CPNCommunity Pharmacy News – April 2016

Pharmacy gets behind the campaignFind out how community pharmacies across England have been

helping the campaign for pharmacy’s future

How to report EPS issues | Ask PSNC | Next stage of Leadership Academy

2 Community Pharmacy News – April 2016

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On the campaign trailLPCs and community pharmacy teams across the country have been

working hard to support the campaign for the sector’s future. Here are

details of just some of the work we’ve heard about.

COMMUNITY SPIRIT BOOSTS SIGNATURE NUMBERS

Nearly 2,000 people have already signed the Downing Street petition in support o

f

pharmacy services at Allison & Sons Pharmacy in Cockermouth. Pharmacist Nat Mitchell

and his team have found the support from patients and their local community

overwhelming.

“People have come into the pharmacy specifically to sign the petition,” says Nat, who

goes on to explain that locals are hearing about the campaign from their friends,

relatives and neighbours. It was even a regular patient who wrote to the local newspaper

which led to the regional TV station, ITV Border, running a piece on

it.

Whilst Nat has found the situation “frustrating as we think we’re doing a good job and

then this happens,” he has realised that the key is to raise awareness of the work

community pharmacy teams do behind the scenes for patients. He has arranged to talk

to a business group and has previously spoken to sixth-formers to try and highlight the

role of pharmacy.

Patients often tell the team that the pharmacy is more like a community centre; for some

of them, it’s a part of their social life, and you can’t put a price on that. Na

t is clear that

“we rely on patients just as they rely on us,” so he encourages all com

munity pharmacy

teams to fight back by talking to their patients and engaging them in the campaign.

The national picture

350,000signatures forthe DowningStreet petitionby 1st April

More than10,000 tweetswere sent

using the #pharmacy24hashtag during the social mediaaction day (24th March)

Over 100 patient case studies

recorded by the NationalPharmacy Association

161 radio stationscovered the storyon the campaignmedia day (22nd March)

Consultation

period extendedThe Department of Health (DH)

has confirmed its consultation

on community pharmacy in

2016/17 and beyond is extended

until 24th May 2016. Pharmacy

minister Alistair Burt said the

extension of the consultation

would give more time for DH to

develop its proposals working

with PSNC and informed by

other stakeholders. The

extension is welcomed by

PSNC who are seeking to

understand more about the

plans and to ensure that

community pharmacy’s role is

recognised and developed.

psnc.org.uk 3

services anD commissioning the healthcare lanDscape lpcsDispensing anD supply

Keep up the good work!PSNC and the other national pharmacy organisations would like to thank community pharmacy teams and LPCs for all their hardwork so far, but please continue to raise awareness by:

Backing the Downing Street petition: ask patients to sign the petition and direct them to supportyourlocalpharmacy.org(materials can be download from that website).

Sharing case studies: collect examples that demonstrate where you have offered exceptional care to patients. These can beemailed to your LPC or campaign@psnc.org.uk.

Posting on social media: share anything you like to show how much of a positive difference you are making to your patientsand don’t forget to use the hashtag #lovemypharmacy.

Press coverage helps securelocal council supportAfter reading about the plight of localpharmacies in The Yorkshire Post, onecouncillor was determined to get behind thecampaign and, at the end of March, Leeds CityCouncil passed a motion in support ofcommunity pharmacies, promising to defendthis vital resource from ‘counter-intuitive’Government proposals.

It was Councillor Stewart Golton who putforward the motion after visiting GarnersPharmacy in the Rothwell area of Leeds. Duringhis visit Cllr Golton was shown how theDepartment of Health’s plans would affectpharmacy and patients. He also spoke toCommunity Pharmacy West Yorkshire’s ChiefOfficer Robbie Turner about the ‘Support YourLocal Pharmacy’ campaign.

Leeds City Council now plans to respond to theGovernment's consultation and write to the

pharmacy minster to set out its specificconcerns. Council members are also calling onLeeds MPs and other local government teamsto join them in their mission to protect this vitalservice.

Cllr Golton said: “As a member of the localHealth and Wellbeing Board with a keen interestin the prevention of ill health, I think localpharmacies are the key to the future of publichealth. Pharmacy should be the first port of callas it is the most accessible healthcare provider.

