September 2018 CPN

CPN

Community Pharmacy News – September 2018

Don’t miss the latest digital developments and events Prescription services going digital New IT platform for flu vaccination questionnaires Sign up for our upcoming webinars with PSNC’s CEO and NHS BSA Brexit: representing pharmacy | CEO Blog | Flu vaccination resources

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Chief Executive’s blog PSNC Chief Executive Simon Dukes uses this section of CPN to provide an update on PSNC’s work. some notable positive work and pilot services, but pharmacy has nonetheless fallen behind in terms of working relationships, understanding what HM Government wants and in developing future funding and service models for the sector.

Simon Dukes

PSNC Chief Executive Two years ago this month, community pharmacy was battling proposed cuts to funding, with relationships with HM Government effectively at a standstill.

While funding is still an issue for the sector, PSNC and others are working hard to rebuild relationships with the people who will decide community pharmacy’s future – the NHS and, ultimately, HM Government.

In the past two years there has been

As part of our work to catch up, I met at the start of the month with Pharmacy Minister Steve Brine, as you may have seen on Twitter (you can follow our account @PSNCNews). We share an ambition to have a renewed and collaborative working relationship, which I believe is positive news for community pharmacies. If we want to develop our services to do more for patients and local communities, we need to be doing that in collaboration with HM Government, who will ultimately be paying for it.

The Minister is very supportive of pharmacies and we explored some of his priorities and challenges, as well as outlining the benefits and great potential of community pharmacy. In particular, we discussed how community pharmacies

could contribute to important areas of NHS work including prevention, reducing pressure on urgent care, helping with the management of people with long-term conditions, improving medicines and patient safety and embracing technology.

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We have an opportunity to catch up some ground

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After a two-year hiatus we have an opportunity to catch up some ground.

As the NHS creates it ten-year plan, community pharmacy can show how it can help HM Government to deliver on the vision for primary care. Developing services in all of the above areas will be a good start, but we need to be bold and ambitious, wherever we have business cases to back-up our claims. Time is short, but get in touch if you have ideas about what you want your future to look like: chiefexec@psnc.org.uk

PSNC webinars PSNC regularly holds online events for community pharmacy teams to make information more accessible; here are two of our recent webinars.

PSNC CEO webinar

End of month submission webinar

This month PSNC Chief Executive Simon Dukes held a webinar to discuss his plans for the future of community pharmacy. An on-demand recording is now available on the PSNC website.

PSNC and the NHS Business Services Authority (NHS BSA) will be holding an ‘End of month submission’ webinar on Tuesday 25th September at 7.30pm.

The webinar, which took place on 20th September, gave contractors an opportunity to hear about the direction he wants PSNC to take.

The PSNC Dispensing and Supply Team will guide viewers through the end of month submission processes including how to correctly prepare, sort and submit the monthly prescription bundle.

Discussing his first impressions of the sector, the key issues and how he plans to move forward, this webinar gave an insight into Simon’s ambitions for the next few years. And time was devoted to answering questions live.

Ben Tindale, Digitisation Lead for NHS Prescription Services, will follow with a description of the NHS BSA’s new ‘Manage Your Service’ online application pilot to enable pharmacy contractors to digitally complete their end of month submission form.

Please visit psnc.org.uk/webinar for details of how to register or watch an on-demand version.

2 Community Pharmacy News – September 2018

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

Brexit: PSNC representing pharmacy in DHSC preparations • Letter sent by DHSC to community pharmacies on contingency plans for medicines supply • PSNC’s Brexit Forum will monitor the impact of these plans on medicine prices • DHSC has been invited to attend the Community Pharmacy Brexit Forum

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There will be operational issues to explore for community pharmacies and our Brexit Forum will provide a platform for doing so

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The Department of Health and Social Care (DHSC) has set out more detail about how it is working to secure the supply of medicines to pharmacies and patients after Brexit.

representatives from the Healthcare Distribution Association (HDA), British Generics Manufacturers Association (BGMA) and the Association of the British Pharmaceutical Industry (ABPI).

PSNC is involved in these important discussions, representing the interests of community pharmacies. Our shared objective is to safeguard the continued supply of medicines to pharmacies and their patients from March 2019, when the UK will exit the European Union.

The outcomes of this work will feed into PSNC’s Brexit Forum which we have set up to provide a platform for the sector to work through issues and to keep all contractors well informed as the Brexit deadline approaches. This includes monitoring the impact of the stockpiling contingency plans on medicine prices.

Like all parts of HM Government, DHSC is making contingency plans in case the UK exits the European Union with no deal. Their focus is on securing medicines supply – pharmacists may have seen national media reports about a national ‘stockpiling’ strategy.

