december 2014 cpn
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CPNCommunity Pharmacy News – December 2014
New MUR target group goes live from JanuaryDirections signed for cardiovascular risk group
Are you an Antibiotic Guardian? | Smartcard changes guide | Dispensing factsheet
2 Community Pharmacy News – December 2014
services and commissioning The healThcare landscape lpcs
Cardiovascular risk MUR target group to beginin JanuarySecretary of State Directions amended with new requirements for the
proportion of MURs falling in target groups to rise from April.
The new target group for MURs covering patients with
cardiovascular risk factors is to be introduced from January, PSNC
can now confirm. But contractors will not need to increase the
proportion of MURs falling within target groups until April 2015.
Pharmacy teams may recall that as part of the 2014-15 community
pharmacy funding settlement some changes to Advanced Services
were agreed between PSNC, NHS Employers and NHS England.
These included the addition of a new target group for MURs and an
increase in the proportion of MURs to be undertaken with patients
in target groups from 50% to 70%.
The Department of Health signed amendments to the Secretary of
State Directions on 4th December 2014 which implement these
changes to the MUR service. The Directions will be published in the
January 2015 Drug Tariff and will mean that the new
cardiovascular risk MUR target group will commence from 1st
January 2015.
However, the minimum percentage of MURs that must fall within
the target groups will remain at 50% until 31st March 2015;
increasing to 70% only for MURs carried out from 1st April 2015.
This should help pharmacies to manage the transition to the new
groups and targets more easily.
A revised spreadsheet for pharmacies to use to report quarterly
MUR data to their NHS England area team has been agreed and
NHS England will publish this shortly. The first time this amended
spreadsheet will have to be used will be for quarter 1 2015–16
data, i.e. the report that has to be sent to area teams following the
end of June 2015. Prior to that point the existing spreadsheet that
is available on the PSNC website should be used for all reports to
area teams even though this will not allow data to be reported on
the new cardiovascular risk group from 1st January 2015.
Full details of the new MUR target group and other changes to
Advanced Services agreed as part of the 2014-15 contractual
framework can be found in PSNC Briefing 016/14: Advanced
Services (MURs and the NMS) which can be downloaded from
psnc.org.uk/briefings.
Settlement 2014-15 update
PSNC is continuing work to progress the other changes agreed as
part of the 2014-15 funding settlement and to work towards
agreeing a 2015-16 settlement as early as possible.
The audit which will be undertaken by all pharmacies on the
emergency supply of medicines next year has been developed and
is now being piloted in pharmacies to ensure that it is best
designed to work in practice; and more details on this will follow
next year.
We will advise on implementation dates for the requirements for
pharmacies to give advice to appropriate patients about the
benefits of the repeat dispensing service and to change the way in
which they report patient safety incidents when the relevant
changes to terms of service and Approved Particulars have been
finalised.
Politicians urged to back pharmacyCommunity pharmacy representative
organisations are urging politicians and
policy makers to back community
pharmacy and to do more to make the
most of the sector in the reformed NHS.
PSNC, Pharmacy Voice and the
Independent Pharmacy Federation (IPF)
last week launched a Community
Pharmacy Manifesto at an event held in
the Houses of Parliament and chaired by
Sir Kevin Barron MP, who is also Chair of
the All-Party Pharmacy Group.
The manifesto asks politicians from all
parties to sign up to five key pledges for
the future of community pharmacy; and itlists a series of actions that they could take
to help to make that future a reality. The
manifesto covers topics such as using
pharmacy to relieve pressure on GPs and
improve public health; getting pharmacies
access to patient records; and ensuring
that local commissioners are maximising
their use of pharmacies.
Pharmacies will be asked to help engage
with politicians and gain their support for
the manifesto in the New Year when a
toolkit will be released to support this
activity.
More information as well as sign up forms
for politicians and others to pledge their
support for the manifesto can be found at:pharmacymanifesto.com
psnc.org.uk 3
funding and sTaTisTics conTracT and iT dispensing and supplypsnc’s work
New stop smoking campaign for JanuaryNHS Smokefree is launching a new stop smoking campaign in the New Year
featuring improved NHS Quit Cards and resources for pharmacies.
Pharmacies across England have once
more been invited to work in partnership
with Public Health England (PHE) to
distribute the NHS Quit Cards to smokers.
In January PHE will be launching a new
health harms campaign to drive motivation
to quit smoking. Alongside this campaign,
smokers will be advised that they can pick
up the new and improved NHS Quit Cards
from their local pharmacy to help them
find the right support tool for them.
The NHS Quit Cards are specially designed
to help pharmacy teams engage their
customers in conversation about stopping
smoking. They take smokers through a
step-by-step journey to help them:
• Get to know their level of addiction;
• Understand how their local pharmacy
team can help support them on their
quit journey and;
• Find the right free Smokefree support
tool for them.
Alongside the NHS Quit Cards is the newly
developed Advisor Guide – an easy-to-use
reference tool which pharmacy staff can
keep with them and use when engaging
smokers. It includes information on how
pharmacy staff can tailor their advice to
the addiction test results and the key
benefits of the Smokefree support tools.
