October 2019 CPN

CPN

Community Pharmacy News – October 2019

CPCS goes live

Launch of Community Pharmacist Consultation Service marks significant moment for community pharmacy Five-year CPCF implemented | PSNC annual report | SSPs for Fluoxetine capsules

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Chief Executive’s blog PSNC Chief Executive Simon Dukes uses his monthly blog to welcome the launch of the NHS Community Pharmacist Consultation Service as part of the five-year contractual agreement. overly concerned if you have yet to see the service really take off. It is still very early days, and it’s going to take NHS111, and of course patients, some time to get used to this new way of working. As always, PSNC is doing all that we can to help – we have a raft of guidance and FAQs about the service on our website; we’re in close contact with the LPCs about ongoing implementation challenges and successes; and we’ll be monitoring referral rates with NHSE&I to check if any more work is needed on this with NHS111.

Simon Dukes

PSNC Chief Executive The reputation of community pharmacies as hard working, forward thinking, innovative and patient-focused businesses has been established over many decades. I witness it as I tour the country, visiting LPCs and local pharmacies and talking (and listening) to pharmacy teams about the issues you are dealing with on a daily basis. I was therefore perhaps one of the few people who wasn’t at all surprised to hear that nearly 9,000 pharmacies had already signed-up to the Community Pharmacist Consultation Service (CPCS) by the launch date of 29 October.

We know that figure has already grown, and I expect it to continue to do so as we head towards the first staging post of 1 December – and the last day for contractors to claim the £900 registration fee.

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Nearly 9,000 pharmacies signed-up to CPCS by the launch date

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This enthusiastic response by community pharmacy to the CPCS means that the pressure is now on the NHS to deliver patients to us: first by NHS111; and then through 111Online and GP referrals in 2020.

We stand ready, willing and able to provide a minor ailments service much needed by patients and NHS. Moreover, the data we have access to at PSNC clearly shows that referrals are filtering through. But do not be

2 Community Pharmacy News – October 2019

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Over the five years, there will be radical changes in the clinical services that all pharmacies can offer

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There is much potential for the CPCS to really develop in future years. It should help to integrate us more effectively into primary care, to demonstrate our value within the NHS, and it will give us important leverage for future negotiations with Government.

And of course if the service is slower to start than we would like, the negotiated total funding for pharmacies is protected – this year, for instance, any monies set aside for the CPCS that are not delivered will be distributed via transitional payments later in the financial year. This service is just the first step - over the course of five years, there will be radical changes in the clinical services that all community pharmacies can offer, allowing you and your teams to use to the maximum the clinical skills you have trained so hard for. So, thank you for taking this first step to embrace that future.

The changes that community pharmacies will experience over the next four to five years mean that those that represent and support them also need to examine whether they

need to change too. As you know, I have proposed a review of how PSNC and LPCs do this. In particular, I want an independent review to explore what representation and support is needed now and what the future requirement is likely to be. We should aim to build on what works well and identify where we are collectively lacking. But importantly, I think we need the review to use the new Community Pharmacy Contractual Framework (CPCF) to guide what the best structure is to represent and support pharmacies on the front line – looking to the experiences of our colleagues in Wales and Scotland, as well as other healthcare professionals to see what can be learned. To this end, the review will be (indeed, has to be) a contractor-focused process. Only then can we ensure the best possible support for community pharmacies in order to help them deliver the NHS Long Term Plan and the CPCF. The review, once commissioned, will seek input from LPCs and PSNC, but also from contractors, so please do look out for it and contribute if you can.

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PSNC will be monitoring referral rates to check if any more work is needed on this with NHS111

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Finally, a plea for your feedback. We are looking back on our CPCF Roadshows this year and we would like to hear from you about what worked well with our autumn roadshows, and also about what you might like from us next year – if we repeated the communications exercise with more to say on the progression of the CPCF and on our collective future. Would you like to see more local roadshows; larger regional events; more digital events; or something else altogether?

Please email me at chiefexec@psnc.org.uk with any views

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

The CPCF Roadshows PSNC ran a series of free roadshow events across England to explain the context of the new five-year CPCF agreement and what it means for pharmacies.

psnc.org.uk 3

SERVICES AND COMMISSIONING

Workforce wellbeing campaign The Royal Pharmaceutical Society (RPS) has launched a campaign, in partnership with the charity Pharmacist Support, which calls for all pharmacists to have access to services to support their mental health and wellbeing.

