Community
Pharmacy News
jaNuary 2013
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Inside this issue
• Quick Guide to Drug Tariff appliances
• PSNC Member Interview
• Community Pharmacy Conference – 24 april 2013 – London
January 2013 Community Pharmacy News
2
General News
PSNC committee member recognised
in New Year honours
PSNC committee member raj Patel has
been recognised in the New year
honours list for his services to pharmacy.
Raj, who is an independent contractor
and owner of six pharmacies, said he was
delighted to have been appointed MBe.
“I’m delighted to have received this
recognition, but this is not just an award
for me, it reflects the recognition that
community pharmacy as a whole is now
getting not just from patients, but from
the Government too.”
Raj has been an influential member of
the PsNC since 2000. He now sits on the
committee’s Funding and Contract
subcommittee and he was closely
involved in the work and negotiation
leading up to the introduction of the 2005
community pharmacy contractual
framework.
essex community pharmacist Kaushik
Chaturbhai Patel was also appointed MBe
for services to pharmacy in this year’s
honours, while Leslie Morgan, pharmacist
and managing director of specialist
medical supply company Durbin PLC, was
appointed OBe for services to the
pharmaceutical industry and to charity.
“Having three pharmacists on the New
Year honours list this year shows how
much we have progressed and the
respect that we now have,” Raj said.
It is always great to see pharmacists
making the New Year honours list and
getting well deserved recognition for the
vital work they are doing for their patients
and local communities.
Congratulations go to all those named
this year – it is a brilliant achievement.
www.psnc.org.uk
NMS goes international
In December PSNC hosted a visit from three pharmacists from the
Norwegian pharmacy organisation Apokus. This recently formed
organisation supports the development of new services and educational
support for community pharmacies in Norway.
The visit followed interest from Norwegian community pharmacies in
undertaking a pilot NMS for new anticoagulant medicines. The Apokus
pharmacists heard from Alastair Buxton (Head of NHS Services, PSNC)
about the development of the New Medicine Service and lessons learnt
during its implementation.
The Norwegian delegation was also briefed on the DH funded
evaluation of the NMS being undertaken by the Schools of Pharmacy
at Nottingham University and University College London. They were then
given a practitioner perspective on the NMS by Alistair Murray at
Greenlight Pharmacy, Euston and Peter Marks, Chairman of Stockport
LPC at PCT Healthcare's pharmacy in Stockport.
The delegation completed their fact finding mission with a visit to
CPPE in Manchester to learn about the central role CPPE played in
supporting pharmacy learning on the NMS prior to launch of the service.
Commenting on the visit, Alastair Buxton said, “It is great to know that
the hard work of implementing and providing the NMS undertaken by
community pharmacists and their teams across England has not gone
unnoticed beyond the UK.
“The positive impact the NMS is having for patients in this country
may soon be matched by similar benefit in Norway and beyond;
community pharmacy teams across England should be proud of the way
service provision here is providing learning that pharmacy colleagues
across the globe can follow.”
(left to right) Alistair Murray (Greenlight Pharmacy), Eirik Torheim
(Apokus), James Davies (UCL School of Pharmacy), Christine Frigaard and
Elin Andersen (Apokus) at Greenlight Pharmacy in Euston. Want to find information on a particular service?
On the services database page of the PSNC website click on the search button to find details of local services across the country.
Want to share details of a service?
If you have developed or implemented a service in your area and would like to share the details including any documentation with PSNC
and LPCs then you can upload the information to the online services database by clicking ‘submit information on a Local Service’.
Heading here if needed
3
In the first of a new series designed to help you find out more about PSNC committee members, Raj Patel of Hollowood Chemists
talks about what it’s like to sit on the committee and what contractors can expect in the coming year.
How long have you been a member of
PSNC?
I think since around 2000, so a number of
years. I’m an NPA representative on the full
committee and I sit on the Funding and
Contract subcommittee.
What’s the best thing about being a PSNC
committee member?
The best thing about being on PsNC, and I
think this is the thing that every
committee member wants, is being able
to make a real difference to the profession
in a positive way. we try to be constructive
and to be the voice of our contractors
through both our own experiences in
practice and from speaking to contractors
in our constituencies. My aim is to gain an
understanding of their problems and then
bring that back to the table so that we can
do something about it and make a
difference for them. Of course it’s not an
easy task trying to get the best for
everyone and we’re never going to keep
everybody happy. But we do try to do
things that the majority of people are
content with and that will make a positive
difference, and when we achieve those
things, I feel that we’re doing a good job.
