Subscribe to Hints & Tips. Issue 18.

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1 Issue 18 Prescribing-only GPs (Personal Administration) Dispensing Doctors Pharmacy Subscribe to Hints & Tips If you would like to receive Hints & Tips by , please let us know and we ll add you to the distribution list. Please Include the following: (PADM) and put Subscribe to Hints & Tips Dispensing Trading name Contractors in your subject line. Name What type of contractor you are e.g. pharmacy, appliance, dispensing doctor or GP who dispenses personally administered items Appliance Contractors 1

2 Welcome to your new look Hints & Tips! Welcome to the January 2015 issue of Hints & Tips, your regular newsletter packed with ideas and advice! This month we re discussing how to access and use our knowledge base Ask Us to best effect, the need to check claims for exemption from prescription charges and how to ensure your monthly batch of prescriptions is delivered to us safely and on time. Details of the recent changes to pharmacy Practice Payments are also included, along with forthcoming changes to how you ll access the electronic Drug Tariff and advice on how clear prescribing and endorsing can help to ensure accurate reimbursement. We ve also included a special section full of ideas on how to make more of the Electronic Prescription Service. Contents Have you Asked Us yet? Prescription exemption claims checking at the point of dispensing Did you know? Practice Payments have changed Precise prescribing and endorsing makes a clear difference A new home for the refreshed electronic Drug Tariff Securing safe delivery of your prescriptions Make more of the Electronic Prescription Service in your pharmacy EPS nomination patients have a choice Understand which specials and imported unlicensed medicines are in scope for EPS Endorse electronically not on the dispensing token Declaring your EPS claims Do you know the difference between mark as not dispensed and return to Spine? Pharmacy Dispensing Doctors Prescribing-only GPs (Personal Administration) If you ve got any suggestions for topics you d like see included in a future edition, please contact us at: Understand the payment schedule for EPS to ensure you get paid in the right month Are you buying or selling a pharmacy? Ten ways to make EPS work better for you nhsbsa.communicationsteam@nhs.net Useful Links Your dedicated helpline Appliance Contractors 2

3 Have you Asked Us yet? The Contact Centre at the NHS Business Services Authority (NHSBSA) has been providing an award-winning telephone and service to our customers for many years. The future vision for the Contact Centre is to continue to provide this outstanding service while also enabling our customers to self-serve as much as possible. Ask Us has proved to be very popular since its launch, enabling our customers to find answers to their queries outside of normal Contact Centre hours. Some of the information available can also be used as a potential training tool. We ve already introduced Facebook pages for our European Health Insurance Cards and Help with Health Costs services, and our most recent innovation has been to launch our Ask Us knowledge base. Ask Us is easy to use and is available on the NHSBSA website: template-group.do?name=nhsbsa&id=4868 Top Tip - If you have recently moved over to Electronic Prescription Service (EPS) Release 2 you can find helpful information within the Electronic Prescription Service (EPS) category of the NHS Prescription Services option. allowing our customers to find answers to their queries 24 hours a day, 7 days a week. Simply choose the option related to your query, e.g. NHS Prescription Services or Exemption Checking Service and you can then navigate the system using either the search function or the listed categories. 3

4 Prescription exemption claims checking at the point of dispensing With the increase in the number of exemption checks being carried out and the changes to the checking process, please remember that if a patient claims exemption from prescription charges you should ask for proof at the point of dispensing unless they are age exempt. Patients are age exempt from prescription charges if they are 60 or over or under 16 and their date of birth is automatically printed out on a hard copy paper prescription or inserted into an electronic prescription. Where necessary, you should advise patients that they need to obtain a valid certificate (e.g. Maternity Exemption certificate, Medical Exemption certificate, HC2 (Low Income) certificate, or Prescription Prepayment certificate) or need to show proof of being in receipt of relevant benefits before claiming exemption from prescription charges. If a patient is unsure whether they are entitled to free prescriptions, you should encourage them to pay and provide them with an FP57 which they can then use to claim a refund if they later find out they are exempt from prescription charges. You should also remind patients of the possible penalties if they claim free prescriptions when they are not entitled to. They could face a penalty charge of up to 100 as well as the original prescription charge, and may also face a further charge of up to 50 if they don t pay within the required timescale. The NHS Business Services Authority (NHSBSA) has sent every dispensing contractor and GP practice a supply of Claiming free prescriptions? booklets and posters for their patients. These provide information on the consequences of claiming exemption illegitimately and include advice for those patients who may be uncertain of their eligibility or unaware of the help available to them. The booklets and posters are also available on the NHSBSA website at: 4

