Download - September 2015 CPN
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 [email protected]
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.
lpcs psnc’s work funDing anD statisticsthe healthcare lanDscape
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 [email protected]).
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: [email protected] © 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