But when I read about these plans, I thoughtthey were counter-intuitive: whilst on the onehand saying local pharmacies having animportant role, these proposals will take themout of the very communities that rely on them.This is the same as what happened with thepost offices – it’s a death knell for the highstreet.”

When Northern, Eastern andWestern Devon ClinicalCommissioning Group (CCG)wanted to create a newsletterarticle reminding the publicabout community pharmacyservices available over Easter,they turned to Devon LPC. Keento make the most of thisopportunity, Bootsrepresentative Tom Kallisworked with the CCG to developa ‘day in the life of apharmacist’ piece.

Tom’s prior involvement with aBBC Radio Devon showdiscussing what the cuts willmean for local pharmacies and

their communities inspired theidea to further bring attention tothe work involved in communitypharmacy. He decided hewanted to outline exactly what a‘typical’ day might look like for apharmacist so people wouldunderstand what they wouldmiss if their pharmacy was nolonger there. The article hassince been published on theCCG’s website (dld.bz/eyc2c),leading to further attention viasocial media.

Leading on from the success ofthe article, LPC Chief Officer SueTaylor has organised a visit to apharmacy in Chagford, central

Devon, with a local BBCjournalist to go one stagefurther and show them a ‘day inthe life of a communitypharmacy’, with an emphasis onhow their day to day worksupports their rural community.

Tom has seen first-hand howuseful local media can be as acampaigning tool and his topcampaign tip for LPCs is to builda relationship with your localmedia providers. In particular,Tom suggests learning theirnews cycles as experience hastaught him, “they willt behungry for press releases duringtheir quieter periods”.

Working with CCG creates promotional opportunity

4 Community Pharmacy News – April 2016

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Community pharmacy regulations updateThe regulations governing the NHS

community pharmacy contract must be

followed by all contractors so it is

important to be aware of any amendments

made and when they come into effect.

Pharmacy premises standards

The Pharmacy (Premises Standards, Information Obligations, etc) Order

2016 came into effect on 12th April 2016. This enacted a number of changes

surrounding the setting of standards for the safe and effective practice of

pharmacy, and for the enforcement of those standards.

Key amendments to The Medicines Act 1968 and Pharmacy Order 2010

include:

• the removal of the requirement for the General Pharmaceutical Council

(GPhC) standards for registered pharmacy premises to be set in rules;

• applying the standards to the delivery of pharmacy services as well as to

pharmacies;

• revising the sanctions which the GPhC may use where pharmacy owners

breach the standards;

• introducing the use of interim suspension orders by the GPhC against

pharmacy owners when that is in the public interest;

• changes to the GPhC’s powers to gather information from pharmacy

owners; and

• clarity as to what information the GPhC may publish in its reports of

pharmacy inspections*.

*The GPhC can publish reports of the inspections and other visits that its inspectors make, andthese reports may include an account of the outcomes of such inspections and visits.

NHS stationery ordering portalPrimary Care Support England's (PCSE) online portal for ordering NHS stationery has gone live, and all community pharmacy

contractors should have received registration letters. If any queries arise, the PCSE website has a number of helpful FAQs:

pcse.england.nhs.uk/help

One query that has been raised a number of times is "Will I be charged for my order?" This question has arisen because the

online ordering portal includes prices for many of the items. As stated in the relevant FAQ, contractors will not be charged for

standard orders made using the portal. PCSE is committed to ensuring NHS England supplies are ordered responsibly and for

this reason, prices for items are included to help contractors make an informed decision about what they need. (Note, there may

be a charge for urgent supplies.)

The Department of Health and the Medicines and Healthcare products Regulatory Agency (MHRA) have launched a consultation on

changes to the Human Medicines Regulations and the Medicines Act.

The consultation, which runs until 17th May 2016, seeks views on allowing independent pharmacies to make use of 'hub and spoke'

dispensing models. Additionally, the consultation seeks views on publishing the price of medicines on dispensing labels. It also seeks to

clarify the current dispensing label requirements for monitored dosage systems and medicines supplied under Patient Group Directions.

