CommunityPharmacy News

Inside this issue• Community Pharmacy Conference 2012• Drug Tariff FAQs• Bowel cancer awareness

Preparing to deployEPS Release 2Special Feature

JANUARY 2012

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s2 Preparing to deploy EPS Release 2

It is still early days in the nationaldeployment of ePs Release 2 but as thetwo largest GP system suppliers now havenational roll-out authority, the rate ofdeployment is expected to accelerate inthe coming months. every pharmacycontractor will need to consider theirindividual circumstances and carefullyweigh up benefits, risks, opportunities andcosts to determine the optimal timeto upgrade.

As a starting point, it is important to tryand understand when local GPs are likelyto start issuing electronic prescriptions, forexample, does your PCT have authority tostart directing prescribers to issueelectronic prescriptions (see Part XVIIID ofthe Drug Tariff )? which clinical systems dolocal GPs use and have these systemsbeen granted ePs Release 2 full roll-outapproval (definitive information on thedevelopment status of systems can befound on the Connecting for Healthwebsite: www.cfh.nhs.uk/eps/stats)?Finally, when do local GPs expect todeploy ePs Release 2 (seek a view fromlocal GPs or use the online deploymentmap on the Connecting for Healthwebsite: www.cfh.nhs.uk/eps/maps)?

Different suppliers have different leadtimes for deploying Release 2 upgradesso this also needs to be taken into

consideration. More information onsupplier’s deployment plans can beobtained by contacting individualsuppliers.

The benefits of Release 2 will only startbeing realised once a pharmacy startsreceiving electronic prescriptions. somepharmacies have chosen to upgrade toePs Release 2 well in advance of theirlocal GPs for a number of reasonsincluding positioning themselves readyfor ePs Release 2, to access the ePsRelease 2 one-off allowance or to enablethe pharmacy to begin technically settingpatient nominations on the PersonalDemographics service (PDs), wherepatients have consented.

where a pharmacy has not yetupgraded to ePs Release 2, it is stillpossible to start collecting patientconsent for nomination. However, if thereis a delay of greater than 4 – 6 weeksbetween collecting consent and changingthe patient’s preference on the PersonalDemographics service, the pharmacycontractor must confirm that there hasbeen no change in the patient’scircumstances, including their choice ofnominated dispensing site. Thedeployment status of pharmacies in alocality can be found in the onlinedeployment map on the Connecting forHealth website: www.cfh.nhs.uk/eps/maps.

when making a decision on when toupgrade, it is important to balance theopportunities and benefits of upgradingagainst costs and risks. system supplierswill be able to provide information onone-off deployment costs as well as anyincreases in ongoing costs for the system.If there is a significant gap between thepharmacy system being upgraded toRelease 2 and starting to receiveelectronic prescriptions there is a risk thatsome costs will be duplicated, for examplethere may be a need to refresh stafftraining and if the system is not beingregularly used by staff, there may be anincreased risk that staff forget theirindividual smartcard passcodes.

For the time being, only ‘nominated’prescriptions can be sent electronically.

Once a pharmacy is ePs Release 2enabled, they will be shown as such onNHs Choices and could be nominated bypatients registered with any ePs Release 2enabled prescriber, anywhere in england.To ensure patient access to medicines,once ePs Release 2 is enabled, at all times,there needs to be at least one staffmember in the pharmacy with afunctioning smartcard and the ability touse the system in case an electronicprescription is received.

Selecting a System SupplierPharmacy systems are business critical soit is essential to give careful considerationto selecting a system supplier. Questionsthat you may want to ask a prospectivesupplier include:� How is the supplier planning to roll out

Release 2 of the software and whatcosts will be incurred in upgrading(one-off and ongoing)?

� what is the contract length and thedetail of the service level agreement? Isthere a penalty clause for earlytermination of the contract? what is theease and cost of transferring data intothe system at the beginning of thecontract or out of the system at the endof the contract?

� will the pharmacy need any additionalhardware?

� Does any hardware supplied remain theproperty of the supplier, or is thepharmacy purchasing the equipmentoutright, and who is responsible forfaulty equipment”

� what arrangements are in place forwhen something goes wrong? what arethe opening hours of the supplier’shelpdesk? what are the guaranteedresponse times for dealing withproblems when they occur? whatmeasures does the supplier recommendthat you take to ensure resilience of thelocal system, for example 3G back-upcards, off-site back-ups etc.? what arethe escalation routes if the supplierdoesn’t meet the guaranteed responsetimes? Are there options available forraising an incident or do all supportrequests need to be made by phone?

