CPN Community Pharmacy News – June 2016 Community pharmacy: beyond the consultation As the community pharmacy consultation comes to an end, PSNC briefs contractors and MPs on the latest developments Smartcard management | Aspiring pharmacy leaders | Preventing prescription returns
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CPNCommunity Pharmacy News – June 2016
Community pharmacy: beyond the consultationAs the community pharmacy consultation comes to an end,
PSNC briefs contractors and MPs on the latest developments
Contractor update on fundingnegotiationsThe Chair of PSNC’s Funding and Contract
Subcommittee issues a statement preparing
contractors for what may lie ahead in the
remainder of 2016/17.
2 Community Pharmacy News – June 2016
psnc’s work funDing anD statistics contract anD it
PSNC has published its response to the Government’s letter
from 17th December 2015 entitled “Community pharmacy in
2016/17 and beyond”.
Within the response, PSNC makes clear that the proposals
contained in the letter represent a major threat to the future
availability of accessible healthcare, support and advice from
community pharmacies. We are concerned that this threat has
not been made clear to the public, and that the policies
underpinning the letter have not been based on analysis of the
likely consequences or costs to the public as patients, members
of our communities, or taxpayers.
The response also highlights that whilst PSNC is willing and
keen to work collaboratively to achieve change, proper,
informed negotiations have been made impossible by the lack of
clarity, detail or analysis of the issues raised. To read PSNC’s
response to the letter in full, please visit: ow.ly/bmeQ300xfmi
PSNC responds to 17th December letter
We will continue working with
our colleague organisations to
find new ways to convince
policy makers of the value of
our current services.
The Department of Health (DH) has announced reductions to Category M prices which willapply to prescriptions between June and September 2016.
The reduction is intended to reclaim excess margin that DH believes was delivered tocontractors in 2015/16 above the agreed allowed £800m. PSNC accepts margin levels werehigh during the period, but has not agreed to the reduction.
Requirements for access: an N3 connection and a Smartcard are necessary.
Where you cannot access the NHS Spine portal, this may relate to
software/Java settings and therefore your IT helpdesk can be contacted (e.g.
your IT department if you have one, and/or your system supplier) to ensure
your system is setup to run CIS as well as all of the other programs the
pharmacy will need. Read more at: psnc.org.uk/wes
Training: The Health & Social Care Information Centre (HSCIC) has published a
screen-by-screen guide to explain how it can be used: tinyurl.com/cisguide
Improving CIS: pharmacy staff who would like to make suggestions for CIS
improvement can contact HSCIC: tinyurl.com/cisimprove
More information is available in our ‘Quick reference guide’ over the page.
Why use CIS?Using CIS will enable pharmacy teams to resolve many of the common
Smartcard issues more speedily because there may be no need to
contact the RA. Additionally, the RA will be able to place more focus on
critical tasks such as issuing new Smartcards.
Description CIS rights
Local SmartcardAdministrators(LSAs)
PSNC recommends that each pharmacy premiseshas someone with the LSA rights so that they cansupport staff. Read more at: psnc.org.uk/lsa
LSAs can support pharmacy team members withrenewing Smartcard certificates and unlockingSmartcards.
Sponsors Advanced Smartcard users or support staff mayrequest Sponsor powers. Read more at:psnc.org.uk/scsponsor
Sponsors have the LSA rights plus a few additionalones, e.g. they are able to help with requests for anew Smartcard, or a change to a staff member’s roles.
RegistrationAuthority (RA)
The local RA manage local Smartcard issues: e.g.assigning roles and sites onto new ones. Contactdetails are available from psnc.org.uk/ra (but if RAissues need escalating, please visit:psnc.org.uk/scescalation)
The RA staff have all of the LSA and Sponsor rightsplus many additional ones such as authorisingapplications and requests and applying changes toSmartcards.
contract anD it Dispensing anD supply services anD commissioning th
Managing your Smartcard: Quick reference guideThis guide explains how you can self-manage your Smartcard.