Find out more about the consultation at: dld.bz/ew9kk

Hub and Spoke consultation launched

Changes to incorporate SCR accessand NHS fraud checkingCommunity pharmacy contractors should be aware of

the following amendments to the NHS (Pharmaceutical

and Local Pharmaceutical Services) Regulations 2013:

Summary Care Record

From 1st April 2016, the Terms of Service require

community pharmacists who have access to the

Summary Care Record (SCR) to access this if they

consider, in their clinical judgment, that it is in the best

interests of the patient to do so.

Guidance on accessing the SCR can be found at:

dld.bz/eus2v

Prescription charge exemption anti-fraud measures

From 1st July 2016, anyone who does not produce

evidence of their entitlement to exemption from NHS

prescription charges must be informed by a member of

the community pharmacy team that NHS checks are

routinely undertaken to verify exemptions.

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Reporting EPS issuesCommunity pharmacy teams will sometimes experience issues with the

Electronic Prescription Service Release 2 (EPS R2) system. Here we explain

all you need to know about reporting these issues.

All EPS system issues need to be reported to pharmacy system suppliers. In some cases, the problem may be resolved over the phone,

for example, if it is a training or local IT system configuration problem. In other cases, the supplier may need to add it on to their

work-plan as a future development.

Where the supplier is unable to resolve a problem due to it being outside of their control – for example, if it is an issue with the GP

system or with national IT infrastructure – the pharmacy supplier should:

(a) escalate the issue to the Health and Social Care Information Centre (HSCIC)'s National Service Desk (NSD) to co-ordinate

resolution; and

(b) report progress back to the pharmacy, including providing the HSCIC national incident number (NIN).

This diagram illustrates how the EPS service model operates:

TOP TIP: When reporting an EPS issue to your system supplier, ask for a helpdesk reference number. If the supplier does

not resolve the problem in a satisfactory way, the reference number is required to escalate the problem via other routes.

Alerts

Register to receive text or

email alerts in the event

that the national HSCIC

systems supporting

EPS are experiencing

issues at: tinyurl.com/Spinealerts

Checker

Visit the HSCIC service

status checker webpage

(Smartcard required) for

the status of national

systems at:

tinyurl.com/EPSchecker

Tracker

Find information on

the status of individual

prescriptions using the

EPS Prescription

Tracker at:

tinyurl.com/EPStracker

How to identify issues with the national EPS systems

Electronic

Prescription

Service

GP systemsupplier

HSCIC Spineteam

Escalation andcomplaints

nhs.uk

N3

NSD coordinates withrelevant parties

Smartcardissues

EPS issues

Higher SeverityServices Incident

(HSCIC ServiceBridge)

National Service Desk (NSD)

Message handler ofpharmacy system

supplier

Problems with accessingservices from your

Registration Authority (RA) -see psnc.org.uk/ra

Pharmacy

System supplier

– note helpdesk

reference

number

Pharmacy

team need to

report EPS

national/local

or system issue

PSNC recommends pharmacy staff use the following three EPS tools:

6 Community Pharmacy News – April 2016

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PSNC’s leadership development programme for LPCs began last month

and here we find out what two trainees have been up to so far.

Andy Beardshall Vice Chair of Barnsley LPC, Andy Beardshall, hopes that the

PSNC Leadership Academy programme will guide him on how

to make the most of his role so he can better represent

community pharmacy contractors.

Compared to some LPCs, Barnsley is quite small so Andy has

found it difficult to bounce ideas off others and is therefore

eager to use this opportunity to gain insight and help drive

him, and his LPC, forward.

During the first training session on 3rd March, Andy says he

was inspired by the others in the group and has already taken

forward an idea for LPC members to visit contractors prior to

each LPC meeting.

Course leader Rachel Harrison has also given Andy

personalised support and helped him to develop a strategy

plan as part of his one-to-one coaching session in preparation

for the next training session later this month. Andy’s goal is to

become an LPC Chair or Chief Officer and, one day, hopes to

be elected a PSNC Regional Representative.

Sarah WoodWhen the PSNC Leadership Academy programme was announced,

Bury and Rochdale LPC’s Sarah Wood was intrigued and – with a little

encouragement from her LPC Chair and Chief Officer – she applied.

Sarah found comparing different leadership styles during the

training session really useful and found it reassuring to discover that,

whilst every LPC was different, they were all facing the same

challenges.

