July 2015 CPN

CPNCommunity Pharmacy News – July 2015

Looking to pharmacy’s IT future➢ £7.5 million for care records access ➢ More than 1,350 tune in for PSNC’s endorsing webinar➢ Making the most of the electronic script tracker

Temporary Smartcard access | NMS reminder poster | Latest Drug Tariff FAQs

2 Community Pharmacy News – July 2015

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Following a successful proof of concept trial, NHS England has commissioned HSCIC

to help give all community pharmacies in England access to the SCR. Pharmacy

minister Alistair Burt announced last month that a fund of £7.5 million would be

available to support the roll out, and we expect implementation to begin in autumn

2015.

The SCR provides key clinical information about a patient, sourced from the GP

record. It is used by authorised healthcare professionals, with the patient’s consent,

to support their care and treatment. Community pharmacists and pharmacy

technicians will be provided with secure approved and monitored access to the SCR

which will allow them to support patients with better informed and tailored care.

More than 96% of the population have an SCR and it is already being successfully

used in many settings across the NHS, such as A&E departments, hospital

pharmacies, NHS 111, GP out of hours services and walk in centres.

Community pharmacy has been pressing for access to the records for a number of

years as they will give pharmacy teams more information about patients and so help

them to improve the care they can offer. National pharmacy bodies have welcomed

the roll out of the SCR in a joint statement from PSNC, the Royal Pharmaceutical

Society (RPS) and Pharmacy Voice which can be found at: dld.bz/dHAqK

NHS England gives go-ahead for roll out ofSummary Care Record (SCR) to pharmaciesHealth and Social Care Information Centre (HSCIC) project backed by

funding and set to launch in autumn 2015

The SCR access trial

140pharmaciesacross five geographical areas were given SCR access in late 2014

85%of pharmacistssurveyed agreed orstrongly agreed thatSCR access reducedthe need for them to contact the patient’s GP

In 18%of SCR access encounters

the risk of a prescribingerror was avoided’

92%of the time when

pharmacistsaccessed the SCRthey did not need

to signpostpatients to other care

Get the latest PSNC and community pharmacy news deliered to your inbox:psnc.org.uk/email

NHS England has announced a £15 million

scheme to fund, recruit and employ clinical

pharmacists in GP practices.

The pharmacists will offer a range of clinical

care including helping patients to manage

long-term conditions, giving advice on

medications, managing repeat prescription

requests and developing bespoke medicine

plans for patients.

The three-year initiative will focus on areas

where GPs are under greatest pressure and

is intended to ease GP workload and

improve communication with other

healthcare providers including community

pharmacies.

Responding to the announcement, PSNC

Chief Executive Sue Sharpe made the

following statement:

“We are pleased that NHS England

recognises the medicines expertise of

pharmacists and the role that they can play

to better support patients in their

treatment plans. Pharmacists working in GP

practices to supplement and support the

care already given by GPs and community

pharmacists could be a real advance,

bringing clinical benefits to many patients.

Community pharmacy teams are the most

accessible healthcare professionals and

often the ones who are seen most

regularly by patients. They have shown

how they can help patients and we must

build on this potential, with pharmacists in

other settings collaborating closely with

them to ensure patients are receiving

joined up and consistent care. We hope

that this project will give community and

other pharmacists a chance to explore new

ways of working, and perhaps training,

together to offer the best possible care to

patients.”

PSNC has also encouraged LPCs to try to

ensure that the new posts actively support

use and development of community

pharmacy services and a collaborative

approach between general practice and

community pharmacists. More information

is included in LPC News and LPCs needing

further support can contact the office.

NHS practice pharmacy initiative unveiled

Community pharmacy teams can now

access an online recording of PSNC’s

recent webinar on the dos and don’ts of

endorsing and submitting prescriptions.

More than 1,350 people tuned into the

webinar on 30th June when PSNC’s in-

house Drug Tariff experts (Head of

Pricing, Harpreet Chana, and Head of

Dispensing and Supply, Komal George)

conducted the live workshop.

Attendees had first worked through a

series of prescription examples from

PSNC’s Pricing Audit Centre and Harpreet

and Komal talked through these,

explaining how to endorse and sort them

correctly whilst highlighting the most

common errors made and how to avoid

them.

They also gave a run-down of their top

tips and the last section of the webinar

was dedicated to viewers’ questions.

This workshop would be a valuable

resource for anyone involved in

dispensing and end of month processes.

Did you miss the webinar?

An on-demand recording of the webinar

is now available to watch at:

psnc.org.uk/webinar. To view the

recording you will need to register (or

input the email address you registered

with previously).