Obtaining or replacing a Smartcard: Contact your Registration Authority (RA) to
obtain a new Smartcard. A face-to-face meeting and identity check will be required. If aSmartcard is lost or stolen contact your RA immediately. Read more at:psnc.org.uk/scobtain
Changing your Smartcard roles: Smartcard ‘roles’ control what a pharmacy team
member can do and what they can see. Appropriate roles are applied by an RA or Sponsorand are dependent upon the tasks the pharmacy team member needs to perform. Readmore at: psnc.org.uk/scrole
Changing your Smartcard sites: A pharmacy staff member who regularly works at
four local pharmacies, will have had those four premises added by the RA to theirSmartcard. Locums who work at five or more sites at short notice may have the multi-site‘FFFFF’ code for use when necessary, but should also have their regular premises added totheir Smartcard. Read more at: psnc.org.uk/scmultisite
Unlocking your Smartcard: If a Smartcard passcode is accidentally entered
incorrectly three times, the smartcard can become locked. Where two readers are present,Local Smartcard Administrators (LSAs) or Sponsors can use the Care Identity Service (CIS) tounlock a Smartcard. Alternatively, the RA may support the unlocking. Read more at:psnc.org.uk/scunlock
Renewing your Smartcard: Without action Smartcards expire after two years, for
Information Governance (IG) purposes. When the expiry date approaches you will beprompted at each login to renew your own card using the CIS in good time.LSAs/Sponsors/RAs may also assist where needed. You can only self-renew twice – the thirdtime requires an RA, and another identity check. Read more at: psnc.org.uk/screnew
Smartcard expiry: If a Smartcard is not renewed within the two-year period (see
above), it will expire and be permanently locked. A face-to-face meeting with the RA isrequired to make the Smartcard usable again. Read more at: psnc.org.uk/scexpiry
Passcode / contact detail updating: The process involves logging into ‘My Profile’
of the CIS to enter-in the information. Read more at: psnc.org.uk/scupdate
Change site or cancel: If a member of staff is leaving, the pharmacist or pharmacy
manager should advise the RA who will make the necessary changes. Leavers with nointention of working at another pharmacy will have their Smartcard revoked. Read more at:psnc.org.uk/sccancel
Smartcard and CIS top tips• Check you are aware of how to contact your local RA in case you need to in an emergency: psnc.org.uk/ra
• Regular locums should have regular premises added to their Smartcard rather than relying only on the generic locum
FFFFF code.
• Do not let your Smartcard reach expiry: Renew it yourself using CIS when you are prompted.
• Test your CIS access using the link above: Add it as a favourite and desktop shortcut.
• Smartcard readers: At least one terminal could be setup with two Smartcard readers to make the best use of the CIS. If you
need extra Smartcard readers speak to your IT system supplier.
• Ensure someone on the premises requests LSA rights: as described above.
Find out more at: psnc.org.uk/sc and http://systems.hscic.gov.uk/rasmartcards
RD1 Form Patient Agreement /Consent Form (for sharing information on repeat dispensing).
RD2 Leaflet Repeat Dispensing Patient Leaflet.
STC Card Steroid Treatment Card.
FP57 Form Receipt and Refund form for patients claiming reimbursement for prescription charges. Note: 1 unit is 100 pads of 10.
FP10CDF Form Controlled Drug Requisition form for use where the Controlled Drugs will be ordered from a communitypharmacy/another practice. Requisitions not received on the new mandatory form after 30th November2015 cannot be processed by the Pricing Authority, as they are not legally valid.The new mandatory form can also be obtained online from the Pricing Authority’s website. They can bedownloaded, completed online, printed and signed in wet ink. Find out more at: psnc.org.uk/cd
FP10DT Token Electronic Prescription Service (EPS) Release 2 Dispensing Token.
Drug Tariff Copies of the Drug Tariff are sent out every month to all pharmacy contractors in England. Some pharmacy teams find it useful to use the online version which can be accessed from the PricingAuthority’s website. We have created a shortlink for quick access: psnc.org.uk/dt
Useful links:• The portal can be accessed via the PCSE website: pcse.england.nhs.uk/pharmacies
• A step-by-step guide to ordering supplies can also be found on the PCSE website: pcse.england.nhs.uk/howtoorder - all
supplies orders will be delivered by CitySprint, operating on planned daily routes on a weekly schedule.
• For further help or information, please visit their FAQ page: pcse.england.nhs.uk/help
• Alternatively, you can contact PCSE by emailing [email protected] or via their website: pcse.england.nhs.uk/contact
• If your enquiry is urgent, you can telephone the PCSE customer service centre on 0333 014 2884.
NHS stationery for community pharmacyobtainable from the PCSE portalThis guide highlights which pharmacy resources are now managed by
Dispensing anD supply services anD commissioning the healthcare lanDscape
How to avoid prescription returnsPSNC’s Dispensing and Supply Team explains how
community pharmacy teams can avoid prescriptions
being returned for clarification.
Approximately 0.16% of prescriptions are returned by the Pricing Authority to pharmacy
teams each month for clarification. The majority of these prescriptions are returned because
of insufficient or unclear endorsements. To try and help reduce the number of returned
items, we have compiled a list of common issues for pharmacy staff to be aware of (Please
Note: this list is not exhaustive).
Issue Examples of the issue How to avoid them
A branded product ismarketed by multiplesuppliers
Dianette tablets are manufactured by Bayer Plcbut are supplied to Mylan under third partylivery. When a prescriber issues a brandedprescription for Dianette tablets, a pharmacistcan dispense either the Bayer or Mylan product.
Endorse the name of the supplier as per thepackaging. Go to our page psnc.org.uk/returnsfor a list of products known to be affected bythis issue. Please note: If the prescription is resubmittedwithout the required endorsement,reimbursement will be made based on thebranded product with the lowest price (as perPart II Clause 7C of the Drug Tariff).
