In the last few months PSNC has received several reports from pharmacy contractors who have incurred significant losses from dispensing unlicensed medicinal products (specials) because prescriptions have not been issued/written correctly by the prescriber.

Where prescribing of a specials product is considered appropriate by the prescriber, a prescription must be issued with the correct product selected by the prescriber to indicate that a special is required. If a prescription for a specials is issued/written incorrectly by the prescriber, pharmacy contractors are strongly advised to seek replacement prescriptions for any specials products(s) – in line with guidance below – to ensure accurate reimbursement.

To minimise the risk of dispensing at a loss, PSNC has issued the following guidance for pharmacy contractors to ensure prescriptions (both EPS and paper) for specials products are correctly issued/written by prescribers.

Prescribing of specials using EPS 

A prescriber must select the appropriate Actual Medicinal Product (AMP) on their prescribing system to allow pharmacy teams to supply and be reimbursed for dispensing a special.

In EPS, a prescription for a special would read:

• ‘Drug name (Drug Tariff Special Order)’ – for a Part VIIIB listed special’; or
• ‘Drug name (Special Order)‘ – for a non-Part VIIIB special; or
• ‘Drug name (Imported (Country))’ – for an unlicensed import

Example of a correctly issued electronic prescription for a special

Example of an incorrectly issued electronic prescription for a special

It is important to note that if a prescriber adds free-typed supplementary information such as ‘Special’ or ‘Special Order’ into a different EPS field for example, as part of the dosage instructions or additional information field, this will not be taken into account for reimbursement purposes as this information is not captured by the NHS Business Services Authority (NHSBSA) during processing. For further information on the inclusion of additional product information within the dosage area field see psnc.org.uk/dosearea.

For technical reasons, not all products can be issued via EPS because:

• a required product may not be listed within the NHS Dictionary of Medicines and Devices (dm+d), or
• the prescribing systems may not be able to generate a prescription because the prescribing system supplier has not ‘mapped’ across the appropriate codes.

Pharmacy teams may need to refer to this guidance during discussions with a prescriber to help explain that an EPS prescription needs to be cancelled and re-issued with the correct AMP selected (where listed on dm+d) or that a replacement paper FP10 form written as ‘Drug name (Special Order)’ needs to be issued to ensure that it can be accurately priced by the NHSBSA.

Prescribing of specials using paper FP10 prescriptions

As mentioned above, where a prescriber is unable select and issue an electronic prescription for a specials product via EPS, they would need to issue a paper FP10 prescription written as ‘Drug name (Special Order)’. It is preferable to have the  wording ‘(Special Order)‘, included in the first line of the prescribed product as part of the drug name to ensure NHSBSA can recognise and reimburse the specials products(s) correctly.

Example of a correctly written paper FP10 prescription for an unlicensed product

Paper FP10 prescriptions for specials must be correctly endorsed and placed in the red separator during end of month submission. See our Unlicensed specials and imports page for guidance on endorsing EPS and paper FP10 prescriptions.

See our Unlicensed specials and imports page for guidance on endorsing EPS and paper FP10 prescriptions.

Further resources

Dispensing unlicensed medicines factsheet

NHSBSA dm+d viewer

Endorsing non-Part VIII EPS items