PSNC E-NEWSTo receive a weekly summary of the latestnews and guidance featured on the PSNCwebsite including pharmacy contractnews, Drug Tariff News, NCSO updates,events information and much more, signup to receive PSNC’s weekly e-newsletter.Visit www.psnc.org.uk/enews to register

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� How much user engagement was therein the development of the system?

� Beyond ePs, what functionality is in thesystem or in development to supportthe provision of services (for examplesupport for the New Medicine service,support for recording MURselectronically and generating printedcopies of the MUR Form etc.)?

� If the pharmacy uses or is planning touse an ePOs system or dispensingrobot, does the PMR integrate withthis technology?

A list of pharmacy system suppliersproviding or intending to provide ePsRelease 2 enabled systems can be foundonline at: www.psnc.org.uk/systemsuppliers.

Making your system workfor youIn developing their systems, pharmacysystem suppliers are required toparticipate in NHs Connecting for Health’s(NHs CFH) ‘Common Assurance Process’which assures compliance with therequirements laid down by Connectingfor Health. system suppliers have beenprovided with a functional specificationfrom Connecting for Health. This defineswhat the system must do but there is stillsignificant flexibility for suppliers in theway that systems are developed tosupport use of the ePs service. It isessential that pharmacy contractors

engage with their suppliers to ensuresystems meet user needs. Key discussionpoints include:� Recording prescription chargeexemption information: In ePs Release2, the patient’s exemption status needsto be entered into the electronic claimmessage. How will the systemefficiently support recording of thisinformation where it is obtained at thepoint of hand-out? will the systemsupport auto-populating thisinformation where the patient holds avalid exemption certificate and staffhave recorded this information in thepatient record? what audit reports willthe system generate to supportchecking that staff have enteredexemption information where required?

� Sending prescriptions forreimbursement: In ePs Release 2,electronic prescriptions must besubmitted electronically to NHsPrescription services for payment.endorsements must be madeelectronically. what functionality willthere be in the system to support thepharmacy contractor or pharmacist-in-charge to review this information tosatisfy themselves that pharmacy staffhave made electronic endorsementscorrectly?

� Recording “collected prescriptions”:In ePs Release 2 once a patient hascollected their prescription a dispensenotification message has to be returned

to the spine. How does the systemsupport the efficient processing ofcollected prescriptions?

� On-screen display of patientmedication history: Under paper-based processes, pharmacy staff oftenview the patient’s history at the sametime as generating repeat prescriptionlabels. How will the system supportpharmacy staff in efficiently reviewingthe relevant history in ePs Release 2?

� Repeat dispensing: suppliers haveflexibility to put in place schedulingfunctionality to draw down repeatprescriptions in advance of the patientvisiting the pharmacy. How will thesystem support this?

� Reports:what type of reportingfeatures does the system have tosupport users? Is there a report tosupport completion of the FP34csubmission document?

� Nominated patients: For managementpurposes will the system support thegeneration of a list of patients that haverecently received prescriptions vianomination?

� Communicating information from theright hand side of the prescription: Incertain circumstances, information fromthe prescriber that would traditionallyhave been included on the right handside of the prescription form needs tobe passed by the pharmacy to thepatient. How will the system supportstaff in passing on this information?

Smokers can now pick up new and improved NHS Quit Kits fromthousands of pharmacies across England to help them stop smoking.The campaign, which runs until 31 March 2012 and is supported bynational TV and radio advertising, aims to increase the number ofquit attempts by smokers and to help make those quit attemptsmore successful.More than 7,000 pharmacies across England have already signed

up to distribute Quit Kits in 2012 – nearly double the number ofparticipants in 2011 – and participating pharmacies, along withfurther information on the campaign, can be found by visitingwww.nhs.uk/smokefree. This is an opportunity for pharmacists andtheir teams to engage with people collecting quit kits and to helpthem quit smoking through opportunistic advice or briefinterventions and, where appropriate, the sale of suitable OTC NRT product or referral into an NHS Stop Smoking service.Any pharmacy wanting to stock Quit Kits that have not already expressed an interest are still able to participate. Independentpharmacies and smaller chains with fewer than 10 branches should call 0800 678 3173 and larger chains should emailsmokefree@dh.gsi.gov.uk

Quit Kit campaign 2012 launched

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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, PSNC, 59 Buckingham Street, Aylesbury HP20 2PJor email changes to cpn@psnc.org.uk or fax changes to 01296 438427.

