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FP10MDA Dispensing
Endorsement Guidance
The NHSBSA PPD has received a number
of enquiries from pharmacists about the correct way
to endorse FP10MDA prescription forms. This information
is intended as a guide to the remuneration of fees payable
for instalment dispensing and to the endorsements required
to calculate these payments.
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The requirements for the supply of controlled
drugs by instalments in England are that:
- FP10MDA prescription forms must be used for instalment
prescribing,
- the period of treatment is not to exceed 14 days,
- the prescriber must specify the number of instalments
to be dispensed and the interval between each instalment.
- only Schedule 2 Controlled Drugs plus buprenorphine
and diazepam can be prescribed in instalments on an
FP10MDA prescription.
Prescribers can use a number of ways to convey their instalment
instructions, such as computer generated grids of instalment
dates, rubber stamps or handwritten instructions. It would
be impossible to give examples of all scenarios, phrases
and situations and what the resultant acceptable endorsements
would be but the basic principle to remember is that contractors
will be paid based on what has been prescribed.
Remuneration (as set out in Drug Tariff Part IIIA)
All prescription items attract a Professional Fee. An
additional fee is also payable for controlled drugs
in Schedules 2 or 3 of the Misuse of Drugs Regulations
2001. For controlled drugs supplied by instalments,
these dispensing fees will be paid for each separate
instalment as specified by the prescriber that has been
dispensed. PCTs may have local payment arrangements
in place for supervising the consumption of daily instalments.
Dispensing Endorsements
Dispensers should complete the right hand side of the
form with details of each separate instalment specified
by the prescriber that has been dispensed. Where instalments
are prescribed at intervals less frequently than daily
and the prescriber has not requested that the product
should be dispensed into individual daily dose containers
and supplied in advance, such as in example 1, only
one set of fees will apply per instalment. This is because,
although the prescriber has stated 40ml daily, the prescriber
has not specified that the product should be "dispensed
in daily dose containers in advance".
In some situations the prescriber will
request daily instalments to be dispensed but supplied
in advance, for example to cover when the pharmacy is
closed or to accommodate when the patient is unable
to collect their medicine. If the prescriber has requested,
and the dispenser has dispensed daily doses into separate
containers and endorsed the prescription as illustrated
in example 2, then the dispensing fees will also be
applied to the instalments supplied in advance. If the
advance instalments were not specified to be dispensed
separately by the prescriber and therefore have been
supplied in one bottle/pack (e.g. if 120ml was supplied
instead of 3 x 40ml), then the prescription should be
endorsed as illustrated in example 1.
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Supervised Consumption
Where the prescriber has requested supervised consumption
and the patient has also taken away an instalment, for
example to cover a day where the pharmacy is closed,
two fees may be claimed for the supply on that day (see
example 3). However, if the advance supply covers more
than one day, for example to cover a Sunday and Bank
Holiday, then only one fee would be applicable for the
total advance supply (see example 4), unless the prescriber
has also specified that the product should be supplied
in separate daily dose containers in advance. If so,
then a fee would apply for the supervised dose and for
each of the advance daily doses that have been dispensed
(see example 5). Remuneration arrangements for supervision
may also be paid locally by PCTs.
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Points to Remember
- A dispensing fee and additional schedule
2 or 3 controlled drug fee (where appropriate) will
be paid for each instalment specified by the prescriber
that has been dispensed.
- Where the prescriber has requested
instalments at daily intervals in separate containers
and specified that supply can be made in advance,
and the dispenser has supplied these instalments separately
and endorsed the prescription as detailed above, then
the fees will also be applied to the instalments supplied
in advance.
- Where prescribers indicate supply
by instalments at intervals less frequent than daily,
dispensers should endorse the total amount supplied
on the day specified by the prescriber.
- Where the prescriber has indicated
supervised consumption or observed self-administration,
a fee may be claimed for both the supervised instalment
and for any instalments taken away in advance. If
the prescriber has also indicated that the take-home
supply should be dispensed in daily dose containers,
a fee may be claimed for each container dispensed
- If a prescriber has ordered more
than fourteen instalments, then the lines on the right
hand side of the prescription form can be split to
allow all the instalments to be endorsed.
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