In a letter sent by DHSC to frontline healthcare professionals, community pharmacies throughout the UK have been advised that they “do not need to take any steps to stockpile additional medicines, beyond their business as usual stock levels.” Pharmaceutical companies are being asked to hold an additional six weeks supply of medicines, and arrangements will be put in place for the air freight of medicines with short shelf-lives. DHSC also states that prescribers are not required to write longer NHS prescriptions.

PSNC is working collaboratively with DHSC on this alongside

We will share information as it becomes available, but all pharmacies should continue to operate on a business as usual basis.

PSNC Chief Executive Simon Dukes said: “PSNC supports this important DHSC work to secure the supply of medicines to pharmacies and patients. Medicines form a vital part of many people’s treatments and after Brexit everyone in the UK must still be able to access the medicines they need, when they need them, from community pharmacies.

There will be operational issues to explore for community pharmacies and our own Brexit Forum will provide another platform for doing so and for ensuring that all pharmacy contractors have the information that they need as we approach the Brexit deadline.”

Successful Type 2 diabetes service The final evaluation of a community pharmacy patient activation project in Cornwall has concluded that this pilot service has had a significant impact in improving the activation of patients with Type 2 diabetes.

The aim of the project was to pilot the use of patient activation measure (PAM) scoring combined with motivational coaching for patients diagnosed with Type 2 diabetes, to assess the impact this may have on patients to better self-manage and improve clinical outcomes.

A total of 234 patients completed the full intervention, and patient feedback was

extremely positive with 100% indicating that the pharmacy was a good place to provide the service due to the accessibility of the pharmacy and that no appointment was needed.

The evaluation shows that, on average, patients saw an increase in their PAM scores of 9 points, with 44% increasing their activation. Based on the existing body of evidence around PAM, this could equate to an 18% reduction in hospital admissions for participants.

Due to the positive outcomes demonstrated by this pilot, NHS Kernow Clinical Commissioning Group has agreed to

Find out more Representatives from Cornwall LPC will be presenting on the service in the PSNC Services Innovation Theatre at the Pharmacy Show on Monday 8th October 2018. commission a new pilot for patients with Type 1 diabetes and extend the current pilot for patients with Type 2 diabetes for a longer period.

psnc.org.uk 3

SERVICES AND COMMISSIONING

Clarification of aTIV guidance PSNC has published a Briefing which summarises the different documents and news stories relating to the use of adjuvanted trivalent influenza vaccine (aTIV) for patients aged 65 and over, as well as clearly explaining what contractors should do if they have no aTIV available.

Download the briefing from: ow.ly/Od7S30lRD8Z

IT platform for Flu Vaccination Service NHS England has launched an IT platform to enable patient questionnaires from the Flu Vaccination Service to be completed electronically either by the patient themselves or with help from the pharmacy team.

Contractors can also view, for their own pharmacy, a high-level summary of patient responses on the IT platform. Contractors are encouraged to monitor this throughout the flu season to see how patients are responding to questions about the service being provided. Find out more at: ow.ly/VY9b30lGPJd

Flu vaccination resources from PHE Public Health England (PHE) has issued a guidance document on inactivated influenza vaccine, which includes advice on administering the vaccine to patients with pre-existing medical conditions.

This can be downloaded from: ow.ly/96Je30lGPS9 PHE has also published a leaflet which explains to patients how they can help protect against flu, including the importance of people at risk and their carers having their free vaccination every year. Hard copies of the leaflet can be ordered free of charge, via the online ordering portal (www.orderline.dh.gov.uk) or calling 0300 123 1002 and quoting the product code: 3079111C.

4 Community Pharmacy News – September 2018

THE HEALTHCARE LANDSCAPE

LPCS

Flu Vaccination Service gets underway • The 2018/19 Community Pharmacy Flu Vaccination Service began on 1st September 2018 • PSNC secured a number of improvements for the service, including a fee increase • New documentation and online recording platforms have been made available

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The improvements negotiated by PSNC are a positive indication of the collaborative relationship with Government

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Following the amendment of the Secretary of State Directions, community pharmacy contractors that fully meet the requirements for provision of the Community Pharmacy Seasonal Influenza Vaccination Advanced Service were given the go ahead to provide the service from 1st September 2018.

The new Secretary of State Directions, which provide the legal basis for provision of the service, were published on the NHS Business Services Authority (NHS BSA) website on 31st August.

In last month’s issue of CPN we informed community pharmacy teams of the improvements introduced by NHS England following negotiation with PSNC. Here is a reminder of those changes: Funding: £7.98 per administered dose of vaccine plus an additional fee of £1.50 per vaccination (giving a total of £9.48).

Training requirements: The interval at which pharmacists providing the service must undertake face-to-face training for injection technique and basic life support has been extended to every three years.

Sign up requirement: The requirement to register to provide the service with the NHS BSA has been removed.

