CPNCommunity Pharmacy News – September 2015

Setting out community pharmacy’s futurePSNC highlights vital role for sector in reducing NHSpressures, and urges caution over funding change suggestions

Flu resources library | Medicines database guide | Contract monitoring update

2 Community Pharmacy News – September 2015

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PSNC has commented on the Royal Pharmaceutical Society (RPS)

and National Association of Primary Care (NAPC) consultation on

future primary care models, stressing the need for any future

arrangements to adequately protect community pharmacies.

The consultation considers the integration of community

pharmacy and general practice in the future. It sets out a range of

proposals for the extension of community pharmacy services, but

also supports the removal of a ‘one size fits all’ central core

contract and funding for pharmacies.

PSNC supports many of the suggestions for service development

and for better integration between pharmacy and general

practice outlined in the consultation. However, we believe that a

national core contract allows this and also offers protection for

community pharmacy owners, allowing them to invest in their

businesses to offer other services and care. We also believe it is

vital for all patients to be able to access a reliable core service

including the dispensing of medicines from any pharmacy,

anywhere in the country.

Commenting on the consultation, Sue Sharpe, PSNC Chief

Executive, said:

We agree with the RPS and NAPC on the need for community

pharmacists to be a first port of call for people with symptoms

and as we confirmed earlier this summer we had been seeking a

community pharmacy minor ailments advisory service as part of

the 2015/16 funding negotiations.

Where we part company with the RPS and NAPC is their apparent

suggestion that we can abandon national provider-based

commissioning. We are very concerned by the comments from

the RPS President

stating that community

pharmacy has been

straightjacketed by a

‘top down’ national

contract. Far from

being a straightjacket,

for pharmacy owners

the core contractual

framework and its funding has been and remains a vital

protection and PSNC will battle to protect this principle.

None of the service and role developments the RPS and NAPC

want to see for community pharmacists are in any way hampered

by having a strong, core national contract. We have seen

countless examples of innovative local services but these

developments have taken time, effort, investment and risk, none

of which would have been possible for businesses without the

support of the national core funding.

We are also cautious about suggestions to transfer the

community pharmacy network into multi-disciplinary care

settings. While community pharmacy can clearly have a role in

some if not all of these settings, a core benefit of community

pharmacy is its accessibility particularly in some of the most

deprived communities.

We are therefore urging the RPS to carefully consider the

consequences of its suggestions and we will be responding to the

consultation in due course.

Sue Sharpe’s full comment is available to read on the PSNC website.

PSNC warns future care development plansmust work for patients and pharmaciesAs the Royal Pharmaceutical Society consults on future integration of

community pharmacy and general practice, PSNC urges caution and

stresses need for protection for community pharmacy owners.

The NHS needs to make better use of

community pharmacies as a matter of

urgency if it is to meet the demand and

financial challenges it faces, PSNC has told

an influential committee of MPs.

Responding to the Health Select

Committee’s inquiry into primary care,

PSNC set out the ways in which community

pharmacy services could improve the

quality of care for patients and help the

NHS. “With the right enablers community

pharmacies could offer major changes to

the provision of primary healthcare quickly

and relatively easily,” PSNC stressed.

Local services currently offered value for

commissioners and could reduce pressure

on GP and urgent care services, but “their

impact is stifled by patchy and low quality

local commissioning”, the response read.

PSNC also highlighted where decisions by

national commissioners had prevented

pharmacy services with clear benefits from

being implemented.

In particular PSNC pointed to the five

services outlined in its recently published

Pharmacy 5 Point Forward Plan, calling on

NHS England to commission these

nationally. “A national decision would

support rapid implementation and uptake

and so bring most benefits to patients and

the NHS,” the response read.

Find out more and read the full Pharmacy

5 Point Forward Plan at

psnc.org.uk/5pointplan

NHS needs pharmacy to survive current pressures, PSNC tells MPs

psnc.org.uk 3

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Last month, the Daily

Telegraph featured an

article raising concerns

over plans for community

pharmacy to be given

access to the Summary

Care Record (SCR). The

article contained concerns

that pharmacists, particular

those in larger multiples,

would use their new access

rights to target patients

with particular products.

PSNC, the Royal

Pharmaceutical Society

(RPS) and Pharmacy Voice

have worked together to

address the concerns

raised within the story and

to highlight the safeguards

that will be put in place to prevent unauthorised access to the

SCR. The joint response, which was published in the Daily

Telegraph, is shown above and the original letter can be viewed in

its entirety on the PSNC website.

Patients can be assured that their information will only be

accessed by a registered pharmacist or pharmacy technician using

an NHS Smartcard and PIN, and then only after the patient has

given consent. The registered professional’s access is subject to

secure approval and will be monitored by the NHS.

Enabling community pharmacy access to the SCR will allow

patients to be better supported as the pharmacist will be able to

provide better informed and tailored care, as was shown in a pilot

carried out in 140 community pharmacies last year. The evaluation

of that pilot showed pharmacists were able to help people who

needed access to essential medicines by using the SCR, avoiding

unnecessary visits to GPs, and they were also able to provide safer

care with a reduction in the number of avoidable medicine errors.