To get the most out of the workshop you

may first like to carry out the pre-

workshop quiz which can be printed out

from the web page as well. You can then

test your knowledge and understanding

as our experts work through the answers.

psnc.org.uk 3

lpcs psnc’s work funding and sTaTisTicshe healThcare landscape

Although legislation came into force from

1st July 2015 allowing Schedule 2 and 3

Controlled Drugs to be prescribed and

dispensed using the Electronic

Prescription Service (EPS) release 2

messages, the date at which pharmacy

teams will start to receive such

prescriptions has yet to be confirmed.

EPS release 2 prescriptions for Schedule 2

and 3 Controlled Drugs will need to satisfy

the usual prescription writing

requirements including the need to

express the total quantity in words and

figures. In PSNC’s response to the

consultation on allowing Schedule 2 and 3

Controlled Drugs to be prescribed via EPS,

we suggested that this requirement should

not apply to electronic prescriptions, but

the Home Office concluded that the

requirement should remain.

The Health and Social Care Information

Centre (HSCIC) has issued all GP and

community pharmacy system suppliers with

the technical requirements to implement

Controlled Drugs prescribing via EPS,

including the requirement for ‘words and

figures’. All dispensing systems must be

updated and fully deployed across all

pharmacy sites, before it is possible to

enable the new functionality. This is to

avoid the possible risk of a prescriber

sending a prescription for a Controlled Drug

to a pharmacy which can’t then dispense it.

Suppliers have been asked by HSCIC to

consider when they will be able to

implement the changes and until all

suppliers provide this feedback, a decision

can’t be made regarding implementation

timescales.

Turn over for our latest EPS factsheet on

the EPS Prescription Tracker

Update: Schedule 2/3 Controlled Drugs and EPS

PSNC Endorsing and Submission Good PracticeWorkshop: now available on-demandMore than 1,350 people tuned into a live webinar covering the dos and don’ts

of endorsing in June. Catch up now if you missed it at psnc.org.uk/webinar

“I learnt lots, maybe we endorse too

much. Looking forward to more

practice prescriptions.”

Tracy Robinson, Dispensing Assistant

“This was my first PSNC webinar and it

will not be my last. I found it very

informative and well thought out.”

Hazel Hughes, Locum Pharmacist

“I found it very useful; it reinforced my

understanding and also I was able to

pick up a couple of tips.”

Margaret Clement, Community

Pharmacist

92%

said they would‘recommend toothers’

91%

said they would‘change theirpractice’ as aresult

97%

found it ‘useful’ or ‘very useful’

Feedback on the workshopEarly indications from our feedback survey are:

4 Community Pharmacy News – July 2015

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The EPS Prescription Tracker is an online

tool provided by the NHS that provides

community pharmacy teams with an

additional means of viewing the status of

electronic prescriptions on the NHS Spine.

What information does the tracker

provide?

It provides basic information about a

prescription. Initially the status, issue date

and prescription treatment type (acute,

repeat prescribing or repeat dispensing)

will be presented. You can then choose to

look at the GP practice who issued the

prescription, the patient’s NHS number

and the event history of that electronic

prescription. Contact details for

prescribers and dispensers are also

provided.

The tracker does not provide patient

demographic or prescribed medication

details.

What can I use it for?

The most likely reason for using the

tracker will be when a patient says they

are expecting to collect a prescription, but

you can’t see it on your dispensing system.

By searching the patient’s NHS number, or

the prescription ID if they have a

prescribing token, you will be able to

check on the status of their prescription.

The information provided will enable you

to take appropriate action. This might be

to remind the patient that they have

nominated a different pharmacy, or to

confirm that there is a system issue and

the prescription has not yet downloaded

to your dispensing system.

Tip: If you cannot find a prescription in

your dispensing system, you can cut

and paste the Prescription ID into your

dispensing system and use it to ‘pull

down’ the prescription from the Spine.

Note: You can only do this if the patient

wants the prescription to be dispensed at

your dispensing site.

How do I use it?

You can search for specific prescriptions

by entering the prescription ID.

Tip: if you have a barcode scanner,

then click on the prescription ID input

box and scan the barcode.

Or you can search for all prescriptions for

your pharmacy or for a particular patient,

by specifying a date range of your choice.

You will need the patient’s NHS number to

use this search.

Pharmacy teams are expected to use the

tracker when there is a valid reason to do

so, e.g. to verify that a prescription exists

or its status during the prescribing and

dispensing process.

What is the ‘my site’ search option?

One of the new features is the

introduction of a ‘my site’ option. This

allows you to search for all prescriptions

for your pharmacy.

