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Pharmaceutical Services Negotiating Committee

Schedule Of Payments

Please note this page is in the process of being updated for July bundle submission and Schedule following the recent Drug Tariff changes. You may find the recent news story on July submission useful in the meantime: http://www.psnc.org.uk/news.php/1390/reminder_july_submission_changes

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FP34c Submission form


The FP34C is the submission document which must be completed by the contractor and submitted for pricing with each month’s prescriptions, containing the number of items declared, payments taken, and other details. The Schedule of Payments is a document which provides contractors with a detailed breakdown of reimbursement for drugs and appliances provided against NHS prescriptions as well as the fees paid for dispensing these items and providing related services.

Completing the FP34c Submission Document


The FP34C submission document must be sent to the NHS Prescription Services along with each month’s prescriptions. It contains 3 parts.

 

 

Part 1—Submissions

Part 1 of the FP34C Form is used to record the number of forms being submitted to the NHS Prescription Services. Contractors should write clearly in the spaces provided on the form and leave any unused boxes blank.

Sorting:

Guidance on sorting prescriptions can be found on the FP34C Submission Document and on the PSNC website.

Items

Contractors are required to declare the number of prescription forms and items being submitted to the NHS Prescription Services. A guide to counting items can be found at the bottom of this page.  

Repeat Authorising Forms:

Contractors should tick the box on Part 1 of the Submission Form if any repeat authorising forms have been dispensed. There is no requirement to indicate the actual number of these forms that have been submitted.

ETP Tokens:

There is also provision on the form for contractors to declare if they have dispensed any ‘ETP Tokens’ where payment is being based on the electronic reimbursement claim message sent to the NHS Prescription Services. This will not begin to happen until Release 2 of the Electronic Prescription Service. Additional guidance will be made available on the processing of tokens before national roll out of Release 2 begins.

FP57 Refund Forms:

Pharmacies also need to declare the total number of FP57 forms submitted and the total amount refunded to patients as in the following example: 

If no FP57 forms have been submitted, then the number 0 should be written in the ‘Number of FP57 Forms Submitted’ box.

Part 2—Declarations

Contractors need to make declarations for: their total claim for out of Pocket Expenses, the number of dispensing staff hours, the number of Medicines Use Reviews including Prescription Interventions undertaken and the number of Appliance Use Reviews undertaken.

Out of Pocket Expenses (OOP)

Out of Pocket Expenses (OOP) can be claimed in exceptional circumstances on all medicines except products in Category A or M of Part VIII of the Drug Tariff. Out of Pocket Expenses can also be claimed on appliances in Part IXB and IXC of the Drug Tariff but cannot be claimed on items listed in Part IXA or IXR.

For contractors having their prescriptions processed via the CIP system, payment for out of pocket expenses will be based on the declaration on the FP34C Submission Document. Therefore to ensure correct payment, it is essential that this declaration is completed accurately and clearly. Contractors must also continue to endorse individual prescriptions when making an OOP expense claim for NHS Prescription Services audit purposes. Such prescriptions should be clearly marked with an indication that out of pocket expenses are being claimed (the recommended endorsement is ‘XP’) along with information on the amount being claimed and the reason for the claim (e.g. “postage & packing”). Documentary evidence of the claim should not be sent to NHS Prescription Services, however PSNC recommends that evidence to support the claim, for example the receipt or invoice, is stored in the pharmacy in case of query or investigation.

For contractors having their prescriptions priced via the NHS Prescription Services legacy processing arrangements, payment will be based on the endorsements on individual prescription forms.

Staffing Levels

Pharmacy contractors must declare the total number of hours that staff members supporting the dispensing process work in an average week. If a pharmacy declares less than the minimum staffing levels required, outlined in Part VIA of the Tariff, they will only receive the level of the Practice Payment for the number of items indicated by their lower staffing level. If no declaration is made, the practice payment will be paid at the minimum level.

Detailed guidance on declaring staffing levels is available in the Funding for Essential & Advanced Services section of the PSNC website.