Additionally, PSNC has put together PSNC Briefing 042/15: SCR

access in the media: Responsive lines for LPCs and pharmacy

teams to help address any media queries or concerns from

members of the public. This briefing is available from

psnc.org.uk/briefings

Alastair Buxton, PSNC’s Director of NHS Services, said:

“Community pharmacists are regularly identified as the most

trusted healthcare professionals and they are already well

informed about patients’ medicines and in some cases the

conditions they are treating. This sensitive information is already

handled properly and confidentially in pharmacies and similar

practices will be adopted to secure the data in the SCR.

Pharmacists are regulated healthcare professionals and all use of

the SCR can be accessed and monitored by the NHS.”

PSNC defends Summary Care Record accessPSNC, the Royal Pharmaceutical Society and Pharmacy Voice publish joint

response addressing concerns raised in the national media about

community pharmacy access to the Summary Care Record.

Practice Payment change in September 2015

Community pharmacy contractors should be aware of

changes to the levels of Practice Payment that have

been made in the September 2015 Drug Tariff. The

increase is related to delivering the agreed funding

of £2bn through fees and allowances in 2015/16.

PSNC will continue to monitor funding delivery

during 2015/16 to determine if further changes are

required to meet the target.

The table opposite outlines the Practice Payments

effective from 1st September 2015 in England:

Number of items permonth

Practice Payments for1st September 2015 to31st March 2016

Monthly Practice Payment(as it will appear in yourFP34 Schedule of Payment)

Up to 1,099 £350 £50

1,100 – 1,599 £3,268 £466.86

1,600 – 2,499 £4,575 £653.57

2,500+ 54.7p per item 54.7p per item

Missed our Endorsing and Submission Good Practice Workshop? Or found it so useful you want another look?

You can now find the webinar prescription quiz, listen to an on-demand recording, or view the slides without

commentary on the PSNC website.

Just visit psnc.org.uk/webinar

4 Community Pharmacy News – September 2015

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Dedicated webpage

The new PSNC webpage on the Flu

Vaccination Advanced service is the hub

for all the resources linked to the service.

It includes a wealth of information and

support tools for contractors, pharmacy

teams and LPCs including the poster

opposite, which pharmacy teams may

like to put up in the dispensary, and a

template anaphylaxis telephone card to

guide staff on calling an ambulance if a

patient has an anaphylactic reaction to a

vaccination. Why not take a look now?

Visit psnc.org.uk/flu

FAQ directory

Our flu FAQs page contains answers to

queries on topics ranging from training

requirements and data recording, to the

practicalities of service provision and the

timing of the service launch. Check for

regular updates at psnc.org.uk/flufaqs

Process poster

A PSNC Briefing has been published

setting out the steps involved in offering

and giving a flu vaccination. The briefing

has been designed as a poster which

could be displayed in your consultation

room as a reminder to pharmacy staff. It

may also help pharmacy teams to think

about the processes they will need to

put in place to deliver the service

smoothly and efficiently.

Why not take a look now?

Visit our Briefings Database

(psnc.org.uk/briefings)

Promoting the service

On this section of the flu webpage you

can download a range of resources

including posters, letters and flyers to

help you recruit patients to the service.

We also have translated versions of some

of the resources coming soon, and a

patient leaflet designed to tackle

common issues and misconceptions

about pharmacy flu vaccination

resources. Download the resources now

from psnc.org.uk/flupatientcomms

Flu vaccination service: the resource libraryMany community pharmacy teams are preparing to offer their patients flu

vaccinations this winter. PSNC has a whole range of resources available to

help, so make sure you don’t miss out.

Key facts and latestinformation:

Key facts reminder

• Your pharmacy must have a

consultation room to provide the flu

vaccination service.

• Eligible patients are those aged 18

years and over in the at-risk groups

defined in the Annual Flu Letter.

• Only the pharmacist can administer the

vaccine and they must be trained to do

so.

• There is no limit on the number of

vaccinations pharmacies can claim for as

long as they are given to eligible

patients.

Service timing

As CPN went to press the wording of the

service specification and the associated

paperwork for the flu vaccination

Advanced Service had been agreed

between NHS England, NHS Employers

and PSNC and was going through NHS

England’s internal governance procedures.

It will be published once it has successfully

passed through those procedures.

Alongside the service specification PSNC

will publish full guidance on implementing

the service for pharmacy contractors and

their teams.

In order for pharmacies to begin offering

the Advanced Service, Secretary of State

Directions are needed to provide the legal

basis for provision of the service. As CPN

went to press the Department of Health

were drafting amendments to The

Pharmaceutical Services (Advanced and

Enhanced Services) (England) Directions

2013 to allow implementation of the

service.

Contractors are advised to look out for the

latest updates – see Keeping up-to-date

opposite.