Note: This type of search will not return

any results for users logged on using a

Virtual Local Pharmacy (FFFFF) user role

profile as no prescriptions are associated

with that virtual organisation.

What else is new?

One of the new features is the visibility

of actioned or pending cancellation

requests. You’ll be able to see if the

cancellation applies to the whole

prescription or one of the prescribed

items on it. You’ll also be able to see the

cancellation reason.

Who can use it?

Pharmacy teams, appliance contractor

staff and GP teams are the main users.

All users will need a Smartcard.

Further information

• The Tracker has an integrated help

function, but if you have any problems

accessing the Prescription Tracker, you

should contact your IT support (e.g.

your IT department if you have one or

your system supplier helpdesk).

• More information about the tracker is

available at: psnc.org.uk/tracker

EPS Prescription Tracker: How it can help in your day to day workThe EPS Prescription Tracker has recently been updated and this factsheet

tells you all you need to know about the changes and how it can help

ElectronicPrescriptionService

You can find the tracker at tinyurl.com/epsr2tracker(Smartcard required)

Where can I find the Prescription Tracker?

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Transfer of care e-learning programme

30–70% of patients have either an error or

unintentional change to their medicines when

their care is transferred; this can result in

death, serious harm or avoidable readmission

to hospital.Community pharmacy teams can play their

part including by offering patients an MUR

following their discharge from hospital.

The Centre for Pharmacy Postgraduate

Education (CPPE) has a new e-learning

programme to enable pharmacy teams to

facilitate safe and effective transfer of

care for patients.

Programme details:

d ld.bz/dGDFA

Reminder: Mandatory logofor selling medicines onlineAs of 1st July 2015, anyperson or organisation in theUK selling medicines online tothe public must be registeredwith the Medicines andHealthcare productsRegulatory Agency (MHRA) and display the newEuropean Union (EU) common logo.This is separate from the voluntary logoscheme run by the General PharmaceuticalCouncil (GPhC) as it is a legal requirementacross Europe.The penalty for not being registered ordisplaying the logo is up to two years in prisonor a fine, or both.

Logo registration: https://pclportal.mhra.gov.uk

In this section of Community Pharmacy News we have highlighted some keynotices for you and your team to be aware of in the coming weeks and months

Pharmacy notice board

Looking for repeat

dispensing resources?

A Repeat Dispensing Referral

Form has just been added to

the Repeat Dispensing section

of our website to help you

refer patients to GP

practices.

You can also access NHS

England’s new guidance

Electronic Repeat Dispensing

– Guidance which you may like

to share with CCGs and local

practice teams.

Visitpsnc.org.uk/repeatdispensing

Temporary Access Smartcard guidanceTemporary Access Cards (TACs) are ‘blank’ Smartcards with a

pre-defined set of access rights. If a Smartcard is lost or stolen,

TACs can be activated by the Smartcard sponsor or Local

Smartcard Administrator.HSCIC has issued guidance for pharmacy teams recommending that

those with few Smartcard users should consider discussing TACs or

what other options may be available to them with their local

Registration Authority (RA) team.

If a Smartcard is lost or stolen:Report to the local RA as soon as possible;Activate and securely store your TACs; andOnce the pharmacy team member hasreceived a permanent replacement card,restore the TAC to a blank state.

Further information about Smartcards: psnc.org.uk/smartcards

6 Community Pharmacy News – July 2015

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This year Boxing Day, 26th December, falls

on a Saturday and this means the Boxing

Day bank holiday moves to the next

available weekday, i.e. Monday 28th

December. This change to the bank holiday

has an impact on the opening hours

requirements for community pharmacies.

If the pharmacy would normally open on a

Saturday, it must open as usual on Saturday

26th December, unless it acquires

permission from the local NHS England

team to change any core opening hours

(but see note below). Note, if the Saturday

opening hours are supplementary hours

only, these can be amended by giving at

least 90 days’ notice – permission to close

is not required.

NHS England has issued the following

statement:

“NHS England considers community

pharmacy to be an important part of our

system resilience. We have been

promoting community pharmacy to the

public as a first stop for self-care and

professional advice to elderly people who

are ‘feeling under the weather’. In order to

support this we will be asking all primary

care contractors whose contracted hours

include Saturdays to open their normal

hours on 26th December 2015. Local

arrangements will be put in place to ensure

adequate pharmaceutical services are

available on the Boxing Day bank holiday

on 28th December 2015.”