Paperwork: In light of the General Data Protection Regulations (GDPR) and to facilitate the expansion of the post-

payment verification process, the consent form and record form have been separated.

Eligibility criteria: Social care workers and hospice care workers have been added as eligible ‘at-risk’ groups.

Off-site vaccinations: • Contractors can now administer vaccinations in the patient’s home, where this is requested by the patient, providing the pharmacy has an existing clinical relationship with the patient.

• Contractors should submit a completed declaration form to NHS England ahead of undertaking any off-site vaccination.

Claiming for payment: Contractors will this year have the option to submit their claims electronically via the NHS BSA webform.

Tricia Kennerley, a member of PSNC’s Negotiating Team and Director of International Public Affairs, Walgreens Boots Alliance, said: “Although offering NHS flu vaccinations is by now a well-established community pharmacy service, each year an enormous amount of work goes into negotiating and finalising the details with NHS England, so it is very good news that once again pharmacies can be a part of this important campaign. At the same time, we hope that the improvements and increased payments negotiated successfully by PSNC, are a positive indication of the collaborative relationship that we are working to rebuild with the NHS and Government.”

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Support for the Flu Vaccination Service A number of resources have been published to help community pharmacy teams planning to offer the 2018/19 Flu Vaccination Service. This includes forms, factsheets and guidance documents.

PSNC and NHS England have been busy publishing resources to help pharmacies to offer this service

DISPENSING AND SUPPLY

Flu Vaccination Service webinar More than 550 people tuned in to PSNC’s recent Flu Vaccination Service webinar, with 94% saying they would recommend it to others.

During the webinar Alastair Buxton, Director of NHS Services at PSNC, explained how the Flu Vaccination Advanced Service differs for 2018/19, highlighting important changes to be aware of. We also heard from Ben Tindale, Digitisation Lead for NHS Prescription Services, who described the new digital submission process for flu vaccination claims.

Resource

Description

PSNC Briefing 042/18: Guidance on the Seasonal Influenza Vaccination Advanced Service 2018/19

This guidance explains what community pharmacy contractors need to do to offer the service. A checklist is also included, which contractors can work through to ensure they have everything they need in place to provide the service. Downloadable from: ow.ly/IGOV30lFlP7

Community pharmacy teams can access an online recording at: psnc.org.uk/fluwebinar

PSNC Briefing 043/18: Services Factsheet – Eligible Groups for the Flu Vaccination Service 2018/19

This could be displayed and used as a ‘quick reference’ to assist with determining if a patient is eligible for a vaccination. Downloadable from: ow.ly/Kjoi30lFlPE

LPC flu vaccination toolkit

PSNC Briefing 048/18: Pharmacist checklist for the Flu Vaccination Service

This PSNC Briefing provides a checklist for community pharmacists (both locum and employed pharmacists) on tasks to complete before providing the NHS Seasonal Influenza Vaccination Advanced Service 2018/19.

Downloadable from: ow.ly/I3ne30lGPlx

Use of appropriate flu vaccines

NHS England has advised that for the 2018/19 flu vaccination season, adjuvanted trivalent influenza vaccine (aTIV) (Fluad, Seqirus) should be offered to all those aged 65 and over. Guidance is available from: ow.ly/JUyO30lF6qU

Patient record form and patient consent form

In light of the General Data Protection Regulations (GDPR) and to facilitate the expansion of the post-payment verification process to cover the Flu Vaccination Service, the consent form and record form have been separated into two different forms for the 2018/19 service. The new forms are available from: ow.ly/IHjY30lF6ks

GP practice notification form

The GP notification form has been updated for 2018/19 to reflect the additional groups of patients eligible for vaccination and to update the SNOMED CT code which is used to record the vaccination in GP clinical systems.

Downloadable from: ow.ly/kIon30lF5Vo

Notification of intent to provide off-site NHS flu vaccinations

Contractors must notify NHS England in advance of administering their first off-site visit by completing this form and then emailing it to the local NHS England team.

Downloadable from: ow.ly/iAnF30lF6oN

Ask PSNC: Flu FAQs

PSNC’s Flu FAQs series returns to answer all your Flu Vaccination Service-related queries. Look out for a new set of questions published on the PSNC website each week. A full library of FAQs is kept at: psnc.org.uk/flufaqs

Further information and resources are available from psnc.org.uk/flu

PSNC has launched a toolkit to help LPCs to promote the 2018/19 Flu Vaccination Service. The toolkit contains a wider range of resources which aim to gain interest from the local media, as well as more general information intended for patients and the public. The toolkit can be found at: psnc.org.uk/ lpcflutoolkit The launch of this service presents a good time to reach out to your local politicians by inviting them to visit a pharmacy. The latest version of our MP visit guidance document, included within the toolkit, contains a template letter and press release for an MP flu vaccination visit, plus a range of flyers and infographics demonstrating the value of pharmacy.

