October 2016 CPN

CPN

Community Pharmacy News – October 2016

Pharmacy campaign goes on the road Political party conferences hear case for making better use of pharmacy and developing services

Capita services review | Provider company launches plan | Antibiotic Guardian poster

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Support your local pharmacy campaign: party conference season Community pharmacy made its voice heard loudly and clearly at this year’s political party conferences through a range of coordinated lobbying activity.

Over the past month the national pharmacy bodies (PSNC, Pharmacy Voice, RPS, NPA, AIMp, and the CCA) have continued to work together closely to ensure politicians know that the future of community pharmacy is still under threat.

100

MPs engaged

3 roundtable events

PSNC and others sent representatives to the Conservative, Labour and Liberal Democrat party conferences to hold roundtables with selected MPs, health charities and patient representative groups, whilst drawing attention to the valuable services that community pharmacy provides with interactive exhibition stands.

The stands saw more than 350 people have their blood pressure checked by pharmacists, and visitors included ministers, the Secretary of State for Health, MPs and local councillors. At the Labour Conference the stand was awarded a prize for being the second best designed stand – as voted for by delegates.

The roundtable events focused on community pharmacy and the future, covering both the current threats to community pharmacy and the Community Pharmacy Forward View and how that might be implemented. At the Conservatives Conference the Support Your Local Pharmacy campaign also had a major presence with logos on the conference bags.

Politicians from across the political spectrum were supportive of pharmacy and concerned about the threats, with one local councillor calling the current approach to pharmacy ‘a scandal’. Others called the Support Your Local Pharmacy Campaign ‘phenomenal’ with one MP saying it had led to the the biggest postcard pile their desk had seen this year.

350+

blood pressure checks

Get involved in the campaign To support the campaign, community pharmacy contractors may like to consider some of the following activities: • highlight the results of the recent PwC report on the value of community pharmacy services using our infographic (download from the resources section at: psnc.org.uk/valueofpharmacy); • use the NPA's lobbying tool (lobby.supportyourlocalpharmacy.org); • keep promoting the campaign on social media; • ask your LPC if they are organising any local events that you could be a part of; and • continue to send any details of MP correspondence to campaign@psnc.org.uk.

Further resources are available from: psnc.org.uk/campaign

PSNC and the Department of Health re-enter negotiations In September, the Department of Health (DH) invited PSNC to re-enter negotiations on community pharmacy in 2016/17 and beyond.

The Department stated that its aim was to announce a package by mid-October, to be implemented from December 1st.

DH said it had been considering its position in light of the consultation and information that had come to light in the interim period.

This included the Community Pharmacy Forward View (see psnc.org.uk/forwardview for more information) and the report by PricewaterhouseCoopers: ‘The value of community pharmacy’ (see psnc.org.uk/valueofpharmacy for more information).

The Department also wrote to other pharmacy organisations to inform them of their plans.

PSNC’s priority in negotiations will be to secure the best possible outcome for community pharmacy contractors. All announcements and updates will be posted at psnc.org.uk/news

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NHS England addresses PSNC’s concerns about Capita PSNC receives acknowledgement of poor performance levels and a commitment to review those services provided by Capita from NHS England.

NHS England has responded to PSNC’s concerns about Primary Care Support (PCS) England services, setting out plans for an operational assurance review of the services provided by Capita and apologising that some services have not met expectations.

PSNC wrote to NHS England’s National Director of Operations & Information in July to request remedial action regarding Capita’s operation of PCS England services following a range of issues raised by LPCs and community pharmacy contractors.

In its response to PSNC, NHS England provided the following information: Controlled stationery NHS England apologises that the service has not met expectations over the last few months and cites the significant improvement made to the supplies management process since Capita took on responsibility for PCS, including a full review of the delivery hubs, rebalancing stock levels, and amending descriptions and quantities in the catalogue.

The latest information from Capita states that there are no supply backlogs other than where they are awaiting stock through the NHS supply chain. NHS England continue to work with supply chain partners and to monitor service performance to see how this can further be improved.