In light of the above statement it is unlikely

that NHS England will give permission for

changes in core hours. Pharmacy

contractors that do wish to amend core

hours for Saturday 26th December should

make their applications without delay, and

will need to provide such information as is

reasonably requested by NHS England in

respect of any changes to the needs of the

people in its area, or other likely users of

the pharmacy, for pharmaceutical services.

It should also be noted that in previous

years appeals against refusals have been

unsuccessful.

Monday 28th December

Pharmacy contractors may close on

Monday 28th December as this is the

declared public holiday, unless they have

been directed to open by NHS England or

they are bound by conditions imposed

when they applied for inclusion in the

pharmaceutical list.

However, although most pharmacies are

entitled to close, LPCs and contractors may

wish to work with NHS England to ensure

the availability of adequate pharmaceutical

services, through a locally commissioned

Enhanced service.

For further details about opening hours

see our Opening Hours page at:

psnc.org.uk/hours

Important notice: Boxing Day 2015Community pharmacy contractors should be aware of pharmacy opening

hours requirements and how they apply to Boxing Day 2015

PSNC regularly receives questions from LPCs and pharmacy

contractors about what is going on in the wider health and care

landscape beyond community pharmacy. In this round-up we

cover the latest news from the past month.

Manchester plan includes 7-day service

Seven-day GP services will be rolled out

across the whole of Greater Manchester

after a local pilot scheme was found to

reduce A&E attendances by up to 8%.

Care.data restarts

The Care.data project, which aims to link

patients’ GP and hospital records,

restarted in June with the project being

piloted in four areas: Blackburn with

Darwen, Somerset, West Hampshire and

Leeds. The NHS England led project had

been delayed by concerns about patient

confidentiality.

Five Year Forward View update

The seven principal national health bodies

have published Five Year Forward View:

Time to Deliver (dld.bz/dJt3W). The report

looks at the progress made so far towards

delivering the Five Year Forward View,

and sets out the next steps.

£200m cut to public health budgets

Council controlled public health budgets

may be slashed by £200m as the

Department of Health (DH) is set to

consult on an in-year cut worth 7.4% of

the annual budget.

More than one in 10 born to smokers

New figures published by the Health and

Social Care Information Centre (HSCIC)

a seven-day GP service pilotscheme was found to

reduce A&E attendances by up to 8%

A year on from the National Review of

Asthma Deaths (NRAD), which highlighted

prescribing errors in nearly half of asthma

deaths in primary care, new analysis from

Asthma UK has revealed that unsafe

prescribing is putting the lives of more

than 120,000 people at risk.

Data from over 500 GP practices showed

that over 22,000 people with asthma in

the UK, including 2,000 children, have

been prescribed medicines (long-acting

reliever inhalers) in a way that is so unsafe

they have a ‘black box warning’ in the USA

due to the risk they pose. This error

occurs when a dangerous monotherapy

including long-acting beta agonists (LABA)

and/or a long-acting muscarinic

antagonists (LAMA) are prescribed

without an inhaled corticosteroid (ICS).

In addition, Asthma UK’s research

indicates that almost 100,000 people with

asthma have been prescribed too many

short-acting reliever inhalers (more than

12 in a year) without the British Thoracic

Society/Scottish Intercollegiate Guidelines

Network (BTS/SIGN) national clinical

guidelines being followed, leaving them

at risk of asthma attacks.

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Study calls for better asthma supportPharmacists urged to help people at risk of attack due to unsafe prescribing

500GP practicesprovided datafor the study

22,000people with asthma in

the UK have beenprescribed medicines

in an unsafe andpotentially life-

threatening manner

Almost100,000people with asthmahave been prescribedmore than 12 short-acting reliever inhalerswithin a year

90,000people in England have uncontrolled asthma which is not being monitored by healthcare professionals

Asthma UK has called on healthcare

professionals to review their systems and

recall patients who have been prescribed

long-acting relievers on their own without

a steroid preventer, or not as a

combination inhaler.

Head of the Asthma UK Helpline, Sonia

Munde, said: “Community pharmacists can

play an important role by helping to

identify patients who have been

prescribed a LABA and/or LAMA with no

inhaled corticosteroid and flag this back to

their GP or asthma nurse. Another way

pharmacists can help people with asthma

is to make them aware hay fever can make

them at increased risk of an attack.”

PSNC has a range of resources on asthma.

See psnc.org.uk/asthma

5The charity’s report, along with practical guidance for healthcare professionals, can befound at: asthma.org.uk/prescribing-safety

show that 11.4% of pregnant women were

recorded as smokers at the time of giving

birth in 2014/15. This latest figure

continues the steady decline from 2006/07

(15.1%) to become the lowest on record.