We have also included a section on promoting the service to umbrella local care provider support organisations and other stakeholders to help increase awareness that care/ nursing home, domiciliary care and hospice care workers can now have an NHS flu vaccination in a community pharmacy.

psnc.org.uk 5

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Influencing the NHS long-term plan PSNC submits evidence to NHS leaders showing community pharmacy’s potential contribution to the NHS ten year plan.

Since the announcement of a £20 billion NHS funding increase in June, work to develop a new long-term plan for the health service has been ongoing.

The NHS long-term plan will set out how health services will be improved in return for the funding uplift, and work to develop it is being led by NHS England, based on the advice of a range of clinical experts and stakeholders.

PSNC is working closely with the other national pharmacy organisations to coordinate pharmacy’s input into the plan, and, as part of that work, PSNC and the National Pharmacy Association have this month submitted three briefing documents to NHS England and others.

The briefings highlight how community pharmacy could help to meet the specific challenges that the NHS is trying to address,

and they have each been written for one of the working groups which are leading the development of the long-term plan.

The national pharmacy organisations have also been taking part in engagement events around the Primary Care workstream of the plan, and will be submitting responses to the wider electronic consultation on the longterm plan which closes on September 30th.

LPCs will discuss the long-term plan at the Annual Conference of LPCs in Birmingham at the end of September.

The long-term plan: priorities The Prime Minister has set out a number of priorities for the NHS including: • Building on the safety and quality of care; • Better integration of health and social care; • A focus on prevention; and • Better mental health and cancer care.

Matt Hancock, Secretary of State for Health and Social Care, has identified prevention, technology and the healthcare workforce as his top early priorities for the health service.

And Simon Stevens, NHS England Chief Executive, has set out a number of longterm aims that will form part of the plan for the NHS. These include: • Major improvements to mental health services; • An overhaul to many aspects of cancer screening services; • A new focus around cardiovascular disease and outcomes for brain bleed strokes; • A renewed focus on children’s services, including prevention and inequality; and • New objectives for reducing health inequalities for people with learning disabilities, rough sleepers and the homeless.

Learn more about PSNC’s work on the NHS ten year plan at psnc.org.uk

New Vaccination Services DoC launched CPPE has launched a new DoC applicable for both the NHS Flu Vaccination Service and locally commissioned influenza services.

The Centre for Pharmacy Postgraduate “Education (CPPE) has updated its Declaration of Competence (DoC) framework for vaccinations.

Lesley Grimes, CPPE lead pharmacist, learning development

Previously, there have been two separate DoC frameworks for vaccinations; the NHS Seasonal Influenza Vaccination Advanced Service and other locally commissioned Immunisation services. This meant that those providing the NHS service along with a locally commissioned influenza service were required to complete two DoCs.

Those two DoCs have now been merged into a new single DoC framework for all vaccination services.

It is recommended that you revisit the DoC every two years, so some people may not need to complete the new, merged DoC if they completed the practical training and DoC for the 2017/18 influenza

6 Community Pharmacy News – September 2018

season. As the new DoC covers all vaccinations, the competency framework should be revisited and the statement of declaration resigned whenever a service for a different vaccination is introduced.

In addition to completing the DoC, the requirement for healthcare professionals to complete an annual update, which can be selfdirected learning rather than face-to face training, remains.

The 2018 National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners include a new requirement for supervised clinical practice following training. Both the merged DoC and statement of declaration have been amended to include a clause relating to this.

PSNC has developed some frequently asked questions relating to the supervision clause at: ow.ly/NrnA30lF0ac For further information on the Declaration of Competence system, visit: www.cppe.ac.uk/doc

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCS

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.

Order your Stoptober toolkit

Stoptober, the Public Health England campaign encour aging smokers to quit during October, is back for 2018 and the pharmacy toolkit is available to order now.

Order the free toolkit from the PHE Campaign Resour ce Centre or by calling the pharmacy order line on 0300 123 1019 and quoting STOP18-PHA. Find out more at: ow.ly/h zna30lH Xqa

Hints & Tips ne wsletter

The Pricing Au thority produc es a quarterly newsletter called Hints & Tips fo r dispensing contractors.

We would like to draw your attention to the latest editio n (Issue 32) wh ich contains some really us eful informatio n and advice on endorsing pr escriptions, EP S items prescribed with a manufacturer , exemption checking, plus much more.

All editions of the Hints & Tip s newsletter ca be found at: ww n w. nh sb sa .nh s.u k/ 319 1.a sp x

Heart Age campaign September 2018 campaign to raise awareness of heart health and reduce the risk of developing heart disease.

Free pharmacy toolkit contains posters, leaflets and wallet-size cards.