Pharmacists and pharmacy contractors practising in Wales should visit the Community Pharmacy Wales website

(cpwales.org.uk) for information on flu vaccination services in Wales.

Keeping up-to-dateOur national flu vaccination service information, guidance and resources will

be updated on an ongoing basis. You can stay up-to-date:

Online — check psnc.org.uk/flu regularly

By email — sign up for PSNC’s email newsletters at psnc.org.uk/email

On Twitter — follow @PSNCNews and look at #getreadyforflu

psnc.org.uk 5

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For LPCs

1. Support local pharmacies.

It’s different from waiting for the green script to come to you

so pharmacy teams will need support in delivering the service;

they need to know how you might try and sell a flu vaccine.

2. Combat negativity from GPs.

Have well-informed arguments about why the community

pharmacy is different, why there is strength of multiplicity of

providers.

3. Prove how the service is successful.

Emphasise the need for data collection as a way to “share the

good story” and try to have sight of the data and do something

with it.

4. Promote the service

PSNC has a range of resources available to help LPCs to

promote the service locally including template press releases

and some possible radio advert scripts. Download these frompsnc.org.uk/flu

Top tips for fluvaccination serviceEarlier this year PSNC spoke to a number of pharmacists, LPCs

and pharmacy teams involved in successful flu vaccination

schemes in 2014/15 to ask them what they had learnt. Here is a

selection of their advice.

*Additional pointersa) Put anaphylaxis procedures in place

Remember to ensure staff know where the Anaphylaxis

Pack/Adrenaline injection is kept; consider training

members of the dispensary staff to draw up the

Adrenaline; and have a card by the phone detailing what

information to provide when calling an ambulance (a

template card is available on the PSNC website).

b) Think about stock management

Consider multiple delivery drops and remember to bear

in mind your fridge capacity.

c) Plan your appointments or walk in system

10 minute appointments are probably the best to start

with. Once the pharmacist’s skill and confidence has built

up (after the first few patients) you will find there is

plenty of time to perform other duties and maybe even

squeeze in a walk-in between appointments.

For pharmacy teams1. Think about your pharmacy and your patients.

Would appointments work or would a ‘drop in’ service be

better? We had a ‘drop in’ service and it worked well for our

pharmacy, although appointments will work better for some.

2. Be organised.*

This is with regard to stock, paperwork and the running of your

service as a whole. Utilising the skills of your staff is pivotal. Try

and instil them with enthusiasm.

3. Go for it.

If you’re going to do it, then go ‘all in’. There’s no point in being

half hearted

4. Appoint a ‘flu helper’

This is someone on the team with a specific brief to discuss the

betnefits of flu vaccination with eligible patients who come

into the pharmacy.

5. Talk to local GP practices

Consider whether you could speak to any local GP practices

about the service to try to work together to ensure that

patients are not confused and that vaccination targets are met.

6. Make the most of everyone on the team

Although the pharmacist must carry out the vaccination

process, other team members can help both before and after

that for example asking patients to complete the post-

vaccination questionnaire.

The above infographic details the process involved in flu

vaccinations to help deliver the service smoothly and efficiently. It

could be stuck on a wall in your consultation room as a reminder

to pharmacy staff. The routine is based on advice provided to

pharmacy teams in Cumbria by John Urwin, owner of Seaton

Pharmacy in Workington and a member of Cumbria LPC.

6 Community Pharmacy News – September 2015

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The Dictionary of Medicines and Devices

(dm+d) is the NHS standard database of

medicinal items, and is used across the NHS,

for example in the Electronic Prescription

Service (EPS) and for prescription pricing

purposes. Pharmacy and GP system

suppliers adopt or map to the information

included within it. Each medicinal item has

an entry in the database in which

information is stored in several interlocking

levels; there is information relevant to

pharmacy teams in each level (see diagram

of the structure below).

Using the database for information

You can view dm+d information online using

an internet browser. Datapharm

(collaborating with the Pricing Authority)

provide access at the website:

dmd.medicines.org.uk and this can help

support the dispensing process. The

examples at the bottom of this page show

dm+d information at generic (VMP), supplier

level (AMP), and supplier pack level (AMPP).

Reimbursement/EPS issues

Each medicinal item listed in dm+d has its

own unique code and new products are

added by the Pricing Authority. With EPS

prescriptions, reimbursement will be based

on the dm+d code attached to the EPS

prescription.

� Electronic endorsing: Additional

information for pricing can be provided

by endorsing the electronic prescription

using your PMR system endorsement

options.

� Supplementary product information

added by the prescriber in the dosage

section of an EPS prescription: The

Pricing Authority will not take into

account supplementary product

information included in the dosage area

section, i.e. immediately after the

dosage instructions

(psnc.org.uk/dosageissue).

� Non-dm+d items are outside the scope

of EPS so may not be processed and

How to use the NHS medicines database (dm+d)This guide explains how the NHS medicines database impacts on

reimbursement and how you can use it to find out what you will be paid. It

also highlights how it is used in the Electronic Prescription Service.

