PSNC’s Dispensing and Supply team help contractors and everyone working in community pharmacies to carry out all tasks related to dispensing medicines. The team are available on the phone or by email and can help with anything from day-to-day enquiries about endorsing to more complex policy queries about medicines supply.
Information and knowledge
The NHS Terms of Service for community pharmacies are complex, and the monthly Drug Tariff is a very technical document. PSNC works to translate this information into more manageable chunks to help community pharmacy teams to make sense of it.
We published monthly factsheets last year to explain a number of dispensing themes encountered by pharmacy teams every day. These included discount deduction, prescription submission, prescription endorsements, and exemptions from the NHS prescription charge. Longer briefings were available on some topics, such as the availability of gluten-free foods on NHS prescription, and five PSNC webinars made information more accessible and meant pharmacy teams could have their questions answered live.
KEY TASK: COLLABORATION WITH NHSBSA
PSNC works with staff at the NHS Business Services Authority (NHSBSA) to improve the information being provided to community pharmacy teams about dispensing, claiming payment for and processing prescriptions. With a particular focus on digital developments, NHSBSA staff co-presented three PSNC webinars in 2018/19.
How we helped with dispensing: a timeline
PSNC warns cross-party MPs on the Public Accounts Committee about the impact of generic price increases on pharmacy workload.
Following PSNC representations, DHSC makes the unprecedented decision to increase the concession for Risperidone 2mg tablets to £20.00.
PSNC provides guidance on the restriction of gluten-free foods on NHS prescription.
PSNC writes to the Health Select Committee highlighting concerns about how a no-deal Brexit could impact medicines supply, and stressing the need for protection for pharmacies.
As pregabalin and gabapentin are reclassified as Schedule 3 Controlled Drugs, PSNC produces guidance to explain what the amendments would mean for pharmacies.
Supply issues and price concessions
Medicine supply disruption and pricing issues remain a serious concern for community pharmacies and PSNC continues to work to find solutions to this complex issue. In 2018/19 PSNC reviewed thousands of reports of shortages and pricing issues from pharmacies and we secured 767 price concessions
in total. We estimate that last year alone, PSNC prevented potential losses to pharmacies of some £330 million through our negotiation of concessionary prices.
However, there were times when concessions were imposed and PSNC felt the need to push back even after the imposition. Following additional representations, coupled with the provision of more evidence, we managed to increase August’s concession of £8.91 for Buprenorphine 8mg sublingual tablets to £15.74 in September. And, in October, the Department of Health and Social Care (DHSC) made the unprecedented decision to increase the previously announced concession of £1.80 for Risperidone 2mg tablets to £20.00.
To ensure pharmacy teams had access to the latest list of agreed concessions as soon as was possible, we sent 35 email news alerts about updates to the price concessions list.
We also developed a range of resources to support community pharmacy teams and LPCs in discussing supply issues with patients, prescribers and others. These included a leaflet to give patients affected by medicine shortages, a briefing for prescribers, and a factsheet on how the price concession system works.
Drug Tariff changes
Any change to the Drug Tariff has the potential to have a significant impact on contractors’ NHS payments. PSNC reviews the possible consequences of proposed changes and in 2018/19 we opposed changes, for clinical and patient safety reasons, to reference products from a brand originator or one with greater market share to a branded generic. PSNC also resisted the addition of food supplements where a licensed equivalent or unlicensed medicinal product was available.
Lobbying for system improvements
Throughout 2018/19 PSNC held regular discussions with DHSC to try and improve the price concession system. These were based around a set of key principles to ensure that hard working pharmacies did not face unfair risks, and that the impact of supply problems was not passed on to them or their patients.
Both the National Audit Office and the Public Accounts Committee investigated the rise in generic medicine prices that had occurred in 2017, and PSNC provided written and oral evidence, highlighting the impact that the generic shortages and price rises were having on community pharmacies, as well as describing all the work that pharmacy teams were doing to ensure that no patients are harmed.
KEY TASK: PAYMENT SCRUTINY
PSNC’s Prescription Pricing Audit Centre undertakes audits of the pricing of NHS prescriptions to assess the accuracy of the payments made to pharmacies. PSNC also audits the community pharmacy annual margins surveys. In 2018/19, approximately 1.5 million prescription items were checked and nearly 4,000 errors were identified – this is a vital task in protecting contractors’ income. We also supported numerous individual contractors to reclaim missing or delayed payments for Advanced Services and to resolve other reimbursement issues.
How we helped with dispensing: the numbers
webinars co-hosted with the NHSBSA
price concessions agreed in 2018/19
people watched our Endorsing Webinar
payment accuracy checks carried out at PSNC’s Pricing Audit Centre