A first step in the campaign is a survey for pharmacists across all settings.

The results will form a report, to be presented to Government, which will identify areas where additional support and intervention might be needed.

Community pharmacists are encouraged to take part in the survey at: ow.ly/JDOu30pNWF4

PhIF Pharmacy Techs training pilot Health Education England (HEE) is looking to work with employers to develop and run a Pre-registration Trainee Pharmacy Technician integrated training pilot, funded by the Pharmacy Integration Fund (PhIF).

HEE is looking for tri-partnerships that will support 48 trainee Technicians in three of the following healthcare settings: secondary care; community mental health; community pharmacy; general practice; and care homes.

Employers have until 15th November 2019 to submit expressions of interest.

Find out more at: ow.ly/peZ430pNWmv

Flu data transfer pilot Pharmacies in Leeds have begun sending electronic flu vaccination notifications to GP practices as part of an NHS Digital pilot. The notifications are securely transferred from PharmOutcomes to GP practices using the SystmOne clinical system.

This is expected to save time for GP practice staff, help improve data quality and reduce the likelihood of transcribing errors.

If the pilot is a success, NHS Digital will work with the system suppliers to rollout the functionality to all PharmOutcomes and SystmOne users.

Learn more at: ow.ly/Bgmv30pNWCH

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THE HEALTHCARE LANDSCAPE

LPCS

Community Pharmacist Consultation Service launches The launch of a new Advanced service where patients are referred into community pharmacy by other NHS providers.

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CPCS incorporates community pharmacies into NHS referral pathways

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The NHS Community Pharmacist Consultation Service (CPCS) launched on 29th October.

This new service enables NHS 111 to refer patients to community pharmacies when they have a minor illness or need an ’emergency supply’ of a medicine that they have previously been prescribed. The aim is to help relieve pressure on the wider NHS and speed up patient access to treatment by making use of pharmacists’ core knowledge and skills.

Following the successful piloting of its two predecessors – the NHS Urgent Medicine Supply Advanced Service (NUMSAS) and Digital Minor Illness Referral Service (DMIRS) – the CPCS has been nationally commissioned across England. The service is a key component of the five-year Community Pharmacy Contractual Framework (CPCF) settlement which came fully into effect in October 2019.

Numerous community pharmacies have already signed up to offer the service. If your pharmacy has yet to do so, please note that you need to register by 1st December 2019 to receive the £900 Transitional payment.

Contractors are also encouraged to make sure they have read the final version of the CPCS service specification (see: ow.ly/2izv30pNuyr). This version differs slightly from the draft in that the references to ‘annual reviews’ of Standard Operating Procedures and Business Continuity Plans has been amended to ‘regular reviews’, providing greater flexibility for pharmacy contractors.

PSNC Director of NHS Services, Alastair Buxton, said: “The commencement of CPCS is a milestone for community pharmacy and its role within the NHS. The service will be instrumental in changing the public mindset to consider pharmacy as the first port of call for their healthcare needs. It will showcase the expertise of community pharmacists and the valuable work that pharmacies can do for their communities. As that value becomes clear, we hope to adapt the service in future years to cover self-referral by patients themselves.”

Are you ready for CPCS? Once they have signed up for the CPCS, community pharmacy contractors must make sure their team is ready to provide the service. The CPCS Toolkit, available to download from the NHS Business Services Authority (NHSBSA) website, includes key information and resources. Additionally, PSNC has created a checklist provides a reminder of the key things to cover off before offering the service: ow.ly/rkw650wRmv7

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

CPCF Update: Funding and the Drug Tariff To support the implementation of the five-year Community Pharmacy Contractual Framework (CPCF), a number of recent changes relating to payment have been made to the Drug Tariff.

Serious Shortage Protocols (SSPs) Amendments have been made to Parts I, II and IIIA of the Drug Tariff to recognise SSPs. The new wording provides details of the endorsement requirements, reimbursement and remuneration for supplies made in accordance with SSPs. Reimbursement: Payment is for the medicine or appliance supplied in accordance with an SSP, not the originally prescribed medicine/appliance.

Remuneration: Aside from the usual dispensing fees and allowances for any items supplied in accordance with an SSP, contractors will receive an additional SSP fee of £5.35 per item.