Public speaking is an area Sarah has identified as needing

improvement and she has begun looking for opportunities to

practice. Sarah’s first step was to give a talk about her pharmacy

career at a University of Manchester alumni event and she was

delighted to receive positive feedback, including the event organiser

posting an endorsement on her LinkedIn page.

During her one-to-one session, Sarah found course leader Rachel’s

coaching style helped her consider what she needed to do to achieve

her goals and create a plan, making her feel more confident in her

own abilities. Sarah sees herself moving into an LPC leadership role in

the next year or two.

LPCs supported by PSNC media trainingAs the campaign for community pharmacy digs in for the long term, LPCs need to use the media effectively to keep up the

pressure and maintain interest – as well as responding quickly when approached for an interview or comment.

To help make sure LPCs have the necessary skills to handle media and get the best coverage for contractors, PSNC

commissioned leading communications agency Luther Pendragon to provide training specific to running and managing a local

campaign. During February and March, training was held in the north of England, the Midlands and London.

For the latest news on the work your LPC is doing to support your interests in this challenging time, check out your LPC

website via our portal: lpc-online.org.uk

138 patients helped by anticoagulant service in 6 months

Six months after the launch of Swindon’s New Medicine Service (NMS) anticoagulant referral service

with Great Western Hospital, 138 patients have been referred into the service.

When Fiona Castle, Chief Officer of Swindon and Wiltshire LPC, delivered a presentation to GPs

promoting the role of community pharmacy teams in supporting patients prescribed anticoagulants, it

served to highlight that many were not receiving an NMS because they were not being referred by the

hospital team. Fiona approached Great Western Hospital about this and the LPC worked closely with

the hospital team to develop an NMS referral service for patients who were prescribed anticoagulants.

In 15 cases so far, the pharmacist reported that the interaction had improved the patient’s knowledge, confidence or ability to

continue taking their medicine and nearly all of the pharmacies involved have found the referral process useful.

The first step towards leadership

psnc.org.uk 7

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The Mental Capacity Act

The Centre for Pharmacy Postgraduate Education (CPPE) is working to guide and advise pharmacy

professionals in supporting patients who lack capacity to make particular decisions.

We have developed a new workshop – The Mental Capacity Act 2005 and covert administration of

medicines.

The General Pharmaceutical Council (GPhC) Guidance on Consent states ‘Every adult is presumed to have

capacity to make their own decisions (that is, they are competent) and to give consent for a service or

treatment unless there is evidence to suggest otherwise.’

However, some adults may permanently or temporarily lack capacity to make these decisions. The Mental

Capacity Act 2005 provides a legal framework for people who lack capacity to make decisions for

themselves. It sets out who can take decisions, in which situations, and how they should go about this. The

Act is intended to be enabling and supportive of people who lack capacity, not restricting or controlling of

their lives. It aims to protect people who lack capacity to make particular decisions, but also to maximise

their ability to make decisions, or to participate in decision-making, as far as they are able to do so.

Pharmacy professionals and their teams in the community might encounter situations concerning mental capacity during their

practice and an area where this can be challenging and discussions can be difficult is the covert use of medicines.

Our new workshop The Mental Capacity Act 2005 and covert administration of medicines will offer you the opportunity to work

through various covert administration scenarios where patients may have permanent or temporary lack of capacity. You will have

the opportunity to discuss these scenarios with your peers and also to be given guidance from a local expert.

If you are not familiar with the five statutory principles that underpin and your responsibility to comply with the Mental Capacity Act

2005 you would benefit from attending one of our local workshops. You can book your place on our website: www.cppe.ac.uk.

Paula HigginsonLead Pharmacist,

Learning Development

Pharmacy services: recently published resources

“

”

Healthy Living Pharmacy infographics

Public Health England (PHE) has

published a set of infographic slides to

illustrate the role of HLPs in the health

and care system.

The three infographic slides aim to

explain what an HLP is by highlighting

the features that make up an HLP,

using statistics to demonstrate the

impact that they are having across the

country, and providing the total

number of HLPs and qualified health

champions across England.

The infographics can be downloaded

from: dld.bz/ewNyF and further

information on HLPs can be found at:

psnc.org.uk/hlp

LGA highlights role of pharmacy

The Local Government Association (LGA) has

published The community pharmacy offer for

improving the public’s health, a briefing for

councillors and commissioners, describing the

increasing role of community pharmacy in public

health and explains councils’ roles and duties.

