CPNCommunity Pharmacy News – October 2015

National flu service gets underway PSNC and NPA answer your questions live as service

gets green light

Prescription direction poster | Showcasing local services | Eligible flu groups guide

2 Community Pharmacy News – October 2015

services and commissioning The healThcare landscape lpcs

NHS England publishes flu service documentation

Community pharmacy contractors can now access the necessary paperwork

to begin providing the national flu vaccination service.

Resources round upBriefings

PSNC has produced a number of briefings to help

pharmacy teams with the service, including a poster

showing the process to follow, responsive lines to

use when faced with negativity and template radio

scripts for promotion.

These can all be found on the Briefings Database

(psnc.org.uk/briefings)

Patient communication materials

PSNC has developed a range of patient

communication materials which are available from

psnc.org.uk/flupatientcomms

PSNC has also been working to obtain translations

of these materials and those we have so far can be

found at the above link.

We are continuing to publish resources to help

pharmacy teams and LPCs to promote the service

and these will all be available from psnc.org.uk/flu

Q. The national PGD refers to groups of

eligible patients not listed in Annex A

of the service specification, e.g.

morbidly obese patients. Does this

mean pharmacists can administer

vaccines to these additional groups of

patients?

No. Only patients who fall into a group

listed in Annex A of the service

specification can be vaccinated as part of

the service. This is clearly stated on page

4 of the national PGD.

Q. Can I administer flu vaccinations at

premises other than the pharmacy

premises?

If a pharmacy receives a request from a

long-stay residential care home or other

long-stay care facility to vaccinate a

resident/patient away from the

pharmacy premises and approval is given

by NHS England then a contractor can

provide vaccinations at a suitable

location within the care home or care

facility (contractors must follow the

protocols set out in Annex C of the

service specification). However, the

service does not allow pharmacists to

provide off-site vaccinations for any

other group of patients at any other

premises.

Q. Should pharmacy teams verify the

eligibility of patients requesting flu

vaccination under the service?

In many circumstances pharmacy teams

will know the patients who are

requesting vaccination under the service

and they will therefore be able to

determine whether a patient falls within

an eligible group as a result of

knowledge of the patient and their

patient medication record. There will

however be circumstances where the

patient is not known to the pharmacy

team. In that case it will be necessary for

the pharmacist to talk to the patient and

to use their professional judgement to

determine whether the patient falls

within an eligible group. As part of the

service patients must sign a form which

contains a declaration that the

information they have given in relation

to the service is correct and complete.

Frequently Asked Questions

As of 16th September, pharmacy contractors that fully meet the

requirements for provision of the Community Pharmacy Seasonal

Influenza Vaccination Advanced Service can provide the service. This

follows the amendment of the Secretary of State Directions and the

publication of the national Patient Group Direction (PGD) on the NHS

England website.

Links to the service specification, national PGD and Secretary of State

Directions (which provide the legal basis for provision of the service) are

available from psnc.org.uk/flu

Once contractors are fully ready to provide the service, they must notify

NHS England of their intention to begin providing the service by

completing a notification form on the NHS BSA website (a link to the form

is available at psnc.org.uk/flu). PSNC has produced a detailed guidance

document to support the preparation process and it includes a checklist

which contractors can print out and work through to ensure they have

everything they need in place to successfully provide the service.

PSNC Briefing 053/15: Guidance on the Seasonal Influenza Vaccination

Advanced Service can be found at psnc.org.uk/flubriefing

Alastair Buxton, Director of NHS Services at PSNC, said:

“The publication of the service specification and the completion of the

regulatory changes mean community pharmacy teams can now start

offering NHS flu vaccinations. Our guidance talks contractors through the

preparation for the service step by step so we hope this will not have been

too arduous. This is a very exciting time for community pharmacy and I

look forward to hearing how pharmacy teams across England are getting

behind the service and showing patients and the NHS what we can do!”

psnc.org.uk 3

funding and sTaTisTics conTracT and iT dispensing and supplypsnc’s work

More than 1,000 people joined a webinar on the national flu

vaccination service held by PSNC and the NPA last month

(16th September).

Attendees first heard about the official documentation and

requirements for provision of the service from PSNC’s Director of

NHS Services, Alastair Buxton, and then it was over to Leyla

Hannbeck, the NPA’s Head of Pharmacy Services, for support with

the practicalities of getting started.