How do you have time to do all of that as
well as running your business?
By getting other people to do things for
me! I couldn’t do all of the things I do,
such as my committee work, and still work
every single day in a pharmacy. It’s very
hard for community pharmacists to do the
minutes without them needing to have
an appointment. we now offer a very
professional service with consultation
rooms. Appropriate training means we’re
confident delivering it and all the
feedback so far suggests that patients are
confident in us too. we only started
offering the service last year and we had
a number of people coming back to us
this time.
So do you have any advice for others
struggling to do everything?
Prioritisation is really important. It is
important to keep on top of the business
and when we consider we are juggling a
number of balls at any one time, it is
imperative to ensure that tasks are
completed. I have always advised my
pharmacists to prioritise and know what
they have to do each day and focus on
that – if you let things linger the list will
only get longer tomorrow, and, as we all
know, tomorrow never comes.
What do you think 2013 holds for
contractors?
Remuneration is tough and for all the
obvious reasons that is not likely to change
in the immediate future so contractors are
going to have to continue to really focus on
controlling costs and expenses. we also
need to be aware that in the future
pharmacy will need to look at increasing
the number of services it provides and
generating as much income as possible
from those – if we can do that then it
becomes possible to move away from a
supply only function. There are already
people rising to this challenge and my
message for all pharmacies is to try to make
2013 the year that they too rise to that
challenge. Doing nothing is not an option,
but pharmacy will be fruitful to those who
are willing to rise to the challenge.
How has pharmacy changed since you
first became a member of PSNC?
Pharmacy has changed beyond
recognition over the last 10 years or so as
we have shifted towards services and
medicines management rather than
focussing solely on procurement. Our
patients have bestowed a huge amount
of trust in us during that time, too - ten
years ago we would never have imagined
that we might be giving flu jabs and that
many patients would choose to come to
us for them rather than going to the GP
practice. But we’ve really shown patients
and our paymasters what we can do and
how well we have done it.
As pharmacy delivers an increasing
number of services, do you have a
particular favourite?
I do think that pharmacists can take a lot
of satisfaction from delivering MURs, but
overall for me flu vaccination is the
favourite. It’s a service that many patients
want and our accessibility can be a real
help for them - often they just pop in and
we can give them the jab in a few
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Do you have any highlights from your time
on PSNC?
I was very heavily involved in the 2005
contract negotiations as I was a member
of the negotiating team, and that was a
very interesting time. It was bewildering
because it was a huge task that we had
taken on and there were so many strands
that needed to be tied up within the new
framework. It took a huge amount of work
and then a lot of negotiation as we got
towards the end of the job, but it was
great to be a part of all of that and then to
have a new contractual framework from it.
day job now when you take into account
all the fire-fighting that needs to be done
and the administrative tasks on top of
supply and services. And it’s
monumentally difficult for contractors
practising five days a week to do all of
that and keep on top of their business as
well - I’m constantly impressed by those
who are juggling it all and still managing
to deliver great services to their patients.
Community Pharmacy News January 2013
PSNC – the word from your committee members
4
General News
www.psnc.org.uk
January 2013 Community Pharmacy News
Want expert health advice
and treatment without an appointment?
Quit Kits 2013 and national stop
smoking campaign
Think
Pharmacy!
Your pharmacist provides expert self care advice and
over the
counter treatments for a range of common illnesses
and
ailments from sprains to stomach upsets. Before you
visit your
GP – Think Pharmacy!
Service promotion
posters now available
a new set of display posters designed to help promote key
pharmacy services to the public can now be downloaded
from the PSNC website.
The posters were designed by Cumbria LPC and feature the
‘Think Pharmacy’ slogan. They can be printed off either in poster
form or as smaller leaflets and are suitable for use both in
pharmacies and other local community venues.
The posters cover medicines advice, smoking cessation help,
travel health advice, eHC and minor ailments and could be used
to promote specific local NHs services or as more general
promotional materials. They advise patients that rather than
visiting their GP, they should ‘think pharmacy’ as their local
pharmacist is likely to be able to help them.