Download the toolkit via the PHE Campaign Resource Centre or call 0300 123 1019 to order.

into new care models P lans to integrate pharmacy

ility and programme aimed at Sustainab New pharmacy integration Systems (ICSs). e Car d rate Integ (STPs) and Transformation Partnerships le medicines ework setting out how to tack Created to develop a fram optimisation priorities.

essionals to expertise of pharmacy prof The programme will use the s. icine nt outcomes from med deliver the best value and patie 0lHX 1f Learn more at: ow.l y/Vl DE3

psnc.org.uk 7

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Dispensing Factsheet: No Charge and Multi-Charge Items Pharmacy teams can be presented with prescriptions for items which incur either a single charge, no charge, or multiple charges. Here we list some commonly encountered no charge and multiple charge items.

Multiple Prescription Charges Multiple prescription charges are payable where on the same prescription: • Different drugs, types of dressings or appliances; including those ordered with extra parts are supplied; • Different formulations or presentations of the same drug or preparation are prescribed and supplied; • Additional parts are supplied together with a complete set of apparatus or additional dressing(s) together with a dressing pack; • More than one piece of elastic hosiery is prescribed and supplied (there is one charge for each anklet, knee cap, below knee, above knee or thigh stocking supplied).

Examples of Two Charge Items Including Combination Packs Actonel Combi Cyclo-progynova 2mg Ametop 4% gel disp pack Elleste Duet 1mg or 2mg Canesten Combi pessary & cream Evorel Sequi patches Canesten Oral & Cream Duo Femoston 1/10mg or 2/10mg Clinorette FemSeven Sequi patches

Migraleve (combination pack) Pabrinex I/M High Potency 5ml + 2ml Pabrinex I/V High Potency 5ml + 5ml Tridestra Trisequens

No Prescription Charge No charge is payable for contraceptive substances and listed contraceptive appliances for women (as referenced in Part XVI Clause 10 of the Drug Tariff) prescribed on FP10 or any of its variants. These items do not need to be annotated for contraceptive use by the prescriber and a prescription charge should not be levied for these products.

Prescriptions for any other drug not referenced in Part XVI Clause 10 of the Drug Tariff which is to be used for contraceptive purposes must be annotated by the prescriber with ‘CC’, ‘OC’ or the female symbol ♀. In the absence of such an endorsement by the prescriber the normal prescription charge will apply to that item; where the patient does not have any valid exemption.

The following list contains commonly dispensed products which incur either no prescription charge or multiple prescription charges.

List of Contraceptive Drugs to be Dispensed Free of Charge: Brevinor Ethinylestradiol 20µg / Cerazette Gestodene 75µg tablets Cerelle Ethinylestradiol 30µg / Cilest Gestodene 75µg tablets Cimizt Ethinylestradiol 20µg / Daylette 0.02mg/3mg tablets Norethisterone acetate 1mg Depo-Provera 150mg/ml tablets Desogestrel Tablets Ethinylestradiol 30µg / 75microgram Norethisterone acetate 1.5mg Desomono 75µg tablets tablets Elevin Ethinylestradiol 35µg / Ellaone Norethisterone 500µg tablets Eloine 0.02mg/3mg tablets Ethinylestradiol 35µg / Ethinylestradiol 20µg / Norgestimate 250µg tablets Desogestrel 150µg tablets Etonogestrel 68mg implant Ethinylestradiol 30µg / Evra Desogestrel 150µg tablets Feanolla Ethinylestradiol 20µg / Femodene and Femodene ED Drospirenone 3mg tablets Femodette Ethinylestradiol 30µg / Gedarel 20µg/150µg tablets Drospirenone 3mg tablets Gedarel 30µg/150µg tablets

Jaydess 13.5mg intrauterine device Levonelle 1500 Levonelle One-Step Levonorgestrel 13.5mg intrauterine device Levonorgestrel Tablets 1.5mg Levonorgestrel 20µg/24hours intrauterine device Levosert 20µg/24hours intrauterine device Loestrin 20 and 30 Logynon and Logynon ED Lucette tablets Marvelon Medroxyprogesterone Acetate Injection (Aqueous Suspension) 150mg/5ml Mercilon Microgynon 30 and 30 ED Micronor

Mirena System Nexplanon Norgeston Noriday Norimin Norinyl-1 Noristerat Injection Nuvaring Ovranette Qlaira Rigevidon tablets Sayana Press Injection Sunya Synphase Triadene TriRegol tablets Upostelle tablets Yacella 0.03mg /3mg tablets Yasmin Zelleta 75µg tablets Zoely

Please note these lists are not exhaustive and are subject to change.

For more information on the number of charges payable see Part XVI Clause 10, 11 & 12 of The Drug Tariff.

