CPNCommunity Pharmacy News – June 2016

Community pharmacy: beyond the consultationAs the community pharmacy consultation comes to an end,

PSNC briefs contractors and MPs on the latest developments

Smartcard management | Aspiring pharmacy leaders | Preventing prescription returns

Since the publication of the Government’s

17th December letter, PSNC has been

working, both with the other national

pharmacy organisations and in discussions

with the Department of Health and NHS

England, to convince policy makers of the

need to make better use of community

pharmacy. This work included putting a

counter proposal to the NHS, setting out

how community pharmacy could be used to

make the £170 million savings while also

improving care for patients.

The full PSNC Committee met last month

to review the outcome of our discussions

and agree next steps. Peter Cattee, Chair of

PSNC’s Funding and Contract

Subcommittee and CEO of PCT Healthcare,

made the following statement:

“In our meetings with the Department of

Health and NHS England it has become

clear that they have little interest in

commissioning additional national

community pharmacy services or in our

constructive proposals to make better use

of community pharmacy to help the NHS to

make savings. The Government appear

unshaken in their determination to remove

a sum of £170m from community pharmacy

funding this year, and to do so via

reductions in fees and allowances. As a

committee of contractors PSNC is

extremely concerned about this and we

continue to work with the other pharmacy

organisations seeking to persuade policy

makers of the value of community

pharmacy and the dangers in implementing

a funding reduction of this nature.

In addition to this we realise there was a

major over delivery of margin in 2015/16,

and the Drug Tariff changes also

announced begin a programme by the

Department of Health to recover that

margin from community pharmacy [see box

below]. Combined with the determination

to remove £170m from community

pharmacy in October, this financial year will

be very difficult for the sector. We strongly

advise all contractors to make whatever

provisions they can for the funding

reductions. Earnings from the first half of

this financial year will be adversely affected

by the Category M price reductions, but will

still be significantly above those expected

for the second half.

The Committee are very pessimistic about

the outcome of the consultation on

community pharmacy’s future. We are also

very concerned that the NHS and

Government have not been clear about

their aims, for example, on hub and spoke

dispensing and the community pharmacy

access scheme. We will continue our work

seeking the best possible outcome for

contractors and will continue working with

our colleague organisations to try to find

new ways to convince policy makers at both

a national and local level of the value of our

current services, and the opportunities for

the NHS to make better use of community

pharmacy.”

Contractor update on fundingnegotiationsThe Chair of PSNC’s Funding and Contract

Subcommittee issues a statement preparing

contractors for what may lie ahead in the

remainder of 2016/17.

2 Community Pharmacy News – June 2016

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PSNC has published its response to the Government’s letter

from 17th December 2015 entitled “Community pharmacy in

2016/17 and beyond”.

Within the response, PSNC makes clear that the proposals

contained in the letter represent a major threat to the future

availability of accessible healthcare, support and advice from

community pharmacies. We are concerned that this threat has

not been made clear to the public, and that the policies

underpinning the letter have not been based on analysis of the

likely consequences or costs to the public as patients, members

of our communities, or taxpayers.

The response also highlights that whilst PSNC is willing and

keen to work collaboratively to achieve change, proper,

informed negotiations have been made impossible by the lack of

clarity, detail or analysis of the issues raised. To read PSNC’s

response to the letter in full, please visit: ow.ly/bmeQ300xfmi

PSNC responds to 17th December letter

We will continue working with

our colleague organisations to

find new ways to convince

policy makers of the value of

our current services.

The Department of Health (DH) has announced reductions to Category M prices which willapply to prescriptions between June and September 2016.

The reduction is intended to reclaim excess margin that DH believes was delivered tocontractors in 2015/16 above the agreed allowed £800m. PSNC accepts margin levels werehigh during the period, but has not agreed to the reduction.

Category M price reduction

As the consultation on changes to community pharmacy in

2016/17 and beyond came to a close on Tuesday 24th May 2016,

community pharmacy representatives were in Westminster

briefing MPs and their teams about community pharmacy services

and presenting a patient petition to Downing Street.

Around 50 MPs and a

further 10

Parliamentary

researchers attended

a Pharmacy health

checks and speed

briefing event in

Westminster to hear

about the vital work

that community

pharmacies do for

their patients and

concerns about the

proposed funding cut

for the sector. MPs heard how the plans are putting some

pharmacy services at risk and the impact that could have on

patients.

The drop-in speed

briefing session,

hosted by Sir Kevin

Barron MP and

Michael Dugher MP,

gave Parliamentarians

and their staff the

opportunity to find

out what is happening

in pharmacy, as well as

the chance to receive

a health check from a

front-line pharmacist.