The final section of the webinar was dedicated to viewers’

questions but, with over 200 submitted, unfortunately not

everyone’s questions could be answered. PSNC has now picked

out the most commonly asked questions and added them to our

flu FAQs page; a selection of these new FAQs have also been

replicated in the banner across the bottom of this double page.

With the majority of attendees rating the webinar at least 4 out

of 5, the feedback we received on the night was equally positive.

So if you missed out, or just want to watch again, you will be

happy to hear that an on-demand recording of the webinar is now

available to watch at: psnc.org.uk/webinar

Flu vaccination service webinar now availableon-demandCommunity pharmacy teams can now access an online recording of the

recent joint webinar on the national flu vaccination service.

Q. What does the service specification

mean when it says a contractor should

seek to ensure that the service is

available throughout the pharmacy’s

contracted opening hours?

That wording reflects NHS England’s

desire that the service is very accessible

for patients and that there is therefore

continuity of service provision across the

full opening hours of the pharmacy. In

previously commissioned local

vaccination services, good availability of

the service across the week was an

aspect of the service that was highly

valued by patients. Once a contractor

starts to provide the service they must

ensure, in so far as is practicable, that the

service is available throughout the

pharmacy’s core and supplementary

opening hours.

Q. What are the knowledge and skills

required in order to provide a

vaccination service?

The National Minimum Standards for

Immunisation Training and the associated

Core Curriculum for Immunisation

Training set out the knowledge and skills

that healthcare professionals undertaking

vaccination services need to have. NHS

England has determined that pharmacists

providing the flu vaccination service need

to attend face-to-face training for both

injection technique and basic life support

training every two years. This

requirement means that a pharmacist

who undertook face-to-face training for

both injection technique and basic life

support in 2014 would not need to

undertake face-to-face training in 2015.

Assuming the service continues to be

commissioned in 2016, the pharmacist

would then need to undertake face-to-

face training in order to continue to

provide the service. Pharmacists who last

undertook face-to-face training in 2013

would need to undertake face-to-face

training in 2015, prior to providing the flu

vaccination service.

Q. How do I claim payment for provision

of the service?

Contractors must complete the claim

form for the service at the end of each

month and submit this to the Pricing

Authority with their script bundle

submission (see psnc.org.uk/flu for a link

to the form).

The full list of FAQs can be found at

psnc.org.uk/flufaqs

Follow @PSNCNews for the latest pharmacy news, including priceconcession updates, funding announcements, and usefulresources.

You can also find PSNC's Director of NHS Services, Alastair Buxton,Head of Communications and Public Affairs, Zoe Smeaton, andPharmacy and NHS Policy Officer, Rosie Taylor, on Twitter.

Are you on Twitter?

4 Community Pharmacy News – October 2015

services and commissioning The healThcare landscape lpcs

Factsheet: Eligible groups for the flu vaccination

Eligible Groups Further details

All people aged 65 years or over Including those becoming age 65 years by 31 March 2016.

All pregnant women (includingthose women who becomepregnant during the flu season)

Pregnant women at any stage of pregnancy (first, second or third trimesters).

People living in long-stayresidential care homes or otherlong-stay care facilities

Vaccination is recommended for people living in long-stay residential care homes or other long-stay care facilities where rapid spread is likely to follow introduction of infection and cause highmorbidity and mortality. This does not include, for instance, prisons, young offender institutions,or university halls of residence.

Carers People who are in receipt of a carer’s allowance, or those who are the main carer of an older ordisabled person whose welfare may be at risk if the carer falls ill. Note that care workers who arepaid to provide care to people (for example in their own homes or in care homes) are not eligiblefor vaccination under the NHS Flu Vaccination Service – this would be an occupational healthresponsibility which should be funded by the person’s employer.

Household contacts ofimmunocompromised individuals

People who are household contacts, of immunocompromised individuals, specifically individualswho expect to share living accommodation on most days over the winter and, therefore, forwhom continuing close contact is unavoidable.

People aged from 18 years to less than 65 years of age with one or more serious medical condition(s) outlined below:

Chronic (long term) respiratorydisease, such as severe asthma,chronic obstructive pulmonarydisease (COPD) or bronchitis

Asthma that requires continuous or repeated use of inhaled or systemic steroids or withprevious exacerbations requiring hospital admission. Chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema;bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonarydysplasia (BPD).

