How are your prescriptions processed?
How are your prescriptions processed?
The Pricing Authority CIP
To improve the efficiency of prescription pricing, the NHS Business Services Authority (NHSBSA), introduced an automated pricing system, known as the Capacity Improvement Programme (CIP) in 2007.
Since the introduction of CIP, PSNC’s auditing function (see this page for more details) has helped to identify some processing issues which had caused errors in payment for some prescription items. Error correction and system improvement work is ongoing, and both PSNC and NHSBSA are continuing to scrutinise the system closely.
NHSBSA’s pricing system uses high-speed scanning equipment and Intelligent Character Recognition (ICR) software to support the capture of printed information from prescription forms. This is supplemented by the information input manually by NHSBSA’s operators. Once information is captured, it is processed by the ‘rules engine’ to determine the payment due to contractors.
A summary of the key steps in the pricing process are outlined below. A diagram of this process can be downloaded here.
Prescription bundles received by NHSBSA must first be prepared for the scanning process which can be hindered by the way prescriptions have been submitted.
For information on how to properly sort your prescription bundle prior to submission please see our Sorting Your Prescriptions Prior to Submission page.
Once a prescription bundle is received, NHSBSA staff must make sure all clips, staples and sticky labels have been removed as they can jam or damage the scanning equipment. The information that has been entered onto the FP34c submission document is input alongside the scanned images and this is used to calculate the pharmacy’s advance payment; therefore it is crucial that this has been completed accurately.
For more information/guidance on how to complete the submission document correctly, please see our Completing Your FP34c Submission Document & Dispatching Your Prescription Bundle page.
Prescription Information Data Capture
The scanning system is only used to support the capture of data from the prescription, for example the prescriber ID, prescription form type, exemption status and details of the prescribed items. If the scanning process cannot determine this information with confidence, for example if the prescription is handwritten, then the prescription will be referred to a Type 1 Exception Handler who will enter the prescription details manually.
At this stage if the system flags that a prescription may have been submitted in the incorrect charge group, it will be referred to a Type 1 Exception Handler for verification of whether the form was in fact submitted incorrectly or not. If it was submitted incorrectly then it will be switched. No forms are switched automatically by the system; they are only switched once verified by a trained member of staff.
Further guidance on switching is available on our Prescription Switching page.
Prescriptions which cannot be processed automatically by the system will be sent to an operator who will manually capture the relevant information required to price the prescription.
Prescriptions that have been placed in the red separator are processed by a specialist team of handlers who are trained to price these types of prescriptions. The following prescriptions are required to be submitted in a red separator:
- Expensive items (items with a net ingredient cost of £100 or over);
- Specials and unlicensed products;
- Broken bulk ‘BB’
- Out of pocket expense claims ‘OOP/XP’;
- Where the prescribers signature encroaches into the prescribing area;
- Items with supplementary product information; and
- Items with prescriber handwritten amendments.
At this stage, items which still cannot be priced due to a lack of information must be referred back to the contractor for clarification. Payment will only be delayed for the item for which the clarification is required, and not for any other items which appear on the same prescription form. For more information on returned prescriptions and how to prevent these being returned please see our Prescription Returns page.
Once the data on the prescription forms has been confirmed, the information will be processed automatically via the ‘rules engine’. This system will automatically apply the Drug Tariff rules for the month for which the prescriptions were submitted.
The total payment due for items dispensed will be calculated from the automatically captured data and the manually captured data. Any adjustments are made and the contractor’s final payment is calculated.