Information for pharmacy contractors on the sorting, submission, and endorsement of prescription forms

The NHS Business Services Authority’s Prescription Pricing Division (NHSBSA PPD) receives 10,000 prescription batches every month from pharmacy contractors (and additionally from doctors and other types of dispensers). To facilitate the accurate processing of these batches, contractors should follow the basic principles outlined below when sorting, submitting and endorsing prescription forms.

Sorting the monthly prescription batch

The main sorting requirements are shown on the FP34C submission document that is distributed each month. These instructions include the need to:

• Sort the FP10 submission into 3 groups: exempt (including no charge contraceptives), chargeable and, where applicable, old charge rate
• Sort the forms, within these groups, as described on the FP34C (i.e. by form type, prescriber type, etc). It is particularly important to sort the FP10s alphabetically by prescribing doctor surname. (There is still no requirement to sort forms by surname for prescribers with fewer than 20 forms in the account – these can still be grouped together in a miscellaneous section)
• Sort other forms separately (e.g. Repeat Authorising forms, ETP tokens for non-payment, FP57s) but submit as part of same account
• For those contractors whose accounts are processed through our new system we request that the following prescriptions are separated from the main body of your batch:
• Any prescriptions where Broken Bulk is claimed
• Any Calendar Pack prescriptions where the quantity prescribed differs from that of the pack size and the prescribed quantity is dispensed.

These two sets of prescriptions should be secured separately and placed on top of your batch prior to despatch. These prescriptions do not need to be sorted alphabetically by prescribing doctor name.

Completion of the FP34C submission document

The revised FP34C (August 2007) has 3 separate sections to complete. These are –

• Part 1 – Submissions
• Part 2 – Declarations
• Part 3 – Authorisation

Part 1 is used to record details of the type of forms submitted. Areas to complete include –

• The number of forms/items within each group –
  
  • The exempt from patient charge group (including no charge contraceptive items)
  • Patient charge paid group
  • The old rate group.
  • These should then be added up into a total figure for all FP10 prescriptions submitted

(Any unused boxes in the above section only should be left blank i.e. they should not be crossed through in any way. The “No Charge Prescriptions in Group 2 or 3” box has also been removed. Any items in these 2 groups which do not attract charges should be added to the figures for the exempt group items in order for the 80% advance to be correctly calculated. Alternatively, the correct number of fees/charges will be paid following the actual processing of the account as these items will be identified accordingly).

• Indication of any ETP tokens for non-payment or Repeat Authorising forms submitted.

(These are to be indicated by a tick only – there is no requirement to indicate the number of these forms submitted)

• Any FP57 refunds that have been given by the pharmacy. This is recorded as –
  
  • The number of refunded FP57 forms submitted
  • The total amount refunded on FP57s

(If the number of FP57s to be submitted is zero, then “0” should be written in the relevant box. The number of pounds reclaimed as part of the FP57 procedure should be right-justified next to the decimal point).

Part 2 is used to record three further declarations.

• The number of hours per week dispensing staff are involved in supporting the dispensing process in an average week.
• The number of Medicine Use Reviews undertaken
• Claims for out of pocket expenses this is recorded as -
• The number of items claimed for out of pocket expenses.
• The total amount clamied for out of pocket expenses.

Declaration of Dispensing Staff Hours

In this section, pharmacists should declare the total number of hours that staff members supported the dispensing process in an average week. The PPD takes into account staffing levels declared on the FP34C in the calculation of the Practice Payment. If pharmacies have less than the minimum staffing levels, they will receive the level of the Practice Payment for the number of items indicated by their actual level of staffing.

The declaration should include all staff members involved in the dispensing process, including the pharmacist. All staff involved in the dispensing process can be counted in the declaration of dispensing staff levels; this includes pharmacists, pre-registration trainees (only half of the pre-registration trainees hours should be counted for this purpose), pharmacy technicians, dispensing/pharmacy assistants and medicines counter assistants or an assistant trained to undertake the functions being performed. The 'dispensing process' includes:

• the taking in and issuing of prescriptions;
• dispensing prescriptions;
• clinical assessment of prescriptions and accuracy check of dispensed items;
• stock ordering and putting stock away;
• preparation and assembly of medicinal products;
• resolving queries related to prescriptions;
• counselling patients on their prescriptions, and
• carrying out the administration necessary for the payment of prescriptions (e.g. endorsing and filing prescriptions);

Where a staff member has multiple roles (for example, a medicines counter assistant who spends 50% of their time taking in prescriptions and helping patients complete the exemption declaration and 50% of their time undertaking general tasks on the retail side of the pharmacy business), only the number of hours spent supporting the dispensing process may be counted in the staffing declaration.