Chronic heart disease, such asheart failure

Congenital heart disease, hypertension with cardiac complications, chronic heart failure,individuals requiring regular medication and/or follow-up for ischaemic heart disease.

Chronic kidney disease at stagethree, four or five

Chronic kidney disease at stage 3, 4 or 5, chronic kidney failure, nephrotic syndrome, kidneytransplantation.

Chronic liver disease Cirrhosis, biliary atresia, chronic hepatitis.

Chronic neurological disease,such as Parkinson’s disease ormotor neurone disease, orlearning disability

Stroke, transient ischaemic attack (TIA). Conditions in which respiratory function may becompromised due to neurological disease (e.g. polio syndrome sufferers).Clinicians should offer immunisation, based on individual assessment, to clinically vulnerableindividuals including those with cerebral palsy, learning disability, multiple sclerosis and relatedor similar conditions; or hereditary and degenerative disease of the nervous system or muscles;or severe neurological disability.

Diabetes Type 1 diabetes, type 2 diabetes requiring insulin or oral hypoglycaemic drugs, diet controlleddiabetes.

A weakened immune system dueto disease (such as HIV/AIDS) ortreatment (such as cancertreatment)

Immunosuppression due to disease or treatment, including patients undergoing chemotherapyleading to immunosuppression, bone marrow transplant, HIV infection at all stages, multiplemyeloma or genetic disorders affecting the immune system (e.g. IRAK-4, NEMO, complementdeficiency).Individuals treated with or likely to be treated with systemic steroids for more than a month at adose equivalent to prednisolone at 20mg or more per day (any age).It is difficult to define at what level of immunosuppression a patient could be considered to be at agreater risk of the serious consequences of influenza and should be offered seasonal influenzavaccination. This decision is best made on an individual basis and left to the patient’s clinician.Some immune-compromised patients may have a suboptimal immunological response to the vaccine.

Splenic dysfunction This also includes conditions such as homozygous sickle cell disease and coeliac syndrome thatmay lead to splenic dysfunction.

The national flu vaccination service covers those patients most at risk from influenza aged 18

years and older, as listed below. This list is taken from PSNC Briefing 053/15: Guidance on the

Seasonal Influenza Vaccination Advanced Service, which includes comprehensive guidance on

preparing to start the service. Download the full briefing from psnc.org.uk/flubriefing

psnc.org.uk 5

funding and sTaTisTics conTracT and iT dispensing and supplypsnc’s work

Patients have the right to choose freely which pharmacy dispenses

their prescriptions. NHS England has written to all general practices

and pharmacies to ask for their help in ensuring that all patients are

aware of this right and can exercise it without influence from their

general practice or from a pharmacy.

NHS England is concerned that, in a small number of cases, general

practices or pharmacies are seeking to influence inappropriately

which pharmacy dispenses a patient’s medicines, or which

pharmacy a patient nominates to receive their prescriptions

electronically. They have been working in collaboration with both

GP and pharmacy representative bodies, as well as NHS Protect, to

look at ways to ensure patient’s rights are not undermined.

NHS England states that we all have a duty to ensure patients’

rights under the NHS Constitution are met and NHS England take

very seriously any attempt to undermine this. Action will be taken

against individuals and contractors to protect patients’ rights.

In order to ensure patients are fully informed of their choice NHS

England is asking all general practices and pharmacies to display

the poster on pages 6 and 7 prominently, as close as practicable

to the location where patients receive prescriptions. Pharmacycontractors can obtain additional copies of the poster from PSNC

by contacting shantel.christian@psnc.org.uk.

Distance selling and internet

pharmacies should display this

information prominently on their

websites and take reasonable steps to

bring it to the attention of all patients,

for example, by including a copy of this

poster with dispensed medicines that

are delivered to patients.

If you are aware of a situation where

the right of patients to choose where

their prescriptions are dispensed is

being influenced NHS England would encourage you to

take this up, in the first instance, with your Local Medical

Committee and Local Pharmaceutical Committee (LPC). If the

situation cannot be resolved it should be escalated to NHS

England via the local office or via

england.primarycareops@nhs.net (including ‘Prescription

Direction’ in the subject heading).