MURs

Pharmacy contractors conducting the Medicines Use Review and the Prescription Intervention Advanced Service can claim fees for delivering the service via the FP34C Submission Form.

The current fee level can be found in Part VIC of the Drug Tariff.

AURs

Pharmacy contractors conducting the Appliance Use Review Service can claim fees for delivering the service via the FP34C Submission Form. The declaration is split into two parts; the first declaration for any AURs carried out on pharmacy premises and subsequent AURs carried out in the same external location within 24hrs; the second declaration for the first AUR carried out in each external location.

The current fee level can be found in Part VIE of the Drug Tariff.

Part 3 – Authorisation

Once Parts 1 and 2 of the Form have been completed, the form should be signed, dated and stamped with the pharmacy stamp.

Errors in Payment linked to the Declarations

The information declared in sections 1 & 2 of the FP34C Submission Form is manually keyed into the NHS Prescription Services pricing System by NHS Prescription Services staff. PSNC is aware of a number of cases, where this information has been keyed in incorrectly resulting in incorrect payment to the Pharmacy Contractor and we now undertake checks on this during our routine pricing audits.

To minimise the risk of error, contractors should ensure the declarations are made accurately and clearly. PSNC also recommends taking a photocopy of the completed FP34C Form before submission as a reference in the event of suspected error. If you believe there has been an error at the NHS Prescription Services in transcribing information from the submission document, this should be reported directly to NHS Prescription Services.


Timing of  Payments

 

 

The above diagram illustrates the payment timescale for items dispensed in April. The prescriptions must be submitted to the NHS Prescription Services for pricing before the 5th of May. The contractor will then receive an advance payment in early June, based on an estimated 80% of the total payment for items dispensed in April. In early July, the contractor will receive the balance due for the dispensed items, which should be the remaining 20% of total payment.

Therefore, each monthly payment is comprised of components relating to different dispensing months, as outlined below:



More details on payment structure can be found here.

 


Schedule of Payments

 

Breakdown of Payments


The Schedule of Payments is a document which provides contractors with a detailed breakdown of reimbursement for drugs and appliances provided against NHS prescriptions as well as the fees paid for dispensing these items and providing related services.

Above is a typical Schedule of Payment from the NHS Prescription Services.

The diagram below shows a basic flow of payments and deductions resulting in the net payment made by the NHS Prescription Services to pharmacy contractors.

Total of Account

This is the total amount due to the contractor for that dispensing month with regard to the total value of drugs and appliances dispensed and fees and allowances received, minus the value of the prescription charges retained by the contractor (i.e. prescription charges received minus refunds given back to patients).

Total of Drugs and Appliances

This section details the reimbursement due to contractors for the drugs and appliances which they have dispensed against prescriptions for that dispensing month.

It shows the value of items dispensed at the standard discount rate as well as the value of items dispensed which have not had discount deducted (shown as ‘zero discount’ on the Schedule). The number of items which fall into these categories can be found in the Prescription Data section of the Schedule.

This section also shows the rate and amount deducted from payment, (calculated with reference to the total of basic prices at standard discount rate and the discount deduction scale in Part V of the Drug Tariff). It also shows a total of allowances and adjustments made to the contractor, linked to reimbursement, for example Out of Pocket Expenses and the Container Allowance.

 

Total of Fees

This section outlines the fees and allowances earned by the pharmacy contractor.

It shows the professional fee, commonly known as the dispensing fee, which is paid to the contractor for every item dispensed which attracts a fee.

It also shows the practice payment made to the contractor, the establishment payment, the repeat dispensing fee, and any additional fees which may have been claimed, including any Medicines Use Reviews the contractor may have conducted during the month.

 

Advance For Next Month

The 80% advance is an amount paid to the contractor based on the previous dispensing month's AIV, and the number of items declared on the submission document for the dispensing month in question, with a deduction made for the number of charges taken by the contractor for that dispensing month. For example, the advance payment for April's prescriptions would be calculated based on the number of items declared on the submission document enclosed with April's prescriptions and the AIV for March's prescriptions with a deduction for the value of prescription charges retained by the pharmacy contractor as declared on the April submission document.