For information on the prescription charges that should be levied for a particular product or combination of products, please contact the PSNC Dispensing and Supply Team on 0203 1220 810 or email info@psnc.org.uk

8 Community Pharmacy News – September 2018

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

The NHS BSA Prescription Services is going digital • The NHS Business Services Authority (NHS BSA) is trialling digital submission • Community pharmacies will be able to send prescription submission information online • PSNC spoke to Ben Tindale who is leading on this project to find out more

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The aim of ‘Manage Your Service’ is to provide pharmacies with a digital alternative to the current prescription submission process.

Currently pharmacies complete the ‘FP34C’ form with sensitive, numerical data which they then send along with all prescriptions they dispensed during the month to one of our three processing sites. This form enables us to provide the pharmacies with an ‘advanced payment’ prior to processing their full account. On the face of it this might not seem like a big deal, but how comfortable would you be if you needed to rely on sending a form in the post to receive your salary?

‘Manage Your Service’ will be much less time consuming, not as paper heavy, provide real-time tracking and safer (no concern of it being lost in transit).

It will also allow pharmacies to send prescription returns back to the NHS BSA (this is known as ‘referred back’) through the online application as opposed to the post. This ‘referred back’ item functionality

NHS website change As part of a programme of work by NHS Digital to improve its services, the NHS Choices website will be referred to as the NHS website going forward. The NHS Choices logo has been removed from the website, but the NHS identity and website URL (www.nhs.uk) remain the same.

References to ‘NHS Choices’ will need to be updated to ‘the NHS website’ on pharmacy websites and patient materials. NHS Digital has issued guidance on how to remove references, which can be found at: ow.ly/GDV130lGRKR

‘Manage Your Service’ will be much less time consuming, not as paper heavy, provide real-time tracking and safer

I am Digitisation Lead for NHS Prescription Services at the NHS BSA. Since the start of 2017, my role has been primarily focused on developing a new online application, Manage Your Service (formally Manage Your Submission).

CONTRACT AND IT

is currently being tested by 86 pharmacies across the country.

As with anything new, the journey hasn’t been plain-sailing and we’re currently trying to overcome the significant challenge of accessibility. I’m sure you can appreciate the sensitivity of the data pharmacies handle, (their IT system suppliers certainly do!) so trying to design a web-based application that is easily accessible to all that need it has been a significant undertaking but something I’m pleased to say we soon hope to have resolved.

We’re aiming to make ‘Manage Your Service’ available to contractors around the country early next financial year (2019/20).

We’ve also developed another online application so that pharmacies can submit their flu vaccination forms digitally (this is done separately to the monthly prescription service mentioned above).

Apart from all the benefits mentioned, it will also allow pharmacies to test the new online application and provide feedback prior to ‘Manage Your Service’ rolling out across England.

If you are reading this and wondering if it is compulsory, it’s not. The digital claim forms are completely optional, and the paper claim form will still be available.

Got a question?

Contact NHS BSA on nhsbsa.mys@nhs.net if you have any questions about the pilot.

Gluten-free prescribing update From December 2018 it is expected that the only Gluten Free (GF) products allowed on NHS prescription will be for GF bread and mixes. This will have implications for stockholding, and community pharmacy contractors will want to consider this in their ordering processes between now and then.

The Government has launched a consultation describing what will be done to apply the changes. The first proposal is to amend Part XV (‘ACBS list’) of the Drug Tariff to remove discontinued products. Learn more at: ow.ly/ektj30lI4cI

Paperwork submission NHS Prescriptions Services has announced that it is no longer able to return documents incorrectly submitted with community pharmacies’ end-of-month bundles. It is therefore important to check that you only include the required forms and paperwork along with your FP34C submission document.

Common incorrect paperwork sent to NHS Prescription Services includes Think Pharmacy First Scripts, Nicotine Replacement Therapy vouchers, Hospital Outpatients Forms, and CCG Submission Document for Dispensed Specials.

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Endorsing Webinar: Your Questions Answered Following PSNC’s endorsing webinar in June, our Dispensing and Supply Team is working to respond to the questions you posed on the night but they didn’t have time to answer.

Q. I received a prescription for Avanafil 100mg tablets, quantity 8. I endorsed that I had dispensed 2 packs of 4 (written 2/4 in left-hand margin) however I was only reimbursed for 2 tablets, why was that?

A. Avanafil 100mg tablets are available in two pack sizes; a pack of 4 tablets and a pack of 8 tablets. Your endorsement of 2/4 has been interpreted by the Pricing Authority as 2 tablets out of a pack of 4 dispensed.

The correct convention of endorsement to follow is quantity dispensed over pack size used, not pack size/ over quantity or number of packs/pack size.

Incorrect Endorsement

Please don’t stamp over age box

Number of days’ treatment N.B. Ensure dose is stated Endorsements

This would be read as two tablets out of a pack of four dispensed

2/4

Correct Endorsement

NHS Number:

Quantity dispensed over pack size used.