You can download the letter and poster from NHS England frompsnc.org.uk

NHS England notice: raising awareness of patient choice

You have the right to collect medicines that havebeen prescribed for you from any pharmacy youchoose.Your choice should not be influenced by lettersyou receive in the post, or by any doctor orpharmacist.�%��+���(',��,������' %�'��"��+(&�('��"+�,*0"' �,("'�%-�'���0(-*����"+"('�('�.!"�!�)!�*&��0�0(-.(-%��%"$��,(�-+���(-���'��(',��,������' %�'��"'�,!���(%%(."' �.�0+ ��%% �������������������&�"% ���' %�'���(',��,-+�'!+�'�,�.",!�10(-*�)*�+�*"),"(' �0(-*��!("��2�"'�,!��+-�#��,�%"'���(+, ���������' %�'�������(/����������",�!��������

Your prescription: your choice

Check34 got its first upgrade at the

beginning of October and now provides

contractors with even more information on

their NHS dispensing performance.

A new key performance indicator (KPI)

showing how the ‘EPS vs. Paper’ dispensing

split is changing over time has been added.

More information on the key performance

indicators and how they impact on monthly

reimbursement is included. Other changes

improve the way dispensing trend data is

presented and make the dashboard more

user friendly.

Nearly 3,000 pharmacies can now sign in to

Check34 and see their dispensing data. The

upgrade follows suggestions from users for

improvements. Other changes include:

• The information boxes on script

switches, MURs and NMS at the top of

the dashboard have been clarified to

include monthly and annual figures and

fees.

• Trend lines have been added for national,

local and other comparators, and the

period can be adjusted for 12, 9, 6 or 3

months. Additionally, 13 months data

now appears, allowing year-on-year

comparisons to be easily made.

• A list of Expensive Items (over £300) can

be called up by scrolling over the bar

chart on the Expensive Items KPI.

Check34 provides even more...Check34, the online service that enables contractors to view 12 key

indicators showing the performance of their NHS dispensing business, has

been upgraded to allow even better performance tracking.

How to get aCheck34 account• All NPA members in England have

Check34 as part of their NPA

subscription package for at least 12

months. Go to the NPA website at

npa.co.uk/check34 for more

information and to apply for a

Check34 account.

• The NPA is also looking after

subscription sales for Check34 to

non-NPA member pharmacies.

Contact check34@npa.co.uk or call

Katie Smith on 01727 858687 for

subscription rates and more

information.

• CCA members who wish to find out

more about Check34 can email

check34admin@psnc.org.uk or

contact the PSNC office on 0203

1220 820.Clicking on the information icon next to the KPIdescription gives detailed information on what itmeasures and how it can impact on reimbursement.

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8 Community Pharmacy News – October 2015

services and commissioning The healThcare landscape lpcs

Devon pharmacy teams help more than

8,000 patients

The evaluation of a ‘Pharmacy First’ scheme

in Devon (which included a minor ailments

service delivered via a PGD, a winter ailments

service and an emergency supply service)

has found that more than 8,000 patients

were helped during its first five months.

The scheme, funded by the Prime Minister’s

Challenge Fund, aimed to make accessing

prescription medicines more convenient for

patients and reduce pressure on out of

hours services.

Read the Pharmacy First evaluation in full

at: psnc.org.uk/pharmacyfirst

Sheffield’s joint working pilot

A number of pharmacy contractors and GP

surgeries in Sheffield previously took part

in a pilot designed to promote and develop

joint working, with the aim of enhancing

patient care. A bid for funding under the

Prime Minister’s Challenge Fund has now

been successful, allowing roll out of the

scheme across the city from October 2015.

The pilot was commissioned by Sheffield

Clinical Commissioning Group (CCG) and

included four pilot sites, with a further

three sites being identified to carry out

associated work.

Sheffield CCG’s evaluation of the service

shows that positive outcomes have been

achieved with the pharmacists practising

their unique skill set and taking on tasks

that GPs had been performing. Safer use

of medicines was also reported both in

prescribing and patient use.

Showcasing pharmacy servicesIn this section of Community Pharmacy News we showcase some of the

work pharmacy teams, LPCs and PSNC have been doing on services.