 

Recovery of Advance

Once the prescriptions have been processed and total payment calculated, a deduction is made for the advance payment made the previous month. This is shown as ‘recovery of advance’ on the Schedule.

Additional Advance Payment

There are now two additional details in this section, 'Additional Advance Payment' and 'Recovery of Additional Advance Payment'. This outlines what has been paid or recovered for an additional advance payment regarding safeguarding payment (Part XIVC of the Drug Tariff) Claim 1.  

Balance Due

The balance due is the amount owed to the contractor by the NHS Prescription Services. It is the ‘total of account’ minus the ‘recovery of advance’.

Other sections of the Schedule (FP34) 

Charges (Page 2 of the Schedule):


The charges section shows a more detailed breakdown of how many charges were deducted from the payment made to the contractor. It shows the number of charges and the rate of prescription charge, as well as the value of FP57 refunds, to provide the final amount to be deducted from payment by the NHS Prescription Services.

Details of Local Amounts Authorised by a PCT

The 'Temporary Safeguard Payment' outlines the payment  for additional remuneration under (Part XIVC of the Drug Tariff) Claim 2.

 

Details of Other Amounts Authorised

The 'Amendment Allowance' outlines what payment has been made in recognition of the administrative time required to make a claim under Part XIVC of the Drug Tariff. 

 

Prescription Data (Page 2 of the Schedule):


This section provides statistics linked to the prescriptions submitted to the NHS Prescription Services for pricing for the dispensing month detailed in the FP34. It shows the total number of forms received, and the number of items dispensed for which a fee will be paid to the contractor, including standard discount rate and zero discount rate items.

It also shows the average item value (AIV) for the dispensing month, which is used to calculate the advance payment for the following month, and it details the number of medicines use reviews conducted by the contractor and the number of dispensing staff hours declared, as declared on the FP34C Submission Form.

Items Transferred Between Exempt and Chargeable Groups:


This section shows the number of items submitted to the NHS Prescription Services for pricing which have been switched between the exempt and chargeable groups.

To try and minimise loss from prescription switching contractors are advised to monitor this closely, for example to ensure that staff are following SOPs and ensuring that exemption declarations are completed as required.

Summary of Expensive Items:


This section shows the number and value of expensive items which were dispensed during the month, which have an item value of £100 or more. These values are important as fluctuations in the number or value of expensive items dispensed can have a significant impact on the average item value in a given month, and consequently the advance paid for the following month.

Contractors are now receiving a revised Schedule of Payment which contains a greater level of detail regarding their payments. The information provided now contains an itemised list of items with a Basic Price equal to or over £100. This is useful for identifying high value items which should be sorted and submitted for payment within the red separators.

When checking the itemised list for expected payments the following aspects need to be considered:

  • The itemised list is in value order with the largest value at the top of the list. At present it is not possible to list the products in alphabetical order;
  • The prices quoted are the Basic Price of the quantity prescribed/dispensed and do not include any additional fees or adjustments due to broken bulk;
  • A product on the list may be described as an ‘Exception Handler Unspecified Item' or ‘Exception Handler Discount Not Deducted Item'. These will include: a special order product which is not listed in the dm+d list; if the product is a multiple ingredient product which includes a branded product e.g. Eumovate in WSP;
  • When a product is extemporaneously dispensed from multiple ingredients (with a total Basic Price equal to or over £100) this will only be listed if one of the ingredients (elements) is £100 or over.
  • If the quantity of the product dispensed is made up by the issue of several different pack sizes then only Basic Prices of each pack size equating to £100 or over will be shown.

For example:

Maxalt Melt 28 prescribed; 4 x 6 and 1 x 3 dispensed; only 4 x 6 will show on the itemised list although paid for quantity dispensed.