‘Generic’ perspective e.g. ‘Atenolol 100mg tablet’This is the generic product title described as the virtual

medicinal product (VMP).Information in this part of the database determines things

such as the drug form and whether the medicine is aControlled Drug.

Supplier’s product perspectivee.g. Tenormin 100mg tablets (Actavis UK Ltd)’

This is the product level which is usually linked to a particularsupplier, or the ‘actual medicinal product’ (AMP).

The supplier can have information listed here relating toavailability and licensing status.

CD status ofa product

Here there are links tothe suppliers’ product(AMP level, see pictureopposite).

VMP describes thegeneric product

Link to patientinformation leaflet

Link to the relevantpack levels

Manufacturer/SupplierName of product

Licensing statusof product

Link to the relevant pack levels, or the virtual medicinal productpack (VMPP). Information here determines such things as DrugTariff category and whether the item is a combi-pack.

Information levels on dm+d

psnc.org.uk 7

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priced correctly: Most items which are

prescribed are listed in dm+d, but if a

prescriber wishes to prescribe a

medication item which is not listed in

the dm+d (e.g. a particular special

formulation), an electronic prescription

should not be issued by EPS and national

paper prescription processes should be

followed.

Differences between EPS dm+d

prescriptions and paper ones

Prescribers issue prescriptions for

products via EPS using either a product’s

VMP or AMP code from dm+d. There can

therefore be differences between EPS

prescriptions and paper ones, such as:

• Changes to medicine descriptions

compared with historical medicine

descriptions: For example 'enteric

coated' tablets are described in dm+d as

'gastro-resistant', and for inhalers, dm+d

uses the term 'dose' as opposed to

'actuation', 'inhalation' or 'puff'. In

dm+d, products are described in the

order: product, strength, form.

• Quantities and units of measurement:

In EPS R2, GPs cannot prescribe ‘packs’

but must instead prescribe using dm+d

quantities. For example since inhalers

are expressed within dm+d using

‘number of doses’ prescribers may

select '200 dose' rather than '1 inhaler'.

PMR systems can support pharmacy

teams by calculating the prescribed

quantity as a number of packs for ease

of dispensing.

• Terminology length and abbreviations:

Many products have a full name and an

abbreviated name so that the latter can

assist with dispensing label space

restrictions.

Mapping of system supplier drug

databases to dm+d

The mapping process: Prescribers can

issue EPS prescriptions using either the

generic VMP or the supplier-linked AMP

code. Most GP and pharmacy system

suppliers use drug databases in their

systems, and have to ‘map’ the dm+d

products to products listed in their

databases so that EPS messages can be

sent and received. EPS R2 system suppliers

must use dm+d information no more than

two months old.

Reporting medicine ‘mapping errors’

(EPS): Where a particular item held on the

GP system’s drug database is not mapped

with a dm+d code, or the mapping is

inaccurate, there may be risk of medico-

legal consequences. If pharmacy teams

spot that information printed on the token

is different from prescribing information

shown on the screen, they should report it

to their pharmacy system supplier

immediately and also report it as a patient

safety incident to the National Reporting

and Learning System (NRLS)

(npsa.nhs.uk/eform).

More information about dm+d can be found

at: psnc.org.uk/dmd,

dmd.medicines.org.uk, and dmd.nhs.uk

Supplier’s product pack perspectivee.g. ‘Tenormin 100mg tablets (AstraZeneca) 28 tablet’

This describes the pack levels relating to the above, or the ‘actual medicinal product pack’ (AMPP).The supplier can list the NHS-listed price, whether broken bulk can be claimed, and whether the product is a POM, a ‘special container’,

‘discounted’ etc.

Note: Indicative NHS pricedoes not always apply toreimbursement e.g. where aPart VIII item has beenprescribed generically, or if aproduct has recently changedin price (then the DrugTariff's price changemechanism would apply, seepsnc.org.uk/pricematch).

This section includes:• patient prescription charges;• professional dispensing fees;• broken bulk eligibility;• special container status; and• discount not deducted status.

If a product isP, POM, or GSL

Pack size/subpack size

8 Community Pharmacy News – September 2015

PSNC’s Health Policy and Regulation

subcommittee was asked to consider an

abbreviated Community Pharmacy

Assurance Framework (CPAF)

questionnaire, which contains 10 questions,

each covering parts of the terms of service

set out in the NHS (Pharmaceutical and

Local Pharmaceutical Services) Regulations

2013. The results of this together with

additional information collated by the

NHSBSA and NHS England will be used to

prioritise monitoring visits to help ensure

that patients and members of the public

receive safe, effective and high quality

pharmaceutical services. The full CPAF will

then be sent to those pharmacy contractors

that are being considered for a visit.

PSNC supports the completion of the

abbreviated CPAF by all pharmacies.

However, the full CPAF will also be available

in due course, and whether the pharmacy is

asked to complete one or not as part of the

pre-visit planning, we would recommend

that pharmacy contractors complete the

full version.