Market entry NHS England states that it is aware of a number of issues associated with market entry involving delays in processing applications, and errors occurring. The

letter cites difficulty in managing the very wide range of local processes and services previously overseen by local in-house teams has been a major challenge for Capita. NHS England assures PSNC that it will be doing all it can to ensure issues are addressed quickly and fairly.

Operational assurance review As a result of a number of stakeholder concerns, NHS England has pledged to undertake an operational assurance review of the services provided by Capita.

The review will support Capita to assess the effectiveness of the processes in place for PCS England services and make recommendations for how Capita could improve the organisation and management of transition from local arrangements. The aim is to ensure local issues and requirements associated with each service line are being managed effectively.

Gordon Hockey, PSNC Director of Operations and Support, said: “We welcome NHS England’s acceptance that Capita is not meeting the needs of its service users and assurances that it is monitoring the situation, but remain cautious about how quickly these issues can be resolved.

Whilst Capita have made improvements following information we have provided, there is still some way to go and a certain level of inconsistency remains. We hope NHS England can give more sustained support through the operational assurance review to guide Capita for future reliability of PCS services.

PSNC will continue to collate reports on PCS England service levels from LPCs and pharmacy contractors, highlighting to Capita and NHS England as necessary.”

Over 150k flu vaccinations administered in three weeks Community pharmacy teams have made an amazing start to the delivery of the Flu Vaccination Service by delivering over 150,000 flu vaccinations in just over three weeks.

Data from PharmOutcomes and Sonar Informatics has confirmed that pharmacy teams have hit the 150k mark, although the total number of vaccinations administered will be even higher as some pharmacy teams are not using the electronic systems to record administration of vaccines.

Additionally, as of 16th September, 7,998 contractors had signed up on the NHS Business Services Authority’s website to provide the Flu Vaccination Service. Further statistics on the community pharmacy service can be found at: psnc.org.uk/flustats An A3 poster promoting the Flu Vaccination Service to people with long term conditions is available in the centre of this month’s edition of CPN. It’s double-sided for display in a window. For more promotional materials, please visit: psnc.org.uk/flupatientcomms

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National provider company sets out plans and prospectus National pharmacy organisations create new company to support LPCs in developing successful tenders for local NHS services.

On Friday 30th September Healthcare Together, the national provider company formed with National Pharmacy Association (NPA) and PSNC members and the support of the Company Chemists’ Association (CCA) and Association of Independent Multiple Pharmacies (AIMp), launched their website and prospectus.

Healthcare Together was formed to better support LPCs and their associated provider companies to help them address current and future local commissioning challenges.

The organisation will guide LPC-supported provider companies through a range of tasks from company formation to the implementation of successful tenders.

The team comprises experts in the fields of pharmacy, finance and law, as well as tender writing specialists, and can provide expert support and advice.

Services currently available from Healthcare Together include advice on what type of

company to set up, help with setting it up, finding tenders, writing them in a compelling way and even finding you the help to implement them. All LPCs have been signed up to receive notifications of tenders launched, via the organisation’s tender scanning service.

Due to the involvement of PSNC and the NPA, this range of services is being made available to all LPCs and their associated provider companies either for free or at a competitive or discounted rate.

Healthcare Together will hold a number of presentations over the next few months to inform LPCs about its services and future plans. The first of these will take place at the LPC Chairs and Chief Officers meeting in London on 1st November.

In the meantime, LPC members can log in to the national provider company’s website (www.healthcaretogether.co.uk) for details about the services already on offer.

New research demonstrates high patient satisfaction with MURs Researchers from the Reading School of Pharmacy, University of Reading, have published what is believed to be the first quantitative, nationwide study of patient satisfaction levels with the Medicines Use Review (MUR) service conducted within one pharmacy chain. The research project was conducted in collaboration with the East of England Respiratory Clinical Network and the Day Lewis Pharmacy group.

An existing framework of MUR patient satisfaction was used to develop a questionnaire, which was initially piloted on a small scale, involving 30 patients across three community pharmacies.