� Local housekeeping: Does the systemsupport filtering prescriptioninformation on-screen, for exampleoffer the flexibility to separate Release1 and Release 2 prescriptions,dispensed prescriptions from thosethat are awaiting collection andprescriptions that are endorsed andready to claim from those with actionsoutstanding?

� Spine housekeeping: In somescenarios where a prescription hasbeen dispensed but reimbursementhas not been claimed, it will beremoved from the spine after 6months. what reports and alerts willbe in place in the system to alertpharmacy staff of the need to claimthese outstanding prescriptions?

� There is currently no standard ‘dosagesyntax’ and a problem in Release 1 hasbeen prescribers using abbreviationswhich are passed through to thepharmacy via the electronic message.will the pharmacy system ‘remember’if the pharmacist changed theinstructions for the last prescription forthe patient to support automaticallyconverting the GP’s abbreviatedmessage to a suggested alternative?Or has the supplier found analternative way around this problem?

� General Workflow: How does thesystem integrate ePs with otherbusiness processes such as preparingmonitored dosage systems?

� Alerts when the system is down:willthe system be able to generate alertsfor pharmacy staff when the system isdown, for example connectivity to theinternet is lost or the local system isunable to connect to the spine ormessage broker?

� Feedback: Feedback on the use of thesystem in practice is important forsuppliers in the ongoing developmentof their systems. Apart from callingthe helpdesk, is your supplierconsidering any other solutions tosupport the efficient recording offeedback and suggestions about thesystem? Is there scope to join a usergroup?

EPS Release 2 DeploymentChecklistsNHs Connecting for Health hasdeveloped three draft checklists tohelp pharmacies navigate their waythrough from preparing for ePsRelease 2 to getting the maximumbenefit after they have upgraded.

The first checklist covers the timeup to ordering a Release 2 system,the second covers the period fromordering to installing a Release 2system and the final checklist coversthe day Release 2 is switched onuntil it becomes business as usual.

Links to the checklists can befound in the ePs section of thePsNC website (www.psnc.org.uk/EPS).

The Electronic PrescriptionPaymentWindowPharmacy contractors are required tobundle up dispensed paper prescriptionseach month and submit the batch to NHsPrescription services for payment, beforethe 5th of the following month. NHsPrescription services then base paymentfor a particular month on the paperprescriptions received in that bundle.

Pharmacy contractors can submitelectronic claims for ePs Release 2prescriptions to NHs Prescription servicesthroughout the month however paymentcontinues to be calculated on a monthlybasis. For a given month, NHs Prescriptionservices consider for payment, allelectronic prescriptions where items havea dispensing notification date up to andincluding the month concerned andwhere the claim message was received byNHs Prescription services up to midnighton the 5th of the following month. Forexample:� For payment purposes, a form and item

sent to NHs Prescription services on the5th september but dispensed in August(e.g. dispensing notification date = 29thAugust) would be included with Augustprescriptions.

� For payment purposes, a form and itemsent to NHs Prescription services on the5th september and dispensed in

september (e.g. dispensing notificationdate = 2nd september) would beincluded with september prescriptions.

A claim message cannot be sent to NHsPrescription services until a dispensenotification message has been sent forevery item on the form. If the product isnot going to be dispensed or is onlygoing to be part dispensed, the dispensenotification message can be sent carryingthis information.

Completing the FP34cSubmission FormAt the end of each month, pharmacycontractors should declare the combinedtotal of paper (forms/items) and electronicprescriptions (messages/items) beingsubmitted to NHs Prescription services forreimbursement. Pharmacy systems shouldsupport pharmacy staff in doing this.

For electronic prescriptions, thenumbers declared should relate to thesubmission of electronic forms and itemswith a dispensing notification date up toand including the month concerned andwhere the claim message was received byNHs Prescription services up to midnighton the 5th of the following month. Thenumber of items declared should beadjusted to take into consideration anyadditional fees due (for example if an HRTproduct normally attracts 3 fees, it shouldbe counted as 3 items). This will ensurecorrect advance payment, however ifcontractors do not enter these items inthe relevant group, it is a self-correctingprocess and the contractor will be paidcorrectly via the final payment.