A number of case studies are included within the

briefing that demonstrate the variety of

collaborative approaches taken by community

pharmacies working with councils and other

community partners, as well as key information

on Healthy Living Pharmacies (HLPs) and the

approach of Making Every Contact Count to

improve health and reduce health inequalities.

The briefing can be downloaded from:

dld.bz/ewNWy

NHS Standard Contract 2016/17

NHS England has published the

following documents which may be of

interest:

• NHS Standard Contract 2016/17;

• NHS shorter-form Contract 2016/17

(for use in defined circumstances);

• NHS Standard Contract 2016/17

Technical Guidance (providing an

overview of the key changes which

have been made);

• Sanctions reporting template;

• Sustainability and Transformation

Fund Service Development

Improvement Plan template; and

• Equality Impact Analysis.

Find out more at:

tinyurl.com/NHScontract201617

All details correct at time of printing.

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

Produced for PSNC by Communications International Group. ©. 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.

Communications International Group

Linen Hall, 162-168 Regent Street, London W1B 5TB

Tel: 020 7434 1530 Fax: 020 7437 0915

Distributedfor PSNC by:

8 Community Pharmacy News – April 2016

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PSNC regularly receives questions from LPCs and

pharmacy contractors about what is going on in the

wider health and care landscape beyond community

pharmacy. For a more comprehensive round-up,

please visit: psnc.org.uk/hclbriefings

In the news• The NHS Diabetes Prevention

Programme, the world’s first such

scheme, is due to start its first wave.

Across 27 areas, there will be 20,000

places available, rising to an expected

100,000 places to be made available

across the whole country in subsequent

years.

• Public Health England (PHE) is

supporting the creation of ten ‘healthy

new towns’ as test sites across the

country, potentially covering 170,000

residents from more than 76,000 new

homes.

• NHS England has allocated £55 million

to reward GPs and hospitals to make

digital referrals by 2018 and end the

practice of referring via post. At the

moment, around 50% of patients are

referred for hospital appointments

electronically, but it is intended for this

to increase rapidly to 100% by 2018.

Evaluations and statistics• PHE’s latest figures show that alcohol-

related deaths such as heart disease and

certain cancers, have increased from the

years 2012 to 2014, but alcohol-specific

deaths have decreased by 3%. This data

comes from PHE’s Local Alcohol Profiles

for England (LAPE) tool.

• The introduction of financial incentives

in April 2015 by NHS England and PHE

has seen antibiotic prescribing fall by

two million, in comparison to the same

period in 2014.

• The research paper, Estimating the

population impact of e-cigarettes on

smoking cessation in England, suggests

that 2.5% of the smokers who used an e-

cigarette in their quit attempt

succeeded, would have failed if they had

used nothing or used a licensed nicotine

product.

Useful resources• The National Institute for Health and

Care Excellence (NICE) has published its

Medicines optimisation quality standard

(dld.bz/ewMRg). NICE quality standards

describe high-priority areas for quality

improvement in a defined care or

service area, drawing on existing

guidance, which provides an

underpinning, comprehensive set of

recommendations.

• PHE has published its fourth edition of

Health Matters (dld.bz/ewMRq),

focussing on midlife approaches for

reducing the risk of dementia. The PHE

resource includes a wealth of

information, plus a pack of infographics

to help when highlighting the risks of

dementia in local areas.

• The House of Commons Library has

published a briefing, The structure of the

NHS in England (dld.bz/ewMRB), which

provides an overview of the funding and

accountability relationships under the

new system, and an introduction to the

roles of key organisations.

• NICE has published a guideline covering

community engagement approaches

(dld.bz/ewMR3) to reduce health

inequalities, ensure health and

wellbeing initiatives are effective and to

help local authorities and health bodies

meet their statutory obligations.

• PHE has published Child Health Profiles

2016 (dld.bz/ewMR7) to present data

across 32 key health indicators of child

health and wellbeing. They are designed

to help local authorities and health

services improve the health and

wellbeing of children and tackle health

inequalities.