Pharmacists and national

representatives were on

hand to brief MPs and

their staff on the

important contribution

which pharmacies make

to their local

communities, and to

discuss how they could

do more to support the

overstretched NHS.

Also on 24th May,

pharmacy teams and

patients took their concerns to Downing Street, presenting the

Prime Minister with a public petition in support of local

pharmacies across the country. The petition has so far been

signed by more than 1.8 million people who value their local

pharmacies and want to save them from the plans to significantly

cut their funding.

psnc.org.uk 3

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MPs briefed as pharmacy consultation endsPSNC and the other national pharmacy organisations held a briefing event for

MPs in the House of Commons to highlight the value of community pharmacy

and the potential damage to patient care if Government plans go ahead.

PSNC has published its response to the consultation on ‘hub and

spoke’ dispensing.

Following confirmation from the Department of Health that the

draft regulations, if implemented, would permit hub and spoke

dispensing between “relevant clinical entities” which it is

proposed would include hospitals and surgeries, PSNC became

concerned that this could potentially bypass registered

pharmacy premises.

While changes to the Medicines Act 1968 or Human Medicines

Regulations 2012 do not change NHS provisions (and doctors

have always been able to supply medicines to their patients),

these changes, if implemented, would provide an entirely new

legislative framework for the retail supply of medicines on which

there has been no consultation.

Read PSNC’s response in full at: ow.ly/VzPt300uEqz

PSNC responds to ‘Hub and Spoke’ consultation

PSNC is continuing to make the case for community

pharmacy by developing relationships with key influential

MPs. Following the Westminster event, we sent these MPs

an infographic style briefing detailing alternative ways

that community pharmacy could save the NHS money, the

current funding situation and the potential for pharmacy

teams to do more.

LPCs are also continuing to work hard on behalf of their

contractors by securing a significant amount of local press

coverage and supporting the campaign for community

pharmacy’s presence on social media.

What’s happening now?

4 Community Pharmacy News – June 2016

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Gathering evidence of community pharmacy’ssocial valueAn independent assessment of the social value

of community pharmacy is being carried out on

behalf of PSNC. Data has been pouring in from

across England and analysis is now underway.

Community pharmacy teams across

England have been getting involved in a

PSNC project to assess the social value of

community pharmacy.

PSNC has appointed

PricewaterhouseCoopers (PwC) to carry out

the independent assessment to provide a

robust evidence base to use in discussions

with stakeholders and in future

negotiations.

Pharmacy teams have been taking part in:

1. A survey on the number of additional

activities that they have provided in

relation to dispensing prescriptions, for

example, delivery of medicines and

provision of monitored dosage systems;

and

2. Data collection of how many times in a

week advice on self-care or on the use of

over-the-counter (OTC) medicines has

been provided.

As CPN went to press, more than 800

pharmacy teams had responded to the

first activity and PwC were in the process

of analysing the data received. Further

information will be published on the PSNC

website in due course.

Healthcare news in briefNHS sets out local NHS fundingNHS England has announced that it will invest around £112m in

2016/17 in the vanguard projects around the country. It will

also help local NHS and care leaders develop their Sustainability

and Transformation Plans, to demonstrate how they will

implement the NHS Five Year Forward View in their locality.

New model yields positive resultsA few months after the Primary Care Home model pilot started,

several test sites have reported seeing a positive impact on care

and services. Many of the test sites are focussing on common

themes, including an emphasis on co-location of community

staff within GP services and developing joined-up IT systems to

better share data and resources.

Quality checks for NHS servicesNHS England has announced it will employ people with a

learning disability to help improve NHS services ranging from

dentistry to acute care. The NHS Quality Checkers programme

will ask them to inspect local NHS services and give feedback

on how they can better meet their needs.

GP collaboration case studiesThe Royal College of General Practitioners has published a

report, The Future of GP Collaborative Working, which

showcases innovative schemes designed to improve the

integration of patient care. It highlights seven case studies

covering a wide range of GP-led services across the UK.

For more information on any of these stories, please see the

monthly updates available at: psnc.org.uk/hclbriefings

NHS England has announced it will recommission the

Community Pharmacy Seasonal Influenza Vaccination

programme in 2016/17. The terms and fees for the

recommissioned service will remain the same as in 2015/16.

Further guidance will be issued to community pharmacy

contractors once legislation and associated documents have

been updated to take into account the recommissioning of this

service. These will be added to PSNC’s dedicated pharmacy flu

vaccination service hub: psnc.org.uk/flu

PSNC has published a paper examining the research around

dispensing errors and automated dispensing in pharmacy.

The paper was written in response to Chief Pharmaceutical

Officer, Dr Keith Ridge, commenting that dispensing errors

in community pharmacy occur in around 3% of all items

dispensed, whilst large-scale automated dispensing would

reduce the error rate to 0.00001%.