Tokens must be submitted to NHsPrescription services, but sortedseparately from the paper FP10prescriptions, for the same monthlypayment period that the correspondingelectronic prescription is processed forpayment by NHs Prescription services.when tokens are submitted, the ‘eTPToken for non-payment’ box on the FP34csubmission document should be ticked.

Although different members of thepharmacy team may submit the‘reimbursement claim’ messages for

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electronic prescriptions, in the same waythat different members of staff maysupport the endorsement of paperprescription forms, the paper FP34csubmission document will continue to bethe form on which the official claim forpayment is made. By signing and datingsection 3 of the submission documentand including the pharmacy stamp, acontractor or the person authorised tosign on his behalf is declaring that all ofthe endorsement information provided inthe ‘reimbursement claim’ messages andon the paper prescription formssubmitted is correct and accurate and thatthe contractor is entitled to claimpayment in accordance with the relevantprovisions of the Terms of servicecontained in the NHs (Pharmaceuticalservices) Regulations 2005.

Schedule of PaymentsChanges have been made to theschedule of Payments to support theimplementation of ePs Release 2. In futurethe schedule will provide information onthe number of prescription forms anditems received electronically. Thisinformation will appear in the ‘PrescriptionData’ section which is normally on page 2of the schedule. These fields are onlyvisible on the schedule where someelectronic prescriptions have beenreceived by NHs Prescription serviceselectronically.

The numbers provided relate to thephysical receipt of electronic forms anditems identified with a dispensingnotification date up to and including themonth concerned and where the claimmessage was received by NHsPrescription services up to midnight onthe 5th of the following month. Thesefigures have not been adjusted to takeinto consideration any additional fees due,for example if an HRT product normallyattracts 3 fees, it will be counted as 1 itemon the schedule of Payments for thispurpose. This means that the basis for thenumber of electronic prescriptions to bedeclared on the submission form differsfrom the basis used to report the numberof items on the schedule of payments.

The schedule of payments does notadjust for the number of additional feespaid,contractors should adjust for thenumber of fees due when making thedeclaration on the submission form. NHsPrescription services are givingconsideration to enhancing theinformation on the schedule to supportcontractors with reconciling theirsubmission document and schedule.

EPS Release 2 DeploymentUpdatesix pharmacy systems now have ePsRelease 2 full roll-out approval, AAHProscript Link, Cegedim Nexphase,Cegedim Pharmacy Manager, Positivesolutions Analyst, RX systems Proscript

and the Lloyds Compass system. TwoGP systems, eMIs web and InPracticeVision have been granted ePs Release 2full roll-out approval. Authoritativeinformation on the Release 2development status of GP andpharmacy systems can be found onthe Connecting for Health website(www.cfh.nhs.uk/eps/stats).

As suppliers move beyond InitialImplementation, CFH are supporting theroll-out of ePs to a number of exemplarPCTs. The first is the Isle of wight with all13 GP Practices and 30 pharmacies on theisland now ePs Release 2 enabled (seemap below). It is hoped that these siteswill help gather best practice to supportwider roll-out of the service.

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EPS Release 2 Statistics (extracted 14th December 2011)

ePs R2 enabled GP Practices 57

ePs R2 enabled Pharmacies 2,672

Number of R2 prescription messages to date 205, 202 prescriptions containing471,098 items have been dispensed

Number of patient nominations set 129,933

Number of PCTs with secretary of state 83Directions

EPS Deployment Map: Isle ofWight

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Midazolam 10mg/1ml oralsolutionThe Department of Health hasannounced changes to howprescriptions for Midazolam 10mg/1mloral solution (listed in Part VIIIB of theDrug Tariff ) will be processed. Please seeFAQ below for details

FAQ. How should I endorse a prescriptionfor Midazolam 10mg/1ml oral solution?The Department of Health has agreedthat, from 1 December 2011, where thecontractor has provided the prescribedquantity of Midazolam 10mg/ml oralsolution in containers with an integralmeans of administration, theseprescriptions will be reimbursed asmultiples of the 5ml basic price listed inPart VIIIB of the Drug Tariff.

To ensure accurate payment,contractors must clearly endorse wherethey have supplied containers with anintegral means of administration e.g. thequantity dispensed over pack size(20ml/5ml) or as 4x5ml.

where the prescription is notendorsed to indicate that the contractorhas supplied a container with anintegral means of administration,payment will be based on the existing

arrangements laid out in Part VIIIB – theminimum volume (5ml) plus theprice/ml for any volume dispensedthereafter. Please see illustration below.