New vaccination programmes

Public Health Minister, Jane Ellison, has

announced the introduction of two new

vaccination programmes in England:

MenACWY and MenB vaccines. The MenB

programme means that England is the

first country in the world to begin

national and publicly funded MenB

immunisation.

‘New deal’ for general practice

Secretary of State for Health, Jeremy

Hunt, has set out the first steps in his

‘new deal’ for general practice. Part of the

deal will require GP practices to improve

the quality and continuity of care for

vulnerable patients and delivering better

access, 7 days a week, for everyone.

He reiterated the election commitment to

increasing the primary care workforce by

at least 10,000 and focusing more effort

on recruiting new GP trainees, as well as

ensuring all medical students have

experience in general practice.

Health Committee chair re-elected

Dr Sarah Wollaston has been re-elected as

Chair of Parliament’s Health Select

Committee. The remaining members of

the Committee will be nominated by the

House in the coming weeks.

MERS update

Chief Medical Officer, Professor Dame

Sally Davies, has written to healthcare

professionals outlining the latest

information on the MERS Coronavirus

outbreak in South Korea, stating that

whilst the risk to the UK is currently low,

she expects healthcare teams to remain

vigilant.

If a patient presents with sudden and

unexplained febrile illness, pharmacy

teams should obtain details of their travel

history and, if they have travelled from

any of the affected countries, advice

should be sought from the local infection

disease clinician. The supporting

algorithm (dld.bz/dJt4a), published by

Public Health England, provides further

guidance.

11.4% of pregnant women were recorded as smokers at the time of giving birth in 2014–15

8 Community Pharmacy News – July 2015

The healThcare landscape lpcs psnc’s work

Hunt sets personal responsibility challengeHealth Secretary plans to include indicative prices on medicines packs to

encourage people to reduce waste and improve adherence

The Government has called on patients to

take more responsibility for their own

health and for reducing waste in the NHS.

Speaking to local authority representatives

Health Secretary Jeremy Hunt said people

needed to feel ‘firmly in the driving seat for

their own health outcomes’.

Highlighting the roles that factors such as

smoking and obesity still play in driving up

health costs, he added: “The best person to

manage a long-term condition is the person

who has that long-term condition.”

Hunt also set out plans to publish indicative

medicines costs to the NHS on the packs of

all medicines costing more than £20. This

would reduce waste and improve patient

care by improving adherence, he said.

Responding to the announcement, Sue

Sharpe, PSNC Chief Executive, outlined

pharmacy’s vital role in helping patients.

“Pharmacy’s role in supporting personal

responsibility can and should be far more

extensive, including helping to minimise

unnecessary use of GP time and visits to

urgent care centres,” she stressed.

Sue added that any system for noting the

cost of medicines would be “far from

straightforward to implement” as the costs

of prescribed medicines vary depending on

a wide range of factors. “We will explore

these with the NHS as it progresses this

policy,” she said.

Read Sue Sharpe’s full statement at

psnc.org.uk

CPWY Ramadan support videos

Community Pharmacy West Yorkshire

(CPWY) has worked with a local imam

and a film production company to

create some really useful videos

explaining how community pharmacy

teams can advise Muslim patients on

their medicines use during the Holy Month of Ramadan.

Three videos were produced: information for patients (to be

used in local mosques); information for pharmacy teams (the

original highlights video); and a final video to explain how

pharmacy teams are being trained and supported in advising

Muslim patients during Ramadan. All three are now freely

available on YouTube at: tinyurl.com/

RamadanPharmacyVideos

Devon LPC features on web TV channel

David Bearman and Mark Stone of Devon

LPC have appeared on a web TV channel to

highlight the importance of community

pharmacy. TV channel Hiblio interviewed the

pair as part of a programme which aimed to

make the public more aware of the services

and advice available from their local pharmacy team.

Hiblio was created by the South Devon Healthcare NHS

Foundation Trust to bring local health and wellbeing

information to a wider audience. Watch the programme on-

demand at: vimeo.com/129416089

PSNC commissioners portal

PSNC has developed a new

'Commissioners Portal' which was

launched to coincide with the Health

Service Journal (HSJ) and Local

Government Chronicle (LGC)

supplement on community pharmacy

services. Now the portal is fully up

and running LPCs may like to direct

their local commissioners to it; and also to ask them to sign

up for the commissioners mailing list using the form on the

main page. LPCs have been sent copies of the HSJ/LGC

supplement to help in their local conversations and should

look out for these. The portal can be found at:

psnc.org.uk/commissioners

Think Pharmacy events

A briefing has been created to

provide all the materials LPCs need to

organise and run a Think Pharmacy

event. Think Pharmacy is a brand that

has already been successfully used by

many LPCs to engage their local

commissioners. Rather than going to

commissioners individually, an LPC

Think Pharmacy event brings everyone together to learn

more about community pharmacy and showcase pharmacy

services. Find the briefing at: psnc.org.uk/briefings

LPC News and Resources

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conTracT and iT dispensing and supply services and commissioningfunding and sTaTisTics