For general information on SSPs, please visit: psnc.org.uk/SSPs Establishment Payment changes Amendments have been made to Part VIA to update the monthly Establishment Payment levels. This is a continuation of the phasing out of this payment. The table below shows the new amounts for pharmacy contractors in England: Number of items per month from 1 October 2019

Monthly Establishment Payments from 1 October 2019

2,500 – 2,829

£582

2,830 – 3,149 3,150+

These payments are intended to support preparations for a more service-based role and they are being made in recognition of costs associated with changes such as implementation of the Falsified Medicines Directive (FMD) and integration into Primary Care Networks (PCNs). These payments are not linked to any specific activity, but instead are a payment made to support the transitional costs envisaged.

Please note: These monthly Transitional Payments are separate to the additional one-off Transitional Payment which is available to pharmacies signing up to provide the new NHS Community Pharmacy Consultation Service (CPCS).

The Transitional Payments are being funded by repurposing monies from the managed withdrawal of Establishment Payments and Medicine Use Reviews (MURs), both of which are being phased out as part of the CPCF settlement.

Transitional Payments will be paid on a monthly basis according to the number of prescription items submitted and reimbursed by the NHS Business Services Authority (NHSBSA) in the relevant month, as set out in the table below: Number of items per month from 1 October 2019

Monthly Transitional Payment from 1 October 2019

£605

0–2,500

£100.00

£628

2,501–5,000

£700.00

5,001–19,167

£780.00

19,168+

£833.33

The monies from the Establishment Payment are being reinvested elsewhere to keep the overall funding sum at £2.592bn.

Transitional Payments Amendments have been made to Part VIA to add Transitional Payments to the Drug Tariff. All contractors will automatically receive these payments from October 2019.

These figures will apply to Transitional Payments until March 2020. Negotiations on funding distribution, including the Transitional Payments, for 2020/21 are still ongoing – more information will be shared as soon as possible.

Flu vaccination PPV verification From October 2019, the NHS Business Services Authority (NHSBSA) will extend the post-payment verification (PPV) process of payments to community pharmacy contractors to the Flu Vaccination Service. NHSBSA will request evidence to verify payments for the service claimed during the period September 2018 to March 2019.

For the initial sample, the NHSBSA will select contractors that have submitted both digital and paper claims for the service in the same month. Learn more at: ow.ly/6gsz30pLun8

psnc.org.uk 5

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Pharmacy Quality Scheme Updates Further information and resources are now available to support community pharmacy contractors with the Pharmacy Quality Scheme (PQS). Find all the below plus more at: psnc.org.uk/pqs Assessment framework A PQS assessment framework on PharmOutcomes allows contractors to track their progress with achieving the gateway and quality criteria. Once logged into PharmOutcomes, click on ‘Assessments’ and then the framework is listed under ‘PQS – The Pharmacy Quality Scheme 2019/20’.

Gateway dataset report A weekly dataset report from the NHSBSA can be used to check if you meet three out of the four gateway criteria of PQS. The report states whether contractors have met the Advanced Services, NHSmail, and NHS website gateway criteria.

NHS website gateway criterion Contractors must update or validate the three sections of their pharmacy’s NHS website profile by 11:59pm on 30th November 2019 to meet this gateway criterion.

The sections are: opening hours (including for bank holidays between December 2019 and May 2020); the facilities the pharmacy provides (e.g. consultation room); and the services the pharmacy provides (e.g. NMS).

PQS 2019/20

Prevention domain HLP Level 1: The time period for a contractor to reassess their pharmacy against the Healthy Living Pharmacy (HLP) Level 1 quality criterion has been extended from every two years to every three years.

Dementia Friends: PSNC has published a briefing which explains how to become a Dementia Friend.

Dementia-friendly environment: The checklist and action plan to meet this quality criterion is available as Annex 11 in the NHSE&I PQS guidance.

Diabetes: Contractors are reminded that if they intend to meet this quality criterion, they must have started working towards this from 1st October and continue with this until 31st January 2020.

6 Community Pharmacy News – October 2019

PCN domain This domain seeks to encourage pharmacies to collaborate and work together to engage effectively with Primary Care Networks (PCNs). PSNC has published a briefing containing guidance on how to achieve this element of PQS.