Part VIIIB reimbursementPsNC has clarified with NHs Prescriptionservices how reimbursement will workfor Part VIIIB specials in relation to theexpensive item fee.

Concerns had been raised becauseitems in Part VIIIB of the Drug Tariff forquantities greater than the listed Tariffsize are going to be split and itemisedas in 2 parts (i.e. the Tariff pack size anda second item comprising of anyquantity requested over that pack size).An issue identified by PsNC was thepaying of the expensive item fee tocontractors for these lines if for instancethe split causes one or both parts of thetotal quantity to fall below £100 invalue, when if considered as a singlevolume it would have been over £100 invalue.

It has been confirmed that the PartVIIIB specials will be processed as asingle item so the expensive item fee of2% will be calculated correctly. wherethe prescribed quantity is reimbursedwith both Drug Tariff packs these will beinput as multiple pack endorsementsand therefore the expensive fee will becalculated correctly. One professionalfee will be paid.

The Part VIIIB special in this situationwill not be split into two items.

COC/COA requirements forimported productsFollowing communication betweenPsNC and the Department of Health,there has been an update in the

wording for Part VIIIB of the Drug Tariff.The update is regarding the sending ofa Certificate of Analysis (COA)/Certificate of Conformity (COC) for nonPart VIIIB products. The FAQ belowoutlines the change.

FAQ. I am finding it very difficult to gethold of a Certificate of Analysis (COA)/Certificate of Conformity (COC) for animported product, what should I do?The Drug Tariff states that for importedunlicensed products not listed in PartVIIIB, the contractor shall make everyreasonable effort to obtain a Certificateof Analysis (COA)/Certificate ofConformity (COC) for each importedproduct sourced.

However, it also says that where aCOA/COC is not available, the contractormust stamp, date, initial and endorsethe invoice with the invoice price lessdiscount (where not clearly detailed bythe supplier) and the prescriber's details.

At the end of each month, thecontractor shall send a copy of theappropriately endorsedCOA/COC/invoice to the PCT of theprescriber, allowing the PCT to matchexpenditure to the special supplied.

Category M price changesfrom January 2012The Department of Health hasannounced the new Category M priceswhich will apply to prescriptionsdispensed from January to March 2012.

The following products have beenadded to Category M from 1st January:exemestane 25mg tablets (30)Letrozole 2.5mg tablets (14)Letrozole 2.5mg tablets (28)Levetiracetam 1g tablets (60)Levetiracetam 250mg tablets (60)Levetiracetam 500mg tablets (60)Levetiracetam 750mg tablets (60)Olanzapine 10mg tablets (28)Olanzapine 15mg tablets (28)Olanzapine 2.5mg tablets (28)Olanzapine 20mg tablets (28)Olanzapine 5mg tablets (28)Olanzapine 7.5mg tablets (28)

The following product has been

This month includes:News on:� Midazolam 10mg/1ml oral solution� Part VIIIB reimbursement� COC/COA requirements for imported

products� Category M price changes from

January 2012� Changes to Pfizer discount scheme

Drug Tariff FAQs

Drug TariffNewsat a glance

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

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removed from Category M with effect1st January:Salbutamol 2mg/5ml oral solution sugarfree (150ml)

For more information and todownload a copy of the list in full,please visit www.psnc.org.uk/funding

Changes to Pfizer discountschemePfizer applied a reduced discount rate of7.5% to their patented product range

from 1 January 2012. Details of thesearrangements were outlined in a letterthat was sent out to all contractors on5 December 2011 (http://tinyurl.com/pfizerletter).

PSNC commentThe DH and PsNC measure marginsavailable to independent contractors.This covers brand, generic and specialsand shows margin available afterclawback has been deducted. enquiries

consistently show that available marginsexceed target levels. However the PsNCis extremely concerned about any moveswhich reduce the margins after clawbackavailable on branded medicines as thiscan distort the equitable delivery offunding. Contractors can be assured thatthe margins survey will reflect thechanges. The PsNC has representedcontractors’ concerns strongly to therelevant company, and will ensure this israised in negotiations with the DH.

Product Pack Status Changes

NHs Prescription services have confirmed the following items have changed pack status:

Item Pack Size Old Pack Status New Pack Status

Fenofibrate micronised 200mg capsules 28 Calendar pack standard pack

Flutamide 250mg tablets 84 Calendar pack standard pack

General information on special containers and calendar packs along with an online searchable database of products granted this status canbe found in the online Drug Tariff Resource Centre (www.psnc.org.uk/specialcontainer).