Rotherham Retailer Awards

The team at Abbey Pharmacy has

found a lovely way to get local press

coverage for pharmacy – win the

Customer Service Award at the 2015

Rotherham Retail Awards! The team

demonstrated their superb

assistance to patients and excellent

product knowledge during a mystery

shopper test.

Community Pharmacy Humber

Awards

PSNC Chief Executive Sue Sharpe

joined over 100 guests for the

Community Pharmacy Humber

Awards Dinner last month where

Newland Community Pharmacy,

known for their work on initiatives

such as the Carer-Friendly Pharmacy

pilot, received the Pharmacy Team

of the Year Award.

LPCs can find the latest events and

communications in the LPC

resources centre at psnc.org.uk

Award-winning pharmacy teams New Health mattersresourcePublic Health England (PHE) has launched a

new resource, ‘Health matters’, which is

designed to support commissioning and the

delivering of services across local areas.

Health matters: smoking and quitting in

England (dld.bz/dUBej) is the first in a series

of these resources to be published with

further editions planned to cover PHE's seven

priority areas: tobacco, obesity, alcohol,

antimicrobial resistance, tuberculosis, early

years and dementia, as well as other areas of

PHE's mandated functions.

LPCs may find the statistics and links to other

resources it provides useful as supporting

evidence when building business cases for

locally commissioned services.

PSNC has been developing some prospectuses to help introduce

pharmacy services to commissioners: each one highlights a

healthcare challenge and explains how community pharmacy can

provide a solution.

These can be found, along with further resources and support, on

our Think Pharmacy webpage: psnc.org.uk/thinkpharmacy

They also appear in our ‘Commissioners Portal’ which was

launched earlier this year as a way to direct commissioners to

useful information and resources about pharmacy services.

Additionally, our new ‘Pharmacy Commissioning’ email newsletter

highlights news and resources that may be of particular interest

to people working in local commissioning organisations.

LPCs may like to direct local commissioners to the

Commissioners Portal (psnc.org.uk/commissioners); and ask

them to sign up for the Pharmacy Commissioning emails using

the form on the main page.

Working with local commissioners

Prime Minister’s Challenge Fund updates

Interventions

made during

Pharmacy

First Service

MinorAilmentsvia PGD

30%

WinterAilments

40%

EmergencySupply

30%

psnc.org.uk 9

funding and sTaTisTics conTracT and iT dispensing and supplypsnc’s work

Latest NHS technology developments

NHS England has revealed that more than 3.7m repeat

prescriptions were ordered online and over 3m people registered

for record access in the first quarter of 2015/16.

Health Secretary Jeremy Hunt has said that by 2016 he wants all

patients to be able to access their own GP electronic record online

in full, seeing not just a summary of their allergies and medication

but blood test results, appointment records and medical histories.

GPs will be provided with instant electronic discharge summaries

from hospitals for all acute and day care patients from October

2015. NHS England has said that this will ensure information is

immediately available at the time of patient handover.

Transforming urgent and emergency care services

NHS England has published Transforming urgent and emergency care

services in England – Safer, faster, better: good practice in delivering

urgent and emergency care (dld.bz/dUAV7) in which they state

community pharmacies can make valuable contributions to local

health communities’ urgent care programmes. The report cites a

number of examples of community pharmacy services that can

reduce pressure on GPs and enhance patient safety, including

medicines reviews, repeat prescription management and providing

urgent access to medicines.

5m at high risk of diabetes

Five million people in England have blood sugar levels indicating

a high risk of developing Type 2 diabetes, according to a new

report (dld.bz/dUAV2) published by Public Health England

(PHE).

An evidence review (dld.bz/dUAV5) also published by PHE

shows programmes similar to the NHS Diabetes Prevention

Programme can be successful in preventing 26% of people at

high risk of Type 2 diabetes from going on to develop the

condition. People supported by diabetes prevention

programmes lose on average 1.57kg more weight than those

not on such a programme.

Call for whooping cough immunisation of pregnant women

PHE is calling for pregnant women to have the whooping cough

(pertussis) vaccine in order to protect themselves and their

babies from this serious disease as new data (dld.bz/dUAVA)

shows that in 2014/2015 whooping cough vaccine coverage in

pregnant women averaged 56.4% in England.