Multiple flavours of an enteral feed are prescribed and dispensed with a total Basic Price equal to or over £100. If the value of the quantity of an individual flavour dispensed does not exceed £100 then it will not appear in the list.

If a product which you are expecting to see on the itemised list does not appear this does not necessarily mean that you have been paid incorrectly. In these cases further enquiries can be made via NHS Prescription Services Help desk on 0300 330 1349 or by email at prescriptionpricinghelpdesk@ppa.nhs.uk.

Work is ongoing to improve the level and format of pricing information that is provided to contractors.

Frequently asked questions regarding the Schedule of Payments


Q. What do I do if I lose my FP34C before submission?

Contractors are reminded that it is essential that they use the correct declaration form/submission document (FP34 C) when submitting prescriptions to NHS Prescription Services for payment.

NHS Prescription Services send the FP34C to contractors in advance and it is important that this document is stored in a safe place until it is needed.

Each FP34C is personalised and has a barcode on it specific to each contractor and to each dispensing month. This is used at the start of the pricing process to identify the contractor and the month in which the prescriptions were supplied. Never use a photocopy or a copy from another contractor or from another month.

If you lose your form or do not get it before you have to send in your claim, please telephone NHS Prescription Services helpdesk on 0300 330 1349 or email them prescriptionpricinghelpdesk@ppa.nhs.uk and they will offer the following options: 

Either:
a) to send a duplicate copy of the FP34C by first class post or: 
b) to send a pdf file of the FP34C (which the contractor will need to print out).

Please note that for operational issues NHS Prescriptions Services can no longer provide duplicates of the FP34C by fax because the faxed copies cannot be scanned when the account is received.

Q. Why do my advance payments fluctuate when my advance items are relatively stable?

The advance payment for a particular month is based on the number of items declared on the FP34C submission document and the previous month’s average item value (AIV). Fluctuations in the AIV will therefore cause the advance payments to fluctuate. These fluctuations in AIV can be caused by many factors, for example, changes in product mix, changes in the total of fees or the amount of discount deducted.

Q. Why was my practice payment or establishment payment lower this month?

The practice payment and establishment payment are volume banded fees, and vary according to the number of items dispensing in a particular month. If the number of items dispensed was lower in a particular month, then this may have meant the calculation was based on a lower payment band. If this is the case, it may be possible to claim a ‘top up payment’, if the total amount paid for the periods of April to September or October to March would have been greater if they had been calculated on a 6 month basis, rather than a monthly basis (more guidance is available on our website www.psnc.org.uk/topup).

A common reason for the Practice payment being lower than expected is if less than the minimum dispensing staff levels are declared or there is no declaration of staffing hours (see Part VIA of the Drug Tariff for more information).

Q. Where is the ETP allowance payment shown on my Schedule of Payments?

The ETP allowance payment appears on Part 2 of the schedule of payments, in the section ‘Details of local amounts authorised by PCT’.

Q. How do my Zero Discount and Expensive item values affect my net ingredient cost?

Fluctuations in the dispensing levels of ‘zero discount items’ (items exempt from discount deduction) as well as high value expensive items can have a significant impact on the level of your reimbursement. The high value of expensive items and the absence of discount deduction on zero discount items can mean they have a greater impact on AIV than the lower value standard discount rate items.

Therefore a dip in the value of these items dispensed can cause a disproportionate drop in the net ingredient cost, which will have a knock on effect on the average item value and hence the advance payment received, causing the overall ‘net payment made by NHS Prescription Services’ to be lower.

Q. I carried out some MURs in September but I cannot see the payment listed on my November Schedule of Payments, why is this?

The MUR payment is made with the final payment rather than with the 80% advance therefore if MURs were declared on the FP34C Form for September’s prescriptions which was submitted by 5th October, payment should be expected in early December.

Q. How should items attracting no charge from patients be sorted when submitting prescriptions for pricing?

Pharmacies should add the number of ‘No Charge’ items to the ‘Exempt from Patient Charge’ Group. This will ensure correct advance payment, however if contractors do not enter these items in the relevant group, it is a self correcting process and the contractor will be paid correctly via the final payment.

