mg capsules (250) – Zincomed Part VIIIA amendments • Ferrous fumarate 322mg tablets (28) Category C – Fersaday is changing to Category C – AMCo 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 Allevyn Plus Cavity dressing

Size, type and product code 5cm x 6cm 10cm x 10cm 15cm x 20cm

Drainable Pouch Clamp, Beige (Hollister Ltd)

Pack of 1 (code: 8770)

TRUEone testing strips

Pack of 50

have you seen our Dispensing factsheet: the Drug tariff preface? find this plus more much about the Drug tariff at: psnc.org.uk/dtresources

Distributed for PSNC by:

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