This pilot led to the launch of the research project involving at least 105 pharmacies from the Day Lewis group and a total of 490 questionnaires were handed out to patients.

The results of the survey demonstrate a high degree of patient satisfaction with the delivery and impact of the MUR service.

Find out more, and download the research summary, from: ow.ly/UXYE304Gozv

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Liz Colling, Chair and Board Director of Healthcare Together said: “I am pleased to be launching Healthcare Together and its new tender scanning service. It is great to be working with the NPA and the PSNC to deliver solutions and services for LPCs and their associated provider companies. Being an enabler to support the continuous provision and development of community pharmacy services allows us to be part of the evolution of healthcare.”

Key facts from MUR research

97%

of those surveyed were glad to have the opportunity to raise questions or concerns

8/10

felt more confident about their condition following the MUR

96%

were happy with the pharmacists’ advice and recommendations

9/10

would recommend the MUR service to others

18 or over with a long term medical condition?

18 or over with a long term medical condition?

Providing NHS Services

This free service is funded by NHS England.

Ask us today for more information.

If so, you may be eligible for a free NHS u vaccination from our pharmacy.

If so, you may be eligible for a free NHS u vaccination from our pharmacy.

Ask us today for more information.

This free service is funded by NHS England.

Providing NHS Services

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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.

Pharmacy’s role in screening recognised

An evaluation of a hepatitis C virus testing service pilot has shown that community pharmacy teams on the Isle of Wight provided a pivotal role in linking up patients to local specialist organisations.

The pharmacy-based service was able to reach patients with more diverse risk factors, who may not be known to local drug and alcohol services and so were less likely to have been tested previously.

Meanwhile, Coeliac UK has published findings from a pilot study that concludes community pharmacy is an appropriate location for the early recognition of patients in whom coeliac disease is suspected, with a high level of reported customer and service provider satisfaction.

Further details on both of these services can be found on the PSNC website at: ow.ly/kDHx304WNYV and ow.ly/zhMB304WOa2

New Talking About Cancer e-learning course

free eCancer Research UK has created a more urage learning course designed to enco er. canc conversations about and early The course focuses on prevention n and matio diagnosis, but the cancer infor be also may tools and conversation tips cancer to g talkin s team acy pharm helpful for ds. patients and their families and frien OkU1304NAII Sign up or find out more at: ow.ly/

e-Repeat Dispensing campaign NHS Digital are launching a new campaign to boost the usage of the electronic Repeat Dispensing (eRD) service.

GP practices will receive new eRD training opportunities as part of the campaign.

Find out more about the campaign at: psnc.org.uk/erd

Did you know about the recent SCR webinars?

PSNC recently held a webinar on how to go live with Summary Care Record (SCR) access in your pharmacy. It was one of two webinars held in October on SCR access, the second was hosted by the NPA. On-demand recordings of both webinars are now available from: psnc.org.uk/SCRwebinar You may also be interested in watching an NHS Digital webinar for SCR Privacy Officers (POs) who have already attended face-to-face PO events. The next PO webinars will be held on: Sunday 13th November at 10.30am and Thursday 8th December at 2pm.

Find out more about any of these events by visiting: psnc.org.uk/screvents

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2016 Antibiotic Guardian campaign Pharmacy teams invited to support antibiotics awareness efforts by using their community reach to spread the message further.

This year as part of World Antibiotic Awareness Week, community pharmacy teams are invited to participate in European Antibiotics Awareness Day (EAAD), World Antibiotic Awareness Week (WAAW) and the Antibiotic Guardian campaign 2016.

The Antibiotic Guardian campaign, which was launched in September 2014, has now seen over 32,800 individuals (public and healthcare professionals) become Antibiotic Guardians; each choosing a pledge about how they will personally use antibiotics more prudently. Evaluation of the campaign has highlighted that it is effective for changing behaviour and increasing knowledge (self reported).

