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Pharmaceutical Services Negotiating Committee

Sorting & Submission

Please note this page is in the process of being updated for July bundle submission following the recent Drug Tariff changes. For July submission, please see the related news article: http://www.psnc.org.uk/news.php/1390/reminder_july_submission_changes

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Resources

Click here to download a submission check guide (relevant for prescription sorting following July 2012 changes)

Click here to download a diagram illustrating how different types of prescriptions should be sorted within the submission bundle

 


Red Separator sorting

Dispensed prescriptions contractors should use the red separators provide by NHS Prescription Services to sort the following prescriptions separately:

  • Broken bulk items
  • Items with a NIC of £100 or more
  • ‘Specials'*
  • Handwritten amendments
  • Prescriber's signature encroaching on prescribed items
  • (new) Out of pocket expense claims

*Include prescription forms with any of the following items within this sorting category:

• "Specials" - an unlicensed medicine manufactured in response of a prescription for an individual patient where a licensed product is not available. They may be procured from a third party e.g. a specials manufacturer.

• Prescription items endorsed that they have been extemporaneously prepared (see Drug Tariff Part IIIA)

• Prescription items where the prescriber has provided additional product information not in the product information field e.g. preservative-free or sugar-free within the dosage instructions.

Updated sorting instructions on page 2 of the contractor's submission document reflect these new red separator sorting arrangements.

To assist with the revised sorting arrangments the following information is published on PSNC website.

List of commonly dispensed items over £100 with pack size.

List of commonly dispensed items over £100 with quantities.

NHS Prescription Services changed the payment schedule with effect from April 2010 accounts so that it lists separately any items that are priced with a net ingredient cost of £100 or more. This information  assists pharmacy staff in identifying items dispensed in their pharmacy with a value of £100 or over and also provides  information to check that payments of items over £100 have been accurate.

FAQ: Clarification on securing the prescription bundle in transit to NHS Prescription Services

Q: I know I should not use rubber bands, paper clips or staples to separate prescriptions (e.g. into doctor / surgery groups) or post it notes / sticky tabs to mark prescriptions or provide information. However may I use rubber bands to secure the paid bundle, exempt bundle and red separator bundle to keep them together during transit to NHS Prescription Services?

A: Yes. You can use rubber bands to separate the exempt bundle and charged bundle, and red separators, however contractors should ensure not to use rubber bands or other means to separate prescriptions within these groups, e.g into sections for each doctor / prescriber, as these have to be removed and can cause delays in the processing of the prescription bundle.

FAQ: Clarification on sorting items with a NIC >£100.

Q: From April 2010 dispensed prescriptions should I sort prescriptions into the red separators if the NIC of a single pack of the item prescribed is less than £100 but the quantity dispensed is more than one pack and has a total NIC of more than £100?

A: Yes. From April 2010 dispensed prescriptions, if the prescription contains an item which has a total NIC for the item of >£100 for the total quantity dispensed then it should be placed within the red separators. For example (based of April 2010 Drug Tariff prices):

Drug name

Price per pack of 60 Is sorting required when 1 pack dispensed?  Is sorting required when 2 packs dispensed? Is sorting required when 3 packs dispensed?
Levetiracetam 250mg tablets (Keppra) £29.70 No No No
Levetiracetam 500mg tablets (Keppra) £52.30 No Yes Yes
Levetiracetam 750mg tablets (Keppra) £89.10 No Yes Yes
Levetiracetam 1G tablets (Keppra) £110.10 Yes Yes Yes

NCSO Endorsements

When claiming NCSO Concession it is essential that prescriptions are endorsed fully with the letters ‘NCSO' and full details of the product dispensed e.g. manufacturer or supplier or brand name and pack size. If a particular supplier's product is not listed with a price on the NHS Prescription Services pricing system prescriptions must also be endorsed with the price paid (before discount and ex VAT). An indication of which suppliers are listed on the NHS Prescription Services pricing system  for a particular product is available through Dictionary of Medicines and Devices.

The endorsement must also be signed or initialed and dated. If any of this information is missing, payment will be based on the Drug Tariff price rather than the endorsed product.


Not Dispensed (ND) Endorsement

Where a pharmacist does not dispense an item on a prescription, pharmacy staff should score through the prescribed item on the prescription and endorse the initials ‘ND’ beside the prescribed item in the prescriber’s area on the prescription form. ‘ND’ endorsements without the item being scored out may not be picked up, resulting in an incorrect payment to the pharmacy contractor. There is no requirement to sort ‘not dispensed’ prescriptions differently for submission to NHS Prescription Services.


Out of Pocket Expenses

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 should also continue to endorse individual prescriptions when making an OOP expense claim so that investigations can be carried out by NHS Prescription Services should the need arise. Such prescriptions should be clearly marked with an indication that out of pocket expenses are being claimed (using the 'OOP' endorsement or ‘XP’ for electronic prescriptions) 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.


Repeat Dispensing Batch Issues: EMIS Printing Problem

NHS Prescription Services have alerted us to a problem with the way that certain repeat dispensing prescriptions are being generated. Information obtained to date suggests this problem is limited to certain versions of the EMIS prescribing system. In some cases where there are 4 items listed on the repeat authorising (RA) form, the 4 items are being printed over 2 batch issue (RD) forms, for example, details of the prescribed product may appear on the first batch issue but the quantity to be prescribed and the directions for use on the second batch issue.