Subject to the prescriber having the appropriate prescribing rights, any food, drug, toiletry or cosmetic may be prescribed on an NHSprescription unless the product is listed in Part XVIIIA of the Drug Tariff (the ‘blacklist’) or the criteria set out in the Tariff forprescribing 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 theproduct has a recognised ‘official title’.

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 theDrug Tariff. Registered medical devices can be identified by a ‘CE’mark on the product’s packaging.

Product Allowed on Product Commentan FP10 TypePrescription

Complan No Dietary “Complan” appears in Part XVIIIA of the Drug Tariff (the ‘blacklist’) so would not be allowed.supplement However, Complan shake is recognised to be a different product so therefore is allowed on an FP10.

Jobst UlcerCARe Yes Device This product appears in Part IXA of the Drug Tariff so is allowed on an FP10.medical stockingand compressionliner

wartner wart & No Device These products do not appear in Part IX of the Drug Tariff so are not allowed on an FP10.Verucca Remover

saline nasal No Device Nasal douches are considered to be medical devices and so would have to appear in Part IX of thedouche Drug Tariff to be allowed on an FP10.

softswabs Yes Device These would be allowed, but as this product is only listed in Part IXA as “non-woven fabric swabs,7.5cm square sterile”, reimbursment will be based on the listed generic price.

Is it allowed?

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 PSNCand LPCs then you can upload the information to the online services database by clicking ‘submit information on a Local Service’.

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The Preface of the Drug Tariff can (and should) be used toidentify products which are entering or being removedfrom the Tariff. Below is a quick summary of the changesdue to take place from 1st February 2012. Please notethat not every change due to take place can be knownin advance.

Part VIIIA changesAdditions� Agomelatine 25mg tablets (28 calendar pack) – Valdoxan� Co-danthramer 25mg/200mg/5ml oral suspension sugar free

(300ml)� Co-danthramer 75mg/1000mg/5ml oral suspension sugar free

(300ml)� Lacosamide 100mg tablets (56) – Vimpat� Lacosamide 150mg tablets (56) – Vimpat� Lacosamide 15mg/ml oral solution sugar free (200ml special

container) – Vimpat� Lacosamide 200mg tablets (56) – Vimpat� Lacosamide 50mg tablets (14) – Vimpat� Mesalazine 3g gastro-resistant modified-release granules

sachets sugar free (60) – Salofalk� Rupatadine 10mg tablets (30) – Rupafin

Deletions� Bismuth subcarbonate powder (250g) – J M Loveridge Ltd

� Hamamelis water (500ml) – Alliance Healthcare (Distribution) Ltd� Ketoprofen 2.5% gel (30g) – other pack sizes still available� Leuprorelin 11.25mg powder and solvent for suspension for

injection vials (1) – Prostap 3� Leuprorelin 3.75mg powder and solvent for suspension for

injection vials (1) – Prostap SR� Promazine 25mg tablets (100)� Purified talc powder (500g) – J M Loveridge Ltd� sodium salicylate powder (250g) – J M Loveridge Ltd� Zinc ointment (500g) – J M Loveridge Ltd

Part IX changesDeletions� wOUND MANAGeMeNT DRessINGs – Lyofoam C� wOUND MANAGeMeNT DRessINGs – Contreet Hydrocolloid� wOUND MANAGeMeNT DRessINGs – Advazorb Plus� sILK GARMeNTs – Dermasilk – Briefs (various adult and some

child sizes)� sTOMA APPLIANCes – Two Piece Ostomy systems – Pelican

select (various sizes in different versions of this product)� CHeMICAL ReAGeNTs – Ketur Test

Other notable changes� PART II – Contractors should note changes made to Clause 11

Broken Bulk and Clause 12 Out of Pocket expenses regardingunclaimed payments for unlicensed medicines.

The PSNC Information Team can providesupport on a broad range of topicsincluding whether an item is allowedon an NHS prescription and how muchreimbursement to expect for supplyingan item. Frequently asked questionsinclude:

Q. How will the SP / ED fee be displayed onmymonthly Schedule of Payments?A. The fees paid for the dispensing ofunlicensed medicines will be displayed inthe Prescription Fees section on page 1 ofthe schedule of Payments. The total valueof these fees paid to the contractor for themonth in question will be displayed under‘Additional fees – 2A unlicensedmedicines’.