PHE is encouraging pharmacy teams to get involved and is hoping to achieve the following:

• to double the number of pharmacy teams making an Antibiotic Guardian pledge to 10,000 – pharmacy teams can make their pledge on the Antibiotic Guardian website; • for 50% of the members of the public who become Antibiotic Guardians during 2016/17 to find out about this via community pharmacy; and • for at least 10% of community pharmacy teams to register to promote antibiotic awareness/the Antibiotic Guardian campaign during World Antibiotic Awareness Week (WAAW) which is 1420th November 2016.

Pharmacists can register their community pharmacy premises to lead promotional activities for EAAD, WAAW and the Antibiotic Guardian campaign 2016 at: ow.ly/MmoX304WRLh. PHE has produced

resources to support local and social media campaigns, which are available to be downloaded from: tinyurl.com/AGcampaignresources

Campaign poster An Antibiotic Guardian poster, produced by PHE, can be found on page 9 of this month’s edition of CPN. The poster (supported by PSNC, the Royal Pharmaceutical Society, Pharmacy Voice, the Centre for Pharmacy Postgraduate Education, the Association of Pharmacy Technicians UK and the British Pharmaceutical Students’ Association) is intended to help pharmacy teams increase awareness of the Antibiotic Guardian campaign amongst their patients.

Urgent care campaign New campaign from the Centre for Pharmacy Postgraduate Education (CPPE) highlights pharmacy’s role in urgent care. focusing on managing urgent care in pharmacy practice began on Monday 3rd October, but Liz Reid there’s still time Senior pharmacist, learning development, for you to get CPPE involved.

The five-week campaign aims to enable pharmacy professionals in all sectors to understand your role in urgent care, and to recognise the opportunities available to extend your scope of practice and provide effective support for patients presenting with urgent care needs.

6 Community Pharmacy News – October 2016

You should have now received a copy of our distance learning programme, Urgent care: a focus for pharmacy, and a campaign leaflet explaining the five challenges.

Our campaign challenges ask you to: 1. Test your knowledge by completing our e-challenge.

2. Learn and engage by working through the Urgent care: a focus for pharmacy distance learning programme.

3. Promote pharmacy by talking to local press or radio or other healthcare professionals to raise awareness of the pharmacy as a place to go for urgent care or advice.

4. Learn from others by visiting our website and watching the videos of pharmacists describing how they have

changed their approach to urgent care.

5. Plan a caring approach by working with your team to make sure your pharmacy is a welcoming environment for those who feel they need urgent care.

To get involved, sign up to the campaign at: www.cppe.ac.uk/urgentcare and record your progress towards earning an urgent care campaign virtual badge.

You can also follow us on Facebook and Twitter (using #urgentcare) to keep up to date with the campaign and help spread the message.

“

Our latest “learning campaign

Details of all CPPE’s learning programmes can be found at: www.cppe.ac.uk

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

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

For paper prescriptions, where the patient’s age is shown on the front of the prescription as “59” they would not be age exempt, unless their 60th birthday has taken place between the time of being provided with the prescription and making their declaration of exemption. The patient should sign the back of the prescription form to declare that they are indeed over the age of 60 on the day they are asked to pay.

For Electronic Prescription Service (EPS) prescriptions, your

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

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

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

Q. How can I use my PMR system to check and amend EPS Release 2 endorsements and exemptions to avoid switches and payment issues?

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

PMR systems should assist users by (1) preventing prescriptions being sent to the Pricing Authority unless an exemption category option has been selected; and/or (2) where needed, asking whether either, the ‘paid’ status is right, or, if instead, the category needs adjusting.

EPS prescriptions should also be able to have their endorsement and exemption status amended at any time after claim notification has been sent, and the EPS prescription has been sent to the Pricing Authority, as long as the prescription’s relevant ‘5th of the month’ pricing deadline has not passed. NHS Digital has made amendments to the Spine to allow this functionality to be implemented and one PMR system already has this functionality available to users according to NHS Digital information.