The declaration should record the normal staffing levels for the pharmacy therefore if a member of staff has been absent due to annual leave or sickness they may still be included in the declaration, as the declaration is a record of the normal staffing levels for the pharmacy. Similarly if a member of staff leaves and the pharmacy is actively engaged in seeking a replacement for the post, that post may also be included in the declaration. However if a member of staff is not replaced for a prolonged period of time the PCT, who will be monitoring staffing levels, may decline to accept that post as counting towards the pharmacy’s staffing level. The PCT may wish to look at payroll and other evidence of employment if it has concerns about the validity of the declaration.

The total number of hours declared on the FP34C should be rounded to the nearest whole number. If the number is 0.5 hours or less, it should be round down and if the number is more than 0.5 hours it should be round up. If the number of dispensing staff hours per week, based on establishment, alters in the course of the month for which the declaration is being made, for example because a brand new post is established, the lowest number should be declared.

The number of hours written in this space should be right-justified. If no declaration is made, the contractor will be paid at the minimum level (i.e. £500 per annum). For example, for a pharmacy employing a pharmacist and two full time members of staff that support the dispensing process, each working forty hours in an average week, the declaration will be:

Medicine Use Reviews

The number of Medicines Use Reviews (MUR's) undertaken for that month should be written in this space ensuring that the numbers are right-justified. The contractor should declare zero values in the box if no claims are being made for MUR's in that monthly submission.

Decleration of Dispensing Staff Hours

In this section, pharmacists should declare the total number of hours that staff members supported the dispensing process in an average week. The PPD takes into account staffing levels declared on the FP34C in the calculation of the Practice Payment. If pharmacies have less than the minimum staffing levels, they will receive the level of the Practice Payment for the number of items indicated by their actual level of staffing.

The declaration should include all staff members involved in the dispensing process, including the pharmacist. All staff involved in the dispensing process can be counted in the declaration of dispensing staff levels; this includes pharmacists, pre-registration trainees (only half of the pre-registration trainees hours should be counted for this purpose), pharmacy technicians, dispensing/pharmacy assistants and medicines counter assistants or an assistant trained to undertake the functions being performed. The 'dispensing process' includes:

• the taking in and issuing of prescriptions;
• dispensing prescriptions;
• clinical assessment of prescriptions and accuracy check of dispensed items;
• stock ordering and putting stock away;
• preparation and assembly of medicinal products;
• resolving queries related to prescriptions;
• counselling patients on their prescriptions, and
• carrying out the administration necessary for the payment of prescriptions (e.g. endorsing and filing prescriptions);

Where a staff member has multiple roles (for example, a medicines counter assistant who spends 50% of their time taking in prescriptions and helping patients complete the exemption declaration and 50% of their time undertaking general tasks on the retail side of the pharmacy business), only the number of hours spent supporting the dispensing process may be counted in the staffing declaration.

The declaration should record the normal staffing levels for the pharmacy therefore if a member of staff has been absent due to annual leave or sickness they may still be included in the declaration, as the declaration is a record of the normal staffing levels for the pharmacy. Similarly if a member of staff leaves and the pharmacy is actively engaged in seeking a replacement for the post, that post may also be included in the declaration. However if a member of staff is not replaced for a prolonged period of time the PCT, who will be monitoring staffing levels, may decline to accept that post as counting towards the pharmacy’s staffing level. The PCT may wish to look at payroll and other evidence of employment if it has concerns about the validity of the declaration.

The total number of hours declared on the FP34C should be rounded to the nearest whole number. If the number is 0.5 hours or less, it should be round down and if the number is more than 0.5 hours it should be round up. If the number of dispensing staff hours per week, based on establishment, alters in the course of the month for which the declaration is being made, for example because a brand new post is established, the lowest number should be declared.