5 Did you know...? Practice Payments have changed Practice payments in England and Wales changed on 1st November, so you may see a difference on your Schedule of Payments. Details of the changes are set out below: Changes to Practice Payment: Number of items per month Practice Payment for 1 April 2014 to 31 October 2014 Up to 1, ,100-1,599 3,955 2,095 1,600-2,429 5,536 2,933 2, p per item 49.1p per item Practice Payment for 1 November 2014 to 31 March 2015 Changes to Contribution in Practice Payment for provision of auxiliary aids for people eligible under the Equality Act 2010 (EA). (Please note the contribution amounts detailed below are already included in the Practice Payment amounts shown above). Number of items per month Contribution in Practice Payment for EA for 1 April 2014 to 31 October 2014 Up to 1, ,100-1, ,600-2, , p per item 6.6p per item Contribution in Practice Payment for EA for 1 November 2014 to 31 March

6 Precise prescribing and endorsing makes a clear difference Where a prescriber wants a patient to receive a medicine produced by a specific manufacturer, this should be specified in the prescribed order. Additionally, the specified brand or manufacturer should be included in the first line of the order, not in the dosage or directions line. Please make sure that you place any orders which include supplementary information regarding required brand or manufacturer in the directions or dosage instructions in the red separator to ensure accurate and timely reimbursement. When you have Not Dispensed an item, please make sure that you learly endorse the item ND ; you need to mark ND next to the item and score a line horizontally through the prescribed item. However, please take care to only use ND when you have not dispensed the item at all. It must not be used when you have dispensed less than the prescribed quantity or you risk not being reimbursed for the item. For example, if a quantity of 28 tablets was prescribed and you have only dispensed 21, do not endorse ND7 as you may not receive reimbursement for the 21 tablets dispensed. In these cases you need to endorse the item as, for example, 21 ex 28 or 21 dispensed. Please also remember that in July 2012 prescription endorsements were standardised to make things easier and clearer for contractors. When you need to endorse, the standard prescription endorsement codes stated in the Drug Tariff must be used; nothing else can be accepted. The Drug Tariff standard endorsement codes and their application are as follows: Endorsement Code BB and the pack size supplied ED MF No cheaper stock obtainable or NCSO, plus initials and date PD(n) SP Application To make a claim for Broken Bulk as specified in Drug Tariff Part II Clause 11 To claim an additional fee for dispensing an unlicensed medicine prepared under the Section 10 exemption from the Medicines Act 1968 To claim an additional fee for measuring and fitting the supply of Elastic Hosiery (Compression Hosiery), Trusses or Para stomal garments (belts and girdles) where size is not indicated in the Drug Tariff. Where an item is in Part VIII, in the opinion of the Secretary of State for Health and the Welsh Ministers there is no product available to contractors at the price in Part VIII, and the contractor has made all reasonable efforts to obtain the product at the appropriate price but has not succeeded; the contractor must also endorse the relevant brand name / manufacturer / wholesaler and pack size used. To claim an additional fee(s) where the quantity dispensed to the patient for a prescription for oral liquid methadone covers more than one dose and the contractor has packaged each dose separately (n = number of doses packaged separately minus the number of times the contractor has dispensed the medicine to the patient) To claim an additional fee for dispensing an unlicensed medicine manufactured under an MHRA specials license or sourced under an MHRA importers licence XP or OOP To make a claim for Out of Pocket Expenses as specified in Drug Tariff Part II Clause 12 Please make sure that you only use endorsement codes in the correct circumstances. For example, XP / OOP must only be used where Out of Pocket Expenses are being claimed as defined in Drug Tariff Part II Clause 12; you mustn t use these endorsements to indicate the Invoice Price of an item. Further guidance on prescription endorsements is available at 6

