A Guide to the Processing and Pricing of Prescriptions

The Prescription Pricing Authority processes all prescriptions issued and dispensed in England under the National Health Service Act 1977. It receives prescriptions for the supply of medicines, appliances and chemical reagents issued by GPs and other NHS prescribers, as dispensed by community pharmacists, dispensing GPs and appliance contractors under contract to local Health Authorities; known collectively as dispensing contractors. Claims are also received from GPs for items that have been administered to the patient by the GP, for example influenza vaccines. Such items are usually referred to as "Personal Administration" claims.

Dispensing contractors are required to despatch their prescriptions, appropriately sorted, to the PPA no later than the fifth day of the month following that in which the medicine was dispensed.

Upon arrival at the PPA, prescription forms are passed through high speed numbering machines. The forms are then transferred to data input processing teams who, after deciphering and interpreting the orders and taking account of endorsements made to the form by the dispenser, enter the data into the computer system. Each team is allocated responsibility for a specific group of contractor accounts, and the team leader acts as the account manager, resolving payments or other queries direct with the dispensing contractor concerned. This enhances the personal service ethic. The Prescription Processing Service has been awarded the International Quality Accreditation of ISO 9002, a reaffirmation of the PPA principle of "getting it right first time".

Remuneration and reimbursement paid to dispensing contractors for prescriptions dispensed varies according to contract type and is detailed for pharmacy and appliance contractors and interested parties to see in the monthly Drug Tariff which is published by the PPA on behalf of the NHS Executive.

Pharmacy contractors are entitled to reimbursement and remuneration for the following:

  • the total price of the medicines, appliances and chemical reagents supplied, less a deduction for the discount received by the contractors
  • other fees and remuneration as listed in the Drug Tariff
  • the professional fee for each item dispensed
  • an allowance for containers and measuring devices

Prescription charges collected from patients by the pharmacy contractor are deducted from the payment. The basis of payment for prescriptions submitted by dispensing doctors and for personal administration claims, is contained in the Statement of Fees and Allowances.

The PPA calculates the payment due for prescriptions dispensed by contractors in England. In the case of pharmacy and appliance contractors, and oxygen concentrator suppliers, the PPA makes the payment direct to these contractors. The sums due, including local payments notified to the PPA by Health Authorities, are paid no later than the first working day of the month.

The PPA also calculates payments on an agency basis for the Isle of Man, Jersey and Guernsey Authorities.

The provision of high quality, cost effective service is the basis on which the PPA operates. Dispensing contractors can therefore be assured that accuracy and quality of service are afforded the highest priority, and taxpayers can be assured that the most effective use is made of NHS resource.