Pharmacy advice is crucial in helping
smokers make a quit attempt, and in 2014,
75% of pharmacies across England helped
support the campaign, distributing over
half a million Quit Cards. PHE hopes to
secure the same level of support from the
sector again.
Gul Root, Principal Pharmaceutical Officer
at the Department of Health and Lead
Pharmacist for the Health and Wellbeing
Directorate, PHE, said: “The new Quit
Cards provide a huge opportunity for
pharmacy teams to start a conversation
with people about quitting smoking. We
have worked with Pharmacy Voice, PSNC,
RPS and AIMp to improve the Quit Cards,
so pharmacy teams can use them more
easily.”
Quit Cards will be provided to pharmacies
free of charge. Pharmacies can place an
order for 50 Quit Cards and a point-of-sale
toolkit by calling 0300 123 1019 from 24th
November 2014. The order line will be
open Monday to Friday, from 8am to 6pm,
until 26th March 2015 or whilst stocks last.
If you are a large multiple pharmacy or
part of a small chain of pharmacies, please
check with your head office as PHE may
already be liaising with your organisation.
Be Clear on Cancer:latest campaign Pharmacy teams are advised that the latest national Be Clear on
Cancer campaign will run from 26 January to 22 February 2014. The
aim this time will be to raise awareness of persistent heartburn for 3
weeks or more as a symptom of stomach and oesophageal cancers.
The Department of Health and Public Health England have asked
pharmacies for their continued support to help improve early
diagnosis of these diseases, pointing out the great potential in the
pharmacy environment to capture people who are asking for advice
on how to treat their symptoms of persistent heartburn or who are
regularly purchasing over-the-counter medicines for the treatment
of heartburn.
A variety of materials will be available to support this campaign,
including posters, leaflets, symptom cards and a pharmacy briefing
sheet. To order free campaign materials (including accessible
versions), visit https://www.orderline.dh.gov.uk or call 0300 123
1002.
Reminder: reporting genericmedicines shortages
Pharmacy teams will be familiar with the price concession
system for agreeing a reimbursement price in month for
products unavailable at the Drug Tariff price.
PSNC has seen an increase in generic shortages over the
past year. The graph
(right) demonstrates
just how many lines
we have agreed
concessionary prices
for between
October 2013 and
October 2014.
To assist us with identifying products, we would be grateful
if contractors could continue to report generic supply issues
to us by completing our generic shortages form at
psnc.org.uk/feedback or emailing us on [email protected]
4 Community Pharmacy News – December 2014
The healThcare landscape lpcs psnc’s work
Pharmacy teams have been asked, along
with all other health professionals and the
public, to pledge their support to a
campaign aiming to reduce the spread of
resistance to antibiotics.
The campaign is part of a five-year UK
strategy on antimicrobial resistance, and
was once again centred on a European
Antibiotic Awareness Day (EAAD) held on
November 18th. The day saw healthcare
professionals across England encouraged
to think about the appropriate use of
antibiotics and the need to prevent the
spread of infections.
Posters, flyers and other resources
highlighted key pieces of evidence and
information such as those pictured (below).
And people were asked to sign up to the
Antibiotic Guardian Campaign at
antibioticguardian.com.
The website features a number of simple
pledges to help people make better use of
antibiotics and help save this vital
medicine. For example; patients could
pledge to talk to their pharmacists about
how to treat the symptoms of coughs and
colds rather than visiting their GP.
For pharmacy teams options include:
• Checking that antibiotic prescriptions
comply with local guidance and
querying those that do not;
• Using patient information leaflets to
explain to patients presenting with self-
limiting coughs/colds the potential
duration of illness and how to treat
symptoms; or
• Undertaking CPD or e-challenges from
the EAAD resources page.
The Antibiotic Guardian campaign has
been developed by Public Health England
in collaboration with the Department of
Health’s Expert Advisory Committee on
Antimicrobial Resistance and Healthcare
Associated Infections (ARHAI); the
Department for Environment Food and
Rural Affairs (DEFRA), the Devolved
Administrations and professional bodies/
organisations towards the ‘One Health’
initiative.
All pharmacy teams can start to take
action quickly and easily by pledging to
become Antibiotic Guardians on the
Antibiotic Guardian website:
antibioticguardian.com
Antibiotic Guardians campaign gathers paceHealthcare professionals and public asked to sign up to pledges to help
reduce the spread of antibiotic resistance.