7 A new home for the refreshed electronic Drug Tariff The electronic Drug Tariff has now been around for over ten years, so to keep it as functional and userfriendly as possible we re refreshing the production software we use. The new version will be available in the next few months, and you may notice some very slight cosmetic differences along with some minor changes to the functionality. However, popular features such as search and next facilities will still be available. The electronic Drug Tariff will also have a new domain to go with its refresh. We ll keep you updated with more information as we progress to completion, including details of the new domain name. Make sure you bookmark it as soon as it s live to ensure you continue to have quick and easy access to the electronic Drug Tariff! Securing safe delivery of your prescriptions If your monthly submissions of prescriptions aren t received by the NHS Business Services Authority (NHSBSA) in time, there is a risk that your payments may be delayed. When sending in your prescriptions, please remember that you need to despatch the forms along with the appropriate claim form to the relevant division of the NHSBSA no later than the 5th day of the month following that in which the supply was made. If you re a pharmacy enrolled in the Pharmacy Early Payment Scheme you need to ensure they re delivered by the 3rd or 8th day of the month in order to access funds early. Your prescriptions should be appropriately sorted as described on your claim form and must be sent by a secure trackable and traceable method, using a reputable courier or by post. 7

8 Make more of the Electronic Prescription Service in your pharmacy... Hundreds of pharmacies are using EPS every day to provide a better, safer service for patients. In this Hints & Tips special we provide helpful information on how to make sure you are getting the most from EPS in your pharmacy and some top tips for making EPS work better for you. EPS nomination patients have a choice Over 96% of pharmacies have now switched on EPS Release 2, along with more than a third of GPs, and more than 11 million patients have set a nomination to enable them to use the service. Around 150,000 nominations are set on average per week, so it is important that the principles behind nomination are well understood and adhered to. To use EPS, patients must nominate a dispenser, which means that they choose which pharmacy and/or dispensing appliance contractor (DAC) they want to get their items from. ensure that all staff in your pharmacy are fully aware of EPS and nomination and are able to explain this to patients ensure all staff know how to set, change and remove a nomination using the pharmacy system ensure patients are fully informed about EPS before setting their nomination on the system. They must opt-in add nomination requests to the system as soon as possible Tell patients: Do: Nomination is not mandatory and some patients may choose not to set a nomination as they prefer to use a variety of dispensers or in some cases they like to collect the paper prescription from the surgery. Patients can change or cancel their nomination at any time, and therefore switch to another dispenser. Don t: Do not change or remove nomination unless the patient requests this. It is not acceptable to set or remove a nomination for a patient without their full and proper consent Do not add nomination requests that have been gathered on paper more than six weeks previously without reconfirming with the patient first Do not automatically nominate patients Do not persuade or influence patient choice or provide incentives. Ensure all staff are familiar with the four nomination principles: Explain - patients must be provided with sufficient information about EPS before nomination is captured. Do not influence or persuade patients to nominate a specific dispenser. Act quickly - update systems with nomination details as soon as possible. Use a Standard Operating Procedure which follows these four nomination guidance principles. 8