New Medicine Service – condition/therapy areasIf a patient is newly prescribed a medicine listed in the

chapters/sub-headings of the British National Formulary (BNF) as detailed

below then they will be eligible to receive the New Medicine Service

(NMS), subject to the pharmacist being able to determine that the

medicine is being used to treat one of the below conditions/therapy area

The patient’s newly prescribed medicine is listed in one of thefollowing BNF chapters/sub-sections:

3.1.1 Adrenoceptor agonists

3.1.2 Antimuscarinic bronchodilators

3.1.3 Theophylline

3.1.4 Compound bronchodilator preparations

3.2 Corticosteroids

3.3 Cromoglicate and related therapy, leukotriene receptorantagonists and phosphodiesterase type-4 inhibitors

The patient’s newly prescribed medicine is listed in one of thefollowing BNF chapters/sub-sections:

6.1.1.1 Short acting insulins

6.1.1.2 Intermediate and long acting insulins

6.1.2 Antidiabetic drugs

The patient’s newly prescribed medicine is listed in one of thefollowing BNF chapters/sub-sections:

2.8.2 Oral anticoagulants

2.9 Antiplatelet drugs

The patient’s newly prescribed medicine is listed in one of thefollowing BNF chapters/sub-sections:

2.2.1 Thiazides and related diuretics

2.4 Beta-adrenoceptor blocking drugs

2.5.1 Vasodilator antihypertensive drugs

2.5.2 Centrally acting antihypertensive drugs

2.5.4 Alpha-adrenoceptor blocking drugs

2.5.5 Drugs affecting the renin-angiotensin system

2.6.2 Calcium-channel blockers

The patient has been newly prescribedthe medicine for asthma or COPD

The patient has beennewly prescribed themedicine asantiplatelet oranticoagulant therapy

The patient hasbeen newlyprescribed themedicine forType 2 diabetes

The patient has been newly prescribedthe medicine for hypertension

10 Community Pharmacy News – July 2015

dispensing and supply services and commissioning The healThcare landscape

All details correct at time of printing.

No part of this publication may be reproduced without the written permission of the PSNC.

Produced for the PSNC by Communications International Group. ©. PSNC.

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.

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Distributedfor PSNC by:

1. How long do NCSO/price concessions last?

PSNC needs to apply/re-apply for concessions on a monthly basis.

Therefore a concession only lasts until the end of the month in

which it was granted. If there is an on-going supply problem, it is

possible that a new concession will be granted by the Department

of Health (DH) the following month, however this is not

guaranteed.

2. Why aren’t NCSO/price concessions granted on the first day of

each month?

If there is an ongoing supply problem, PSNC needs to make a

fresh concession application at the start of every month. The DH

then take time to undertake checks and make a decision. In some

cases, there is a need for negotiation between PSNC and the DH

on an individual product’s circumstances. This can take time. PSNC

would like to see changes to the arrangements that would allow

contractors to have certainty over what they will be reimbursed,

much earlier in the month.

3. How can I claim extra charges for unlicensed specials and

imports?

Reimbursement of charges related to the sourcing of unlicensed

specials and imports falls under the arrangements for payment of

specials and imported unlicensed medicines introduced in

November 2011 (Part VIIIB of the Drug Tariff).

The ‘OOP’ or ‘XP’ endorsement cannot be used on prescriptions

for unlicensed specials and imports. Instead contractors are

entitled to claim a fixed sourcing fee of £20, which is to cover the

additional costs associated with procuring both Part VIIIB and non-

Part VIIIB listed specials. The fee is paid when the prescription has

been endorsed with ‘SP’ (or ‘ED’ for extemporaneously dispensing

the item).

4. How do I endorse a licensed medicine not in the Drug Tariff?

For licensed medicines not included in the Drug Tariff, endorse

the quantity dispensed over the pack size used, and if the

prescription has been issued generically, also endorse the brand

name or the name of the supplier (see picture).