Further Educational SupportIn October the Centre for Pharmacy
Postgraduate Education (CPPE) launched a
new learning campaign, Use antibacterials
wisely. The campaign aims to enable pharmacy
professionals to update their knowledge
about antimicrobial resistance and to raise
awareness of the important role pharmacy
teams can play in antimicrobial stewardship. A
key initiative in the campaign was the mailing
of CPPE’s updated distance learning
programme Antibacterial resistance – a global
threat to public health: the role of the pharmacy
team to all 62,000 GPhC registered pharmacy
professionals in England. Find details of the
programme at www.cppe.ac.uk
The increase inlikelihood ofGPs prescribingantibiotics forcoughs andcolds between1999 and 2011
25,000
40
%
€1.5bn
The number of people who die inEurope each year from infectionsthat are resistant to antibiotics
The proportion of sorethroats that evidencesuggest would benefitfrom antibiotictreatment
The annual EU-wide costof antibiotic resistancein healthcare expensesand loss of productivity
10
%
The December 2014 Drug Tariff sees the inclusion of
Physiotherapists and Chiropodists/Podiatrists to the list of
Independent Prescribers allowed to issue prescriptions on the
NHS. Part XVIIIB(ii) now outlines the prescribing rules for not only
Nurses, Pharmacists and Optometrist Independent Prescribers
but also Physiotherapist and Chiropodists/Podiatrist Independent
Prescribers.
Physiotherapist Independent Prescribers can prescribe anylicensed medicine for any condition within their competence
within the overarching framework of human movement,
performance and function. Podiatrist Independent Prescribers
can prescribe any licensed medicine within their competence and
relevant to the treatment of disorders affecting the foot, ankle
and associated structures.
Currently, both Physiotherapist and Chiropodist/Podiatrist
Independent Prescribers cannot prescribe any Controlled Drug in
schedules 1-5. For further information visit Part XVIIIB(ii):tinyurl.com/cnnrsm
Changes to list of Independent Prescribers
psnc.org.uk 5
conTracT and iT dispensing and supply services and commissioningfunding and sTaTisTics
Sector renews focus on self care Enabling and supporting self care is an increasingly important part of
pharmacies’ role and in the last month both a conference and campaign
week have highlighted this.
Helping patients to treat themselves for
minor and self-limiting conditions is a
crucial role for all pharmacy teams and as
well as helping patients, plays an
important part in reducing pressure on
other parts of the health system.
This year pharmacies may have been
involved in the awareness week which ran
in November and encouraged people to
self care. The awareness week, Self Care
Week, ran with the theme ‘Be Healthy this
Winter’ and it aimed to help the public
understand how to look after coughs and
colds themselves, but also make sure they
can recognise when they do need to seek
NHS support.
The focus for the week followed a study
carried out on behalf of the ‘Treat Yourself
Better with Pharmacist Advice’ campaign,
which estimated that 6 million UK adults
would visit their GP and over 2 million
would visit A&E as a first port of call for
common winter ailments.
The campaign was backed by pharmacy
minister Earl Howe, who said it could help
reduce the current unprecedented
demand on the health service:
“Going further on self care is absolutely
vital for the sustainability of the NHS and is
better for patients. If people are more
involved in their health and care they are
in a much stronger position to manage
their own healthcare and we know that
this results in improved patient outcomes,
fewer unnecessary consultations, better
patient experience and, of course, better
use of resources.”
Also last month the minister attended
North-East London (NEL) LPC’s SelfCare
Pharmacy Conference which raised
awareness of their newly commissioned
SelfCare pharmacy service.
The SelfCare service, which has been
commissioned by Newham CCG, allows
pharmacists and patients to develop a
joint care plan. GPs will refer patients to a
participating pharmacy of their choice,
where a self-care plan will be created.
Three follow up sessions will be arranged
over a 12 week period to empower
behaviour change in patients to improve
their health and wellbeing outcomes.
Initially patients with diabetes,
cardiovascular disease, respiratory and
mental health issues will be invited to
participate in the service.
Expressions of interest have been sought
from pharmacy contractors who wish to
participate in the service with the plan for
the service to go live in April 2015. Further
information on the SelfCare service can be
found on NEL LPC’s website:
nellpc.org.uk
Medicines Compliance Aid Database launched by UKMi
UK Medicines Information (UKMi) has launched a Medicines
Compliance Aid database (tinyurl.com/mcadatabase), which
makes recommendations on the suitability of transferring solid
dose formulations from the manufacturers’ original packaging
into multi-compartment compliance aids (MCAs).
The database, which is open access, makes recommendations
based on physico-chemical stability and characteristics of the
medicine and formulation, information received from
manufacturers, and data (where available) on the storage in
MCAs.
The database can be searched by the brand or generic name of
the medicine, although most entries will be based on the brand
leader. Once searched, the product is given a traffic light
colour-coded UKMi recommendation as to whether it is suitable
or not to be placed in an MCA.
UKMi recommend using the database alongside the Royal
Pharmaceutical Society’s guidance Improving
patient outcomes through the better use of multi-
compartment compliance aids available from
tinyurl.com/mcaresource
6 Community Pharmacy News – December 2014
lpcs psnc’s work funding and sTaTisTics
LPCs in the SpotlightOur new online series highlights best practice and new innovations
from LPCs across the country to help inspire others.
PHE guidance on commissioningchlamydia screeningPublic Health England (PHE) has
published guidance for local authority
commissioners to support them with the
commissioning of chlamydia screening
services from community pharmacies and
general practices as part of the National
Chlamydia Screening Programme.
The document – Information to support
the commissioning of chlamydia screening
in general practice and community
pharmacies – sets out some of the
benefits of commissioning the service
from primary care providers such as
community pharmacies and general
practices and it suggests elements that
should be included in specifications for
the service.
