PhAS update: Contesting a review decision

PhAS update: Contesting a review decision

July 28, 2017

Some community pharmacy contractors have contacted PSNC to raise concerns about NHS England’s decision on their application for a review – of their pharmacy’s eligibility for the Pharmacy Access Scheme (PhAS). In some cases, PSNC agrees that the NHS England review decision seems to be inaccurate or unclear.

In February this year, the following was added to Part XIIA of the Drug Tariff:

‘Applications for review must be made within three months of the start of the scheme (1 December 2016) and NHS England will accept review applications from 1 November 2016. Reviews will be administered and completed by NHS England; including the assessment of and decisions taken on all applications for appeals.

Some review applications are already appeals against a previous decision of the Department of Health (e.g. those for inaccuracy), but some are not (e.g. those relating to a physical feature anomaly or ‘near miss’) and might be expected to have an appeal route. From the wording of the Drug Tariff, there is an argument that all review decisions should have an appeal route.

NHS England has not provided a formal appeal mechanism. Despite this, PSNC expects NHS England to consider and respond to any contractor who raises any inaccuracy or error with a review decision and, if appropriate, for the review decision to be amended, to ensure that all those who are eligible for PhAS payments receive them. This is expected as a matter of fairness.

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