Q. Can I claim broken bulk on specials andimported unlicensed medicines?A. Broken bulk cannot be claimed onspecials and imported unlicensedmedicines covered by Part VIIIB (eitherlisted or unlisted) except where a productnot listed in Part VIIIB has beenextemporaneously dispensed by thepharmacy contractor. In these instances,broken bulk can be claimed on theingredients used to prepare it.

when sourcing specials or imported

unlicensed medicines, contractors areencouraged to order the precise quantityor as close as possible to the precisequantity required to fulfil the prescription.In accordance with Part II Clause 9 of theDrug Tariff, where a product is not listedin Part VIII, contractors must endorse thepack size used when dispensing aprescription and NHs Prescriptionservices will use this information tocalculate the payment. PsNC is inongoing discussions with theDepartment of Health regardingthese arrangements.

Q. I've received a standard FP10prescription for ‘Diazepam Tablets' whichrequests instalment dispensing. Will I bereimbursed for dispensing in instalments?A. No, there is no provision to dispensemedicines in instalments on a standardFP10 prescription form. The prescriber isbreaking their Terms of service by notusing the form provided specially for thepurpose of supply in instalments.

In england, Form FP10MDA allowsinstalment dispensing of schedule 2Controlled Drugs plus Buprenorphine,Buprenorphine/Naloxone (suboxone) andDiazepam. In wales, the rules are slightlydifferent. schedule 2, 3, 4 and 5 ControlledDrugs can be prescribed in installmentson Form wP10MDA. If a wP10MDA

prescription is presented for dispensing inengland, the english rules apply;contractors will only be reimbursed fordispensing schedule 2 Controlled Drugs,Buprenorphine, Buprenorphine/Naloxoneand Diazepam in instalments.

Q. I have received a prescription for anunlicensed special medicine listed in PartVIIIB of the Drug Tariff, which specifies thename of a manufacturer where theprescriber wishes the medicine to beobtained from. Will I be reimbursed forobtaining the specific manufacturer'sproduct, or will I only be reimbursed theDrug Tariff Part VIIIB price?A. where there is no endorsementor there is an indication that the Part VIIIBitem has been supplied then you will bereimbursed the Part VIIIB price. If howeverthere is an endorsement of the specificmanufacturer requested and an invoiceprice (IP) then you will be paid asendorsed.

Look out for more frequently askedquestions next month…If you would like more information onwhether a particular product is allowed onan NHs prescription, the PsNCInformation Team will be happy to help(0844 381 4180 or e-mailinfo@psnc.org.uk).

Drug Tariff FAQs

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The list of medicines where there are supply problems is unchanged from the full list printed in the December 2011Community Pharmacy News. The list is also available on the PSNC website www.psnc.org.uk/brandedshortages.Contractors who have experienced problems in obtaining medicines because of quota arrangements are

encouraged to feed this into the PSNC Information Team to support PSNC’s ongoing monitoring of the situation.PSNC will work to ensure this information is fed into the Department of Health as evidence of the problems that arearising. An online feedback form for this purpose can be found on the PSNC website (www.psnc.org.uk/brandedshortages). For support on this issue, please contact the PSNC Information Team (0844 381 4180).

Medicines Impacted by Branded Medicines Supply Problems

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 by TSS Digital, Margate. Printed by Truprint, Margate.

The publishers accept no responsibility for any statement made in signed contributions orin those reproduced from any other source.

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Be Clear on Cancer – Bowel Cancer CampaignThe first NHS national bowel cancerpublic awareness campaign in Englandwill launch on 30 January 2012 and runfor 9 weeks until the end of March.

The campaign was announced last yearby Health Minister, Paul Burstow, to raisepublic awareness of the symptoms ofbowel cancer and encourage people withsymptoms to visit their GP early. Thecampaign aims to increase earlierdiagnosis of bowel cancer to improve thechances of it being successfully treated,and forms part of the Department ofHealth’s plans to tackle england’s relativelypoor cancer survival rates compared withwestern european countries. It isestimated that 1700 deaths from bowelcancer could be avoided every year ifengland’s cancer survival rates matchedthe best in europe.

The national campaign follows thesuccessful regional pilots of a bowelcancer awareness campaign in the southwest and east of england at the start of2011. Results from the pilots showed therewas high recognition of the campaign, anincrease of 48% of people over 50 visitingtheir GP with relevant symptoms andsignificant increases in urgent referrals tosecondary care.