20,000 places tobe made availablenationwide in NHSDiabetes PreventionProgramme

Alcohol-specific deathshave decreased by 3%between 2012 and 2014

Antibiotic prescribing hasfallen by 2 million since

the introduction offinancial incentives

£55 million allocatedby NHS England toencourage GPs andhospitals to make digitalreferrals by 2018

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contract anD it Dispensing anD supply services anD commissioningfunDing anD statistics

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

Popular factsheetsThe following are PSNC’s most popularfactsheets. Community pharmacy teamsmay find these useful to print them outfor future reference:Checking Prescription Exemption Status(dld.bz/d9pYc)National target Groups for MURs(dld.bz/ewZTR)NMS Medicines List (dld.bz/ewZTW)Community Pharmacy Value Flyer(dld.bz/esSkb)

Do you report your dispensing figures to your accountants each month?Set them up on Check34 and let their fingers do the walking.

Set up a regular financial report for your business at: www.check34.com

Understand your NHS business better with Check34Not yet got an account? Email check34admin@psnc.org.uk for more information.

Error with some EPS R1 prescriptionsPSNC has been made aware of an error with the Electronic Prescription Service(EPS) that allowed some GP practices to send Schedule 2 and 3 Controlled Drugorders via Release 1 (barcoded) prescriptions, which should not occur.

The relevant GP system has implemented a fix, but if you are presented with anaffected prescription:

dispense the prescription as if it had been a paper one – the paper element is thelegal one and both words and figures appear on the physical prescription; and

avoid scanning the barcode, but if you do, this will not cause an issue.

Useful links for NHS IT informationpsnc.org.uk/sc

This section of the PSNC website contains

a summary of the national arrangements

for NHS Smartcards and information about

how to administer them.

psnc.org.uk/scrlist

This links straight to PSNC’s Summary

Care Record implementation checklist.

psnc.org.uk/epstime

This links straight to PSNC’s “Understanding the

EPS payment schedule” factsheet.

Want to share something fromPSNC's website with your colleagues?Our new social media buttons make it

so much easier

Look out for these buttons

10 Community Pharmacy News – April 2016

Dispensing anD supply services anD commissioning the healthcare lanDscape lpcs

Changes regarding prescription pre-payment certificates

Community pharmacy teams should be aware that the

change to the NHS prescription charge also has an impact on

PPCs; patients may ask you about what this means for them.

Following last month’s announcement that the NHS prescription charge will increase to £8.40 per item from 1st April 2016, the April 2016

Drug Tariff also highlights a change regarding prescription pre-payment certificates (PPCs).

Although the cost of a PPC remains at £29.10 for three months and £104 for 12-months, the Drug Tariff (Notes on Charges) now states:

“They are worthwhile for anyone requiring 13 or more items in 12 months or 4 or more items in three months. For the convenience of

patients, pharmacists are asked to hold PPC application forms FP95 (which are also available from 0300 123 0849).”

Pharmacy teams may want to highlight this information when discussing PPCs. Find out more at: psnc.org.uk/externalresources

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 contractor may not be paid for them.

Pharmacy teams may wish to check PSNC’s ‘Dispensing on an FP10 database’ (available at: psnc.org.uk/FP10database) for more information on

whether an item can be dispensed on an FP10. Below is a list of some products that we have recently received queries about.

Product Is the item Does it Is it Can it be Additional listed in the have a ‘CE’ in the dispensed information 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?

XLS-Medical Fat Binder

Tablets

Allergenics Skin lotion

Oralieve moisturising

mouth gel

Acticoat Absorbent

dressing 10cm x 12.5cm

rectangular

No

No

Yes

No

n/a

No

n/a

n/a

Yes

No

Yes

Yes

No

Yes

Yes

No

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

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 appears in

Part IX of the Drug Tariff.

This item is a medical device and is no longer listed in Part

IX of the Drug Tariff.

Pharmacy teams who experience problems in obtaining medicines (generic or branded)

or appliances are reminded to feed this back to our Dispensing and Supply Team, to

support PSNC’s ongoing representation of issues in the supply chain.

PSNC passes a monthly summary of the feedback received to the Department of Health

to support their monitoring of the situation. This information is also used as an evidence

base in discussions with manufacturers on manufacturer-specific problems, for example,

highlighting problems with contingency arrangements and promoting solutions.