The materials were developed by the LPC to help educate the
public about what pharmacy can do. “we had seen some of the
materials used to promote the Portsmouth Healthy Living
Pharmacy scheme and wanted something along those lines to
promote our pharmacy services in an interesting way,” explains
Jeff Forster, Cumbria LPC chief officer. “The PCT helped us to
deliver our materials and our contractors have been able to use
the posters in their pharmacies.”
Contractors are encouraged to use the posters to help to
promote local services in their pharmacies and LPCs and
contractors could consider using them elsewhere in the
community too.
The posters can be downloaded from www.psnc.org.uk/
publications.php, with many thanks to Cumbria LPC and NHs
Cumbria for sharing the materials.
All details correct at time of printing.
No part of this publication may be reproduced without the written permission of the PSNC.
Produced for the PSNC by Communications International Group. ©. PSNC.
Colour repro and printing by Truprint Media, Margate.
The publishers accept no responsibility for any statement made in signed contributions or
in those reproduced from any other source.
The Department of Health has launched a new smoking
health harm campaign to encourage smokers to quit in
the New Year. The campaign is designed to shock,
showing a cancer tumour growing on a cigarette as it is
smoked, and has gone live with TV, online, billboards
and other outdoor advertising which will run until March
2013. Health risks are being featured in the campaign
because statistics show that more than a third of
smokers still think the risks to health from smoking are
greatly exaggerated. However smoking is still the
biggest cause of premature death, responsible for taking
more than 100,000 lives in the UK every year and the
Department of Health aims to reduce smoking
prevalence among all adults to 18.5% by 2015. The
campaign aims to increase awareness by highlighting
the immediate damage being done by every single
cigarette and is being run alongside the Quit Kit 2013
campaign.
Over 8 million people in England smoke, costing the
NHS £2.7bn a year, and while smoking rates have
declined over past decades, the rate of decline has
slowed in recent years. About two thirds of the nation’s
smokers say they want to quit and the campaign urges
them to collect a free Quit Kit from their local
participating pharmacy to help support their quit
attempt. Each Quit Kit is a box of practical tools and
advice and kits are being distributed, free of charge,
through participating pharmacies across England from
January 1st. It is hoped around 375,000 smokers will
make a quit attempt in response to the adverts.
Following the success of last year’s Quit Kit campaign,
over 8,500 pharmacies have already signed up and
placed their orders. The order line will remain open until
March so it’s not too late to get involved:
· Independent pharmacies can place an order for 20
Quit Kits each time by calling 0800 678 3173
· Multiples and pharmacy chains should first check
with their head office as orders may have been made
centrally
· Pharmacy chains can order by emailing
[email protected]
Details of the Quit kit campaign and how to order are
available at www.psnc.org.uk/news.php/1445/new_stop_
smoking_campaign_for_january_2013
Further information on Quit Kits and a locator which
gives the address of the nearest Quit Kit stockist or
pharmacy based on post code can be found
at www.nhs.uk/smokefree
Distributed
for PSNC by:
Communications
International
Group
Linen Hall, 162-168 Regent Street, London W1B 5TB
Tel: 020 7434 1530 Fax: 020 7437 0915
General News
5
Wednesday 24 april 2013 – London
The PsNC Community Pharmacy Conference
2013 – Commissioning Community
Pharmacy – led by leading policy makers,
will give delegates an invaluable insight
into the opportunities for commissioning
local community pharmacy services in the
new commissioning environment. Together
with the chance to hear from LPCs who
have been involved in successful bids, the
Community Pharmacy Conference 2013 is a
not to be missed event for all LPCs and
pharmacy contractors. For local
commissioners, the Community Pharmacy
Conference 2013 is the place to find out
more about the range of services that
community pharmacy can deliver to
improve healthcare outcomes in key areas.
The Community Pharmacy Conference
is in central London on 24th April from
10.30 am – 4pm. In addition to the focus
on local commissioning there will also be
breakouts on a range of issues including
the future community pharmacy funding
and contract. An exhibition with time to
catch-up and network with colleagues
completes a tempting blend to prepare
community pharmacy for the challenges
and opportunities ahead.
Make sure you have 24th April in the
diary for the Community Pharmacy
Conference 2013 and watch out for
registration and programme details in
next month’s PsNC Community
Pharmacy News
Medicines optimisation action plan published
The group has presented its plan,
which includes both ‘quick win’ action
points and longer term strategies, to
pharmacy minister earl Howe.