Medicines safety audits and asthma domains PharmOutcomes is developing support for all the quality criterion in these two domains. Additionally, for the asthma quality criterion, PSNC has published a briefing which includes template resources.

NHSmail gateway criterion PSNC has published a briefing which provides contractors with information and a checklist to assist them with meeting the NHSmail gateway criterion of PQS.

NHSE&I guidance Digital enablers domain Directory of Services (DoS): Contractors have until 11:59pm on 30th November 2019 to edit or confirm the information about their pharmacy is correct on the DoS Profile Updater.

Summary Care Record (SCR): NHS Digital’s spreadsheet of SCR viewing figures and accompanying data visualisation tool can be used to view your pharmacy’s SCR usage on a weekby-week basis.

Contractors are strongly encouraged to read the NHS England and NHS Improvement (NHSE&I) guidance on how to participate in the 2019/20 PQS.

Risk management and safety domain The Centre for Pharmacy Postgraduate Education (CPPE) delivers the training and assessments required for the quality criterion in this domain.

DISPENSING PSNC’S AND WORK SUPPLY

FUNDING AND STATISTICS

CONTRACT AND IT

PSNC publishes 2018/19 annual report

Prevention consultation response

Learn about PSNC’s different workstreams over the past year – as shaped by the Committee of 31 pharmacists.

PMENT KEY DEVELO

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MARCH

2019

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Brexit on medicine of 5 it at a level psnc.org.uk

JANUARY

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PAYMENTS

FEBRUARY

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Chief Executiv about how 6 and 7.

Find out more on pages PSNC works

SEPTEMBER

PSNC 2018/19 at

: QUALITY

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NOVEMBER

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OCTOBER

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KEY DEVELO

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JULY

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ATION we did that : FLU VACCIN some ways

AUGUST

The report outlines the work PSNC did for contractors in 2018/19

2018/19

PSNC The Year at ort community pharmacy

MAY

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Annual Report

During a challenging year for community pharmacy, PSNC worked hard to push for more financial security for the sector and developing crucial guidance documents to help contractors and pharmacy teams. written the PSNC submits to MPs about evidence generic price workload. y impact of on pharmac help increases about our Find out moreng issues on with dispensi10. pages 9 and

JUNE

APRIL 2018

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DISPENSING AND SUPPLY

PSNC has outlined how community pharmacies can contribute to the prevention agenda in its response to the Government’s Advancing our health: prevention in the 2020s green paper.

One question in the consultation was solely focused on community pharmacy.

Here, PSNC put forward a number of suggestions for additional services, including further development of Healthy Living Pharmacies; routine management of patients with long-term conditions; and a wider range of vaccinations.

The consultation has now closed, but you can read PSNC’s response in full at: ow.ly/ZCP230pLbPG

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PSNC’s 2018/19 annual report focusses on the different workstreams undertaken by the PSNC office, as shaped by the Committee of 31 pharmacists. PSNC employs just 30 people to fulfil its core functions which range from negotiating the NHS pharmacy contract and ensuring the delivery of funding to contractors, supporting pharmacy teams in carrying out dispensing activities, creating advocates for community pharmacy, and assisting LPCs with local service development.

The report covers all these areas, with key work from 2018/19 including: • Raising awareness of the impact of generic price increases on pharmacy workload; • Securing funding levels and preventing a £33m funding cut; • Negotiating a fee uplift and other improvements to the Flu Vaccination Advanced Service; • Establishing the Community Pharmacy Brexit Forum; and • Averaging four visits a minute to the PSNC website.

As well as providing details of the work PSNC carried out in 2018/19, the report ends by setting out PSNC’s ambitions for the following year.

Simon Dukes, PSNC Chief Executive, said: “I joined PSNC at the start of 2018/19 and felt that we needed to work harder to communicate with pharmacy contractors. This annual report is one way in which we are doing that, and I hope contractors and LPCs will find it a useful summary of the complex and challenging work that goes on here.

2018/19 was not an easy year for many pharmacy businesses, but we have been and will continue to battle on their behalf; I hope that this report reassures contractors of some of the value that we offer in doing so.”

PSNC Annual Report In order to appeal to people using different platforms, we have developed a number of alternative viewing methods for our annual report. These include an online flipbook, a PDF version and a mobile-friendly micro site. You can find the report on the ‘About PSNC’ page of our website, or by visiting psncannualreport.com

Pharmacy debated by MPs In early October, MPs across multiple political parties spoke passionately about the pharmacy sector during a Parliamentary debated on the role of community pharmacy.