Recently published data (dld.bz/dUAVB) shows that reported

whooping cough cases are still at raised levels in England,

meaning that babies born to unvaccinated mothers remain

vulnerable to the disease in their first few weeks of life.

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

More than 3m people haveaccess to their GP records online

Only 56.4% ofpregnant womenwere vaccinatedagainst whoopingcough in 2014/15

People supported by diabetes prevention programmeslose on average 1.57kg more weight than those not

PSNC pushes plan for future pharmacy servicesPSNC has

continued to

promote its

Pharmacy 5 Point

Forward Plan,

which sets out five

national

community

pharmacy services which the NHS could

commission now to ease pressure on

urgent care services, this month.

Working with partner organisations PSNC

hosted a fringe event at the Labour Party

Conference which was attended by

Parliamentarians, commissioners and

charities. The event was chaired by Sir

Kevin Barron MP, chair of the All-PartyPharmacy Group, and PSNC set out the

need for the NHS to make better use of

community pharmacy, highlighting the

services within the 5 Point Forward Plan.

Sir Kevin was supportive of the roles that

pharmacy can play, calling in particular for

a national minor ailments service, and

delegates discussed the need to include

pharmacy in local winter services planning

and for Health and Wellbeing Boards to

have pharmacy representation.

As CPN went to press PSNC was preparing

to host a similar event at the Conservative

Party Conference to be hosted by Ben

Gummer MP, the Parliamentary Under-

Secretary of State for Care Quality.

Also this month PSNC will be highlighting

its plans for community pharmacy in a

response to the Royal Pharmaceutical

Society (RPS) and National Association of

Primary Care (NAPC) consultation on

improving integration of pharmacies and

GP practice. Although PSNC agrees with

many of the suggestions and principles, it

disagrees strongly with one of the key

principles in the consultation, warning that

proposals which could see an end to the

national contractual arrangements for

community pharmacies could put the

network and the vital service it gives to

patients every day at risk.

You can read more about the party

conference events as well as PSNC’s full

response to the RPS/NAPC consultation atpsnc.org.uk

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

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Tel: 020 7434 1530 Fax: 020 7437 0915

Distributedfor PSNC by:

10 Community Pharmacy News – October 2015

psnc’s work

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

Consultation Skills newsletterThe Centre for Pharmacy PostgraduateEducation (CPPE) has published aConsultation Skills for Pharmacy Practice(CSfPP) newsletter, to update readers onthe latest CSfPP developments.

The first issue includes information onwhat's new, what's on the horizon, and topmessages to share with colleagues. Findout how to get your copy at: dld.bz/dT4ZJ

Reminder: free EPS masterclassesSystem-specific training is being made available to allthose working in community pharmacy.This training will be relevant for counter staff as well asdispensing technicians, pharmacists and locums.Over 800 training events will be held throughout England with at least oneevent per PMR system in each LPC area during the next year.The events are being organised by the EPS Team at the Health andSocial Care Information Centre (HSCIC), in conjunction with LPCs,dispensing system suppliers and the Pricing Authority.PSNC encourages pharmacy teams to attend at least one event to ensurethey can get the most out of EPS, understand their PMR capability, andare prepared for the future. See psnc.org.uk/epstraining

Pfizer and HospiramergerPfizer has confirmed that as of3rd September 2015, Pfizer andHospira are now operating as asingle organisation.

Further information canbe found in Pfizer's letter whichis available from dld.bz/dSYn2

Self Care Week returnsThe annual awareness campaign Self Care Week will runfrom 16th to 22nd November, and pharmacy teams are beingencouraged to get involved.Self Care Week, which is run by the Self Care Forum, aimsto help people understand what they can do to look aftertheir own health and that of their family, as well as living ashealthily as possible.The campaign also reminds people to ensure they have astock of medicines at home and that they canget advice on symptoms from their pharmacist.Further information and resources can befound at: dld.bz/dTe8B

Age restrictions for nicotine inhaling productsFrom 1st October 2015, it will be a criminal offence to sell nicotine inhaling products toanyone under the age of 18 years. The Nicotine Inhaling Products (Age of Sale and ProxyPuchasing) Regulations 2015 generally cover e-cigarettes, certain components parts and e-liquids that contain nicotine.The Department of Health, in conjunction with the MHRA and the Chartered TradingStandards Institute, has produced guidance on this subject which is available, along withfurther information, from dld.bz/dT5bj

The healThcare landscape lpcs

psnc.org.uk 11

services and commissioningfunding and sTaTisTics conTracT and iT dispensing and supply

1. How should I endorse a prescription for

generic insulin?