This guidance will be of interest to LPC
members and officers who are involved in
reviewing existing chlamydia screening
services and developing new services
with local commissioners.
The guidance can be downloaded from
the National Chlamydia Screening
Programme website:
chlamydiascreening.nhs.uk/ps/
resources.asp
LPCs and pharmacies may well have wondered in the past year if
there could be an easier way to do some parts of their jobs; like
reaching out to their local Clinical Commissioning Groups. Our
new interview series may have some of the answers.
In the first interview Community Pharmacy West Yorkshire's
(CPWY) Chief Executive Officer Robbie Turner tells us how
invaluable involvement with the local Urgent Care Working
Group has been in connecting with their CCG. This is a novel
approach; and one that has proved very successful - the LPC has
just secured significant funding for an emergency supply service
in the area.
LPCs around the country operate in different ways according to
what they have learnt works best in their locality. They have
often reached this point by going through a process of trial and
error which has taken time; but as the NHS continues to evolve
many LPCs are looking for new strategies. Sometimes others
have already found easy ways to do things and this insight can
save valuable time and effort elsewhere.
Recognising that LPCs would benefit from discussing the ways
that they work with one another to share tips and good practice,
the LPCs in the Spotlight series is
published once a month in the LPC
Members Area of the PSNC website to
facilitate this sharing of ideas. Whenever a new one is published
we will highlight it to LPC Members via the LPC Newsletter.
In the series so far, topics such as training, organisation, and
contractor engagement have been covered with more due to be
explored. For example, Avon LPC Chief Officer Richard Brown
explained how his LPC has benefitted by sharing an office with
the local LMC.
This month’s edition focuses on Hampshire and Isle of Wight LPC
and their new joint initiative with Dorset LPC, the Community
Pharmacy Wessex Academy (CPWA). The CPWA is an information
hub designed to support the skills and development of local
community pharmacy staff and including resources; workshops;
facilitated networking and social media.
If your LPC would like to contribute to this feature, please
contact Head of LPC and Contractor Support Mike King on
have you seen ourlatest website section?
The ‘website tools/publications tosupport local service development’
page includes links to tools andpublications to help lpcs to identifynew commissioning or development
opportunities for community pharmacyservices; as well as statistics to use as
evidence to support this.
visitpsnc.org.uk/localservices
Smartcard background software to be updatedduring overnight transition due in early 2015
Smartcard users are advised to reduce the impact by renewing Smartcard
certificates in advance of the transition if system prompts them to do so.
Pharmacy staff need working
Smartcards to access the
Electronic Prescription Service
(EPS), so it’s important you note
that there are going to be some
changes to the background IT
system which checks and manages
Smartcards early next year. Older background authentication and
management software will be replaced with the new Care Identity
Service (CIS), which is being developed and run by the Health and
Social Care Information Centre (HSCIC), who also manage the EPS.
HSCIC will be announcing the early 2015 date of the overnight
transition closer to the time of the event, and both HSCIC and
PSNC will publicise the date via websites and email lists.
The impact of this change could be more significant if your
Smartcard certificates need to be renewed soon. The table below
outlines the changes, and will help you to take the appropriate
action.
Talk to your Registration Authority (RA) staff about having a
Local Smartcard Administrator in your pharmacy (a person
assigned with the role B0263 on their Smartcard) to assist with
unlocking and certificate renewal. RA staff can also advise about
Short Term Access Cards.
Unlocking Smartcards
If you lock your Smartcard by accidentally entering an incorrect
passcode three times, it can be unlocked if two smartcard
readers are present and there is a user who:
• Has an RA role (i.e. Sponsor, Agent or Manager) on their card
or
• Has been granted the activity B0263 ‘unlock smartcard’.
Any user with the relevant access rights will
be able to unlock any card except their own.
Frequently asked questions: Renewal
How do I know if my smartcard certificates
need renewing? Users will receive automated ‘count-down’
messages on their system to prompt them to renew their
certificates when they are within 30 days of expiry.
How can I renew? Users are able to self-renew their certificates
30 days before expiry. Before the switchover, this can usually be
done via the Self Service Portal (talk to your supplier if you
cannot access this). After switchover, the message prompting
users to renew will include a link to the relevant CIS application
page, where they can complete the certificate renewal process.
After a renewal, Smartcards will be valid for two years. Every
third renewal (i.e. once every six years), users will need to visit an
RA to re-verify their identity.
What if I do not renew my smartcard certificates causing them
to pass their expiry date? It will no longer be possible to use the
card to access the Electronic Prescription Service. In this situation,
a face-to-face meeting with the RA is required to renew the
expired certificates. Contact the local RA for more information.
Further information
Local RA contact details: NHS England Area Teams (ATs) are
responsible for commissioning local RAs to provide and oversee
Smartcard issues. Your RA contact information may be available
from your AT (tinyurl.com/areateam), or might be listed on your
LPC site (lpc-online.org.uk).
Further information about Smartcards is available on the EPS
website, tinyurl.com/hscicSmartcards or the PSNC website,
psnc.org.uk/smartcards.