Issues raised included the five-year deal, medicines shortages, and support for pharmacies in rural areas.

Jo Churchill, the Minister responsible for pharmacy, told MPs she had recently attended the LPC Conference, which had: “underlined to me again what an essential part of the NHS the pharmacy is, working day in and day out on improving outcomes for patients and for the community.”

Informing GPs and practice teams PSNC has developed some materials to explain the new five-year Community Pharmacy Contractual Framework (CPCF) to GPs and practice teams.

These resources were used to stimulate discussions with attendees of the RCGP annual conference, where we recently exhibited.

Community pharmacy teams and LPCs may wish to direct their local GPs and LMCs to this information to provide an overview of the deal and which elements are of most relevance to general practice.

Visit the PSNC webpage for GPs: psnc.org.uk/pharmacyforGPs

psnc.org.uk 7

LPCS

Transfer of care project saves NHS £9.5m A collaborative project between hospitals and community pharmacies in Cheshire and Merseyside has improved patient care while making estimated savings of £9.5 million.

The Transfer of Care Around Medicines project has seen hospitals digitally contacting community pharmacies at the point of patient discharge, so that advice and support can be given to patients and their carers about any medication changes made during admission.

The initiative started in 2016 and, by May 2019, it had been implemented in 11 hospitals, two mental health trusts and all 635 community pharmacies in Cheshire and Merseyside.

Inhaler use review pilot wins award A pilot scheme in Plymouth allowing patients to have inhaler use reviews in their local community pharmacies has won an award at the summer British Thoracic Society meeting for Innovation in Service Delivery and/or Education and Training in Respiratory.

Set up in response to the area’s relatively low prescribing of spacers compared to that of inhalers, the pilot saw community pharmacists delivering targeted consultations to adults who were prescribed inhaled corticosteroids. As well as advice on inhaler use, patients could receive free spacer devices if MDI technique was observed to be poor. This allowed patients to improve their inhaler technique without an unnecessary trip to the GP for an appointment and a prescription.

A specialist respiratory pharmacist delivered training to community pharmacy teams and pharmacists were given the ability to directly refer consenting patients to a pulmonary rehabilitation course via PharmOutcomes, without the need for GP intervention.

Find out more about local services at: psnc.org.uk/database

8 Community Pharmacy News – October 2019

PSNC’S WORK

FUNDING AND STATISTICS

LPC Conference brings message of collaboration This year’s national Conference of LPCs brought together community pharmacy representatives to share best practice and provide their input into PSNC’s work.

At the end of September, PSNC held its annual LPC Conference in London, bringing together 180 representatives from across the country to discuss current challenges and plans for the future.

Coming at the end of a busy year which included the agreement of a new five-year Community Pharmacy Contractual Framework (CPCF) and the emergence of Primary Care Networks (PCNs), the event was key in helping PSNC to identify priorities and workplans going forwards.

A key theme of the agenda, shaped by the LPCs themselves, was that of collaboration.

As part of an evolving NHS landscape, LPCs and community pharmacy contractors will need to embrace change and working well with others will be central to that.

During a busy but productive day, delegates heard updates from the PSNC Directors and got a view from General Practice, as well as participating in a session on LPC Learning Exchange and action planning.

Pharmacy Minister Jo Churchill also came to address delegates, despite an extremely busy Parliamentary schedule. In her speech Ms Churchill thanked the sector for its support with Brexit contingency planning for medicines supply and pledged to continue to align contracts across primary care to encourage joined-up working.

Representation Review At the LPC Conference, PSNC Chief Executive Simon Dukes proposed a review of the representation of community pharmacy contractors by both PSNC and the LPC network. The changes facing all contractors in the coming years will inevitably increase the workload of already over-stretched resources both nationally and locally.

PSNC suggested an independent review to make sure both we and the LPCs are collectively providing the help and guidance and value to contractors in the best possible way. A survey of the conference delegates was conducted to gather ideas from LPCs to inform the review.

CONTRACT AND IT

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

Mandatory campaign materials Community pharmacy teams should look out for the delivery of some materials for the mandatory Stay Well This Winter campaign.

