| New Contractual Framework
for Community Pharmacy
Background
to the New Contractual Framework
Changes
to Remuneration
Professional
Fee (Part IIIA 1)
Additional
Fees (Part IIIA 2)
Special
Fee (Part IIIA 3)
Endorsement
Requirements
Payment
for Essential Services
Establishment
Payment
Practice
Payment
Protected
Professional Allowance Payments
Repeat
Dispensing Payment
Transitional
Payment
ETP Allowances
Payment
for Advanced Services
Medicines
Use Reviews
Payments
for Enhanced Services
Other
Payments
Essential
Small Pharmacies Scheme (ESPS)
Local Pharmaceutical
Services (LPS)
Revised
Schedule of Payments for pharmacy contractors
Background to the New Contractual
Framework
The
new contractual framework for community pharmacy was
agreed for England and Wales between the Department
of Health (DH), the Pharmaceutical Services Negotiating
Committee (PSNC) and the NHS Confederation and went
live in April 2005.
There
are three tiers of services: nationally set essential
and advanced services and enhanced services commissioned
locally by Primary Care Trusts (PCTs).
Essential
services are defined as those services that must
normally be provided by all community pharmacy contractors
under the new arrangements. Such services together with
advanced services form the ‘nationally agreed’
services and are not open to local negotiation.
Advanced
services are those services that require accreditation
of the pharmacist providing the service and/or specific
requirements to be met in regard to premises.
Enhanced
services are commissioned locally by PCTs. Local
Pharmaceutical Services (LPS) will continue to be an
option available to PCTs for delivery of local services.
Changes to Remuneration
Below
is a summary of the changes to remuneration fees under
the new contract. Please refer to Part IIIA of the Drug
Tariff for further details.
Professional Fee (Part IIIA 1)
The Professional Fee under the new contract is 90p per
prescription item dispensed and is applied to all items
including appliances.
Additional
Fees (Part IIIA 2)
A
– Preparations when extemporaneously dispensed
and endorsed
There is a reduction in the number of fees in this section
under the new contract. The following fees have been
discontinued altogether:
- “Aseptically
dispensed”
- “Extemporaneously
sterilised”
The
“extemporaneously dispensed” fee has been
removed for:
- Unit
dose forms, e.g. cachets, capsules, pills, lozenges,
pastilles, pessaries, powders
-
Ointments, creams, pastes being ‘special formula
preparations’ (not including dilutions)
B
– Appliances
This section (formerly “Appliances and dressings”)
no longer contains the following fees under the new
contract:
- Repairs
to trusses
-
Stoma appliances, suprapubic belts, incontinence appliances
fees (i) and (ii).
Bulk
Prescriptions
The fee for Bulk Prescriptions for schools and institutions
supplied in accordance with the Regulations has been
discontinued under the new contract.
C
– Extra Containers for Extemporaneously Dispensed
Liquids
The fee has been amended to remove reference to the
former fees for "aseptically dispensed" and
"extemporaneously sterilised" prescription
items.
D
– Extra Containers for Liquids of Limited Stability
There is no change to this fee under the new contract.
E
– Controlled Drug Fee
There is no change to this fee under the new contract.
Dispensed
Urgently Fee
This fee has been discontinued under the new contract.
F
– Expensive Prescription Fee
There is no change to this fee other than now it is
referenced as 2F rather than 2H.
Special
Fee (Part IIIA 3)
The Special Fee for appliances and dressings has been
discontinued and was replaced by the Professional Fee
(90p per prescription item).
Endorsement Requirements
| Old
endorsement requirements |
New
endorsement requirements |
| “Extemporaneously
dispensed” |
ED |
| “Measured
and fitted” |
MF |
| CD
(for schedule 2 and 3 controlled drugs) |
no
endorsement required |
Payment for Essential Services
Establishment Payment
Contractors who submit at least 2,120 prescription items
per month receive an Establishment Payment. This payment
is based on the volume of prescription items submitted
by the pharmacy contractor and processed for payment
by the NHSBSA for that month. The number of ‘items’
is calculated from the number of fees payable plus the
number of oxygen items.