Generic prescription forinhalers which include atrademarked name e.g.Accuhaler or Easibreathe
The pharmacy should dispense the proprietaryproduct which meets this description andendorse the prescription accordingly.
No pharmaceutical formlisted on the prescription
• Paracetamol 120mg/5ml sugar-free – thiscould be requesting either oral solution orsuspension
• Metronidazole 200mg PO – this could berequesting either tablets or suspension
Speak to the prescriber to confirm the form tobe supplied and endorse the prescriptionaccordingly using the “PC” endorsement. Please note: If a Schedule 2 or 3 ControlledDrug prescription item has no form, this mustbe returned to the prescriber for amendment.
Total quantity not stated butclear from dosageinstructions
A prescription which states ‘Take 1 tablet TDS forone week’ but does not include a total quantity
Endorse the total quantity dispensed.Please note: If a Schedule 2 or 3 ControlledDrug prescription item has no total quantitystated, this must be returned to the prescriberfor amendment.
Endorsement of non-PartVIIIA generic products
A prescription calls for Diltiazem 120mgmodified-release capsules and Adizem wasdispensed against this; the endorsement willneed to specify whether Adizem-SR or Adizem-XL capsules are being dispensed as both meetthis generic description.
Endorse the following information:• pack size used to dispense from;• brand name or the name of the manufacturer
or supplier from whom the product waspurchased;
• if the product is less common, the purchaseprice before discount (ex VAT).
Dypiridamole 200mg/5ml oral suspension has been
removed from Part VIIIB of the Drug Tariff. This is because
a licenced alternative, Dypiridamole 200mg/5ml oral
suspension sugar free, is now available and has been
added to Part VIIIA effective from 1st June 2016.
Changes to the Drug Tariff impact on reimbursement so
it’s important to take note when amendments are made
to product listings.
The PSNC Dispensing and Supply Team is currently in the process of
updating their section of the PSNC website.
The updated ‘Where to obtain external resources’ page outlines
how to source commonly required resources for community
pharmacy teams.
Head over there now: psnc.org.uk/external-resources
Also, a list of NHS stationery for community pharmacy obtainable
from the Primary Care Support England (PCSE) portal is on page 9.
Dypiridamole 200mg/5ml oral suspensiondeleted from Part VIIIB
Have you seen our updated external resourceswebpage?
psnc’s work funDing anD statistics contract anD itlpcs
Ask PSNCThe PSNC Dispensing and Supply Team can provide pharmacy teams with
support and advice on a range of topics related to the Drug Tariff and
reimbursement. Questions asked in recent months have included:
Q. I heard newprescription chargeexemption checksare coming in soon -what do I need to do?
A. From 1st July 2016, the Terms of Service will require community pharmacy teams to informpatients claiming exemption from prescription charges without presenting any evidence ofentitlement about the exemption checks and action on inappropriate claims that the NHS takes.
Look out for more information on the PSNC website: psnc.org.uk/exemption
When pharmacy teams receive NHS prescriptions, they must check whether the items prescribed are allowed on the NHS before dispensingotherwise the pharmacy contractor may not be paid for them. Below is a list of some products that we have recently received queries about.
Product Is the item Is it Does it Can it be Additional listed in the in the have a ‘CE’ dispensed information Drug Tariff? blacklist?* mark? on an FP10?
*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.
Can it be dispensed on an FP10?
Canespro fungal nail
treatment set
SteriSets Newcastle Urine
Collection Pack
Bladder irrigation syringe
100ml
Lemon Glycerin swabsticks
75 sachet
No
No
Yes
No
Yes
Yes
Yes
Yes
n/a
n/a
n/a
n/a
No
No
Yes
No
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 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.
This item is a medical device (CE marked) and is not listed
in Part IX of the Drug Tariff.
Q. I have received a prescription for twoitems, one is a tablet and the other an eyedrop but the prescriber has not writtenthe quantity on the prescription. However,there are directions on the prescription,can I use these to calculate what quantityto dispense?
A. For the tablets, you can calculate the exact quantity using the directions, e.g.take one tablet twice a day for a month = 84, and endorse accordingly. You willbe paid based on your endorsement.
For the eye drops, you will have to use your professional judgement to decidehow many bottles would be appropriate to meet the requirement. Again,reimbursement would be based on your endorsement. N.B. a month's supply is taken as 28 days unless indicated otherwise.
Q. When resubmittingreturned prescriptions,how do I record themon my FP34c andwhere in my bundleshould they be placed?
A. The number of returned forms and items being resubmitted should be declared with the currentmonth’s figures, in the relevant boxes in Part 1 of the FP34c Submission Document. Whenresubmitting in the next month’s prescription bundle, these returned forms should be sorted at thetop of the ‘exempt’ or ‘charge paid’ group as appropriate.
Please remember only the number of items returned for clarification should be declared on thesubmission document. This is because payment will already have been received for any other itemson the returned forms.