Please make sure you let us know about any supply issues by using our online feedback

forms at: psnc.org.uk/feedback

Experiencing supply issues? Establishment andPractice PaymentsThe current Establishment andPractice Payment levels have beenextended until 30th June 2016.Pharmacies dispensing more than2,500 items per month will continue toreceive an Establishment Payment plusa Practice Payment of 56.4p per item.

Find out more at: dld.bz/exnBh

1. A patient has presented a prescription for two items but says

they only one; how should I mark the item Not Dispensed?

Where an item is not dispensed, it must be clearly annotated to

ensure prescriptions are correctly priced by the Pricing Authority.

For paper prescriptions — endorse “ND” in the left hand

endorsement column and score through the item in the

prescribing area completely (see diagram below). Please note

that if the item is not scored through completely it could

potentially be read by the Pricing Authority's intelligent character

recognition software, which could lead to an overpayment. Any

overpayments made could be recovered from your account if it is

re-checked or audited.

For EPS Release 2 prescriptions — use your PMR system to apply

the “ND” endorsement to the electronic message. If you are

unsure how to do this, you should speak with your system

supplier. Please note that it is not correct practice to mark a

dispensed quantity of zero, and mark such an item as dispensed.

2. A patient has presented a prescription for '28 x 5mg tablets'.

The 5mg strength is unavailable as it is in short supply; however,

I do have '56 x 2.5mg tablets' in stock. As this is the same

amount of drug i.e. 5mg which can be administered at the

prescribed dose by doubling the number of tablets; can I

dispense 56 x 2.5mg tablets against this prescription instead?

No. It is part of the Terms of Service that community pharmacy

contractors must, with reasonable promptness, “provide drugs so

ordered” once a prescription has been presented. “Drugs” includes

medicines e.g. the tablets. In this scenario, the patient has

presented a prescription for 28 x 5mg tablets and therefore

supplying 56 x 2.5mg tablets would not be providing the drugs

“so ordered”.

If you intend to dispense 56 x 2.5mg tablets then the prescription

would need to be amended or a new prescription would need to

be issued by the prescriber at the prescriber’s discretion. It would

also be essential to ensure the patient understands the different

dosage to be taken if there were an amendment to their

prescription.

3. I have received a prescription for Sando-K effervescent tablets

which comes as a pack of 100 in tubes of 5 x 20 tablets. If I

receive a prescription for 20 tablets can I claim broken bulk for

the 100 tablets?

No; Sando-K effervescent tablets have a special container status,

and as such, you cannot claim broken bulk (BB) on special

containers. In this scenario, the sub-pack of 20 is a special

container and falls under the special container rules therefore,

you will be reimbursed for 20 tablets.

4. How do I make a broken bulk claim on an EPS R2 prescription?

Your pharmacy system should enable you to make a broken bulk

(BB) claim through manual endorsement against the item during

the dispensing process. If you are unclear on how to do this, refer

to your pharmacy system manual or speak with your pharmacy

system supplier for guidance.

Look out for more frequently asked questions next month…

psnc.org.uk 11

psnc’s work funDing anD statistics contract anD itlpcs

Ask PSNCThe PSNC Dispensing and Supply Team can provide 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 info@psnc.org.uk).

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: mmabbutt@psnc.org.uk © PSNCPSNC Office: 0844 381 4180 or 0203 122 0810

Removal from Part VIIIBSodium chloride 292.5mg (1mmol/ml) oral solution has been removed from Part VIIIB of the Drug Tariff as of 1st March 2016.There is now a listing for a licensed alternative, Sodium chloride 292.5mg (1mmol/ml) oral solution sugar free 100ml which canbe found in Part VIIIA as a Category C line.

ND

Number of days’ treatment

N.B. Ensure dose is stated

Endorsements

NHS Number:

Omeprazole 20mg dispensiblegastro-resistant tablets28 tabletsTake one daily

Dispensing anD supply services anD commissioning the healthcare lanDscape

Drug Tariff WatchThe Preface lists additions, deletions and alterations to the Drug Tariff. Below is a quick summary of

the changes due to take place from 1st May 2016. You may also wish to see our Dispensing Factsheet:

The Drug Tariff Preface at psnc.org.uk/dtresources

Part XVI – Notes on charges

Please see the article about prescription

pre-payment certificates on page 10.