For the 2015/16 questionnaire NHS

England has requested the NHSBSA to carry

out the administration of CPAF at a national

level on their behalf and this will be

facilitated by a secure on-line mechanism

for contractors to complete their returns.

Contractors will have four weeks to

complete the abbreviated CPAF

questionnaire which will be available from

Monday 5th October 2015 until Sunday 1st

November 2015. The questionnaire should

only take around 20 - 30 minutes to

complete and you will receive information

and instructions on how to access and

complete the questionnaire in advance.

Once you have submitted the completed

questionnaire, responses can be saved or

printed for future reference.

The NHSBSA and or your local NHS England

team will contact you to provide log-on

details. If you have not heard from either by

5th October, contact nhsbsa.help@nhs.net

Community Pharmacy Assurance Framework update

A new shortened monitoring questionnaire has been created for contractors and

will enable NHS England teams to more effectively prioritise their pharmacy visits.

Changes to the NHS Constitution

In his inquiry into the failings at Mid-Staffordshire, Sir

Robert Francis QC recommended amendments to the NHS

Constitution based on prioritising patients, protecting

patients from avoidable harm, providing assistance that

patients need, and staff compliance with guidance.

Each of these recommendations were implemented within

the new NHS Constitution on 27th July 2015.

Additionally, the Department of Health has introduced a

new duty of candour. There had previously been a

requirement to be honest with patients, when things go

wrong, but NHS providers are now required to be both

honest and open.

Section 2(4)(a) and 2(6)(g) of the Health Act require

providers of pharmaceutical services to have regard to the

NHS Constitution, so this amendment is effective without

the need for a change to the pharmacy Terms of Service.

The NHS Constitution and associated guidance can be found

at: tinyurl.com/d7sa3wq

To help pharmacy teams get the most out of EPS, new system-

specific training will be available for all those working in

community pharmacy. This training will be relevant for counter

staff as well as dispensing technicians, pharmacists and locums.

Over 800 training events will be held throughout England with at

least one event per PMR system in each LPC area during the next

year. The events are being organised by the EPS Team at the

Health and Social Care Information Centre (HSCIC), in conjunction

with LPCs, dispensing system suppliers and the Pricing Authority.

The free training will focus on:

1. dispensing system training, tailored specifically to your PMR

system, covering how to use EPS Release 2;

2. business process change and how to get the best out of EPS,

including business continuity; and

3. a claiming and endorsing masterclass by the Pricing Authority.

PSNC encourages all community pharmacy teams to attend at least

one event, to ensure they can get the most out of EPS, understand

their PMR capability, and are prepared for the future of EPS. Sign

up for events in your area at tinyurl.com/traineps or read more at

psnc.org.uk/epstraining

Free EPS masterclasses

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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.

Communications International Group

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

Tel: 020 7434 1530 Fax: 020 7437 0915

Distributedfor PSNC by:

psnc.org.uk 9

In this section of Community Pharmacy News we have highlighted some keynotices for you and your team to be aware of in the coming weeks and months.

Pharmacy notice board

Stoptober returnsThe Stoptober campaign, a 28-day national stop smoking challenge running in October, will return againthis year.The Public Health England campaign, helping encourage England’s smokers to quit, launches on 3rdSeptember whilst Stoptober itself starts on 1st October.Stoptober gives pharmacy teams a way to discuss products, tailor advice and introducesmoking cessation services to smokers who may already be thinking of quitting.Pharmacy teams can get involved by ordering the Stoptober toolkit free of charge from0300 123 1019. The order line is open Monday to Friday, from 8am to 6pm, until 28thOctober 2015 or whilst stocks last.

Antepsin supplyThe manufacturer Chugai hasadvised that there is no stockof Antepsin 1g/5ml OralSuspension and Antepsin 1gTablets for communitypharmacies.

Chugai said: "It is unlikely that supply will be

resumed until the end of 2015."

Remember: when obtaining an unlicensed

product, the prescriber will need to be

contacted and, where appropriate, amend a

generically issued prescription for Sucralfate

to specify 'unlicensed special'.

For more guidance on endorsing unlicensed

specials, see: psnc.org.uk/specials

Updated New MedicineService e-courseThe Centre for PharmacyPostgraduate Education (CPPE) willbe running an updated live e-courseon the New Medicine Service (NMS).The live course entitled ‘New Medicine Service:improving quality and getting it right’ will giveparticipants an understanding of the purpose andscope of NMS; as well as looking at thepracticalities of running the service.Many of the weekly learning activities from thee-course can be done at a time convenient to theparticipant, but the live aspect will allow participantsto interact with colleagues in discussion forums andlearn together in online webinar sessions.28th September 2015 is the last date on which youcan join the 8-week course.