PSNC welcomes a recent clarification of these comments

from Dr Ridge in which further detail is given about where

he acquired his figures and he acknowledges that it was not

appropriate to draw a direct comparison between the two.

Read PSNC’s paper and Dr Ridge’s subsequent clarification

at: ow.ly/DXS63008qxX

Automated dispensing research

NHS England to recommission fluvaccination service

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How to access CIS

Locating 'Manage Smartcard' section

Does your team know how to manage Smartcards?Smartcards are used by community pharmacy team members to access

NHS IT systems such as EPS and the Summary Care Record (SCR).

Smartcards provide security measures to protect patient data. The controlled access these provide ensures only those people who

are directly involved in patient care, and have a legitimate reason to access patient medical information can do so. Each pharmacy

team member whose role requires a Smartcard should have one. Smartcards should not be shared.

Smartcard management and supportThere is a system in place to support pharmacy teams with the maintenance of their Smartcards.

The Care Identity Service (CIS) is the online portal which can be used to carry out Smartcard management activities by a variety of

people. Pharmacy staff without admin or Sponsor rights can use it to renew their own Smartcards or update their contact/ passcode

information (see below).

Administrators, Sponsors and Registration Authority staff provide support for pharmacy users. They also use CIS to manage

Smartcards:

Using the Care Identity Service (CIS)Ensure you can access CIS: it can be selected from the NHS Spine Portal:

https://portal.national.ncrs.nhs.uk/portal/dt (Smartcard required)

Requirements for access: an N3 connection and a Smartcard are necessary.

Where you cannot access the NHS Spine portal, this may relate to

software/Java settings and therefore your IT helpdesk can be contacted (e.g.

your IT department if you have one, and/or your system supplier) to ensure

your system is setup to run CIS as well as all of the other programs the

pharmacy will need. Read more at: psnc.org.uk/wes

Training: The Health & Social Care Information Centre (HSCIC) has published a

screen-by-screen guide to explain how it can be used: tinyurl.com/cisguide

Improving CIS: pharmacy staff who would like to make suggestions for CIS

improvement can contact HSCIC: tinyurl.com/cisimprove

More information is available in our ‘Quick reference guide’ over the page.

Why use CIS?Using CIS will enable pharmacy teams to resolve many of the common

Smartcard issues more speedily because there may be no need to

contact the RA. Additionally, the RA will be able to place more focus on

critical tasks such as issuing new Smartcards.

Description CIS rights

Local SmartcardAdministrators(LSAs)

PSNC recommends that each pharmacy premiseshas someone with the LSA rights so that they cansupport staff. Read more at: psnc.org.uk/lsa

LSAs can support pharmacy team members withrenewing Smartcard certificates and unlockingSmartcards.

Sponsors Advanced Smartcard users or support staff mayrequest Sponsor powers. Read more at:psnc.org.uk/scsponsor

Sponsors have the LSA rights plus a few additionalones, e.g. they are able to help with requests for anew Smartcard, or a change to a staff member’s roles.

RegistrationAuthority (RA)

The local RA manage local Smartcard issues: e.g.assigning roles and sites onto new ones. Contactdetails are available from psnc.org.uk/ra (but if RAissues need escalating, please visit:psnc.org.uk/scescalation)

The RA staff have all of the LSA and Sponsor rightsplus many additional ones such as authorisingapplications and requests and applying changes toSmartcards.

6 Community Pharmacy News – June 2016

contract anD it Dispensing anD supply services anD commissioning th

Managing your Smartcard: Quick reference guideThis guide explains how you can self-manage your Smartcard.

Obtaining or replacing a Smartcard: Contact your Registration Authority (RA) to

obtain a new Smartcard. A face-to-face meeting and identity check will be required. If aSmartcard is lost or stolen contact your RA immediately. Read more at:psnc.org.uk/scobtain

Changing your Smartcard roles: Smartcard ‘roles’ control what a pharmacy team

member can do and what they can see. Appropriate roles are applied by an RA or Sponsorand are dependent upon the tasks the pharmacy team member needs to perform. Readmore at: psnc.org.uk/scrole

Changing your Smartcard sites: A pharmacy staff member who regularly works at

four local pharmacies, will have had those four premises added by the RA to theirSmartcard. Locums who work at five or more sites at short notice may have the multi-site‘FFFFF’ code for use when necessary, but should also have their regular premises added totheir Smartcard. Read more at: psnc.org.uk/scmultisite

Unlocking your Smartcard: If a Smartcard passcode is accidentally entered

incorrectly three times, the smartcard can become locked. Where two readers are present,Local Smartcard Administrators (LSAs) or Sponsors can use the Care Identity Service (CIS) tounlock a Smartcard. Alternatively, the RA may support the unlocking. Read more at:psnc.org.uk/scunlock