For
further details on this payment refer to Part VIA 1
of the Drug
Tariff.
Where
total monthly payments in relation to prescriptions
passed for pricing between 1st April and 31st March
in any financial year are less than the amount which
would have been paid had the payment been calculated
on an annual basis, pharmacy contractors may make a
claim for a top up payment to their PCT for England
and LHB for Wales. This should take account of any Protected
Professional Allowance Payments made, such that pharmacy
contractors do not receive both an Establishment Payment
and a Protected Professional Allowance Payment for the
same month. The contractor should submit copies of FP34
statements for the relevant period (April to March)
as evidence of the total number of prescription items
passed for pricing during this period. This claim needs
to be made by the 30th November following the March
cut off for the period.
This
payment is separately identifiable on the payment schedule
as an ‘Establishment Payment’. Top up facilities
are also available on this payment via the NHSBSA local
payment system.
Practice Payment
All pharmacy contractors are eligible to receive a Practice
Payment. This payment is calculated and paid automatically
by the NHSBSA , based on the volume of prescription
items submitted and the staff declaration made on submission
form FP34C. The number of ‘items’ are calculated
from the number of fees payable plus the number of oxygen
items.
In
order for a contractor to receive the full practice
payment to which they are entitled they must demonstrate
that they have sufficient dispensing staff levels to
support the number of items dispensed each month. Contractors
should declare the total number of hours that staff
members supporting the dispensing process work in an
average week. The total number of hours declared on
submission form FP34C
should be rounded to the nearest whole number. If the
number is 0.5 hours or less, the figure should be rounded
down and if the number is more than 0.5 hours the figure
should be rounded up. The declaration should include
all staff members involved in the dispensing process,
including the pharmacist. Where the number of staff
declared is identified as being less than the required
level for a given volume of prescription items the payment
will be adjusted, as detailed in Part VIA 2 of the Drug
Tariff.
This
payment is separately identifiable on the payment schedule
as a ‘Practice Payment’. An adjustment facility
is also available on this payment via the NHSBSA local
payment system.
Protected Professional Allowance Payments
The period of protection provided under the Pharmaceutical Contractual Framework for
existing pharmacy contractors who were active before the 1st April 2005 and have dispensed
1,100 or more prescription items but fewer than 2,120 per month has now expired therefore no
further payment will be made under this provision.
Repeat Dispensing Payment
All
pharmacy contractors receive a repeat dispensing annual
payment. This consists of an annual fee which is automatically
paid on a monthly basis by the NHSBSA, in equal instalments.
It is paid to all existing and new pharmacy contractors
where prescriptions are submitted, irrespective of the
period in that month the contractor was providing pharmaceutical
services.
The
amount is included on the payment schedule and shown
as ‘Repeat Dispensing Fee’.
Although
this essential service follows the same principles as
the pilot scheme there are a number of changes involved
in the payment and submission processes. Further details
on repeat dispensing can be found on the NHSBSA website
here.
Transitional Payment
All pharmacy contractors will receive a Transitional
Payment which is paid monthly by the NHSBSA and is calculated
based on the number of prescription items submitted
and reimbursed by the NHSBSA, in the relevant month.
This is detailed in the Drug
Tariff Part VIA 5.
The
amount is shown on the payment schedule as ‘Pharmacy
Contract Transition Payment’.
ETP Allowances
The Electronic Prescription Service will be rolled out
in phases with two releases (Release 1 and Release 2)
of ETP Compliant pharmacy systems. Further details of
service implementation and deployment can be found at
www.cfh.nhs.uk
In
order to be able to use the Electronic Prescription
Service pharmacy contractors will need to have:
- an
ETP compliant pharmacy system accredited as such by
NHS Connecting for Health (either Release 1 or Release
2).