Because insulins are not listed in Part VIIIA

of the Drug Tariff, endorsement  of the

brand name/supplier, pack size dispensed

and the net price before discount and

excluding VAT should also be required. This

is to ensure correct reimbursement at the

manufacturer’s list price. If you do not

endorse the product dispensed, and there

are multiple products which meet the

generic description, the prescription will be

returned for clarification, thus delaying

reimbursement.

For further information on endorsement,

please visit psnc.org.uk/endorsement-

guidance

2. I have dispensed the final batch from a

patient’s repeat prescription. How do I

submit the repeat authorisation form to

the Pricing Authority?

Repeat authorisation (RA) forms should be

submitted to the Pricing Authority at the

end of the month in which all batch issue

forms have either been dispensed or

expired or the medication is no longer

required.

It is important that forms are sorted for

submission in the correct order as detailed

on the reverse of Form FP34C. In months

where RA forms are being submitted, tick

the appropriate box on the FP34C

submission document to indicate this.

There is no need to declare the number of

RA forms submitted.

3. How do the payments for repeat

dispensing work?

In addition to the fees and allowances paid

for dispensing all prescriptions,

pharmacies receive a repeat dispensing

annual payment of £1,500 (£125 per

month).

This payment is made to pharmacy

contractors automatically by the Pricing

Authority every month, whether they have

supplied repeat dispensing items or not.

Neither the contractor nor the local NHS

England team needs to do anything to

claim/authorise the payments.

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.

Questions asked in recent months have included:

High Court judgement on Lyrica – update

Pharmacy teams may be aware of the recent High

Court judgement regarding Pfizer’s patent claim for

Lyrica. The judgment, which may be subject to appeal,

has not affected the situation for pharmacists and GPs.

At the time of going to press, NHS England has yet to

consider whether to change its guidance which

requires pharmacists to refer generic prescriptions

back to the prescriber, if they are aware it is for

neuropathic pain, and prescribers to prescribe the

brand for neuropathic pain. Pharmacists should

therefore follow the guidance until further notice.

PSNC will stress to NHS England and the Department

of Health the importance of providing timely, clear and

unequivocal guidance to pharmacists and GPs as and

when the situation changes. Please refer to the PSNC

website for the latest developments.

Sucralfate tablets and suspension removed fromDrug Tariff

With effect from 1st October 2015, Antepsin 1g/5ml oral

suspension and Antepsin 1g tablets have been removed from Part

VIIIA of the Drug Tariff.

If a prescription is received for either product, the prescriber will

need to be contacted to be made aware that the licensed

branded products are not available and, where appropriate, asked

to issue a generic prescription for the unlicensed Sucralfate.

To ensure correct reimbursement, the generic paper

prescriptions will need to specify “unlicensed special”. paper

prescriptions of unlicensed specials also need to be placed into

the red separator. For EPS prescriptions the GP will need to select

"Sucralfate.. (Special Order).

For further guidance on endorsing prescriptions for unlicensed

medicines, please visit psnc.org.uk/specials

When pharmacy teams receive NHS prescriptions they must check whether the items prescribed are allowed on the NHS before dispensing. If the

items are not allowed, the pharmacy contractor may not be paid for them.

Pharmacy teams can check whether medicinal products and medical devices are allowed using the Drug Tariff, or the PSNC’s ‘Dispensing on an FP10

database’ (psnc.org.uk/FP10database).

Can it be dispensed on an FP10?