Renewing your Smartcard: Without action Smartcards expire after two years, for

Information Governance (IG) purposes. When the expiry date approaches you will beprompted at each login to renew your own card using the CIS in good time.LSAs/Sponsors/RAs may also assist where needed. You can only self-renew twice – the thirdtime requires an RA, and another identity check. Read more at: psnc.org.uk/screnew

Smartcard expiry: If a Smartcard is not renewed within the two-year period (see

above), it will expire and be permanently locked. A face-to-face meeting with the RA isrequired to make the Smartcard usable again. Read more at: psnc.org.uk/scexpiry

Passcode / contact detail updating: The process involves logging into ‘My Profile’

of the CIS to enter-in the information. Read more at: psnc.org.uk/scupdate

Change site or cancel: If a member of staff is leaving, the pharmacist or pharmacy

manager should advise the RA who will make the necessary changes. Leavers with nointention of working at another pharmacy will have their Smartcard revoked. Read more at:psnc.org.uk/sccancel

Smartcard and CIS top tips• Check you are aware of how to contact your local RA in case you need to in an emergency: psnc.org.uk/ra

• Regular locums should have regular premises added to their Smartcard rather than relying only on the generic locum

FFFFF code.

• Do not let your Smartcard reach expiry: Renew it yourself using CIS when you are prompted.

• Test your CIS access using the link above: Add it as a favourite and desktop shortcut.

• Smartcard readers: At least one terminal could be setup with two Smartcard readers to make the best use of the CIS. If you

need extra Smartcard readers speak to your IT system supplier.

• Ensure someone on the premises requests LSA rights: as described above.

Find out more at: psnc.org.uk/sc and http://systems.hscic.gov.uk/rasmartcards

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On the path towards leadershipPSNC’s leadership development programme for LPCs is

now well underway and here we find out what two

aspiring leaders have been up to so far.

Claire DickensManchester LPC’s Claire Dickens holds a rare position in the

pharmacy world – a non-pharmacist LPC Chief Officer. And whilst

Claire has been with the LPC for five years now, there has been a

steep learning curve and PSNC’s Leadership Academy seemed

like the next logical step.

As a former member of a Strategic Health Authority (SHA), Claire

knew her strength lay in her planning skills, but looked to the

Academy programme to support her in acquiring a wider skillset.

Claire has found her fellow aspiring leaders to be a good support

network who have helped her develop new ways of thinking.

The coaching sessions with course leader Rachel Harrison have

given Claire more confidence and helped her to recognise what

she has achieved. The one-to-one nature provided an

environment that was reassuring, allowing Claire to open up and

providing motivation for the future.

Claire has also shared some of the materials from the

programme with her fellow LPC officers and is looking forward

to embracing collaboration with the other Greater Manchester

LPCs as part of their work on the DevoManc project.

Lauren SeamonsDespite gaining a considerable amount of experience during her

time at Norfolk LPC, Lauren Seamons had not had any formal

leadership training until she joined PSNC’s Leadership Academy.

Lauren found the practical, problem-solving style of the

programme to be especially useful as it was easier to apply it to her

role. She also appreciated that course leader Rachel was responsive

to the needs of the group, encouraging the aspiring leaders to

interact with the different elements of the training along the way.

She commented that working from a home office can sometimes

feel isolated, so Lauren’s one-to-one coaching was particularly

beneficial. It helped changed her mindset by putting things into

perspective and keeping her focussed on the positive, giving

Lauren the confidence she needed to deliver a winning pitch on re-

commissioning Norfolk’s involvement in the Healthy Living

Pharmacy (HLP) programme.

Lauren now recognises that she needs to delegate to others more,

as well as to know when to ask for help. Also, the LPC has begun to

change its communication style by increasing use of social media

and trialling staff meetings via Skype.

All details correct at time of printing.

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

Produced for PSNC by Communications International Group. ©. PSNC.

Colour repro and printing by Truprint Media, Margate.

The publishers accept no responsibility for any statement made in signed contributions or

in those reproduced from any other source.

Communications International Group

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

Tel: 020 7434 1530 Fax: 020 7437 0915

Distributedfor PSNC by:

2016/17 Flu Plan publishedDetails have been published outlining the

influenza vaccination programme for winter

2016/17. The plan – published by the

Department of Health, NHS England and Public

Health England – sets out a coordinated and

evidence-based approach to planning for, and

responding to, the demands of influenza across

England.

The only change this year is the addition of the

offer of the flu vaccination to children of school

year 3. Also, as in previous years, there is an

expectation for all frontline health workers to

be offered flu vaccination by their employer.