The Pricing Authority reimburses

using the NHS-listed

reimbursement price, but if this is

not known by them (i.e. the supplier

does not list the product/price on the NHS database, dm+d*) then

they will need to use your endorsed price (N.B. the following must

be included: the pack size, and total net price for that pack before

discount and ex VAT). It is important to only include the necessary

information in line with the endorsement requirement as any

additional information could risk misinterpretation which could

lead to an incorrect payment being made.

*For more information on dm+d, please visit: psnc.org.uk/dmd

Look out for more frequently asked questions next month.

Ask PSNCThe PSNC Dispensing and Supply Team give pharmacy teams support and

advice on a range of topics related to the Drug Tariff and reimbursement.

Questions asked in recent months have included:

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 [email protected]).

Have you seen?Have you seen our webpage

‘Completing Your FP34C Submission

Document & Dispatching Your

Prescription Bundle’?

It details the dos and don’ts of completing your FP34C

and information about dispatching your bundle. You will

also find a link to our prescription submission factsheet.

Head over to psnc.org.uk/interactive-fp34c for more

information.

Check34 roll out beginsNearly 20% of all independent pharmacies in

England now have access to the Check34

prescription data analysis tool. Independent

contractor registration for Check34 is being managed by the

National Pharmacy Association (NPA) who reported that 430

members, totalling 1,100 pharmacies, have registered.

Independents outside NPA membership can also register through

them. Developed by PSNC, Check34 is an online software solution

that helps pharmacies to assess their prescription business

performance. Access Check34 at check34.com

want to be alerted to price concessions as they are agreed?

sign up to our email alerts at psnc.org.uk/email

psnc.org.uk 11

psnc’s work funding and sTaTisTics conTracT and iTlpcs

When pharmacy teams receive NHS prescriptions they must check whether the items prescribed are allowed on the NHS before dispensing. If they

are not allowed, the pharmacy 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, and we have listed some products below that

we have recently received queries about.

Product Is the item Does it Is it Can it be Additional information listed in the have a ‘CE’ in the dispensed Drug Tariff? mark? blacklist? on an FP10?

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

Can it be dispensed on an FP10?

Cutimed Protect

Cream

Vaniqa Cream

Hycosan 0.1% eye

drops

Ichthopaste (6/2%)

Yes

Yes

No

Yes

n/a

No

n/a

n/a

Yes

No

Yes

Yes

Yes

Yes

No

Yes

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

the Drug Tariff.

This item is not a medical device (CE marked) and does not appear

in Part XVIIIA (the ‘blacklist’) of the Drug Tariff.

This item is a medical device (CE marked) and is not listed in Part

IX of the Drug Tariff.

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

the Drug Tariff.

Acetylcysteine 10% eye drops

Acetylcysteine 5% eye drops preservative free

Amisulpride 25mg/5ml oral solution/suspension

Amitriptyline 10mg/5ml oral solution/suspension

Chloral hydrate 200mg/5ml oral solution/suspension

Ciclosporin 0.06% eye drops

Ciclosporin 2% eye drops preservative free

Dexamethasone 0.1% eye drops preservative free

Diazepam 10mg/5ml oral suspension

Dipyridamole 100mg/5ml oral suspension

Folic acid 5mg/5ml oral suspension

Furosemide 5mg/5ml oral solution/suspension

Haloperidol 1mg/5ml oral solution/suspension

Midazolam 10mg/ml oral solution

Phenobarbital 50mg/5ml oral solution/suspension

Phosphate 0.98mmol/ml / Sodium 0.78mmol/ml oral suspension

Pregabalin 75mg/5ml oral suspension

Tacrolimus 2.5mg/5ml oral suspension

Tacrolimus 5mg/5ml oral suspension

Trihexyphenidyl 2mg/5ml oral solution/suspension

Reminder: June 2015 removals from Part VIIIB

Pharmacy teams are reminded that a number of lines were removed from Part VIIIB (specials and imported unlicensed medicines) of

the June 2015 Drug Tariff. Therefore, prescriptions for these products now require additional endorsement to ensure correct

payment.

Changes to Part VIIIB of the Drug Tariff

Unlicensed medicines which are not listed in Part VIIIB of the Drug Tariff and are sourced under a

manufacturer’s specials/importer’s licence issued by the MHRA, must be endorsed with the following:

• Amount dispensed over pack size used

• Invoice price per pack size from which the order was supplied less any discount or rebate

• Manufacturer’s/importer’s MHRA licence number

• Batch number of the product supplied

• SP

Further information on dispensing and endorsing unlicensed specials and imports can be found at: psnc.org.uk/specials

July 2015 changes: products moving to Part VIIIA

The listings for the following products are moving from Part VIIIB (specials and imported unlicensed medicines) to Part VIIIA, as these

products are now available as licensed medicines. This change is annotated in the Preface of the July 2015 Drug Tariff.