Pharmacy teams’ work recognisedThe potential for communitypharmacy post-discharge servicesto improve care for patients hasbeen recognised in Healthwatch England's latest inquiryreport.PSNC submitted evidence to HealthWatch England'sspecial inquiry into people's experiences of leavinghospital, highlighting some of the great work alreadybeing carried out locally. Examples included the Isle ofWight's Reablement Project, which saw a 67.5%reduction in hospital bed days following discharge, andhas been showcased in Healthwatch's final report.Read the Healthwatch report, and PSNC's submission tothe inquiry, at: dld.bz/dQxQK

Have you seen PSNC’s factsheet“Sending EPS presriptions with theright exemption information”?Recently PSNC’s Dispensing and Supply Team havehad an increased number of calls relating to thewrong exemption information being populated onEPS resulting in the incorrect claim being sent.

A factsheet has been created tohelp ensure pharmacy teams sendthe right exemption information withEPS claims.

Head over to psnc.org.uk/espexemption to findout more.

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10 Community Pharmacy News – September 2015

10% of primary care budget spent on diabetes

The report Prescribing for diabetes in England (dld.bz/dRRj4)

published by the Health & Social Care Information Centre (HSCIC)

shows that in 2014/15:

• the Net Ingredient Cost for managing diabetes was £868.6

million – this represents 10% of the total primary care

prescribing spend in 2014/15 (£8,704.9 million);

• 47.2 million items were prescribed for diabetes, a 4.6% increase

(2.1 million) from 45.1 million items in 2013/14; and

• diabetes medicines accounted for 4.5% (47.2 million) of all

prescription items (1,059.8 million).

Antimicrobial stewardship programme

NHS England, Health Education England and Public Health

England (PHE) have issued a joint National Patient Safety Alert to

all providers of NHS care in England to highlight the challenge of

antimicrobial resistance and the need for antimicrobial

stewardship.

The joint patient safety alert signposts NHS organisations to the

TARGET (Treat Antibiotics Responsibly, Guidance, Education,

Tools) (dld.bz/dRRjG) and Antimicrobial Stewardship: Start Smart

then Focus (dld.bz/dRRjH) toolkits. These have been developed

by PHE in collaboration with several professional bodies to

support the NHS in improving antimicrobial stewardship in both

primary and secondary care.

Fire and Rescue Services Partnership

NHS England and the Fire and Rescue Services have established a

new partnership to use their collective capabilities and resources

more effectively to enhance the lives of older people and those

with complex conditions.

Working together with PHE, the Chief Fire Officers Association,

the Local Government Association (LGA) and Age UK, the group

has established a new working relationship aimed at improving

the quality of life for people who would benefit from brief health

and wellbeing interventions in their own homes.

Primary Care Workforce Commission report

The Primary Care Workforce Commission has published The future

of primary care, Creating teams for tomorrow (dld.bz/dRRjb),

which calls for wider use of community pharmacists and

pharmacy support staff in managing minor illness and advising

people about optimising their medicines. It also recognises that

greater use of pharmacy services such as weight management

and smoking cessation, could relieve some of the demand for

care from general practices.

More than 200,000 sign Hunt no confidence petition

More than 200,000 people have signed a petition calling for a

vote of no confidence in Health Secretary Jeremy Hunt. The no

confidence petition (dld.bz/dRRjn) was organised by NHS doctors

who say the Health Secretary has alienated the entire workforce

of the NHS by threatening to impose a harsh contract and

conditions on first consultants and then other NHS staff.

Hospital-based GP practice

A GP practice based within a hospital is looking to sign up just

patients who have five or more serious long-term conditions to its

list to help reduce pressure on the Emergency department. The

scheme is run by GPs who have received funding from the Prime

Minister’s Challenge Fund (dld.bz/dRRjw) to increase GP access,

and it has been commissioned by NHS Barking & Dagenham

Clinical Commissioning Group (CCG) and NHS Havering &

Redbridge CCG.

5% of GP appointments are “no-shows”

One in 20 appointments at GP practices are missed by patients,

research by a Local Medical Committee (LMC) has shown. In 2014

68,000 appointments across 29 practices in the Leicester,

Leicestershire and Rutland LMC area were missed by patients.

The findings suggest that across England, more than 16 million

appointments are missed each year.

7-day NHS services

The Department of Health has published a factsheet

(dld.bz/dRRjk) describing why the NHS needs to offer a 7-day

service and further action that the Government wants to take to

make NHS services safer.

E-cigarettes evidence review

PHE has published an expert independent evidence review

(dld.bz/dRRjE), which has concluded that e-cigarettes are

significantly less harmful to health than tobacco and have the

potential to help smokers quit smoking.

PSNC regularly receives questions from LPCs and pharmacy

contractors about what is going on in the wider health and care

landscape beyond community pharmacy. In this round-up we

cover the latest news from the past month

2014/15 saw a 4.6% increase initems prescribed for diabetes

One in 20 appointments at GPpractices are missed

More than 200,000 signed apetition calling for a vote of no

confidence in the Health Secretary

Diabetes management accountedfor 10% of the total 2014/15primary care budget

the healthcare lanDscape lpcs psnc’s work funDing anD statistics

psnc.org.uk 11

1. What is the NHS standard list of medicinal items?

The NHS Dictionary of Medicines and Devices (dm+d) is a

database which contains information about medicines and

devices used in the UK. The Pricing Authority maintains dm+d.