Q. Within the Drug and Appliance Cost section of the FP34C Schedule of Payments document the Adjustment element of this contains a value this month. Where does this value come from?

NHS Prescription Services have confirmed that the Adjustment figure shown within the Drug and Appliance Cost section of the FP34C Schedule of Payments could be due to any of the following;

Divisional Adjustment (Where an adjustment is made to payment at the NHS Prescription Services division)
PSNC Checks
Quality Checks (NHS Prescription Services Checks)
Combination of ... (where the adjustment is more than one of these)

The date of the when the adjustment is for should also be listed on the schedule of payments.

Q. I am reviewing the expensive items detailed on my schedule of payments. Where I have claimed broken bulk for a particular expensive item, will this be shown on the Schedule of Payments?

The schedule of payments now includes a section which shows the number and value of expensive items which were dispensed during the month, which have an item value of £100 or more. The prices quoted on the schedule of payments are the basic price of the quantity prescribed/dispensed and do not include any additional fees or adjustments due to broken bulk claims.

Other things to keep in mind when reviewing the list of expensive items are:

  • With products prescribed as 'assorted flavours' if the value of the quantity of an individual flavour dispensed does not exceed £100 then that flavour will not appear in the list;
  • If you have dispensed an item where the combined net ingredient cost of everything that made up that item is equal to or more than £100, that combined total will appear on the itemised list; 
  • A product on the list may be described as an 'exception handler unspecified item' or 'exception handler discount not deducted Item' (where the contractor has been required to endorse 'DNG' for discount not given). These will include special order products not listed in dm+d. 

If a product does not appear on the itemised list as expected, this does not necessarily mean that there has been incorrect payment. In these cases further enquiries can be made via the NHS Prescription Services Helpdesk on 0300 330 1349.


How to Calculate the Number of Items Submitted to the NHS Prescription Services

Each month, contractors need to declare the number of prescription forms and items submitted to the NHS Prescription Services for reimbursement.

The number of items is equal to the number of professional fees that are payable by the NHS Prescription Services plus any Oxygen items (from Part X of the Drug Tariff). There is often confusion about the number of fees payable (therefore the number of items) for the following products: 

Multiple Flavours: If the prescription does not state mixed, assorted or various flavours, only one professional fee will be paid per prescribed flavour regardless of whether multiple flavours have been dispensed and endorsed.

If the prescription orders mixed, assorted or various flavours and several flavours of the same preparation are supplied, the contractor will receive professional fees equivalent to the number of different flavours dispensed and endorsed on the prescription form. For example, if 4 flavours are dispensed and endorsed, four fees will be earned and this will be counted as 4 items.

Elastic Hosiery: Elastic hosiery items attract a single professional fee regardless of the number of articles supplied, for example two pairs of class I below knee stockings would attract 1 professional fee and this would be counted as 1 item.

There is often confusion with the number of prescription charges that have been levied, for example, a prescription for 2 pairs of elastic hosiery would attract 4 prescription charges. 

Multiple item strengths supplied: If multiple strengths of an item are dispensed then contractors will receive a professional fee for each separate strength that is dispensed. For instance, the Champix starter pack contains Champix 0.5mg tablets and Champix 1mg tablets. The contractor will therefore receive 2 professional fees for dispensing the starter pack. If a separate pack of 1mg tablets are also prescribed on the same prescription, the contractor will still only receive 2 fees and this is considered 2 items.

PSNC's Alphabetical List of Charges includes examples of the number of fees and charges that should be levied for common prescriptions and can be found in the PSNC Dispensing Resources Guide 2008/9.

On the bottom left hand side of prescription forms, there is a box which states ‘number of items'. Although it is not mandatory to endorse the number of items dispensed in this box, it is very helpful for the NHS Prescription Services and the PSNC Pricing Audit Centre to have this information when investigating queries over the number of items priced by the NHS Prescription Services in a particular month.

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