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Make use of the resources in the HUHY winter campaigns pack

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Public Health England (PHE) resources for the Help Us Help You (HUHY) Winter campaigns will start arriving in pharmacies from late October/early November 2019, via deliveries from Healthcare Distribution Association member companies (e.g. AAH and Alliance Healthcare).

The HUHY Stay Well This Winter campaign is one of six campaigns, which have been agreed between PSNC and NHS England and NHS Improvement, as part of the Community Pharmacy Contractual Framework; therefore, all contractors must participate in this campaign.

THE HEALTHCARE LANDSCAPE

Full CPAF questionnaire Pharmacy contractors are reminded that, from 1st November 2019, some community pharmacies in England will be invited to complete the full Community Pharmacy Assurance Framework (CPAF) questionnaire, as part of the CPAF process for this year.

Pharmacies may be selected for the full CPAF questionnaire if, for example, they did not complete a screening questionnaire or if there are concerns about the pharmacy relating to patient safety. Some pharmacies may also be selected to validate their screening questionnaire answers.

EPS Phase 4 rollout to begin NHS Digital will be rolling out EPS Phase 4 to additional GP practices from next month (November 2019), so all community pharmacy teams should be aware that they could start to receive EPS Phase 4 tokens from patients to process.

This campaign aims to encourage people to prepare for winter and get vaccinated against the flu virus. This supports the overall flu vaccination programme to increase uptake amongst key audiences, who are more likely to spread or become seriously ill from the flu virus.

GP practices using the TPP SystmOne GP system will have Phase 4 rolled out in the coming weeks, with dates for EMIS, Microtest and Vision GP practices to be decided shortly. Learn more at: ow.ly/ gy7W30pLbsn

In addition to the above, community pharmacies will also receive resources for the Help Us Help You ‘Before It Gets Worse’ and ‘Know What To Do’ campaigns, as well as the Prescription Exemption Checking ‘Check Before You Tick’ campaign as part of their pack. Whilst contractors are encouraged to display and use these during the winter period, they are not required to do so as part of the contractual requirements.

The start of the national rollout follows a successful pilot which tested the functionality in all four GP prescribing systems. The pilot began in November 2018 and involved 60 GP practices across England.

Social media and digital resources for all these campaigns will also be available on PHE’s Campaign Resource Centre (see: campaignresources.phe.gov.uk) closer to the start date of the campaigns; contractors are encouraged to use these resources if possible.

EU Exit Date Extended

If contractors have not received their packs by Friday 15th November 2019, they should email: partnerships@phe.gov.uk stating the pharmacy name, address and name of the campaign(s) they have not received materials for.

Materials to display Contractors should display the following materials from 11th November 2019 until 31st December 2019: • A5 Stay Well This Winter leaflets (plus counter top dispenser, which can be used by contractors if they wish); • A4 Flu poster aimed at at-risk groups; and • A4 Flu poster aimed at pregnant women.

The UK and the EU have agreed an extension of the Article 50 period until 31 January 2020. If the Withdrawal Agreement is ratified by both the UK and European Parliaments, the UK will leave with a deal. If ratification has not happened by 31 January 2020, the legal default is that the UK will leave the EU without a deal.

The Department of Health and Social Care (DHSC) has said it is making the necessary changes to accommodate this extension and will provide additional guidance about any next steps as and when they are published.

The latest information is available at: psnc.org.uk/Brexit

psnc.org.uk 9

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

SSPs for Fluoxetine The introduction of Serious Shortage Protocols required urgent action by pharmacy teams. Subsequent changes to those protocols now must be taken into account.

On 3rd October 2019, in response to significant ongoing disruption to the supply of Fluoxetine capsules, the first Serious Shortage Protocols (SSPs) were issued by the Department of Health and Social Care (DHSC).

These SSPs for 10mg, 30mg and 40mg capsules were put in place to manage stock and to try to ensure that fewer patients have to return to their prescriber.

The SSP01 for Fluoxetine 10mg capsules was withdrawn on 25th October, whilst SSP02 Fluoxetine 30mg capsules and SSP03 Fluoxetine 40mg capsules have been extended.

Fluoxetine 10mg capsules: DHSC has announced that sufficient stock of fluoxetine 10mg capsules is now available to supply normal demand. Any prescriptions for fluoxetine 10mg capsules must be dispensed in accordance with the prescription, as SSP01 is no longer valid for use.