PsNC believes that community
pharmacies are uniquely placed to take
on the medicines optimisation challenge,
helping the NHs to get the best value out
of its drugs bill and potentially generating
savings by preventing patients from
being harmed by inappropriate use of
their medicines.
The full steering group report can be
read at: www.dh.gov.uk/health/2012/12/
medicines-reduced-waste/
every pharmacy delivering NHs care in
england has a profile presence (miniwebsite) on the NHs Choices website
(www.nhs.uk). Registration to edit a
pharmacy profile and/or respond to
patient feedback left on the site can now
be arranged by emailing the NHs Choices
helpdesk.
During December, the NHs Choices
team sent a letter to all pharmacies,
except CCA and AIMp member
companies, outlining the arrangements
for registration. If you have not already
been signed-up to NHs Choices by
your PCT, simply follow the steps in the
letter to get registered.
If you did not receive the letter, contact
the NHs Choices helpdesk
([email protected]).
They will be able to register you without
the unique reference number provided
on the letter but it will be a longer
process as they will need to verify your
identity.
CCA and AIMp have indicated that
their member companies will be coordinating registration at Head Office
level therefore NHs Choices will be in
direct contact with the relevant Head
Offices rather than individual branches.
More detailed guidance can be found
on the PsNC website
(www.psnc.org.uk/NHSChoices) and
the NHs Choices site
(http://www.nhs.uk/pharmacy). If you
experience problems getting registered,
contact the PsNC Information Team for
support: [email protected]
Yellow Card support now online
A crib sheet designed to help pharmacy staff reporting possible adverse reactions to medicines to the MHRA is now
available to download from PSNC’s website.
The guide can be used to help pharmacy staff to decide whether or not a suspected reaction needs to be reported via
the MHRA’s Yellow Card scheme. It also sets out the information that pharmacies should try to record in any reports
they do submit.
Pharmacies are encouraged to consider whether there is a need for a Yellow Card report when patients report
possible adverse reactions to medicines. The reports can be completed online by either the pharmacy team or the
patient themselves.
The guide is available to download from www.psnc.org.uk/news.php
www.psnc.org.uk
An action plan to enable the NHs to
improve the use of medicines for better
patient outcomes and reduced waste has
been published by a Department of
Health steering group.
The plan, which was pulled together by
stakeholders including Chair of the PsNC
service Development subcommittee
Gary warner, suggested steps such as
extending targeted MURs and the New
Medicine service, and supporting LPCs
and other local NHs organisations to
work together to make post-discharge
MURs an integral part of the medicine
pathway.
Are you registered
to manage your
NHS Choices
profile?
Community Pharmacy News January 2013
THE PSNC
COMMUNITY PHARMACY
CONFERENCE 2013
January 2013 Community Pharmacy News
6
Drug Tariff News
where contractors do not have any stock
of this left, such prescriptions would need
to be returned to the prescriber to be
amended to chlorhexidine gluconate
0.2% oromucosal solution alcohol free
sugar free before being dispensed.
Drug Tariff
News
at a glance
Dispensing Chlorhexidine
gluconate 0.2% oromucosal
solution alcohol free sugar free
on a dental prescription
This month includes:
News on
● Dispensing Chlorhexidine gluconate
0.2% oromucosal solution alcohol
free sugar free on a dental
prescription
Quick Guide:
● Drug Tariff Appliances
FAQs
● Discount not given for fridge lines
● Broken bulk for Buccolam
● Out of pocket expenses for glutenfree products
PsNC has launched a new website to
help you contact the Information Team.
‘Ask PsNC’ provides you with a tracking
system to send your emails to us, and lets
you log in and see all the emails you’ve
ever sent to the Information Team.
It also has a knowledgebase, where you
can find answers to the most commonly
asked queries and links to places on our
website where you can find more
information. To use Ask PsNC, go to
www.askpsnc.org.uk. You can still use the
[email protected] email address but it will
now automatically create a ticket within
the new tracking system.
Is Periogard prescribable on
the NHS?
Periogard has now been discontinued so
Chlorhexidine gluconate 0.2% oromucosal
solution alcohol free sugar free is allowed
to be prescribed on an FP10D because the
generic Chlorhexidine Mouthwash BP
0.2% description in the dental formulary
encompasses all presentations.
Products can be prescribed both
generically and by brand as long as the
generic description appears in the dental
formulary.
However, please note that although
the brand Curasept meets the generic
description it has been registered as a
medical device and is not listed in Part
IX of the Drug Tariff so therefore
cannot be dispensed against either
generic or branded prescriptions.