Although this is legally acceptable, prescription forms are priced by NHS Prescription Services individually so if all of the information required for payment is not on an individual form, there is a risk of incorrect payment or the form being returned to the pharmacy for clarification. The intelligent character recognition software used by CIP would not be able to collect information about a certain prescribed item from 2 different forms in calculating payment. Therefore it is essential that any contractors affected by this problem, ensure that all of the necessary information for payment is contained on the one form. For example, in this scenario, the pharmacist could use the 'PC' endorsement to endorse the quantity on the form containing details of the prescribed product, scoring a line through the directions and quantity printed on the second form.

Both NHS Prescription Services and PSNC have contacted EMIS to ask them to amend their system to resolve this problem.


Prescription Handling Tips

Avoid sticking a label on the prescription during the dispensing process. The residual glue can jam the high speed scanners.

Avoid using any pins, clips or staples on your prescriptions as these have to be removed and can delay processing.

Avoid enclosing invoices or photocopies of invoices with your prescriptions. These will not be used in the pricing process. Where NHS Prescription Services require information on the price of products dispensed, this should be endorsed on the left hand side of the prescription form.

Take care when stamping and endorsing prescriptions, ensuring that pharmacy stamps do not obliterate the age / date of birth box on the front of the prescription form. This makes it difficult for both the intelligent character recognition software and prescription processing staff to determine whether a prescription is exempt from the prescription charge on the grounds of age and could lead to inappropriate switching of prescriptions for patients exempt on age related grounds.

Endorse your prescriptions clearly and only with the minimum amount of information required for your prescriptions to be priced. Endorsements on FP10 prescription forms should be kept within the designated area on the left hand side. This space should be used for endorsements only. Printed endorsements that are faint or out of line with the prescribed product information increase the risk of prescriptions being referred back for clarification. A guide to endorsing is available on both the NHS Prescription Services' and PSNC websites.

Avoid marking prescriptions with ticks or other marks or general notes during the dispensing/checking process. If these are in the left hand endorsement margin or in the prescribing portion they can affect how the Intelligent Character Recognition (ICR) software interprets prescriptions and can lead to procing errors.

Follow instructions from NHS Prescription Services on the way prescriptions should be bundled for submission.

Use the most recently received bar-coded label when submitting prescriptions to NHS Prescription Services.

Dispatch your prescriptions by the 5th of the month in a secure manner that enables tracking and tracing of the delivery.


NHS Prescription Services Address Labels

Each month, NHS Prescription Services post pharmacies a bar-coded label to use when submitting prescriptions for payment. The bar-code contains the details of the pharmacy and the submission month. To ensure correct payment, it is essential that pharmacies use the most recent label that they have received when submitting prescriptions. When a prescription bundle reaches NHS Prescription Services, the bar-code on the label is scanned to log the bundle into the system. Prescriptions are priced based on the reimbursement prices and rules in effect for the month held on the bar-code. Any stocks of old NHS Prescription Services address labels and old FP34C forms should be destroyed. Submission of the incorrect FP34C form or use of an old address label could delay payment or lead to incorrect payment.


Frequently Asked Questions

Where I have sorted broken bulk items, items with a NIC of £100 or more and ‘Specials' separately for submission to NHS Prescription Services, do I need to file these in prescriber order?

No, there is no need to sort the broken bulk, items with a NIC of £100 or more and ‘Specials' prescriptions in prescriber order. The segregated broken bulk, items with a NIC of £100 or more and ‘Specials' prescriptions must be sorted into charge paid and exempt and included at the top of the charge paid or exempt bundles as appropriate. There is no need to separate out the segregated broken bulk prescriptions from the "specials" prescriptions.

When sorting my prescriptions into prescriber order for submission to NHS Prescription Services, I know I have to submit the forms in prescriber order but do I need to put an elastic band around each individual prescriber’s prescriptions?

No, prescriptions should be submitted in prescriber order but contractors should not wrap an elastic band around each individual prescriber’s prescriptions in the bundle. If this is done, each band has to be removed by NHS Prescription Services staff causing delays in processing.

Do I have to sort my prescriptions as requested by NHS Prescription Services?

Yes, Part I Clause 5 of the Drug Tariff requires that ‘Contractors shall sort and despatch forms in such a manner as the PCT for England and LHB for Wales may direct’. In this instance, NHS Prescription Services is acting as an agent of the PCT so contractors are required to sort prescriptions as requested. Annual adjustments are made to the national contract funding arrangements using an agreed formula which takes into consideration increased regulatory burdens. Regulatory burdens are assessed on a retrospective basis. PSNC is working to ensure that the additional workload associated with changes in the sorting requirements is quantified so that additional costs are recognised in the funding arrangements. More detailed information on the formula for negotiating annual uplifts to the value of the contract can be found in the National Contract Funding section of the PSNC website.

I’ve received a prescription for a product but the patient has requested less than the prescribed quantity. Do I need to sort this prescription differently for submission to NHS Prescription Services?

No. The only prescriptions that have to be sorted differently are prescriptions containing broken bulk claims, items with a NIC of £100 or more and ‘Specials'.

In this scenario, to guard against any suggestion of fraud, the prescription should be clearly endorsed in the endorsement column to indicate the dispensed quantity. Although information in the endorsement column may not be picked up in the pricing process, NHS Prescription Services have not asked contractors to separate out prescriptions where the dispensed quantity is less than the prescribed quantity.

Back to the Main CIP Section 


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