9 Understand which specials and imported unlicensed medicines are in scope for EPS All specials and imported unlicensed medicines listed in Part VIIIB of the Drug Tariff can be prescribed and dispensed by EPS Release 2. To claim a Part IIIA unlicensed medicines fee you will need to electronically endorse preparations manufactured under an MHRA specials licence or sourced under an MHRA importers licence with the SP endorsement code. For preparations prepared under the Section 10 exemption from the Medicines Act 1968 you need to electronically endorse the ED endorsement code. There are also a significant number of specials and imported unlicensed medicines that are not listed in Part VIIIB but can be prescribed by EPS Release 2. If you have sourced the product under an MHRA specials licence or MHRA importers licence then in addition to endorsing SP (if you are claiming a Part IIIA unlicensed medicines fee) you also need to electronically endorse the invoice price (IP) endorsement which must include: Pack size from which the order was supplied Invoice price per pack size from which the product was supplied less any discount/rebates Supplier from whom the supply was obtained Manufacturer s/importer s licence number Batch number of the unlicensed medicine. If however you are sourcing the non-part VIIIB product under the section 10 exemption then EPS Release 2 currently lists extemporaneously prepared products as out of scope. Only in this scenario would you contact the prescriber to explain that as you are sourcing this product as a section 10 exemption you will need a paper FP10 prescription. Summary table of when SP, ED and IP endorsements can be used in EPS Release 2 SP endorsement Part VIIIB listed Special Sourced from a MHRA special licence holder Part VIIIB listed Import Sourced from a MHRA import licence holder Part VIIIB listed item Prepared under the section 10 exemption Non-Part VIIIB listed Special Sourced from a MHRA special licence holder Non-Part VIIIB listed Import Sourced from a MHRA import licence holder Non-Part VIIIB listed item Prepared under the section 10 exemption ED endorsement IP endorsement Not applicable as currently out of scope 9

10 Endorse electronically not on the dispensing token NHS Prescription Services base payment solely on information contained in the electronic reimbursement claim message. In the same way as on paper prescriptions, specific endorsements are still required for example endorsements to claim broken bulk, out of pocket expenses etc. These must be selected and submitted using the specific codes provided, together with any supporting information. A guide to endorsing in EPS can be found at Dispensing tokens signed by the patient to capture payment/exemption declarations must be sent to the NHS Business Services Authority (NHSBSA) for counter fraud purposes. They need to be separated from the FP10 paper prescriptions but they do not need to be sorted in the same way that FP10s are. Tokens must never be used to convey endorsement information as they are not used by the NHSBSA but are stored for use by NHS England and NHS Protect. Any tokens that have not been used to capture exemptions or payment declarations should be confidentially destroyed. Declaring your EPS claims When submitting your prescriptions to the NHS Business Services Authority (NHSBSA) each month, please remember that if you re submitting any EPS Release 2 claims you need to declare them on your submission document. You should include the total number of electronic messages submitted to NHS Prescription Services before midnight on the 5th day of the month following that in which they were dispensed, along with the total number of paper prescriptions claimed. Enter these totals into the boxes on Part 1 of your submission document. Although there are no separate boxes for EPS messages, you may also find it useful to note on the submission document the number of EPS claims you are including in your totals. This will also help NHS Prescription Services to determine at the scanning stage whether any discrepancy between the totals declared and actual number of paper forms scanned is due to EPS claims (NHS Prescription Services do not scan any dispensing tokens). This will prevent the NHSBSA needing to take up your time unnecessarily with telephone calls to determine the reason for any discrepancy. 10

11 In the example above, the contractor has declared a total of 1775 forms and has indicated that included within these figures are 444 EPS messages (1166 items). When the batch is scanned the actual total of paper forms scanned should therefore be 1331, and if this is the case there will be no need for NHS Prescription Services to contact the contractor. If the number of EPS messages had not been indicated, a telephone call would have been made to determine the reason for the discrepancy (1331 paper forms scanned, but 1773 prescriptions declared). If you do decide to take this approach please remember that giving this information is in addition to including your EPS message totals in the boxes on Part 1. EPS message totals for both forms and items should still be included in the relevant boxes for Exempt and Paid forms and items on your submission document, as these figures are used to calculate your advance payment. 11