From 30 January 2012 campaignadvertisements will feature on TV, radioand other national media. The campaignmessage is that ‘If you've had blood in youpoo or looser poo for 3 weeks, yourdoctor wants to know’ as these can besymptoms of bowel cancer. Pharmacistsand pharmacy staff have an important

role to play in this campaign. It isanticipated that the number of peopleasking questions about, and presenting totheir pharmacy with these symptoms willincrease as a result of the campaign.Pharmacists who have concerns aboutsomeone's symptoms should encouragethem to see their GP. Although the greatmajority of those presenting withsymptoms will not have bowel cancer,some will – and by catching the cancerearlier, it should be more treatable.Prevention messages are also explained inthe campaign leaflet and include healthyeating, keeping active, reducing alcoholintake and stopping smoking.

The Department is developing a

campaign factsheet to supportpharmacists and pharmacy counter staffand pharmacies can also help promotethe campaign by displaying posters andleaflets about bowel cancer. Thecampaign materials can be ordered onlineat www.orderline.dh.gov.uk and orderscan be placed now and the items will bedelivered free of charge for the start of thecampaign. Community pharmacieswithout a customer number required forordering can register via the registrationpage link.

For further information contactBeth Capper at beth.capper@dh.gsi.gov.uk or Rachel Tattersdill atrachel.tattersdill@dh.gsi.gov.uk.

Let’s be clear.If for the last 3 weeks you’ve had blood in your poo or it’s been looser, tell your doctor.

Dr Rajive Mitra

Unclear on anything? Visit nhs.uk/bowelcancer

© Crown copyright Department of Health 2011

Eat healthily Try to get your 5-a-day. So eat more vegetables and fruit, fi sh, and wholegrain foods. Eat less fatty foods like cakes and pastries and fewer processed meats like bacon and ham.

Cut down on alcoholDrinking too much alcohol can lead to a number of health problems and is linked with bowel cancer. By drinking less, you’ll reduce your health risks.

Look after yourselfKeep active. Swim, cycle, go dancing... the more you can do, the better. Even walking to your local shops instead of taking the car can make a difference.

Stop smokingIt’s never too late to quit. Giving up will lower your risk of getting bowel cancer. There’s plenty of help and support available from the NHS. Visit smokefree.nhs.uk or call 0800 169 0169.

…about how to reduce your chances of getting bowel cancer

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PSNC websiteFor up to date information and news on community pharmacy issues, visit the PSNC website at www.psnc.org.ukPSNC Community Pharmacy News is published by:The Pharmaceutical Services Negotiating Committee, 59 Buckingham Street, Aylesbury, Bucks HP20 2PJCommunity Pharmacy News is edited by:Mike King LLB BSc MRPharmS who can be contacted at the above address or by email at: mike.king@psnc.org.uk © PSNCPSNC Aylesbury Office Switchboard: 0844 381 4180

Partners in the PSNC CommunityPharmacy Development Programme

Community Pharmacy – fitting into thenew health care jigsaw is the theme ofthis years PSNC Community PharmacyConference.

with an array of neworganisations involved incommissioning, and supportingthe provision of, NHs healthcarewhat will they be doing and howwill they fit together and interlockwith pharmacy? How cancommunity pharmacy be avalued player and what are theopportunities?

Chaired by PsNC Chairmansir Peter Dixon speakers from keybodies forming the new healthcarepicture – including ClinicalCommissioning Groups, LocalProfessional Networks, NHs

Commissioning Board, Health andwellbeing Boards-will outline how theorganisations will operate and how theywill work with community pharmacy and

LPCs. with a strong emphasis on thecommunity pharmacy public healthcontribution speakers will also examinecurrent DH public health strategy , the roleof Public Health england and thedevelopment of Healthy Living Pharmacies.Where and when: London Marriot

Grosvenor square hotel – 25th April 2012Who should attend: Community

Pharmacists and Pharmacy contractors,LPC members, Directors of Primary Careand Public Health, Directors ofCommissioning, Prescribing /Pharmaceutical Advisors, MedicinesManagement Leads, Local governmentmembers and directors.For details of speakers and how to register

visitwww.psnc.org.uk/CPC – details willalso be in the February edition of PSNCCommunity Pharmacy News.

Community Pharmacy Conference 2012 –25th April central London

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