Part VIIIA additions

SC Special Container

Category A Additions:

• Midazolam 10mg/2ml solution for

injection ampoules (10)

Category C Additions:

• Aripiprazole 1mg/ml oral solution

(150ml) – Abilify

• Denosumab 60mg/1ml solution for

injection pre-filled syringes SC (1) –

Prolia

• Ibuprofen 200mg capsules (30) –

Nurofen Express

• Lidocaine 2.5% / Prilocaine 2.5% cream

SC (30g) – Emla

• Lithium carbonate 400mg modified-

release tablets (100) – Priadel

• Propranolol 10mg/5ml oral solution

sugar free (150ml) – Syprol

• Propranolol 40mg/5ml oral solution

sugar free (150ml) – Syprol

• Propranolol 5mg/5ml oral solution sugar

free (150ml) – Syprol

• Propranolol 50mg/5ml oral solution

sugar free (150ml) – Syprol

• Sodium alginate 500mg / Potassium

bicarbonate 100mg chewable tablets

sugar free (60) – Gaviscon Advance

• Sodium valproate 100mg modified-

release granules sachets sugar free

(30) – Epilim Chronosphere

• Sodium valproate 1g modified-release

granules sachets sugar free (30) – Epilim

Chronosphere

• Sodium valproate 1g modified-release

granules sachets sugar free (100) –

Episenta

• Sodium valproate 200mg modified-

release tablets (100) – Epilim Chrono

• Sodium valproate 250mg modified-

release granules sachets sugar free

(30) – Epilim Chronosphere

• Sodium valproate 300mg modified-

release tablets (100) – Epilim Chrono

• Sodium valproate 500mg modified-

release granules sachets sugar free

(30) – Epilim Chronosphere

• Sodium valproate 500mg modified-

release granules sachets sugar free

(100) – Episenta

• Sodium valproate 750mg modified-

release granules sachets sugar free

(30) – Epilim Chronosphere

• Tamoxifen 10mg/5ml oral solution sugar

free (150ml) – Soltamox

• Verapamil 40mg/5ml oral solution sugar

free (150ml) – Zolvera

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 as

long as the product does not appear in

Part XVIIIA (the ‘Blacklist’)–but it will need

to be endorsed fully (i.e. brand or supplier

name and the pack size from which the

item was dispensed).

• Co-phenotrope 2.5mg/0.025mg tablets

(100) Category C – AMCo

Part IX deletions

Remember, if you dispense a deleted appliance, payment will not be made for dispensing the item.

Product Size, type and product code

HydroSil rose catheter Female, CH8 (71408)

Acticoat Absorbent dressing 2cm x 30cm

Tegaderm Hydrocolloid dressing Square, 15cm x 15cm

Tegaderm Contact dressing 7.5cm x 20cm

Cutimed Sorbact Hydroactive B dressing 20cm x 20cm

Duratouch dressing 5cm x 7cm, 8cm x 10cm and 12cm x 15cm

Accuseal leg bag extension tube S455

Biotrol Elite colostomy bag with filter Transparent, 30mm (30-830) and White, 60mm (32-860)

Biotrol Elite Petite colostomy bag with filter Beige, 30mm (37-330) and 40mm (37-340)

Biotrol Integrale colostomy bag with filter White, 30mm (32-430)

Biotrol Almarys Preference colostomy bag with filer Beige, 35mm (F008335E)

Biotrol Almarys Quiet colostomy bag with filter Beige, 45mm (F008145E) and 60mm (F008160E)

Welland FreeStyle Flushable colostomy bag with Dual-Carb filter All sizes

Biotrol Almarys Optima Drainable bag Beige, 30mm (F008730E), 35mm (F008735E) and 40mm(F008740E)

Biotrol Almarys Optima Drainable bag with filter Beige, 25mm (F009525E)

Biotrol Elite ileostomy bag Beige, 50mm (38-850) and White, 40mm (34-840) and 45mm(34-845)

Biotrol Elite Petite ileostomy bag Beige, 25mm (37-725)

Softima drainable pouch with filter Beige, 32mm (043732E), 36mm (043736E) and 45mm (043745E)

Softima Key two piece ostomy system (Drainable Pouch with filter) Transparent, 40mm (63440E) and 60mm (63460E)