12 Do you know the difference between mark as not dispensed and return to Spine? Prescriptions can only be cancelled by the prescribing site that has issued the prescription. However, dispensing contractors can mark item/s as not dispensed or can send them back to the Spine. Marking item/s as not dispensed means that they cannot be dispensed by that contractor or any other contractor. The item/s will not be removed from the patient s record and will still show in the prescribing system. Returning a prescription to the Spine is different and can be considered the same as handing a paper prescription back to the patient to be dispensed elsewhere. For more information visit: Understand the payment schedule for EPS to ensure you get paid in the right month When a dispense notification has been sent in a given month the electronic claim message must be received by NHS Prescription Services before midnight on the 5th of the following month to secure payment with that month s submission. Remember you can send the claim message just after you have sent your dispense notification, at the end of each day, in batches or weekly; you do not need to wait until the end of the month. See example payment schedule below: 12

13 Are you buying or selling a pharmacy? When buying a pharmacy remember that collectively your System Supplier, HSCIC and the NHS Business Services Authority need at least 18 working days notice of a change to ensure that your EPS Release 2 System will work on your new Contractor Code (i.e. F Code/ODS Code) from day one. In order to update NHS Choices and the GP systems with the new information, at least one claim message must be sent on the first day of the incoming code. Make sure you claim after a change of code, or no GPs will be able to nominate you. If the claim is sent by close of business on a Tuesday of any given week, the information will appear on NHS Choices and the GP systems on the following Monday. If the claim is sent on a Wednesday, for example, the information will not appear until Monday week. Ten ways to make EPS work better for you 1. Register to receive the EPS bulletin To get the latest from EPS including guidance, tips, case studies and news sign up for your copy of the EPS bulletin at: 2. Get alerts if EPS is ever unavailable If EPS is ever unavailable for any reason you will get an alert straight to your or mobile, and then another when normal service has resumed. Complete the form at: and send it to servicebridge@hscic.gov.uk 3. Think about how you can explain EPS to patients There are plenty of resources available at to help you tell patients about nomination and what it means for them, as well as how to complain if they have an issue. 13

14 4. Make sure you have plenty of dispensing token stationery available so you don t run out Remember not to print tokens on plain white paper. Signatures must be captured on dispensing tokens (FP10DT) for prescription charge payment/exemption purposes. 5. Use the prescription tracker to find the status of a prescription The new version of the tracker is available at: which allows users to enter a prescription ID and find out where a prescription is in the process. You can now also search by NHS number and date range. The tracker will confirm if the prescription has left the prescribing site, if it has reached the Spine or if it has been delivered to an alternative dispensing site. 6. Download prescriptions regularly throughout the day. This will give you the opportunity to prepare the prescription in advance of the patient s arrival and order out of stock items where required. This will mean you ll be more likely to be able to dispense the item/s in full when the patient arrives to collect them. 7. Record prescription charge/exemption information accurately in the electronic reimbursement claim message to ensure correct payment In EPS Release 2 charge paid or exemptions need to be recorded electronically before the dispense notification is sent. Ensure all patient information regarding exemption or prescription charge status is set up before sending the dispense notification and claim. Some systems may default to chargeable status so this will need to be amended if necessary. 8. Send the dispense notification after items have been delivered or collected by the patient and before you send the electronic claim message The dispense notification message informs EPS which medication has/has not been supplied to the patient and ensures the next repeat dispense issue automatically comes down from EPS on time. This also has an impact on any cancellation message at the prescribing site and any subsequent actions that need to be taken. 9. Ensure you understand the escalation route for your system supplier You should always obtain a reference number allowing you to track the issue and get updates. Keep a specific log of issues raised. Get more on this in the troubleshooting guide available at Tell us how EPS is working in your pharmacy so we can share best practice, tips and benefits with the wider pharmacy community your views to eps@hscic.gov.uk 14

15 Useful links on our website NHS England and Wales Drug Tariff drugtariff NCSO products Services/935.aspx Information about sending in your reimbursement and remuneration claims NHS Prescription Services open days opendays Your dedicated helpline For further information please contact the NHS Prescription Services helpdesk: or 15