Fluoxetine 30mg capsules: SSP02 gives pharmacists provision to dispense Fluoxetine 10mg tablets and fluoxetine 20mg capsules to fulfil prescriptions for this medicine. The current end date for the 30mg capsules SSP is 20th November 2019.

Fluoxetine 40mg capsules: SSP03 gives pharmacists provision to dispense Fluoxetine 20mg capsules to fulfil prescriptions for this medicine. The current end date for the 40mg capsules SSP is 20th November 2019.

The expiry dates stated here may be brought forward or extended, and the content may be amended throughout this period. Pharmacists should therefore ensure they are using the current version of an SSP before supplying an alternative product.

Current versions of SSPs can be found at: psnc.org.uk/liveSSPs

Hints & Tips magazine The latest issue of NHS Prescription Services’ “Hints & Tips for dispensing contractors” newsletter contains some useful information and advice on: • How to set up EPS after a change of ownership; • Correct endorsements – don’t get caught out; • Pharmacy teams asked for views on Medicines A to Z; • A guide to prescription charges and exemptions; • Changes to the PPC application form.

Read it now: ow.ly/S1yc30pQO2f

10 Community Pharmacy News – October 2019

PSNC Top Tips on SSP endorsements • Always double check that SSP endorsements reflects the requirements outlined in the corresponding SSP (remember to include ‘NCSO’ endorsement).

• Endorse details of the drug supplied under the SSP – not details of the drug that was originally prescribed.

• Only endorse strength(s)/formulation(s) of drugs that are covered by the SSP. • Ensure the correct quantity of the alternative is endorsed to cover the equivalent number of days treatment as indicated on the original prescription.

• Ensure your endorsement is accurate and clear – NHSBSA processing staff must be able to determine what has been supplied.

• There is no requirement in the current SSP to endorse supplier or manufacturer information as reimbursement is based on the Part VIII Drug Tariff price.

• If there are character restrictions in the NCSO endorsement free-text box field of the EPS claim message, contractors are advised to endorse using the corresponding dispensing token instead – remember to mark the original item on the electronic claim message as ‘Not Dispensed’ so as to avoid double claiming.

• There is no requirement for contractors to endorse the pharmacist’s initials, date for SPP claim or the SSP number. Where the contractor has the ability, these prepopulated fields may be deleted to help free up space to provide a comprehensive endorsement.

• Check that the correct number of patient charges are collected and declared on the end of month FP34C submission form.

Please also see ‘SSPs: Your Questions Answered’ on page 12 of this month’s CPN.

Duplicate GTIN barcodes PSNC has been alerted that there may have been a small number of products with GTIN (product identification) barcodes which have been used on more than one product.

Whilst the majority do not pose a direct risk to patients, there are a small number of these duplicate codes that relate to different drug, dose or form.

Work is ongoing to identify if any of these products remain in the supply chain, but a list of the products currently known to be affected can be found at: ow.ly/bfsa30pQNEo

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Temporary parallel export ban Government issues parallel export ban for a number of medicines to ensure continuity of supply to UK patients.

The Department of Health and Social Care (DHSC) and the Medicines and Healthcare products Regulatory Agency (MHRA) have issued a list of medicines which must not be parallel exported from the UK. This action has been taken to ensure the continued supply of medicines to meet the needs of UK patients.

PSNC Medicine Shortages webpage

DHSC and the MHRA have written to medicine manufacturers and wholesalers to remind them of their responsibilities to ensure the continued supply of medicines to meet the needs of UK patients. The letter also includes the list of medicinal products which “cannot be supplied for parallel export or parallel distribution from the UK or hoarded (held back)” for the time being.

Medicine shortages can hinder pharmacy teams’ efforts to dispense medicines in a timely manner. PSNC is very concerned about the impact that current supply problems are having on pharmacy teams’ workload and about the potential impact on their patients.

The list, will continue to be reviewed on an ongoing basis, to include any product that meets the following criteria: 1. the medicine is required to meet the needs of UK patients; 2. the medicine is either being parallel exported or is at threat of being parallel exported; and 3. the export of that medicine is either contributing to, or may contribute to, a shortage of that medicine in the UK. Any manufacturer or wholesaler found parallel exporting one or more of these medicines could face the immediate suspension of their wholesaler dealer licence.