Payment will be made for two packs of four tablets

Avanafil 100mg tablets [SLS] 8 Use as directed

For products listed in the Drug Tariff, the following information will need to be endorsed: • Quantity dispensed/Pack size used (where there are multiple pack sizes available)

Please don’t stamp over age box

Number of days’ treatment N.B. Ensure dose is stated Endorsements

8/4

• Quantity dispensed/Pack size used (where there are multiple pack sizes available) • Brand name or manufacturer/supplier • Net price before discount and exc. VAT (where no list price is available)

For products not listed in the Drug Tariff, the following information will need to be endorsed:

NHS Number:

Avanafil 100mg tablets [SLS] 8 Use as directed

PSNC TOP TIP: Always endorse quantity dispensed over pack size used to ensure correct payment.

Please see our prescription endorsement factsheet at: psnc.org.uk/endorsementfactsheet

Watch the webinar

View an on-demand version of the webinar at: psnc.org.uk/endorsingwebinar

Can it be dispensed on an FP10?

To ensure payment, community pharmacy teams must check if items prescribed on an FP10 are allowed on the NHS before dispensing them.

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

Ortolux eye shield

No

n/a

Yes

No

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

Opsil artificial eye lubricant

Yes

n/a

Yes

Yes

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

Sterican® Single-use hypodermic needles

No

n/a

Yes

No

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

ClikSTAR hypodermic insulin injection pen

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.

10 Community Pharmacy News – September 2018

LPCS

PSNC’S WORK

FUNDING AND STATISTICS

Drug Tariff Watch: October 2018 Part VIIIA additions Category A: • Adrenaline (base) 1mg/1ml solution for injection pre-filled syringes (1)  • Calcitonin (salmon) 100units/1ml solution for injection ampoules (5) • Calcitonin (salmon) 400units/2ml solution for injection vials (1)  • Calcitonin (salmon) 50units/1ml solution for injection ampoules (5) • Ibandronic acid 3mg/3ml solution for injection pre-filled syringes (1)  • Naloxone 400μg/1ml solution for injection ampoules (10) Category C: • Abatacept 125mg/1ml solution for injection pre-filled disposable devices (4) – Orencia ClickJect • Abatacept 125mg/1ml solution for injection pre-filled syringes (4) – Orencia • *Bambuterol 10mg tablets (30) – Bambec • Benzocaine 20% dental gel sugar free (5.3g)  – Orajel Extra Strength • Chlorhexidine gluconate 0.015%/ Cetrimide 0.15% solution 100ml sachets (10) – Sterets Tisept • Chlorhexidine gluconate 0.015%/ Cetrimide 0.15% solution 25ml sachets (25) – Sterets Tisept • Ciclosporin 100mg/ml oral solution sugar free (50ml)  • Darbepoetin alfa 100μg/0.5ml solution for injection pre-filled disposable devices (1)  – Aranesp SureClick • Darbepoetin alfa 150μg/0.3ml solution for injection pre-filled disposable devices (1)  – Aranesp SureClick • Darbepoetin alfa 20μg/0.5ml solution for injection pre-filled disposable devices (1)  – Aranesp SureClick • Darbepoetin alfa 300μg/0.6ml solution for injection pre-filled disposable devices (1)  – Aranesp SureClick • Darbepoetin alfa 40μg/0.4ml solution for injection pre-filled disposable devices (1)  – Aranesp SureClick • Darbepoetin alfa 500μg/1ml solution for injection pre-filled disposable devices (1)  – Aranesp SureClick • Darbepoetin alfa 60μg/0.3ml solution for injection pre-filled disposable devices (1)  – Aranesp SureClick • Darbepoetin alfa 80μg/0.4ml solution for injection pre-filled disposable devices (1)  – Aranesp SureClick

• Denosumab 120mg/1.7ml solution for injection vials (1)  – Xgeva • Epoetin beta 10,000units/0.6ml solution for injection pre-filled syringes (6) NeoRecormon • Epoetin beta 2,000units/0.3ml solution for injection pre-filled syringes (6) – NeoRecormon • Epoetin beta 20,000units/0.6ml solution for injection pre-filled syringes (6) – NeoRecormon • Epoetin beta 3,000units/0.3ml solution for injection pre-filled syringes (6) – NeoRecormon • Epoetin beta 30,000units/0.6ml solution for injection pre-filled syringes (4) – NeoRecormon • Epoetin beta 4,000units/0.3ml solution for injection pre-filled syringes (6) – NeoRecormon • Epoetin beta 5,000units/0.3ml solution for injection pre-filled syringes (6) – NeoRecormon • Epoetin beta 500units/0.3ml solution for injection pre-filled syringes (6) – NeoRecormon • Epoetin beta 6,000units/0.3ml solution for injection pre-filled syringes (6) – NeoRecormon • Gentamicin 80mg/2ml solution for injection ampoules (5) – Cidomycin Adult Injectable • Insulin isophane biphasic porcine 30/70 100units/ml suspension for injection 10ml vials (1)  – Hypurin Porcine 30/70 Mix • Liquid paraffin 65% bath additive (500ml)  – Doublebase • Methylprednisolone 100mg tablets (20) – Medrone • Methylprednisolone 16mg tablets (30) – Medrone • Methylprednisolone 2mg tablets (30) – Medrone

