Confirmed minutes of 21 November 2000

PRESCRIPTION PRICING AUTHORITY

At a meeting of the Prescription Pricing Authority Public Meeting held at The Building Centre, 26 Store Street, London, on Tuesday 21 November 2000, there were:

PRESENT

Professor D J Johns - Chairman

Dr M Ali Mrs A Galbraith
Mr M Bennett Mr J Norman
Mr P Catchpole Mr N Scholte

IN ATTENDANCE

Mr D Ball Mr M Siswick
Mrs C Dalton Mr W J Smith
Mr M King Mrs E A Stobbart

1 APOLOGIES FOR ABSENCE

Apologies for absence were received from Dr S Purdy and Dr J Ferguson.

2 CHAIRMAN'S INTRODUCTION

The Chairman welcomed and thanked members of the audience for attending the second Public Meeting of the PPA.

3 OVERVIEW OF THE YEAR 1999/2000

Mr Scholte, Chief Executive of the PPA, reported on challenges faced by the Authority and its performance during 1999/2000 highlighting the impact of Category D, provision of prescribing information to HAs and PCGs/Ts and the work involved in Year 2000.

Improvements and developments had been made by the Authority on such issues as the Pharmacy Reward Scheme, Low Income Scheme, prescribing analysis and working with the NHSE on strategic issues.

The Authority published its first Strategic Plan 2000-2005 which supported the Government's aims and objectives for modernising the NHS.
In conclusion Mr Scholte highlighted the challenges the Authority faced from the implementation of The NHS Plan and Pharmacy in the Future. There would be an impact on the Authority in relation to prescription volume and complexity and the subsequent provision of prescribing information to the NHS.

3. CATEGORY D BACKGROUND AND RECOVERY

Mrs Stobbart, Director of Operations, explained the background and impact of the shortage in generic drugs on the processing activity of the Authority and the provision of prescribing information and payments to stakeholders.

In consultation with the NHSE it had been agreed to process the backlog of prescriptions sequentially and as such the Authority developed a recovery strategy which involved a number of changes to processes and systems.

Mrs Stobbart confirmed that the Authority would recover from Category D and return to normal processing in September 2001.

4. ELECTRONIC TRANSMISSION OF PRESCRIPTIONS (ETP)

Mr Ball, Director of Information Technology, gave an overview and provided timescales of the project to establish ETP pilots as announced by Lord Hunt.

Specifically highlighted were the approval process, philosophy, standards and the evaluation process of the pilots.

ETP would have a major impact on the Authority and may result in automatic processing, new quality assurance systems, anomaly detection and treatment based information systems.

Mr Ball reported on the ETP Management Structure and the partnership with the DoH who were the policy lead on ETP.

5. FINANCIAL REPORT

Mr Smith, Director of Finance and Administrative Services, reported on the Authority's financial position during 1999/2000 in respect of the Pharmaceutical Accounts and the Administration Accounts.

Particular reference was made to the new Audit certification standards and the resultant qualified opinion on the Pharmaceutical Services accounts. The qualification had been as a result of an estimated £69 million worth of uncollected prescription charges that was not in accordance with the wishes of Parliament. Discussions were being held with the NHSE to prevent similar occurrences in future years.

Mr Smith reported that the Authority had broke even for the sixteenth consecutive year, that over 95% of suppliers were paid within 30 days and that the cash balance at the end of the year had been £33,000.

New financial challenges to be faced by the Authority during 2000/2001 were Resource Accounting, Category D, ETP and efficiency savings.

6. QUESTIONS AND ANSWERS

Mr R Calvert, Pharmaceutical Advisor, East Riding Health Authority queried the forecast model on expenditure on medicines included in the Prescribing Monitoring Documents. In particular the figures for the early part of the financial year caused concern. Mr Ball confirmed that the forecast did not provide good projections up to month three but projections were more realistic from month four onwards. The model was devised by the Prescribing Support Unit and was the most accurate model that could be developed.

Mr Calvert also advised that the number of prescribing advisors had increased due to the creation of PCGs and therefore more training was required in the use of the PPA prescribing information systems. Mr Ball advised that training had been provided by Barry Lloyd via the National Prescribing Centre and those courses were no longer available. The PPA were organising training courses to commence in the new year. These courses would be on a fee paying basis.

Professor I Jones, Portsmouth University, enquired whether as a result of the point of dispensing checks the number of patients evading prescription charges had reduced. Mr Siswick advised that around 300,000 checks were carried out per annum and the figures were extrapolated and sent to the DoH. The figures indicated that there had been a reduction in the number of charges evaded and that figures were expected to reduce further following the implementation of penalty charges.

Mr P Marshall, Directorate of Counter Fraud Services, clarified that as a result of Point of Dispensing Checks the estimated £117 million of unpaid prescription charges had been reduced by £48 million to £69 million.

Ms E Mason, Redbridge Health Authority, enquired whether there was the intention to provide analysis of prescriptions dispensed on Forms FP10(HP) to Community Trusts. Mr Ball responded that discussions had been held with the DoH to provide information/analysis and the outcome was awaited.

Mr Marshall enquired what the PPA were doing in relation to exemption checks on patients of Hospital Trusts. Mr Siswick responded that as previously agreed with the NHS Executive, the PPA's Compliance Unit were undertaking a pilot exercise covering a number of Trusts. The results would be evaluated in conjunction with the hospitals involved.

Professor Jones asked what percentage of prescriptions were endorsed by pharmacy computer systems and whether the systems caused problems for the PPA. Mrs Stobbart advised that 60% of prescriptions were endorsed by pharmacy computer systems and that processing staff had more difficulty processing those prescriptions due to duplicate endorsements. The Authority would support the introduction of standards for pharmacy computer systems.

7. CONCLUDING REMARKS

The Chairman thanked the members of the audience for attending and formally closed the meeting.