A supporting letter for healthcare professionals,

issued in conjunction with the Flu Plan, has also

been published and both are available from:

ow.ly/nMGy300Bzec

Healthcare news in brief

People’s involvement in their careThe Care Quality Commission (CQC) has published Better care in my hands,

which examines patients’ involvement in their own care. The report provides

examples of good practice, as identified by CQC inspectors.

Public health reportQualityWatch has published a report on public health outcomes, discussing

the impact of recent financial and legislative developments. It includes

quantitative data and interviews with public health professionals.

Place-based services of carePublic Health England has produced a web feature on the place-based

approach to care, providing an illustration of how health and care is integrated

within a local community and explaining the background to the approach.

For more information on any of these stories, please see the monthly updates

available at: psnc.org.uk/hclbriefings

8 Community Pharmacy News – June 2016

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Evolving your consultation skills

The Centre for Pharmacy Postgraduate Education (CPPE) has a wealth of guidance and resources available

to support community pharmacy teams in developing their consultation skills.

Every time you speak with a patient you have an opportunity to make a difference, whether that is

helping them with a healthcare issue or supporting them with their medicines. CPPE are committed

to supporting the pharmacy profession in developing the patient-centred consultation skills to move

practice from counselling to true consultation.

The www.consultationskillsforpharmacy.com programme provides a six-step learning and

development pathway.

The portfolio of learning supports a range of experience and skills – from core skills learning through

to more advanced programmes such as Consulting with children and young people. Good

communication skills are important for the whole pharmacy team and you may have seen our new

consultation skills training resource which was sent to every pharmacy in England earlier in 2016.

Our most recent e-learning programme –

Consultation skills: what good practice looks like –

takes a video wall approach showcasing consultation

skills experts demonstrating some of the skills needed to meet the national practice

standards for pharmacy consultations. The standards in the Consultation Skills for

Pharmacy Practice (CSfPP) pathway (step 2) outline the key skills and behaviours

expected of all pharmacy professionals in a patient-facing role.

And if that wasn’t enough, we also run a number of events, including Confidence in

consultation skills and Consulting with older people.

All this is designed to support you in successfully completing the CSfPP

e-assessment.

Take a look at the www.consultationskillsforpharmacy.com programme to reflect

on your practice and find out how you can advance your consultation skills today.

Lesley GrimesLead Pharmacist,

Learning Development

“

Care homes e-learning programmeCPPE has released its latest programme

for pharmacy professionals, Care homes:

supporting people, optimising medicines.

The e-learning programme serves as an

update for those who are looking to

refresh their knowledge, but can also

support those who are looking to

develop new skills in this area.

Find out more about this course at:

ow.ly/nueA3008xbo“

Healthcare news in brief

PSNC websiteFor up to date information and news on community pharmacy issues, visit the PSNC website at psnc.org.uk

PSNC Community Pharmacy News is published by:The Pharmaceutical Services Negotiating Committee, Times House, 5 Bravingtons Walk, London N1 9AWCommunity Pharmacy News is edited by:Melinda Mabbutt who can be contacted at the above address or by email at: mmabbutt@psnc.org.uk © PSNCPSNC Office: 0844 381 4180 or 0203 122 0810

New series of leaflet guidesPublic Health England has published a

series of leaflets explaining important

issues for women who have had a positive

screening result for hepatitis B, syphilis or

HIV. The leaflets can be used by

healthcare professionals to refer to when

discussing results and follow-on care.

Improving carer wellbeingAs part of its ongoing Commitment to

Carers, NHS England has published a

carers toolkit, which is designed to help

health and social care organisations to

work together in identifying, assessing

and supporting the wellbeing of carers

and their families.

The scale of the LTCs challengeNHS England has updated its long term

conditions (LTC) infographic,

highlighting the prevalence of LTCs and

their effects on the healthcare system

in England. The infographic also

outlines what is already being done to

drive improvements.

For more information on any of these stories, please see the monthly updates available at: psnc.org.uk/hclbriefings

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Resource Description

HC1 Application Form Low Income Scheme application form /Claim for Help with Health Costs.

HC1(LP) Application Form Low Income Scheme Application Form (Large Print).

HC1(SC) Application Form Low Income Scheme application form Special Circumstances.

HC12 Guide A quick guide to help with health costs (including dental, charges and optical voucher values).

HC12LP Guide A quick guide to help with health costs including charges and optical voucher values (Large Print).

HC20 Guide Paying NHS Prescription Charges.

FP1010 Book Peak Flow Meter Charts.

FP92A Pad Application for prescription charge exemption (medical).

FP95 Form Application for certificate of prepayment of prescription charges.

IPD Pack Insulin Passport for Diabetics information booklet.

Lithium Books Pack Lithium Record Books – in addition to those in the packs.