- appropriate
network connectivity to be able to operate the Electronic
Prescription Service (details of connectivity arrangements
for community pharmacies will be made available by
NHS Connecting for Health).
-
staff operating the service who are registered users
and have been issued with smart cards and PIN numbers
by their PCT’s Registration Authority.
Two
allowances of £1,300 were paid to pharmacy contractors
who were active on the appropriate dates. The first
payment of £1,300 was made in December 2005 (to
those pharmacy contractors active on 1st November 2005)
and a second payment was made in February 2006 (to those
pharmacy contractors active on 1st January 2006). These
allowances are linked to a pharmacy deploying Release
1 of the Electronic Prescription Service.
If
the pharmacy has not deployed Release 1 of the service
(by a date as yet to be determined of which three months
notice will be given), the PCT will be able to reclaim
these allowances from the pharmacy contractor via the
local payments application and this will be shown on
the Schedule of Payments.
A
further allowance of £1,000 will be paid in 2006/07
linked to the pharmacy deploying Release 2 of the Electronic
Prescription Service. If the pharmacy has not deployed
Release 2 of the service (by a date as yet to be determined
of which three months notice will be given), the PCT
will be able to reclaim this allowance from the pharmacy
contractor through a deduction via the local payments
application and this will be shown on the Schedule of
Payments.
When
the pharmacy contractor is able to operate the Electronic
Prescription Service if an appropriate prescription
is presented or requested, the pharmacy contractor can
claim £200/month by submitting form PPAETP1
to their PCT (Gateway reference PPA-05-007). The PCT
will enter this payment via the local payments system,
initially under ‘Locum Reimbursement’ which
will later be renamed ‘ETP Payment’. If
at a later date the pharmacy contractor becomes unable
to operate the Electronic Prescription Service, they
must inform the PCT in writing immediately so that payment
of this ongoing allowance is stopped.
Any
queries regarding interpretation of the ETP payments
should be directed to the Department of Health.
PPAETP1
Payment for Advanced Services
Medicines
Use Reviews
A payment is available to pharmacy contractors who are accredited and undertake medication use
reviews (MURs). In England and Wales payments will be made up to a maximum of 400 MURs per
pharmacy per financial year for the period commencing 1 April and ending on 31 March in any year.
However, where a contractor enters into arrangements with the PCT to provide MURs after 1st October,
the maximum number of MURs for the remainder of that year will be 200. The payment for MURs is listed
in Drug Tariff Part VIC and is currently set at £27 per review.
The
pharmacy contractor should declare the number of reviews
carried out each month on submission form FP34C
submitted to the NHSBSA with the contractor batch. The
PPA will make payment based on the number of reviews
declared and will provide information to PCTs on the
number of reviews declared by each pharmacy contractor
for that month. The amount is included on the payment
schedule and shown as ‘Other Fees – Medicine
Use Reviews’
The
PCT may request the NHSBSA to make an adjustment for
payments already made. The NHSBSA provides a facility
to allow the PCT to recover money for overpayments via
the local payment system.
Payments for Enhanced Services
Details
of payments made for enhanced services are to be included
in a future edition of the Drug Tariff in Part VID.
Other
Payments
Essential Small Pharmacies Scheme (ESPS)
Essential Small Pharmacy Scheme (ESPS) arrangements for England ceased on 31 March 2006. New arrangements in the form of Essential Small Pharmacies Local Pharmaceutical Services (ESPLPS), were set out in the Local Pharmaceutical Services (Essential Small Pharmacies) Directions 2005. The ESPS scheme is now closed and no further applications may be made under the ESPS scheme. The ESPS arrangements for Wales will continue. Details can be found in Part XII of the Drug
Tariff.
Local Pharmaceutical Services (LPS)
Local Pharmaceutical Services are continuing under the
new pharmacy contract.
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