Impact of Smartcard Changes
Who’s affected? What you need to know
Any users who try tolog on during thetransition night
There will be a few minutes whenyou will not be able to authenticateyour Smartcards during the night ofthe switchover.
Users with Smartcardcertificates due toexpire during theswitchover period
Smartcard certificates due toexpire during the switchoverperiod must be renewed inadvance.Users whose Smartcards are due toexpire will be warned each time theyauthenticate for 30 days beforetheir certificates expire. If thecertificates are due to expire duringthe switchover weekend, users mustrenew their certificates before theswitchover weekend or they will beunable to renew, and thereforeunable to use their Smartcard untilthe switchover is complete.
Sites that use self-service FallbackSmartcards orpremises cards(tinyurl.com/hscicSmartcards)
You will not be able to use self-service Fallback Smartcards orpremises cards after theswitchover to CIS.Premises cards are used by sites thathave not yet upgraded to EPSRelease 2.N.B. Short Term Access cards shouldcontinue to work.
psnc.org.uk 7
dispensing and supply services and commissioning The healThcare landscapeconTracT and iT
ElectronicPrescriptionService
8 Community Pharmacy News – December 2014
The healThcare landscape lpcs psnc’s work
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.
Medical record access
The National Information Board and the
Department of Health have published
Personalised health and care 2020: a
framework for action
(tinyurl.com/puznhsd), a vision for using
data and technology more effectively to
improve health, transform the quality and
reduce the cost of health and care services
by 2020.
The plan commits to giving all patients
access to their GP records by next year
using approved apps and digital
platforms, and by 2018 patients should be
able to access their full health record
detailing every visit to the GP and
hospital, every prescription, test results,
and adverse reactions and allergies to
drugs. Patients will also be able to
comment on their records, which will be
accessible through multiple routes
including NHS Choices.
Extra £1.5bn for Better Care Fund
The NHS should help local authorities deal
with the tough financial settlement that
they are facing, Health Secretary Jeremy
Hunt has said. Hunt said that the NHS,
which has been prioritised and has
received a protected budget, has a
responsibility to help local authorities
(LAs) due to the interconnected
relationship between the services that the
NHS and local government offer.
In an apparent demonstration of both
sectors’ willingness to collaborate, it has
been revealed that the Better Care Fund
has had an additional £1.5bn added to it
by clinical commissioning groups (CCGs)
and LAs from their local health funding,
taking the original funding of £3.8bn to
£5.3bn.
Proposals to save £10bn
The Health Services Journal (HSJ) has
reported that Health Secretary Jeremy
Hunt has identified areas where the health
service could potentially save £10bn to
help reduce the NHS financial crisis. The
areas include improving use of technology,
releasing money from unused NHS land
and estates, and reducing dependence on
management consultants.
The £10bn would make a significant
contribution to the £22bn in efficiency
savings that the NHS Five Year Forward
View (tinyurl.com/lylnesq) said is required
by 2020 to close the gap in funding caused
by rising patient demand.
A&E fund increased to £700m
The HSJ has reported that an additional
£300m funding is to be allocated to A&E
departments to try to prevent further
decline in performance over the winter
months. This is on top of the £400m
funding that was revealed in June 2014.
The demand is reflected in the number of
major A&E departments failing to meet
the four hour target; most have failed for
the last 68 weeks.
The majority of the additional funding will
be used to provide more bed space and
pay for additional clinical staff in hospitals.
However, £25m will
be used to increase
access to GPs and
£50m will be
allocated to
ambulance services
to help meet
additional demand
and to help them to
return to meeting
standards as soon
as possible.
MyNHS launched on NHS Choices
website
MyNHS (tinyurl.com/lwfofkr), a site where
people can compare the performance of
their local NHS hospital, their care services
and their LA with up-to-date information,
has gone live from 19 November. The site,
which is available on the NHS Choices
website, is the first of its kind allowing
such a wide range of performance
indicators to be freely available to the
public. People can search for data on many
areas of care including food quality,
staffing, patient safety and mental health.
NHS funding boost of £2bn in 2015–16
The Government has announced that an
extra £1.95bn funding will be allocated to
the health service in 2015–16 and that this
will become a recurring allocation in the
baseline funding for the NHS.
This injection of funding follows a briefing
published last week by the King’s Fund,
which said that an additional £2bn funding
was needed to prevent an NHS crisis that
would see staff numbers cut, waiting
times rise and a reduction in the quality of
care.
Friends and Family test update
All GP practices in England have to carry
out the Friends and Family Test (FFT)
(tinyurl.com/cxb2uoc) from 1 December
2014 as part of their contract. The FFT is a
continuous survey rather than a one-off
traditional style survey, which allows
patients the option of giving anonymous
feedback after every interaction with their
GP practice. Anyone on the practice list
should be able to complete the test at any
time.
All details correct at time of printing.
No part of this publication may be reproduced without the written permission of the PSNC.
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The publishers accept no responsibility for any statement made in signed contributions or
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conTracT and iT dispensing and supply services and commissioningfunding and sTaTisTics
When pharmacies 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.