Lithium Alert Card Pack Lithium Alert Card (Red) – in addition to those in the packs.

Lithium Info Book Pack Lithium Info Book – in addition to those in packs.

Lithium Pack Collation of Info Book, Record Book and Alert Card.

MTB Book Methotrexate Treatment Booklets.

OAT Info Book Information Book for oral anticoagulant patients – in addition to those in packs.

OAT Alert Card OAT Alert Card – card only.

OAT Book OAT Record Booklet – in addition to those in packs.

OAT PACK OATPACK collation of all 5 OAT products.

PPAEXENV (RE26) Envelope PPA Return Exemption manilla Envelope.

RD1 Form Patient Agreement /Consent Form (for sharing information on repeat dispensing).

RD2 Leaflet Repeat Dispensing Patient Leaflet.

STC Card Steroid Treatment Card.

FP57 Form Receipt and Refund form for patients claiming reimbursement for prescription charges. Note: 1 unit is 100 pads of 10.

FP10CDF Form Controlled Drug Requisition form for use where the Controlled Drugs will be ordered from a communitypharmacy/another practice. Requisitions not received on the new mandatory form after 30th November2015 cannot be processed by the Pricing Authority, as they are not legally valid.The new mandatory form can also be obtained online from the Pricing Authority’s website. They can bedownloaded, completed online, printed and signed in wet ink. Find out more at: psnc.org.uk/cd

FP10DT Token Electronic Prescription Service (EPS) Release 2 Dispensing Token.

Drug Tariff Copies of the Drug Tariff are sent out every month to all pharmacy contractors in England. Some pharmacy teams find it useful to use the online version which can be accessed from the PricingAuthority’s website. We have created a shortlink for quick access: psnc.org.uk/dt

Useful links:• The portal can be accessed via the PCSE website: pcse.england.nhs.uk/pharmacies

• A step-by-step guide to ordering supplies can also be found on the PCSE website: pcse.england.nhs.uk/howtoorder - all

supplies orders will be delivered by CitySprint, operating on planned daily routes on a weekly schedule.

• For further help or information, please visit their FAQ page: pcse.england.nhs.uk/help

• Alternatively, you can contact PCSE by emailing PCSE.enquiries@nhs.net or via their website: pcse.england.nhs.uk/contact

• If your enquiry is urgent, you can telephone the PCSE customer service centre on 0333 014 2884.

NHS stationery for community pharmacyobtainable from the PCSE portalThis guide highlights which pharmacy resources are now managed by

Primary Care Support England (PCSE).

10 Community Pharmacy News – June 2016

Dispensing anD supply services anD commissioning the healthcare lanDscape

How to avoid prescription returnsPSNC’s Dispensing and Supply Team explains how

community pharmacy teams can avoid prescriptions

being returned for clarification.

Approximately 0.16% of prescriptions are returned by the Pricing Authority to pharmacy

teams each month for clarification. The majority of these prescriptions are returned because

of insufficient or unclear endorsements. To try and help reduce the number of returned

items, we have compiled a list of common issues for pharmacy staff to be aware of (Please

Note: this list is not exhaustive).

Issue Examples of the issue How to avoid them

A branded product ismarketed by multiplesuppliers

Dianette tablets are manufactured by Bayer Plcbut are supplied to Mylan under third partylivery. When a prescriber issues a brandedprescription for Dianette tablets, a pharmacistcan dispense either the Bayer or Mylan product.

Endorse the name of the supplier as per thepackaging. Go to our page psnc.org.uk/returnsfor a list of products known to be affected bythis issue. Please note: If the prescription is resubmittedwithout the required endorsement,reimbursement will be made based on thebranded product with the lowest price (as perPart II Clause 7C of the Drug Tariff).

Generic prescription forinhalers which include atrademarked name e.g.Accuhaler or Easibreathe

• Fluticasone propionate 100micrograms/dosedry powder Accuhaler

• Beclometasone 100micrograms/dose breathactuated Easi-Breathe inhaler

The pharmacy should dispense the proprietaryproduct which meets this description andendorse the prescription accordingly.

No pharmaceutical formlisted on the prescription

• Paracetamol 120mg/5ml sugar-free – thiscould be requesting either oral solution orsuspension

• Metronidazole 200mg PO – this could berequesting either tablets or suspension

Speak to the prescriber to confirm the form tobe supplied and endorse the prescriptionaccordingly using the “PC” endorsement. Please note: If a Schedule 2 or 3 ControlledDrug prescription item has no form, this mustbe returned to the prescriber for amendment.

Total quantity not stated butclear from dosageinstructions

A prescription which states ‘Take 1 tablet TDS forone week’ but does not include a total quantity

Endorse the total quantity dispensed.Please note: If a Schedule 2 or 3 ControlledDrug prescription item has no total quantitystated, this must be returned to the prescriberfor amendment.