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).

dispensing and supply services and commissioning The healThcare landscape

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

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

Part VIIIA additions

SC Special Container

• Budesonide 9mg modified-release

tablets (30) Category C - Cortiment

• Etonogestrel 68mg implant SC (1)

Category C - Nexplanon

• Levocarnitine 1.5mg/5ml oral solution

paediatric SC (20ml) Category A

• Neomycin 500mg tablets (100) Category

C - AMCo

• Raltegravir 100mg granules sachets (60)

Category C - Isentress

• Tretinoin 10mg capsules (100) Category

C - Intrapharm Laboratories Ltd

Part VIIIA amendments

• Aminophylline 250mg/10ml solution for

injection ampoules (10) is changing to

Category C Hameln Pharmaceuticals Ltd

• Amlodipine 10mg/5ml oral solution

sugar free (150ml) is changing to

Category A

• Amlodipine 5mg/5ml oral solution

sugar free (150ml) is changing to

Category A

• Ascorbic acid powder (100g) is

changing to Category C - J M Loveridge

Ltd

• Ketoprofen 50mg capsules (112) is

changing to Category C - Tiloket

• Lidocaine 200mg/20ml (1%) solution

for injection ampoules (10) is changing

to Category C - Hameln Pharmaceuticals

Ltd

Part VIIIA deletions

If a medicinal product has been removed

from Part VIIIA and has no other pack

sizes listed, it can continue to be

dispensed, but it will need to be endorsed

fully (i.e. brand or supplier name from

whom the product was purchased and

the pack size from which the item was

dispensed and price paid) in future.

• Calcium acetate 667mg capsules (200)

Category C - PhosLo

• Carbamazepine 100mg chewable

tablets sugar free (56) Category C -

Tegretol Chewtabs

• Clomipramine 75mg modified-release

tablets (28) Category C - Anafranil SR

• Crotamiton 10% lotion (100ml)

Category C - Eurax

• Salbutamol 4mg modified-release

capsules (56) Category C - Ventmax SR

• Salbutamol 8mg modified-release

capsules (56) Category C - Ventmax SR

Part IX Deletions

It is important to take careful note of removals from Part IX because if you dispense a deleted product, prescriptions will be returned

as disallowed and therefore payment will not be made for dispensing the item.

Brand Product description Product code

MacGregorHealthcare Ltd

Qufora Onestep Intermittent Catheter pack of 30, Male, 6-18 351406-351418

Qufora Onestep Intermittent Catheter pack of 30, Female, 6-16 351206-351216

DressPore 7cm x 8cm (wound contact pad 4cm x 5cm + border 1.5cm) n/a

10cm x 11cm (wound contact pad 6cm x 6cm + border 2.0cm - 2.5cm) n/a

11cm x 15cm (wound contact pad 6cm x 10cm + border 2.5cm) n/a

Dressfilm 6cm x 7cm n/a

12cm x 12cm n/a

Tegaderm Matrix 8cm x 10cm n/a

Rohto Dry EyeRelief

10ml bottle n/a

20 x 0.5ml single dose unit n/a

Prim-Ai Kas II (Tinted, for night time use), pack of 50 71-0952-24 H

Prim-Air Strip Fine Oval (Flesh tone, for sensitive skin), pack of 50 71-0970-00 O

Fine Round (Flesh tone, for sensitive skin), pack of 50 71-0970-00 R

Firm Round (Transparent with strong adhesive), pack of 50 71-0974-00 R

Prima-Resist Air II HME for Prima-Resist/Low-Resist hands-free valves, pack of 50 71-0952-212H

Peak Medical Ltd Combimate Adjustable Elastic Ostomy Belt 50mm wide SB50 1

Uromate 1 piece urostomy pouch, semi-transparent, beige non-woven backing and needle-pin overlap, non-return valve, soft bottom outlet tap, Medium, pre-cut 16mm

UMT116B 20

Uromate 1 piece urostomy pouch, semi-transparent, beige non-woven backing and needle-pin overlap, non-return valve, soft bottom outlet tap, Medium, 19mm – 32mm

UMT119B 20, UMT122B 20,UMT125B 20, UMT128B 20,UMT132B 20

B. Braun Medical Elite bag with skin protector adhesive and fabric backing, Beige, starter hole 38-810 30

Elite bag with skin protector adhesive and fabric backing, Beige, 20mm – 30mm 38-820 30, 38-825 30, 38-830 30

Elite bag with skin protector adhesive and fabric backing, White, 20mm 34-820 30

Elite Petite bag with skin protector adhesive and fabric backing, Beige, 30mm 37-730 30

Elite Petite bag with skin protector adhesive and fabric backing, Beige, 35mm 37-735 30

Preference Bag skin protector, microporous adhesive & fabric backing, Beige, 25mm 34-625 30