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

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

Hints & Tips for dispensing contractors The latest issue (number 24) of the Pricing Authority’s Hints & Tips for dispensing contractors newsletter contains some really useful information on: • EPS nomination, submission and referred back items; • Endorsing FP10MDA forms; and • CPAF screening next steps.

Dispensing and Supply Team. PSNC reports the feedback received to the Department of Health. This information is also used in discussions with manufacturers – for example, highlighting problems with contingency arrangements.

Please let us know about any supply issues by using our online feedback forms at: psnc.org.uk/feedback

You can read issue 24 at www.nhsbsa.nhs.uk/3191.aspx

Guidance on levonorgestrel-containing emergency contraceptive interactions The Medicines and Healthcare products Regulatory Agency (MHRA) has issued updated advice to healthcare professionals about the concomitant use of levonorgestrel-containing emergency

Are you experiencing supply issues?

Pharmacy teams who experience problems in obtaining medicines or appliances are reminded to feed this back to our

hormonal contraception and hepatic enzyme inducing drugs. The updated guidance, along with a related information sheet, can be downloaded from: ow.ly/iXNQ304kLGQ Glycopyrronium bromide 1mg/5ml oral solution moves to Part VIIIA Glycopyrronium bromide 1mg/5ml oral solution has been removed from Part VIIIB of the Drug Tariff because a licensed alternative, Glycopyrronium bromide 1mg/5ml oral solution sugar free, is now available. The licensed product was added to Part VIIIA from 1st October 2016.

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 community pharmacy contractor may not be paid for them. Pharmacy teams may wish to check PSNC’s ‘Dispensing on an FP10 database’ (available at: psnc.org.uk/FP10database) for more information on whether an item can be dispensed on an FP10. 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

Dermalex Repair Scalp Psoriasis gel

No

n/a

Yes

No

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

Canesten Bifonazole Once Daily 1% cream

No

No

No

Yes

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

Thealoz Duo UD eye drops 0.4ml unit dose preservative free

Yes

n/a

Yes

Yes

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

Thealoz Duo eye drops preservative free

Yes

n/a

Yes

Yes

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

Thealoz 3% eye drops

No

n/a

Yes

No

This item is a medical device (CE marked) and is not 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 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 • FP10D (dental prescriber) – Part XVIIA • FP10MDA (instalment dispensing) – psnc.org.uk/mda 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.

8 Community Pharmacy News – October 2016

Distributed for PSNC by:

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

KEEP ANTIBIOTICS SAFE FOR THE FUTURE

Supported by:

Find out more and choose a pledge to help tackle Antibiotic Resistance at www.antibioticguardian.com (takes less than 3 minutes and it is free)

Ask your pharmacist for advice about your symptoms

Colds, most coughs, sinusitis, ear infections and sore throats get better without antibiotics, as your body can usually fight these infections on its own.

Did you know that no amount of antibiotics can cure your cold?

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Drug Tariff Watch Below is a quick summary of the changes due to take place from 1st November 2016.

Part VIIIA additions Category A Additions: • Calcium chloride 14.7% solution for injection 10ml ampoules (10) • Morphine sulfate 10mg suppositories (12) • Sodium chloride 30% solution for injection 10ml ampoules (10) Category C Additions: • Estradiol 1mg / Drospirenone 2mg tablets (84) – Angeliq • Estradiol 2mg / Norethisterone acetate 1mg tablets (84) – Elleste Duet Conti • Estradiol valerate 1mg tablets (84) – Progynova • Estradiol valerate 2mg tablets (84) – Progynova • Ethinylestradiol 20microgram / Gestodene 75microgram tablets (63) – Femodette • Ethinylestradiol 20microgram / Norethisterone acetate 1mg tablets (63) – Loestrin 20 • Ethinylestradiol 30microgram / Drospirenone 3mg tablets (63) – Yasmin • Ethinylestradiol 30microgram / Gestodene 75microgram tablets (63) – Femodene • Ethinylestradiol 30microgram / Norethisterone acetate 1.5mg tablets (63) – Loestrin 30 • Ethinylestradiol 35microgram / Norethisterone 500microgram tablets (63) – Brevinor • Ethinylestradiol 35microgram / Norgestimate 250microgram tablets (63) – Cilest • Ibuprofen 400mg capsules (20) – Nurofen Express • Insulin aspart 100units/ml solution for