Endorsement of non-PartVIIIA generic products

A prescription calls for Diltiazem 120mgmodified-release capsules and Adizem wasdispensed against this; the endorsement willneed to specify whether Adizem-SR or Adizem-XL capsules are being dispensed as both meetthis generic description.

Endorse the following information:• pack size used to dispense from;• brand name or the name of the manufacturer

or supplier from whom the product waspurchased;

• if the product is less common, the purchaseprice before discount (ex VAT).

Dypiridamole 200mg/5ml oral suspension has been

removed from Part VIIIB of the Drug Tariff. This is because

a licenced alternative, Dypiridamole 200mg/5ml oral

suspension sugar free, is now available and has been

added to Part VIIIA effective from 1st June 2016.

Changes to the Drug Tariff impact on reimbursement so

it’s important to take note when amendments are made

to product listings.

The PSNC Dispensing and Supply Team is currently in the process of

updating their section of the PSNC website.

The updated ‘Where to obtain external resources’ page outlines

how to source commonly required resources for community

pharmacy teams.

Head over there now: psnc.org.uk/external-resources

Also, a list of NHS stationery for community pharmacy obtainable

from the Primary Care Support England (PCSE) portal is on page 9.

Dypiridamole 200mg/5ml oral suspensiondeleted from Part VIIIB

Have you seen our updated external resourceswebpage?

psnc.org.uk 11

psnc’s work funDing anD statistics contract anD itlpcs

Ask PSNCThe PSNC Dispensing and Supply Team can provide pharmacy teams with

support and advice on a range of topics related to the Drug Tariff and

reimbursement. Questions asked in recent months have included:

Q. I heard newprescription chargeexemption checksare coming in soon -what do I need to do?

A. From 1st July 2016, the Terms of Service will require community pharmacy teams to informpatients claiming exemption from prescription charges without presenting any evidence ofentitlement about the exemption checks and action on inappropriate claims that the NHS takes.

Look out for more information on the PSNC website: psnc.org.uk/exemption

When pharmacy teams receive NHS prescriptions, they must check whether the items prescribed are allowed on the NHS before dispensingotherwise the pharmacy contractor may not be paid for them. Below is a list of some products that we have recently received queries about.

Product Is the item Is it Does it Can it be Additional listed in the in the have a ‘CE’ dispensed information Drug Tariff? blacklist?* mark? on an FP10?

*n/a is because medical devices are not listed in the blacklist.

Please note: If the prescription is an FP10CN or FP10PN (community nurse prescriber), an FP10D (dental prescriber) or an FP10MDA (instalment

dispensing), please visit psnc.org.uk/prescriptionforms for more information.

Can it be dispensed on an FP10?

Canespro fungal nail

treatment set

SteriSets Newcastle Urine

Collection Pack

Bladder irrigation syringe

100ml

Lemon Glycerin swabsticks

75 sachet

No

No

Yes

No

Yes

Yes

Yes

Yes

n/a

n/a

n/a

n/a

No

No

Yes

No

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

in Part IX of the Drug Tariff.

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

in Part IX of the Drug Tariff.

This item is a medical device (CE marked) and appears in

Part IX of the Drug Tariff.

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

in Part IX of the Drug Tariff.

Q. I have received a prescription for twoitems, one is a tablet and the other an eyedrop but the prescriber has not writtenthe quantity on the prescription. However,there are directions on the prescription,can I use these to calculate what quantityto dispense?

A. For the tablets, you can calculate the exact quantity using the directions, e.g.take one tablet twice a day for a month = 84, and endorse accordingly. You willbe paid based on your endorsement.

For the eye drops, you will have to use your professional judgement to decidehow many bottles would be appropriate to meet the requirement. Again,reimbursement would be based on your endorsement. N.B. a month's supply is taken as 28 days unless indicated otherwise.

Q. When resubmittingreturned prescriptions,how do I record themon my FP34c andwhere in my bundleshould they be placed?

A. The number of returned forms and items being resubmitted should be declared with the currentmonth’s figures, in the relevant boxes in Part 1 of the FP34c Submission Document. Whenresubmitting in the next month’s prescription bundle, these returned forms should be sorted at thetop of the ‘exempt’ or ‘charge paid’ group as appropriate.

Please remember only the number of items returned for clarification should be declared on thesubmission document. This is because payment will already have been received for any other itemson the returned forms.

Dispensing anD supply services anD commissioning the healthcare lanDscape

Drug Tariff WatchThe Preface lists additions, deletions and alterations to the Drug Tariff.

Below is a quick summary of the changes due to take place from 1st July 2016.