Pharmacies can check whether medicinal products and medical devices are allowed using the Drug Tariff:
Medicinal products: assuming the prescriber has the appropriate prescribing rights, any food, drug, toiletry or cosmetic may be prescribed on an
NHS prescription unless the product is listed in Part XVIIIA of the Drug Tariff (the ‘blacklist’).
Medical devices: If a product has been registered as a medical device (also known as an appliance), it can only be prescribed on an NHS prescription
if it is listed in Part IX of the Drug Tariff. Registered medical devices can be identified by a ‘CE’ mark on the product’s packaging.
Dispensers may wish to check PSNC’s Disallowed Appliance List (psnc.org.uk/disallowedappliances) for medical devices they are unsure about, and
we have listed some products below that we have recently received queries about:
Product Is the item Does it If no, is it Can it be Additional information listed in the have a ‘CE’ in the dispensed Drug Tariff? mark? blacklist? on the NHS
Please note: If the prescription is one of the following, pharmacies 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
Is it allowed?
K-Y Jelly (sterile
until opened)
Bexsero vaccine
suspension for
injection 0.5ml
pre-filled syringes
Spare Suspender
for thigh stockings
Otrivine adult
metered dose
Bladder Infusion Kit
Yes
No
Yes
No
Yes
n/a
No
n/a
No
n/a
Yes
No
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
K-Y Jelly is a registered medical device and appears in Part IXA of
the Drug Tariff so it is allowed on FP10.
Bexsero vaccine suspension for injection is not listed in the Drug
Tariff and is not CE marked so it is allowed on an FP10.
Spare Suspender for thigh stockings kit is a registered medical device
and appears in Part IXA of the Drug Tariff so it is allowed on FP10.
Otrivine adult appears in Part IXA of the Drug Tariff so it is allowed
on an FP10.
Bladder Infusion Kit is a registered medical device and appears in
Part IXA of the Drug Tariff so it is allowed on FP10.
In April 2013 as part of the government’s
changes to the benefit system, Universal
Credit was piloted. Following a review, the
scheme has now been extended, rolling
out to cover more areas. People receiving
the Universal Credit benefit are eligible for
free prescriptions.
Areas covered by the Universal Credit
arrangements include:
• Bath
• Hammersmith, London
• Harrogate
• Inverness
• North-west England
• Shotton, Wales
• Sutton
As Universal Credit is being introduced in
stages, the NHS prescription form will not
change for now. Patients who are able to
produce a valid Universal Credit award letter
bearing their name (either as the recipient
or because they are a partner or child of the
recipient), should sign to declare their
exemption and will need to tick the box for
“income-based Jobseeker’s Allowance”
As patients can get their prescriptions
dispensed from any NHS community
pharmacy in the country, pharmacies
outside of the areas listed should also be
aware of these arrangements.
Further information can be found on the
Gov.uk website at: tinyurl.com/blhhvrj
Universal Credit is being extended
10 Community Pharmacy News – December 2014
dispensing and supply services and commissioning The healThcare landscape
1. I have received an FP10D prescription
for Colgate Duraphat Toothpaste, is this
allowed?
Yes. Duraphat contains Sodium Fluoride
0.619%. Sodium Fluoride Toothpaste
0.619% DPF is listed in Part XVIIA of the
Drug Tariff (the Dental Prescribing
Formulary) therefore this prescription
would be passed for payment by the
Pricing Authority.
Dentists can prescribe products by their
generic name or the proprietary
equivalent (providing that the equivalent
is not listed in Part XVIIIA of the Drug
Tariff, the blacklist).
2. I’ve received a lilac FP10P prescription
asking for 150 paracetamol tablets, is this
allowed?
It depends on the type of nurse prescriber.
The Drug Tariff only permits a community
practitioner nurse prescriber to prescribe
paracetamol in quantities of up to 100 (see
Part XVIIB(i) of the Drug Tariff) so they
cannot prescribe this amount.
However, nurse independent prescribers
are not limited in the quantity of
paracetamol that they can prescribe. This
type of prescriber would have the words
“nurse independent/ supplementary
prescriber” printed onto the prescription
forms they use. For more information see
psnc.org.uk/who-can-prescribe-what
3. Where in the prescription bundle should
I put a paid prescription which includes a
free of charge contraceptive medicine?
In this scenario the prescription should be
placed in the ‘chargeable’ group.
The item itself will be switched to give it
an ‘exempt’ status, but it will not be shown
on the Schedule of Payments as a switch
as the Pricing Authority does not deduct
charges where the prescribed item is a
contraceptive medicine or device included
in Part XVI of the Drug Tariff ‘List of
Contraceptive Drugs to be Dispensed Free
of Charge’.
4. I have received an FP10 prescription for
“140ml amoxicillin 125mg/5ml oral
suspension”. What quantity will I be
reimbursed for dispensing?
The pharmacy would be reimbursed for
dispensing 2 x 100ml.
There is an antibiotic rule which means
that where the quantity of a drug
preparation reconstituted from granules
or powder is unavoidably greater than the
quantity ordered and it is not possible for
the contractor to use the remainder of the
reconstituted product to fill another
prescription, payment will be based on the
nearest pack or number of packs necessary
to cover the quantity ordered. This is
outlined in full in the Drug Tariff, Part II,
Clause 13B.