injection 10ml vials SC (1) – NovoRapid • Insulin aspart 100units/ml solution for injection 3ml cartridges (5) – NovoRapid Penfill • Insulin aspart 100units/ml solution for injection 3ml pre-filled disposable devices (5) – NovoRapid FlexPen • Insulin aspart biphasic 30/70 100units/ml suspension for injection 3ml cartridges (5) – NovoMix 30 Penfill • Insulin aspart biphasic 30/70 100units/ml suspension for injection 3ml pre-filled disposable devices (5) – NovoMix 30 FlexPen • Insulin glargine 100units/ml solution for injection 3ml cartridges (5) – Lantus • Insulin glargine 100units/ml solution for injection 3ml prefilled disposable devices (5) – Lantus SoloStar • Insulin isophane biphasic human 30/70 100units/ml suspension for injection 3ml cartridges (5) – Humulin M3 • Insulin isophane biphasic human 30/70 100units/ml suspension for injection 3ml pre-filled disposable devices (5) – Humulin M3 KwikPen • Insulin isophane human 100units/ml suspension for injection 3ml cartridges (5) – Humulin I • Insulin isophane human 100units/ml suspension for injection 3ml pre-filled disposable devices (5) – Humulin I KwikPen • Insulin lispro 100units/ml solution for injection 10ml vials SC (1) – Humalog • Insulin lispro 100units/ml solution for injection 3ml cartridges (5) – Humalog • Insulin lispro 100units/ml solution for injection 3ml pre-filled disposable devices (5) – Humalog KwikPen • Insulin lispro biphasic 25/75 100units/ml

•

•

• • • • •

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

suspension for injection 3ml cartridges (5) – Humalog Mix25 Insulin lispro biphasic 25/75 100units/ml suspension for injection 3ml pre-filled disposable devices (5) – Humalog Mix25 KwikPen Insulin lispro biphasic 50/50 100units/ml suspension for injection 3ml pre-filled disposable devices (5) – Humalog Mix50 KwikPen Salicylic acid 50% ointment SC (12g) – Pickles Salicylic acid 50% SC (28g) – Pickles Salicylic acid 50% SC (6g) – Verrugon Testosterone 2% gel (10mg per actuation) SC (60g) – Tostran Testosterone 50mg/5g gel unit dose tube 30) – Testim

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 where stock is available 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).

• Terbutaline 1.5mg/5ml oral solution sugar free (100ml) – Bricanyl Part VIIIB deletions • Glycopyrronium bromide 1mg/5ml oral solution has been removed from this Part. There is now a licensed product which can be found in Part VIIIA.

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 Cavity dressing, circular Allevyn Cavity dressing, tubular Allevyn Lite dressing, Square Allevyn Lite dressing, Rectangular Allevyn Plus Adhesive dressing, Square Allevyn Plus Adhesive dressing, Rectangular Allevyn Plus Adhesive dressing, Anatomically Shaped Sacral Dressing Allevyn Compression dressing, Square Qufora non-sterile night drainage bag

Size, type and product code 5cm diameter and 10cm diameter 9cm x 2.5cm and 12cm x 4cm 5cm x 5cm and 10cm x 10cm 10cm x 20cm and 15cm x 20cm All sizes12.5cm x 12.5cm (wound contact pad 10cm x 10cm + border 1.25cm) 17.5cm x 17.5cm (wound contact pad 15cm x 15cm + border 1.25cm) 12.5cm x 22.5cm (wound contact pad 10cm x 20cm + border 2cm) 17cm x 17cm (wound contact pad 13cm x 13cm + border 2cm) 22cm x 22cm (wound contact pad 18cm x 18cm + border 2cm) 10cm x 10cm and 15cm x 15cm 2 litre, with 90cm inlet tube (code: 13803104)