Part VIIIA additions

Category A additions:

• Desmopressin 360micrograms/ml oral solution SC (15ml)

• Dexamethasone 2mg soluble tablets sugar free (50)

• Dexamethasone 4mg soluble tablets sugar free (50)

• Dexamethasone 8mg soluble tablets sugar free (50)

Category C Additions:

• Colecalciferol 1,000unit / Calcium carbonate 2.5g chewable

tablets (28) – Calci-D

• Colecalciferol 1,000unit tablets (28) – Stexerol-D3

• Colecalciferol 25,000unit tablets (12) – Stexerol-D3

• Edoxaban 15mg tablets (10) – Lixiana

• Edoxaban 30mg tablets (28) – Lixiana

• Edoxaban 60mg tablets (28) – Lixiana

• *Fludroxycortide 4micrograms/square cm tape 7.5cm SC (20) –

Haelan

• Fluticasone furoate 184micrograms/dose / Vilanterol

22micrograms/dose dry powder inhaler SC (30 dose) – Relvar

Ellipta

• Fluticasone furoate 92micrograms/dose / Vilanterol

22micrograms/dose dry powder inhaler SC (30 dose) – Relvar

Ellipta

• Fluticasone propionate 50micrograms/dose / Azelastine

137micrograms/dose nasal spray SC (120 dose) – Dymista

• Lidocaine 4% cream SC (30g) – LMX 4

• Lisdexamfetamine 20mg capsules (28) – Elvanse

• Lisdexamfetamine 40mg capsules (28) – Elvanse

• Lisdexamfetamine 60mg capsules (28) –

Elvanse

• *Selegiline 10mg tablets (100) – Eldepryl

• *Selegiline 5mg tablets (100) – Eldepryl

• Ticagrelor 60mg tablets (56) – Brilique

• Umeclidinium bromide 65micrograms/dose / Vilanterol

22micrograms/dose dry powder inhaler SC (30 dose) – Anoro

Ellipta

• Vortioxetine 10mg tablets (28) – Brintellix

• Vortioxetine 20mg tablets (28) – Brintellix

• Vortioxetine 5mg tablets (28) – Brintellix

Part VIIIA amendments - additions to Category A

• Lisinopril 5mg/5ml oral solution sugar free (150ml)

• Zonisamide 100mg capsules (56)

• Zonisamide 25mg capsules (14)

• Zonisamide 50mg capsules (56)

Part VIIIA deletions

• Bilastine 20mg tablets (30) Category C – Ilaxten

• Cimetidine 200mg tablets (60) Category A

• Erythromycin ethyl succinate 500mg/5ml oral suspension sugar

free R (100ml) – Category A

• *Fludroxycortide 4micrograms/square cm tape 7.5cm SC (200)

Category C – Haelan

• Hydroxyzine 10mg/5ml oral solution (200ml) Category C – Ucerax

• *Selegiline 10mg tablets (30) – Category A

• *Selegiline 5mg tablets (60) – Category A

Part IX deletions

Product Type and size Product code

Nélaton Catheter (‘ordinary’ cylindrical Catheter) Single useWellspect HealthCare LoFric Plus (non PVC)

Male 10-18 Gauge (Ch) Female 8-18 Gauge (Ch) Female 15cm 10-16 Gauge (Ch) Paediatric 30cm 8-10 Gauge (Ch)

904000-904800943800-944800984000-984600993800-994000

Bioclusive dressing 10.2cm x 12.7cm n/a

Exufiber dressing Rectangular 2cm x 50cm n/a

Unilet General Purpose Superlite lancets (Owen Mumford Ltd) 0.66mm/23 gauge 100 & 200 n/a

Urethral Rochester Medical LtdFemSoft Insert for female stress incontinence Standard Length (35mm)Long Length (45mm)

Size 1 (16CH)Size 2 (18CH)Size 3 (20CH)Size 1 (16CH)Size 2 (18CH)Size 3 (20CH)

712017120271203722017220272203

B. Braun Medical Biotrol Elite colostomy bag with filter, skin protectoradhesive, fabric backing - White

starter hole 3050mm 30

32-81532-850

B.Braun Medical Softima drainable pouch with filter, skin protector,protective cover and "Flow Control" soft outlet - Beige

40mm 30 043740E

B. Braun Medical Almarys Twin + Drainable pouch with filter, protectivecover and "Flow Control" soft outlet - BeigeTransparent

40mm 30 50mm 30 60mm 30 40mm 30 60mm 30

038840E038850E038860E038740E038760E

ConvaTec Ltd Consecura Low Profile Closed Pouch with Filter Standard SizeClear for:

35mm flange 30 S630LP

CozyLab S7 testing strips 50 n/a

KEY:SC Special containerR Item requiring

reconstitution* This pack only

(others alreadyavailable)