Under this rule, in the situation described
above where the quantity ordered falls
between two packs (the Drug Tariff listing
is for a 100ml pack size), the contractor
can round up to dispense the nearest
complete container as it is important for
patients on antibiotics to cover the
complete course of treatment prescribed.
Reimbursement for dispensing two packs
will be automatic under these rules, but, as
is usual with Part VIIIA products, it is good
practice to endorse the prescription and
declare the total amount dispensed over
the pack size used.
Look out for more frequently asked
questions next month…
Ask PSNCThe PSNC Dispensing and Supply Team can give pharmacies support and advice on a range of
topics related to the Drug Tariff and reimbursement. Questions the team have been asked by
pharmacies in recent months have included:
If you would like more information on any
of the topics covered, the PSNC Dispensing
& Supply Team will be happy to help (0844
381 4180 or 0203 1220 810 or e-mail
AS Saliva Orthana 50ml and 500ml sprays have become registered
medical devices (CE marked) and are now listed in Part IXA of the
Drug Tariff. As a consequence, the entry for AS Saliva Orthana in
Part XV (Borderline Substances) has been removed from the Drug
Tariff. However, this change does not affect AS Saliva Orthana
Lozenges which will be reinstated in Part XV of the January Drug
Tariff because they are an unlicensed product approved by the
Advisory Committee on Borderline Substances (ACBS).
AS Saliva Orthana products listed in Part XVIIA Dental Prescribing
of the Drug Tariff have now been annotated as medical devices
listed in Part IXA of the Drug Tariff. This does not apply, however,
to AS Orthana Lozenges and a separate entry will be reinstated
under Artificial Saliva Substitutes in the Part XVIIA of the January
Drug Tariff.
These changes will not affect reimbursement for pharmacycontractors. See: nhsbsa.nhs.uk/4782.aspx
AS Saliva Orthana listings Hyoscine 1mg/72hourstransdermal patches (Scopoderm) The pack of 2 Hyoscine 1mg/72hours transdermal patches
has been added to the December Drug Tariff without notice
in the Preface.
Clause 9 (Part II )of the Drug Tariff states that contractors are
required to endorse a pack size for Category C products
when there are more than one pack size listed. Both packs of
hyoscine transdermal patches are in Category C.
Therefore contractors who are dispensing Hyoscine
1mg/72hours transdermal patches should ensure that they
endorse the prescription appropriately, with the pack size
they have used.
The pack of 5 patches will be deleted in January 2015.
psnc.org.uk 11
psnc’s work funding and sTaTisTics conTracT and iTlpcs
Dispensing Factsheet: No Charge and Multi-Charge ItemsPharmacy teams will often be presented with prescriptions for items which
incur either no charge, or multiple charges. Here we summarise some of
the most commonly encountered items in these groups.
No Prescription Charge
No charge is payable for contraceptive substances and listed
contraceptive appliances for women prescribed on FP10 or any
of its variants.
Systemic drugs promoted as contraceptives which are listed
below will not be specially marked and a prescription charge
should not be levied.
If the prescription is for any other drug to be used for
contraceptive purposes the prescriber should mark the item with
the symbol ♀ (or endorse the item in another way which makes it
clear that the prescription is for contraceptive purposes) and a
prescription charge should not be levied for any items so marked.
In the absence of such an endorsement by the prescriber, the
normal prescription charge will apply to that item.
The following is a list of commonly dispensed products which
incur either no prescription charges or multiple prescription
charges. The list is not intended to be exhaustive.
Multiple Prescription Charges
Multiple prescription charges are payable where:
• Different drugs, types of dressings or appliances are supplied
• Different formulations or presentations of the same drug or
preparation are prescribed and supplied
• Additional parts are supplied together with a complete set of
apparatus or additional dressing(s) together with a dressing
pack
• More than one piece of elastic hosiery is prescribed and
supplied (there is one charge for each anklet, knee cap, below
knee, above knee or thigh stocking supplied).
Two Charge Items
Three Charge items
Additional information can be found in Part XVI of the Drug Tariff.