The number of hours written in this space should be right-justified. If no declaration is made, the contractor will be paid at the minimum level (i.e. £500 per annum). For example, for a pharmacy employing a pharmacist and two full time members of staff that support the dispensing process, each working forty hours in an average week, the declaration will be:

Out of Pocket Expenses

The NHSBSA has agreed with the Pharmaceutical Services Negotiating Committee (PSNC) that from February 2006, a new section on the FP34C submission document should be used by contractors to declare the total claims for out of pocket expenses included within the monthly submission of prescription forms.

Contractors must continue to endorse the prescription form giving full particulars of the claim for out of pocket expenses, as detailed in Drug Tariff Part II, Clause 12 however there is no longer a requirement to attach documentary evidence, such as photocopies of invoices, the relevant information should instead be clearly marked on the prescription form. The NHSBSA will not return invoices to contractors that have been attached to prescription forms.

Contractors are required to declare the number of claims being made for Out of Pocket Expenses in each monthly submission and the total value of the claims for that monthly submission. The form contains two spaces to enter these values and contractors should ensure when completing this section that the numbers are right-justified. For example, if the monthly batch of prescriptions contained five separate claims for out of pocket expenses which totaled £2.50, the following declaration should be made:

The contractor should declare zero values in each box if no claims are being made for out of pocket expenses in that monthly submission.

Part 3 is completed by the contractor as authorisation of the overall submission/declaration. The contractor should –

• Include the pharmacy stamp in the area provided
• Sign and date the FP34C
• Check that the account details and address pre-printed on the FP34C are correct
• In the new system processing the scanners read the barcode on the FP34C, therefore it is essential that contractors use the FP34C form specific to their account. Using an incorrect form would result in incorrect payment.

Once completed, please fold the FP34C into quarters along the fold lines marked on the document itself, so that the bar code and prescriber name/address are visible at the top. This should then be placed at the top of the forms being submitted to the PPD.

A new copy of the FP34C should be sent to you by the PPD each month. If you have not received this by the time you are due to submit your account, or if you have misplaced your copy, please contact the PPD division to which you regularly send your account, and they will endeavour to send you a replacement in time for your submission.

Packing and submitting the monthly prescription batch

The simple advice is to:

• Submit with appropriate claim form
• Sort as appropriate
• Submit in a secure manner that enables tracking and tracing of the delivery
• Submit not later than the fifth day of the month following that in which the supply was made.
• Place the prescriptions which have been sorted into 3 groups into a plastic bag(s), which should be sealed/sellotaped.
• Then place the sealed prescriptions into a strong box of the right size with the invoice, and wrap/seal this carefully.

Occasionally prescription batches are received by the PPD in a damaged condition. The main cause relates to prescriptions being placed openly in a box that is too big for the size of the batch and as a result they have been subject to damage within the postal delivery system. By following the basic principles above your batch will arrive safely and securely.

Common problems encountered include:

• The use of staples, paper clips, too many elastic bands, string or sticky labels and folded forms
• Prescriptions aren't bundled at all and are put loose into their outer packaging so we have to sort them.

Endorsement of prescription forms

The purpose of endorsements added by the dispenser is to ensure that the PPD has clear, accurate and unambiguous information against which we can make the appropriate reimbursement and remuneration. Adding unnecessary endorsements on the prescription form is a common problem, particularly those generated by computer endorsing systems. Although there are many reimbursement and remuneration rules that require endorsements, there are three very basic rules:

• For generic medicines within Part VIII of the Drug Tariff we will reimburse at the drug tariff rate automatically. You do not need to add endorsements unless there is more than one pack size listed in Part VIII, in which case pack size endorsements are required. In those exceptional cases where an 'agreed shortage' has been accepted by the Department of Health, we will accept endorsements for brand items where the prescription is fully endorsed, signed and dated.
• For generic medicines that are not included in the Drug Tariff the supplier should be endorsed, and, if there is more than one pack size, the pack size also.
• For proprietary medicine orders most require no endorsement, other than the appropriate pack size.

Contractors can help themselves and the PPD by reviewing their endorsing methods and systems. We provide some specific advice in our web page entitled 'How to prevent common endorsing errors'.