The database not only includes the vast majority of medicines or

devices that are currently available, but also those that have been

discontinued, used in clinical trials or imported. Each product or

device is assigned a unique code, which is never deleted or reused.

The dm+d underpins many of the NHS IT initiatives including the

Electronic Prescription Service (EPS) which currently only allows

prescribing and dispensing of those items listed in dm+d.

The InDemand version of the dm+d database can be searched and

viewed from: dmd.medicines.org.uk. A guide to dm+d can be

found on pages 6 and 7.

2. What items can be issued on EPS?

Prescribers are able to issue:

• Acute prescriptions;

• Repeat prescriptions (repeat prescribing);

• Repeatable prescriptions (repeat dispensing); and

• Schedule 2,3,4 and 5 Controlled Drugs.*

* Although Schedule 2 and 3 Controlled Drugs can now legally be

prescribed on EPS release 2, the date at which pharmacy teams

will start to receive such prescriptions has yet to be confirmed.

Please note: it is not possible for a prescriber to use EPS release

2 to request a bulk prescription (Drug Tariff Part VIII note 9) for

a school or institution. Private prescriptions are also out of

scope.

There will be occasions where a product cannot be prescribed

electronically for technical reasons. For example, this could

occur if the product is not listed in dm+d or if the prescribing

system is not able to issue a prescription for the item because

the supplier hasn’t ‘mapped’ the appropriate codes.

3. Can EPS be used with items not included within the dm+d?

No, an EPS prescription cannot be issued where the product is

not listed in dm+d or if the prescribing system is not able to

issue a prescription for the item because the supplier hasn’t

‘mapped’ the appropriate codes. This is likely to affect less

commonly prescribed items including products to be specially

manufactured or extemporaneously dispensed products.

Please note: if information is included in the dosage area which

indicates a non-dm+d item, this cannot be taken into account by

the Pricing Authority for reimbursement.

Look out for more frequently asked questions next month…

Ask PSNCThe PSNC Dispensing and Supply Team give pharmacy teams support and advice

on a range of topics related to the Drug Tariff and reimbursement. Below are

some questions the team have been asked by pharmacy teams in recent weeks.

If you would like more information on any of the topics covered,

the PSNC Dispensing and Supply Team will be happy to help

(0844 381 4180 or 0203 1220 810 or e-mail info@psnc.org.uk).

Have you registered for the Pricing

Authority Information Services Portal?

As part of the programme to provide

prescription pricing transparency, the

Pricing Authority has made pharmacy

contractor payment information (i.e. FP34

Schedule of Payments) available to view

via the Information Services Portal (ISP).

To view your FP34 Schedule and gain access

to the upcoming item level payment

reports, register for the portal at:

tinyurl.com/BSAportal

NHSBSA’s Hints & Tips

NHS Prescription Services produces a

quarterly newsletter called Hints & Tips for

dispensing contractors. We would like to

draw your attention to the latest edition

(Issue 20) as it contains some really useful

information and advice regarding:

• Information on changes to the Misuse

of Drugs Regulations;

• News on the new live service reports

for the Electronic Prescription Service

(EPS);

• Information on incorrect patient

declaration of exempt/paid status for

EPS Release 2 messages; and

• Referred back (returned) items.

News from the NHSBSA

contract anD it Dispensing anD supply services anD commissioningfunDing anD statistics

NHSBSA have published a Special

Edition of Hints & Tips on EPS

which may also be of benefit to

pharmacy teams.

All issues of Hints & Tips can be found

at: www.nhsbsa.nhs.uk/3191.aspx

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

Dispensing anD supply services anD commissioning the healthcare lanDscape

SC Special Container

Part VIIIA Category C additions

• Aluminium chloride 20% solution SC

(20ml and 75ml) – Driclor and SC (60ml)

– Anhydrol Forte

• Azelastine 0.05% eye drops SC (8ml) –

Optilast

• Betamethasone 0.1% / Neomycin 0.5%

ear/eye/nose drops SC (10ml) –

Betnesol-N

• Canagliflozin 100mg and 300mg tablets

(30) – Invokana

• Coal tar extract 2% shampoo SC (125ml

and 250ml) – Neutrogena T/Gel

Therapeutic Shampoo

• Desmopressin 120microgram oral

lyophilisates sugar free (30) –

DesmoMelt and (100) – DDAVP Melt

• Desmopressin 240microgram oral

lyophilisates sugar free (30) –

DesmoMelt

• Desmopressin 60microgram oral

lyophilisates sugar free (100) – DDAVP

Melt

• Febuxostat 120mg and 80mg tablets

(28) – Adenuric

• Ibuprofen 5% spray SC (35ml) – Ibuleve

Speed Relief and SC (100ml) – Ibuspray

• Isosorbide dinitrate 20mg and 40mg

modified-release tablets (56) – Isoket

Retard

• Lidocaine 5% medicated plasters 30 (6x

SC 5) – Versatis

• Lidocaine 5% ointment SC (15g) – A A H

Pharmaceuticals Ltd

• Liraglutide 6mg/ml solution for injection

3ml pre-filled disposable devices (2) –

Victoza

• Miconazole 2% powder SC (20g) –

Daktarin

• Midodrine 2.5mg and 5mg tablets (100)