• Amlodipine 10mg/5ml oral solution

• Amlodipine 10mg/5ml oral suspension

• Amlodipine 5mg/5ml oral solution

• Amlodipine 5mg/5ml oral suspension

dispensing and supply services and commissioning The healThcare landscape

PSNC websiteFor 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 9AWCommunity Pharmacy News is edited by:Melinda Mabbutt who can be contacted at the above address or by email at: [email protected] © PSNCPSNC Office: 0844 381 4180 or 0203 122 0810

Drug Tariff Watch

Part VIIIA Additions

Category A Additions:

• Glycopyrronium bromide

200micrograms/1ml solution for

injection ampoules (10)

• Pericyazine 10mg tablets (84)

• Pericyazine 2.5mg tablets (84)

• Sulfadiazine 500mg tablets (56)

Category C Additions:

SC Special Container

• Amiloride 5mg/5ml oral solution sugar

free (150ml) – Amilamont

• Ibuprofen 5% / Levomenthol 3% gel SC

(30g) - Deep Relief

• Ibuprofen 5% / Levomenthol 3% gel SC

(50g) - Deep Relief

• Ibuprofen 5% / Levomenthol 3% gel SC

(100g) - Deep Relief

Part VIIIA Amendments

SC Special Container

• Betamethasone valerate 0.1% /

Neomycin 0.5% cream SC (30g) is

changing to Category A

• Betamethasone valerate 0.1% /

Neomycin 0.5% cream SC (100g) is

changing to Category A

• Betamethasone valerate 0.1% /

Neomycin 0.5% ointment SC (30g) is

changing to Category A

• Betamethasone valerate 0.1% /

Neomycin 0.5% ointment SC (100g) is

changing to Category A

• Glycerol 1g suppositories (12) is

changing to Category C Martindale

Pharmaceuticals Ltd

• Torasemide 10mg tablets (28) is

changing to Category C Torem

• Torasemide 5mg tablets (28) is changing

to Category C Torem

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, 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) and price paid in future.

• Carbocisteine 125mg/5ml oral solution (300ml) Category C - Mucodyne syrup

• Cefixime 100mg/5ml oral suspension (100ml) Category C - Suprax

• Rupatadine 10mg tablets (30) Category C - Rupafin

The first section of the Drug Tariff is the Preface. This contains

valuable information relevant for both the current edition and

the next. It lists additions, deletions and any other alterations to

the Drug Tariff. The Preface should ideally be checked each

month to identify products which are entering or being removed

from the Tariff as well as those products changing between

categories or in the case of Category C items, changes to the

brand used for pricing.

It is especially important to note which are Drug Tariff listed

products as well as which category products are entering and the

pack sizes being included in these entries, as reimbursement will

be based on this classification and its endorsement requirements.

Incorrect endorsement can lead to incorrect payment for items.

It is also important to know the category of an item when

claiming certain payments (e.g. OOP expenses) as these are not

allowed for some categories. For more information visit

psnc.org.uk/oop

Below is a quick summary of some the changes due to take place

from 1st August 2015.

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.

• IryPump S (B Braun Medical) IryPump Container - 29240E

• Molnlycke

System 4 - multi-layer compression bandage kit - 18-25cm

System 4 kits contain a combination of the following components:

Softexe (layer #1) - listed on page 202 10cm x 3.5m

(unstretched)

Setocrepe (layer #2) - listed on page 196 10cm x 4.5m

(stretched)

Elset (layer #3) - listed on page 197 10cm x 8m (stretched)

K Meban Self-Adherent Bandage (layer #4) 10cm x 6m

(stretched)

• HumaPen Memoir (Lilly) 3.0ml - 1 unit (1-60 units)

• Pelican Healthcare Ltd Eakin Closed bag Clear

32mm - 839130 - 20

45mm - 839131 - 20

64mm - 839132 - 20

• Pelican Healthcare Ltd Eakin Closed bag

Large 32mm - 839120 - 20

45mm - 839121 - 20

Small 32mm - 839110 - 20

45mm - 839111 - 20

64mm - 839112 - 20

• ConvaTec Ltd Esteem Synergy+ Closed Pouch with Filter Small -

Clear 48mm - 416780 - 30

• ConvaTec Ltd Drainable Pouch with Invisiclose outlet and no

filter Standard - Clear 35mm - 416797 - 10

Need to know if an item can be dispensed on an FP10?

Check on our database at: psnc.org.uk/FP10database