For information on the prescription charges that should be levied for
a particular product or combination of products, please contact the
PSNC Dispensing and Supply Team on 0203 1220 810 or email
Aizea
Binovum
Brevinor
Cerazette
Cilest
Cimizt
Depo-Provera150mg/ml
Desogestrel
Desomono
Elevin
EllaOne
Evra
Femodene ED
Femodene
Femodette
Gedarel20mcg/150mcg
Gedarel30mcg/150mcg
Gygel 2%
Katya
Levest 150/30
Levonelle 1500
Levonelle OneStep
Levonorgestrel1.5mg tablet
Loestrin 20
Loestrin 30
Logynon ED
Logynon
Marvelon
Mercilon
Microgynon 30 ED
Microgynon 30
Micronor
Millinette20mcg/75mcg
Millinette30mcg/75mcg
Mirena IUD
Nacrez 75mcgtablet
Nexplanon 68mg
Norgeston
Noriday
Norimin
Norinyl-1
Noristerat200mg/1ml
NuvaRing
Ovranette
Ovysmen
Qlaira
Rigevidon
Sayana Press104mg/0.65 mlsuspension forinjection pre-filleddisposable devices
Sunya
Synphase
Triadene
Trinovum
TriRegol
Upostelle1500microgramtablets
Yasmin
Zelleta
Zoely
Actonel Combi
Ametop 4% geldisp pack
Canesten Combipessary & cream
Canesten Oral &Cream Duo
Climagest 1mg or2mg
Clinorette
Cyclo-progynova2mg
Diocalm Complete
Ecostatin TwinPack
Elleste Duet 1mgor 2mg
Evorel Sequipatches
Femoston 1/10mg
Femoston 2/10mg
FemSeven Sequipatches
Migraleve(combination pack)
Napratec OP
Novofem
Nuvelle
Paludrine/Avloclortravel pack
Pabrinex I/M HighPotency
Pabrinex I/V HighPotency
Prempak-C0.625mg
Prempak-C 1.25mg
Tridestra
Trisequens
Fortisip RangeStarter Pack liquid
Cyclo-progynovatabs 1mg and 2mg(prescribedtogether)
Heliclear TriplePack
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:Zoe Smeaton who can be contacted at the above address or by email at: [email protected] © PSNCPSNC Office: 0844 381 4180 or 0203 122 0810
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 in particular categories.
Below is a quick summary of the changes
due to take place from January 2015.
Part VIIIA Additions
Category A Additions:
• Furosemide 500mg tablets 28
• Lactulose 10g/15ml oral solution 15ml
sachets sugar free 10
Category C Additions:
* This pack only (others already available)
SC Special Container
• * Benzylpenicillin 600mg powder for
solution for injection vials 2 - Thornton
& Ross Ltd
• Carmellose 0.5% eye drops 0.4ml unit
dose preservative free 30 – Celluvisc
• Colecalciferol 3,200unit capsules 30 -
Fultium-D3
• Colecalciferol 400unit / Calcium
carbonate 1.5g effervescent tablets 56
(4xSC14) - Adcal-D3 Dissolve
• Itraconazole 50mg/5ml oral solution
sugar free 150ml – Sporanox
• Methylphenidate 54mg modified-
release tablets 30 - Matoride XL
• Nicotine 15mg inhalation cartridges
with device SC 4 – Nicorette
• Nicotine 15mg inhalation cartridges
with device SC 20 (5x4) – Nicorette
• Nicotine 15mg inhalation cartridges
with device SC 36 (9x4) – Nicorette
• Propiverine 45mg modified-release
capsules 28 - Detrunorm XL
• Rivaroxaban 2.5mg tablets 56 - Xarelto
Part VIIIA Amendments
SC Special Container
• Amantadine 100mg capsules (56) is
changing to Category C Auden
McKenzie (Pharma Division) Ltd
• Amantadine 50mg/5ml oral solution
sugar free (150ml) is changing to
Category C Auden McKenzie (Pharma
Division) Ltd
• Benzylpenicillin 1.2g powder for
solution for injection vials (25) is
changing to Category C Thornton &
Ross Ltd
• Coconut oil (500g) is changing to
Category C J M Loveridge Ltd
• Estriol 0.01% cream with applicator SC1
is changing to Category C Marlborough
Pharmaceuticals Ltd
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/ manufacturer name and pack size)
in future.
*This pack only (others still available)
• * Benzylpenicillin 600mg powder for
solution for injection vials (25) –
Crystapen
• Diclofenac 4% cutaneous spray (15ml) -
Voltarol Active
• Hyoscine 1mg/72hours transdermal
patches (5) - Scopoderm TTS
• Metformin 1g oral powder sachets
sugar free 60 - Glucophage
Part IX Deletions
Make 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.
• Contraceptive Devices-
Ancora 375 Ag
Novaplus T 380 Ag (Maxi)
• Dressings-
UrgotulDuo Border 8cm x 8cm
• Lubricant Gels-
K-Y Jelly (sterile until opened) 42g tube
• COLOSTOMY BAGS-
B. Braun Medical – Biotrol, Elite bag
with filter, skin protector adhesive,
fabric backing - Transparent 35mm 30-
835
B. Braun Medical – Biotrol, Elite bag
with filter, skin protector adhesive,
fabric backing - Transparent 40mm 30-
840
B. Braun Medical – Biotrol, Elite Petite
bag with filter, skin protector adhesive,
fabric backing - Beige 35mm 37-335
• ILEOSTOMY (DRAINABLE) BAGS-
B. Braun Medical – Biotrol, Elite bag
with skin protector adhesive and fabric
backing – Beige 40mm 38-840
• SKIN FILLERS AND PROTECTIVES-
3M Health Care Ltd - Cavilon Durable
Barrier Cream
2g sachet
3M Health Care Ltd - Cavilon Durable
Barrier Cream + Honey
2g sachet
Drug Tariff WatchYour monthly summary of any additions, amendments and deletions being
made to the Drug Tariff to help with dispensing and endorsements.