– Bramox

• Naproxen 500mg / Esomeprazole 20mg

modified-release tablets (60) – Vimovo

• Nifedipine 40mg modified-release

tablets (30) – Fortipine LA 40

• Oxytetracycline 3% / Hydrocortisone 1%

ointment SC (30g) – Terra-Cortril

• Prednisolone 5mg/5ml oral solution unit

dose 10 (2x SC 5) – Logixx Pharma

Solutions Ltd

• Salicylic acid 16.7% / Lactic acid 16.7%

paint SC (10ml) – Salactol

• Valsartan 160mg and 80mg tablets (28)

– Macleods Pharma Ltd

Part VIIIA Category A additions

• Alpha tocopheryl acetate 500mg/5ml

oral suspension (100ml)

• Dexamethasone 3.8mg/1ml solution for

injection vials (10)

• Hyoscine hydrobromide

600micrograms/1ml solution for

injection ampoules (10)

• Lidocaine 5% / Phenylephrine 0.5%

nasal spray SC (2.5ml)

Part VIIIA deletions

• Aspirin 300mg suppositories (10) –

Category A

• Bimatoprost 300micrograms/ml eye

drops (3ml) – Category C Lumigan

Drug Tariff WatchBelow is a quick summary of some the changes due to take place from 1st October 2015

Part IX Deletions

Brand Product description Product code

A H Shaw & Partners Ltd

Double Side plasters 128mm x 128mm hole cut to size NSI 46 10 896

Double Side plasters 102mm x 102mm hole cut to size NSI 49 10 864

Night Bag Cover, Cotton NSI 47 1 599

Night Bag Cover, Lycra NSI 45 1 643

Colostomy Belt 102mm wide elastic web made to measure NSI 10 1

Hainsworth bags with body mould adhesive hole size 25mm, 32mm, 38mm, and 51mm NSI 63 20

Hainsworth bags with Healwell adhesive hole size 25mm, 32mm, 38mm, and 51mm NSI 39 20

Stick on bags with plasters NSI 62 10 967

Shaw double seal 280mm x 154mm NSI 64 100 1163

Colostomy bags 350mm x 204mm NSI 65 100

Complete Colostomy outfit comprising of a 102mm wide elastic web belt with groin-strap 660mm, 715mm etc. to 107cm, 1Colostomy facepiece (flange), 100 Colostomy bags 280mm x 154mm

NSI 6 1

Complete Colostomy outfit comprising of an adjustable 102mm wide elastic web belt with groin-strap 660mm, 715mm etc. to107cm, 1 Colostomy facepiece, 100 Colostomy bags 280mm x 154mm

NSI 8 1

Rubber Adhesive Flange NSI 1 1

Rubber Non-Stick Flange NSI 2

Black Rubber Day Bag (with screw cap) 22mm, 29mm and 38mm NSI 66 1

Shaw Healwell Squares hole sizes 25mm, 32mm and 38mm NSI 53 12

Body Mould Squares hole sizes 25mm, 32mm and 38mm NSI 56 5

Washers hole sizes 25mm, 32mm NSI 59 10

Rings hole sizes 25mm, 32mm and 38mm NSI 55 5

Hollister Ltd

Impression “C” with convex wafer, Transparent front with filter and beige Comfort backing on body worn side 19mm 3590 10

Drainable Pouch, symmetrical shape, flexible barrier plus integral filter and Lock and Roll closure system Maxi - Beige with comfortbacking on both sides 20mm

28320 30

Flex Wear Floating Flange pre-cut 55mm flange 35mm 35235 5

Flex Wear Floating Flange pre-cut 55mm flange 40mm 35240 5

Salts Healthcare

Male Continence Sheath 17mm ZL0028 10

Standard Adjustable Ostomy Belt 25mm Button Belt 877011 1

Peri-Prep Wipes 840001 50

Foam Seals as in large twin pack 833085 10

Sigvaris Cotton

Class 2 Below Knee Xtra Maxi Closed Toe Normal, Long XS, S, M, L, XL n/a

Class 2 Below Knee Xtra Maxi Closed Toe Plus Normal, Long XS, S, M, L, XL n/a

Class 3 Below Knee Xtra Maxi Closed Toe Normal, Long XS, S, M, L n/a

Class 3 Below Knee Xtra Maxi Closed Toe Plus Normal, Long XS, S, M, L n/a

Sterifix Dressing (with two adhesive strips) 5cm x 7cm, 7cm x 10cm and 10cm x 14cm n/a