View the full list at: ow.ly/HLDu30pQNjL

To ensure pharmacy teams have access to information of all the current shortage issues in one place, PSNC has created a new Medicine Shortages page: psnc.org.uk/medicineshortages Pharmacy teams can also report any shortages not listed using our online reporting form: psnc.org.uk/reportshortage

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 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. However, below are some products that we have recently received queries about.

Product

Is the item listed in the Drug Tariff?

Is it Does it Can it be in the have a ‘CE’ dispensed blacklist?* mark? on an FP10?

Additional information

TrueTrack System

No

n/a

Yes

No

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

OstoMart Astoa barrier cream 2g sachets ABC2

No

n/a

Yes

No

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

OstoMart Astoa barrier cream 100g ABC100

No

n/a

Yes

No

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

Pelican Deo-Mint deodorant 50ml

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.

psnc.org.uk 11

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

SSPs: Your FAQs answered PSNC’s Dispensing and Supply Team answer some common queries about the Serious Shortage protocols (SSPs).

Q. How will pharmacies receive SSP updates?

A. Pharmacy teams will be notified of any new SSPs or changes to an existing SSP via NHSmail, the NHS Business Services Authority (NHSBSA) website, via the PSNC newsletters, the latest news section of our website and you can also check psnc.org.uk/liveSSPs Q. If the prescribed item cannot be obtained after the expiry of an SSP, can I continue to make supplies of the alternative(s) specified in the expired SSP until stock of the prescribed item becomes available?

A. No. Once an SSP has expired/been withdrawn it is no longer valid for use and you must dispense in accordance with the prescription. If the prescribed item remains unavailable, the patient should be referred back to the prescriber for an alternative.

Q. I have a prescription for two items; one item covered by an active SSP and the other for a non-SSP item. The item covered by SSP is supplied within the period of SSP validity but the non-SSP item is only part-dispensed with an owing for the patient. The balance of the non-SSP item is not dispensed to the patient until after the expiry of the SSP. Will I be reimbursed for an SSP if the prescription is submitted for payment after the SSP expiry date?

A. Contractors have to submit their claim for the SSPs in the usual manner, i.e. by the 5th of the month following that in which supply was made. However, any prescriptions with mixed (SSP and non-SSP items) may be claimed up to three months after the SSP expires to help deal with claims for any owings on the prescription. Using the example of SSP01 which expired on 25th October, the final cut-off for submission to be reimbursed for this SSP would be with your December bundle (submitted by the 5th of January 2020).

Q. What is the process for endorsement?

A. To ensure correct payments (fees and reimbursement) for products supplied under an SSP, a contractor is required to endorse the following information on the paper prescription or if issued using EPS, using either the original electronic prescription or its associated dispensing token (as outlined in Part II of the Drug Tariff): • NCSO – to indicate supply was made in accordance with an SSP;

• Details of product supplied in accordance with the SSP (drug name, quantity, strength, formulation, supplier name or brand)*; • Quantity supplied*; • Pack size – where multiple pack sizes are available; and • Invoice price – if NHSBSA has no list price available on dm+d. *T he drug details and quantity supplied and endorsed will depend on the specific SSP. If the above SSP endorsements cannot be applied using your system supplier, contractors are advised to endorse and submit SSP claims using the corresponding EPS token and mark the original item on EPS electronic message as ‘Not Dispensed’.

Q. For SSP03 (Fluoxetine 40mg capsules), I have submitted the claim message below, will I be reimbursed correctly?

A. No. For every Fluoxetine 40mg capsule, SSP03 allows a pharmacist to supply: 2 x Fluoxetine 20mg capsules.

In this example, Fluoxetine 40mg capsules x 60 are prescribed.

Under SSP03, the pharmacist would be required to supply a quantity equivalent to the number of days prescribed on the original prescription i.e. Fluoxetine 20mg capsules x 120 capsules.

A quantity of 30 has been endorsed by the pharmacist, which could either indicate: • the pack size used for supply, or • that the quantity supplied is less than the number of days specified on original prescription.

Whilst the correct formulation has been endorsed as per SSP03; the quantity has not been doubled up to cover the original order. This SSP claim is invalid and the NHSBSA will reimburse based on the endorsed quantity of 30 capsules i.e. treat as indication of less given.

The image below shows the correct endorsement:

For more information on endorsing SSPs see psnc.org.uk/SSPfactsheet

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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