Is it allowed?
Subject to the prescriber having 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’) or the criteria set out in the Tariff for prescribing products listed in Part
XVIIIB of the Drug Tariff (the ‘selected list’) is not met. as an exception to this rule, ‘blacklisted’ products can be dispensed where a product is
prescribed generically and the generic product is not blacklisted and the name of the product has a recognised ‘official title’.
www.psnc.org.uk
If a product has been registered as a medical device, 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.
Product
Allowed on
an FP10
Prescription
Product
Type
Comment
Complan
No
Dietary
supplement
spirigel alcohol
hand gel
Yes
Cosmetic
spirigel is recognised as a cosmetic so therefore would be allowed unless it appeared in Part XVIIIA of
the Drug Tariff (the 'blacklist'). spirigel does not appear in the “blacklist” and therefore is allowed on an
FP10. Please note: some hand gels have been registered as medical devices (or appliances) and so
would need to be listed in Part IX of the Drug Tariff to be allowed on an FP10 prescription.
Rennie Fruit
500mg tablets
Yes
Medicine
This product is a medicine not found in Part XVIIIA of the Drug Tariff (the “blacklist”); therefore it is
allowed on an FP10. Please note: similarly named products are blacklisted.
scholl
metatarsal arch
support
No
Device
This product is not allowed on an FP10 prescription as it was removed from Part IXA of the Drug Tariff in
september 2012 due to discontinuation of the product. There are currently no alternatives listed in the
Drug Tariff.
Optium Plus
No
Chemical
reagent
Optium Plus is now known as Freestyle Optium, the dual listing ended in september 2012 and therefore
the description Optium Plus will be disallowed on an FP10 prescription as it is no longer listed in Part
IXR of the Drug Tariff.
Complan would not be allowed as it appears in Part XVIIIA of the Drug Tariff (the ‘blacklist’); therefore it
should not be prescribed on an FP10 prescription. Please note: Complan shake does not appear on the
“blacklist” and would be allowed on an FP10 prescription.
Drug Tariff Watch
Part VIIIa changes
Category A additions:
Alimemazine 10mg tablets (28)
Calcium folinate 15mg tablets (10)
Co-careldopa 10mg/100mg tablets (100)
Granisetron 1mg tablets (10)
Haloperidol 10mg/5ml oral solution sugar
free (100ml)
Haloperidol 5mg/5ml oral solution sugar
free (100ml)
Magnesium trisilicate compound tablets
(100)
Nebivolol 2.5mg tablets (28)
Phenoxymethylpenicillin 125mg/5ml oral
solution (100ml)
Phenoxymethylpenicillin 250mg/5ml oral
solution (100ml)
Category C additions:
Calamine lotion (200ml) – Thornton &
Ross Ltd
simple linctus paediatric sugar free
(200ml) – Care
Amendments:
Benzydamine 0.15% mouthwash sugar
free (300ml) is changing to Category A
Flucloxacillin 125mg/5ml oral solution
(100ml) is changing to Category A
Phenoxymethylpenicillin 125mg/5ml oral
solution sugar free (100ml) is changing
to Category A
Phenoxymethylpenicillin 250mg/5ml oral
solution sugar free (100ml) is changing
to Category A
Riluzole 50mg tablets (56) is changing to
Category A
Deletions:
Co-careldopa 10mg/100mg tablets (90) –
sinemet
Tretinoin 0.01% gel (60g) – Retin-A
Part IX changes
Deletions:
DRessINGs – Absorbent, Perforated
Plastic
Film Faced, Dressing – Askina Pad (only
the 10cm x 10cm size still listed)
wOUND MANAGeMeNT DRessINGs –
without Adhesive Border – Mesitran
(10cm x 17.5cm size only)
FINGeR sTALLs – simulated Leather (all
sizes)
Serving patients through a hatch
which includes … (ii) arrangements for
compliance, in the areas of the pharmacy
in which patients receive NHs services,
with any approved* particulars that are
designed to ensure, in a proportionate
manner, that those areas are an
appropriate environment in which to
receive health care’.
*‘Approved’ means approved by the Secretary
of State.
The approved particulars (Gateway
Number 17365) include:
Contractors must ensure that:
1. The pharmacy (other than a distance
selling pharmacy) is seen by the public to
be open for the provision of
pharmaceutical services, during its core
and supplementary opening hours.
