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Appliance
Contractors
Administration)
Prescribing-only
GPs (Personal
Dispensing
Doctors
Pharmacy
Issue 18
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1
We’ve also included a special section
full of ideas on how to make more of
the Electronic Prescription Service.
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’?
Administration)
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.
Have you ‘Asked Us’ yet?
Dispensing
Doctors
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.
Contents
Prescribing-only
GPs (Personal
Welcome to the January 2015
issue of Hints & Tips, your
regular newsletter packed with
ideas and advice!
Pharmacy
Welcome to your new look Hints & Tips!
Understand the payment schedule
for EPS to ensure you get paid in
the right month
If you’ve got any suggestions
for topics you’d like see
included in a future edition,
please contact us at:
Are you buying or selling a
pharmacy?
[email protected]
Useful Links
Your dedicated helpline
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Appliance
Contractors
Ten ways to make EPS work better
for you
2
Have you ‘Asked Us’ yet?
The Contact Centre at the NHS Business Services
‘Ask Us’ has proved to be very popular since
Authority (NHSBSA) has been providing an
its launch, enabling our customers to find
award-winning telephone and email service to
answers to their queries outside of normal
our customers for many years. The future vision
Contact Centre hours. Some of the information
for the Contact Centre is to continue to provide
available can also be used as a potential
this outstanding service while also enabling our
training tool.
customers to self-serve as much as possible.
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:
https://nhsuk.epticahosting.com/selfnhsukokb/
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.
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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:
http://www.nhsbsa.nhs.ukPrescriptionServices/4666.aspx
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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 1,099
1,100-1,599
1,600-2,429
2,430+
£350
£3,955
£5,536
66.2p per item
Practice Payment for 1
November 2014 to 31 March
2015
£250
£2,095
£2,933
49.1p per item
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 1,099
1,100-1,599
1,600-2,429
2,430+
£350
£700
£875
6.6p per item
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Contribution in Practice
Payment for EA for 1
November 2014 to 31 March
2015
£250
£500
£625
6.6p per item
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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’
‘XP’ or ‘OOP’
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
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
http://www.nhsbsa.nhs.uk/PrescriptionServices/1119.aspx
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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.
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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.
Don’t:
Do:
• 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
• ensure that all staff in your
pharmacy are fully aware of EPS and
nomination and are able to explain
this to patients
• Do not add nomination requests that
have been gathered on paper more
than six weeks previously without
reconfirming with the patient first
• 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”
• Do not automatically nominate
patients
• Do not persuade or influence patient
choice or provide ‘incentives’.
• add nomination requests to the
system as soon as possible
Ensure all staff are familiar with the
four nomination principles:
Tell patients:
• 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.
• 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.
• Patients can change or cancel
their nomination at any time, and
therefore switch to another dispenser.
• Use a Standard Operating Procedure
which follows these four nomination
guidance principles.
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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
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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
www.nhsbsa.nhs.uk/PrescriptionServices/1972.aspx
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.
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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.
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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:
http://systems.hscic.gov.uk/eps/library/faqs/dispensing
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:
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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: http://systems.hscic.gov.uk/eps/contacts/signup
2. Get alerts if EPS is ever unavailable
If EPS is ever unavailable for any reason you will get an alert straight to your email or mobile, and
then another when normal service has resumed. Complete the form at:
http://systems.hscic.gov.uk/eps/dispensing/help/index_html
and send it to [email protected]
3. Think about how you can explain EPS to patients
There are plenty of resources available at http://systems.hscic.gov.uk/eps/library/summary.pdf to
help you tell patients about nomination and what it means for them, as well as how to complain
if they have an issue.
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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: http://systems.hscic.gov.uk/eps/library/rxtracker
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
http://systems.hscic.gov.uk/eps/library/disptsguide.pdf
10. Tell us how EPS is working in your pharmacy so we can share best practice,
tips and benefits with the wider pharmacy community
Email your views to [email protected]
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Useful links on our website
NHS England and Wales Drug Tariff
www.nhsbsa.nhs.uk/prescriptions/
drugtariff
NCSO products
http://www.nhsbsa.nhs.uk/PrescriptionServices/935.aspx
Information about sending in your
reimbursement and remuneration
claims
http://www.nhsbsa.nhs.uk/2473.aspx
NHS Prescription Services open days
www.nhsbsa.nhs.uk/prescriptions/
opendays
Your dedicated helpline
For further information
please contact the
NHS Prescription Services
helpdesk:
0300 330 1349
or email:
[email protected]
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