CONTRACT AND IT

KEY:  Special container  Item requiring reconstitution * This pack only (others already available) • Methylprednisolone 4mg tablets (30) – Medrone • Metapyrone 250mg capsules (100) – Metopirone • Morphine 100mg modified-release granules sachets sugar free (30) – MST Continus • Morphine 200mg modified-release granules sachets sugar free (30) – MST Continus • Morphine 20mg modified-release granules sachets sugar free (30) – MST Continus • Morphine 30mg modified-release granules sachets sugar-free (30) – MST Continus • Morphine 60mg modified-release granules sachets sugar free (30) – MST Continus • Nedocromil 2mg/dose inhaler CFC free (112 dose)  – Tilade • Paracetamol 500mg effervescent tablets sugar free (100) – Accord Healthcare Ltd • Sodium dihydrogen phosphate anhydrous 1.936g effervescent tablets (100) (5x  20) – Phosphate Sandoz • Sucroferric oxyhydroxide (iron 500mg) chewable tablets (90) – Velphoro • Testosterone 16.2mg/g gel (20.25mg per actuation) (88g)  – Testogel • Timothy grass pollen allergen extract 75,000 SQ-T oral lyophilisates sugar free (30) – Grazax • Titanium ointment (30g)  – Metanium Nappy Rash • Typhoid vaccine (live, oral, strain ty21a) gastro-resistant capsules (3)  – Vivotif For a full list of the upcoming Drug Tariff changes, please visit: ow.ly/cbXK30lJ8nx

Part IXA deletions Product

Type, Size, Product code

Healthgard I.V. Film Dressing

7cm x 9cm

Healthgard Film Dressing

All sizes

Premierfilm Dressing

All sizes

Premierfilm I.V. Dressing

All sizes

Healthgard Film + Dressing

All sizes

Draina S Vision 100 wound drainage bag

300ml cut to 100mm (H28567E)

Zerodouble Gel

475g

psnc.org.uk 11

PSNC’S WORK

FUNDING AND STATISTICS

CONTRACT AND IT

PSNC resources library In this section of Community Pharmacy News we have provided details of some of the resources that PSNC has produced this month.

PSNC Briefings PSNC Briefing 040/18: Dispensing & Supply Factsheet – Exemptions from the prescription charge In this PSNC factsheet our Dispensing and Supply Team guides you through the categories of exemptions from the NHS prescription charge and the proof required for each.

Download from: ow.ly/WFKm30lGVaM PSNC Briefing 041/18: Changes to the Seasonal Influenza Vaccination Advanced Service 2018/19 Following the recommissioning of the Flu Vaccination Service for 2018/19, PSNC has agreed several changes to the service with NHS England; this PSNC Briefing provides a summary of these changes.

Download from: ow.ly/HnRJ30lGVbu PSNC Briefing 044/18: Summary of the Judicial Review Appeal judgment This briefing summarises the judgment in PSNC’s Judicial Review Appeal Case which was handed down on Thursday 23rd August 2018. There are also a selection of Frequently Asked Questions about the judgment.

Download from: ow.ly/1nm730lGVcc See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources Watch the PSNC CEO webinar Discussing his first impressions of the sector, the key issues and how he plans to move forward, this webinar provides an insight into the PSNC Chief Executive’s ambitions for the next few years.

Watch now: psnc.org.uk/webinar Register for End of month submission webinar Following on from our popular Endorsing webinar, PSNC and the NHS Business Services Authority (NHS BSA) will be holding an ‘End of month submission’ webinar on Tuesday 25th September.

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

Email news alerts Court of Appeal upholds High Court decision on pharmacy funding cuts (23rd August) The announcement of the judgment given in PSNC and the National Pharmacy Association’s Judicial Review Appeal cases. Both cases were dismissed.

Read now: ow.ly/jGnA30lGWQY Directions published for the national Flu Vaccination Service 2018/19 (31st August) This email was to tell community pharmacy contractors that the necessary amendment to the Secretary of State Directions had been published, meaning the Flu Vaccination Service could begin on 1st September.

Read now: ow.ly/G9HR30lGWXT Not receiving our emails? Sign up now at: psnc.org.uk/enews

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

© PSNC