Accordingly the premises should have the
appearance of being open to members of
the public who are outside the premises.
2. where, for reasons such as security, the
doors to the premises are kept locked
during any core or supplementary
opening hours, the pharmacy is laid out
and organised to provide for the following:
a) a member of staff must be posted
immediately inside the door, or a hatch, so
that members of the public seeking
pharmaceutical services can see that there
are staff on the premises available to
provide pharmaceutical services (an
arrangement whereby a doorbell is used
to summon a response from a member of
staff is not sufficient); and
b) the staff are to invite the member of the
public to enter the premises, if this is
necessary to preserve the confidentiality of
any discussions, or if the facilities needed
for the provision of pharmaceutical service
are available only inside the premises.
so, a hatch is permissible, but the
premises must have the appearance of
being open, and a member of staff must
be posted immediately inside the door or
hatch.
For any pharmacist involved in Community Pharmacy,
understanding aspects of the Pharmacy Contract will be relevant CPD.
Why not make a record in your GPhC CPD Plan & record file or on-line at www.uptodate.org.uk
www.psnc.org.uk
PSNC has been asked recently if
pharmacies open for extended hours
are allowed to serve their patients
through a hatch?
The Regulations require all pharmacies to
be ‘open for the provision of
pharmaceutical services’ for the duration of
the core and any supplementary hours. A
100-hour pharmacy is required to be open
for at least 100 hours per week, for example.
However, there is recognition in the
legislation that pharmacies may need to
take precautions, particularly in the out-ofhours periods, to protect the health and
safety of the staff. some choose to do this
by using a hatch during the out-of-hours
periods. However, there are conditions
attached.
The clinical governance section of the
terms of service (schedule 4 of the NHs
(Pharmaceutical services) Regulations
2012) requires pharmacy contractors to
have a ‘premises standards programme
Community Pharmacy News January 2013
The Preface of the Drug Tariff can (and
should) be used to identify products
which are entering or being removed
from the Tariff. Below is a quick summary
of the changes due to take place from
1st February 2013. Please note that not
every change due to take place can be
known in advance.
7
Frequently Asked Questions
The PsNC Information Team can provide
support on a broad range of topics
including whether an item is allowed on
an NHs prescription and how much
reimbursement to expect for supplying an
item. Frequently asked questions include:
1. I don’t receive discount from my supplier
when I order the fridge line Dornase Alfa
2.5mg/2.5ml nebuliser liquid ampoules
(Pulmozyme), but it doesn’t appear in the
“discount not given” list, why?
Pulmozyme falls into the “cold chain
storage” group and therefore it is
recognised as a discount not given line.
Part II of the Drug Tariff lists discount
not given products in two ways: an
alphabetical list of individual items which
meet 3 criteria and group categories.
Items which fall under the group
categories are not listed individually but
all products falling into those categories
are automatically classified as discount not
deducted items.
The discount not deducted categories
are as follows:
• schedule 2 or 3 Controlled Drug
• HazChem (product covered by the
Chemical (Hazard Information and
Packaging for supply) Regulations 2002)
• Cytotoxic or cytostatic item (such
products can be found in section 8.1 of
the BNF)
• Cold-chain storage item (the product
must be stored at 2 - 8°C prior to
dispensing)
Products where the following criteria
apply (these are listed individually):
(i) the manufacturer, AAH and Alliance do
not offer a discount
(ii) fewer than 500,000 items per year are
dispensed
(iii) average net ingredient cost per item is
more than £50
The process for making products,
including unlicensed medicines, exempt
from discount deduction is now
automatic. Therefore the DNG
endorsement has been removed from the
Drug Tariff and will be ignored upon
processing.
Further information can be found on
our discount not given page:
www.psnc.org.uk/dng
2. I have a prescription for 2x Buccolam
10mg/2ml oromucosal solution pre-filled
oral syringes. This product comes in packs
of 4, can I claim broken bulk on the
remainder?
Buccolam is a branded product which is
readily available (i.e. it's not an unlicensed
special) and is not recognised as a special
container. Therefore prescriptions written
as such are eligible for broken bulk claims
if it is unlikely that the pharmacy will be
able to use the remainder within the
following 6 months.
Prescriptions written generically (e.g.
Midazolam 10mg/2ml oromucosal
solution pre-filled oral syringes) are paid
based on the Drug Tariff category. As per
the January 2013 Drug Tariff, all the
generic versions of Buccolam are currently
Category C lines and therefore are also
eligible for broken bulk claims.
To make a broken bulk claim,
contractors must endorse the prescription
with information on the pack size
supplied and the letters 'BB', and such
prescriptions placed in the red separator
with the end of month submission.
Further information can be found on our
broken bulk page: www.psnc.org.uk
/pages/broken_bulk.html
3. If I order gluten-free fresh bread from my
wholesaler and they charge me for
handling/ delivery, can I claim for these
out of pocket expenses?
Gluten-free bread is a readily available
dietary product (i.e. it’s not an unlicensed
special/import or an appliance) and is not
listed in Part VIII of the Drug Tariff.
Therefore, if extra charges cannot be
avoided, this item would be eligible for
out of pocket expense claims on the costs
incurred when procuring it.
Please remember that prescriptions
must be clearly marked with an indication
that out of pocket expenses are being
claimed (either by using 'OOP' [or 'XP' for
electronic prescriptions]) along with
information on the amount being claimed
and the reason for the claim. For example:
OOP
Carriage
£xxx
Further information can be found on our
out of pocket expenses page:
www.psnc.org.uk/oop
Look out for more frequently asked
questions next month…
If you would like more information on
whether a particular product is allowed on
an NHs prescription, the PsNC
Information Team will be happy to help
(0844 381 4180 or 0203 1220 810 or
e-mail [email protected]).
www.psnc.org.uk
January 2013 Community Pharmacy News
8
For the latest PSNC news and information visit
www.psnc.org.uk
Quick Guide
9
The PSNC Information Team has recently received a number of queries about appliances and
reimbursement. read this Quick Guide to help you understand this section of the Drug Tariff.
How to determine if an
appliance is allowed on
prescription
How reimbursement prices for
appliances are set
Appliance manufacturers are required to
apply to the NHsBsA to request that a
particular appliance is added to Part IX of
the Drug Tariff. In deciding whether to list
a product, consideration is given to
whether the product is safe and of good
quality, whether it is appropriate for
prescribing on the NHs and whether it is
cost effective. The price of the product is
set following negotiations between the
manufacturer and the NHsBsA.
Once a product has been listed, there is
an agreed mechanism for the Drug Tariff
reimbursement price to change. For
products listed by brand or manufacturer’s
name, the supplier may seek an optional
price rise once a year which is capped at
the forecast of the gross domestic product
(GDP) deflator minus 0.75 percent.
suppliers can also apply for decreases to
the reimbursement price for their
products at any time. where a
manufacturer asks to withdraw their
appliance from Part IX, for example
because it has been discontinued, three
months’ notice of deletion is provided in
the Drug Tariff.
The reimbursement price of appliances
with a generic listing in the Drug Tariff
automatically increases every June by the
forecast of the GDP deflator minus 0.75
percent.
related expenses for procuring
and dispensing appliances
Neither out of pocket expenses nor
broken bulk can be claimed for items in
Part IXA and IXR of the Drug Tariff, but
both can be claimed for items listed in
Part IXB and IXC.
Part IXB
Part IXC
Part IXA
Part IXR
What to do if you can’t obtain a
Part IXa appliance without extra
charges
where a Part IXA appliance is not available
from your normal wholesalers without
additional charges, it is worth contacting
the manufacturer and finding out who
they supply to and whether it is possible
to obtain the product directly without
charge.
As pharmacy contractors will not be
reimbursed for out of pocket expenses
incurred when items in Part IXA of the
Drug Tariff are dispensed, manufacturers
must ensure that their products are
available from somewhere without extra
charges. If a product appears to be
unavailable without additional charges
from either the manufacturer or the
wholesale network, please report this to
the PsNC Information Team (0203 1220
810 or www.askpsnc.org.uk) who will
investigate and then escalate to NHs
Prescription services as necessary. For
convenience, you can now report these
issues on our new appliance supply
issues form www.psnc.org.uk/feedback).
www.psnc.org.uk
Medical devices (appliances) can only be
prescribed on NHs prescriptions if the
product is listed in Part IX (Appliances
section) of the Drug Tariff.
If you receive a prescription for a new
product or an unusual item, you may wish
to check the packaging to see whether
the product bears a ‘Ce' mark (indicating
that it is a device) or if you are in any
doubt, contact the PsNC Information
Team (0203 1220 810 or
www.askpsnc.org.uk) and they will be able
to find this out for you.
Key points to consider:
■ Check that the prescribed appliance is
an exact match for the listing in the Drug
Tariff; for example is the type and pack
size the same? Particular care needs to be
taken with dressings where only certain
sizes of the dressing may be listed.
■ If there is internet access in the
pharmacy, the Drug Tariff can be viewed
online at
www.nhsbsa.nhs.uk/prescriptions. If the
appliance has been ordered by code
number or brand name, use the search
functionality on the online Tariff to quickly
locate the product.
■ A list of common ‘disallowed appliances’
can be found at
www.psnc.org.uk/disallowedappliances.
This can be a useful reference to doublecheck that a device is not prescribable.
■ watch out for ‘restricted availability
appliances’ (e.g. vacuum pumps and
constrictor rings for erectile dysfunction).
Details of restricted availability appliances
can be found in Part IX of the Drug Tariff
beside the listing for the relevant
appliance. In a similar way to medicines
on the selected list, these appliances may
only be ordered on an NHs prescription
for the patient groups and for the purpose
listed in Part IX of the Tariff, and the
prescriber must endorse the prescription
‘sLs’. If the ‘sLs’ endorsement is missing,
the prescription should not be dispensed
and will not be passed for payment by
NHs Prescription services. Pharmacy staff
cannot make the sLs endorsement.
■ Care also needs to be taken with ‘dual
listed’ products. when the name of an
item listed in Part IX of the Drug Tariff
changes, prescribers have time to change
their prescribing habits from using the old
name to the new one. This period of
grace, when both the old and new name
for a product will be passed for payment
by NHs Prescription services, usually lasts
for 12 months. when the dual listing is
removed, only prescriptions using the
new name as it appears in the Tariff will be
passed for payment.
■ Finally, although medical devices can
only be prescribed on an NHs prescription
if the product is listed in Part IX of the
Drug Tariff, there is an exception that
allows some, ‘drugs packed with non-Drug
Tariff appliances’ to be prescribed where
the appliance is used to administer the
drug, for example metered aerosols
packed with refills, nicotine inhalation
cartridges packed with the device etc.
Community Pharmacy News January 2013
Drug Tariff appliances
January 2013 Community Pharmacy News
10
Quick Guide
As a last resort, NHs pharmacy
contractors are not contractually obliged
to supply appliances that would not
normally be supplied in the course of their
business. Therefore a contractor may
choose not to dispense it.
reimbursement for incomplete
appliance prescriptions
Missing pack size for an appliance:
Contact the prescriber to clarify which of
the Drug Tariff pack sizes should be
dispensed, then add size required and
endorse “PC” (initial and date).
Reimbursement will be based on the
contractor’s endorsement.
If you cannot contact the prescriber,
you could make a professional judgement
as to the size needed* (endorsing size
given) or could return the prescription to
the prescriber.
If there is no endorsement, the
contractor will be reimbursed based on
the smallest pack size of the product listed
in the Drug Tariff.
No type specified for an appliance:
If only one type is listed in the Drug Tariff,
dispense it and endorse the item. If there
is more than one type in the Drug Tariff,
contact the prescriber to find out the
required type and endorse “PC” (initial and
date). Reimbursement will be based on
the contractor’s endorsement.
If there is more than one type and you
cannot contact the prescriber, you could
make a professional judgement and
dispense a type* (endorsing item given)
or could return the prescription to the
prescriber.
* Please note that best practice guidance is
to find out what size/type of appliance is
required from the prescriber if at all possible.
Address change?
Please let us know if your mailing
address used for CPN is incorrect
– either return the wrapper with
any amendments made to
the address to:
Database Changes,
Times House, 5 Bravingtons
Walk, London N1 9AW
or email changes to
[email protected]
www.psnc.org.uk
Partners in the PSNC Community
Pharmacy Development Programme
PSNC website
For up to date information and news on community pharmacy issues, visit the PSNC website at www.psnc.org.uk
PSNC Community Pharmacy News is published by:
The Pharmaceutical Services Negotiating Committee, Times House, 5 Bravingtons Walk, London N1 9aW
Community Pharmacy News is edited by:
Mike King LLB BSc MrPharmS who can be contacted at the above address or by email at: [email protected]
PSNC Office Switchboard: 0844 381 4180
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